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Sample records for abnormalities clinical history

  1. Adults with genetic syndromes and cardiovascular abnormalities: Clinical history and management

    Lin, Angela E.; Basson, Craig T.; Goldmuntz, Elizabeth; Magoulas, Pilar L.; McDermott, Deborah A.; McDonald-McGinn, Donna M.; McPherson, Elspeth; Morris, Colleen A.; Noonan, Jacqueline; Nowak, Catherine; Pierpont, Mary Ella; Pyeritz, Reed E.; Rope, Alan F.; Zackai, Elaine; Pober, Barbara R.

    2009-01-01

    Cardiovascular abnormalities, especially structural congenital heart defects (CHDs), commonly occur in malformation syndromes and genetic disorders. Individuals with syndromes comprise a significant proportion of those affected with selected CHDs such as complete atrioventricular canal, interrupted arch type B, supravalvar aortic stenosis and pulmonary stenosis. As these individuals age, they contribute to the growing population of adults with special health care needs. Although most will require longterm cardiology followup, primary care providers, geneticists and other specialists should be aware of (1) the type and frequency of cardiovascular abnormalities, (2) the range of clinical outcomes, and (3) guidelines for prospective management and treatment of potential complications. This article reviews fundamental genetic, cardiac, medical and reproductive issues associated with common genetic syndromes which are frequently associated with a cardiovascular abnormality. New data are also provided about the cardiac status of adults with a 22q11.2 deletion and with Down syndrome. PMID:18580689

  2. Clinical impact of abnormal FDG uptake in pulmonary nodules detected by CT in patients with only history of non-lung cancers

    Objective: The aim is to assess the clinical impact of positive FDG uptake in single (SPN) or multiple (MPN) pulmonary nodules detected by CT in patients with known past history of non-lung cancers (but no known lung cancers). Materials and Methods: Twenty-eight sequential patients with non-lung cancers (15 breast, 8 colon, 5 prostate) referred for evaluation of SPN or MPN by PET over a period of two years were included. F-18 FDG PET images, covering chest and upper abdomen, were interpreted blindly and then correlated with CT findings for the precise location of abnormal FDG uptake in the chest. Results: There was a significant number of abnormal FDG uptake in both SPN or MPN. Positive abnormal uptake suggestive of malignancy was found in 25% of patients in the form of SPN and 39% of patients in the form of MPN (p<0.03). Positive cases in the pattern of multiple foci of pulmonary uptake were attributed to metastatic disease. Otherwise positive cases were followed by tissue diagnosis and/or surgical attention. The negative cases were followed clinically. Of the 11 positive cases of MPN, 2 patients (18%) showed only abnormal FDG uptake in just one of the nodules, which was later confirmed at surgery to be a primary cancer of lung in both patients. Conclusion: These results suggest that PET scan would be just as useful in patients with SPN and known non-lung cancers as other patients with no history of any cancers. Not all patients with non-lung cancer and MPN have pulmonary metastasis by PET criteria. PET may single out a primary lung malignancy in patients with non-lung cancer and MPN. PET has thus great clinical impact in these patients with pulmonary nodules and known non-lung cancers as the management would otherwise be completely different in situations revealed by the study

  3. Electroencephalogram abnormalities in full term infants with history of severe asphyxia

    Susanti Halim

    2016-11-01

    Full Text Available ingtool used to determine developmental and electrical problemsin the brain. A history of severe asphyxia is a risk factor for thesebrain problems in infants.Objective To evaluate the prevalence of abnormal EEGs infull term neonates and to assess for an association with severeasphyxia, hypoxic ischemic encephalopathy (HIE, and spontaneousdelivery.Methods This cross-sectional study was conducted at thePediatric Outpatient Department of Sanglah Hospital, Denpasar,from November 2013 to January 2014. Subjects were fullterminfants aged 1 month who were delivered and/or hospitalized atSanglah Hospital. All subjects underwent EEG. The EEGs wereinterpreted by a pediatric neurology consultant, twice, with aweek interval between readings. Clinical data were obtainedfrom medical records. Association between abnormal ECG andsevere asphyxia were analyzed by Chi-square and multivariablelogistic analyses.Results Of 55 subjects, 27 had a history of severe asphyxia and 28were vigorous babies. Forty percent (22/55 of subjects had abnormalEEG findings, 19/22 of these subjects having history of severeasphyxia, 15/22 had history of hypoxic-ischemic encephalopathy(HIE, and 20/22 were delievered vaginally. There were strongcorrelations between the prevalence of abnormal EEG and historyof severe asphyxia, HIE, and spontaneous delivery.Conclusion Prevalence of abnormal EEG among full-term neonatesreferred to neurology/growth development clinic is around40%, with most of them having a history of severe asphyxia. AbnormalEEG is significantly associated to severe asphyxia, HIE, andspontaneous delivery.

  4. Abnormal neuronal migration: radiologic-clinic study

    We present our experience in 18 pediatric patients with abnormal neuronal migration. Seven cases of heterotopia of the gray matter, 7 agyria-pachygyria complexes, 1 case of polymicrogyria, 2 cases of schizencephaly and 1 case of hemimegalencephaly were diagnosed by means of ultrasonography, computed tomography and magnetic resonance. The clinical picture was reviewed in each case, with special attention to the occurrence of convulsions, psycho motor development and visual changes. In general, the greater the morphological change, the greater the neurological involvement in these patients. However, the two cases of schizencephaly presented mild clinical expression. Magnetic resonance increases the diagnostic yield in neuronal migration disorders. Nevertheless, either ultrasonography or, especially, computed tomography is useful as a first diagnostic approach in these malformative disorders. (Author)

  5. Family history of alcohol dependence and gray matter abnormalities in non-alcoholic adults

    Sjoerds, Zsuzsika; Van Tol, Marie-Jose; van den Brink, Wim; Van der Wee, Nic J. A.; Van Buchem, Mark A.; Aleman, Andre; Penninx, Brenda W. J. H.; Veltman, Dick J.

    2013-01-01

    Objectives. Alcohol-use disorders in adolescents are associated with gray matter (GM) abnormalities suggesting neurotoxicity by alcohol. However, recently similar GM abnormalities were found in non-drinking children with a family history (FH) of alcohol dependence (AD). The question thus rises wheth

  6. Visual pathway abnormalities were found in most multiple sclerosis patients despite history of previous optic neuritis

    Stella Maris Costa Castro

    2013-07-01

    Full Text Available Objective It was to investigate visual field (VF abnormalities in a group of multiple sclerosis (MS patients in the remission phase and the presence of magnetic resonance imaging (MRI lesions in the optic radiations. Methods VF was assessed in 60 participants (age range 20-51 years: 35 relapsing-remitting MS patients [20 optic neuritis (+, 15 optic neuritis (-] and 25 controls. MRI (3-Tesla was obtained in all patients. Results Visual parameters were abnormal in MS patients as compared to controls. The majority of VF defects were diffuse. All patients except one had posterior visual pathways lesions. No significant difference in lesion number, length and distribution was noted between patients with and without history of optic neuritis. One patient presented homonymous hemianopsia. Conclusion Posterior visual pathway abnormalities were found in most MS patients despite history of previous optic neuritis.

  7. A Brief History of the Development of Abnormal Psychology: A Training Guide. Final Report.

    Phelps, William R.

    Presented for practitioners is a history of the development of abnormal psychology. Areas covered include the following: Early medical concepts, ideas carried over from literature, early treatment of the mentally ill, development of the psychological viewpoint, Freud's psychoanalytic theory, Jung's analytic theory, the individual psychology of…

  8. Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in dogs with fatal acute pancreatitis: 70 cases (1986-1995)

    To determine clinical, clinicopathologic, radiographic, ultrasonographic, and coagulation abnormalities in dogs in which acute pancreatitis was fatal. Retrospective study. 70 dogs. History, clinical signs, and physical examination findings at the time of initial evaluation at the veterinary teaching hospital; results of pretreatment laboratory tests, abdominal radiography, and ultrasonography; and histologic abnormalities were obtained from medical records. Clinical signs included anorexia, vomiting, Weakness, diarrhea, polyuria and polydipsia, neurologic abnormalities, melena, weight loss, hematemesis, and passage of frank blood in feces. At the time of initial examination at the veterinary teaching hospital, 68 (97%) dogs were dehydrated, 18 (26%) were icteric, 22 (32%) were febrile, 40 (58%) had signs of abdominal pain, and 30 (43%) were classified as overweight or obese. Most dogs had leukocytosis, neutrophilia with a left shift, and thrombocytopenia. Various serum biochemical abnormalities were identified, including hypoglycemia, azotemia, hypercalcemia and other electrolyte abnormalities, hypoalbuminemia, high hepatic and pancreatic enzyme activities, hypercholesterolemia, and lipemia. For 17 of 28 (61%) dogs, results of coagulation function tests were abnormal. Results of abdominal ultrasonography and radiography were consistent with a diagnosis of acute pancreatitis in 23 of 34 (68%) and 10 of 41 (24%) dogs, respectively. For 2 dogs, results of abdominal ultrasonography were not suggestive of acute pancreatitis, but results of abdominal radiography were. Clinical signs and results of clinicopathologic tests are inconsistent. Abdominal ultrasonography may be valuable in the diagnostic evaluation of dogs suspected to have acute pancreatitis

  9. Diffusion abnormality maps in demyelinating disease: Correlations with clinical scores

    Background and purpose: Magnetic resonance imaging (MRI) has been explored as a noninvasive tool to assess pathology in multiple sclerosis (MS) patients. However, the correlation between classical MRI measures and physical disability is modest in MS. The diffusion tensor imaging (DTI) MRI technique holds particular promise in this regard. The present study shows brain regions where FA and individual diffusivities abnormalities are present and check their correlations with physical disability clinical scores. Methods: Eight patients and 12 matched healthy controls were recruited. The Multiple Sclerosis Functional Composite was administered. For MR-DTI acquisitions, a Genesis Signa 1.5T MR system, an EP/SE scanning sequence, 25 gradient directions were used. Results: Tract Based Spatial Statistics (TBSS) group comparisons showed reduced FA and increased individual diffusivities in several brain regions in patients. Significant correlations were found between FA and: EDSS, 9-HPT(NON)DOM and 25FW score; between λ2 and: P100 (r and l), 9-HPT(NON)DOM and 25FW; between λ3 and: 9-HPT(NON)DOM and 25FW score. Conclusions: Fractional anisotropy and individual radial diffusivities proved to be important markers of motor disabilities in MS patients when the disease duration mean and the disability scores values range are relatively high.

  10. Patient-centered clinical impact of incidentally detected abnormalities on chest CT scans

    Sherine G. Moftah

    2014-09-01

    Conclusion: The clinically significant different incidental abnormalities on chest CT scans represented 10.4% of all incidental findings, 3.3% were due to malignancies. The clinical impact of incidental abnormalities on chest CT may be of utmost importance on patient care.

  11. 非肺源性腫瘤史患者CT發現肺部結節FDG异常攝取的臨床意義%Clinical impact of abnormal FDG uptake in pulmonary nodules detected by CT in pa tients with only history of non-lung cancers

    王晴兒; Rodolfo Nunez; Robert J. Welsh; Gary W. Chmielewski; Elizabeth A. Hill; Jack C. Hill; Korembeth P. Ravikrishnan; Darlene Fink-Bennett; Howard J. Dworkin

    2001-01-01

    目的評價陽性FDG攝取對于有非肺源性惡性腫瘤病史而CT發現單發(SPN) 或多發肺結節(MPN)的患者的臨床意義。方法非肺源性腫瘤患者28例(乳腺癌15例,結腸癌8 例,前列腺癌5例),用PET評價其SPN或MPN。應用18F-FDG對胸部及上腹部進行PET顯像,然后結合CT所見對胸部的FDG异常攝取精確定位。結果SPN及MPN均有明顯數目的FDG异常攝取。 25%SPN的患者及39%MPN的患者發現有异常的陽性攝取考慮爲惡性病變(p<0.03);肺部多個病窟攝取陽性則判爲轉移性病變。另外,陽性病例隨后進行組織診斷或/和手術追踪,陰性病例進行臨床隨訪。11例陽性的MPN患者中,2例(18%)患者的多發結節僅其中1個結節發現FDG攝取异常,后來手術證實這2例患者均爲原發性肺癌。結論結果表明PET顯像對于SPN且已知非肺源性腫瘤的患者,同對無任何腫瘤病史的其他患者一樣有用。并非所有發現MPN的非肺源性腫瘤患者應用PET標準都判定爲腫瘤肺轉移。PET可從MPN的非肺源性患者中找出肺部原發性惡性病變。研究表明,PET對發現肺部結節的已知非肺源性腫瘤患者,有很重要的臨床意義,否則,治療方法會完全不同。%Objective The aim is to assess the clinical impact of positive FD G uptake in single (SPN) or multiple(MPN) pulmonary nodules detected by CT in pa tients with known past history of non lung cancers (but no known lungcancers). Materials and Methods Twenty-eight sequential patients with non-lung cancers (15 breast, 8 colon, 5prostate) referred for evaluation of SPN or MPN by PET over a period of two years were included. F-18 FDG PETimages, covering chest and upper abdomen, were interpreted blindly and then correlated with CT findings for the preciselocation of abnormal FDG uptake in the chest. Results There was a signifi cant number of abnormal FDG uptake in bothSPN or MPN. Positive abnormal uptake s uggestive of malignancy was found in 25% of

  12. Risk assessment models in genetics clinic for array comparative genomic hybridization: Clinical information can be used to predict the likelihood of an abnormal result in patients

    Marano, Rachel M.; Mercurio, Laura; Kanter, Rebecca; Doyle, Richard; Abuelo, Dianne; Morrow, Eric M.; Shur, Natasha

    2013-01-01

    Array comparative genomic hybridization (aCGH) testing can diagnose chromosomal microdeletions and duplications too small to be detected by conventional cytogenetic techniques. We need to consider which patients are more likely to receive a diagnosis from aCGH testing versus patients that have lower likelihood and may benefit from broader genome wide scanning. We retrospectively reviewed charts of a population of 200 patients, 117 boys and 83 girls, who underwent aCGH testing in Genetics Clinic at Rhode Island hospital between 1 January/2008 and 31 December 2010. Data collected included sex, age at initial clinical presentation, aCGH result, history of seizures, autism, dysmorphic features, global developmental delay/intellectual disability, hypotonia and failure to thrive. aCGH analysis revealed abnormal results in 34 (17%) and variants of unknown significance in 24 (12%). Patients with three or more clinical diagnoses had a 25.0% incidence of abnormal aCGH findings, while patients with two or fewer clinical diagnoses had a 12.5% incidence of abnormal aCGH findings. Currently, we provide families with a range of 10–30% of a diagnosis with aCGH testing. With increased clinical complexity, patients have an increased probability of having an abnormal aCGH result. With this, we can provide individualized risk estimates for each patient.

  13. The clinical significance of normal mammograms and normal sonograms in patients with palpable abnormalities of the breast

    We wanted to evaluate the clinical significance of normal mammograms and normal sonograms in patients with palpable abnormalities of the breast. From Apr 2003 to Feb 2005, 107 patients with 113 palpable abnormalities who had combined normal sonographic and normal mammographic findings were retrospectively studied. The evaluated parameters included age of the patients, the clinical referrals, the distribution of the locations of the palpable abnormalities, whether there was a past surgical history, the mammographic densities and the sonographic echo patterns (purely hyperechoic fibrous tissue, mixed fibroglandular breast tissue, predominantly isoechoic glandular tissue and isoechoic subcutaneous fat tissue) at the sites of clinical concern, whether there was a change in imaging and/or the physical examination results at follow-up, and whether there were biopsy results. This study period was chosen to allow a follow-up period of at least 12 months. The patients' ages ranged from 22 to 66 years (mean age: 48.8 years) and 62 (58%) of the 107 patients were between 41 and 50 years old (58%). The most common location of the palpable abnormalities was the upper outer portion of the breast (45%) and most of the mammographic densities were dense patterns (BI-RADS Type 3 or 4: 91%). Our cases showed similar distribution for all the types of sonographic echo patterns. 23 patients underwent biopsy; all the biopsy specimens were benign. For the 84 patients with 90 palpable abnormalities who were followed, there was no interval development of breast cancer in the areas of clinical concern. Our results suggest that we can follow up and prevent unnecessary biopsies in women with palpable abnormalities when both the mammography and ultrasonography show normal tissue, but this study was limited by its small sample size. Therefore, a larger study will be needed to better define the negative predictive value of combined normal sonographic and mammographic findings

  14. A prospective clinical study of feto-maternal outcome in pregnancies with abnormal liquor volume

    Rutwa J. Chavda; Hardev B. Saini

    2014-01-01

    Background: Evaluating feto-maternal outcome in pregnancies with abnormal liquor volume. Methods: 200 pregnant subjects between 20 and 42 weeks of gestation, who were clinically suspected to have an abnormal amniotic fluid volume (oligohydramnios or polyhydramnios) were subjected to ultrasonographic (USG) assessment of amniotic fluid index. The subjects were closely monitored during pregnancy, labour and puerperium. Results: Ultrasonically, abnormal liquor volume was confirmed in 90-93...

  15. A prospective clinical study of feto-maternal outcome in pregnancies with abnormal liquor volume

    Rutwa J. Chavda

    2014-02-01

    Conclusions: A good clinical examination can pick up most subjects of abnormal liquor volume. Abnormal liquor volumes are associated with increased maternal morbidity and adverse perinatal outcome. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 181-184

  16. Frequency and clinical significance of erythrocyte genetic abnormalities in Omanis.

    White, J. M.; Christie, B S; Nam, D; S. Daar; Higgs, D R

    1993-01-01

    The frequencies of four malaria associated erythrocyte genetic abnormalities have been established in 1000 Omani subjects. They are: homozygous alpha+ thalassaemia (-alpha/-alpha) 0.45; high Hb A2 beta thalassaemia trait 0.015; sickle trait (Hb A/S) 0.061; and glucose 6 phosphate dehydrogenase deficiency (Gd-): males 0.27, females 0.11. From our data the alpha+ (-alpha/) thal gene (confirmed by Southern blotting) is pandemic in this population. Moreover, in spite of the very high frequency of...

  17. CT abnormality in multiple sclerosis analysis based on 28 probable cases and correlation with clinical manifestations

    In order to investigate the occurrence and nature of CT abnormality and its correlation with clinical manifestations in multiple sclerosis, 34 CT records obtained from 28 consecutive patients with probable multiple sclerosis were reviewed. Forty-six percent of all cases showed abnormal CT. Dilatation of cortical sulci was found in 39%; dilatation of the lateral ventricle in 36%; dilatation of prepontine or cerebello-pontine cistern and the fourth ventricle, suggesting brainstem atrophy, in 18%; dilatation of cerebellar sulci, superior cerebellar cistern and cisterna magna, suggesting cerebellar atrophy, in 11%. Low density area was found in the cerebral hemisphere in 11% of cases. Contrast enhancement, performed on 25 CT records, did not show any change. There was no correlation between CT abnormality and duration of the illness. Although abnormal CT tended to occur more frequently during exacerbations and chronic stable state than during remissions, the difference was not statistically significant. CT abnormalities suggesting brainstem atrophy, cerebellar atrophy or plaques were found exclusively during exacerbations and chronic stable state. The occurrence of CT abnormalities was not significantly different among various clinical forms which were classified based on clinically estimated sites of lesion, except that abnormal CT tended to occur less frequently in cases classified as the optic-spinal form. It is noteworthy that cerebral cortical atrophy and/or dilatation of the lateral ventricle were found in 31% of cases who did not show any clinical sign of cerebral involvement. There was a statistically significant correlation between CT abnormalities and levels of clinical disability. Eighty percent of the bedridden or severely disabled patients showed abnormal CT, in contrast with only 29% of those with moderate, slight or no disability. (author)

  18. Cugini's syndrome: its clinical history and diagnosis

    Laura Gasbarrone

    2013-09-01

    Full Text Available INTRODUCTION: This article deals with the description and diagnosis of a new nosographic syndrome, which received the eponym of "Cugini's syndrome" by the name of the Author who discovered its clinical picture. This syndrome is characterized by the binomial: "minimal target organ damage associated to monitoring prehypertension". CLINICAL HISTORY AND DIAGNOSIS: Between the years 1997 and 2002, the Author published a series of investigations regarding some office normotensives who inexplicably showed incipient signs of target organ damage (TOD. Investigated via ambulatory (A blood (B pressure (P monitoring (M, these subjects were surprisingly found not to be hypertensive. Neverthless, the office normotensives with TOD exibited the daily mean level of their systolic (S and diastolic (D BP (DML SBP/DBP significantly more elevated as compared to true normotensives. Because of these ABPM findings, the Author realized that the investigated subjects were false normotensives whose TOD was associated with a monitoring prehypertension (ABPM-diagnosable prehypertension alias monitoring prehypertension alias masked prehypertension. The year after the last Cugini's investigation, the INC-7 Reports introduced the term: "prehypertension" in its classification of arterial hypertension, as an office sphygmomanometric condition in between office normotension and office hypertension. The ABPM cut-off upper limits for a differential diagnosis between monitoring normotension, prehypertension and hypertension are reported, as calculated by the Author in its collection of ABPMs. The eponym of "Cugini's syndrome" was assigned in 2007 and confirmed in 2009. CONCLUSIVE REMARKS: The monitoring prehypertension is a further condition of discrepancy between office sphygmomanometry and ABPM, as per a masked prehypertension, whose diagnosis has to be immediately diagnosed, for preventing the onset of a TOD. There are reported the present investigations dealing with the possible

  19. Optimising the diagnostic imaging process through clinical history documentation

    In the United Kingdom the 1990s were characterised by radiographer role extension including radiographic reporting and the performance of a variety of contrast examinations. In Australia where a privatised health system constrains the role of radiographers, other ways need to be found to improve professional practice and enhance patient care. One such way is for radiographers to develop knowledge and skills in clinical history taking. The paper advocates the development of a formalised approach to clinical history taking that portrays the radiographer as a professional and advocate of patient rights and welfare. The paper examines history taking approaches used by other health care professionals and proposes a clinical history template using five key areas of interview: area and type of symptoms, current history, past history, special considerations and psychosocial/occupational history. Copyright (2003) Australian Institute of Radiography

  20. Effect of metabolic abnormalities on cognitive performance and clinical symptoms in schizophrenia

    Wysokiński, Adam; Dzienniak, Małgorzata; Kłoszewska, Iwona

    2013-01-01

    Aim. The objective of this study is to determine whether and how metabolic abnormalities are associated with clinical symptoms and cognitive performance in schizophrenia. Methods. 46 adult patients with schizophrenia taking first- or second generation antipsychotics were included in the study. The following data were collected: BMI, abdominal circumference, lipid panel and blood glucose, blood pressure and treatment of comorbidities. Clinical symptoms were assessed using PANSS, CDSS, CGI a...

  1. Rhegmatogenous retinal detachment in Kniest Syndrome : Clinical model of abnormal vitreoretinal traction in children .

    Jorge Orellana Rios

    2012-05-01

    Full Text Available Introducing the management of non traumatic rhegmatogenous retinal detachment in pediatric patient in the context of a genetic syndrome associated with failure of type 2 collagen synthesis which manifests itself in ocular , hearing , facial , bone and joint abnormalities. We describe the clinical presentation of the picture and surgical repaire technique consisted of lensectomy , vitrectomy , peeling of vitreoretinal proliferation membranes , giant retinal tear management and prolonged tamponade by silicone oil. Long term clinical follow-up was carried out. We highlight this case report to be a therapeutic challenge in a deaf and high myopic child , with motor disabilities and atypical vitreoretinal disorders have generated difficulties in surgical resolution , there is also little scientific reference in world literature and represent a clinical model of abnormal vitreoretinal interaction 

  2. Clinical impact of ' in-treatment' wall motion abnormalities in hypertensive patients with left ventricular hypertrophy: the LIFE study

    Cicala, S.; Simone, G. de; Wachtell, K.; Gerdts, E.; Boman, K.; Nieminen, M.S.; Dahlof, B.; Devereux, R.B.

    2008-01-01

    ( MI), or stroke history. Echocardiographic segmental wall motion abnormalities at baseline and annual re-evaluations (' as time- varying covariate') were examined in relation to endpoints ( cardiovascular mortality, MI, stroke, and hospitalized heart failure). Adjusted Cox regression was used to...

  3. Palpable pediatric thyroid abnormalities – diagnostic pitfalls necessitate a high index of clinical suspicion: a case report

    Klopper Joshua P

    2007-06-01

    Full Text Available Abstract A 12-year-old girl presented with a 4 year history of an enlarged, firm thyroid gland. On exam, her thyroid was firm and fixed and an enlarged cervical lymph node was palpable as well. Though a thyroid ultrasound prior to referral was read as thyroiditis, clinical suspicion for thyroid carcinoma mandated continued investigation. The diagnosis of papillary thyroid cancer was established and her workup revealed lymph node metastases as well as a tremendous burden of pulmonary metastases. Pediatric thyroid cancer is extremely rare, but often presents with aggressive disease. Palpable thyroid abnormalities in an individual under 20-years-old should be viewed with suspicion and should be thoroughly investigated to rule out malignancy even in the face of negative diagnostic procedures. Though pediatric papillary thyroid cancer often presents with loco-regional and even distant metastatic disease, mortality rates in follow-up for as long as 20 years are very favorable.

  4. Effect of metabolic abnormalities on cognitive performance and clinical symptoms in schizophrenia

    Wysokiński, Adam

    2013-12-01

    Full Text Available Aim. The objective of this study is to determine whether and how metabolic abnormalities are associated with clinical symptoms and cognitive performance in schizophrenia. Methods. 46 adult patients with schizophrenia taking first- or second generation antipsychotics were included in the study. The following data were collected: BMI, abdominal circumference, lipid panel and blood glucose, blood pressure and treatment of comorbidities. Clinical symptoms were assessed using PANSS, CDSS, CGI and SAS scales. Cognitive performance was assessed using CNS Vital Signs computerized battery of tests: Verbal Memory test, Visual Memory test, Finger Tapping Test, Symbol Digit Coding, Stroop Test, Shifting Attention Test, and Continuous Performance Test. Results. Dyslipidemia, raised LDL and raised blood glucose levels were the best predictors of more severe clinical symptoms (PANSS, PANSS P, PANSS G, CGI and lower neurocognitive index, worse cognitive flexibility, executive functions, complex attention composite memory, verbal memory, slower reaction time and worse performance in SAT, CPT, ST tests. Obesity was associated with worse results in VBM, VIM, FTT, SDC tests. Raised blood pressure was associated with improvements in all cognitive domains and better performance in SAT, CPT, ST tests. Discussion. There are several weak associations between severity of clinical symptoms and metabolic abnormalities. Most of these were for blood glucose levels and raised blood glucose. Lipids and glucose abnormalities are the best predictors of deteriorated cognitive performance. Contrary to previous observations, raised blood pressure was associated with better results in cognitive tests. Conclusions. These findings indicate that cognitive impairment and metabolic abnormalities may be linked in patients with schizophrenia

  5. Rhegmatogenous retinal detachment in Kniest Syndrome : Clinical model of abnormal vitreoretinal traction in children .

    Jorge Orellana Rios; Karim E. Sanchez; Hérnan I. Valenzuela; José M.R. Undurraga

    2012-01-01

    Introducing the management of non traumatic rhegmatogenous retinal detachment in pediatric patient in the context of a genetic syndrome associated with failure of type 2 collagen synthesis which manifests itself in ocular , hearing , facial , bone and joint abnormalities. We describe the clinical presentation of the picture and surgical repaire technique consisted of lensectomy , vitrectomy , peeling of vitreoretinal proliferation membranes , giant retinal tear management and prolonged tampon...

  6. The Accuracy of the VISA-P Questionnaire, Single-Leg Decline Squat, and Tendon Pain History to Identify Patellar Tendon Abnormalities in Adult Athletes.

    Mendonça, Luciana de Michelis; Ocarino, Juliana Melo; Bittencourt, Natália Franco Netto; Fernandes, Ludmila Maria Oliveira; Verhagen, Evert; Fonseca, Sérgio Teixeira

    2016-08-01

    Study Design Cross-sectional clinical assessment. Background Patellar tendinopathy is not always accompanied by patellar tendon abnormalities (PTAs). Thus, clinical screening tools to help identify patients with patellar tendon pain who have PTAs could enhance clinical decision making and patient prognosis. Objectives To test the diagnostic accuracy of the Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire, a single-leg decline squat (SLDS), tendon pain history, age, and years of sports participation to identify athletes with symptomatic patellar tendons who have PTAs confirmed on imaging. Methods Data provided by ultrasound examination, the VISA-P questionnaire, the SLDS, tendon pain history, age, and years of sport participation were collected in 43 athletes. A classification and regression tree (CART) model was developed to verify variables associated with PTA occurrence. Likelihood ratios (LRs) were computed for positive and negative tests. Results The SLDS, VISA-P questionnaire, and tendon pain history were associated with PTA occurrence. Athletes with negative results on all 3 tests (CART model) had a lower likelihood of having PTAs (negative LR = 0.3; 95% confidence interval [CI]: 0.2, 0.5). The isolated use of the SLDS or tendon pain history (positive LR = 4.2; 95% CI: 2.3, 7.14 and 4.5; 95% CI: 1.8, 11.1, respectively) had similar influence on probability of PTA presence compared to the CART model (positive LR = 4.1; 95% CI: 2.5, 6.3). Conclusion Although the objective was to investigate a clinical test to identify PTAs, the combined use of the tests had greater accuracy to identify individuals without PTAs. Level of Evidence Diagnosis, level 3b. J Orthop Sports Phys Ther 2016;46(8):673-680. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6192. PMID:27374017

  7. Clinical Symptoms of Minor Head Trauma and Abnormal Computed Tomography Scan

    Maghsoudi

    2015-11-01

    Full Text Available Background Minor head trauma accounts for 70% to 90% of all head traumas. Previous studies stated that minor head traumas were associated with 7% - 20% significant abnormal findings in brain computed tomography (CT-scans. Objectives The aim of this study was to reevaluate clinical criteria of taking brain CT scan in patients who suffered from minor head trauma. Patients and Methods We enrolled 680 patients presented to an academic trauma hospital with minor head trauma in a prospective manner. All participants underwent brain CT scan if they met the inclusion criteria and the results of scans were compared with clinical examination finding. Results Loss of consciousness (GCS drop or amnesia was markedly associated with abnormal brain CT scan (P < 0.05. Interestingly, we found 7 patients with normal clinical examination but significant abnormal brain CT scan. Conclusions According to the results of our study, we recommend that all patients with minor head trauma underwent brain CT scan in order not to miss any life-threatening head injuries.

  8. Association of coexisting morphological umbilical cord abnormality and clinical cord compromise with hypoxic and thrombotic placental histology.

    Stanek, Jerzy

    2016-06-01

    To assess the usefulness and limitations of placental histology when morphological umbilical cord (UC) abnormality coexists with clinical UC compromise, 5634 consecutive placentas were divided into four groups and statistically compared: group 1-182 placentas from pregnancies with clinical features of UC compromise (variable decelerations, UC entanglement, prolapse, or true knot at delivery); group 2-1355 placentas with abnormal UC morphology or insertion; group 3-152 placentas with at least one phenotype from group 1 and one from group 2; group 4-3945 placentas with no clinical or morphological UC-related phenotypes (control group).Differences were analyzed by ANOVA or χ (2). Of 68 phenotypes studied, 13 clinical and 18 placental phenotypes were statistically significant. In group 1, 2 phenotypes were most common (oligohydramnios and abnormal fetal heart rate tracing). In group 2, 6 phenotypes were most common, including 4 clinical (abnormal umbilical artery Dopplers, nonmacerated stillbirth, multiple pregnancy, and fetal growth restriction) and 2 placental. In group 3, 23 phenotypes were most common, including 7 clinical (gestational hypertension, polyhydramnios, induction of labor, cesarean section, macerated stillbirth, congenital malformations, and abnormal 3rd stage of labor) and 16 placental. The existence of clinical signs of UC compromise alone was associated with the absence of pathomorphological placental abnormalities. However, the coexistence of clinical and abnormal morphological UC phenotypes was statistically significantly associated with placental histological signs of decreased fetal blood flow, hypoxia (acute and chronic post uterine), shallow placental implantation, and/or amnion nodosum. Thus, confirmation of clinical UC compromise should not be expected on placental examination if no morphological UC abnormality or abnormal UC insertion has been found. PMID:26983702

  9. Analysis of imaging findings and clinical abnormalities in patients with lymphoma

    Computed tomography is currently the method of choice for the diagnostic and staging of lymphomas. Computed tomography enables accurate measurements of both tumor extent and volume and provides information that can be used to plan an appropriate strategy for the treatment. The purpose of the present article is to describe and analyze the chest and abdomen computed tomography and ultrasound findings in HIV-negative patients with lymphoma. Clinical abnormalities, such as the reason the patient sought medical assistance already showing evidence of lymphocytic disease (not yet diagnosed at this point) and the physical examination abnormalities seen on the first consultation were also studied. This study comprised 30 patients: 40% with non-Hodgkin lymphoma, 46,6% with Hodgkin lymphoma, 10% with Burkitt's lymphoma and 3,3% with lymphoblastic lymphoma. (author)

  10. Abnormal Unsaturated Fatty Acid Metabolism in Cystic Fibrosis: Biochemical Mechanisms and Clinical Implications

    Adam C. Seegmiller

    2014-09-01

    Full Text Available Cystic fibrosis is an inherited multi-organ disorder caused by mutations in the CFTR gene. Patients with this disease exhibit characteristic abnormalities in the levels of unsaturated fatty acids in blood and tissue. Recent studies have uncovered an underlying biochemical mechanism for some of these changes, namely increased expression and activity of fatty acid desaturases. Among other effects, this drives metabolism of linoeate to arachidonate. Increased desaturase expression appears to be linked to cystic fibrosis mutations via stimulation of the AMP-activated protein kinase in the absence of functional CFTR protein. There is evidence that these abnormalities may contribute to disease pathophysiology by increasing production of eicosanoids, such as prostaglandins and leukotrienes, of which arachidonate is a key substrate. Understanding these underlying mechanisms provides key insights that could potentially impact the diagnosis, clinical monitoring, nutrition, and therapy of patients suffering from this deadly disease.

  11. Spinal Cord Injury without Radiographic Abnormality (SCIWORA) – Clinical and Radiological Aspects

    The acronym SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) was first developed and introduced by Pang and Wilberger who used it to define “clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability”. SCIWORA is a clinical-radiological condition that mostly affects children. SCIWORA lesions are found mainly in the cervical spine but can also be seen, although much less frequently, in the thoracic or lumbar spine. Based on reports from different authors, SCIWORA is responsible for 6 to 19% and 9% to 14% of spinal injuries in children and adults, respectively. Underlying degenerative changes, including spondylosis or spinal canal stenosis, are typically present in adult patients. The level of spinal cord injury corresponds to the location of these changes. With recent advances in neuroimaging techniques, especially in magnetic resonance imaging, and with increasing availability of MRI as a diagnostic tool, the overall detection rate of SCIWORA has significantly improved

  12. Abnormal neuronal migration: radiologic-clinic study. Alteraciones en la migracion neural: estudio clinico-radiologico

    Martinez Fernandez, M.; Menor Serrano, F.; Bordon Ferre, F.; Garcia Tena, J.; Esteban Hernandez, E.; Sanguesa Nebot, C.; Marti Bonnati, L. (Hospital Infantil La Fe, Valencia (Spain))

    1994-01-01

    We present our experience in 18 pediatric patients with abnormal neuronal migration. Seven cases of heterotopia of the gray matter, 7 agyria-pachygyria complexes, 1 case of polymicrogyria, 2 cases of schizencephaly and 1 case of hemimegalencephaly were diagnosed by means of ultrasonography, computed tomography and magnetic resonance. The clinical picture was reviewed in each case, with special attention to the occurrence of convulsions, psycho motor development and visual changes. In general, the greater the morphological change, the greater the neurological involvement in these patients. However, the two cases of schizencephaly presented mild clinical expression. Magnetic resonance increases the diagnostic yield in neuronal migration disorders. Nevertheless, either ultrasonography or, especially, computed tomography is useful as a first diagnostic approach in these malformative disorders. (Author)

  13. Making the history of psychology clinically and philosophically relevant.

    Vande Kemp, Hendrika

    2002-08-01

    The author discusses ways to make the history of psychology course relevant for a clinical psychology doctoral program within a multidenominational Protestant theological seminary. She uses a personalist orientation to emphasize the need to integrate psychology, philosophy, and theology. She differentiates among the intrapersonal, interpersonal, impersonal, and transpersonal dimensions of experience. She illustrates the rich multidisciplinary historical roots of contemporary psychology by tracing the the history of the term psychology and examining its meanings in the existential psychology of Søren Kierkegaard and in the 19th-century novel. She includes brief histories of the "new psychology" and of the unconscious. She describes how she uses the field of psychotheological integration to illustrate principles of historiography and summarizes resources used to supplement traditional textbooks. PMID:12269333

  14. Clinical history and physical examination skills - A requirement for radiographers?

    Radiographer's roles have evolved with their scope broadening over the last 20 years culminating in the development of advanced and consultant posts. Yet one development has not been embraced, despite being inherent in medicine and a common extension of nurse and other allied health professionals' roles, is that of clinical assessment. This article explores the evolving role of the radiographer and discusses whether this should include skills in clinical history taking and physical examination. Issues for education and development will be addressed together with examples of current and potential roles

  15. Clinical history and physical examination skills - A requirement for radiographers?

    Snaith, Beverly A. [Radiology Department, Mid Yorkshire Hospitals NHS Trust, Pinderfields General Hospital, Aberford Road, Wakefield WF1 4DG (United Kingdom)], E-mail: bev.snaith@midyorks.nhs.uk; Lancaster, Anne [Radiology Department, Mid Yorkshire Hospitals NHS Trust, Dewsbury District Hospital, Halifax Road, Dewsbury WF13 4HS (United Kingdom)

    2008-05-15

    Radiographer's roles have evolved with their scope broadening over the last 20 years culminating in the development of advanced and consultant posts. Yet one development has not been embraced, despite being inherent in medicine and a common extension of nurse and other allied health professionals' roles, is that of clinical assessment. This article explores the evolving role of the radiographer and discusses whether this should include skills in clinical history taking and physical examination. Issues for education and development will be addressed together with examples of current and potential roles.

  16. Clinical research into anesthetic neurotoxicity: does anesthesia cause neurological abnormalities in humans?

    Lei, Susan Y; Hache, Manon; Loepke, Andreas W

    2014-10-01

    General anesthetics mitigate distress and exaggerated hemodynamic responses to pain and stressful stimulation, allowing surgery and diagnostic procedures to be performed worldwide in millions of children every year. Emerging studies, mainly carried out in early postnatal laboratory animals, demonstrate widespread neuronal elimination, alteration in neuronal circuitry, and long-term neurological disabilities following exposure to all commonly used sedatives and anesthetics. These findings have raised concerns among parents, anesthesiologists, neuroscientists, and government regulators about the safety of anesthetic drugs in children, especially infants. Accumulating evidence from epidemiological studies suggests an association between surgery with anesthesia in early childhood and subsequent behavioral and cognitive abnormalities. During the Fourth Pediatric Anesthesia NeuroDevelopmental Assessment (PANDA) symposium, a meeting attended by many stakeholders, the most recent findings in the field were presented and discussed. This review summarizes the current state of clinical research into the effects of anesthetic exposure in human brain development, addresses some of the difficulties in examining the phenomenon, and introduces the most recent clinical findings presented at the PANDA symposium. The unanimous consensus among participants was that additional preclinical and clinical research efforts are urgently required to address this important concern for child health. PMID:25144503

  17. Clinical features, MRI brain, and MRS abnormalities of drug-naïve neurologic Wilson′s disease

    Satyabrata Pulai

    2014-01-01

    Full Text Available Background: Magnetic resonance imaging (MRI helps in the diagnosis of neurologic Wilson′s disease (WD. The literature regarding MR spectroscopy (MRS and diffusion-weighted imaging (DWI in WD is limited. Objectives: To evaluate the clinical features and neuroimaging findings in drug-naοve neurologic WD and to find correlation between clinical stage and disease duration with different imaging findings. Materials and Methods: The study subjects included consecutive and follow-up neurologic WD patients attending movement disorder clinic. The initial clinical and MRI features before commencement of chelation therapy were noted. Of 78 patients, 34 underwent DWI study and MRS was done in 38 patients and in 32 control subjects. Results: Dystonia, dysarthria, tremor, and behavioral abnormality were common presenting features. All patients had MRI abnormality with major affection of basal ganglia. The clinical severity and anatomical extent of MRI abnormalities were positively correlated (P < 0.001; r s = 0.709. Presence of diffusion restriction was inversely related to duration of disease (P < 0.001; r s = 0.760. WD patients had reduced N-acetylaspartate/creatine (Cr and choline (Cho/Cr ratio (P < 0.001 as compared with control subjects in MRS study. Conclusion: Dystonia, dysarthria and tremor are common neurological features of WD. In this study, MRI abnormalities were positively correlated with disease severity; diffusion restriction was inversely correlated with the duration of the disease process. MRS was also a sensitive tool for diagnosing patient of neurologic WD.

  18. Anormalidades cromossômicas em casais com história de aborto recorrente Chromosomal abnormalities in couples with history of recurrent abortion

    Andrea Kiss

    2009-02-01

    Full Text Available OBJETIVO: verificar a prevalência e as características clínicas de casais com história de abortos de repetição e anormalidade cromossômica atendidos em nosso serviço. MÉTODOS: foram avaliados retrospectivamente todos os casais encaminhados de janeiro de 1975 a junho de 2008 por história de abortos de repetição. Foram incluídos no estudo somente aqueles casais, em que a análise cromossômica feita com o cariótipo por bandas GTG foi realizada com sucesso. Foram coletados dados clínicos referentes às suas idades, bem como o número de abortamentos, natimortos, crianças polimalformadas, nativivos por casal e resultado do exame de cariótipo. Para comparação da frequência das alterações cromossômicas encontradas em nosso estudo com as da literatura, bem como entre os diferentes subgrupos de nossa amostra, foi utilizado o teste exato de Fisher (pPURPOSE: to asses the prevalence and clinical characteristics of couples with history of recurrent spontaneous abortion and chromosome abnormality, attended at the present service. METHODS: all the couples referred to our service due to history of recurrent spontaneous abortion, from January 1975 to June 2008, were evaluated. Only the ones whose chromosome karyotype analysis by GTG bands has been successfully made were included in the study. Clinical data on their age, as well as on the number of abortions, stillbirth, multiple malformations, livebirth per couple, and the result of the karyotype exam were collected. Fisher's exact test (p<0.05 has been used to compare the incidence of chromosome alterations found in our study, with data in the literature. RESULTS: there were 108 couples in the sample. Their ages varied from 21 to 58 years old among the men (average of 31.4 years old, and from 19 to 43 among the women (average of 29.9 years old. In ten couples, one of the mates (9.3% presented chromosome alterations, which corresponded respectively to three cases (30% of reciprocal

  19. Natural history of chronic myelomonocytic leukemia: gene sequencing identifies multiple clonal molecular abnormalities associated with rapid progression to acute myeloid leukemia

    Xiang, Zhifu; Kaur, Varinder; Aburiziq, Ibrahim K; Mehta, Paulette; Emanuel, Peter; Schichman, Steven A.

    2014-01-01

    Key Clinical Message Gene panel sequencing in a CMML patient without any detectable genetic abnormality by conventional genetic studies identified four concurrent somatic mutations in three genes. Gene panel mutation analysis is a rapidly emerging clinical tool to demonstrate the clonality in hematologic malignancies, and to identify the potential targets for therapy.

  20. Inhaled corticosteroids for abnormal pulmonary function in children with a history of Chronic Lung Disease of Infancy: study protocol [ISRCTN55153521

    Sauve Reginald

    2005-04-01

    Full Text Available Abstract Background There is considerable evidence from the literature that children with chronic lung disease of infancy (CLD have abnormal pulmonary function in childhood and this could have an impact on their life quality and overall health. There are similarities between CLD and asthma, and corticosteroids are the mainstay treatment for asthma. Many physicians use inhaled corticosteroids in children with CLD with no evidence. Therefore we wish to conduct a randomized double-blinded placebo controlled trial to test for the role of inhaled corticosteroids in children aged from3 to 9 years with a history of CLD. Our primary hypothesis will be that inhaled corticosteroids are beneficial in children with CLD. Methods Our primary hypothesis is that using inhaled steroids; Beclomethasone Dipropionate (QVAR 100 mcg 2 puffs 2 times a day for 6 weeks will improve the respiratory system resistance and the quality of life in children with CLD. Discussion We propose that Beclomethasone Dipropionate (QVAR will affect the pulmonary function after 6 weeks of treatment. In summary we think that our study will highlight knowledge on whether the use of inhaled steroids is clinically effective for CLD.

  1. Clinical significance of brain SPECT abnormalities of thalami and cerebellum in cerebral palsy with normal MRI

    Park, C. H.; Lim, S. Y.; Lee, I. Y.; Kim, O. H.; Bai, M. S.; Kim, S. J.; Yoon, S. N.; Cho, C. W. [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    1997-07-01

    The cerebral palsy(CP) encephalopathies are often of uncertain etiology and various functional image findings comparing with anatomical image findings have been reported. However, only a few have mentioned its clinical implications. The purpose of our report is to compare clinical severity and functional SPECT abnormalities of thalami and cerebellum in CP patients with normal MRI. Thirty six CP patients with bilateral spastic palsy who had normal MRI and brain SPECT were studied from July 1996 to September 1997. The patients' age at the time of SPECT was 22.84{+-}17.69 months. The patients were divided into two groups according to motor quotient(MQ); moderate defect (>50MQ : n=27 MQ=22.78{+-}10.36), mild defect (<50MQ : n=9, MQ=66.11{+-}13.87). The degree of rCBF decrease between the two groups was evaluated by {chi}{sup 2} test. Brain SPECT was performed following IV administration of 0.05-0.1 mCi/kg (minimum 2.0 mCi) of Tc-99m ECD and chloral hydrate sedation (50-80 mg/kg p.o) using a triple head system (MS 3, Siemens). Interpretation of brain SPECT was visual analysis: severe decrease is defined when the defect is moderate to marked and mild decrease in rCBF as mild. Seven of 36 (19.4%) showed unilateral or bilateral moderate decrease in rCBF in thalami, 20(55.6%) showed mild decrease, and 9(25.0%) showed no decreased rCBF. All 7 who had moderate thalamic defect reveled moderate motor defect clinically. Ten of 36(27.9%) revealed unilateral or bilateral moderate rCBF defect, 23 (63.9%) depicted mild defect, and 3(8.3%) showed no defect. Sixteen with moderate thalamic rCBF defect showed moderate motor defect in 15 patients. There was statistically significant (p=0.02605) relationship between rCBF defect and motor defect in our CP patients. In conclusion, brain SPECT appears sensitive, non-invasive tool in the evaluation as well as in the prognostication of bilateral spastic cerebral palsy patients and deserves further study using larger number of patients.

  2. Clinical significance of brain SPECT abnormalities of thalami and cerebellum in cerebral palsy with normal MRI

    The cerebral palsy(CP) encephalopathies are often of uncertain etiology and various functional image findings comparing with anatomical image findings have been reported. However, only a few have mentioned its clinical implications. The purpose of our report is to compare clinical severity and functional SPECT abnormalities of thalami and cerebellum in CP patients with normal MRI. Thirty six CP patients with bilateral spastic palsy who had normal MRI and brain SPECT were studied from July 1996 to September 1997. The patients' age at the time of SPECT was 22.84±17.69 months. The patients were divided into two groups according to motor quotient(MQ); moderate defect (>50MQ : n=27 MQ=22.78±10.36), mild defect (2 test. Brain SPECT was performed following IV administration of 0.05-0.1 mCi/kg (minimum 2.0 mCi) of Tc-99m ECD and chloral hydrate sedation (50-80 mg/kg p.o) using a triple head system (MS 3, Siemens). Interpretation of brain SPECT was visual analysis: severe decrease is defined when the defect is moderate to marked and mild decrease in rCBF as mild. Seven of 36 (19.4%) showed unilateral or bilateral moderate decrease in rCBF in thalami, 20(55.6%) showed mild decrease, and 9(25.0%) showed no decreased rCBF. All 7 who had moderate thalamic defect reveled moderate motor defect clinically. Ten of 36(27.9%) revealed unilateral or bilateral moderate rCBF defect, 23 (63.9%) depicted mild defect, and 3(8.3%) showed no defect. Sixteen with moderate thalamic rCBF defect showed moderate motor defect in 15 patients. There was statistically significant (p=0.02605) relationship between rCBF defect and motor defect in our CP patients. In conclusion, brain SPECT appears sensitive, non-invasive tool in the evaluation as well as in the prognostication of bilateral spastic cerebral palsy patients and deserves further study using larger number of patients

  3. Clinical manifestation and humoral immuno-function of myasthenia gravis patients with abnormal and normal thymus gland

    Fuhua Peng; Yongqiang Dai; Wei Qiu; Xueqiang Hu

    2006-01-01

    BACKGROUND: Myasthenia gravis (MG) is an autoimmune disease which mainly affects neuromuscular junctions. The ages, modified Osserman classification and clinical manifestation and humoral immunol function of MG with and without thymic abnormality are different.OBJECTIVE: To explore the clinical manifestation and humoral immuno-function of MG with abnormal and normal thymus gland.DESIGN: Contrast observation.SETTING: Department of Neurology, the Third Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: A total of 49 inpatients with MG were selected from the Third Affiliated Hospital of Sun Yat-sen University from March 2000 to August 2005. All the patients had typical clinical manifestation of MG and positive neostigmine test. All the patients knew and agreed the laboratory examinations. There were 22 males and 27 females of 2-69 years old. Chest MRI or CT scan were performed to reveal thymus gland abnormality. According to whether there was tumor in superior mediastinum, all patients were divided into 2 groups, abnormal and normal groups. Normal thymus gland group (n=30) contained 16 males and 14 famales of 6-43 years old. Abnormal thymus gland group (n=19) contained 6 male and 13 female of 2-69years old.METHODS: ① All patients were questioned about initial symptoms. Meanwhile, main clinical manifestations were recorded at hospital admission. ② 7180A automatic biochemical analyzer and automatic microplate reader were used in detecting seroimmunity index. The levels of C3, C4, IgG, IgA, IgM and CH50 in blood serum were analyzed by nephelometry. ③ Clinical classification is based on modified Osserman classification. The patients with MG were divided into six types: Ⅰ (Ocular myasthenia), Ⅱ a (Mild generalized myasthenia), Ⅱ b (Moderately severe generalized myasthenia), Ⅲ (Acute fulminating myasthenia), Ⅳ (Late severe myasthenia).MAIN OUTCOME MEASURES: ① Differences of initial symptoms and clinical manifestation of two group patients.

  4. A CLINICAL STUDY OF CARDIOVASCULAR ABNORMALITIES IN PATIENTS WITH CHRONIC RENAL FAILURE AT VIMS HOSPITAL, BELLARY.

    Huggi

    2014-12-01

    Full Text Available BACKGROUND: Chronic Renal Failure (CRF is one of the common conditions which a physician comes across in day to day practice. Chronic Renal Failure affects every aspect of the lives of the patients who suffer it and involves all systems of body & results in various abnormalities. Today , cardiovascular complications are a major clinical problem in ureamic patients accounting for 4 4% of all deaths in this population. Left Ventricular Hypertrophy (LVH is a major Echocardiographic finding in Chronic Renal Failure (CRF. Prevalence of LVH increases with decline of renal function. Left ventricular hypertrophy is an independent predictor of survival , present in approximately 70% of patients at the initiation of dialysis. MATERIALS AND METHODS : The data for this study was collected from the one hundred subjects fulfilling the inclusion /exclusion criteria admitted and patients vis iting OPD and patients undergoing dialysis in dialysis unit of VIMS Hospital during the period from Jan 2010 To June 2011. RESULTS : LVH is a major echocardiographic finding in uremic patients. In the present study , 12 (17% patients of mild , 18(26% patien ts of moderate and 39(57% patients of severe Chronic Renal Failure group had Left Ventricular Hypertrophy. In the present study , the most common cause of CRF in the Severe CRF group was Diabetes plus Hypertension in 47% followed by Diabetes alone in 33% a s compared to Moderate CRF group where in Diabetes plus Hypertension accounted for 47% , followed by Diabetes in 47% , whereas in Mild CRF group Diabetes was the cause 38% , followed by Diabetes plus Hypertension in 33% of cases. Pericardial effusion was seen in 25% of cases (15 cases had mild and 10 cases had moderate pericardial effusion . CONCLUSIONS : The high prevalence of Left ventricular hypertrophy in these populations on echocardiography implies that these patients require detailed cardiovascular evalua tion despite absence of symptoms and control of

  5. Abnormal Neural Responses to Emotional Stimuli but Not Go/NoGo and Stroop Tasks in Adults with a History of Childhood Nocturnal Enuresis.

    Mengxing Wang

    Full Text Available Nocturnal enuresis (NE is a common disorder in school-aged children. Previous studies have reported that children with NE exhibit structural, functional and neurochemical abnormalities in the brain, suggesting that children with NE may have cognitive problems. Additionally, children with NE have been shown to process emotions differently from control children. In fact, most cases of NE resolve with age. However, adults who had experienced NE during childhood may still have potential cognitive or emotion problems, and this possibility has not been thoroughly investigated.In this work, we used functional magnetic resonance imaging (fMRI to evaluate brain functional changes in adults with a history of NE. Two groups, consisting of 21 adults with NE and 21 healthy controls, were scanned using fMRI. We did not observe a significant abnormality in activation during the Go/NoGo and Stroop tasks in adults with a history of NE compared with the control group. However, compared to healthy subjects, young adults with a history of NE mainly showed increased activation in the bilateral temporoparietal junctions, bilateral dorsolateral prefrontal cortex, and bilateral anterior cingulate cortex while looking at negative vs. neutral pictures.Our results demonstrate that adults with a history of childhood NE have no obvious deficit in response inhibition or cognitive control but showed abnormal neural responses to emotional stimuli.

  6. Abnormal Neural Responses to Emotional Stimuli but Not Go/NoGo and Stroop Tasks in Adults with a History of Childhood Nocturnal Enuresis

    Wang, Mengxing; Zhang, Kaihua; Zhang, Jilei; Dong, Guangheng; Zhang, Hui; Du, Xiaoxia

    2015-01-01

    Background Nocturnal enuresis (NE) is a common disorder in school-aged children. Previous studies have reported that children with NE exhibit structural, functional and neurochemical abnormalities in the brain, suggesting that children with NE may have cognitive problems. Additionally, children with NE have been shown to process emotions differently from control children. In fact, most cases of NE resolve with age. However, adults who had experienced NE during childhood may still have potential cognitive or emotion problems, and this possibility has not been thoroughly investigated. Methodology/Principal Findings In this work, we used functional magnetic resonance imaging (fMRI) to evaluate brain functional changes in adults with a history of NE. Two groups, consisting of 21 adults with NE and 21 healthy controls, were scanned using fMRI. We did not observe a significant abnormality in activation during the Go/NoGo and Stroop tasks in adults with a history of NE compared with the control group. However, compared to healthy subjects, young adults with a history of NE mainly showed increased activation in the bilateral temporoparietal junctions, bilateral dorsolateral prefrontal cortex, and bilateral anterior cingulate cortex while looking at negative vs. neutral pictures. Conclusions/Significance Our results demonstrate that adults with a history of childhood NE have no obvious deficit in response inhibition or cognitive control but showed abnormal neural responses to emotional stimuli. PMID:26571500

  7. Natural history and clinical assessment of Taiwanese patients with mucopolysaccharidosis IVA

    2014-01-01

    Background Mucopolysaccharidosis IVA (MPS IVA) is a rare lysosomal storage disorder caused by N-acetylgalactosamine-6-sulfatase deficiency, which catalyzes a step in the catabolism of glycosaminoglycans, keratan sulfate and chondroitin-6-sulfate. This disease has a variable age of onset and rate of progression. Methods A retrospective analysis of medical records of 24 patients with MPS IVA (11 males, 13 females; current mean age ± SD, 12.6 ± 6.6 years; age range, 1.4-29.4 years) seen at 6 medical centers in Taiwan from January 1996 through June 2013 was performed. Results Mean ages of onset of symptoms and confirmed diagnosis were 2.0 ± 1.6 and 5.7 ± 4.5 years, respectively. The most prevalent clinical manifestations were kyphosis (100%), pectus carinatum (96%), abnormal gait (93%), striking short trunk dwarfism (92%), genu valgum (92%), and valvular heart disease (91%). Eight patients (33%) experienced at least one surgical procedure with the most common being ear tube insertion (25%), adenoidectomy (17%), tonsillectomy (13%), supraglottoplasty (13%), spinal decompression (13%), and spinal fusion (13%). The most prevalent cardiac valve abnormalities were aortic stenosis (45%) and mitral regurgitation (45%). At the time of the study, 8 out of 24 patients (33%) have died at the mean age of 17.2 ± 7.7 years. Conclusions An understanding of the natural history involved in MPS IVA may allow early diagnosis of the disease. All affected Taiwanese patients experienced significant functional limitations. Adequate evaluations and timely management may improve clinical outcomes and quality of life. PMID:24513086

  8. TO STUDY THE CLINICAL SPECTRUM AND HAEMATOLOGICAL ABNORMALITIES IN PATIENTS OF MACROCYTIC ANAEMIA

    Daljinderjit

    2015-06-01

    Full Text Available BACKGROUND : Folate and vitamin12 deficiency have been known to cause megaloblastic anaemia. Megaloblastic anaemia is not uncommon in India , but data are insufficient regarding its prevalence , causative factors and precipitating factors. AIMS & OBJECTIVES : To evaluate the clinic o - haematological profile in patients of macrocytic anaemia. MATERIAL AND METHODS : In the present study , 50 patients of >20years of age with hemoglobin 95 fl and PBF showing macrocytosis and pancytopenia were included. Detailed history with clinical examination was performed and investigations (Bone Marrow aspiration , Serum Folate and cobalamin assays were carried out. RESULTS : The peak incidence of megaloblas tic anaemia was in the age group of 41 - 50 years (48% , with male preponderance (71% . ( The predominant symptoms were fatigue (54% followed by low grade fever (52% , breathlessness (50% , and mild jaundice (22% . ( Physicalfindingswere pallor (88 % , hepatomegaly (80% , knuckle hyperpigmentation (68% , glossitis (50% , peripheral neuropathy (28% and mild icterus was the least common finding in 22% of patients. 64% patients of macrocytic anaemia were found to be lactovegetarian. Cobalamin deficiency wa s present in maximum patients (50% , followed by combined cobalamin and folate deficiency in 34% and folate deficiency in 16% of patients. Bonemarrowsmears revealed megaloblastic picture in 58% of patients and 42% patients had non - megaloblastic bone marrow picture. C ONCLUSION : Megaloblastic anaemia must be considered in the differential diagnosis of patients presenting with pyrexia of unknown origin , mild ic terus or pancytopenia. Therefore , the early screening for cobalamin and folic acid deficiency can lead to improvement in the wellbeing and prolongs the life of people in our community.

  9. Myelin Abnormalities in Schizophrenia: Insights from Proteomic Investigations of Post-Mortem Schizophrenia and Pre-Clinical Animal Models

    Farrelly, Lorna

    2014-01-01

    Accumulating evidence from epidemiologic and clinical findings report that both exposure to prenatal inflammation and prenatal iron deficiency significantly increase the risk of developing Schizophrenia in the offspring. Abnormalities in myelin are the most robust neuropathological findings in post-mortem human Schizophrenia, however the exact mechanisms at the protein and pathway levels owing to the myelin deficits are largely unknown. Animal models offer a fruitful approach to study the ...

  10. CORRELATION OF LIVER FUNCTION TEST ABNORMALITIES WITH CLINICAL OUTCOMES IN PATIENT S WITH FEBRILE THROMBOCYTOPENIA : A CROSS SECTIONAL STUDY

    Prakash Kikkeri

    2015-07-01

    Full Text Available Febrile thrombocytopenia is a common clinical condition encountered in medical wards especially so during Dengue fever epidemics. Hepatic dysfunction is a well - recognized feature of dengue infection manifested by mild to moderate increases in transaminase levels, although jaundice and acute liver failure are generally uncommon. We undertook this cross sectional clinical study to find out the pattern of liver function test abnormalities in patients with febrile thrombocytopenia and to know whether it has any adverse clinical outcome. One hundred patients aged 18 years and above with established fever and a platelet count of <1,00,000 w ho were admitted to medical wards of Victoria hospital, Bangalore during the dengue epidemic between May 2013 and August 2013 were enrolled into this study. Relevant laboratory tests were done including dengue serology to establish the cause of fever and to rule out liver disorders, ITP and other hematological disorders. There were 71 male patients and 29 females with majority in the age group 21 to 40 years. 65 patients tested positive on dengue serology (IgM antibody, NS1 antigen or both, and in 24 patients no cause of fever could be established. Liver function tests were normal in 54(54% patients. Among 46 patients who had LFT abnormalities, raised SGOT and raised ALP were the most common abnormalities present in 30% each of the patients. Raised total bilirubin was present in only 4% patients. There was no statistically significant difference in severity of thrombocytopenia in patients with LFT abnormalities as well as duration of hospital stay and requirement for platelet transfusions, when compared to patients with normal liver function. Derangement of LFT could be one manifestation of a systemic infective/ inflammatory process without any serious adverse clinical outcomes in patients with febrile thrombocytopenia.

  11. Abnormalities of the bilateral basal ganglia and thalami - diagnostic possibilities

    Several diseases may cause non specific MRT abnormalities of the bilateral basal ganglia and thalami. As such, diagnosis of the underlying etiology may be difficult to achieve at imaging. In one clinical case are presented the diagnostic possibilities based on clinical date (previous history, clinical symptoms and evolution) and imaging data (type of signal abnormalities, location of lesions and associated abnormalities). The main categories of diseases causing MRT abnormalities of the bilateral basal ganglia and thalami in adult are: toxic, metabolic, vascular, infectious, inflammatory diseases and tumors.

  12. History, Epidemiology, and Clinical Manifestations of Zika: A Systematic Review

    Barreto, Florisneide; da Glória Teixeira, Maria; da Conceição N. Costa, Maria; Rodrigues, Laura C.

    2016-01-01

    Objectives. To describe salient epidemiological characteristics of Zika virus outbreaks across the world and to examine the clinical presentations, complications, and atypical manifestations related to their occurrence in recent history. Methods. We conducted a systematic review of the literature by searching through MEDLINE, Embase, and Global Health Library, as well as the epidemiological bulletins and alerts from the World Health Organization, the Pan American Health Organization, and the European Centre for Disease Prevention and Control over the period 1954 to 2016. Results. The search yielded 547 records. We retained 333 for further analysis, to which we added 11 epidemiological bulletins from various sources. Of these, we systematically reviewed 52 articles and reports, revealing some epidemiological features and patterns of spread of the Zika virus worldwide, as well as pathological outcomes suspected to be linked to Zika outbreaks. Neurologic disorders among zika patients were similar in Brazil and French Polynesia but a causal link is not established. Incidence of zika infection in pregnant women is not known. In Brazil, during the zika outbreak the incidence of microcephaly increased more than 20 times. Among 35 infants with microcephaly, born from women suspected to have Zika infection during pregnancy in northeast Brazil, 74% of the mothers reported rash during the first and second trimester. Conclusions. On February 1, 2016, The World Health Organization declared the ongoing Zika crisis an emergency and that, although not yet scientifically proven, the link between the virus and growing numbers of microcephaly cases was “strongly suspected.” However, the causal relationship between zika and microcephaly is not universally accepted. Public Health Implications. The current situation with regard to Zika is not encouraging, because there is no vaccine, no treatment, and no good serological test, and vector control remains a challenge. PMID:26959260

  13. Predictive value of clinical history compared with urodynamic study in 1,179 women

    Jorge Milhem Haddad

    2016-02-01

    Full Text Available SUMMARY Objective: to determine the positive predictive value of clinical history in comparison with urodynamic study for the diagnosis of urinary incontinence. Methods: retrospective analysis comparing clinical history and urodynamic evaluation of 1,179 women with urinary incontinence. The urodynamic study was considered the gold standard, whereas the clinical history was the new test to be assessed. This was established after analyzing each method as the gold standard through the difference between their positive predictive values. Results: the positive predictive values of clinical history compared with urodynamic study for diagnosis of stress urinary incontinence, overactive bladder and mixed urinary incontinence were, respectively, 37% (95% CI 31-44, 40% (95% CI 33-47 and 16% (95% CI 14-19. Conclusion: we concluded that the positive predictive value of clinical history was low compared with urodynamic study for urinary incontinence diagnosis. The positive predictive value was low even among women with pure stress urinary incontinence.

  14. Clinical Observation of Kaixin Capsule (开心胶囊) in Treating Type 2 Diabetes Mellitus Complicated with Abnormal Lipidemia

    薛军; 陈镜合

    2002-01-01

    Objective: To observe the clinical efficacy of Kaixin Capsule (KXC, 开心胶囊), a Chinese compound preparation, in treating type 2 diabetes mellitus (DM) complicated with abnormal lipidemia. Methods: Seventy-two DM inpatients were medicated on the basis of administering conventional hypoglycemics, and KXC was orally taken. They were compared with those patients only taking hypoglycemics to observe the change of blood lipid before and after treatment. Results: The total cholesterol of KXC combined with hypoglycemics group had their blood lipid lowered by 14% after treatment and triglyceride lowered by 36%, HDL-C raised by 11%, and LDL-C lowered by 24%. Compared with only hypoglycemics treatment, there was significant difference (P<0.01). Conclusion: KXC has good blood lipid regulating effect on DM complicated with abnormal lipidemia.

  15. Abnormal Unsaturated Fatty Acid Metabolism in Cystic Fibrosis: Biochemical Mechanisms and Clinical Implications

    Seegmiller, Adam C.

    2014-01-01

    Cystic fibrosis is an inherited multi-organ disorder caused by mutations in the CFTR gene. Patients with this disease exhibit characteristic abnormalities in the levels of unsaturated fatty acids in blood and tissue. Recent studies have uncovered an underlying biochemical mechanism for some of these changes, namely increased expression and activity of fatty acid desaturases. Among other effects, this drives metabolism of linoeate to arachidonate. Increased desaturase expression appears to be ...

  16. Development of a decision support tool to facilitate primary care management of patients with abnormal liver function tests without clinically apparent liver disease [HTA03/38/02]. Abnormal Liver Function Investigations Evaluation (ALFIE

    Sullivan Frank M

    2007-04-01

    Full Text Available Abstract Background Liver function tests (LFTs are routinely performed in primary care, and are often the gateway to further invasive and/or expensive investigations. Little is known of the consequences in people with an initial abnormal liver function (ALF test in primary care and with no obvious liver disease. Further investigations may be dangerous for the patient and expensive for Health Services. The aims of this study are to determine the natural history of abnormalities in LFTs before overt liver disease presents in the population and identify those who require minimal further investigations with the potential for reduction in NHS costs. Methods/Design A population-based retrospective cohort study will follow up all those who have had an incident liver function test (LFT in primary care to subsequent liver disease or mortality over a period of 15 years (approx. 2.3 million tests in 99,000 people. The study is set in Primary Care in the region of Tayside, Scotland (pop approx. 429,000 between 1989 and 2003. The target population consists of patients with no recorded clinical signs or symptoms of liver disease and registered with a GP. The health technologies being assessed are LFTs, viral and auto-antibody tests, ultrasound, CT, MRI and liver biopsy. The study will utilise the Epidemiology of Liver Disease In Tayside (ELDIT database to determine the outcomes of liver disease. These are based on hospital admission data (Scottish Morbidity Record 1, dispensed medication records, death certificates, and examination of medical records from Tayside hospitals. A sample of patients (n = 150 with recent initial ALF tests or invitation to biopsy will complete questionnaires to obtain quality of life data and anxiety measures. Cost-effectiveness and cost utility Markov model analyses will be performed from health service and patient perspectives using standard NHS costs. The findings will also be used to develop a computerised clinical decision

  17. Attachment Organization and History of Suicidal Behavior in Clinical Adolescents.

    Adam, Kenneth S.; And Others

    1996-01-01

    Adolescents in psychiatric treatment (N=133) participated in a case-comparison study investigating the association of attachment patterns with a history of suicidal behaviors. Attachment patterns were assessed using the Adult Attachment Interview. In accordance with definitions provided in the scoring system, 86% of case and 78% of comparison…

  18. Normal behavior and the clinical implications of abnormal behavior in guinea pigs.

    Bradley, T A

    2001-09-01

    Cavies are becoming more popular as pets because they are relatively easy to care for and provide never-ending love and entertainment with their curious but gentle nature. As with other species, the best way to learn about guinea pig behavior is to own guinea pigs. Understanding normal behavior provides the practitioner with the ability to more easily recognize pathology and abnormal behavior. This allows the veterinarian to provide necessary supportive care and pain management more quickly while performing diagnostics and determining the need for therapeutics. Understanding the behavior of cavies allows the clinician to better educate guinea pig-owning clients and to better and more quickly serve the needs of their guinea pig patients. PMID:11601108

  19. Clinical Application of Breast Fiberoptic Ductoscopy in 354 Cases with Abnormal Nipple Discharge

    HengweiZhang; GuifenYang; HuaYang; FawenLiu; ShudeCui

    2004-01-01

    OBJECTIVE To use the breast duct endoscope for studying thepathological characteristics of breast-duct disease with nipple discharge,and offer methods that can improve diagnostic accuracy.METHODS A total of 354 patients with nipple discharge were examinedusing the fiberoptic duct endoscope (FVS-3000M). Ducts and theirbranches were investigated to define and locate the extent of intraductallesions. Core biopsies were taken of suspicious lesions and the findingswere analyzed retrospectively.RESULTS In cases of bloody and serosanguineous nipple discharge,72.3% were papilloma and papillomatosis, 5.2% duct cancer and 22.5%mammary duct ectasia and galactophoritis. In patients with watery nippledischarge, 56.0% were papilloma and papillomatosis, 8.0% were breastcancer and 5 patients without abnormal findings were regarded asnormal.CONCLUSION Fiberoptic duct endoscopy can accurately locate the siteand pathology of nipple discharge allowing the improvement in diagnosisof early breast cancer.

  20. [Clinical and therapeutic aspects of pyelo-ureteral junction abnormalities at the University Hospital of Point G].

    Tembely, Aly; Kassogué, Amadou; Berthé, Honoré; Ouattara, Zanafon

    2016-01-01

    This study is meant to analyze the clinical and therapeutic aspects of abnormalities ureteropelvic junction. Cross-sectional and descriptive study on 35 cases of abnormalities of the AUPJ collected the Urology Department of the University Hospital of Point G for a period of 4 years (January 2010 to December 2014). Data were collected on the survey forms, medical records and records of the block. The socio-demographic, clinical and therapeutic data were entered into Microsoft Word 2007 and Excel 2007 and analyzed on SPSS 18.0. Between January 2010 and December 2014, 35 cases of AUPJ were collected. The average age was 29.3 years. The back pain was the most frequent reason for consultation or 40%. 20% of patients were consulting for the first time 10 years symptomatic evolution. Kidney destruction was observed in 28.6%. The association Ultrasound + IVU has established the diagnosis in 37.1%. A urinary tract infection was found in 60%. The gallstone complication was present in 17.1% of patients. 51.4% of patients received open pyeloplasty by Anderson Kuss. The anomaly of the ureteropelvic junction in our study was marked by a consultation with delay formidable complications. The open surgery has been the gold standard with satisfactory results. The endopyéloplasty, the treatment of laparoscopic minimally invasive joint surgeries are not available to us but to encourage and incorporate in the therapeutic arsenal. PMID:27516821

  1. The History of Cystinosis: Lessons for Clinical Management

    Paul Goodyer

    2011-01-01

    Cystinosis is a rare disorder, and, accordingly, progress on the understanding and treatment of this disease has been relatively slow. Although cystinosis was identified over 100 years ago, the history of cystinosis is marked by a few sudden leaps forward in our understanding rather than by a sustained research effort fuelled by the larger research community. Major conceptual break-throughs include (a) its discovery in 1903, (b) recognition of the renal Fanconi syndrome, (c) realization that ...

  2. CLINICAL HISTORY AND OUTCOME OF 59 PATIENTS WITH IDIOPATHIC HYPERPROLACTINEMIA

    SLUIJMER, AV; LAPPOHN, RE

    1992-01-01

    Objective: To investigate the clinical course of hyperprolactinemia without demonstrable cause. Design: Prospective study of all patients with idiopathic hyperprolactinemia first seen between 1974 and 1985. Setting: Outpatient Department of University Hospital. Patients: Fifty-nine patients followed

  3. Magnetic resonance imaging of sacroiliitis in early seronegative spondylarthropathy. Abnormalities correlated to clinical and laboratory findings

    Puhakka, K B; Jurik, A G; Schiøttz-Christensen, Berit;

    2004-01-01

    OBJECTIVE: To compare a new MRI scoring system of the sacroiliac joints (SIJs) in early spondylarthropathy (SpA) with clinical and laboratory parameters. METHODS: Forty-one patients (24 males, 17 females) with a median age of 26 yr and a median duration of inflammatory low back pain of 19 months...... were included. They all fulfilled the ESSG-criteria for SpA. The patients were examined by MRI of the SIJs using a new scoring system. Clinical examinations, biochemical tests, functional score (BASFI), and pain score (BASDAI) were also performed. RESULTS: 95% of the patients had inflammation and....../or destructive bone changes of the SIJs at MRI. No correlation was found between MRI pathology and clinical findings. MRI demonstrated significantly greater severity of both inflammation and destruction of the SIJs in HLA B27 positive patients than in the HLA B27 negative patients. CONCLUSIONS: In patients with...

  4. Non-invasive prenatal testing for fetal chromosome abnormalities: review of clinical and ethical issues.

    Gekas, Jean; Langlois, Sylvie; Ravitsky, Vardit; Audibert, François; van den Berg, David Gradus; Haidar, Hazar; Rousseau, François

    2016-01-01

    Genomics-based non-invasive prenatal screening using cell-free DNA (cfDNA screening) was proposed to reduce the number of invasive procedures in current prenatal diagnosis for fetal aneuploidies. We review here the clinical and ethical issues of cfDNA screening. To date, it is not clear how cfDNA screening is going to impact the performances of clinical prenatal diagnosis and how it could be incorporated in real life. The direct marketing to users may have facilitated the early introduction of cfDNA screening into clinical practice despite limited evidence-based independent research data supporting this rapid shift. There is a need to address the most important ethical, legal, and social issues before its implementation in a mass setting. Its introduction might worsen current tendencies to neglect the reproductive autonomy of pregnant women. PMID:26893576

  5. Non-invasive prenatal testing for fetal chromosome abnormalities: review of clinical and ethical issues

    Gekas, Jean; Langlois, Sylvie; Ravitsky, Vardit; Audibert, François; van den Berg, David Gradus; Haidar, Hazar; Rousseau, François

    2016-01-01

    Genomics-based non-invasive prenatal screening using cell-free DNA (cfDNA screening) was proposed to reduce the number of invasive procedures in current prenatal diagnosis for fetal aneuploidies. We review here the clinical and ethical issues of cfDNA screening. To date, it is not clear how cfDNA screening is going to impact the performances of clinical prenatal diagnosis and how it could be incorporated in real life. The direct marketing to users may have facilitated the early introduction of cfDNA screening into clinical practice despite limited evidence-based independent research data supporting this rapid shift. There is a need to address the most important ethical, legal, and social issues before its implementation in a mass setting. Its introduction might worsen current tendencies to neglect the reproductive autonomy of pregnant women. PMID:26893576

  6. Normal and abnormal development of pulmonary veins : State of the art and correlation with clinical entities

    Douglas, Yvonne L.; Jongbloed, Monique R. M.; DeRuiter, Marco C.; Gittenberger-de Groot, Adriana C.

    2011-01-01

    Interest for the pulmonary veins has increased in the past decade after the potential arrhythmogenicity of the myocardial sleeve surrounding these structures has been recognized. Furthermore, there are several clinical entities, such as anomalous connection pattern and pulmonary vein stenosis, that

  7. Clinical manifestations that predict abnormal brain computed tomography (CT in children with minor head injury

    Nesrin Alharthy

    2015-01-01

    Full Text Available Background: Computed tomography (CT used in pediatric pediatrics brain injury (TBI to ascertain neurological manifestations. Nevertheless, this practice is associated with adverse effects. Reports in the literature suggest incidents of morbidity and mortality in children due to exposure to radiation. Hence, it is found imperative to search for a reliable alternative. Objectives: The aim of this study is to find a reliable clinical alternative to detect an intracranial injury without resorting to the CT. Materials and Methods: Retrospective cross-sectional study was undertaken in patients (1-14 years with blunt head injury and having a Glasgow Coma Scale (GCS of 13-15 who had CT performed on them. Using statistical analysis, the correlation between clinical examination and positive CT manifestation is analyzed for different age-groups and various mechanisms of injury. Results: No statistically significant association between parameteres such as Loss of Consciousness, ′fall′ as mechanism of injury, motor vehicle accidents (MVA, more than two discrete episodes of vomiting and the CT finding of intracranial injury could be noted. Analyzed data have led to believe that GCS of 13 at presentation is the only important clinical predictor of intracranial injury. Conclusion: Retrospective data, small sample size and limited number of factors for assessing clinical manifestation might present constraints on the predictive rule that was derived from this review. Such limitations notwithstanding, the decision to determine which patients should undergo neuroimaging is encouraged to be based on clinical judgments. Further analysis with higher sample sizes may be required to authenticate and validate findings.

  8. Stents and statins: history, clinical outcomes and mechanisms.

    Nair, Pradeep K; Mulukutla, Suresh R; Marroquin, Oscar C

    2010-09-01

    The 1980s witnessed the inception of both stents and 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitors (statins). While they evolved separately, it was soon realized that they each offered a unique and powerful mechanism for targeting the major offender in cardiovascular disease, namely atherosclerosis. Coincidentally, the first statin was approved by the US FDA in 1987, the same year that the coronary stent was conceived. Since that time, stents and statins have revolutionized the field of cardiovascular medicine and their paths have been intertwined. Several pivotal randomized clinical trials have established statins as an effective therapy for improving clinical outcomes after percutaneous coronary intervention (PCI) among patients presenting with stable coronary artery disease and acute coronary syndromes. In addition, chronic statin therapy and acute loading of statins prior to PCI has consistently been shown to limit periprocedural myocardial necrosis. The mechanism for improved clinical outcomes with statins has clearly been associated with statin-induced reductions in LDL. In addition, statins may also exert 'pleiotropic' effects, independent of LDL lowering, that might counteract the inflammatory and prothrombotic mileu created with PCI. This article provides a brief historical perspective of the evolution of the use of statins and stents in patients with coronary artery disease, an evaluation of the available clinical data supporting the use of statins in patients undergoing PCI across a wide spectrum of clinical scenarios, and a discussion of the potential mechanisms of the benefit of statins in these patients. PMID:20828351

  9. Electrocardiographic pattern combined with echocardiographic wall motion abnormalities in stress related cardiomyopathies: clinical and pathophysiological insights

    Berti, Marco; Ghizzoni,Giuseppe; Gualeni,Anna; Cantamessa,Paola; Oneglia,Carlo

    2012-01-01

    We report five cases of stress related cardiomyopahies that occurred in post-menopausal women (age range from 49 to 90) consecutively admitted to our Department in the last year in different clinical settings: typical anginal pain, carotid endarterectomy, pulmonary edema, cardiogenic shock, and severe asthenia. Apical left ventricular involvement was observed in three patients in conjunction with ECG mild ST segment elevation in anterior precordial leads resembling acute anterior myocardial i...

  10. 不良孕产史孕妇羊水细胞胎儿染色体核型特点%Amniotic cell karyotyping in pregnant women with a history of abnormal pregnancy

    付杰; 马京梅; 于丽; 潘虹; 杨慧霞

    2014-01-01

    目的:探讨有不良孕产史的孕妇行胎儿染色体核型分析的临床意义。方法2005年1月4日至2013年12月31日,共1193例孕妇因不良孕产史在北京大学第一医院行羊膜腔穿刺羊水细胞胎儿染色体核型分析。根据既往不良孕产史病因,将其分为4组,分别是:生育过遗传代谢性疾病或单基因遗传性疾病患儿的孕妇273例(A组),孕育过染色体病患儿的孕妇81例(B组),夫妇一方为染色体异常携带者8例(C组),不良孕产史病因不详的孕妇833例(D组)。回顾分析这些孕妇胎儿染色体异常核型的分布特点。结果共发现胎儿染色体异常48例[4.0%(48/1193)],其中染色体多态性变异26例,染色体结构和数目异常22例,包括4例21-三体、4例性染色体异常、3例18-三体、3例额外小染色体、3例相互易位、1例罗伯逊易位、1例6号染色体臂间倒位、1例3号染色体臂间倒位、1例14-三体嵌合型、1例14号染色体结构异常。A组检出4例(1.5%)有临床意义的胎儿染色体核型异常及4例多态性变异;A组同时检出61例遗传代谢性疾病或单基因遗传性疾病胎儿及2例基因突变携带者,但均未合并染色体核型异常。B组检出2例(2.5%)胎儿染色体核型异常。C组检出2例(2/8)胎儿染色体相互易位,核型均与亲代相同。D组共检出3例21-三体、3例18-三体、2例性染色体异常、2例额外小染色体,均为高龄孕妇;还检出4例染色体结构异常及22例染色体多态性变异,夫妇均行外周血染色体检查,证实胎儿异常核型来自双亲之一。结论应根据不良孕产史的病因,选择合适的产前诊断方法。%Objective To study the clinical significance of chromosome karyotyping in pregnant women with a history of abnormal pregnancy. Methods The fetal chromosome karyotypes of 1 193 pregnant women with a history of abnormal pregnancy in Peking

  11. Hypertrophic cardiomyopathy in infants: clinical features and natural history

    The clinical and morphologic features of hypertrophic cardiomyopathy in 20 patients recognized as having cardiac disease in the first year of life are described. Fourteen of these 20 infants were initially suspected of having heart disease solely because a heart murmur was identified. However, the infants showed a variety of clinical findings, including signs of marked congestive heart failure (in the presence of nondilated ventricular cavities and normal or increased left ventricular contractility) and substantial cardiac enlargement on chest radiograph. Other findings were markedly different from those usually present in older children and adults with hypertrophic cardiomyopathy (e.g., right ventricular hypertrophy on the ECG and cyanosis). Consequently, in 14 infants, the initial clinical diagnosis was congenital cardiac malformation other than hypertrophic cardiomyopathy. The clinical course was variable in these patients, but the onset of marked congestive heart failure in the first year of life appeared to be an unfavorable prognostic sign; nine of the 11 infants with congestive heart failure died within the first year of life. In infants with hypertrophic cardiomyopathy, unlike older children and adults with this condition, sudden death was less common (two patients) than death due to progressive congestive heart failure

  12. Non-invasive prenatal testing for fetal chromosome abnormalities: review of clinical and ethical issues

    Gekas J

    2016-02-01

    Full Text Available Jean Gekas,1,2 Sylvie Langlois,3 Vardit Ravitsky,4 François Audibert,5 David Gradus van den Berg,6 Hazar Haidar,4 François Rousseau2,7 1Prenatal Diagnosis Unit, Department of Medical Genetics and Pediatrics, Faculty of Medicine, Université Laval, Québec City, QC, Canada; 2Department of Medical Biology, CHU de Québec, Québec City, QC, Canada; 3Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada; 4Bioethics Program, Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada; 5Department of Obstetrics and Gynecology, Hospital Sainte-Justine, Montreal, QC, Canada; 6Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec City, QC, Canada; 7Department of Molecular Biology, Medical Biochemistry and Pathology, Faculty of Medicine, Université Laval, Québec City, QC, Canada Abstract: Genomics-based non-invasive prenatal screening using cell-free DNA (cfDNA screening was proposed to reduce the number of invasive procedures in current prenatal diagnosis for fetal aneuploidies. We review here the clinical and ethical issues of cfDNA screening. To date, it is not clear how cfDNA screening is going to impact the performances of clinical prenatal diagnosis and how it could be incorporated in real life. The direct marketing to users may have facilitated the early introduction of cfDNA screening into clinical practice despite limited evidence-based independent research data supporting this rapid shift. There is a need to address the most important ethical, legal, and social issues before its implementation in a mass setting. Its introduction might worsen current tendencies to neglect the reproductive autonomy of pregnant women. Keywords: prenatal diagnosis, Down syndrome, non-invasive prenatal testing, cell-free fetal DNA, informed consent, reproductive autonomy

  13. The History of Cystinosis: Lessons for Clinical Management

    Paul Goodyer

    2011-01-01

    Full Text Available Cystinosis is a rare disorder, and, accordingly, progress on the understanding and treatment of this disease has been relatively slow. Although cystinosis was identified over 100 years ago, the history of cystinosis is marked by a few sudden leaps forward in our understanding rather than by a sustained research effort fuelled by the larger research community. Major conceptual break-throughs include (a its discovery in 1903, (b recognition of the renal Fanconi syndrome, (c realization that tissue accumulation of cystine reflects a defective channel in the lysosomal membrane, (d translation of this discovery to trials of cysteamine, (e discovery of the CTNS gene, and (f report of successful stem cell therapy in the cystinotic mouse. This paper focuses on the importance management lessons from these milestones and the potential new therapeutic strategies which may be looming in the near future.

  14. History of Neural Stem Cell Research and Its Clinical Application.

    Takagi, Yasushi

    2016-03-15

    "Once development was ended…in the adult centers, the nerve paths are something fixed and immutable. Everything may die, nothing may be regenerated," wrote Santiago Ramón y Cajal, a Spanish neuroanatomist and Nobel Prize winner and the father of modern neuroscience. This statement was the central dogma in neuroscience for a long time. However, in the 1960s, neural stem cells (NSCs) were discovered. Since then, our knowledge about NSCs has continued to grow. This review focuses on our current knowledge about NSCs and their surrounding microenvironment. In addition, the clinical application of NSCs for the treatment of various central nervous system diseases is also summarized. PMID:26888043

  15. The natural history and clinical syndromes of degenerative cervical spondylosis.

    Kelly, John C

    2012-01-01

    Cervical spondylosis is a broad term which describes the age related chronic disc degeneration, which can also affect the cervical vertebrae, the facet and other joints and their associated soft tissue supports. Evidence of spondylitic change is frequently found in many asymptomatic adults. Radiculopathy is a result of intervertebral foramina narrowing. Narrowing of the spinal canal can result in spinal cord compression, ultimately resulting in cervical spondylosis myelopathy. This review article examines the current literature in relation to the cervical spondylosis and describes the three clinical syndromes of axial neck pain, cervical radiculopathy and cervical myelopathy.

  16. 5alpha-reductase: history and clinical importance.

    Marks, Leonard S

    2004-01-01

    The treatment of men with symptomatic benign prostatic hyperplasia (BPH) has shifted dramatically from surgery to drug therapy over the past decade. The revolution in BPH treatment began with the discovery of congenital 5alpha-reductase (5AR) deficiency, leading to the appreciation of 2 different androgenic hormones: testosterone, which mediates overt masculinization in the adult male, and dihydrotestosterone (DHT), which mediates prostatic growth, acne, facial beard, and male pattern baldness. Inhibition of DHT in adults results in prostatic shrinkage and symptomatic relief in many men, without the side effects seen with conventional androgen-deprivation therapy. The 5AR inhibitor drugs (finasteride and the dual inhibitor, dutasteride) are able to ablate the accumulation of intraprostatic DHT, the mechanism most responsible for prostate growth and maintenance. Not only may these drugs relieve symptoms, but they may also alter the natural history of the BPH process. Future indications for the 5ARI drugs could include chemoprevention of prostate cancer, prophylaxis of BPH-related complications, and treatment of BPH-associated hematuria. PMID:16985920

  17. Radioisotopic diagnosis of ischemic heat disease in clinically healthy subjects with ECG abnormalities following maximal exercise

    Twenty four clinically healthy pilots, 34 to 59 years of age, who on scanning for latent ischemic heart disease (IHD) showed a positive maximal exercise challenge ECG test - depression of ST segment from 0,1 mV more to 0,08 sec. after point ''7''. Fourty five seconds before the maximal exercise was over, 74 MBq 201TI-chloride was applied and the localisation, extent and severity of the regional perfusion changes were evaluated on gamma camera by the redistribution of the radionuclide in the heart muscle from stress to rest. Radionuclide kineventriculography was performed with sup(99m)Tc-PYP-erythrocytes at rest and after exercise. The total and regional ejection fractions and disturbances in left ventricular wall kinetics were determined. Of 21 subjects with ischemic ST-depression under study, hypoperfusion zones were visualized on gamma camera in 5 and regional hypokinesis of the left ventricular wall in 2. Of 3 subjects with rhythm and conduction disorders, provoked by maximal exercise, one had hypoperfusion localized in two myocardial zones, while the other two had descreased ejection fraction in the postero-lateral area of the left ventricle. In the event of positive finding in the exercise challenge test, one should invariably perform investigation with 201TI-chloride and sup(99m)Tc-PYP-erythrocytes after exercise for precise determination of the myocardial perfusion disturbances in the left ventricle

  18. Neurodegenerative changes in patients with clinical history of bipolar disorders.

    Shioya, Ayako; Saito, Yuko; Arima, Kunimasa; Kakuta, Yukio; Yuzuriha, Takefumi; Tanaka, Noriko; Murayama, Shigeo; Tamaoka, Akira

    2015-06-01

    Neurodegeneration in bipolar disorder (BPD) is poorly understood. Therefore, the current study was designed to assess the immunohistochemical changes in neurodegenerative markers in patients with BPD. Eleven consecutive autopsy cases diagnosed with BPD were analyzed. Sections were obtained from archival paraffin blocks of representative areas and stained using conventional methods, as well as immunostained with several antibodies to screen for neurodegenerative diseases. Age- and non-argyrophilic grains (AGs) degeneration matched controls were selected for each case. Clinical information was retrospectively collected from medical charts. All patients were men, and the average age of death was 70 years. Neuropathological diagnoses included dementia with grains (2), argyrophilic grain disease (2), corticobasal degeneration (CBD, 1), Lewy body disease (1), hypoxic encephalopathy (1) and cerebral infarction (1). All cases showed AGs to various degrees. Three patients died in their 50s; one demonstrated dementia with Lewy bodies, while the other two showed abundant AGs in the thalamus and amygdala. Of the three patients who died in their 60s, one showed AGs preferentially in the thalamus and amygdala, while the others demonstrated limbic predominance. The patients who died in/after their 70s demonstrated AGs similar to controls, except for the patient with CBD. Our data provides potentiality that neurodegenerative diseases may be an underlying pathology in certain cases of BPD. PMID:25819679

  19. The risk factors for abnormal ankle-brachial index in type 2 diabetic patients and clinical predictive value for diabetic foot

    张净

    2013-01-01

    Objective To investigate the prevalence of diabetic foot (DF) and the normal,high and low ankle brachial index (ABI) in type 2 diabetic patients and explore the risk factor for abnormal ABI and the clinical predictive value for DF.Methods A total of 2 681 type 2 diabetic patients who visited our hospital between January,2007and December,2009 were enrolled in the study.The clinical data were analyzed and the risk factors for abnormal ABI were determined by logistic regression analysis.Results ABI was normal (0.9-<1.3) in 2 362 cases

  20. Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice

    Megan Doerr

    2014-03-01

    Full Text Available Family health history is a leading predictor of disease risk. Nonetheless, it is underutilized to guide care and, therefore, is ripe for health information technology intervention. To fill the family health history practice gap, Cleveland Clinic has developed a family health history collection and clinical decision support tool, MyFamily. This report describes the impact and process of implementing MyFamily into primary care, cancer survivorship and cancer genetics clinics. Ten providers participated in semi-structured interviews that were analyzed to identify opportunities for process improvement. Participants universally noted positive effects on patient care, including increases in quality, personalization of care and patient engagement. The impact on clinical workflow varied by practice setting, with differences observed in the ease of integration and the use of specific report elements. Tension between the length of the report and desired detail was appreciated. Barriers and facilitators to the process of implementation were noted, dominated by the theme of increased integration with the electronic medical record. These results fed real-time improvement cycles to reinforce clinician use. This model will be applied in future institutional efforts to integrate clinical genomic applications into practice and may be useful for other institutions considering the implementation of tools for personalizing medical management.

  1. CT diagnosis of abnormal transparent septum in clinical meaning%透明隔异常CT诊断的临床意义

    曹连义; 张勇

    2003-01-01

    AIM:Abnormal transparent septum is common in clinical works but little in meaning,so some CT reports are not listed.We collected complete abnormal transparent septum cases to perform comparison analysis between CT diagnosis and clinical data.METHODS:109 abnormal transparent septum diagnosed by CT was compared with symptom of clinics.Axis scanning and no enhanced scanning were used in CT and 2 doctors in charge of sample collection.The 109 cases were excluded with abnormal transparent septum induced by secondary local cerebral atrophy and secondary perforation deformity.RESULTS:There were 15 cases with the fifth ventricle of cerebrum and 22 cases with the fifth and sixth ventricle of cerebrums,10 cases with transparent septum cyst,28 cases with translocation of transparent septum,8 cases with no crack in the forebrain,6 cases with poor development of keratoma and 20 cases of other deformity.CONCLUSION:Abnormal transparent septum cannot be omitted and should be clearly diagnosed by CT.

  2. Brief history of the clinical diagnosis of malaria: from Hippocrates to Osler

    Cunha, Cheston B.; Cunha, Burke A.

    2008-01-01

    Since antiquity, malaria had a major impact on world history but this brief historical overview focuses on clinical features of malaria from Hippocrates to Osler. In antiquity, physicians tried to differentiate malaria from other acute fevers. The classic descriptions of malaria by Hippocrates in ancient Greece and Celsus in ancient Rome are excerpted here from the original Greek and Latin. Their clear clinical descriptions prove malaria was recognized in antiquity. In the modern era, it ...

  3. Evolution of clinical research: A history before and beyond james lind

    Jeremy Hugh Baron

    2010-01-01

    The evolution of clinical research traverses a long and fascinating journey. From the first recorded trial of legumes in biblical times to the first randomized controlled of trial of streptomycin in 1946, the history of clinical trial covers a wide variety of challenges - scientific, ethical and regulatory. The famous 1747 scurvy trial conducted by James Lind contained most elements of a controlled trial. The UK Medical Research Council's (MRC) trial of patulin for common cold in 1943 was the...

  4. Clinical and prognostic significance of bone marrow abnormalities in the appendicular skeleton detected by low-dose whole-body multidetector computed tomography in patients with multiple myeloma

    Clinical significance of medullary abnormalities in the appendicular skeleton (AS) detected by low-dose whole-body multidetector computed tomography (MDCT) in patients with multiple myeloma (MM) was investigated. A total of 172 patients with monoclonal gammopathy of undetermined significance (MGUS) (n=17), smoldering MM (n=47) and symptomatic MM (n=108) underwent low-dose MDCT. CT values (CTv) of medullary density of AS⩾0 Hounsfield unit (HU) was considered as abnormal. Percentage of medullary abnormalities and the mean CTv of AS in patients with MGUS, smoldering MM and symptomatic MM were 18, 55 and 62% and −44.5 , −20.3 and 11.2 HU, respectively (P<0.001 and P<0.001). Disease progression of MM was independently associated with high CTv on multivariate analysis. In symptomatic MM, the presence of abnormal medullary lesions was associated with increased incidence of high-risk cytogenetic abnormalities (34.4% vs 7.7% P=0.002) and extramedullary disease (10.4% vs 0% P=0.032). It was also an independent poor prognostic predictor (hazard ratio 3.546, P=0.04). This study showed that CTv of AS by MDCT is correlated with disease progression of MM, and the presence of abnormal medullary lesions is a predictor for poor survival

  5. Maternal Drug Abuse History, Maltreatment, and Functioning in a Clinical Sample of Urban Children

    Onigu-Otite, Edore C.; Belcher, Harolyn M. E.

    2012-01-01

    Objective: This study examined the association between maternal drug abuse history, maltreatment exposure, and functioning, in a clinical sample of young children seeking therapy for maltreatment. Methods: Data were collected on 91 children, mean age 5.3 years (SD 1.0). The Preschool and Early Childhood Functional Assessment Scales (PECFAS) was…

  6. The influence of family history on prostate cancer risk : implications for clinical management

    Madersbacher, Stephan; Alcaraz, Antonio; Emberton, Mark; Hammerer, Peter; Ponholzer, Anton; Schroeder, Fritz H.; Tubaro, Andrea

    2011-01-01

    A family history of prostate cancer has long been identified as an important risk factor for developing the disease. This risk factor can be easily assessed in clinical practice and current guidelines recommend to initiate prostate cancer early detection 5 years earlier (i.e. around the age of 40 ye

  7. The clinical significances of the abnormal expressions of Piwil1 and Piwil2 in colonic adenoma and adenocarcinoma

    Wang HL

    2015-05-01

    Full Text Available Hai-Ling Wang,1 Bei-Bei Chen,1 Xin-Guang Cao,1 Jin Wang,2 Xiu-Feng Hu,1 Xiao-Qian Mu,1 Xiao-Bing Chen1 1The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, People’s Republic of China; 2The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China Objective: The objective of the present investigation was to study the clinical significances of the abnormal expressions of Piwil1 and Piwil2 protein in colonic adenoma and adenocarcinoma.Methods: This study had applied immunohistochemical method to detect 45 cases of tissues adjacent to carcinoma (distance to cancerous tissue was above 5 cm, 41 cases of colonic adenoma and 92 cases of colon cancer tissues, and their Piwil1 and Piwil2 protein expression levels.Analysis: The correlation of both expression and its relationship with clinicopathological features of colon cancer was analyzed.Results: Positive expression rates of Piwil1 in tissues adjacent to carcinoma, colonic adenoma, and colon cancer were 11.1% (5/45, 53.7% (22/41, and 80.4% (74/92, respectively; the expression rates increased, and the comparisons between each two groups were statistically significant (P<0.05. In each group, the positive expression rates of Piwil2 were 24.4% (11/45 cases, 75.6% (31/41 cases, and 92.4% (85/92 cases; expression rates increased, and the comparisons between each two groups were statistically significant (P<0.05. Piwil1 expression and the correlation of the degree of differentiation, TNM stage, and lymph node metastasis were statistically significant (P<0.05. Piwil2 expression and the correlation of the degree of differentiation, tumor node metastasis (TNM stage, and lymph node metastasis had no statistical significance (P>0.05. In colon cancer tissue, Piwil1 and Piwil2 expressions were positively correlated (r=0.262, P<0.05.Conclusion: The results showed that the abnormal expression of Piwil1 and Piwil2 might play an important role in

  8. Graeco-Roman case histories and their influence on Medieval Islamic clinical accounts.

    Alvarez Millan, C

    1999-04-01

    The medieval Islamic medical tradition was the direct heir of Classical and Hellenistic medicine thanks to an unprecedented movement of translation into Arabic, commentaries and systematizations of Greek scientific texts. In the process of assimilation, not only theoretical principles, but also literary models of presenting medical knowledge were adopted, amongst them the case history. Since the clinical account can be used as a tool for medical instruction as well as an instrument for professional self-promotion, this study seeks to investigate which purpose most motivated Islamic physicians, and to demonstrate the extent to which they were influenced by the stylistic patterns which served them as a model. This article comprises an analysis of the context, literary devices and purpose of case histories of the Epidemics, Rufus of Ephesos and Galen, and compares them with those by the tenth-century Islamic physician Abu Bakr Muhammad b. Zakariya al-Razi. Author of the largest number of case histories preserved within the medieval Islamic medical literature, al-Razi's clinical records constitute an instrument with which to study and expand medical knowledge as well as providing useful material for students' medical training. Although al-Razi fused elements from the sources which served him as a model, he did not emulate Galen's use of the clinical history to assert himself in order to gain authority and prestige, but remained faithful to the Hippocratic essence. PMID:11623808

  9. Brief history of the clinical diagnosis of malaria: from Hippocrates to Osler

    Cheston B. Cunha

    2008-08-01

    Full Text Available Since antiquity, malaria had a major impact on world history but this brief historical overview focuses on clinical features of malaria from Hippocrates to Osler. In antiquity, physicians tried to differentiate malaria from other acute fevers. The classic descriptions of malaria by Hippocrates in ancient Greece and Celsus in ancient Rome are excerpted here from the original Greek and Latin. Their clear clinical descriptions prove malaria was recognized in antiquity. In the modern era, it remains difficult to clinically differentiate malaria from typhoid fever. Since physicians used the term ‘typho-malaria’ to describe acute undifferentiated fevers a testimony to their lack of clinical acumen. Osler, the great clinician, by careful observation in clinical features and fever patterns was able to clearly differentiate malaria from typhoid fever as did the ancients.

  10. Haemorrhage in intracerebral arteriovenous malformations: detection with MRI and comparison with clinical history

    Fifty-one patients with 59 angiographically proven cerebral arteriovenous malformations (AVMs) were examined by high-field MRI to detect blood breakdown products. Results were correlated with the history of intracranial bleeding. Evidence of previous episodes of haemorrhage was seen in 10 of 12 patients (83.3%) with verified bleeding, 4 of 9 patients (44.4%) with symptoms which could suggest bleeding and in 6 of 30 patients (20%) with negative histories. Because of the known rebleeding rate and the increased risk of associated complications, identification of the subgroup who had had haemorrhage and should therefore be considered for surgery may be beneficial. MRI can make a contribution to management by demonstrating prior haemorrhage in patients with an inadequate clinical history. (orig.)

  11. The influence of family history on prostate cancer risk: implications for clinical management.

    Madersbacher, Stephan; Alcaraz, Antonio; Emberton, Mark; Hammerer, Peter; Ponholzer, Anton; Schröder, Fritz H; Tubaro, Andrea

    2011-03-01

    • The most recent evidence for the link between a family history of prostate cancer and individual risk for future disease was examined, with the aim of understanding what the existence and nature of a family history of prostate cancer does to a man's risk of developing the disease. • Our findings highlighted the clear association between a family history of prostate cancer and increased risk of developing the disease; with a greater proximity of relatedness, greater number of family members affected and/or earlier age at diagnosis of the family member elevating risk further. • These findings have important clinical implications for the identification and subsequent management of men deemed to be at increased risk of developing prostate cancer. The evidence for prostate cancer risk reduction with the mono 5α-reductase inhibitor (5ARI) finasteride in a low-risk population and, more recently, with the dual 5ARI dutasteride in a population at increased risk of developing the disease, has potential to expand management options for men at risk of developing prostate cancer beyond more frequent and/or earlier surveillance. • Given that family history can be easily assessed in routine clinical practice, it should be regarded as an important parameter to consider alongside PSA level for prostate cancer risk assessment. PMID:21166744

  12. [Subjectivity and a clinical approach in primary healthcare: narratives, life histories and social reality].

    Barros, Rebeca Silva de; Botazzo, Carlos

    2011-11-01

    The focus of this article is on oral healthcare in Primary Healthcare. We discuss the issue taking the relationship of listening-host-link as a focus debating on the existence of a dichotomy between clinical-collective health. This investigation, took place in Cotia, São Paulo State between July and December 2007, based on the following assumptions: 1) answer the user's relevant oral care problem; 2) remove the dental focus; 3) establish the case through anamnesis; and 4) use electronic scheduling, medical files and sterilization of the health unit. Listening to the complaint, the oral clinical examination and compilation of the clinic history were recorded in the medical file, without using dental records. To discuss the approaches in the clinical area, we list 8 `Patographic Histories.' The objectives of communication during consultation are to listen, perform an accurate diagnosis and interfere to alleviate suffering by restoring the corporal homeostasis and creating a bond by modifying technical references and clinical language. The bond is the result of dialogue, the acceptance of responsibilities of both the professional and the user and the resolution of their complaints and needs. PMID:22124814

  13. Antibiotics and the social history of the controlled clinical trial, 1950-1970.

    Podolsky, Scott H

    2010-07-01

    The histories of antibiotics, controlled clinical trials, and attempts by academics to inculcate an explicitly rational therapeutics among clinicians in the United States were linked during a formative period from 1950 to 1970. Maxwell Finland and Harry Dowling would serve at the epicenter of such efforts in the context of first the broad-spectrum antibiotics, and then, and still more critically, the since-forgotten influx of "fixed-dose combination" antibiotics. With their attention focused less upon individual clinicians than upon pharmaceutical marketers, clinical investigators, the American Medical Association, and the federal government, Finland, Dowling and their supporters would wield the "controlled clinical trial" against the pharmaceutical "testimonial" as a means of ensuring a rational therapeutics. In doing so, they would play an important role in the direction the subsequent Kefauver hearings (1959-1962) would take toward mandating proof of drug efficacy via controlled clinical trials prior to new drug approval. Understanding such a trajectory allows us to better appreciate not only the social history of the controlled clinical trial and the priorities of leaders in infectious disease in the United States during this time, but the consequences of their efforts as well. PMID:20215414

  14. Ultrasonographic abnormalities and inter-reader reliability in Danish patients with systemic lupus erythematosus - a comparison with clinical examination of wrist and metacarpophalangeal joints

    Dreyer, L; Jacobsen, Søren; Juul, L; Terslev, L

    2015-01-01

    OBJECTIVES: We aimed to determine 1) ultrasound (US) abnormalities in patients with systemic lupus erythematosus (SLE) with and without hand arthralgia at the day of examination compared with clinical evaluation and healthy controls, and 2) inter-observer reliability of the US abnormalities....... METHODS: Thirty-three female SLE patients were twice examined with US by three trained examiners. Using B-mode and Doppler US, unilateral wrist and metacarpophalangeal (MCP) joints were examined for synovitis and erosions as well as signs of hand tenosynovitis using a GE Logiq 9 US machine with Doppler...... settings for slow flow. All patients also underwent clinical joint evaluation and were compared with 11 healthy controls (HC). RESULTS: Among the patients with SLE 16 (48%) had signs of wrist synovitis, which was only observed in one HC (p = 0.03). Corresponding figures for any MCP joint were 12 (36%) and...

  15. Cytogenetic and Clinical Features in Children Suspected With Congenital Abnormalities in 1 Medical Center of Zhejiang Province From 2011 to 2014

    Mao, Shujiong; Sun, Liying; Tu, Miaoying; Zou, Chaochun; Wang, Xiumin

    2015-01-01

    Abstract This study aimed to investigate the detection rate of chromosome abnormalities in children suspected with congenital disorders in 1 single center, identify any differences according to different classification criteria, and try to enlighten the medical professionals what clinical features should be transferred for cytogenetic analysis. From January 1, 2011 to March 31, 2014, children who were suspected with chromosomal disorders were included. All the cytogenetic analyses were perfor...

  16. Automated ancillary cancer history classification for mesothelioma patients from free-text clinical reports

    Richard A Wilson

    2010-01-01

    Full Text Available Background: Clinical records are often unstructured, free-text documents that create information extraction challenges and costs. Healthcare delivery and research organizations, such as the National Mesothelioma Virtual Bank, require the aggregation of both structured and unstructured data types. Natural language processing offers techniques for automatically extracting information from unstructured, free-text documents. Methods: Five hundred and eight history and physical reports from mesothelioma patients were split into development (208 and test sets (300. A reference standard was developed and each report was annotated by experts with regard to the patient′s personal history of ancillary cancer and family history of any cancer. The Hx application was developed to process reports, extract relevant features, perform reference resolution and classify them with regard to cancer history. Two methods, Dynamic-Window and ConText, for extracting information were evaluated. Hx′s classification responses using each of the two methods were measured against the reference standard. The average Cohen′s weighted kappa served as the human benchmark in evaluating the system. Results: Hx had a high overall accuracy, with each method, scoring 96.2%. F-measures using the Dynamic-Window and ConText methods were 91.8% and 91.6%, which were comparable to the human benchmark of 92.8%. For the personal history classification, Dynamic-Window scored highest with 89.2% and for the family history classification, ConText scored highest with 97.6%, in which both methods were comparable to the human benchmark of 88.3% and 97.2%, respectively. Conclusion: We evaluated an automated application′s performance in classifying a mesothelioma patient′s personal and family history of cancer from clinical reports. To do so, the Hx application must process reports, identify cancer concepts, distinguish the known mesothelioma from ancillary cancers, recognize negation

  17. Clinical and neuroimaging correlates of abnormal short-latency Somatosensory Evoked Potentials in elderly vascular dementia patients: A psychophysiological exploratory study

    Tsiptsios, Iacovos; Fountoulakis, Konstantinos N; Sitzoglou, Konstantinos; Papanicolaou, Anastasia; Phokas, Konstantinos; Fotiou, Fotis; St Kaprinis, George

    2003-01-01

    Background Short Latency Somatosensory Evoked Potentials (SEPs) may serve to the testing of the somatosensory tract function, which is vulnerable and affected in vascular encephalopathy. The aim of the current study was to search for clinical and neuroimaging correlates of abnormal SEPs in vascular dementia (VD) patients. Materials and Methods The study included 14 VD patients, aged 72.93 ± 4.73 years, and 10 controls aged 71.20 ± 4.44 years. All subjects underwent a detailed clinical examina...

  18. The study of the karyotype analysis results of 358 couples with abnormal pregnancy history%358例不良孕产史夫妇的染色体核型分析

    应香朵; 程启航

    2011-01-01

    目的 探讨具有不良孕产史夫妇的不良孕产史与染色体核型异常的关系.方法 采用外周血淋巴细胞培养技术,对358例具有不良孕产史的夫妇进行常规G显带核型分析.结果 358例不良孕产史夫妇中,共检出异常染色体核型39例,异常率为10.89%.其中随体变异13例,9号染色体臂间倒位9例,副缢痕的增长8例,相互易位7例,数目异常2例.染色体异常在男女发生的比例相当.结论 染色体核型异常是导致不良孕产史的重要原因之一,对不良孕产史夫妇双方进行细胞遗传学检查,提供优生咨询,再孕指导与监测,能够有效防止患儿出生,提高出生人口素质.%Objective: To investigate the relationship of abnormal pregnancy history and karyotype abnormality in 358 couples.Methods: The G - banding Patterns of the Chromosomes in 358 couples with abnormal pregnancy history were studied by Culture of Peripheral Blood Lymphocytes. Results: 39 karyotype abnormalities were detected in 358 couples, abnomal karyotype rate was 10. 89%.Among 39 cases, 13 had chromosome satellile varaiations, 9 had pericentric inversion 9, 8 had extended secondary constriction, 7 had balanced translocations, 2 had abnormal chromosome number. The abnomal karyotype rate was same between men and women.Conclusion: The karyotype abnormality is one of the important reasons of abnormal pregnancy. Cytogenetical study, eugenic advice,pregnancy guide and monitoring for couples with abnormal pregnancy history is useful to population quality.

  19. White matter abnormalities in tuberous sclerosis complex

    Griffiths, P.D. [Sheffield Univ. (United Kingdom). Academic Dept. of Radiology; Bolton, P. [Cambridge Univ. (United Kingdom). Section of Developmental Psychiatry; Verity, C. [Addenbrooke`s NHS Trust, Cambridge (United Kingdom). Dept. of Paediatric Radiology

    1998-09-01

    The aim of this study was to investigate and describe the range of white matter abnormalities in children with tuberous sclerosis complex by means of MR imaging. Material and Methods: A retrospective cross-sectional study was performed on the basis of MR imaging findings in 20 cases of tuberous sclerosis complex in children aged 17 years or younger. Results: White matter abnormalities were present in 19/20 (95%) cases of tuberous sclerosis complex. These were most frequently (19/20 cases) found in relation to cortical tubers in the supratentorial compartment. White matter abnormalities related to tubers were found in the cerebellum in 3/20 (15%) cases. White matter abnormalities described as radial migration lines were found in relation to 5 tubers in 3 (15%) children. In 4/20 (20%) cases, white matter abnormalities were found that were not related to cortical tubers. These areas had the appearance of white matter cysts in 3 cases and infarction in the fourth. In the latter case there was a definable event in the clinical history, supporting the diagnosis of stroke. Conclusion: A range of white matter abnormalities were found by MR imaging in tuberous sclerosis complex, the commonest being gliosis and hypomyelination related to cortical tubers. Radial migration lines were seen infrequently in relation to cortical tubers and these are thought to represent heterotopic glia and neurons along the expected path of cortical migration. (orig.)

  20. White matter abnormalities in tuberous sclerosis complex

    The aim of this study was to investigate and describe the range of white matter abnormalities in children with tuberous sclerosis complex by means of MR imaging. Material and Methods: A retrospective cross-sectional study was performed on the basis of MR imaging findings in 20 cases of tuberous sclerosis complex in children aged 17 years or younger. Results: White matter abnormalities were present in 19/20 (95%) cases of tuberous sclerosis complex. These were most frequently (19/20 cases) found in relation to cortical tubers in the supratentorial compartment. White matter abnormalities related to tubers were found in the cerebellum in 3/20 (15%) cases. White matter abnormalities described as radial migration lines were found in relation to 5 tubers in 3 (15%) children. In 4/20 (20%) cases, white matter abnormalities were found that were not related to cortical tubers. These areas had the appearance of white matter cysts in 3 cases and infarction in the fourth. In the latter case there was a definable event in the clinical history, supporting the diagnosis of stroke. Conclusion: A range of white matter abnormalities were found by MR imaging in tuberous sclerosis complex, the commonest being gliosis and hypomyelination related to cortical tubers. Radial migration lines were seen infrequently in relation to cortical tubers and these are thought to represent heterotopic glia and neurons along the expected path of cortical migration. (orig.)

  1. Clinical and polygraphic improvement of breathing abnormalities after valproate in a case of Pitt-Hopkins syndrome.

    Maini, Ilenia; Cantalupo, Gaetano; Turco, Emanuela Claudia; De Paolis, Fernando; Magnani, Cinzia; Parrino, Liborio; Terzano, Mario Giovanni; Pisani, Francesco

    2012-12-01

    Pitt-Hopkins syndrome is a rare genetic form of severe psychomotor delay, caused by mutations in transcription cell factor-4 gene and characterized by distinctive dysmorphic features and abnormal breathing pattern. The current report describes the polygraphic features of the syndrome's typical breathing pattern in a patient both in wakefulness and in sleep. The control of these breathing alterations is important to prevent the neurological sequelae linked to chronic cerebral hypoxemia in early ages. No data are available on effective treatment options for breathing abnormalities of Pitt-Hopkins syndrome. The authors polygraphically documented a reduction of apneic and hypopneic phenomena, with a significant improvement in saturation values, after the introduction of sodium valproate. PMID:22378662

  2. Juvenile osteochondritis dissecans: a 5-year review of the natural history using clinical and MRI evaluation

    Although MRI prognostic features for juvenile osteochondritis dissecans (JOCD) have been determined, the natural history of JOCD on serial MRI has not been fully documented. To document the natural history of JOCD on serial MRI and to correlate this with arthroscopy and clinical outcome over a 5-year follow-up. Twenty-one knees in 19 patients (15 boys, 4 girls; age range 5-15 years) with JOCD underwent MRI and clinical follow-up over 5 years. Lesions were classified as stable or unstable on MRI and compared with clinical and arthroscopic data. On 5-year follow-up, 17 of 19 patients were asymptomatic and 2 of 19 had minimal pain. Fourteen arthroscopies were performed on 11/21 knees. One of twenty-one had fragment fixation. On initial MRI, eight knees had marked fragmentation, high signal at the fragment/bone interface and incomplete defects in the hyaline cartilage (MRI stage III-stable), but no tear. Of these, five had arthroscopy, all confirming intact cartilage. One of twenty-one knees was unstable (MRI stage IVb) with a detached osteochondral fragment, requiring surgery. Despite extensive subchondral bone changes on MRI, all cases with intact cartilage (95%) improved with conservative treatment. Early MRI allows prompt diagnosis and institution of conservative treatment. This results in healing and avoidance of surgery in most patients. (orig.)

  3. Analysis of imaging findings and clinical abnormalities in patients with lymphoma; Analise de achados de imagem e alteracoes clinicas em pacientes com linfoma

    Caldas, Flavio Augusto Ataliba; Montomiya, Carolina Tsumori [Faculdade de Medicina de Marilia, SP (Brazil)]. E-mail: flavio_caldas@hotmail.com; Silva, Helena Cristina da [Faculdade de Medicina de Marilia, SP (Brazil). Hospital de Clinicas

    2002-04-01

    Computed tomography is currently the method of choice for the diagnostic and staging of lymphomas. Computed tomography enables accurate measurements of both tumor extent and volume and provides information that can be used to plan an appropriate strategy for the treatment. The purpose of the present article is to describe and analyze the chest and abdomen computed tomography and ultrasound findings in HIV-negative patients with lymphoma. Clinical abnormalities, such as the reason the patient sought medical assistance already showing evidence of lymphocytic disease (not yet diagnosed at this point) and the physical examination abnormalities seen on the first consultation were also studied. This study comprised 30 patients: 40% with non-Hodgkin lymphoma, 46,6% with Hodgkin lymphoma, 10% with Burkitt's lymphoma and 3,3% with lymphoblastic lymphoma. (author)

  4. Impact of parental history of substance use disorders on the clinical course of anxiety disorders

    Moskowitz Amanda T

    2007-04-01

    Full Text Available Abstract Background Among the psychological difficulties seen in children of parents with substance use problems, the anxiety disorders are among the most chronic conditions. Although children of alcoholic parents often struggle with the effects of parental substance use problems long into adulthood, empirical investigations of the influence of parental substance use disorders on the course of anxiety disorders in adult offspring are rare. The purpose of this study was to examine prospectively the relationship between parental substance use disorders and the course of anxiety disorders in adulthood over the course of 12 years. Methods Data on 618 subjects were derived from the Harvard/Brown Anxiety Research Project (HARP, a longitudinal naturalistic investigation of the clinical course of multiple anxiety disorders. Kaplan-Meier survival estimates were used to calculate probabilities of time to anxiety disorder remission and relapse. Proportional hazards regressions were conducted to determine whether the likelihood of remission and relapse for specific anxiety disorders was lower for those who had a history of parental substance use disorders than for individuals without this parental history. Results Adults with a history of parental substance use disorders were significantly more likely to be divorced and to have a high school level of education. History of parental substance use disorder was a significant predictor of relapse of social phobia and panic disorders. Conclusion These findings provide compelling evidence that adult children of parents with substance use disorders are more likely to have relapses of social phobia and panic disorders. Clinicians who treat adults with anxiety disorders should assess parental substance use disorders and dependence histories. Such information may facilitate treatment planning with regards to their patients' level of vulnerability to perceive scrutiny by others in social situations, and ability to

  5. Clinical values for abnormal {sup 18}F-FDG uptake in the head and neck region of patients with head and neck squamous cell carcinoma

    Lee, Hwan Seo [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Jae Seung [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Roh, Jong-Lyel, E-mail: rohjl@amc.seoul.kr [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Choi, Seung-Ho; Nam, Soon Yuhl [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Sang Yoon [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Biomedical Research Institute, Korea Institute of Science and Technology, Seoul (Korea, Republic of)

    2014-08-15

    Highlights: • Abnormal {sup 18}F-FDG uptakes in the head and neck (HN) region can be carefully interpreted as being index primary, second primary cancer (SP) or benign. • {sup 18}F-FDG PET/CT identified 91.9% primary HN squamous cell carcinomas (HNSCC). • The specificity and negative predictive value of {sup 18}F-FDG PET/CT for identification of SP were as high as 98.7% and 99.3%, respectively. • Proper detection of primary tumors and SP in the HN region may promote appropriate therapeutic planning of HNSCC patients. - Abstract: Purpose: Fluorine 18-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET)/computed tomography (CT) is used to identify index or second primary cancer (SP) of the head and neck (HN) through changes in {sup 18}F-FDG uptake. However, both physiologic and abnormal lesions increase {sup 18}F-FDG uptake. Therefore, we evaluated {sup 18}F-FDG uptake in the HN region to determine clinical values of abnormal tracer uptake. Methods: A prospective study approved by the institutional review board was conducted in 314 patients with newly diagnosed HN squamous cell carcinoma (HNSCC) and informed consent was obtained from all enrolled patients. The patients received initial staging workups including {sup 18}F-FDG PET/CT and biopsies. All lesions with abnormal HN {sup 18}F-FDG uptake were recorded and most of those were confirmed by biopsies. Diagnostic values for abnormal {sup 18}F-FDG uptake were calculated. Results: Abnormal {sup 18}F-FDG uptake was identified in primary tumors from 285 (91.9%) patients. False-negative results were obtained for 22.3% (23/103) T1 tumors and 2.2% (2/93) T2 tumors (P < 0.001). Thirty-eight regions of abnormal {sup 18}F-FDG uptake were identified in 36 (11.5%) patients: the thyroid (n = 13), maxillary sinus (n = 7), palatine tonsil (n = 6), nasopharynx (n = 5), parotid gland (n = 2) and others (n = 5). Synchronous SP of the HN was identified in eight (2.5%) patients: the thyroid (n = 5), palatine

  6. Evolution of clinical research: A history before and beyond james lind

    Arun Bhatt

    2010-01-01

    Full Text Available The evolution of clinical research traverses a long and fascinating journey. From the first recorded trial of legumes in biblical times to the first randomized controlled of trial of streptomycin in 1946, the history of clinical trial covers a wide variety of challenges - scientific, ethical and regulatory. The famous 1747 scurvy trial conducted by James Lind contained most elements of a controlled trial. The UK Medical Research Council′s (MRC trial of patulin for common cold in 1943 was the first double blind controlled trial. This paved the way for the first randomized control trial of streptomycin in pulmonary tuberculosis carried out in 1946 by MRC of the UK. This landmark trial was a model of meticulousness in design and implementation, with systematic enrolment criteria and data collection compared with the ad hoc nature of other contemporary research. Over the years, as the discipline of controlled trials grew in sophistication and influence, the streptomycin trial continues to be referred to as ground breaking. The ethical advances in human protection include several milestones - Nuremberg Code, Declaration of Helsinki, Belmont Report, and 1996, International Conference on Harmonization Good Clinical Practice guidance. In parallel to ethical guidelines, clinical trials started to become embodied in regulation as government authorities began recognizing a need for controlling medical therapies in the early 20th century. As the scientific advances continue to occur, there will be new ethical and regulatory challenges requiring dynamic updates in ethical and legal framework of clinical trials.

  7. Correlation between Triazole Treatment History and Susceptibility in Clinically Isolated Aspergillus fumigatus

    Tashiro, Masato; Izumikawa, Koichi; Hirano, Katsuji; Ide, Shotaro; Mihara, Tomo; Hosogaya, Naoki; Takazono, Takahiro; Morinaga, Yoshitomo; Nakamura, Shigeki; Kurihara, Shintaro; Imamura, Yoshifumi; Miyazaki, Taiga; Nishino, Tomoya; Tsukamoto, Misuzu; Kakeya, Hiroshi

    2012-01-01

    This is the first report of a detailed relationship between triazole treatment history and triazole MICs for 154 Aspergillus fumigatus clinical isolates. The duration of itraconazole dosage increased as the itraconazole MIC increased, and a positive correlation was observed (r = 0.5700, P < 0.0001). The number of itraconazole-naïve isolates dramatically decreased as the itraconazole MIC increased, particularly for MICs exceeding 2 μg/ml (0.5 μg/ml versus 2 μg/ml, P = 0.03). We also examined t...

  8. Crossed pulmonary arteries: a report on 20 cases with an emphasis on the clinical features and the genetic and cardiac abnormalities.

    Babaoğlu, Kadir; Altun, Gürkan; Binnetoğlu, Köksal; Dönmez, Muhammed; Kayabey, Özlem; Anık, Yonca

    2013-01-01

    Crossed pulmonary arteries (CPAs) are a rare abnormality in which the ostium of the left pulmonary artery originates superior to the right pulmonary artery and to its right. Recognition of this rare pathology is important because it generally is accompanied by other congenital heart defects, extracardiac anomalies, and certain genetic problems. To date, only a few cases have been reported, and most of these cases have been associated with complex cardiac abnormalities. The authors detected 20 cases of CPA between June 2009 and November 2012 through their increasing awareness of this anomaly. Approximately 9,250 echocardiograms were performed during this period, and all of them also were checked for this anomaly. This report describes 20 cases of this CPA, with an emphasis on the clinical features and the genetic and cardiac abnormalities. The patients ranged in age from 1 day to 13 years at the time of the initial diagnosis. Four patients had complex cardiac pathologies such as tetralogy of Fallot, truncus arteriosus, transposition of the great arteries, and complete atrioventricular septal defect. Of the 20 patients, 11 had ventricular septal defects, and 12 had atrial septal defects. Pulmonary artery stenosis was detected in 12 (55 %) of the 20 patients. Aortic arch abnormalities such as interrupted aortic arch, right aortic arch, and coarctation of the aorta were detected in six patients. One patient had a left persistent superior vena cava. In 45 % of the cases, an associated genetic syndrome (DiGeorge-, Noonan-, Holt-Oram syndromes, vertebral, anal, cardiac, tracheal, esophageal, renal, limb anomalies [VACTERL] anomalies) was present. These syndromes were diagnosed based on their clinical features. Karyotype and fluorescent in situ hybridization (FISH) analyses for a 22q11 deletion were performed for 11 patients, with 10 patients found to have normal karyotype and FISH results. Only one patient had a 22q11 deletion. Six patients underwent successful operations

  9. Small vessel vasculitis History, classification, etiology, histopathology, clinic, diagnosis and treatment

    Small-vessel vasculitis is a convenient descriptor for a wide range of diseases characterized by vascular inflammation of the venules, capillaries, and/or arterioles with pleomorphic clinical manifestations. The classical clinical phenotype is leucocytoclastic vasculitis with palpable purpura, but manifestations vary widely depending upon the organs involved. Histopathologic examination in leucocytoclastic vasculitis reveals angiocentric segmental inflammation, fibrinoid necrosis, and a neutrophilic infiltrate around the blood vessel walls with erythrocyte extravasation. The etiology of small-vessel vasculitis is unknown in many cases, but in others, drugs, post viral syndromes, malignancy, primary vasculitis such as microscopic polyarteritis, and connective tissue disorders are associated, The diagnosis of small- vessel vasculitis relies on a thorough history and physical examination, as well as relevant antibody testing including antinuclear antibody and anti neutrophil cytoplasmic antibody, hepatitis B and C serologies, assessment of complement, immunoglobulins, blood count, serum creatinine liver function tests, urinalysis, radiographic imaging and biopsy. The treatment is based primarily on corticosteroid and immunosuppressive agents

  10. Status of Toxoplasma gondii infection in pregnant women with an abnormal pregnancy history%异常妊娠史孕妇弓形虫感染情况调查

    刘长生

    2011-01-01

    Fluorescent quantitation PCR (FQ-PCR) was used to detect toxoplasmosis infection in 419 pregnant women with an abnormal pregnancy history and 178 pregnant women with a normal pregnancy history. Pregnant women who tested positive also received effective treatment. Women with an abnormal pregnancy history tested positive for toxoplasmosis at a rate of 22. 2%(93/419) and while women with a normal pregnancy history did so at a rate of 4. 49% (8/178) (x2 =23. 44, P0. 05). After treatment, 85. 14% of the women with a toxoplasmosis infection (86/101) no longer tested positive for the infection.%采用实时荧光定量PCR调查了419例有异常妊娠史孕妇和178例无异常妊娠史孕妇(对照组)弓形虫感染情况,结果两组孕妇弓形虫感染率分别为22.20%(93/419)和4.49 %(8/178),差异有统计学意义(X2=23.44,P0.05).101例弓形虫感染者经药物治疗后转阴率为85.14% (86/101).

  11. Integrated Genomic Analysis Identifies Clinically Relevant Subtypes of Glioblastoma Characterized by Abnormalities in PDGFRA, IDH1, EGFR, and NF1

    Verhaak, Roel GW; Hoadley, Katherine A; Purdom, Elizabeth; Wang, Victoria; Qi, Yuan; Wilkerson, Matthew D; Miller, C Ryan; Ding, Li; Golub, Todd; Mesirov, Jill P; Alexe, Gabriele; Lawrence, Michael; O' Kelly, Michael; Tamayo, Pablo; Weir, Barbara A; Gabriel, Stacey; Winckler, Wendy; Gupta, Supriya; Jakkula, Lakshmi; Feiler, Heidi S; Hodgson, J Graeme; James, C David; Sarkaria, Jann N; Brennan, Cameron; Kahn, Ari; Spellman, Paul T; Wilson, Richard K; Speed, Terence P; Gray, Joe W; Meyerson, Matthew; Getz, Gad; Perou, Charles M; Hayes, D Neil; Network, The Cancer Genome Atlas Research

    2009-09-03

    The Cancer Genome Atlas Network recently cataloged recurrent genomic abnormalities in glioblastoma multiforme (GBM). We describe a robust gene expression-based molecular classification of GBM into Proneural, Neural, Classical, and Mesenchymal subtypes and integrate multidimensional genomic data to establish patterns of somatic mutations and DNA copy number. Aberrations and gene expression of EGFR, NF1, and PDGFRA/IDH1 each define the Classical, Mesenchymal, and Proneural subtypes, respectively. Gene signatures of normal brain cell types show a strong relationship between subtypes and different neural lineages. Additionally, response to aggressive therapy differs by subtype, with the greatest benefit in the Classical subtype and no benefit in the Proneural subtype. We provide a framework that unifies transcriptomic and genomic dimensions for GBM molecular stratification with important implications for future studies.

  12. Magnetic Resonance Imaging of Patients With Chronic Lateral Epicondylitis: Is There a Relationship Between Magnetic Resonance Imaging Abnormalities of the Common Extensor Tendon and the Patient's Clinical Symptom?

    Qi, Liang; Zhang, Yu-Dong; Yu, Rong-Bin; Shi, Hai-Bin

    2016-02-01

    The aim of the study is to determine the inter-reliability and intra-observer reliability of magnetic resonance imaging (MRI) for lateral epicondylitis and investigate whether there is a potential relationship between MRI abnormalities of the common extensor tendon (CET) and its clinical symptom.The study group comprised 96 consecutive patients (46 men and 50 women) with a clinical diagnosis of chronic lateral epicondylitis, which were examined on 3.0 T MR. An MRI scoring system was used to grade the degree of tendinopahty. Three independent musculoskeletal radiologists, who were blinded to the patients' clinical information, scored images separately. Clinical symptoms were assessed using the Patient-Rated Tennis Elbow Evaluation (PRTEE).Of all the patients, total 96 elbows had MRI-assessed tendinopathy, including 38 (39.6%) with grade 1, 31 (32.3%) with grade 2, and 27 (28.1%) with grade 3. Inter-observer reliability and intra-observer agreement for MRI interpretation of the grades of tendinopathy was good, and a positive correlation between the grades of tendinopathy and PRTEE was determined.MRI is a reliable tool in determining radiological severity of chronical lateral epicondylitis. The severity of MR signal changes positively correlate with the patient's clinical symptom. PMID:26844506

  13. "Addicted to Euphoria": The History, Clinical Presentation, and Management of Party Drug Misuse.

    Bearn, Jenny; O'Brien, Matthew

    2015-01-01

    Eating, drinking, sexual activity, and parenting invoke pleasure, an emotion that promotes repetition of these behaviors, are essential for survival. Euphoria, a feeling or state of intense excitement and happiness, is an amplification of pleasure, aspired to one's essential biological needs that are satisfied. People use party drugs as a shortcut to euphoria. Ecstasy (3,4-methylenedioxymethamphetamine), γ-hydroxybutyric acid, and ketamine fall under the umbrella of the term "party drugs," each with differing neuropharmacological and physiological actions. This chapter seeks to survey the history and epidemiology of party drug use; we will then discuss the pharmacological characteristics of each drug to provide a platform for understanding the difficulties that party drug users encounter through intoxication, harmful use, dependence, and withdrawal and how these should be clinically managed. PMID:26070759

  14. Congenital Abnormalities

    ... blood flow to the fetus impair fetal growth. Alcohol consumption and certain drugs during pregnancy significantly increase the risk that a baby will be born with abnormalities (e.g. fetal alcohol spectrum disorders ). Eating raw or uncooked foods during pregnancy can also be dangerous to health of the ...

  15. Topographic abnormalities of proinsulin to insulin conversion in functioning human insulinomas. Comparison of immunoelectron microscopic and clinical data.

    Roth, J; Komminoth, P; Heitz, P. U.

    1995-01-01

    It has been proposed that the major defect in human insulinomas is a decreased hormone storage capacity resulting in uncontrolled release of proinsulin and insulin. By immunoelectron microscopy with monoclonal antibodies we studied the subcellular distribution of proinsulin and insulin in benign and malignant functioning insulinomas of different histology and compared the findings with various clinical and pathohistological parameters. We found that, in contrast to normal B cells, the proinsu...

  16. Familial history of diabetes and clinical characteristics in Greek subjects with type 2 diabetes

    Apostolou Ourania

    2009-04-01

    Full Text Available Abstract Background A lot of studies have showed an excess maternal transmission of type 2 diabetes (T2D. The aim, therefore, of the present study was to estimate the prevalence of familial history of T2D in Greek patients, and to evaluate its potential effect on the patient's metabolic control and the presence of diabetic complications. Methods A total of 1,473 T2D patients were recruited. Those with diabetic mothers, diabetic fathers, diabetic relatives other than parents and no known diabetic relatives, were considered separately. Results The prevalence of diabetes in the mother, the father and relatives other than parents, was 27.7, 11.0 and 10.7%, respectively. Patients with paternal diabetes had a higher prevalence of hypertension (64.8 vs. 57.1%, P = 0.05 and lower LDL-cholesterol levels (115.12 ± 39.76 vs. 127.13 ± 46.53 mg/dl, P = 0.006 than patients with diabetes in the mother. Patients with familial diabetes were significantly younger (P 2, P = 0.08, higher prevalence of dyslipidemia (49.8 vs. 44.6%, P = 0.06 and retinopathy (17.9 vs. 14.5%, P = 0.08 compared with patients with no diabetic relatives. No difference in the degree of metabolic control and the prevalence of chronic complications were observed. Conclusion The present study showed an excess maternal transmission of T2D in a sample of Greek diabetic patients. However, no different influence was found between maternal and paternal diabetes on the clinical characteristics of diabetic patients except for LDL-cholesterol levels and presence of hypertension. The presence of a family history of diabetes resulted to an early onset of the disease to the offspring.

  17. Correlation between severity of perfusion abnormalities with clinical symptoms and risk factors for CAD in patients with mild to moderate coronary artery stenosis (50-75%)

    Full text: Aim: Evaluate the relationship between the severity of perfusion abnormalities, clinical symptoms and risk factors for coronary artery diseases (CAD) in patients with mild to moderate coronary artery stenosis. Material and methods: 136 patents were included in the study, of which 44 with angiographically proven mild to moderate (50-75%) coronary artery stenosis (1st group) and 9 without stenosis (2nd group) from a total of 136 patients who had undergone Tl-201 and Tc99m tetrofosmine myocardial perfusion SPECT and coronary angiography. As a risk factors for CAD we included: hyperlipidaemia, hypertension and diabetes mellitus. As clinical symptom we included chest pain. According myocardial perfusion scintigraphy (MPS) findings of all patients were evaluated according severity of the perfusion defects on MPS and not the extent of them. Results: In the 1st group of patients there is higher incidence of diabetic patients (twice more) and hypertensive (1/3 more) patients than in the second group without CA stenosis. In addition no significant difference was found in the number of patients without risk factors in both groups. The mean number of clinical symptoms for 1 patient in both groups was not statistically significant 1,54 ± 0,24 and 1,25 ± 0,25 respectively, P>0,5. In the 1st group of patients 77,4% of them have reversible myocardial ischemia ,18,1% MI and only 4.5% normal perfusion uptake. Moderate reversible myocardial ischemia was detected in 44.5% of patients of the second group. Comparing the two groups of patients showing moderate reversible myocardial ischemia, (50-75% stenosis and without stenosis), the presence of risk factors was not statistically significant (1,64±0,16 and 1,27±0,32,p-0, 2). Conclusion: No relationship was found between the severity of perfusion abnormalities, clinical symptoms and risk factors of CAD in patients with mild to moderate coronary artery stenosis

  18. A review of blood substitutes: examining the history, clinical trial results, and ethics of hemoglobin-based oxygen carriers

    Jiin-Yu Chen; Michelle Scerbo; George Kramer

    2009-01-01

    The complications associated with acquiring and storing whole blood for transfusions have launched substantial efforts to develop a blood substitute. The history of these efforts involves a complicated mixture of science, ethics, and business. This review focuses on clinical trials of the three hemoglobin-based oxygen carriers (HBOC) that have progressed to Phase II or III clinical trials: He-mAssist (Baxter; Deerfield, IL, US), PolyHeme (Northfield; Evanston, IL, US), and Hemopure (Biopure; ...

  19. Reversible splenial abnormality in hypoglycemic encephalopathy

    Kim, Ji Hyun; Choi, Jeong Yoon; Koh, Seong-Beom [Korea University School of Medicine, Department of Neurology, Guro Hospital, Seoul (Korea); Lee, Younghen [Korea University School of Medicine, Department of Radiology, Ansan Hospital, Ansan City (Korea)

    2007-03-15

    Lesions involving the splenium of the corpus callosum (SCC) have been rarely reported in cases of hypoglycemic brain injury. We identified signal abnormalities in the SCC in three adult patients with hypoglycemic encephalopathy by using diffusion-weighted imaging (DWI) on a 1.5-T MR scanner. Repeat DWI was performed in all patients following a marked clinical improvement, and MR angiography and routine MRI were also performed. We examined each patient's detailed medical history and blood laboratory tests in order to exclude other conditions causing similar SCC abnormalities. Initial DWI was performed during which each patient showed altered mental status that was attributed to profound hypoglycemia. We observed an identical pattern of DWI abnormality characterized by high signals in the SCC with apparent diffusion coefficient reductions that were reversed completely within several days following appropriate correction of hypoglycemia. T2-weighted or FLAIR images also showed no residual lesion in the SCC and MR angiography was normal in all patients. These case reports suggest that the SCC should be added to the list of selective vulnerability to hypoglycemia and that hypoglycemia, in turn, be included in the differential diagnosis of reversible SCC abnormalities. (orig.)

  20. Reversible splenial abnormality in hypoglycemic encephalopathy

    Lesions involving the splenium of the corpus callosum (SCC) have been rarely reported in cases of hypoglycemic brain injury. We identified signal abnormalities in the SCC in three adult patients with hypoglycemic encephalopathy by using diffusion-weighted imaging (DWI) on a 1.5-T MR scanner. Repeat DWI was performed in all patients following a marked clinical improvement, and MR angiography and routine MRI were also performed. We examined each patient's detailed medical history and blood laboratory tests in order to exclude other conditions causing similar SCC abnormalities. Initial DWI was performed during which each patient showed altered mental status that was attributed to profound hypoglycemia. We observed an identical pattern of DWI abnormality characterized by high signals in the SCC with apparent diffusion coefficient reductions that were reversed completely within several days following appropriate correction of hypoglycemia. T2-weighted or FLAIR images also showed no residual lesion in the SCC and MR angiography was normal in all patients. These case reports suggest that the SCC should be added to the list of selective vulnerability to hypoglycemia and that hypoglycemia, in turn, be included in the differential diagnosis of reversible SCC abnormalities. (orig.)

  1. Publishing history does not correlate with clinical performance among internal medicine residents.

    Cavalcanti, Rodrigo B; Detsky, Allan S

    2010-05-01

    OBJECTIVES Selection criteria for applicants to the internal medicine programme at the University of Toronto have included the number and quality of scholarly items published. We sought to determine whether previous publishing record correlated with resident performance as measured by in-training evaluation reports (ITERs) and global impressions of clinical competency by site programme directors and senior educators (global impression). METHODS Data on the total number, quality and type of items published, as well as the timing of publishing with regard to pre-MD training, were abstracted from the curricula vitae of individuals who applied for residency during 2001-2005. These were correlated with overall, Expert and Scholar role ITER scores, and with global impression, using Spearman rank correlation scores. RESULTS We gathered publishing history data on 181 residents, for 162 of whom ITER data were available. Overall, 68.5% of residents had published, but only 14.9% had published during medical school. There was a weak correlation of borderline significance (rho = 0.15, P = 0.055) between overall ITER score and number of items published. No such correlation was found with CanMEDS Medical Expert and Scholar role scores. Global impression classified 33.9% of residents as top-rated. More top-rated residents had published (76.7% versus 65.1%; P = 0.07), but the number of items published during medical school were similar between top-rated and non-top-rated residents (16.1% versus 12.3%; P = 0.46). CONCLUSIONS Our results do not support publishing record as a predictor of residents' clinical performance. Surprisingly, the correlation between publishing record and Scholar role scores was also weak, possibly indicating an inability of the ITER to capture this competency. Further research is needed to identify predictors and measures of performance in scholarly activities. PMID:20345694

  2. Retrospective database analysis of clinical outcomes and costs for treatment of abnormal uterine bleeding among women enrolled in US Medicaid programs

    Bonafede MM

    2014-10-01

    Full Text Available Machaon M Bonafede,1 Jeffrey D Miller,1 Shannon K Laughlin-Tommaso,2 Andrea S Lukes,3 Nicole M Meyer,1 Gregory M Lenhart1 1Truven Health Analytics, Cambridge MA, 2Mayo Clinic, Department of Obstetrics and Gynecology, Rochester, MN, 3Women's Wellness Clinic and Research Center, Durham, NC, USA Background: Women with abnormal uterine bleeding (AUB may be treated surgically with hysterectomy or global endometrial ablation (GEA, an outpatient procedure. We compared the costs and clinical outcomes of these surgical procedures for AUB among women in Medicaid programs.Methods: The Truven Health MarketScan® Medicaid Multi-State Database was used to identify Medicaid women aged 30–55 years with AUB who newly initiated GEA or hysterectomy (index event during 2006–2010. Patients were required to have 12 months of continuous enrollment pre-index and post-index. Baseline characteristics were assessed in the pre-index period; health care utilization and costs (2011 USD, treatment complications, and reinterventions were assessed in the post-index period.Results: Of 1,880 women who met the study criteria (mean age 40.7 years, 53.4% were Caucasian, 33.1% were African-American, and 2.3% were Hispanic; many (42.8% received their Medicaid eligibility due to disability. Similar proportions received GEA (50.9% or hysterectomy (49.1%. At baseline, both groups also had similar Deyo-Charlson Comorbidity scores (0.65, and use of antibiotics (69.4%, nonsteroidal anti-inflammatory drugs (56.3%, and oral contraceptives (5.3%. More hysterectomy patients than GEA patients had a treatment-related complication (52% versus 36%, respectively, P<0.001. Initial treatment costs were higher for hysterectomy ($11,270 than for GEA ($3,958, P<0.001; monthly gynecology-related costs in the remainder of the year were not significantly different for hysterectomy ($63 and GEA ($16, P=0.11.Conclusion: Hysterectomy was nearly three times more costly than GEA for initial treatment of AUB

  3. Autism and chromosome abnormalities-A review.

    Bergbaum, Anne; Ogilvie, Caroline Mackie

    2016-07-01

    The neuro-behavioral disorder of autism was first described in the 1940s and was predicted to have a biological basis. Since that time, with the growth of genetic investigations particularly in the area of pediatric development, an increasing number of children with autism and related disorders (autistic spectrum disorders, ASD) have been the subject of genetic studies both in the clinical setting and in the wider research environment. However, a full understanding of the biological basis of ASDs has yet to be achieved. Early observations of children with chromosomal abnormalities detected by G-banded chromosome analysis (karyotyping) and in situ hybridization revealed, in some cases, ASD associated with other features arising from such an abnormality. The introduction of higher resolution techniques for whole genome screening, such as array comparative genome hybridization (aCGH), allowed smaller imbalances to be detected, some of which are now considered to represent autism susceptibility loci. In this review, we describe some of the work underpinning the conclusion that ASDs have a genetic basis; a brief history of the developments in genetic analysis tools over the last 50 years; and the most common chromosome abnormalities found in association with ASDs. Introduction of next generation sequencing (NGS) into the clinical diagnostic setting is likely to provide further insights into this complex field but will not be covered in this review. Clin. Anat. 29:620-627, 2016. © 2016 Wiley Periodicals, Inc. PMID:27012322

  4. 临床综合分析及治疗儿童多瞬症%Clinical comprehensive analysis and treatment of children abnormal blinking

    宿可昕; 王兴民; 马娟; 姜红; 魏秀华; 徐晶

    2015-01-01

    Objective To study the curative effect of integrated Chinese and Western medicines treatment by clinical practical observation, visual function training, drug therapy and psychological guidance in the treatment of children abnormal blinking.Methods Treatment was given according to pathogenesis of 168 children abnormal blinking cases by detailed inquiry, visual function examination and eye examination. Visual function training, drug therapy and psychological guidance were given as integrated Chinese and Western treatment.Results After receiving treatment, there were 126 cured cases in 1 course, accounting for 75.0% and 41 cured cases in 2 courses, accounting for 24.4%, while only 1 case with relieved symptoms (psychological factors).Conclusion Therapies of integrated Chinese and Western medicines can effectively treat children abnormal blinking by visual function training, lysine alkamine vitamin B12, Stulln, Gegenshumu decoction, and psychological guidance.%目的:探讨通过临床实践观察、视功能训练、药物及心理辅导等中西医结合方法治疗儿童多瞬症的疗效。方法通过详尽问诊、视功能检查及眼部检查了解明确168例儿童多瞬症发生的病因,按因施治,然后通过视功能训练、药物及心理辅导等中西医结合方法治疗儿童多瞬症。结果经治疗,1个疗程治愈者126例,占总人数的75.0%;2个疗程治愈者41例,占总人数的24.4%,只有1例患儿(心理因素)症状缓解。结论视功能训练、赖氨基醇维生素B12、施图伦、葛根舒目汤、心理辅导等中西医方法相结合可有效的治疗儿童多瞬症。

  5. A brief conversation analytic communication intervention can change history-taking in the seizure clinic.

    Jenkins, Laura; Cosgrove, Jeremy; Ekberg, Katie; Kheder, Ammar; Sokhi, Dilraj; Reuber, Markus

    2015-11-01

    Question design during history-taking has clear implications for patients' ability to share their concerns in general and their seizure experiences in particular. Studies have shown that unusually open questions at the start of the consultation enable patients to display interactional and linguistic markers which may help with the otherwise challenging differentiation of epileptic from nonepileptic seizures (NES). In this study, we compared the problem presentation approach taken by trainee neurologists in outpatient encounters with new patients before and after a one-day conversation analytic training intervention in which doctors were taught to adopt an open format of question design and recognize diagnostically relevant linguistic features. We audio/video-recorded clinical encounters between ten doctors, their patients, and accompanying persons; transcribed the interactions; and carried out quantitative and qualitative analyses. We studied 39 encounters before and 55 after the intervention. Following the intervention, doctors were significantly more likely to use nondirective approaches to soliciting patient accounts of their presenting complaints that invited the patient to describe their problems from their own point of view and gave them better opportunity to determine the initial agenda of the encounter. The time to first interruption by the doctor increased (from 52 to 116 s, p<.001). While patients were given more time to describe their seizure experiences, the overall appointment length did not increase significantly (19 vs 21 min, n.s.). These changes gave patients more conversational space to express their concerns and, potentially, to demonstrate the interactional and linguistic features previously found to help differentiate between epilepsy and NES, without impacting the length of the consultations. PMID:26409131

  6. Abnormal skull shape: clinical management

    Dover, M.S. [Birmingham Children' s Hospital, West Midlands Supra-regional Craniofacial Unit, Birmingham (United Kingdom)

    2008-06-15

    Little has changed in terms of the surgery over the past 40 years, with many of the original principles still holding true. Where significant changes have occurred it is in the understanding of the genetic basis of these conditions, earlier diagnosis, better paediatric anaesthesia and vastly superior imaging techniques. The latter have been instrumental in accurate diagnosis, the pre-planning of surgery and in quantifying outcome. (orig.)

  7. Knowledge of family history as a clinically useful index of psychological well-being and prognosis: A brief report.

    Duke, Marshall P; Lazarus, Amber; Fivush, Robyn

    2008-06-01

    Based on an instance of "clinical lore" we assess the efficacy of children's and adolescents' knowledge of family history as an index of psychological well-being and potential for positive change in clinical and educational settings. We report that knowledge of family history is significantly correlated with internal locus of control, higher self-esteem, better family functioning, greater family cohesiveness, lower levels of anxiety, and lower incidence of behavior problems. We suggest that through the use of a brief measure of family knowledge, practicing clinicians can rapidly generate a data-based correlate of children's well-being and likelihood of overcoming psychological and educational challenges. (PsycINFO Database Record (c) 2010 APA, all rights reserved). PMID:22122420

  8. Portal hypertensive gastropathy: A systematic review of thepathophysiology, clinical presentation, natural history andtherapy

    2016-01-01

    AIM To describe the pathophysiology, clinical presentation,natural history, and therapy of portal hypertensivegastropathy (PHG) based on a systematic literaturereview.METHODS: Computerized search of the literature wasperformed via PubMed using the following medicalsubject headings or keywords: "portal" and "gastropathy";or "portal" and "hypertensive"; or "congestive"and "gastropathy"; or "congestive" and "gastroenteropathy".The following criteria were applied for studyinclusion: Publication in peer-reviewed journals, andpublication since 1980. Articles were independentlyevaluated by each author and selected for inclusionby consensus after discussion based on the followingcriteria: Well-designed, prospective trials; recent studies;large study populations; and study emphasis on PHG.RESULTS: PHG is diagnosed by characteristic endoscopicfindings of small polygonal areas of variableerythema surrounded by a pale, reticular border in amosaic pattern in the gastric fundus/body in a patientwith cirrhotic or non-cirrhotic portal hypertension. Histologicfindings include capillary and venule dilatation,congestion, and tortuosity, without vascular fibrinthrombi or inflammatory cells in gastric submucosa.PHG is differentiated from gastric antral vascular ectasiaby a different endoscopic appearance. The etiology ofPHG is inadequately understood. Portal hypertensionis necessary but insufficient to develop PHG becausemany patients have portal hypertension without PHG.PHG increases in frequency with more severe portalhypertension, advanced liver disease, longer liver diseaseduration, presence of esophageal varices, and endoscopicvariceal obliteration. PHG pathogenesis is related to ahyperdynamic circulation, induced by portal hypertension,characterized by increased intrahepatic resistance toflow, increased splanchnic flow, increased total gastricflow, and most likely decreased gastric mucosal flow.Gastric mucosa in PHG shows increased

  9. History of the Clinical Institute of Radiology in Ljubljana on its 80th anniversary (1923-2003). Historia Magistra Vitae

    Background. The manuscript presents a short history of the Clinical Radiology Institute in Ljubljana, University Clinical Centre, and the leading radiological institution in Slovenia since its establishment in 1923. Throughout its history the Institute has been faced with numerous obstacles. Its major problems have always included the lack of professional and economical independence, which has made it difficult for the Institute to keep up with the fast technological development of the world's radiology, as well as the shortage of radiologists and radiographers with the consequence of the excessive work load and difficulties in educational and research activities. Despite some serious problems the expertise of the Institute's leadership, together with the enthusiasm of all radiologists and radiographers, has enabled a continuous professional and technological development which is the basis of today's high quality diagnostic and interventional radiology. Many of the remarkable achievements would not have been possible without some extraordinary personalities who laid down the solid foundations of today's Institute. Conclusions. Eighty years of Clinical Radiology Institute in Ljubljana is a history of the successful development of the republic's leading radiological institution, a success based on determination, unity and the professional integrity of all its members and management. (author)

  10. Signs and symptoms of developmental abnormalities of the genitourinary tract

    Paulo Cesar Koch Nogueira

    2016-06-01

    Full Text Available Abstract Objective: The abnormalities of the genitourinary tract development are the leading cause of chronic kidney disease (CKD in children. The diagnosis of this disease in Brazil is late and incomplete, which results in increased morbidity and mortality in this age group. Early diagnosis of this condition is the prerogative of generalist pediatricians, and the aim of this study was to review the clinical signs and symptoms associated with developmental abnormalities of the genitourinary tract. Data sources: Based on the description of a symbolic clinical case, the authors conducted a non-systematic review of medical literature. Data synthesis: The results suggest that the following data should be used as a warning for early diagnosis of affected children: (a combined urinary tract abnormalities (chromosomal abnormalities; sequence of malformations [VACTERLand Prune-Belly]; and musculoskeletal, digestive tract, heart, and nervous system malformations; (b previous history (congenital anomalies of the kidney and urinary tract [CAKUT] in the family, low birth weight, and oligoamnios; (c clinical signs (polyuria/nocturia, urinary tract infection, systemic arterial hypertension, failure to thrive, weak urinary stream, difficulty to start urination, distended bladder, non-monosymptomatic enuresis, urinary/urge incontinence, and bowel and bladder dysfunction; and (d pre- and postnatal ultrasonographic alterations (increased anteroposterior diameter of the renal pelvis, mainly in the third trimester of pregnancy; single kidney; hydronephrosis associated with other abnormalities; and hydronephrosis with parenchymal involvement in the post-neonatal assessment. Conclusion: The suggestions shown here can help the pediatrician to establish clinical hypotheses for the early diagnosis of developmental abnormalities of the genitourinary tract without resorting to expensive and invasive procedures.

  11. An audit comparing the discrepancies between a verbal enquiry, a written history, and an electronic medical history questionnaire: a suggested medical history/social history form for clinical practice.

    Carey, Barbara

    2011-04-01

    In everyday practice, dentists are confronted with an increasing number of patients with complex medical problems. There is divergence of opinion among dentists regarding how to obtain a thorough medical\\/social history.

  12. Splenic mass with remote trauma history: a management dilemma.

    McCarthy, C J

    2012-02-01

    BACKGROUND: Delayed presentation of splenic trauma is a well described entity. METHOD: We report two patients who presented with splenic abnormality found incidentally on imaging for other medical problems. A remote history of splenic trauma was elicited during clinical evaluation; 18 months in one patient and 11 years in the second patient. Both patients underwent surgical exploration. CONCLUSIONS: Radiological investigations could not reassure us that the splenic abnormalities were benign, and their management was the subject of some debate.

  13. Splenic mass with remote trauma history: a management dilemma.

    McCarthy, C J

    2011-03-02

    BACKGROUND: Delayed presentation of splenic trauma is a well described entity. METHOD: We report two patients who presented with splenic abnormality found incidentally on imaging for other medical problems. A remote history of splenic trauma was elicited during clinical evaluation; 18 months in one patient and 11 years in the second patient. Both patients underwent surgical exploration. CONCLUSIONS: Radiological investigations could not reassure us that the splenic abnormalities were benign, and their management was the subject of some debate.

  14. Comparison of Postpartum and Nonpostpartum Depression: Clinical Presentation, Psychiatric History, and Psychosocial Functioning.

    Whiffen, Valerie E.; Gotlib, Ian H.

    1993-01-01

    Compared postpartum women diagnosed with depression with nonpostpartum depressed group and two nondepressed groups. Postpartum depression tended to be relatively mild. Both depressed groups had high rates of positive psychiatric history and were equally likely to have recovered at six-month follow-up. Findings suggest little to distinguish…

  15. Ultrasonography of splenic abnormalities

    Ming-Jen Chen; Ming-Jer Huang; Wen-Hsiung Chang; Tsang-En Wang; Horng-Yuan Wang; Cheng-Hsin Chu; Shee-Chan Lin; Shou-Chuan Shih

    2005-01-01

    AIM: This report gives a comprehensive overview of ultrasonography of splenic abnormalities. Certain ultrasonic features are also discussed with pathologic correlation.METHODS: We review the typical ultrasonic characteristics of a wide range of splenic lesions, illustrating them with images obtained in our institution from 2000 to 2003.One hundred and three patients (47 men, 56 women),with a mean age of 54 years (range 9-92 years), were found to have an abnormal ultrasonic pattern of spleen.RESULTS: We describe the ultrasonic features of various splenic lesions such as accessory spleen, splenomegaly,cysts, cavernous hemangiomas, lymphomas, abscesses,metastatic tumors, splenic infarctions, hematomas, and rupture, based on traditional gray-scale and color Doppler sonography.CONCLUSION: Ultrasound is a widely available, noninvasive,and useful means of diagnosing splenic abnormalities. A combination of ultrasonic characteristics and clinical data may provide an accurate diagnosis. If the US appearance alone is not enough, US may also be used to guide biopsy of suspicious lesions.

  16. Off-label psychopharmacologic prescribing for children: History supports close clinical monitoring

    Fegert Joerg M

    2008-09-01

    Full Text Available Abstract The review presents pediatric adverse drug events from a historical perspective and focuses on selected safety issues associated with off-label use of medications for the psychiatric treatment of youth. Clinical monitoring procedures for major psychotropic drug classes are reviewed. Prior studies suggest that systematic treatment monitoring is warranted so as to both minimize risk of unexpected adverse events and exposures to ineffective treatments. Clinical trials to establish the efficacy and safety of drugs currently being used off-label in the pediatric population are needed. In the meantime, clinicians should consider the existing evidence-base for these drugs and institute close clinical monitoring.

  17. Clinical and polysomnographic predictors of the Natural History of poor sleep in the general population

    Fernandez-Mendoza, Julio; Vgontzas, Alexandros N.; Bixler, Edward O.; Singareddy, Ravi; Shaffer, Michele L.; Calhoun, Susan L.; KARATARAKI, MARIA; Vela-Bueno, Antonio; Liao, Duanping

    2012-01-01

    Study Objectives: Approximately 8-10% of the general population suffers from chronic insomnia, whereas another 20-30% of the population has insomnia symptoms at any given time (i.e., poor sleep). However, few longitudinal studies have examined risk factors of the natural history of poor sleep, and none have examined the role of polysomnographic (PSG) variables. Design: Representative longitudinal study. Setting: Sleep laboratory. Participants: From a random, general population ...

  18. Problems for clinical judgement: 2. Obtaining a reliable past medical history

    Redelmeier, Donald A.; Jack V Tu; Schull, Michael J; Ferris, Lorraine E.; Hux, Janet E.

    2001-01-01

    ORDINARY HUMAN REASONING MAY LEAD PATIENTS to provide an unreliable history of past experiences because of errors in comprehension, recall, evaluation and expression. Comprehension of a question may change depending on the definition of periods of time and prior questions. Recall fails through the loss of relevant information, the fabrication of misinformation and distracting cues. Evaluations may be mistaken because of the “halo effect” and a reluctance to change personal beliefs. Expression...

  19. Clinical characteristics of chemical sensitivity: an illustrative case history of asthma and MCS.

    Ross, G H

    1997-01-01

    A case history of the induction of asthma and chemical sensitivity in a 42-year-old registered nurse illustrates several of the characteristic features of multiple chemical sensitivity (MCS). This patient's problems started shortly after moving into a new home under construction, with associated chemical exposures. Other MCS patients report the onset of the condition with other chemical exposures such as those encountered at their places of work or use of pesticides at their residences. Patie...

  20. Effect of Family History on Outcomes in Patients Treated With Definitive Brachytherapy for Clinically Localized Prostate Cancer

    Purpose: To determine the impact familial prostate cancer has on prognosis in men treated with brachytherapy for clinically localized prostate cancer. Methods and Materials: A total of 1,738 consecutive patients with prostate cancer (cT1-3, N0/X, M0) received low-dose-rate brachytherapy alone or in combination with external beam radiation therapy or hormone ablation from 1992 to 2005. The primary end-point was freedom from biochemical failure (FFBF) using the Phoenix definition. Minimum follow-up was 2 years and the median follow-up was 60 months (range, 24-197 months). Results: A total of 187 of 1,738 men (11%) had a family history of prostate cancer in a first-degree relative. For the low-risk patients, both groups had similar actuarial 5-year FFBF (97.2% vs. 95.5%, p = 0.516). For intermediate-risk patients, there was a trend toward improved biochemical control in men positive for family history (5-yr FFBF 100% vs. 93.6%, p = 0.076). For the high-risk patients, men with a positive family history had similar 5-year FFBF (92.8% vs. 85.2%, p = 0.124). On multivariate analysis, family history was not significant; use of hormones, high biologic effective dose, initial prostate-specific antigen value, and Gleason score were the significant variables predicting biochemical control. Conclusions: This is the first study to examine the relationship of familial prostate cancer and outcomed in men treated with brachytherapy alone or in combination therapy. Men with a positive family history have clinicopathologic characteristics and biochemical outcomes similar to those with sporadic disease

  1. α1-Antitrypsin deficiency • 3: Clinical manifestations and natural history

    Needham, M; Stockley, R

    2004-01-01

    A review of the clinical manifestations of α1-antitrypsin (AAT) deficiency, including lung disease and liver disease, and risk factors affecting the rate of decline in lung function in AAT deficient patients.

  2. Gender Differences in HIV-Related Perceptions, Sexual Risk Behaviors, and History of Sexually Transmitted Diseases Among Chinese Migrants Visiting Public Sexually Transmitted Disease Clinics

    Wang, Bo; Li, Xiaoming; Stanton, Bonita; Fang, Xiaoyi; LIANG, GUOJUN; Liu, Hui; Lin, Danhua; Yang, Hongmei

    2007-01-01

    The goal of this study was to explore gender difference in HIV-related perceptions according to a social cognitive theory and sexual risk behaviors and to examine associations between mobility, sexual risk, and history of sexually transmitted diseases (STDs) among male and female migrants visiting STD clinics. A cross-sectional study among migrants visiting STD clinics in three large cities in China assessed HIV-related perceptions, sexual activity, condom use, and history of STDs was used. A...

  3. Clinical and genetic challenges in a family with history of childhood polyp, aortopathy, and clinical diagnosis of hereditary hemorrhagic teleangiectasia (HHT)

    Kadiyska, Tanya; Nossikoff, Alexander; Kratunkov, Pencho; Hachmerian, Mary; Angelova, Ludmila

    2016-01-01

    Hereditary hemorrhagic teleangiectasia (HHT) is a genetic disorder, characterized by abnormal vessel formation and arteriovenous malformations (AVMs). The so-called “Curaçao criteria” are most commonly employed for the purposes of clinical diagnosis. However, children may not exhibit the full magnitude of symptoms and the Curaçao criteria appear to be less sensitive in this setting. We describe a family, in which two members were clinically diagnosed with HHT and referred for genetic testing. As there were phenotypic features suggesting the high likelihood of combined syndrome of juvenile polyposis with hereditary hemorrhagic teleangiectasia (JPHT), we proceeded with genetic testing of SMAD4 gene as initial step, which revealed a novel frameshift mutation. This case shows the variety of challenges that clinicians and genetic laboratories may face in complex cases such as combined JPHT syndrome. Knowledge of the syndrome features is of paramount importance as they could frequently point at the most appropriate gene to be tested. PMID:27212857

  4. Cytogenetic abnormalities additional to t(11;14) correlate with clinical features in leukaemic presentation of mantle cell lymphoma, and may influence prognosis: a study of 60 cases by FISH.

    Parry-Jones, N; Matutes, E; Morilla, R; Brito-Babapulle, V; Wotherspoon, A; Swansbury, G J; Catovsky, D

    2007-04-01

    Mantle cell lymphoma (MCL), characterised by t(11;14)(q13;q32), has a poor prognosis. Many cases have additional cytogenetic abnormalities, and often have a complex karyotype. Fluorescence in situ hybridisation (FISH) was used to study 60 cases with leukaemic presentation of MCL, to determine the frequency, clinical correlations and prognostic impact of a panel of molecular cytogenetic abnormalities: 17p13 (TP53 locus), 13q14, 12 p11.1-q11 (centromere), 6q21 and 11q23. CD38 expression, of prognostic value in chronic lymphocytic leukaemia (CLL), was also studied, and correlations with clinical and cytogenetic abnormalities sought. Eighty per cent of cases had at least one abnormality in addition to t(11;14). Deletions at 17p13 (TP53) and 13q14 were most frequent and involved the majority of the leukaemic clone. Cases with TP53 deletion were more likely to have splenomegaly and marked leucocytosis (>30 x 10(9)/l), and less likely to have lymphadenopathy than those without deletion. Deletions at 11q23 and 6q21 were associated with extranodal disease. 13q14 and 11q23 deletions showed a trend towards worse prognosis by univariate analysis. In multivariate analysis, deletions at 13q14 and 6q21 were independent predictors of poor outcome. Deletion at 17p13 did not show prognostic impact in this series. CD38, positive in two-thirds of cases, was associated with male gender and nodal disease but not with any cytogenetic abnormality, or with survival. PMID:17391491

  5. Mycotic Aneurysm following a Dog Bite: The Value of the Clinical History and Molecular Diagnostics.

    Evans, Terry J; Lyons, Oliver T; Brown, Aisling; Price, Nicholas; Bell, Rachel E; Sallam, Morad

    2016-04-01

    A 63-year-old Caucasian taxi driver presented with a 3-week history of malaise, night sweats, 7 kg weight loss, generalized arthralgia, and persistent mid-lower abdominal pain. Blood inflammatory markers were raised, and a computed tomography scan demonstrated an irregular degeneration of the infrarenal aorta, with a differential diagnosis including aortic infection. An urgent type IV thoracoabdominal aneurysm repair was performed with a rifampicin-soaked aortic tube graft during an open procedure. No organisms were grown from multiple peripheral blood cultures or culture of the affected aorta. However, subsequent 16S ribosomal polymerase chain reaction analysis of the resected aorta identified Capnocytophaga canimorsus as the causative organism-a commensal that lives in the mouth of dogs and cats. The patient subsequently gave a history of multiple bites from his pet dog over recent months-the likely source of infection. He was treated with 8 weeks of intravenous antibiotics before switching to oral antibiotics for an additional 6 weeks. PMID:26802291

  6. Monomelic amyotrophy: clinical profile and natural history of 279 cases seen over 35 years (1976-2010).

    Nalini, Atchayaram; Gourie-Devi, Mandavilli; Thennarasu, Kandavel; Ramalingaiah, Aravinda Hanumanthapura

    2014-09-01

    Our objective was to study the clinical characteristics and natural history of monomelic amyotrophy (MMA). We used a retrospective study of 279 patients diagnosed to have either upper (Hirayama disease) or lower limb MMA. Results showed that brachial MMA (BMMA) occurred in 224 patients (male:female, 9:1). Mean age of onset was 19.5 ± 4.18 years. Progression occurred over less than five years in the majority (95.9%) of patients. Duration at the last follow-up was: up to five years in 61.4%, 5-10 in 21.3%, 10-15 in 7.2%, > 15 years in 10.1%. MRI showed asymmetrical lower cervical cord atrophy in 44.6% of patients. Crural MMA (CMMA) occurred in 55 patients (male:female, 13:1). Mean age of onset was 21.38 ± 5.3 years. Similar to BMMA, most cases (65.5%) had onset between 15 and 25 years of age. Total duration of illness at the last follow-up was up to five years in 52.7%, 10 and beyond in 47.3%. In conclusion, a large cohort of patients with monomelic amyotrophy seen over 35 years (1976-2010) is described. Study data support the clinical findings and its natural history with long term follow-up, and the findings emphasize that monomelic amyotrophy is a 'benign' condition with a self-limiting course. PMID:24853410

  7. Clinical research regulation in India-history, development, initiatives, challenges and controversies: Still long way to go

    Mohammed Imran

    2013-01-01

    Full Text Available The Central Drugs Standard Control Organisation and its chairman Drug Controller general of India are bequeathed to protect the citizens from the marketing of unsafe medication. The startling findings, of the 59 th report of the Parliamentary Standing Committee on Health and Family Welfare, have uncovered the lax standards followed by the regulatory authorities in India. The growing clinical research after the product patents rights for the pharmaceutical industries as per the trade related aspects of intellectual property rights agreement and adverse drug reaction monitoring of the marketed drugs have raised many ethical and regulatory issues regarding the promotion of new drugs in Indian markets. Many controversial group of medicines; unauthorised and irrational FDCs not relevant to India′s medical needs, are available which are not sold in any of the countries with matured regulatory bodies. It becomes vital to understand the history, growth and evolution of the regulatory aspects of drugs which are handled by multiple Ministries and Departments of the Government of India. Although amendment to Schedule Y, registration of Contract Research Organisations, registration of Clinical Trials, Speeding up review process, Pharmacovigilance (PhV programme for India and Inspection of clinical trial sites have been started by the various regulatory agencies. However due to casual approach in marketing approval for sale of the drugs, the unethical steps taken by some pharmaceutical companies and medical practitioners has reiterated the need to get appropriate understanding of present regulation of drugs and clinical research especially regarding the practical rules and regulations.

  8. Early history of electroencephalography and establishment of the American Clinical Neurophysiology Society.

    Stone, James L; Hughes, John R

    2013-02-01

    The field of electroencephalography (EEG) had its origin with the discovery of recordable electrical potentials from activated nerves and muscles of animals and in the last quarter of the 19th century from the cerebral cortex of animals. By the 1920s, Hans Berger, a neuropsychiatrist from Germany, recorded potentials from the scalp of patients with skull defects and, a few years later, with more sensitive equipment from intact subjects. Concurrently, the introduction of electronic vacuum tube amplification and the cathode ray oscilloscope was made by American physiologists or "axonologists," interested in peripheral nerve recordings. Berger's findings were independently confirmed in early 1934 by Lord Adrian in England and by Hallowell Davis at Harvard, in the United States. In the United States, the earliest contributions to human EEG were made by Hallowell Davis, Herbert H. Jasper, Frederic A. Gibbs, William Lennox, and Alfred L. Loomis. Remarkable progress in the development of EEG as a useful clinical tool followed the 1935 report by the Harvard group on the electrographic and clinical correlations in patients with absence (petit mal) seizures and altered states of consciousness. Technical aspects of the EEG and additional clinical EEG correlations were elucidated by the above investigators and a number of others. Further study led to gatherings of the EEG pioneers at Loomis' laboratory in New York (1935-1939), Regional EEG society formation, and the American Clinical Neurophysiology Society in 1946. PMID:23377440

  9. Clinical Characteristics and Treatment Outcome of Depression in Patients with and without a History of Emotional and Physical Abuse

    Miniati, M.; Rucci, P.; Benvenuti, A.; Frank, E.; Buttenfield, J.; Giorgi, G.; Cassano, G.B.

    2009-01-01

    Clinical features and treatment outcome were compared in depressed outpatients with and without a history of emotional and physical abuse (EPA), including childhood maltreatment. Patients were initially randomized to IPT or SSRI and then augmented with the second treatment if they did not remit with monotherapy. Assessments included the SCID-I, the SCID-II for DSM-IV diagnoses, the HRSD, the QIDS and the Mood Spectrum Self-Report (MOODS-SR). Seventy-eight (25%) patients reported a history of EPA; 60 (76.9%) were women. Patients with a history of EPA did not differ from those without on HRSD scores at baseline, but showed an earlier age at onset of depression and a longer duration of illness. The two groups differed on several mood spectrum factors, namely: ‘depressive mood’ (15.6±4.9 vs. 13.5±5.4; p<0.004), ‘psychomotor retardation’ (11.7±4.5 vs. 9.6±4.7; p<0.001), ‘drug and illness-related depression’ (1.3±1.3 vs. 0.6±1.0; p<0.0001), and ‘neurovegetative symptoms’ (8.3±2.6 vs. 6.9±2.9; p<0.0001). Patients with EPA had also a significantly longer time to remission (89 vs. 67 days, log-rank test, p=0.035). The need for augmentation treatment was significantly more frequent among patients with EPA than in those without. The present study suggests that patients with a history of EPA show a subtype of depression characterized by poor treatment response and more severe neurovegetative and psychomotor symptoms. PMID:19800634

  10. Clinical effect of increasing doses of lenalidomide in high-risk myelodysplastic syndrome and acute myeloid leukemia with chromosome 5 abnormalities

    Möllgård, Lars; Saft, Leonie; Treppendahl, Marianne Bach;

    2011-01-01

    Patients with chromosome 5 abnormalities and high-risk myelodysplastic syndromes or acute myeloid leukemia have a poor outcome. We hypothesized that increasing doses of lenalidomide may benefit this group of patients by inhibiting the tumor clone, as assessed by fluorescence in situ hybridization...

  11. Association of parental history of type 2 diabetes with age, lifestyle, anthropometric factors, and clinical severity at type 2 diabetes diagnosis

    Svensson, Elisabeth; Berencsi, Klara; Sander, Simone;

    2016-01-01

    Type 2 Diabetes cohort. We examined the prevalence ratios (PR) of demographic, lifestyle, anthropometric, and clinical factors according to parental history, using Poisson regression adjusting for age and gender. RESULTS: Of 2825 T2D patients, 34% (n = 964) had a parental history of T2D. Parental......BACKGROUND: We investigated whether parental history of type 2 diabetes mellitus (T2D) is associated with age, lifestyle, anthropometric factors, and clinical severity at the time of T2D diagnosis. METHODS: We conducted a cross-sectional study based on the Danish Centre for Strategic Research in...... diabetes complications or comorbidities at T2D diagnosis was not associated with parental history. CONCLUSIONS: The lack of an association between parental history and adverse lifestyle factors indicates that T2D patients do not inherit a particular propensity for overeating or inactivity, whereas patients...

  12. The natural history of spinal neurofibromatosis: a critical review of clinical and genetic features.

    Ruggieri, M; Polizzi, A; Spalice, A; Salpietro, V; Caltabiano, R; D'Orazi, V; Pavone, P; Pirrone, C; Magro, G; Platania, N; Cavallaro, S; Muglia, M; Nicita, F

    2015-05-01

    Spinal neurofibromatosis (SNF) is a related form of neurofibromatosis 1 (NF1), characterized by bilateral neurofibromas (histologically proven) of all spinal roots (and, eventually, of all the major peripheral nerve branches) with or without other manifestations of classical NF1. By rigorous application of these criteria to the 98 SNF cases published, we developed: (i) a cohort of 49 SNF patients (21 males and 28 females; aged 4-74 years]: 9 SNF families (21/49), 1 mixed SNF/NF1 family (1/49) and 27 of 49 sporadic SNF patients (including 5 unpublished patients in this report); and (ii) a group of 49 non-SNF patients including: (a) 32 patients with neurofibromas of multiple but not all spinal roots (MNFSR): 4 mixed SNF/MNFSR families (6/32); (b) 14 patients with NF1 manifestations without spinal neurofibromas, belonging to SNF (8/49) or MNFSR families (6/32); (c) 3 patients with neurofibromas in one spinal root. In addition to reduced incidence of café-au-lait spots (67% in SNF vs 56% in MNFSR), other NF1 manifestations were less frequent in either cohort. Molecular testing showed common NF1 gene abnormalities in both groups. The risk of developing SNF vs NF1 was increased for missense mutations [p = 0.0001; odds ratio (OR) = 6.16; confidence interval (CI) = 3.14-13.11], which were more frequent in SNF vs MNFSR (p = 0.0271). PMID:25211147

  13. Recent progress in understanding the natural and clinical histories of the Marfan syndrome.

    Pyeritz, Reed E

    2016-07-01

    Over the past 4 decades, remarkable progress in understanding the cause, pathogenesis, and management of the MFS has led to an increase in life expectancy to near normal for most patients. Accompanying this increased life span has been the emergence of previously rare or unanticipated clinical problems. Despite much more detailed knowledge of the molecular, cellular, and tissue effects of a mutation in FBN1, targeted, effective therapy remains elusive. Until such precision medicine takes hold, management will depend on early diagnosis, regular scrutiny by imaging, chronic β-blockade, and perhaps ARBs, and prophylactic cardiothoracic surgery. Without question, MFS will remain a fertile subject for basic, translational, and clinical research for the foreseeable future. PMID:26908026

  14. Anti-MOG antibody: The history, clinical phenotype, and pathogenicity of a serum biomarker for demyelination.

    Ramanathan, Sudarshini; Dale, Russell C; Brilot, Fabienne

    2016-04-01

    Myelin oligodendrocyte glycoprotein (MOG) is a protein exclusively expressed on the surface of oligodendrocytes and myelin in the central nervous system. MOG has been identified as a putative candidate autoantigen and autoantibody target in demyelination for almost three decades, with extensive literature validating its role in murine models of experimental autoimmune encephalomyelitis. Seminal studies using murine anti-MOG antibodies have highlighted the fact that antibodies that target epitopes of native MOG in its conformational state, rather than linearized or denature`d MOG, are biologically relevant. However, the relevance of anti-MOG antibodies in humans has been difficult to decipher over the years due to varying methods of detection as well as the fact that it was assumed that these antibodies would be clinically associated with multiple sclerosis. There is now international consensus that anti-MOG antibodies are important in both pediatric and adult demyelination, and the clinical association of MOG antibody-associated demyelination has been refined to include acute disseminated encephalomyelitis, relapsing and bilateral optic neuritis, and transverse myelitis. Anti-MOG antibodies are now thought not to be associated with multiple sclerosis in adults. Patients with MOG antibody-associated demyelination appear to have a unique clinical, radiological, and therapeutic profile, which represents a major advance in their diagnosis and management. It is imperative to understand whether anti-MOG antibodies are indeed pathogenic, and if so, their mechanisms of action. As it has become apparent that there are differences in MOG epitope binding between species, translation of animal studies to human demyelination should be analyzed in this context. Further work is required to identify the specific epitope binding sites in human disease and pathogenic mechanisms of anti-MOG antibodies, as well optimal therapeutic strategies to improve prognosis and minimize

  15. The Natural History of Femoroacetabular Impingement

    Kuhns, Benjamin D.; Weber, Alexander E.; David M. Levy; Wuerz, Thomas H.

    2015-01-01

    Femoroacetabular impingement (FAI) is a clinical syndrome resulting from abnormal hip joint morphology and is a common cause of hip pain in young adults. FAI has been posited as a precursor to hip osteoarthritis (OA); however, conflicting evidence exists and the true natural history of the disease is unclear. The purpose of this article is to review the current understanding of how FAI damages the hip joint by highlighting its pathomechanics and etiology. We then review the current evidence r...

  16. Clinical Analysis of the Relationship between Balanced Chromosomal Translocation and Abnormal Pregnancy%染色体平衡易位携带者引起不良孕育的临床分析

    沈红霞; 尹坤

    2015-01-01

    目的:通过对2450例有自然流产、死胎、畸胎、少精等不良孕育史的患者的染色体结果调查,探讨平衡易位与不良孕育史的关系。方法:取外周血进行淋巴细胞培养,染色体G显带分析。结果:2450例患者中检出染色体平衡易位22例(罗伯逊易位3例),占0.90%。患者表现为自然流产、死胎、畸形儿、少精等不良孕育史。结论:染色体平衡易位是导致患者不良孕育史的重要原因之一。对这类人群进行遗传优生和产前诊断及辅助生殖指导等有针对性的检查和临床干预是非常必要的。%Objective: To investigate 2 450 patients' chromosomes with a history of abnormal pregnancy such as spontaneous abortion, fetal death, teratism, and oligospermia and to explore the relationship between balanced chromosomal translocation and abnormal pregnancy. Methods:Chromosomal analysis was made by peripheral lymphocytes culture and G-banding. Results:22 cases of balanced translocation were discovered(3 cases of robertsonian translocation)accounting for 0.90%. Spontaneous abortion, fetal death, teratism, and oligospermia were main manifestations of abnormal pregnancy. Conclusion:Balanced chromosomal translocation was a major reason for abnormal pregnancy. Examination of heredity and prepotency, prenatal diagnosis, guidance on assisted production were necessary for balanced chromosomal translocation carriers.

  17. Clinical study on the mechanism of abnormal accumulation in lung scanning with N-isopropyl-p-123I-iodoamphetamine (123I-IMP)

    Sixty-three cases with gross abnormalities on chest radiograms were studied by lung scanning with 123I-IMP. Abnormal accumulation in comparison with the normal lung field was detected in all patients 24 hours after the intravenous injection of 123I-IMP and these sites were seen within hypoperfusion areas observed by lung scanning using 99mTc-MAA. However, no intratumoral accumulation was detected in the patients with tumor. Comparison between the image obtained after the initial distribution of 123I-IMP and that obtained 24 hours later showed that during this period, 123I-IMP accumulated in the area of decreased or no distribution of 123I-IMP. It was speculated that the area of low pulmonary blood flow showed abnormal accumulation, because even in a low blood flow, 123I-IMP reached the sites of receptor, and the wash-out from these sites was delayed. These findings indicate the possibility that lung scanning with 123I-IMP is a useful agent as assessing pulmonary blood flow. (author)

  18. Knee loading for abnormal gait

    Hutchison, J.; Madsen, D.; Norman, T. L.; -Blaha, J. D.

    2014-01-01

    The purpose of the study was to develop a mathematical model for determining knee loads for abnormal gait. Abnormal gait was defined as a person with varus, i.e. “bowleggedness”, or a person who had an external rotation of the femur (or the inability to internally rotate the femur) which caused an indirect varus in the forward positions of gait. Conditions such as these have been observed clinically to result in increased wear on the medial condyle of total knee replacements. This problem was...

  19. The History, Mechanism, and Clinical Application of Auricular Therapy in Traditional Chinese Medicine

    Pu-Wei Hou

    2015-01-01

    Full Text Available Auricular therapy includes acupuncture, electroacupuncture, acupressure, lasering, cauterization, moxibustion, and bloodletting in the auricle. For 2500 years, people have employed auricular therapy for treating diseases, but the methods have been limited to bloodletting and cauterization. Only after 1957, the international scientific community became aware that the map of the ear resembles an inverted fetus, its introduction has led to auricular acupuncture (AA becoming a more systemic approach, and, following the identification and standardization of more precise points, AA has been employed in clinical applications. The mechanisms of AA are considered to have a close relationship with the autonomic nervous system, the neuroendocrine system, neuroimmunological factors, neuroinflammation, and neural reflex, as well as antioxidation. Auricular therapy has been applied, for example, for pain relief, for the treatment of epilepsy, anxiety, and obesity, and for improving sleep quality. However, the mechanisms and evidence for auricular therapy warrant further study.

  20. The History, Mechanism, and Clinical Application of Auricular Therapy in Traditional Chinese Medicine.

    Hou, Pu-Wei; Hsu, Hsin-Cheng; Lin, Yi-Wen; Tang, Nou-Ying; Cheng, Chin-Yi; Hsieh, Ching-Liang

    2015-01-01

    Auricular therapy includes acupuncture, electroacupuncture, acupressure, lasering, cauterization, moxibustion, and bloodletting in the auricle. For 2500 years, people have employed auricular therapy for treating diseases, but the methods have been limited to bloodletting and cauterization. Only after 1957, the international scientific community became aware that the map of the ear resembles an inverted fetus, its introduction has led to auricular acupuncture (AA) becoming a more systemic approach, and, following the identification and standardization of more precise points, AA has been employed in clinical applications. The mechanisms of AA are considered to have a close relationship with the autonomic nervous system, the neuroendocrine system, neuroimmunological factors, neuroinflammation, and neural reflex, as well as antioxidation. Auricular therapy has been applied, for example, for pain relief, for the treatment of epilepsy, anxiety, and obesity, and for improving sleep quality. However, the mechanisms and evidence for auricular therapy warrant further study. PMID:26823672

  1. Definition and natural history of metabolic steatosis: clinical aspects of NAFLD, NASH and cirrhosis.

    Serfaty, L; Lemoine, M

    2008-12-01

    Metabolic steatosis or non-alcoholic fatty liver (NAFLD) is the most common cause of chronic liver injury in Western countries. Histological signs of necroinflammation, indicating the presence of non-alcoholic steatohepatitis (NASH), are present in 20-30% of cases. While steatosis on its own has a benign course, NASH may be associated with fibrosis and may progress to cirrhosis, terminal liver failure and hepatocellular carcinoma. NAFLD is closely associated with the metabolic syndrome, its prevalence reaching 50-90% in obese patients. The clinical impact of NAFLD has been demonstrated in large cohort studies by the overprevalence of cirrhosis and hepatocellular carcinoma in obese and diabetic patients. In terms of survival, liver disease is the third most common cause of mortality in patients with NAFLD. When associated with other causes of liver disease such as alcohol consumption or hepatitis C infection, metabolic steatosis may be a major risk factor for disease progression. PMID:19195623

  2. Screening for fetal and genetic abnormalities.

    Simpson, J L

    1991-09-01

    Screening for genetic abnormalities is an integral part of obstetrics. Prior to initiating screening, however, several prerequisites must be met: (i) capacity to alter clinical management, (ii) cost effectiveness, (iii) reliable means (usually assays) of assessment, and (iv) capacity to handle problems. In all pregnancies one should determine in systematic fashion whether family history places a pregnant woman at increased risk over the background risk of 2-3% congenital anomalies. All women over age 35 years at delivery should be offered prenatal cytogenetic testing, and women of all ages should be offered maternal serum alpha-fetoprotein screening for neural tube defects. Screening ostensibly normal populations is appropriate in certain ethnic groups to determine heterozygosity for selected disorders: Blacks for sickle-cell anaemia, Mediterranean people for beta-thalassaemia, Southeast Asians and Filipinos for alpha-thalassaemia, Ashkenazi Jews and perhaps French-Canadians for Tay-Sachs disease. Cystic fibrosis screening (delta F508 mutations) is not currently recommended for the general populations, but should be offered to relatives of an individual having delta F508 cystic fibrosis. Irrespective of the extent of screening programmes for Mendelian traits, the mutant allele will remain in the general population because by far the greatest genetic load lies in clinically normal heterozygotes, affected contributing far less to the load despite the obvious clinical effect. PMID:1720071

  3. A review of blood substitutes: examining the history, clinical trial results, and ethics of hemoglobin-based oxygen carriers

    Jiin-Yu Chen

    2009-01-01

    Full Text Available The complications associated with acquiring and storing whole blood for transfusions have launched substantial efforts to develop a blood substitute. The history of these efforts involves a complicated mixture of science, ethics, and business. This review focuses on clinical trials of the three hemoglobin-based oxygen carriers (HBOC that have progressed to Phase II or III clinical trials: HemAssist (Baxter; Deerfield, IL, US, PolyHeme (Northfield; Evanston, IL, US, and Hemopure (Biopure; Cambridge, MA, US. Published animal studies and clinical trials carried out in a perioperative setting have demonstrated that these products successfully transport and deliver oxygen, but all may induce hypertension and lead to unexpectedly low cardiac outputs. Overall, these studies suggest that HBOCs resulted in only modest blood saving during and after surgery, no improvement in mortality and an increased incidence of adverse reactions. To date, the results from these perioperative studies have not led to regulatory approval. All three companies instead chose to focus their efforts on large trials of trauma patients in the pre-hospital setting. Baxter abandoned the development of HemAssist after a trial in the U.S. was prematurely halted when the first 100 patients showed significantly increased mortality rates as compared to patients treated with blood products. Northfield's PolyHeme trial demonstrated a non-significant trend towards increased mortality and a very modest reduction in the subsequent need for blood. The testing of Biopure's Hemopure for trauma patients has been halted for several years because of FDA concerns over trial design and study justification. Ethical concerns have also been raised regarding the design and implementation of all HBOC clinical trials. Thus, the available evidence suggests that HemAssist, Polyheme, and Hemopure are associated with a significant level of cardiovascular dysfunction. The next generation of HBOCs remains

  4. Analysis of clinical outcomes for prenatal diagnosis of occurrence of chromosomal abnormalities for new babies%产前诊断中胎儿新发生染色体异常的临床结局分析

    郭化山; 陈曼萍; 吴来春

    2012-01-01

    OBJECTIVE To analyze the clinical outcomes for prenatal diagnosis of occurrence of chromosomal abnormalities for new babies. METHODS 6 cases of chromosomal abnormalities were found in the 1 346 cases of prenatal diagnosis of chromosomal karyotype from January 2007 to December 2009. Observed the cytogenetic result of fetal chromosomal abnormalities, prenatal ultrasound findings and pregnancy outcome were taken for analysis in the 6 new cases. RESULTS There were 4 cases with unbalanced sex chromosome abnormalities, accounting for 66.7%. There were 2 cases of balanced chromosomal abnormalities, accounting for 33.3%. There were 2 cases of terminal pregnancy through induced abortion in the 4 cases of unbalanced chromosome abnormalities, among whom 1 case of term delivery, 1 case of losing follow-up, the former was found with delayed development in language. 2 cases of balanced chromosomal abnormalities had term delivery, in follow-up after birth, there were no abnormalities. CONCLUSION The fetal phenotype of new chromosomal abnormalities can be predicted by analysis of detailed karyorype and further molecular cytogenetic detection of chromosome composition provided by the structural abnormalities. The prenatal ultrasound examination can provide a strong reference basis for the assessment of pregnancy outcomes.%目的 分析产前诊断中胎儿新发生染色体异常的临床结局.方法 对某院1997年1月-2009年12月1346例产前诊断细胞染色体核型分析发现的6例新发生的胎儿染色体异常病例进行分析,观察6例新发生的胎儿染色体异常病例的细胞遗传学检测结果、产前超声检查结果及妊娠结局.结果 6例新发生染色体异常的胎儿中,非平衡性染色体异常4例,占66.7%:2例平衡性染色体异常,占33.3%;4例非平衡染色体异常的胎儿中有2例选择引产终止妊娠,有1例足月分娩,1例出生后失访.足月分娩者随访至2周岁发现语言功能发育迟缓.2例平衡性染

  5. 自然流产胚胎染色体数目异常的临床研究%Clinical research on chromosomal numerical abnormality in embryos of spontaneous abortion

    韦红卫; 杜娟; 陈科; 蒋丽; 谭芸; 白华; 夏红卫; 莫云

    2012-01-01

    Objective: To explore the relationship between chromosomal numerical abnormality and spontaneous abortion, analyze the influencing factors of spontaneous abortion. Methods: Fluorescent in situ hybridization technique was used to detect the chromosomal number in chorionic villus of one hundred cases with early spontaneous abortion, then the relationship between chromosomal number and spontaneous abortion was analyzed. Results: Among 100 cases, 42 cases were found with chromosomal numerical abnormality, accounting for 42. 00% ; 16 cases were found with chimera, accounting for 16.00%. The most common chromosomal abnormality was triploid, accounting for 35. 71% , followed by 45, X and trisomy 16, accounting for 16.67% and 14. 29% , respectively. The detection rate of chromosomal abnormality in advanced age group (3=35 years) was 45.46% (10/22), while the detection rate of chromosomal abnormality in non - advanced age group ( 0.05) . The detection rate of chromosomal abnormality in the cases with history of spontaneous abortion was 42.55% (20/47), while the detection rate of chromosomal abnormality in the cases without history of spontaneous abortion was 41.51% ( 22/53), there was no significant difference ( P > 0. 05) . The detection rate of chromosomal abnormality in the cases of S10 gestational weeks was 45.00% (27/60), while the detection rate of chromosomal abnormality in the cases of > 10 gestational weeks was 37.50% (15/40) , there was no significant difference (P >0.05) . Conclusion; Chromosomal abnormality is the main cause of early spontaneous abortion, regardless of maternal age, previous history of spontaneous abortion or not, and gestational weeks, the cases with spontaneous abortion at this time may be associated with chromosomal abnormality. Clinicians should pay more attention to chromosomal examination, in order to provide genetic counseling for subsequent pregnancy.%目的:探讨染色体数目异常与自然流产的关系及其影响因素.方法:

  6. Urine - abnormal color

    ... medlineplus.gov/ency/article/003139.htm Urine - abnormal color To use the sharing features on this page, please enable JavaScript. The usual color of urine is straw-yellow. Abnormally colored urine ...

  7. Natural history of soy allergy and/or intolerance in children, and clinical use of soy-protein formulas.

    Cantani, A; Lucenti, P

    1997-05-01

    Atopic diseases of infants and children are common, debilitating, chronic and sometimes even life-threatening. Several well-conducted studies in high risk babies have demonstrated a significant reduction in the prevalence and severity of atopic diseases with dietary and environmental manipulations. The currently available cow's milk (CM) substitutes for infants are soy protein (SP) formulas (SPFs), hydrolyzed formulas (HF), and home-made meat-based formulas. Soybeans have been cultivated in Eastern countries for many centuries and were first used to feed US babies with CM allergy (CMA) in 1929. Since then, SPFs containing purified SP, a mixture of vegetable oils, and purified carbohydrate have been developed. From a nutritional point of view, SPFs are adequate, support normal growth, protein status, bone mineralization, are well accepted, and economical. SPFs are used for different conditions including CMA, lactose and galactose intolerance and in the management of severe gastroenteritis, and some studies show that feeding SPFs for the first six months of life significantly reduces the prevalence of atopic diseases in high risk babies. Although gastrointestinal symptoms and atopic dermatitis (AD) may occur in some SPF-fed children, anaphylaxis following the ingestion of soybean is extremely rare in children. However, in the past few years the antigenicity/allergenicity of SPFs has been over-emphasized in the medical literature. In this paper on the natural history of soy antigenicity/allergenicity we discuss all the pros and cons of SPFs, their composition and nutritional value, the basic immune definitions, chemistry and characterization of SPs. We then discuss the antigenicity and allergenicity of SPFs in animals, recent data on the use of SPFs and the incidence of soy allergy in children, clinical reactions to SPFs, and the clinical relevance of skin testing and IgE antibodies to soy, challenge test procedure, clinical indication of SPFs, and their relevance in

  8. Holoprosencephaly due to numeric chromosome abnormalities.

    Solomon, Benjamin D; Rosenbaum, Kenneth N; Meck, Jeanne M; Muenke, Maximilian

    2010-02-15

    Holoprosencephaly (HPE) is the most common malformation of the human forebrain. When a clinician identifies a patient with HPE, a routine chromosome analysis is often the first genetic test sent for laboratory analysis in order to assess for a structural or numerical chromosome anomaly. An abnormality of chromosome number is overall the most frequently identified etiology in a patient with HPE. These abnormalities include trisomy 13, trisomy 18, and triploidy, though several others have been reported. Such chromosome number abnormalities are almost universally fatal early in gestation or in infancy. Clinical features of specific chromosome number abnormalities may be recognized by phenotypic manifestations in addition to the HPE. PMID:20104610

  9. Crimean-Congo hemorrhagic fever: history, epidemiology, pathogenesis, clinical syndrome and genetic diversity.

    Bente, Dennis A; Forrester, Naomi L; Watts, Douglas M; McAuley, Alexander J; Whitehouse, Chris A; Bray, Mike

    2013-10-01

    the features of CCHF, including the clinical syndrome, diagnosis, treatment, pathogenesis, vaccine development and laboratory animal models of CCHF. The paper ends with a discussion of the possible future geographic range of the virus. For the benefit of researchers, we include a Supplementary Table listing all published reports of CCHF cases and outbreaks in the English-language literature, plus some principal articles in other languages, with total case numbers, case fatality rates and all CCHFV strains on GenBank. PMID:23906741

  10. Natural History of Clinically Staged Low- and Intermediate-Risk Prostate Cancer Treated With Monotherapeutic Permanent Interstitial Brachytherapy

    Purpose: To evaluate the natural history of clinically staged low- and intermediate-risk prostate cancer treated with permanent interstitial seed implants as monotherapy. Methods and Materials: Between April 1995 and May 2005, 463 patients with clinically localized prostate cancer underwent brachytherapy as the sole definitive treatment. Men who received supplemental external beam radiotherapy or androgen deprivation therapy were excluded. Dosimetric implant quality was determined based on the minimum dose that covered 90% of the target volume and the volume of the prostate gland receiving 100% of the prescribed dose. Multiple parameters were evaluated as predictors of treatment outcomes. Results: The 12-year biochemical progression-free survival (bPFS), cause-specific survival, and overall survival rates for the entire cohort were 97.1%, 99.7%, and 75.4%, respectively. Only pretreatment prostate-specific antigen level, percent positive biopsy cores, and minimum dose that covered 90% of the target volume were significant predictors of biochemical recurrence. The bPFS, cause-specific survival, and overall survival rates were 97.4%, 99.6%, and 76.2%, respectively, for low-risk patients and 96.4%, 100%, and 74.0%, respectively, for intermediate-risk patients. The bPFS rate was 98.8% for low-risk patients with high-quality implants versus 92.1% for those with less adequate implants (p < 0.01), and it was 98.3% for intermediate-risk patients with high-quality implants versus 86.4% for those with less adequate implants (p < 0.01). Conclusions: High-quality brachytherapy implants as monotherapy can provide excellent outcomes for men with clinically staged low- and intermediate-risk prostate cancer. For these men, a high-quality implant can achieve results comparable to high-quality surgery in the most favorable pathologically staged patient subgroups.

  11. Urogenital abnormalities and atresia of the gastrointestinal tract

    Dobanovački Dušanka

    2005-01-01

    Full Text Available Introduction. The goal of the study was to investigate the frequency of urogenital congenital abnormalities among atresias of the digestive system and analyze fetal maldevelopment. The study also deals with gastrointestinal and urogenital embryology. Material and methods. This retrospektive study analyzed the clinical status of 55 new-borns admitted to the Pediatric Surgery Clinic in Novi Sad due to atresia of the gastrointestinal tract during 1995-2003. All atresias were classified at primordial gut levels (foregut, midgut and hindgut. The incidence of associated abnormalities, especially urogenital, was analyzed. Diagnostic procedures included standard methods: clinical investigation, ultrasound, native and contrast medium radiography, etc. Results. Results showed that urogenital anomalies were present in 21 (38.18% newborns with gastrointestinal atresia. Foregut atresia was diagnosed in 14 newborns and it was associated with urogenital congenital anomalies in 9 (64.28% newborns. Midgut atresias were found in 15 patients and in 4 (22.22% they were associated with urogenital anomalies. Hindgut atresias were established in 23 and in 8 (34.78% cases they were associated with urogenital anomalies. Discussion and conclusions. It was confirmed that foregut atresias are commonly accompanied by associated abnormalities. That is why the fourth gestational week is important when both gastroinestinal and urogenital systems are developed. When midgut differentiates into its own derivates, the frequency of congenital anomalies decreases for a short period, and then increases again during foregut development (seventh and eighth gestational weeks. There were no information on environmental teratogenic factors in maternal history. These abnormalities may be explained by complex urorectal development and separation of two systems. .

  12. ICU患儿发生心理异常反应的临床表现及应对措施%Clinical Presentation of Abnormal Psychological Reaction of ICU Children and Corresponding Intervention

    李颖; 胡凤华; 曲东; 任晓旭; 郭琳瑛; 王贺茹

    2011-01-01

    Objective To investigate clinical presentation of abnormal psychological reaction of PICU children and corresponding intervention. Methods 146 patients were admitted to PICU from October 2009 to October 2010 (above 1 year of age with more than 3-day hospitalization). We investigated these children' s verbal behavior change in recovery period after quitting depressants and revealed that 25 out of 146 children developed abnormal psychological reaction. We also carried out 6-month followed up with the 10 children after discharge to learn their psychological outcome based on parents' feedback. Analyses were made regarding clinical presentation of abnormal psychological reaction as well as effectiveness of psychological intervention. Result Clinical presentation of abnormal psychological reaction of PICU children include: some mild symptoms,fear, nightmare, insensitivity, unusual obedience, oppositional defiant, aggressive behavior, language regression and even arrhythmia. These conditions might be relieved through psychological intervention by both medical practitioners and parents. Strategies of corresponding intervention include enhanced psychological care, prompt psychological consultation, early transfer to chaperon ward, and even psychological rehabilitation if necessary. Most of the children had recovered through psychological intervention. Conclusion There are a variety of clinical presentations of abnormal psychological reaction. Medical practitioners should raise the awareness of and identify the development of abnormal psychological reaction and provide timely intervention, by which psychological recovery of these children will be improved.%目的 探讨ICU患儿发生心理异常反应的临床表现及应对措施.方法 2009年10月至2010年10月ICU收治146 例患儿(年龄大于1岁,住院超过3天),当患儿进入恢复期,并停止药物镇静后,医务人员观察其语言行为,发现有25例患儿出现心理异常反应.在出院后追踪6个

  13. Thyroid abnormality in perimenopausal women with abnormal uterine bleeding

    Prasanna Byna

    2015-11-01

    Full Text Available Background: AUB is a common but complicated clinical presentation and occurs in 15-20% of women between menarche to menopause and significantly affects the women's health. Women with thyroid dysfunction often have menstrual irregularities, infertility and increased morbidity during pregnancy. The objective of present study is to find the correlation between thyroid disorders and AUB in perimenopausal women attending gynecology OPD. Methods: In the present study, fifty five patients with AUB were included and were evaluated for the cause including thyroid abnormality. Thyroid function tests were done in all patients. Results: Among 55 patients, 12 patients were diagnosed as hypothyroidism and 7 as hyperthyroidism, women with AUB 36 (65.4% were euthyroid. Among 19 women with thyroid abnormality, heavy menstrual bleeding was seen in 8 (42% women, 6 (31.57% had polymenorrhagia, 5 (26.31% had oligomenorrhoea. The frequent menstrual abnormality in women with hypothyroidism (12 women was heavy menstrual bleeding in 5 (41.6% women, 3 (25% had oligomennorhoea, 4 (33.3% had polymenorrhagia. Out of 7 women with hyperthyroidism, 2 (28.57% had oligomenorrhoea, 3 (42.8% had heavy menstrual bleeding, 2 (28.57% had polymenorrhagia. In a total of 55 patients with AUB, 11 (20% had structural abnormalities in uterus and ovaries. 5 (9% had adenomyosis, 3 (5.4% had ovarian cysts, 3 (5.4% had fibroids. Conclusions: It is important to screen all women for thyroid abnormality who are presenting with AUB especially with non-structural causes of AUB. Correction of thyroid abnormalities also relieves AUB. This will avoid unnecessary hormonal treatment and surgery. [Int J Res Med Sci 2015; 3(11.000: 3250-3253

  14. Clinical effect of increasing doses of lenalidomide in high-risk myelodysplastic syndrome and acute myeloid leukemia with chromosome 5 abnormalities

    Möllgård, Lars; Saft, Leonie; Treppendahl, Marianne Bach;

    2011-01-01

    Background Patients with chromosome 5 abnormalities and high-risk myelodysplastic syndromes or acute myeloid leukemia have a poor outcome. We hypothesized that increasing doses of lenalidomide may benefit this group of patients by inhibiting the tumor clone, as assessed by fluorescence in situ...... hybridization for del(5q31). DESIGN AND METHODS: Twenty-eight patients at diagnosis or with relapsed disease and not eligible for standard therapy (16 with acute myeloid leukemia, 12 with intermediate-risk 2 or high-risk myelodysplastic syndrome) were enrolled in this prospective phase II multicenter trial and...... 16 weeks of trial responded to treatment. Using the International Working Group criteria for acute myeloid leukemia and myelodysplastic syndrome the overall response rate in treated patients with acute myeloid leukemia was 20% (3/15), while that for patients with myelodysplastic syndrome was 36% (4...

  15. Clinical implications of mismatched uptakes of beta-methyl fatty acid analogue and thallium in infarcted myocardium. Correlations with coronary stenosis and regional wall motion abnormality

    Nakata, Tomoaki; Hashimoto, Akiyoshi; Miyamoto, Kenjiro [Sapporo Medical Coll. (Japan)] [and others

    1995-10-01

    Myocardial perfusion and fatty acid metabolism were assessed by using myocardial single-photon emission computed tomography with thallium and beta-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) during acute and/or late stages of myocardial infarction in 157 infarcted segments of 100 patients. The incidence of reduced thallium perfusion relative to BMIPP uptake (`T-type` mismatch) was significantly (p<0.05) lower (9%) compared to that of reduced BMIPP uptake relative to thallium perfusion (`B-type` mismatch) (59%) or non-mismatched segment (32%). In an anteroseptal region, B-type dissociation had a significantly higher incidence compared to no or T-type mismatch; 68% vs. 27% vs. 5%, respectively, whereas the incidence of T-type uptake was relatively high in inferior and posterolateral regions; 13%, 11%, respectively. Severe coronary stenosis was observed in 76% of B-type segments and 72% of non-mismatched segments but in only 43% of T-type segments. The incidence of regional wall motion abnormality was significantly lower (46%) in the T-type mismatch segments when compared to the B-type (91%) or non-mismatched segments (96%). In conclusion, myocardial fatty acid metabolism was more markedly impaired compared to an involved coronary perfusion, resulting in the mismatch of perfusion and fatty acid metabolism. Coronary stenosis and regional wall motion abnormality are more closely related to `B-type` mismatch but not necessarily to `T-type` dissociation, probably because of attenuation artifacts in inferior and posterolateral regions in thallium scan. (author).

  16. Children's chromosome with abnormal karyotypes and clinical analysis in Huzhou city%湖州地区遗传咨询儿童染色体异常核型及临床分析

    翁学军; 沈国松

    2012-01-01

    Objective: Through the study of genetic counseling children's chromosome with abnormal karyotypes characteristics, in order to provide a scientific basis for reducing the birth rate of children with chromosome disease of the region and improving population quality. Method; To analyze the chromosome karyotype of peripheral blood of the children who have the clinical manifestations of mental retardation, growth retardation, congenital malformation. Result: 93 cases were found abnormal chromosome karyotype, abnormal detection rate 38. 43% ; 80 cases were autosomal abnormal karyotype, accounting for the total number of checks of 33. 06% , accounting for abnormal number of 86. 02% , 13 cases were abnormal of the sex chromosome karyotype, accounting for the total number of checks of 5. 37% , accounting for the number of abnormal of 13. 98%. Conclusion; Chromosomal abnormalities is one important cause leading to children's mental retardation, growth retardation, congenital malformations, or even death, strengthen health education and genetic counseling during pregnancy, further increase the intensity of prenatal screening and prenatal diagnosis, and continuously improve the diagnostic accuracy of chromosomal diseases, is an effective means to reduce the birth rate of chromosomal sick children and improve the quality of birth.%目的 通过探讨我院遗传咨询儿童染色体异常核型特点,为降低本地区染色体病患儿的出生率、提高出生人口素质提供科学依据.方法 对临床表现为智能低下、生长发育迟缓、先天畸形、特殊表型等儿童进行外周血染色体核型分析.结果 发现染色体异常核型93例,异常检出率为38.43%;其中常染色体异常核型80例,占总检查数的33.06%,占异常数的86.02%,性染色体异常核型13例,占总检查数的5.37%,占异常数的13.98%.结论 染色体异常是导致儿童智能低下、生长发育迟缓、先天畸形、甚至死亡的重要病因之一,

  17. Acute inversion injury of the ankle without radiological abnormalities: assessment with high-field MR imaging and correlation of findings with clinical outcome

    Acute inversion injuries of the ankle are the most common sports accidents, accounting for approximately 10% of emergency room admissions. In up to 85%, an injury of the lateral collateral ligaments is observed. Classically, the assessment of these injuries has relied on clinical examination and radiographs, including stress views. The aim of our study was to correlate prospectively the findings of high-field 3 T MRI in acute ankle distortion with clinical outcome. During a 6-month period, 38 patients were prospectively included. MRI was performed within 48 h of trauma and clinical examination using a protocol consisting of axial T2-weighted and coronal and sagittal T1-weighted images and a sagittal proton density (PDw) sequence. Each ligament injury was graded on a three-point scale. Functional outcome was evaluated using the AOFAS ankle-hindfoot scale. In 24/38 patients (63.12%), ligament injury was observed. In 22/24 cases, this was an injury of the lateral ligaments and in 2/24 cases of the medial ligaments. Injury of the syndesmosis occurred in three patients, a bone bruise in four, and an osteochondral lesion in three cases. Patients with an injury of two or more ligaments or a bone bruise had a lower AOFAS score and returned to sports activities and full weight-bearing later (P < 0.01). MR imaging at 3 Tesla is an independent predictor for clinical outcome. Therefore MRI may be beneficial in those cases where the findings influence further treatment. (orig.)

  18. Acute inversion injury of the ankle without radiological abnormalities: assessment with high-field MR imaging and correlation of findings with clinical outcome

    Langner, Inga; Frank, Matthias; Hinz, Peter; Ekkernkamp, Axel [Ernst-Moritz-Arndt-University Greifswald, Department of Trauma and Orthopedic Surgery, Emergency Department, Greifswald (Germany); Kuehn, Jens Peter; Hosten, Norbert; Langner, Soenke [Ernst-Moritz-Arndt-University Greifswald, Institute for Diagnostic Radiology and Neuroradiology, Greifswald (Germany)

    2011-04-15

    Acute inversion injuries of the ankle are the most common sports accidents, accounting for approximately 10% of emergency room admissions. In up to 85%, an injury of the lateral collateral ligaments is observed. Classically, the assessment of these injuries has relied on clinical examination and radiographs, including stress views. The aim of our study was to correlate prospectively the findings of high-field 3 T MRI in acute ankle distortion with clinical outcome. During a 6-month period, 38 patients were prospectively included. MRI was performed within 48 h of trauma and clinical examination using a protocol consisting of axial T2-weighted and coronal and sagittal T1-weighted images and a sagittal proton density (PDw) sequence. Each ligament injury was graded on a three-point scale. Functional outcome was evaluated using the AOFAS ankle-hindfoot scale. In 24/38 patients (63.12%), ligament injury was observed. In 22/24 cases, this was an injury of the lateral ligaments and in 2/24 cases of the medial ligaments. Injury of the syndesmosis occurred in three patients, a bone bruise in four, and an osteochondral lesion in three cases. Patients with an injury of two or more ligaments or a bone bruise had a lower AOFAS score and returned to sports activities and full weight-bearing later (P < 0.01). MR imaging at 3 Tesla is an independent predictor for clinical outcome. Therefore MRI may be beneficial in those cases where the findings influence further treatment. (orig.)

  19. Results of the Dyslipidemia International Study (DYSIS-Middle East: clinical perspective on the prevalence and characteristics of lipid abnormalities in the setting of chronic statin treatment.

    Saud N Al Sifri

    Full Text Available BACKGROUND: Therapeutic intervention with low-density lipoprotein cholesterol-lowering agents known as statins has been demonstrated to reduce cardiovascular risk. However, many patients on statin treatment have persistent dyslipidemia and remain at a high risk of cardiovascular disease. Therefore, the objective of this study was to assess the frequency of lipid abnormalities in patients receiving chronic statin treatment. METHODS: As part of an international, cross-sectional, observational study, DYSIS-Middle East enrolled 2,182 patients in the United Arab Emirates (UAE, Saudi Arabia, Lebanon and Jordan. All patients were over 45 years of age and had been on statin treatment for at least three months. Data on demographics, lipid parameters and cardiovascular risk profile were recorded. Cardiovascular risk was defined according the guidelines of the European Society of Cardiology. RESULTS: The majority of patients (82.6% were classified as being at very high risk of cardiovascular events, and 61.8% of all patients did not attain LDL-C target levels. Low high-density lipoprotein cholesterol levels and elevated triglyceride levels were noted in 55.5% and 48.5% of patients, respectively. Multivariate logistical regression modeling indicated that factors independently associated with LDL-C levels not being at goal were lifestyle choices, diabetes mellitus, ischemic heart disease, and blood pressure ≥ 140/90 mmHg. CONCLUSIONS: Almost two-thirds of statin-treated patients in the United Arab Emirates, Saudi Arabia, Lebanon and Jordan had inadequately controlled lipid levels. More comprehensive surveillance, awareness and treatment regimens, as well as modification of lifestyle choices, is necessary to halt the rise in cardiovascular disease-related mortality.

  20. The clinical significance analysis of the cytogentic abnormality in the infertile males%男性不育症患者外周血染色体核型分析的临床意义

    陈亮; 鞠慧岩; 薛晴; 左文莉; 徐阳; 杨慧霞; 付杰; 于丽; 齐雯; 马京梅; 潘虹; 陈菲; 张娜; 王晟

    2014-01-01

    Objective To investigate the clinical significance of the cytogenetic abnormality in the infertile males. Methods Cytogenetics of patients was examined by culturing peripheral-blood lymphocyte and G-banding technology, and karyotyping analysis technique were used to study the abnormality and the polymorphism of chromosomes. Results Of 813 infertile men, 55 (6.76%) were detected to have chromosomal abnormalities in chromosomal analysis, including 36 cases with the numeric abnormality (4.43%), 17 cases with chrom osomal rearrangement (2.09%). In 55 cases with chromosomal abnormalities, the constituted ratios of numeric aberration and the rearrangement were 65.4%and 30.91%respectively. Two cases of male pseudohermaphroditism were detected. Klinefelter syndrome and balanced reciprocal translocations were the most common aberration of the chromosomal abnormalities. In addition, 44 cases were detected to have polymorphic variations (5.41%,44/813), including 11 cases with the somatic chromosomal polymorphic variations (1.35%,11/813), 21 cases with the big Y(2.58%,21/813) and 12 cases with bit Y chromosomal(1.48%,12/813). The somatic chromosomal polymorphism included secondary constriction increases, satellite increases in the D/G group. Y chromosomal polymorphism was the most common chromosomal polymorphism. The main clinical features of the male infertility attributing to the chromosomal abnormality and polymorphism were azoospermia, abnormal spermatozoa (oligozoospermia, asthenospermia and teratozoospermia). Conclusion Chromosome and abnormality polymorphisms showed negative effects on the male fertile function. The infertile males with chromosomal abnormality or polymorphisms definitely had an increasing risk in heredity. Karyotype testing screening is necessary for the infertile males, and PGD is helpful to decrease the genetic risk.%目的:基于外周血染色体核型分析,探讨男性不育症患者染色体核型异常的特点及临床意义。方法回顾

  1. Clinical significant evaluation of the inversion abnormality of chromosome on the fertile dysfunction%生育障碍患者中染色体倒位核型的特点及临床分析

    陈亮; 鞠慧岩; 薛晴; 左文莉; 徐阳; 付杰; 贺占举; 于丽; 齐雯; 潘虹; 陈菲; 张娜; 王玲

    2014-01-01

    Objectives:To analyze the clinical significance of the inversion abnormality of chromosome on the adverse pregnancy events.Methods:Cytogenetics of patients was examined by culturing peripheral-blood lym-phocyte and G-banding technology,and karyotyping analysis technique was used to study the relationship between the chromosomal inversion abnormality and the fertile dysfunction in 1408 couples with adverse pregnancy outcome. Results:Among 2816 cases with adverse pregnancy events,31cases (16 male and 15 female)were found with chromosomal inversion abnormality,and the abnormal rate was 1.10%.There was no significant difference in the abnormal rate of chromosomal inversion between the different genders (male:1.13%,female:1.06%,P>0.05). 25 cases with inv (9)were detected and the detectable rate was 0.89%(25/2816).The other types of inversion abnormality included:one case with inv (6)(q11q21),one case inv (7)(p15q36),one case with inv (18) (p11q21),one case with inv (1)(q34q22),one case with inv(X)(p22q26)and one case with inv (10) (q12q22).The clinical symptoms of inversion abnormality were miscarriage,embryonic diapause,fetal anomalies and et al.Conclusion:During the inversion abnormality related to the fertile dysfunction couples,inv (9 )is the most common type.Inv (9)maybe have some potential effect on the adverse pregnancy events.There is no signifi-cant difference of the detectable rate of inversion abnormality between the different genders.Therefore,the couples with adverse pregnancy outcome should both receive cytogenetically examination at the same time.Possibly,the PGD and ICSI may be helpful to the patients with the inversion abnormality,but the detailed issues need to be fur-ther investigated.%目的:分析及总结生育障碍患者中染色体倒位核型的特点及临床意义。方法:临床分析不良妊娠结局夫妇双方的外周血染色体核型,对男方及女方不同性别间染色体异常的检出率进行比较并进

  2. Urine - abnormal color

    The usual color of urine is straw-yellow. Abnormally colored urine may be cloudy, dark, or blood-colored. ... Abnormal urine color may be caused by infection, disease, medicines, or food you eat. Cloudy or milky urine is a sign ...

  3. Hindlimb lameness and gait abnormalities in bitches with pyometra.

    Klainbart, S; Ranen, E; Glikman, G; Kelmer, E; Bdolah-Abram, T; Aroch, I

    2014-07-12

    The objective of this study was to assess the frequency of gait abnormalities and lameness (GAL) in bitches with pyometra, and their association with clinical and laboratory findings. The study included 79 bitches diagnosed with pyometra and 35 negative control intact bitches presented with other soft tissue surgical disorders. Dogs with a history of chronic lameness due to orthopaedic or neurological origin were excluded. A history of GAL was more frequent in the pyometra group (47 per cent) compared with the control group (20 per cent) (P=0.007). In the pyometra group, bitches presenting GAL had (Ppyometra, anorexia and vomiting, as well as higher serum creatinine concentration and muscle enzymes activity, compared with those in without GAL. GAL signs resolved postovariohysterectomy in all but one bitch. The results suggest that GAL signs occur frequently in bitches with pyometra, especially in closed-cervix disease. Therefore, pyometra should be considered among the differential diagnoses when GAL occurs, especially when the clinical signs are non-specific and the reproductive history is unclear. PMID:24789856

  4. Clinical applications of basic research that shows reducing skin tension could prevent and treat abnormal scarring: the importance of fascial/subcutaneous tensile reduction sutures and flap surgery for keloid and hypertrophic scar reconstruction.

    Ogawa, Rei; Akaishi, Satoshi; Huang, Chenyu; Dohi, Teruyuki; Aoki, Masayo; Omori, Yasutaka; Koike, Sachiko; Kobe, Kyoko; Akimoto, Masataka; Hyakusoku, Hiko

    2011-01-01

    We use evidence-based algorithms to treat abnormal scarring, including keloids and hypertrophic scars (HSs). This involves a multimodal approach that employs traditional methods such as surgical removal, postoperative radiotherapy, corticosteroid injection, laser, and silicone gel sheets. As a result, the rate of abnormal scarring recurrence has decreased dramatically over the past 10 years. However, several problems remain to be solved. First, despite the optimization of a radiotherapy protocol, over 10% of cases who are treated with surgery and postoperative radiotherapy still recur in our facility. Second, the treatment options for cases with huge keloids are very limited. To address these problems, we performed basic research on the mechanisms that drive the formation of keloids and HSs. Extrapolation of these research observations to the clinic has led to the development of two treatment strategies that have reduced the rate of abnormal scar recurrence further and provided a means to remove large scars. Our finite element analysis of the mechanical force distribution around keloids revealed high skin tension at the keloid edges and lower tension in the keloid center. Moreover, when a sophisticated servo-controlled device was used to stretch wounded murine dorsal skin, it was observed that the stretched samples exhibited upregulated epidermal proliferation and angiogenesis, which are also observed in keloids and HSs. Real-time RT-PCR also revealed that growth factors and neuropeptides are more strongly expressed in cyclically stretched skin than in statically stretched skin. These findings support the well-established notion that mechanical forces on the skin strongly influence the cellular behavior that leads to scarring. These observations led us to focus on the importance of reducing skin tension when keloids/HSs are surgically removed to prevent their recurrence. Clinical trials revealed that subcutaneous/fascial tensile reduction sutures, which apply

  5. Does Dyspnoea during dipyridamole cardiac stress testing indicate bronchospasm and is the pretest clinical history predictive of this side-effect?

    This study investigates the acute effects of intravenous dipyridamole (0.7 mg/kg) on pulmonary airflow in relation to clinical parameters suggestive of chronic obstructive pulmonary disease (COPD) in order to assess predictive and causative factors of dyspnoea during cardiac stress testing. Mild pulmonary airflow obstruction was noted in all patients, but reached statistical significance only in small airways. The changes in pulmonary function parameters were independent of the clinical history. Dyspnoea under dipyridamole stress testing occurred in parallel with angina, yet was not associated with ischaemic or non-ischaemic left ventricular dysfunction. These data do not support the use of dipyridamole stress testing in asthmatics, but show that (1) the acute effects of a diagnostic dose of dipyridamole on pulmonary airflow are mild even in patients with a history suggestive of COPD and (2) dyspnoea during dipyridamole testing is not necessarily indicative of bronchospasm. (orig./MG)

  6. Clinical analysis of thyroid abnormalities in 55 children with Turner syndrome%55例Turner综合征患儿甲状腺异常临床分析

    陈瑞敏; 张莹; 杨晓红; 林祥泉

    2013-01-01

    Objective Turner syndrome (TS) is characterized with reduced adult height and gonadal dysgenesis and associated with a number of complications including thyroid disease.The purpose of this study was to investigate the prevalence of thyroid diseases and the association between thyroid autoantibodies (TAA) and thyroid dysfunction,age,and karyotype.Methods Fifty-five girls with TS were diagnosed by chromosome analyses and were divided into 2 groups according to whether there was TAA-positive or not:TAA-positive group and TAA-negative group.Thyroid autoantibodies (antithyroglobulin antibody,thyroperoxidase antibody),thyroid function (free T3,free T4,and TSH) were determined with immunochemiluminescent.Ultrasound was applied in TAA-positive group.Results Thyroid functions in 34 TAA-negative girls were normal.Of the 21 TAA-positive girls (21/55,38.2%),7 girls suffered from hypothyroidism and 3 girls had hyperthyroidism.All of 21 TAA-positive girls were diagnosed as cases of Hashimoto's thyroiditis.As compared with the girls in TAA-negative group,the age of girls in TAA-positive group was significantly higher [(12.16 ± 2.55 vs 9.95 ± 4.50) years,P<0.05].6 cases under 5 years old were TAA-negative.31.3 % (5/16) of patients aged 5-10 years old,48.1% (13/27) aged 10-15 years old and 50.0% (3/6) above the age of 15 were TAA-positive.There were no significant differences in the numbers of TAApositive cases among different karyotypes (P > 0.05).Thyroid ultrasound in girls with positive-TAA showed the abnormal echogenicity in bilateral lobus lateralis of thyroid.Conclusion Patients with TS are prone to suffer from Hashimoto's thyroiditis leading to thyroid dysfunction,when they are older than 5 years.Thyroid function should be evaluated yearly in girls with TS after 5 years old.There is no specific association between the incidence of autoimmune thyroid disease and certain karyotypes.%目的 观察Turner综合征(TS)患儿甲状腺异常的发生率、甲状腺

  7. Chromosomal Abnormalities in ADHD

    J Gordon Millichap

    2002-07-01

    Full Text Available The prevalence of fragile X syndrome, velocardiofacial syndrome (VCFS, and other cytogenetic abnormalities among 100 children (64 boys with combined type ADHD and normal intelligence was assessed at the NIMH and Georgetown University Medical Center.

  8. Chromosomal abnormalities and autism

    Farida El-Baz

    2016-01-01

    Conclusion: Chromosomal abnormalities were not detected in the studied autistic children, and so the relation between the genetics and autism still needs further work up with different study methods and techniques.

  9. Abnormal Blood Glucose as a Prognostic Factor for Adverse Clinical Outcome in Children Admitted to the Paediatric Emergency Unit at Komfo Anokye Teaching Hospital, Kumasi, Ghana

    Emmanuel Ameyaw

    2014-01-01

    Full Text Available Dysglycaemia (hyper- or hypoglycaemia in critically ill children has been associated with poor outcome. We compared the clinical outcomes in children admitted to Pediatric Emergency Unit (PEU at Komfo Anokye Teaching Hospital (KATH for acute medical conditions and presenting with euglycaemia or dysglycaemia. This is a prospective case matching cohort study. Eight hundred subjects aged between 3 and 144 months were screened out of whom 430 (215 with euglycaemia and 215 with dysglycaemia were enrolled. The median age was 24 months (range: 3–144 months. In the dysglycaemia group, 28 (13% subjects had hypoglycemia and 187 (87% had hyperglycemia. Overall, there were 128 complications in 116 subjects. The number of subjects with complications was significantly higher in dysglycaemia group (n=99, 46% compared to euglycaemia group (n=17, 8% (P<0.001. Forty subjects died out of whom 30 had dysglycaemia (P=0.001. Subjects with dysglycaemia were 3 times (95% CI: 1.5–6.0 more likely to die and 4.8 times (95% CI: 3.1–7.5 more likely to develop complications (P=0.001. Dysglycaemia is associated with increased morbidity and mortality in children with acute medical conditions and should lead to intensive management of the underlying condition.

  10. Freud Was Right. . . about the Origins of Abnormal Behavior

    Muris, Peter

    2006-01-01

    Freud's psychodynamic theory is predominantly based on case histories of patients who displayed abnormal behavior. From a scientific point of view, Freud's analyses of these cases are unacceptable because the key concepts of his theory cannot be tested empirically. However, in one respect, Freud was totally right: most forms of abnormal behavior…

  11. Natural history of cardiovascular manifestations in Marfan syndrome

    Karnebeek, van, C.D.; Naeff, M.S.J.; Mulder, B.J.M.; Hennekam, R C M; Offringa, M

    2001-01-01

    AIMS—To investigate the natural history of mitral valve and aortic abnormalities in patients with Marfan syndrome during childhood and adolescence.
METHODS—Fifty two patients with Marfan syndrome were followed for a mean of 7.9 years. Occurrence of adverse cardiovascular outcomes was measured clinically and by ultrasound examination.
RESULTS—Mitral valve prolapse (MVP) was diagnosed in 46 patients at a mean age of 9.7 years, more than 80% of whom presented as "silent MVP"...

  12. Approach to Investigating Congenital Skeletal Abnormalities in Livestock.

    Dittmer, K E; Thompson, K G

    2015-09-01

    Congenital skeletal abnormalities may be genetic, teratogenic, or nutritional in origin; distinguishing among these different causes is essential in the management of the disease but may be challenging. In some cases, teratogenic or nutritional causes of skeletal abnormalities may appear very similar to genetic causes. For example, chondrodysplasia associated with intrauterine zinc or manganese deficiency and mild forms of hereditary chondrodysplasia have very similar clinical features and histologic lesions. Therefore, historical data are essential in any attempt to distinguish genetic and acquired causes of skeletal lesions; as many animals as possible should be examined; and samples should be collected for future analysis, such as genetic testing. Acquired causes of defects often show substantial variation in presentation and may improve with time, while genetic causes frequently have a consistent presentation. If a disease is determined to be of genetic origin, a number of approaches may be used to detect mutations, each with advantages and disadvantages. These approaches include sequencing candidate genes, single-nucleotide polymorphism array with genomewide association studies, and exome or whole genome sequencing. Despite advances in technology and increased cost-effectiveness of these techniques, a good clinical history and description of the pathology and a reliable diagnosis are still key components of any investigation. PMID:25910781

  13. Clinical predictors of abnormal esophageal pH monitoring in preterm infants Preditores clínicos para pHmetria esofágica anormal em prematuros

    Maria Aparecida Mezzacappa

    2008-09-01

    Full Text Available BACKGROUND: Risk factors for gastroesophageal reflux disease in preterm neonates have not been yet clearly defined. AIM: To identify factors associated with increased esophageal acid exposition in preterm infants during the stay in the neonatal unit. METHODS: A case-control study in preterm infants who had undergone prolonged monitoring of distal esophageal pH, following clinical indication. Eighty-seven preterms with reflux index (percentage of total time of esophageal pHmetry >10% (cases and 87 unpaired preterms were selected with reflux index 10% in preterms were: vomiting, regurgitation, Apnea, female gender. The variables that were associated with a lower frequency of increased reflux index were: volume of enteral intake at the onset of symptoms >147 mL/kg/day, and postnatal corticoid use. CONCLUSIONS: Vomiting, regurgitation, apnea, female gender and acute respiratory distress during the first week of life were variables predictive of increased esophageal acid exposition in preterm infants with birthweight 10%.RACIONAL: Os fatores de risco para a doença pelo refluxo gastroesofágico em recém-nascidos prematuros não foram, até momento, claramente estabelecidos. OBJETIVO: Identificar fatores associados ao aumento da exposição ácida intra-esofágica em prematuros durante o período de internação em unidade neonatal. MÉTODOS: Realizou-se estudo de caso controle com prematuros que realizaram monitorização prolongada do pH esofágico por suspeita clínica de doença do refluxo. Foram selecionados 87 recém-nascidos com valor do índice de refluxo (percentual do tempo total do exame com pH abaixo de 4 >10% (casos e 87 recém-nascidos com índice de refluxo 10% foram: vômitos, regurgitações, apnéia, sexo feminino e insuficiência respiratória na 1ª semana de vida. As variáveis que se associaram a menor freqüência de índice de refluxo 147mL/kg/d e uso de corticóide pós-natal. CONCLUSÕES: Vômitos, regurgitações, apn

  14. Distribution of causes of abnormal uterine bleeding using the new FIGO classification system

    Objective: To categorise all women with Abnormal Uterine Bleeding attending a tertiary care centre according to new classification system by the International Federation of Gynaecology and Obstetrics (FIGO). Methods: The descriptive cross-sectional study comprised all non-gravid women of reproductive age with unpredictable, excessive duration, abnormal volume, and/or abnormal frequency of menses for at least 3 months coming to the outpatient department of Lady Willingdon Hospital, Lahore, from August 2010 to July 2011. The subjects underwent structured history, physical examination and pelvic ultrasonography. Endometrium and hysterectomy specimen were obtained for histopathology where applicable. Possible underlying causes were categorised according to the new classification system. Results: A total of 2109 women comprised 19.6% of total of the 10712 woman who visited the gynecological outpatients clinic, 2109(19.6%) had abnormal uterine bleeding. PALM-COEIN categorization done in 991(47%) cases that showed 30(3%) polyp, 15(15%) adenomyosis, 250(25%) leiomyoma, 66(6.6%) malignancy and hyperplasia, 3(0.3%) coagulopathy, 236(24%) ovulatory dysfunction, 48(5%) endometritis, and 53(6%) iatrogenic. The remaining 155(15%) cases were uncategorised. Conclusion: The classification should facilitate multi-institutional investigation into the epidemiology, etiology and treatment of women with Abnormal Uterine Bleeding. (author)

  15. Children with Congenital Hypothyroidism Have Similar Neuroradiological Abnormal Findings as Healthy Ones

    Marianna Rachmiel

    2013-01-01

    Full Text Available Objective. To assess the neuroradiological findings of children with congenital hypothyroidism (CHT compared to healthy controls (HC. Patients and Methods. Thirty children with CHT, mean age 12.5 ± 1.6 years, 14 (44.8% males, were compared with 38 HC mean age 11.7 ± 1.7 years, 16 (45.7% males. Clinical data were collected from medical charts and questionnaires seeking information on family history, birth and perinatal period events, medications, and overall health history. Neurocognitive function was assessed for global intelligence, visual and verbal memory, and executive functioning using standardized tests. Neuroimaging was performed using 1.5 T magnetic resonance imaging and assessed by two pediatric radiologists. Results. Children with CHT had a similar proportion of incidental findings as did the children in the HC group, at 43.3% and 39.5%, respectively, . Abnormalities of the sellar region were reported in 13.3% of CHT group and 7.9% of HC group, . Other incidental findings included cerebellar ectopia, choroidal fissure and pineal cysts, and multiple increased signal intensity foci. Neuroradiological findings were not associated with clinical and neurocognitive abnormalities. Conclusion. Neuroimaging of children with CHT demonstrated a similar incidence of structural abnormalities as in the healthy population. There is no association between those findings and neurocognitive function.

  16. Dento-maxillofacial abnormalities caused by radiotherapy and chemotherapy

    Park, Cheol Woo; Hwang, Eui Hwang; Lee, Sang Rae [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Kyunghee University, Seoul (Korea, Republic of)

    2000-12-15

    A case of dento-maxillofacial abnormality involving a 10-year-old male patient with a history of esthesioneuroblastoma is presented. This patient had been treated with 54 Gy {sup 60}Co-gamma-radiation to the nasal cavity for 6 weeks and 6 cycles of combination chemotherapy of Cyclophosphamide, Cisplatin, Adriamycin, VM-26 (Teniposide), and DTIC (Dacarbazine) when he was 16 months of age. Five years after cessation of cancer therapy, he was disease free and transferred for extensive dental care to Kyung Hee University Dental Hospital. A clinical and radiologic follow-up over last 4 years showed root stunting, premature closure of the root apices, microdontia, developmental arrest, small crowns, and partial anodontia. Maxillofacial morphology evaluated by cephalometric analysis showed deficiency of maxillary development.

  17. An unusual cause for a relatively common radiographic abnormality.

    Odedra, Anand; Farrugia, Mark; Babiker, Zahir

    2014-01-01

    A 59-year-old Indian woman presented to the respiratory clinic with chest pains, long-standing swallowing difficulties and a chest radiograph, which was reported as showing a shadow in the right paratracheal region. A CT scan was obtained and was reported as demonstrating a right-sided paratracheal lymph node and varicosities adjacent to the inferior vena cava. Histology from an endobronchial ultrasound-guided biopsy revealed a heavily blood-stained sample but showed no evidence of granulomas or malignancy. Subsequently, the images were reviewed, with the conclusion that they were actually of an engorged azygos vein compressing the oesophagus. MRI confirmed the absence of mediastinal lymphadenopathy and the presence of a prominent hemiazygos vein compressing the oesophagus. This case highlights the importance of including anatomical abnormalities in the differential diagnosis and reassessing patients when the history and investigations do not correlate. PMID:25540206

  18. Value of past clinical history in differentiating bronchial asthma from COPD in male smokers presenting with SOB and fixed airway obstruction

    Prahlad Rai Gupta

    2015-01-01

    Full Text Available Objective: Differentiating asthma from chronic obstructive pulmonary disease (COPD is difficult. Steroid trial may be of help but has several pitfalls. The present study aims to assess the value of past clinical profile of asthma and its differential diagnosis from COPD in male smokers and thereby to formulate clinical parameters to diagnose bronchial asthma in such patients. Patients and Methods: Male smokers who reported at the Respiratory Medicine Department of the National Institute of Medical Sciences (NIMS Hospital, Jaipur, (India, with shortness of breath (SOB and showing less than 12% postbronchodilator bronchial reversibility (BR on spirometry were recruited. These patients were given oral prednisolone 1 mg/kg for two weeks. Post steroid (PS spirometry was performed to ascertain BR. The past clinical history was recorded and analyzed to determine if it is of any use in differentiating asthma from COPD. Result: Out of 104 patients, four were lost to follow up, 52 were diagnosed as bronchial asthma, and the remaining 48 as COPD. It was revealed that past history of (H/O seasonal variation, wheezing, eye allergy, nasal allergy, dust allergy, skin allergy, and family H/O asthma/allergy were positive in 50, 40, 34, 30, 18, 14, and 12 asthma patients as compared to 10, 8, 2, 4, 6, 0, and 0 in 48 COPD patients (P < 0.001. The odds ratio (OR for diagnosing asthma was highest for the presence of any other two symptoms/variables, besides SOB, in the past (OR = 275, P < 0.0001. Conclusion: Past clinical history is of immense value in differentiating asthma from COPD in male smokers presenting with SOB and fixed airway obstruction.

  19. Neurological abnormalities predict disability

    Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje;

    2014-01-01

    To investigate the role of neurological abnormalities and magnetic resonance imaging (MRI) lesions in predicting global functional decline in a cohort of initially independent-living elderly subjects. The Leukoaraiosis And DISability (LADIS) Study, involving 11 European centres, was primarily aimed...... at evaluating age-related white matter changes (ARWMC) as an independent predictor of the transition to disability (according to Instrumental Activities of Daily Living scale) or death in independent elderly subjects that were followed up for 3 years. At baseline, a standardized neurological examination...... abnormality independently predicted transition to disability or death [HR (95 % CI) 1.53 (1.01-2.34)]. The hazard increased with increasing number of abnormalities. Among MRI lesions, only ARWMC of severe grade independently predicted disability or death [HR (95 % CI) 2.18 (1.37-3.48)]. In our cohort...

  20. A型肉毒毒素注射除皱致面部表情异常的临床研究%Clinical research of facial abnormal expressions caused by Botulinum toxin A injection

    孙瑛; 孙玉萍; 于波; 白秀文

    2012-01-01

    Objective Observing characteristics of facial abnormal expressions caused by Botulinum toxin A injection. Through communication skills, injection drug selection, injection skills to avoid or reduce the adverse events, reduce the incidence of the medical disputes . Methods The patients were divided into crow's-feet groups,Look-up wrinkle groups, glabellum wrinkle groups , Respectively observed the chara-cteristics of abnormal expressions.according to the results, selecting clinical skills.Results To reduce the incidence of the medical disputes,it is necessary that fully communication before injection , legal botulinum toxin , clinical skills and remedial measure after injection. Conclusion Although botulinum toxin injection is simple to implement and effective, the aesthetic doctor must pay attention to the selection of preoperative indication , good communication skills in injection, summarizing experience.%目的:观察A型肉毒毒素注射除皱致面部表情异常的发生特点,从沟通技巧、注射药物选择、注射技巧等方面避免或减轻该不良反应的发生,减少由此而引起的医疗纠纷.方法:将接受注射除皱治疗的患者分为鱼尾纹组、眉间纹组、额纹组,分别观察各组出现表情异常的特点,有针对地运用临床技巧.结果:注射前充分沟通、使用正规合法的肉毒毒素制品、注射部位与剂量的巧妙结合及注射后及时采取有效的补救措施,可大大降低注射后表情异常的发生.结论:A型肉毒毒素注射美容操作简单,效果立竿见影,但美容主诊医生切不可麻痹大意,应注意术前适应证的严格选择及良好沟通,在注射技巧上总结经验,方能将注射后表情异常的不良反应降到最低.

  1. The clinical analysis on the characteristics of dyslipidemia and abnormal Hpid metabolism in different types of elderly people with hypertension%老年人群血脂紊乱特点及其与高血压关系

    刘蕾

    2011-01-01

    目的 探讨老年人群血脂紊乱的特点及不同类型血脂代谢异常合并高血压情况。方法 对门诊老年人群查体资料进行回顾性分析。结果 老年人群中血脂紊乱者占人群总数的69.63%,其中单纯高胆固醇(HTC)者23.65%,单纯高甘油三酯(HTG)者26.71%,HTC伴HTG(混合型)19.27%;正常血脂者30.37%。正常血脂组及HTC组比较,HTG组高血压患病率较高(P<0.05)。结论 老年人群血脂紊乱的患病率高,合并高血压的患病率高。%Objective To study the clinical characteristics of abnormal lipid metabolism in different types of elderly people with hypertension.Methods The clinical data,collected from the elderly people who underwent annual physical examination,the characteristics of dyslipidemia and abnormal lipid metabolism in different types of elderly people with hypertension were analyzed retrospectively. Results The prevalence of dyslipidemia was 69. 63%, in which the prevalence of hypercholesteremia and hypertriglyceridemia was 23. 65%, and 26. 71% respectively. The prevalence of hypercholesteremia accompanied hypertriglyceridemia( mixed group) was 19. 27%, and normal group was 30. 37%. Hypertriglyceridemia group was easier to be accompanied with hypertension than normal group and HTC group(P <0. 05). The hypertriglyceridemia had higher risk of cardiovascular and cerebrovascular diseases than norral group and HTC group( P < 0. 05 ). Conclusion The elderly people had high prevalence of dyslipidemia and metabolic syndrome,and with high prevalence of hypertension, which led to higher risk of cardiovascular and cerebrovascular diseases. The hypertriglyceridemia had more strong impact on cardiovascular and cerebrovascular diseases than hypercholesteremia.

  2. Prevalence of asymptomatic urinary abnormalities among adolescents

    Mohamed Fouad

    2016-01-01

    Full Text Available To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1% individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8% at the second screening, (P <0.001. Hematuria was the most common urinary abnormalities detected in 245 (9.8% adolescents who had persistent urine abnormalities; 228 (9.1% individuals had non glomerular hematuria. The hematuria was isolated in 150 (6% individuals, combined with leukocyturia in 83 (3.3% individuals, and combined with proteinuria in 12 (0.5% individuals. Leukocyturia was detected in 150 (6% of all studied adolescents; it was isolated in 39 (1.6% individuals and combined with proteinuria in 28 (1.1% of them. Asymp- tomatic bacteriuria was detected in 23 (0.9% of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6% of all the studied adolescents; 45 (1.8% indivi- duals had <0.5 g/day and twenty (0.8% individuals had 0.5-3 g/day. Asymptomatic urinary abnormalities were more common in males than females and adolescents from rural than urban areas (P <0.01 and (P <0.001, respectively. The present study found a high prevalence of asymptomatic urinary abnormalities among adolescents in our population.

  3. The Long-Term Clinical Follow-Up and Natural History of Men with Adult-Onset Idiopathic Hypogonadotropic Hypogonadism

    Dwyer, Andrew A.; Hayes, Frances J.; Plummer, Lacey; Pitteloud, Nelly; Crowley, William F.

    2010-01-01

    Context and Objective: Adult-onset idiopathic hypogonadotropic hypogonadism (AHH) is a rare disorder characterized by an isolated failure of gonadotropin secretion occurring after an otherwise normal sexual maturation in men. This study aims to examine the etiology and long-term natural history of this disorder.

  4. Clinical observation of abnormal glucose metabolism in patients with cardiovascular department of Internal Medicine%心血管内科住院患者糖代谢异常的临床观察

    李丽

    2015-01-01

    ObjectiveTo explore cardiovascular department of internal medicine hospitalized patients with abnormal glucose metabolism,understanding of abnormal glucose metabolism oncardiovascular effects of patient health,and better treatment of patients with cardiovasculardisease.MethodsIn our hospital in 2013 June~2014 year in March treated 200 cases ofcardiovascular department of internal medicine hospitalized patients as the research object,including 50 cases with clinical diagnosed with diabetes,the remaining 150 patients,were used toobserve the cardiovascular department of internal medicine sugar glucose metabolism of patients hospitalized for observation and analysis of tolerance test and fasting blood glucose detection two experimental methods.ResultsThe two test results show,in 200 patients with fasting blood glucose detection,diagnosis of abnormal glucose metabolism in 50 patients,and oral glucose tolerance test on the remaining 150 patients,diagnosed with abnormal glucose metabolism in 100 cases(67%) of the number of sampling experiment,by comparing with the glucose tolerance,test of cardiovascular patients blood glucose were detected,the rate of missed diagnosis of patients with greatly reduced.ConclusionThe oral glucose tolerance test glucose metabolism in patients with cardiovascular disease than that of fasting blood glucose test to conifrm the diagnosis of glucose metabolism in patients with cardiovascular disease rate is high,is worth in clinicaldetection of glucose metabolism of the patients,and vigorously promote the use of.%目的:探究心血管内科住院患者的糖代谢异常,了解糖代谢异常对心血管患者身体健康的影响,从而更好的治疗患者的心血管疾病。方法选取我院2013年6月~2014年3月收治的200例心血管内科住院的患者为研究对象,其中50例经过临床各项检查确诊为糖尿病,对剩余150例患者,分别采用葡萄糖耐量试验和空腹血糖检测实验方法对患者的

  5. Abnormal feeling in swallowing: a complication of cervical spondylopathy

    Objective: To study the relationship between abnormal feeling in swallowing and cervical spondylopathy and improve the understanding of cervical spondylopathy complicated by abnormal feeling in swallowing. Method: The study group included 11 patients who were clinically diagnosed as cervical spondylopathy in our hospital from 1996 to 2002. On Toshiba 500 mA KXO-15C radiography system, patient swallowing dense barium was examined in several projections. Results: Hyperostosis of vertebral body resulted in local compression of the laryngopharynx and the posterior wall of upper esophageal tube, causing abnormal feeling in swallowing. Conclusion: Abnormal feeling in swallowing could be one of the clinical symptoms of cervical spondylopathy

  6. Chromosomal abnormalities in patients with sperm disorders

    L. Y. Pylyp

    2013-02-01

    Full Text Available Chromosomal abnormalities are among the most common genetic causes of spermatogenic disruptions. Carriers of chromosomal abnormalities are at increased risk of infertility, miscarriage or birth of a child with unbalanced karyotype due to the production of unbalanced gametes. The natural selection against chromosomally abnormal sperm usually prevents fertilization with sperm barring in cases of serious chromosomal abnormalities. However, assisted reproductive technologies in general and intracytoplasmic sperm injection in particular, enable the transmission of chromosomal abnormalities to the progeny. Therefore, cytogenetic studies are important in patients with male factor infertility before assisted reproduction treatment. The purpose of the current study was to investigate the types and frequencies of chromosomal abnormalities in 724 patients with infertility and to estimate the risk of chromosomal abnormalities detection in subgroups of patients depending on the severity of spermatogenic disruption, aiming at identifying groups of patients in need of cytogenetic studies. Karyotype analysis was performed in 724 blood samples of men attending infertility clinic. Chromosomal preparation was performed by standard techniques. At least 20 GTG-banded metaphase plates with the resolution from 450 to 750 bands per haploid set were analysed in each case. When chromosomal mosaicism was suspected, this number was increased to 50. Abnormal karyotypes were observed in 48 (6.6% patients, including 67% of autosomal abnormalities and 33% of gonosomal abnormalities. Autosomal abnormalities were represented by structural rearrangements. Reciprocal translocations were the most common type of structural chromosomal abnormalities in the studied group, detected with the frequency of 2.6% (n = 19, followed by Robertsonian translocation, observed with the frequency of 1.2% (n = 9. The frequency of inversions was 0.6% (n = 4. Gonosomal abnormalities included 14 cases

  7. Semi-quantitative assessment of cerebral blood flow with {sup 99m}Tc-HMPAO SPET in type I diabetic patients with no clinical history of cerebrovascular disease

    Quirce, R.; Carril, J.M.; Jimenez-Bonilla, J.F.; Amado, J.A.; Gutierrez-Mendiguchia, C.; Banzo, I.; Blanco, I.; Uriarte, I.; Montero, A. [Servicio de Medicina Nuclear, Hospital Universitario Marques de Valdecilla, Santander (Spain)

    1997-12-01

    In 65 type I diabetic patients we prospectively evaluated brain perfusion by means of single-photon emission tomography after the injection of 740- 1110 MBq of technetium-99m hexamethylpropylene amine oxime. Thirty-five of the patients presented complications secondary to their diabetes. None showed CNS symptoms. A semiquantitative analysis was performed drawing 50 symmetrical regions of interest (ROIs) per patient. The relative contribution of each ROI to the total blood flow in each slice was compared with the relative contribution of the same ROI in a control group of ten healthy volunteers. Relative values of any ROI in the study group higher or lower than the mean {+-}2 SD in respect of the same ROI in the control group were considered abnormal. The results revealed hypoperfusion in 207 ROIs in the 65 patients with diabetes mellitus: of these ROIs, 113 were frontal, 10 frontotemporal, 20 temporal, 18 parietal, 11 occipital and 35 cerebellar. A total of 137 ROIs showed hyperperfusion: 17 frontal, 3 frontotemporal, 19 temporal, 18 parietal, 19 parieto-occipital, 29 occipital and 32 cerebellar. Out of 65 type I diabetic patients, 61 showed at least one hypoperfused ROI (P = 0.0064 vs. controls) and 25 showed more than three hypoperfused ROIs. None of the control subjects showed more than three hypoperfused regions (P<0.001). The results obtained demonstrate the existence of subclinical abnormalities of brain blood perfusion in patients with type I diabetes mellitus and no history of cerebrovascular disease, thereby allowing the initiation of intensive preventive measures. (orig.) With 3 figs., 5 tabs., 33 refs.

  8. Semi-quantitative assessment of cerebral blood flow with 99mTc-HMPAO SPET in type I diabetic patients with no clinical history of cerebrovascular disease

    In 65 type I diabetic patients we prospectively evaluated brain perfusion by means of single-photon emission tomography after the injection of 740- 1110 MBq of technetium-99m hexamethylpropylene amine oxime. Thirty-five of the patients presented complications secondary to their diabetes. None showed CNS symptoms. A semiquantitative analysis was performed drawing 50 symmetrical regions of interest (ROIs) per patient. The relative contribution of each ROI to the total blood flow in each slice was compared with the relative contribution of the same ROI in a control group of ten healthy volunteers. Relative values of any ROI in the study group higher or lower than the mean ±2 SD in respect of the same ROI in the control group were considered abnormal. The results revealed hypoperfusion in 207 ROIs in the 65 patients with diabetes mellitus: of these ROIs, 113 were frontal, 10 frontotemporal, 20 temporal, 18 parietal, 11 occipital and 35 cerebellar. A total of 137 ROIs showed hyperperfusion: 17 frontal, 3 frontotemporal, 19 temporal, 18 parietal, 19 parieto-occipital, 29 occipital and 32 cerebellar. Out of 65 type I diabetic patients, 61 showed at least one hypoperfused ROI (P = 0.0064 vs. controls) and 25 showed more than three hypoperfused ROIs. None of the control subjects showed more than three hypoperfused regions (P<0.001). The results obtained demonstrate the existence of subclinical abnormalities of brain blood perfusion in patients with type I diabetes mellitus and no history of cerebrovascular disease, thereby allowing the initiation of intensive preventive measures. (orig.)

  9. Semen abnormalities :Clinical investigation(Ⅱ)

    Edson Gurfinkel; Agnaldo P. Cedenho; Ysao Yamamura; Miguel Srougi

    2004-01-01

    @@ ◆ Results All patients completed the treatment, indicating a good patient tolerance to the procedure. However, statistical analysis was performed with 8 patients in the Study Group. One was excluded on account of incomplete seminal data.

  10. CT of pleural abnormalities

    Briefly discussed were CT diagnosis of pleural thickening, CT technique for examining the pleura or pleuro-pulmonary disease, diagnosis of pleural collections, diagnosis of pleural fluid abnormalities in patients with pneumonia, pleural neoplasms, malignant (diffuse) mesothelioma, metastases, local fibrous tumor of the pleura (benign mesothelioma) (21 refs.)

  11. The Relative Importance of Family History, Gender, Mode of Onset, and Age at Onset in Predicting Clinical Features of First-Episode Psychotic Disorders.

    Compton, Michael T; Berez, Chantal; Walker, Elaine F

    2014-11-01

    Objective: Family history of psychosis, gender, mode of onset, and age at onset are considered prognostic factors important to clinicians evaluating first-episode psychosis; yet, clinicians have little guidance as to how these four factors differentially predict early-course substance abuse, symptomatology, and functioning. We conducted a "head-to-head comparison" of these four factors regarding their associations with key clinical features at initial hospitalization. We also assessed potential interactions between gender and family history with regard to age at onset of psychosis and symptom severity.Methods: Consecutively admitted first-episode patients (n=334) were evaluated in two studies that rigorously assessed a number of early-course variables. Associations among variables of interest were examined using Pearson correlations, ÷2 tests, Student's t-tests, and 2x2 factorial analyses of variance.Results: Substance (nicotine, alcohol, and cannabis) abuse and positive symptom severity were predicted only by male gender. Negative symptom severity and global functioning impairments were predicted by earlier age at onset of psychosis. General psychopathology symptom severity was predicted by both mode of onset and age at onset. Interaction effects were not observed with regard to gender and family history in predicting age at onset or symptom severity.Conclusions: The four prognostic features have differential associations with substance abuse, domains of symptom severity, and global functioning. Gender and age at onset of psychosis appear to be more predictive of clinical features at the time of initial evaluation (and thus presumably longer-term outcomes) than the presence of a family history of psychosis and a more gradual mode of onset. PMID:25367167

  12. Clinical observation of MTA applied to the preventive pulp capping of premolar abnormal central cusp%MTA在前磨牙畸形中央尖预防性盖髓术中的疗效观察

    赵献平; 徐芳

    2015-01-01

    Objective To observe the clinical effect of MTA applied to preventive pulp capping of prenmolar abnormal central cusp.Methods 78 unifected premolar steep abnormal central cusp teeth collected from 66 case were treated in our department of our hospital during June in 2011 to June in 2013.They were randomly divided into two groups .MTA was used in preventive pulp capping in the experimental group while Dycal was applied in the control group.At each (3、6、12months and two group),the teeth were assessed dimically to evaluate clinical effect.Results After three months ,the treatment success rate of the MTA group was 97% and the treatment success rate of the Dycal group was 95%.There was no statistically significant difference at the shot term clinical effect between the two groups(P>0.05).After two years ,the treatment success rate of the MTA group was 95% and the treatment success rate of the Dycal group was 72% ,The long term clinical effect of the treatment with MTA was better than Dycal in preventive pulp capping(P<0.05). Conclusion MTA applied to the preventive pulp capping of central cusp deformity is a better way.%目的:观察MTA在前磨牙畸形中央尖预防性盖髓术中的疗效。方法选择2011年7月~2013年7月在我科就诊的未感染前磨牙高陡畸形中央尖患者66例牙齿78颗,随机分为两组,分别用MTA和氢氧化钙进行预防性盖髓,术后3、6、12个月及2年后复查,观察疗效,评价疗效。结果术后3个月复查,MTA组成功率为97%,Dycal组成功率为95%,比较两组近期疗效,差异无统计学意义(P>0.05),术后2年复查, MTA组成功率为95%,Dycal组为72%,比较两组之间远期疗效,MTA组明显高于Dycal组,差异有统计学意义(P<0.05)。结论应用MTA行前磨牙畸形中央尖预防性盖髓术是一种较好的治疗方法。

  13. Defining natural history: assessment of the ability of college students to aid in characterizing clinical progression of Niemann-Pick disease, type C.

    Jenny Shin

    Full Text Available Niemann-Pick Disease, type C (NPC is a fatal, neurodegenerative, lysosomal storage disorder. It is a rare disease with broad phenotypic spectrum and variable age of onset. These issues make it difficult to develop a universally accepted clinical outcome measure to assess urgently needed therapies. To this end, clinical investigators have defined emerging, disease severity scales. The average time from initial symptom to diagnosis is approximately 4 years. Further, some patients may not travel to specialized clinical centers even after diagnosis. We were therefore interested in investigating whether appropriately trained, community-based assessment of patient records could assist in defining disease progression using clinical severity scores. In this study we evolved a secure, step wise process to show that pre-existing medical records may be correctly assessed by non-clinical practitioners trained to quantify disease progression. Sixty-four undergraduate students at the University of Notre Dame were expertly trained in clinical disease assessment and recognition of major and minor symptoms of NPC. Seven clinical records, randomly selected from a total of thirty seven used to establish a leading clinical severity scale, were correctly assessed to show expected characteristics of linear disease progression. Student assessment of two new records donated by NPC families to our study also revealed linear progression of disease, but both showed accelerated disease progression, relative to the current severity scale, especially at the later stages. Together, these data suggest that college students may be trained in assessment of patient records, and thus provide insight into the natural history of a disease.

  14. Dysmorphometrics: the modelling of morphological abnormalities

    Claes Peter

    2012-02-01

    Full Text Available Abstract Background The study of typical morphological variations using quantitative, morphometric descriptors has always interested biologists in general. However, unusual examples of form, such as abnormalities are often encountered in biomedical sciences. Despite the long history of morphometrics, the means to identify and quantify such unusual form differences remains limited. Methods A theoretical concept, called dysmorphometrics, is introduced augmenting current geometric morphometrics with a focus on identifying and modelling form abnormalities. Dysmorphometrics applies the paradigm of detecting form differences as outliers compared to an appropriate norm. To achieve this, the likelihood formulation of landmark superimpositions is extended with outlier processes explicitly introducing a latent variable coding for abnormalities. A tractable solution to this augmented superimposition problem is obtained using Expectation-Maximization. The topography of detected abnormalities is encoded in a dysmorphogram. Results We demonstrate the use of dysmorphometrics to measure abrupt changes in time, asymmetry and discordancy in a set of human faces presenting with facial abnormalities. Conclusion The results clearly illustrate the unique power to reveal unusual form differences given only normative data with clear applications in both biomedical practice & research.

  15. Heterotaxy syndromes and abnormal bowel rotation

    Newman, Beverley [Stanford University, Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Koppolu, Raji; Sylvester, Karl [Lucile Packard Children' s Hospital at Stanford, Department of Surgery, Stanford, CA (United States); Murphy, Daniel [Lucile Packard Children' s Hospital at Stanford, Department of Cardiology, Stanford, CA (United States)

    2014-05-15

    Bowel rotation abnormalities in heterotaxy are common. As more children survive cardiac surgery, the management of gastrointestinal abnormalities has become controversial. To evaluate imaging of malrotation in heterotaxy with surgical correlation and provide an algorithm for management. Imaging reports of heterotaxic children with upper gastrointestinal (UGI) and/or small bowel follow-through (SBFT) were reviewed. Subsequently, fluoroscopic images were re-reviewed in conjunction with CT/MR studies. The original reports and re-reviewed images were compared and correlated with surgical findings. Nineteen of 34 children with heterotaxy underwent UGI, 13/19 also had SBFT. In 15/19 reports, bowel rotation was called abnormal: 11 malrotation, 4 non-rotation, no cases of volvulus. Re-review, including CT (10/19) and MR (2/19), designated 17/19 (90%) as abnormal, 10 malrotation (abnormal bowel arrangement, narrow or uncertain length of mesentery) and 7 non-rotation (small bowel and colon on opposite sides plus low cecum with probable broad mesentery). The most useful CT/MR findings were absence of retroperitoneal duodenum in most abnormal cases and location of bowel, especially cecum. Abnormal orientation of mesenteric vessels suggested malrotation but was not universal. Nine children had elective bowel surgery; non-rotation was found in 4/9 and malrotation was found in 5/9, with discrepancies (non-rotation at surgery, malrotation on imaging) with 4 original interpretations and 1 re-review. We recommend routine, early UGI and SBFT studies once other, urgent clinical concerns have been stabilized, with elective laparoscopic surgery in abnormal or equivocal cases. Cross-sectional imaging, usually obtained for other reasons, can contribute diagnostically. Attempting to assess mesenteric width is important in differentiating non-rotation from malrotation and more accurately identifies appropriate surgical candidates. (orig.)

  16. Disease history and medication use as risk factors for the clinical manifestation of type 1 diabetes in children and young adults: an explorative case control study.

    Soulmaz Fazeli Farsani

    Full Text Available BACKGROUND: There is a highly variable asymptomatic period of beta cell destruction prior to the clinical presentation of type1 diabetes. It is not well known what triggers type 1 diabetes to become a clinically overt disease. This explorative study aimed to identify the association between disease history/medication use and the clinical manifestation of type 1 diabetes. METHODOLOGY/PRINCIPAL FINDINGS: An explorative case control study was conducted in the Dutch PHARMO Record Linkage System. Cases (n = 1,107 were younger than 25 years and had at least 2 insulin prescriptions between 1999 and 2009. For each case, up to 4 controls (without any prescription for the glucose lowering medications (n = 4,424 were matched by age and sex. Conditional logistic regression analysis was used to evaluate the association between disease history/medication use in the year prior to the diagnosis of type 1 diabetes and clinical manifestation of this disease. Type1 diabetes was significantly associated with a history of mental disorder (odds ratio (OR 8.0, 95% confidence interval (CI 1.5-43.7, anemia (OR 5.1, 95% CI 1.1-22.9, and disease of digestive system (OR 2.6, 95% CI 1.2-5.5. The following drug exposures were significantly associated with the clinical manifestation of type 1 diabetes: "systemic hormonal preparations" (OR 1.7, 95% CI 1.1-2.6, medications for "blood and blood forming organs" (OR 1.6, 95% CI 1.1-2.6, "alimentary tract and metabolism" (OR 1.3, 95% CI 1.1-1.6, and "anti-infectives for systemic use" (OR 1.2, 95% CI 1.01-1.4. CONCLUSIONS: Our explorative study demonstrated that in the year prior to the presentation of type 1 diabetes in children and young adults, hospitalization for a diverse group of diseases and drug exposures were significantly more prevalent compared with age- and sex-matched diabetes-free controls.

  17. A systematic overview of the first pasteurised VWF/FVIII medicinal product, Haemate P/ Humate -P: history and clinical performance

    Berntorp, E.; Archey, W.; Auerswald, G.;

    2008-01-01

    to have a VWF multimer profile remarkably close to that of normal plasma. This bibliographic review presents previously unpublished clinical data of Haemate P, based upon internal clinical study reports of the proprietor, CSL Behring, in addition to data already presented in other publications. The data...... demonstrate a predictable and well-characterised pharmacokinetic profile, and a proven record of short- and long-term safety, while effectively correcting the haemostatic defects in VWD and HA. Recently available data have also shown Haemate P to be of haemostatic value in exceptional clinical circumstances...... of thromboembolic complications does exist while receiving Haemate P, as it does with any FVIII replacement therapy, the incidence of such complications has remained notably low. Given the robust data that have accumulated for the use of Haemate P, dosing recommendations are also described in this review...

  18. Abnormal ionization in sonoluminescence

    张文娟; 安宇

    2015-01-01

    Sonoluminescence is a complex phenomenon, the mechanism of which remains unclear. The present study reveals that an abnormal ionization process is likely to be present in the sonoluminescing bubble. To fit the experimental data of previous studies, we assume that the ionization energies of the molecules and atoms in the bubble decrease as the gas density increases and that the decrease of the ionization energy reaches about 60%–70%as the bubble flashes, which is difficult to explain by using previous models.

  19. Spectrum of brain abnormalities detected on whole body 18F FDG PET/CT in patients undergoing evaluation for non-CNS malignancies

    We present the pattern of metabolic brain abnormalities detected in patients undergoing whole body (WB) 18F flurodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) examination for non-central nervous system (CNS) malignancies. Knowledge of the PET/CT appearance of various intracranial metabolic abnormalities enables correct interpretation of PET scans in oncological patients where differentiation of metastasis from benign intracranial pathologies is important and improves specificity of the PET study. A complete clinical history and correlation with CT and MRI greatly helps in arriving at a correct imaging diagnosis. (author)

  20. Initial clinical validation of Health Heritage, a patient-facing tool for personal and family history collection and cancer risk assessment.

    Baumgart, Leigh A; Postula, Kristen J Vogel; Knaus, William A

    2016-04-01

    Personal and family health histories remain important independent risk factors for cancer; however they are currently not being well collected or used effectively. Health Heritage was designed to address this need. The purpose of this study was to validate the ability of Health Heritage to identify patients appropriate for further genetic evaluation and to accurately stratify cancer risk. A retrospective chart review was conducted on 100 random patients seen at an adult genetics clinic presenting with concern for an inherited predisposition to cancer. Relevant personal and family history obtained from the patients' medical records was entered into Health Heritage. Recommendations by Health Heritage were compared to national guidelines of eligibility for genetic evaluation. Agreement between Health Heritage referral for genetic evaluation and guideline eligibility for genetic evaluation was 97 % (sensitivity 98 % and specificity 88 %). Risk stratification for cancer was also compared between Health Heritage and those documented by a geneticist. For patients at increased risk for breast, ovarian, or colorectal cancer as determined by the geneticist, risk stratification by Health Heritage agreed 90, 93, and 75 %, respectively. Discordances in risk stratification were attributed to both complex situations better handled by the geneticist and Health Heritage's adherence to incorporating all information into its algorithms. Health Heritage is a clinically valid tool to identify patients appropriate for further genetic evaluation and to encourage them to confirm the assessment and management recommendations with cancer genetic experts. Health Heritage also provides an estimate of cancer risk that is complementary to a genetics team. PMID:26711915

  1. Incidence of Hyperpronation in the ACL Injured Knee: A Clinical Perspective

    Beckett, Mark E.; Massie, Denise L.; Bowers, K. Douglas; Stoll, David A.

    1992-01-01

    Assessing abnormal biomechanics when treating various lower extremity pathologies provides the athlete with comprehensive management and promotes injury prevention. However, there have been few previous investigations of abnormal biomechanical forces on ligamentous pathologies of the knee. During this clinical study we investigated the incidence of hyperpronation in subjects who have had an anterior cruciate ligament (ACL) injury. Fifty subjects with a past medical history of ACL rupture and ...

  2. Craniofacial abnormalities among patients with Edwards Syndrome

    Rafael Fabiano M. Rosa

    2013-09-01

    Full Text Available OBJECTIVE To determine the frequency and types of craniofacial abnormalities observed in patients with trisomy 18 or Edwards syndrome (ES. METHODS This descriptive and retrospective study of a case series included all patients diagnosed with ES in a Clinical Genetics Service of a reference hospital in Southern Brazil from 1975 to 2008. The results of the karyotypic analysis, along with clinical data, were collected from medical records. RESULTS: The sample consisted of 50 patients, of which 66% were female. The median age at first evaluation was 14 days. Regarding the karyotypes, full trisomy of chromosome 18 was the main alteration (90%. Mosaicism was observed in 10%. The main craniofacial abnormalities were: microretrognathia (76%, abnormalities of the ear helix/dysplastic ears (70%, prominent occiput (52%, posteriorly rotated (46% and low set ears (44%, and short palpebral fissures/blepharophimosis (46%. Other uncommon - but relevant - abnormalities included: microtia (18%, orofacial clefts (12%, preauricular tags (10%, facial palsy (4%, encephalocele (4%, absence of external auditory canal (2% and asymmetric face (2%. One patient had an initial suspicion of oculo-auriculo-vertebral spectrum (OAVS or Goldenhar syndrome. CONCLUSIONS: Despite the literature description of a characteristic clinical presentation for ES, craniofacial alterations may be variable among these patients. The OAVS findings in this sample are noteworthy. The association of ES with OAVS has been reported once in the literature.

  3. A clinical procedures curriculum for undergraduate medical students: the eight-year history of a third-year immersive experience

    Thompson, Laura; Exline, Matthew; Leung, Cynthia G.; Way, David P.; Clinchot, Daniel; Bahner, David P.; Khandelwal, Sorabh

    2016-01-01

    Background Procedural skills training is a critical component of medical education, but is often lacking in standard clinical curricula. We describe a unique immersive procedural skills curriculum for medical students, designed and taught primarily by emergency medicine faculty at The Ohio State University College of Medicine. Objectives The primary educational objective of this program was to formally introduce medical students to clinical procedures thought to be important for success in residency. The immersion strategy (teaching numerous procedures over a 7-day period) was intended to complement the student's education on third-year core clinical clerkships. Program design The course introduced 27 skills over 7 days. Teaching and learning methods included lecture, prereading, videos, task trainers, peer teaching, and procedures practice on cadavers. In year 4 of the program, a peer-team teaching model was adopted. We analyzed program evaluation data over time. Impact Students valued the selection of procedures covered by the course and felt that it helped prepare them for residency (97%). The highest rated activities were the cadaver lab and the advanced cardiac life support (97 and 93% positive endorsement, respectively). Lectures were less well received (73% positive endorsement), but improved over time. The transition to peer-team teaching resulted in improved student ratings of course activities (ptraining medical students received in the clinical setting. Students appreciated hands-on activities and practice. The peer-teaching model improved course evaluations by students, which implies that this was an effective teaching method for adult learners. This course was recently expanded and restructured to place the learning closer to the clinical settings in which skills are applied. PMID:27222103

  4. A clinical procedures curriculum for undergraduate medical students: the eight-year history of a third-year immersive experience

    Laura Thompson

    2016-05-01

    Full Text Available Background: Procedural skills training is a critical component of medical education, but is often lacking in standard clinical curricula. We describe a unique immersive procedural skills curriculum for medical students, designed and taught primarily by emergency medicine faculty at The Ohio State University College of Medicine. Objectives: The primary educational objective of this program was to formally introduce medical students to clinical procedures thought to be important for success in residency. The immersion strategy (teaching numerous procedures over a 7-day period was intended to complement the student's education on third-year core clinical clerkships. Program design: The course introduced 27 skills over 7 days. Teaching and learning methods included lecture, prereading, videos, task trainers, peer teaching, and procedures practice on cadavers. In year 4 of the program, a peer-team teaching model was adopted. We analyzed program evaluation data over time. Impact: Students valued the selection of procedures covered by the course and felt that it helped prepare them for residency (97%. The highest rated activities were the cadaver lab and the advanced cardiac life support (97 and 93% positive endorsement, respectively. Lectures were less well received (73% positive endorsement, but improved over time. The transition to peer-team teaching resulted in improved student ratings of course activities (p<0.001. Conclusion: A dedicated procedural skills curriculum successfully supplemented the training medical students received in the clinical setting. Students appreciated hands-on activities and practice. The peer-teaching model improved course evaluations by students, which implies that this was an effective teaching method for adult learners. This course was recently expanded and restructured to place the learning closer to the clinical settings in which skills are applied.

  5. The Natural History of Femoroacetabular Impingement

    Benjamin D. Kuhns

    2015-11-01

    Full Text Available Femoroacetabular impingement (FAI is a clinical syndrome resulting from abnormal hip joint morphology and is a common cause of hip pain in young adults. FAI has been posited as a precursor to hip osteoarthritis, however, conflicting evidence exists and the true natural history of the disease is unclear. The purpose of this article is to review the current understanding of how FAI damages the hip joint by highlighting its pathomechanics and etiology. We then review the current evidence relating FAI to osteoarthritis. Lastly, we will discuss the potential of hip preservation surgery to alter the natural history of FAI, reduce the risk of developing osteoarthritis and the need for future arthroplasty.

  6. Synergistic effects of elevated homocysteine level and abnormal blood lipids on the onset of stroke

    Lu Hao; Zhenzhen Cheng; Qiang Wu; Shuzhang Li; Liming Chen; Xiaoyong Sai; Zhefeng Liu; Guang Yang; Rongzeng Yan; Lili Wang; Caiyun Fu; Xuan Xu

    2013-01-01

    Hyperhomocysteinemia and abnormal blood lipids are independent risk factors for stroke. However, whether both factors exert a synergistic effect in the onset of stroke remains unclear. The present study is a retrospective analysis of 2 089 cases of stroke and 2 089 control cases of simple inter-vertebral disk protrusion using a paired multivariate logistic regression method. Adjusting for known confounding variables including the patients’ age, gender, smoking status, alcohol consumption status, patient and family medical history, and clinical biochemical indices, elevated homocysteine level was related to the onset of stroke. Patients with elevated homocysteine levels and abnormal blood lipids showed a 40.9%increase in the risk for stroke compared to patients with normal ho-mocysteine levels and blood lipids (odds ratio 1.409;95%confidence interval 1.127-1.761). These results indicate that elevated homocysteine and abnormal blood lipids exert synergistic effects in the onset of stroke. Patients with elevated homocysteine levels and abnormal blood lipids are predis-posed to stroke.

  7. Relationship Between Migraine and Abnormal EEG Findings in Children

    Habibe NEJAD BIGLARI

    2012-09-01

    Full Text Available How to Cite this Article: Nejad Biglari H, Rezayi A, Nejad Biglari H, Alizadeh M, Ahmadabadi F. Relationship Between Migraine and Abnormal EEG Findings in Children. Iran J Child Neurol 2012; 6(3: 21-24.ObjectiveMigraine is a disabling illness that causes absence from school andaffects the quality of life. It has been stated that headache may representan epileptic event. EEG abnormality is a prominent finding in children with migraine. The aim of this study was to evaluate EEG abnormalities in children with migraine.Materials & MethodsTwo-hundred twenty-eight children were enrolled into the study. Evaluation and following of cases was performed by one physician, paraclinical tests were used to increase the accuracy. The study wasconducted under the supervision of pediatric neurology masters and theselected cases were from different parts of the country.ResultsComparing EEG abnormalities in different types of migraine revealed that there is an association between them. There was also a significant difference between EEG abnormalities in different types of aura. Migraine type was associated with the patient’s age. Sleep disorders were more common in patients with a positive family history of seizure.ConclusionOur study disclosed migraine as a common problem in children with abnormalities present in approximately 20% of the patients. Migraine and abnormal EEG findings are significantly associated.ReferencesOttman, R, Lipton RB, Comorbidity of migraine and epilepsy. Neurology 1994 Nov;44(11:2105-10.Haut SR, Bigal ME, Lipton RB. Chronic disorders with episodic manifestations: focus on epilepsy and migraine.Lancet Neurol 2006 Feb;5(2:148-57.Piccinelli P, Borgatti R, Nicoli F, Calcagno P, Bassi MT,Quadrelli M et al. Relationship between migraine and epilepsy in pediatric age. Headache 2006 Mar;46(3:413-21.Hauser WA, Annegers JF, Anderson VE. Epidemiology and the genetics of epilepsy. Res Publ Assoc Res Nerv Ment Dis 1983;61:267-94.Yankovsky AE

  8. Advances in understanding paternally transmitted Chromosomal Abnormalities

    Marchetti, F; Sloter, E; Wyrobek, A J

    2001-03-01

    Multicolor FISH has been adapted for detecting the major types of chromosomal abnormalities in human sperm including aneuploidies for clinically-relevant chromosomes, chromosomal aberrations including breaks and rearrangements, and other numerical abnormalities. The various sperm FISH assays have been used to evaluate healthy men, men of advanced age, and men who have received mutagenic cancer therapy. The mouse has also been used as a model to investigate the mechanism of paternally transmitted genetic damage. Sperm FISH for the mouse has been used to detect chromosomally abnormal mouse sperm, while the PAINT/DAPI analysis of mouse zygotes has been used to evaluate the types of chromosomal defects that can be paternally transmitted to the embryo and their effects on embryonic development.

  9. Diagnosis and Clinical Course of Unexplained Dysphagia

    Yeom, Jiwoon; Song, Young Seop; Lee, Won Kyung; Oh, Byung-Mo; Han, Tai Ryoon; Seo, Han Gil

    2016-01-01

    Objective To investigate the final diagnosis of patients with unexplained dysphagia and the clinical and laboratory findings supporting the diagnosis. Methods We retrospectively analyzed 143 patients with dysphagia of unclear etiology who underwent a videofluoroscopic swallowing study (VFSS). The medical records were reviewed, and patients with a previous history of diseases that could affect swallowing were categorized into a missed group. The remaining patients were divided into an abnormal...

  10. Carbamazepine for acute psychosis with eeg abnormalities

    Ivković Maja

    2004-01-01

    Full Text Available Aim. To investigate the efficacy of carbamazepine as adjuvant drug therapy in acute paranoid psychosis with associated EEG abnormalities, compared to sole antipsychotic treatment. Methods. Eleven medication-naive patients diagnosed with acute paranoid psychosis with associated EEG abnormalities were divided into two treatment groups: sole fluphenazine group, with flexible dosing of 5-10 mg/day (n=6, and carbamazepine group (n=5 with the addition of carbamazepine (600 mg/day to fluphenazine treatment. Clinical Global Impression (CGI, Brief Psychiatric Rating Scale (BPRS, Scale for the Assessment of Negative Symptoms (SANS, and EEG were assessed on the baseline and after 6 weeks of treatment. Paired and two-tailed t-tests were used for statistical significance. Results. All the patients showed significant improvement of mental state after 6 weeks of treatment with no significant differences in CGI, BPRS, and total SANS scores in relation to the therapy with carbamazepine. Nevertheless, after 6 weeks of the treatment, EEG findings were significantly better in carbamazepine group, in relation to the findings from the onset of the treatment, as well as in comparison to sole fluphenazine group. Conclusion. Although carbamazepine stabilized abnormal brain electrical activities it seemed that the associated EEG abnormalities were not significant for acute psychosis observed. These preliminary results suggested that there was no convincing evidence that carbamazepine was efficient as the augmentation of antipsychotic treatment for patients with both acute paranoid psychosis and EEG abnormalities.

  11. Evaluation of endometrium in peri-menopausal abnormal uterine bleeding

    Kotdawala, Parul; Kotdawala, Sonal; Nagar, Nidhi

    2013-01-01

    Abnormal Uterine Bleeding (AUB) is one of the most common health problems encountered by women. It affects about 20% women of reproductive age, and accounts for almost two thirds of all hysterectomies. Gynaecologists are often unable to identify the cause of abnormal bleeding even after a thorough history and physical examination. Diagnostic evaluations and treatment modalities have been evolving over time. The onus in AUB management is to exclude complex endometrial hyperplasia and endometri...

  12. Key discoveries in bile acid chemistry and biology and their clinical applications: history of the last eight decades

    Hofmann, Alan F.; Hagey, Lee R.

    2014-01-01

    During the last 80 years there have been extraordinary advances in our knowledge of the chemistry and biology of bile acids. We present here a brief history of the major achievements as we perceive them. Bernal, a physicist, determined the X-ray structure of cholesterol crystals, and his data together with the vast chemical studies of Wieland and Windaus enabled the correct structure of the steroid nucleus to be deduced. Today, C24 and C27 bile acids together with C27 bile alcohols constitute most of the bile acid “family”. Patterns of bile acid hydroxylation and conjugation are summarized. Bile acid measurement encompasses the techniques of GC, HPLC, and MS, as well as enzymatic, bioluminescent, and competitive binding methods. The enterohepatic circulation of bile acids results from vectorial transport of bile acids by the ileal enterocyte and hepatocyte; the key transporters have been cloned. Bile acids are amphipathic, self-associate in solution, and form mixed micelles with polar lipids, phosphatidylcholine in bile, and fatty acids in intestinal content during triglyceride digestion. The rise and decline of dissolution of cholesterol gallstones by the ingestion of 3,7-dihydroxy bile acids is chronicled. Scientists from throughout the world have contributed to these achievements. PMID:24838141

  13. Behavioral abnormalities in captive nonhuman primates.

    Mallapur, Avanti; Choudhury, B C

    2003-01-01

    In this study, we dealt with 11 species of nonhuman primates across 10 zoos in India. We recorded behavior as instantaneous scans between 9 a.m. and 5 p.m. In the study, we segregated behaviors for analyses into abnormal, undesirable, active, and resting. The 4 types of abnormal behavior exhibited included floating limb, self-biting, self-clasping, and stereotypic pacing. In the study, we recorded 2 types of undesirable behavior: autoerotic stimulation and begging. Langurs and group-housed macaques did not exhibit undesirable behaviors. A male lion-tailed macaque and a male gibbon exhibited begging behavior. autoerotic stimulation and self-biting occurred rarely. Males exhibited higher levels of undesirable behavior than did females. Animals confiscated from touring zoos, circuses, and animal traders exhibited higher levels of abnormal behaviors than did animals reared in larger, recognized zoos. The stump-tailed macaque was the only species to exhibit floating limb, autoerotic stimulation, self-biting, and self-clasping. Our results show that rearing experience and group composition influence the proportions of abnormal behavior exhibited by nonhuman primates in captivity. The history of early social and environmental deprivation in these species of captive nonhuman primates probably is critical in the development of behavioral pathologies. Establishing this will require further research. PMID:14965782

  14. 老年咬合异常患者咬合重建修复的临床研究%Clinical study on occlusal rehabilitation in elderly patients with abnormal occlusion

    李玉民; 高平; 殷恺; 李长义

    2009-01-01

    Objective To evaluate the clinical effects and clinical classification of occlusal rehabilitation in elderly patients with abnormal occlusion, and to discuss the diagnosis principles and the practical techniques of the dental prosthesis for occlusal rehabilitation. Methods Forty two elderly patients with abnormal occlusion were treated with occlusal rehabilitation with fixed dentures, fixed-removable dentures and removable partial dentures. Eight patients among them simultaneously had temporomandibular joint(TMJ) disorder. After the clinical procedures including examination, diagnosis, prosthesis design, manufacture, application of occlusal rehabilitation and post-treatment evaluation, the using condition of dentures, patients' satisfaction ratings, TMJ functions and abutment teeth healthy status were examined before and after treatment. Results All the patients were satisfied with their dentures' general functions 1 year after treatment. Compared with the removable partial dentures, the other two types of prosthesis showed better clinical outcomes (χ2=4.15,P<0.05) and compacts on phonation of the dentures (χ2=4.71,P<0.05). In the 8 patients with TMJ disorder, 7 cases were cured completely. The treatment effects of TMJ pain (χ2=0.031, P<0.05)and TMJ click (χ2=0.038, P<0.05)had statistical differences. 30 teeth of the 203 abutment teeth (14.8%) had the problems of periodontal diseases and secondary caries and the incidences of these problems were higher in using removable partial dentures treatment than in the other two methods. Conclusions After the systematic diagnosis and the prosthesis design procedures of occlusal rehabilitation, it is important to choose a proper prostheses for the elderly patients according to their physical and psychological features, which may give the patients satisfactory results.%目的 评价不同种类咬合重建修复的临床效果,探讨老年咬合异常患者咬合重建的临床分类、诊断

  15. Cato Guldberg and Peter Waage, the history of the Law of Mass Action, and its relevance to clinical pharmacology.

    Ferner, Robin E; Aronson, Jeffrey K

    2016-01-01

    We have traced the historical link between the Law of Mass Action and clinical pharmacology. The Law evolved from the work of the French chemist Claude Louis Berthollet, was first formulated by Cato Guldberg and Peter Waage in 1864 and later clarified by the Dutch chemist Jacobus van 't Hoff in 1877. It has profoundly influenced our qualitative and quantitative understanding of a number of physiological and pharmacological phenomena. According to the Law of Mass Action, the velocity of a chemical reaction depends on the concentrations of the reactants. At equilibrium the concentrations of the chemicals involved bear a constant relation to each other, described by the equilibrium constant, K. The Law of Mass Action is relevant to various physiological and pharmacological concepts, including concentration-effect curves, dose-response curves, and ligand-receptor binding curves, all of which are important in describing the pharmacological actions of medications, the Langmuir adsorption isotherm, which describes the binding of medications to proteins, activation curves for transmembrane ion transport, enzyme inhibition and the Henderson-Hasselbalch equation, which describes the relation between pH, as a measure of acidity and the concentrations of the contributory acids and bases. Guldberg and Waage recognized the importance of dynamic equilibrium, while others failed to do so. Their ideas, over 150 years old, are embedded in and still relevant to clinical pharmacology. Here we explain the ideas and in a subsequent paper show how they are relevant to understanding adverse drug reactions. PMID:26174880

  16. MR appearance of normal and abnormal bile: Correlation with imaging and endoscopic finding

    Identification of abnormal bile related to various pathological processes in the pancreaticobiliary tract can be important in the diagnosis of disease and the determination of appropriate treatment. Magnetic resonance (MR) imaging can allow comprehensive evaluation of abnormal bile because MR usually provides better tissue characterization than other imaging modalities. A high-intensity signal from bile is frequently encountered on T1-weighted images and can be seen in concentrated bile, sludge, stones, or hemobilia. Contrast-enhanced MR features, such as inhomogeneous hepatic enhancement in the arterial phase and papillitis or mild-to-moderate bile duct wall thickening with enhancement, along with clinical characteristics, may suggest clinically significant bile, such as sludge or purulent bile, rather than merely concentrated bile. A history of trauma and appropriate imaging findings in the hepatobiliary tract can support a diagnosis of hemobilia. MR imaging may assist in diagnosing intraductal papillary mucinous neoplasm of the bile duct via detection of an intraductal mass or several indirect signs, suggesting a large amount of mucin. Additionally, Gd-EOB-DTPA-enhanced MR may delineate mucin as a filling defect surrounding hyperintense bile. A floating filling defect on all MR sequences is helpful in discriminating pneumobilia from other intraluminal filling defects. Familiarity with the various different MR features of abnormal bile signals can therefore facilitate accurate diagnosis and treatment.

  17. Adults with Chromosome 18 Abnormalities.

    Soileau, Bridgette; Hasi, Minire; Sebold, Courtney; Hill, Annice; O'Donnell, Louise; Hale, Daniel E; Cody, Jannine D

    2015-08-01

    The identification of an underlying chromosome abnormality frequently marks the endpoint of a diagnostic odyssey. However, families are frequently left with more questions than answers as they consider their child's future. In the case of rare chromosome conditions, a lack of longitudinal data often makes it difficult to provide anticipatory guidance to these families. The objective of this study is to describe the lifespan, educational attainment, living situation, and behavioral phenotype of adults with chromosome 18 abnormalities. The Chromosome 18 Clinical Research Center has enrolled 483 individuals with one of the following conditions: 18q-, 18p-, Tetrasomy 18p, and Ring 18. As a part of the ongoing longitudinal study, we collect data on living arrangements, educational level attained, and employment status as well as data on executive functioning and behavioral skills on an annual basis. Within our cohort, 28 of the 483 participants have died, the majority of whom have deletions encompassing the TCF4 gene or who have unbalanced rearrangement involving other chromosomes. Data regarding the cause of and age at death are presented. We also report on the living situation, educational attainment, and behavioral phenotype of the 151 participants over the age of 18. In general, educational level is higher for people with all these conditions than implied by the early literature, including some that received post-high school education. In addition, some individuals are able to live independently, though at this point they represent a minority of patients. Data on executive function and behavioral phenotype are also presented. Taken together, these data provide insight into the long-term outcome for individuals with a chromosome 18 condition. This information is critical in counseling families on the range of potential outcomes for their child. PMID:25403900

  18. New aspects of clinical pathology and electro-physiological muscle disturbances in patients with history of trichinellosis

    Kociecka W.

    2001-06-01

    Full Text Available Clinical studies performed in 44 patients, one, three, four, six or seven years after they had experienced trichinellosis demonstrated the persistence of various general and motor ailments in 88.7 % of the patients. The persisting for many years antibodies against E/S antigen of Trichinella in 86.4 % of examined patients seem to reflect chronic stimulation by the larvae which, as shown by parasitological and histopathological tests, survived longer and underwent gradual destruction in muscles. Bio-electric disturbances in muscles were most frequently of a mixed type, with prevalence of a neural type record. These observations illustrate a disturbed function of motor neurones and of impulse transmission at the myoneural junction in patients chronically infected with Trichinella.

  19. Syncope as a health risk for soldiers:Influence of medical history and clinical findings on the sensitivity of head-up tilt table testing

    Hans-Joachim Gilfrich; Lena Marie Heidelmann; Franziska Grube; Hagen Frickmann; Sven Andreas Jungblut

    2015-01-01

    Background: Syncope is a relevant health problem in military environments. Reliable diagnosis is challenging. Tilt table testing is an important tool for syncope diagnosis. The aim of this study was to determine whether signs such as prodromal symptoms, co-morbidity, frequency of syncopal events, body length, body mass index, and electrocardiography (ECG) abnormalities can be used to predict the success of tilt table testing at diagnosing syncope. Methods: Data from 100 patients with histories of syncope or pre-syncope, who were diagnosed using head-up tilt table testing, were retrospectively analyzed in a cross-sectional analysis. The diagnostic procedure was based upon a modified version of the Westminster protocol without any pharmacological provocation. Results: Patients showing pathological reaction patterns during tilt table testing suffered from prodromal symptoms, such as dizziness and sweating, significantly more often. The patients reported more injuries resulting from syncopal events and more previous syncopal events, and the prevalence of co-morbidity was greater among patients presenting negative findings during tilt testing. An asthenic-leptosomal physique was not confirmed as a risk factor for syncopal events as is the case for idiopathic arterial hypotension. However, patients with pathological reaction patterns during tilt table testing were significantly taller. This finding was detected for both females and males. No significant predictors were found in the ECG patterns of patients showing syncope during tilt table testing. Conclusions: Frequency of prior syncope and prodromal symptoms, and increased body length with an otherwise good state of health influence the predictive value of tilt table testing for syncope diagnosis. In particular, if these factors are present, tilt table testing should be considered part of the diagnostic algorithm for soldiers with recurrent syncope.

  20. CT cold areas in both putamens in cases with history of perinatal asphyxia

    CT bilaterally showed a cold area in the putamen of 5 infants with cerebral palsy who had had asphyxia at birth. The etiology was discussed, and 4 of the cases were clinically studied. All four patients had convulsive tetraplegia, or convulsive bilateral paralysis with the element of athetosis. Three of them had a history of infantile epilepsy, accompanied by abnormal ocular movement. Two patients with tetraplegia showed marked hypotonia of the trunk in ventral support (Landau). Impairment of the bilateral putamens in the abnormal muscle tone was inferred. (Chiba, N.)

  1. CT cold areas in both putamens in cases with history of perinatal asphyxia

    Ishizaki, Asayo; Maruyama, Hiroshi (Tokyo Women' s Medical Coll. (Japan))

    1982-12-01

    CT bilaterally showed a cold area in the putamen of 5 infants with cerebral palsy who had had asphyxia at birth. The etiology was discussed, and 4 of the cases were clinically studied. All four patients had convulsive tetraplegia, or convulsive bilateral paralysis with the element of athetosis. Three of them had a history of infantile epilepsy, accompanied by abnormal ocular movement. Two patients with tetraplegia showed marked hypotonia of the trunk in ventral support (Landau). Impairment of the bilateral putamens in the abnormal muscle tone was inferred.

  2. Migraine and structural abnormalities in the brain

    Hougaard, Anders; Amin, Faisal Mohammad; Ashina, Messoud

    2014-01-01

    PURPOSE OF REVIEW: The aim is to provide an overview of recent studies of structural brain abnormalities in migraine and to discuss the potential clinical significance of their findings. RECENT FINDINGS: Brain structure continues to be a topic of extensive research in migraine. Despite advances in...... neuroimaging techniques, it is not yet clear if migraine is associated with grey matter changes. Recent large population-based studies sustain the notion of increased prevalence of white matter abnormalities in migraine, and possibly of silent infarct-like lesions. The clinical relevance of this association is...... not clear. Structural changes are not related to cognitive decline, but a link to an increased risk of stroke, especially in patients with aura, cannot be ruled out. SUMMARY: Migraine may be a risk factor for structural changes in the brain. It is not yet clear how factors such as migraine sub...

  3. Circadian Rhythm Abnormalities

    Zee, Phyllis C.; Attarian, Hrayr; Videnovic, Aleksandar

    2013-01-01

    Purpose: This article reviews the recent advances in understanding of the fundamental properties of circadian rhythms and discusses the clinical features, diagnosis, and treatment of circadian rhythm sleep disorders (CRSDs).

  4. Lithium treatment and thyroid abnormalities

    Bocchetta Alberto

    2006-09-01

    Full Text Available Abstract Background Although the interactions between lithium treatment and thyroid function have long been recognised, their clinical relevance is still controversial. This paper sets out a review of the literature to date, considering that lithium still represents the gold standard among prophylactic treatments of manic-depression several decades after its introduction. Method PubMed database was used to search for English-language articles relating to lithium treatment and thyroid function. As the amount of relevant papers totalled several hundreds, this review refers to previous reviews, especially with regard to older literature. Moreover, the authors particularly refer to a series of studies of thyroid function performed in a cohort of patients at different stages of lithium treatment, who were followed up by their group from 1989 onwards. Results The main findings from this review included: a lithium definitely affects thyroid function as repeatedly shown by studies on cell cultures, experimental animals, volunteers, and patients; b inhibition of thyroid hormone release is the critical mechanism in the development of hypothyroidism, goitre, and, perhaps, changes in the texture of the gland which are detected by ultrasonic scanning; c compensatory mechanisms operate and prevent the development of hypothyroidism in the majority of patients; d when additional risk factors are present, either environmental (such as iodine deficiency or intrinsic (immunogenetic background, compensatory potential may be reduced and clinically relevant consequences may derive; e hypothyroidism may develop in particular during the first years of lithium treatment, in middle-aged women, and in the presence of thyroid autoimmunity; f thyroid autoimmunity is found in excess among patients suffering from affective disorders, irrespective of lithium exposure; g in patients who have been on lithium for several years, the outcome of hypothyroidism, goitre, and thyroid

  5. Cardiac ultrasonography in structural abnormalities and arrhythmias. Recognition and treatment.

    Brook, M. M.; Silverman, N H; Villegas, M.

    1993-01-01

    Fetal cardiac ultrasonography has become an important tool in the evaluation of fetuses at risk for cardiac anomalies. It can both guide prenatal treatment and assist the management and timing of delivery. We recommend that a fetal echocardiogram be done when there is a family history of congenital heart disease; maternal disease that may affect the fetus; a history of maternal drug use, either therapeutic or illegal; evidence of other fetal abnormalities; or evidence of fetal hydrops. The op...

  6. Hemostatic abnormalities in liver cirrhosis

    Kendal YALÇIN

    2009-06-01

    Full Text Available In this study, 44 patients with liver cirrhosis were investigated for hemostatic parameters. Patients with spontaneous bacterial peritonitis, hepatocellular carcinoma, hepatorenal syndrome and cholestatic liver diseases were excluded. Patients were classified by Child-Pugh criterion and according to this 4 patients were in Class A, 20 in Class B and 20 in C. Regarding to these results, it was aimed to investigate the haematological disturbances in liver cirrhotic patients.In the result there was a correlation between activated partial thromboplastin time, serum iron, ferritin, transferrin, haptoglobin and Child-Pugh classification. Besides there was no correlation between prothrombin time, factor 8 and 9, protein C and S, anti-thrombin 3, fibrinogen, fibrin degradation products, serum iron binding capacity, hemoglobin, leukocyte, mean corpuscular volume and Child-Pugh classification.There were significant difference, in terms of AST, ferritin, haptoglobulin, sex and presence of ascites between groups (p0.05. In the summary, we have found correlation between hemostatic abnormalities and disease activity and clinical prognosis in patients with liver cirrhosis which is important in the management of these patients. This is also important for identification of liver transplant candidiates earlier.

  7. CHROMOSOMAL ABNORMALITIES IN A REFERRED POPULATION: A REPORT OF 383 IRANIAN CASES

    M. T. Akbari.

    1998-07-01

    Full Text Available This report presents the cytogenetic findings (G -banded chromosomal analysis} in 383 cases referred for suspected chromosomal abnormalities because of abnormal clinical features. Chromosomal aberrations were found in 63 116.5% of these cases, free trisomy 21 (7% being the most common abnormality , followed by 47, XXYkaryotype (4%. The breakdown figures for each group is discussed in the text.

  8. Systemic abnormalities in liver disease

    Minemura, Masami; Tajiri, Kazuto; Shimizu, Yukihiro

    2009-01-01

    Systemic abnormalities often occur in patients with liver disease. In particular, cardiopulmonary or renal diseases accompanied by advanced liver disease can be serious and may determine the quality of life and prognosis of patients. Therefore, both hepatologists and non-hepatologists should pay attention to such abnormalities in the management of patients with liver diseases.

  9. Myocardial perfusion abnormalities in asymptomatic patients with systemic lupus erythematosus

    Accelerated coronary artery disease and myocardial infarction in young patients with systemic lupus erythematosus is well documented; however, the prevalence of coronary involvement is unknown. Accordingly, 26 patients with systemic lupus were selected irrespective of previous cardiac history to undergo exercise thallium-201 cardiac scintigraphy. Segmental perfusion abnormalities were present in 10 of the 26 studies (38.5 percent). Five patients had reversible defects suggesting ischemia, four patients had persistent defects consistent with scar, and one patient had both reversible and persistent defects in two areas. There was no correlation between positive thallium results and duration of disease, amount of corticosteroid treatment, major organ system involvement or age. Only a history of pericarditis appeared to be associated with positive thallium-201 results (p less than 0.05). It is concluded that segmental myocardial perfusion abnormalities are common in patients with systemic lupus erythematosus. Whether this reflects large-vessel coronary disease or small-vessel abnormalities remains to be determined

  10. Intracranial abnormalities in infantile esotropia detected by magnetic resonance imaging

    Twenty-one cases of infantile esotropia were examined for possible intracranial abnormalities by magnetic resonance imaging, MRI. Subnormal findings, which did not seem to be related to the development of infantile esotropia, were detected in 3 cases, 14%. All the three cases had a history of ischemic episodes during the perinatal period. (author)

  11. Epidemiologic natural history and clinical management of Human Papillomavirus (HPV) Disease: a critical and systematic review of the literature in the development of an HPV dynamic transmission model

    Dasbach Erik J; Insinga Ralph P; Elbasha Elamin H

    2009-01-01

    Abstract Background Natural history models of human papillomavirus (HPV) infection and disease have been used in a number of policy evaluations of technologies to prevent and screen for HPV disease (e.g., cervical cancer, anogenital warts), sometimes with wide variation in values for epidemiologic and clinical inputs. The objectives of this study are to: (1) Provide an updated critical and systematic review of the evidence base to support epidemiologic and clinical modeling of key HPV disease...

  12. Abnormal lung gallium-67 uptake preceding pulmonary physiologic impairment in an asymptomatic patient with Pneumocystis carinii pneumonia

    Reiss, T.F.; Golden, J. (Univ. of California, San Francisco (USA))

    1990-05-01

    Pneumocystis carinii pneumonia was suggested by a diffuse, bilateral pulmonary uptake of gallium-67 in an asymptomatic, homosexual male with the antibody to the immunodeficiency virus (HIV) who was undergoing staging evaluation for lymphoma clinically localized to a left inguinal lymph node. Chest radiograph and pulmonary function evaluation, including lung volumes, diffusing capacity and arterial blood gases, were within normal limits. Bronchoalveolar lavage revealed Pneumocystis carinii organisms. In this asymptomatic, HIV-positive patient, active alveolar infection, evidenced by abnormal gallium-67 scanning, predated pulmonary physiologic abnormalities. This observation raises questions concerning the natural history of this disease process and the specificity of physiologic tests for excluding disease. It also has implications for the treatment of neoplasia in the HIV-positive patient population.

  13. Abnormal lung gallium-67 uptake preceding pulmonary physiologic impairment in an asymptomatic patient with Pneumocystis carinii pneumonia

    Pneumocystis carinii pneumonia was suggested by a diffuse, bilateral pulmonary uptake of gallium-67 in an asymptomatic, homosexual male with the antibody to the immunodeficiency virus (HIV) who was undergoing staging evaluation for lymphoma clinically localized to a left inguinal lymph node. Chest radiograph and pulmonary function evaluation, including lung volumes, diffusing capacity and arterial blood gases, were within normal limits. Bronchoalveolar lavage revealed Pneumocystis carinii organisms. In this asymptomatic, HIV-positive patient, active alveolar infection, evidenced by abnormal gallium-67 scanning, predated pulmonary physiologic abnormalities. This observation raises questions concerning the natural history of this disease process and the specificity of physiologic tests for excluding disease. It also has implications for the treatment of neoplasia in the HIV-positive patient population

  14. Bohmian Histories and Decoherent Histories

    Hartle, James B.

    2002-01-01

    The predictions of the Bohmian and the decoherent (or consistent) histories formulations of the quantum mechanics of a closed system are compared for histories -- sequences of alternatives at a series of times. For certain kinds of histories, Bohmian mechanics and decoherent histories may both be formulated in the same mathematical framework within which they can be compared. In that framework, Bohmian mechanics and decoherent histories represent a given history by different operators. Their ...

  15. Understanding the contribution of family history to colorectal cancer risk and its clinical implications: A state-of-the-science review.

    Lowery, Jan T; Ahnen, Dennis J; Schroy, Paul C; Hampel, Heather; Baxter, Nancy; Boland, C Richard; Burt, Randall W; Butterly, Lynn; Doerr, Megan; Doroshenk, Mary; Feero, W Gregory; Henrikson, Nora; Ladabaum, Uri; Lieberman, David; McFarland, Elizabeth G; Peterson, Susan K; Raymond, Martha; Samadder, N Jewel; Syngal, Sapna; Weber, Thomas K; Zauber, Ann G; Smith, Robert

    2016-09-01

    Persons with a family history (FH) of colorectal cancer (CRC) or adenomas that are not due to known hereditary syndromes have an increased risk for CRC. An understanding of these risks, screening recommendations, and screening behaviors can inform strategies for reducing the CRC burden in these families. A comprehensive review of the literature published within the past 10 years has been performed to assess what is known about cancer risk, screening guidelines, adherence and barriers to screening, and effective interventions in persons with an FH of CRC and to identify FH tools used to identify these individuals and inform care. Existing data show that having 1 affected first-degree relative (FDR) increases the CRC risk 2-fold, and the risk increases with multiple affected FDRs and a younger age at diagnosis. There is variability in screening recommendations across consensus guidelines. Screening adherence is communication are important barriers. Effective interventions incorporate strategies for overcoming barriers, but these have not been broadly tested in clinical settings. Four strategies for reducing CRC in persons with familial risk are suggested: 1) improving the collection and utilization of the FH of cancer, 2) establishing a consensus for screening guidelines by FH, 3) enhancing provider-patient knowledge of guidelines and communication about CRC risk, and 4) encouraging survivors to promote screening within their families and partnering with existing screening programs to expand their reach to high-risk groups. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2633-2645. © 2016 American Cancer Society. PMID:27258162

  16. 血清异常凝血酶原检测在原发性肝癌临床诊断中的应用%Application of serum abnormal prothrombin in clinical diagnosis of primary hepatocellular carcinoma

    濮珏彪; 王学锋; 彭奕冰

    2014-01-01

    Objective To investigate the significance of serum abnormal prothrombin [protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ)]in clinical diagnosis of primary hepatocellular carcinoma.Methods There were 365 samples from inpatients in Ruijin Hospital,including 100 patients with primary hepatocellular carcinoma and the other 265 patients with no primary hepatocellular carcinoma (59 cases of chronic liver disease,50 cases of gastrointestinal cancer,50 cases of secondary liver cancer,56 cases of other hepatopathy and 50 cases of healthy controls).Serum alpha fetoprotein (AFP)and PIVKA-Ⅱlevels were detected by Roche Cobas e601 automatic immunity analyzer and LUMIPULSE G1200 automatic immunity analyzer,respectively.Data were analyzed statistically by SPSS 16.0 software.Results Serum AFP and PIVKA-Ⅱlevels were significantly higher in primary hepatocellular carcinoma group than those in other disease group and healthy controls.Serum AFP had a sensitivity of 63.00%and a specificity of 84.91% in the diagnosis of primary hepatocellular carcinoma,while PIVKA-Ⅱhad a sensitivity of 74.00% and a specificity of 89.81%.The results of receiver operating characteristic (ROC)curve showed that the areas under the curve of AFP and PIVKA-Ⅱwere 0.789 and 0.873,respectively.The diagnosis sensitivity and specificity of the combination determination of AFP and PIVKA-Ⅱreached to 81.00% and 98.49%.Conclusions Serum PIVKA-Ⅱhas a better diagnosis significance than AFP,and can be a tumor marker in the diagnosis of primary hepatocellular carcinoma.Moreover,the combination determination of AFP and PIVKA-Ⅱcan improve the diagnosis efficiency for clinical primary hepatocellular carcinoma.%目的:研究血清异常凝血酶原[又称维生素K缺乏或拮抗剂Ⅱ诱导的蛋白质(PIVKA-Ⅱ)]检测在临床原发性肝癌诊断中的价值及意义。方法收集瑞金医院住院365例患者的血清,其中100例为原发性肝癌患者血清,265例为非原发

  17. SERUM CHEMISTRY ABNORMALITIES IN CHILDREN WITH UNPROVOKED SEIZURES

    J. Akhondian MD,

    2007-02-01

    Full Text Available ObjectiveMost children brought to the emergency department (ED for evaluation of seizures undergo an extensive laboratory workup. Since results are usually negative, the value of such routine laboratory workups has been questioned. A group of children with unprovoked seizures was prospectively studied to determine the diagnostic values of routine serum chemistries and to identify risk factors predictive of abnormal findings.Materials & MethodsAll patients evaluated at the ED of the Ghaem hospital during a consecutive 12 months period between Jan 2004 through Jan 2005 were studied. We collected data for patient's demographics, details of the history of present illness (including vomiting, diarrhea, apnea, medication use, past history of seizures, family history of seizures, metabolic disorders or other chronic medical illnesses, neonatal history and neurological examination as well as nutritional status, type and time of seizure. The role of abnormal serum chemistries as a seizure trigger factor was assessed in patients with a history of seizure.ResultsA total of 210 patients (mean age 19.2 months with unprovoked seizures were evaluated. Twenty- three serum abnormalities were noted in the patients (12 cases of hyponatremia, 7 of hypoglycemia, 4 of hypokalemia, 4 of uremia. The incidence of abnormal serum biochemical values was higher in patients with a first seizure, younger patients, and those with gastrointestinal symptoms.ConclusionAccording to the present study, one can conclude that in children younger than 2 years and having no structural CNS abnormality, electrolyte and glucose screening is recommended only for a first unprovoked seizure, when gastrointestinal symptoms or symptoms suggesting electrolyte disturbances are present.

  18. SERUM CHEMISTRY ABNORMALITIES IN CHILDREN WITH UNPROVOKED SEIZURES

    J. Akhondian MD

    2009-01-01

    Full Text Available ObjectiveMost children brought to the emergency department (ED for evaluation of seizures undergo an extensive laboratory workup. Since results are usually negative, the value of such routine laboratory workups has been questioned. A group of children with unprovoked seizures was prospectively studied to determine the diagnostic values of routine serum chemistries and to identify risk factors predictive of abnormal findings.Materials & MethodsAll patients evaluated at the ED of the Ghaem hospital during a consecutive 12 months period between Jan 2004 through Jan 2005 were studied. We collected data for patient's demographics, details of the history of present illness (including vomiting, diarrhea, apnea, medication use, past history of seizures, family history of seizures, metabolic disorders or other chronic medical illnesses, neonatal history and neurological examination as well as nutritional status, type and time of seizure. The role of abnormal serum chemistries as a seizure trigger factor was assessed in patients with a history of seizure.ResultsA total of 210 patients (mean age 19.2 months with unprovoked seizures were evaluated. Twenty- three serum abnormalities were noted in the patients (12 cases of hyponatremia, 7 of hypoglycemia, 4 of hypokalemia, 4 of uremia. The incidence of abnormal serum biochemical values was higher in patients with a first seizure, younger patients, and those with gastrointestinal symptoms.ConclusionAccording to the present study, one can conclude that in children younger than 2 years and having no structural CNS abnormality, electrolyte and glucose screening is recommended only for a first unprovoked seizure, when gastrointestinal symptoms or symptoms suggesting electrolyte disturbances are present.Keywords:Unprovoked, Seizure, Biochemistry, Children

  19. Radiological abnormalities in infants with urinary tract infections.

    Bourchier, D.; Abbott, G.D.; Maling, T M

    1984-01-01

    An intravenous urogram and micturating cystourethrogram were carried out in 100 infants presenting with documented urinary tract infections. Ninety three cases were identified by suprapubic aspiration and 7 by culture of two voided urine samples containing greater than 100 X 10(6) organisms per litre. The urinary tract abnormalities were analysed in respect of their clinical importance, patient's age, sex, and prematurity (in the 10 preterm infants). Radiological abnormalities were found in 4...

  20. 脑卒中后吞咽障碍并发抑郁相关因素的临床研究%A clinical investigation of related factors to depression complicated by swallowing abnormality following stroke

    陈逢俭; 陈湛愔; 陈文荣; 陈奕奕

    2008-01-01

    Objectire To investigate the incidence rate and related factors to depression complicated by swallowing abnormality following stroke. Methods 106 patients with shoulder - hands syndrome after stroke were involved in the study. Their mental status were investigated and evaluated by the means of SCL -90, HAMD, SDS, and neurological impairment. Results The incidence rate of poslslrcke depression complicated by swallowing abnormality was 58.94%, it was 30.00% in control group. The incidence rate of neurological impairment were 25±6 and. 15±7 respectively in the two groups. Conclusion There has a higher incidence rate of depression complicated by swallowing abnormality following stroke, and the degree of neurological impairment is significant. There is more algesic in swallowing abnormality, ,there is more severe depression. It can supply the evidence for preventing the depression following stroke.%目的 探讨脑卒中后吞咽障碍并发抑郁的发生率及相关因素.方法 对106例脑卒中后吞咽障碍患者进行症状自评量表(SCL-90)、汉密顿抑郁量表(HAMD)、抑郁自评量表(SDS)、神经功能缺损评分进行调查及评分.结果 脑卒中后吞咽障碍并发抑郁的发生率为58.49%,对照组为30.00%,神经功能缺损评分观察组为25±6,对照组为15±7,吞咽障碍越严重抑郁越严重.结论 脑卒中后吞咽障碍并发抑郁发生率高,神经功能缺损明显.吞咽障碍越严重并发押郁程度越严重,这为预防脑卒中后抑郁的发生提供了依据.

  1. Skin - abnormally dark or light

    ... ency/article/003242.htm Skin - abnormally dark or light To use the sharing features on this page, ... the hands. The bronze color can range from light to dark (in fair-skinned people) with the ...

  2. TRANSIENT ABNORMAL MYELOPOIESIS IN A NEONATE

    Ketan P

    2013-01-01

    Full Text Available ABSTRACT: Transient abnormal myelopoiesis (TAM is a unique di sorder of newborns associated intimately with Down’s syndrome, present ing with clinical and morphological features indistinguishable from acute myeloid leuka emia (AML. We report a case in a neonate, presenting with severe perinatal asphyxia and cyanosis ; complicated by metabolic acidosis. The hemogram revealed leucocytosis and thrombocytopenia. The peripheral smear showed marked left shift and 55% circulating myeloblasts. Additio nal findings included a hepatomegaly and mild dysmorphic features. The child eventually succu mbed to pulmonary hemorrhage on day one itself. TAM has to be differentiated from conge nital leukemia which portends a poor prognosis

  3. Relationship between pulmonary and cardiac abnormalities in sickle cell disease: implications for the management of patients

    Maria Christina Paixão Maioli

    2016-02-01

    Full Text Available ABSTRACT Objective: To evaluate the association between clinical, pulmonary, and cardiovascular findings in patients with sickle cell disease and, secondarily, to compare these findings between sickle cell anemia patients and those with other sickle cell diseases. Methods: Fifty-nine adults were included in this cross-sectional study; 47 had sickle cell anemia, and 12 had other sickle cell diseases. All patients underwent pulmonary function tests, chest computed tomography, and echocardiography. Results: Abnormalities on computed tomography, echocardiography, and pulmonary function tests were observed in 93.5%, 75.0%; and 70.2% of patients, respectively. A higher frequency of restrictive abnormalities was observed in patients with a history of acute chest syndrome (85% vs. 21.6%; p-value < 0.0001 and among patients with increased left ventricle size (48.2% vs. 22.2%; p-value = 0.036, and a higher frequency of reduced respiratory muscle strength was observed in patients with a ground-glass pattern (33.3% vs. 4.3%; p-value = 0.016. Moreover, a higher frequency of mosaic attenuation was observed in patients with elevated tricuspid regurgitation velocity (61.1% vs. 24%; p-value = 0.014. Compared to patients with other sickle cell diseases, sickle cell anemia patients had suffered increased frequencies of acute pain episodes, and acute chest syndrome, and exhibited mosaic attenuation on computed tomography, and abnormalities on echocardiography. Conclusion: A significant interrelation between abnormalities of the pulmonary and cardiovascular systems was observed in sickle cell disease patients. Furthermore, the severity of the cardiopulmonary parameters among patients with sickle cell anemia was greater than that of patients with other sickle cell diseases.

  4. Family History

    ... Brain Aneurysm Statistics and Facts Seeking Medical Attention Pediatric Aneurysms Brain Aneurysm Causes and Risk Factors Family History ... Brain Aneurysm Statistics and Facts Seeking Medical Attention Pediatric Aneurysms Brain Aneurysm Causes and Risk Factors Family History ...

  5. Memetics clarification of abnormal behavior

    2007-01-01

    AIM: Biological medicine is hard to fully and scientifically explain the etiological factor and pathogenesis of abnormal behaviors; while, researches on philosophy and psychology (including memetics) are beneficial to better understand and explain etiological factor and pathogenesis of abnormal behaviors. At present, the theory of philosophy and psychology is to investigate the entity of abnormal behavior based on the views of memetics.METHODS: Abnormal behavior was researched in this study based on three aspects, including instinctive behavior disorder, poorly social-adapted behavior disorder and mental or body disease associated behavior disorder. Most main viewpoints of memetics were derived from "The Meme Machine", which was written by Susan Blackmore. When questions about abnormal behaviors induced by mental and psychological diseases and conduct disorder of teenagers were discussed, some researching achievements which were summarized by authors previously were added in this study, such as aggressive behaviors, pathologically aggressive behaviors, etc.RESULTS: The abnormal behaviors mainly referred to a part of people's substandard behaviors which were not according with the realistic social environment, culture background and the pathologic behaviors resulted from people's various psychological diseases. According to the theory of "meme", it demonstrated that the relevant behavioral obstacles of various psychological diseases, for example, the unusual behavior of schizophrenia, were caused, because the old meme was destroyed thoroughly but the new meme was unable to establish; psychoneurosis and personality disorder were resulted in hard establishment of meme; the behavioral obstacles which were ill-adapted to society, for example, various additional and homosexual behaviors, were because of the selfish replications and imitations of "additional meme" and "homosexual meme"; various instinct behavioral and congenital intelligent obstacles were not significance

  6. Diagnosis and Clinical Course of Unexplained Dysphagia

    Yeom, Jiwoon; Song, Young Seop; Lee, Won Kyung; Oh, Byung-Mo; Han, Tai Ryoon

    2016-01-01

    Objective To investigate the final diagnosis of patients with unexplained dysphagia and the clinical and laboratory findings supporting the diagnosis. Methods We retrospectively analyzed 143 patients with dysphagia of unclear etiology who underwent a videofluoroscopic swallowing study (VFSS). The medical records were reviewed, and patients with a previous history of diseases that could affect swallowing were categorized into a missed group. The remaining patients were divided into an abnormal or normal VFSS group based on the VFSS findings. The clinical course and final diagnosis of each patient were examined. Results Among the 143 patients, 62 (43%) had a previous history of diseases that could affect swallowing. Of the remaining 81 patients, 58 (72.5%) had normal VFSS findings and 23 (27.5%) had abnormal VFSS findings. A clear cause of dysphagia was not identified in 9 of the 23 patients. In patients in whom a cause was determined, myopathy was the most common cause (n=6), followed by laryngeal neuropathy (n=4) and drug-induced dysphagia (n=3). The mean ages of the patients in the normal and abnormal VFSS groups differed significantly (62.52±15.00 vs. 76.83±10.24 years, respectively; p<0.001 by Student t-test). Conclusion Careful history taking and physical examination are the most important approaches for evaluating patients with unexplained swallowing difficulty. Even if VFSS findings are normal in the pharyngeal phase, some patients may need additional examinations. Electrodiagnostic studies and laboratory tests should be considered for patients with abnormal VFSS findings. PMID:26949675

  7. Abnormal Cervical Cancer Screening Test Results

    ... AQ FREQUENTLY ASKED QUESTIONS FAQ187 GYNECOLOGIC PROBLEMS Abnormal Cervical Cancer Screening Test Results • What is cervical cancer screening? • What causes abnormal cervical cancer screening test ...

  8. Electrocardiographic abnormalities and cardiac arrhythmias in chronic obstructive pulmonary disease.

    Goudis, Christos A; Konstantinidis, Athanasios K; Ntalas, Ioannis V; Korantzopoulos, Panagiotis

    2015-11-15

    Chronic obstructive pulmonary disease (COPD) is independently associated with an increased burden of cardiovascular disease. Besides coronary artery disease (CAD) and congestive heart failure (CHF), specific electrocardiographic (ECG) abnormalities and cardiac arrhythmias seem to have a significant impact on cardiovascular prognosis of COPD patients. Disturbances of heart rhythm include premature atrial contractions (PACs), premature ventricular contractions (PVCs), atrial fibrillation (AF), atrial flutter (AFL), multifocal atrial tachycardia (MAT), and ventricular tachycardia (VT). Of note, the identification of ECG abnormalities and the evaluation of the arrhythmic risk may have significant implications in the management and outcome of patients with COPD. This article provides a concise overview of the available data regarding ECG abnormalities and arrhythmias in these patients, including an elaborated description of the underlying arrhythmogenic mechanisms. The clinical impact and prognostic significance of ECG abnormalities and arrhythmias in COPD as well as the appropriate antiarrhythmic therapy and interventions in this setting are also discussed. PMID:26218181

  9. Effects of abnormal excitation on the dynamics of spiral waves

    Min-Yi, Deng; Xue-Liang, Zhang; Jing-Yu, Dai

    2016-01-01

    The effect of physiological and pathological abnormal excitation of a myocyte on the spiral waves is investigated based on the cellular automaton model. When the excitability of the medium is high enough, the physiological abnormal excitation causes the spiral wave to meander irregularly and slowly. When the excitability of the medium is low enough, the physiological abnormal excitation leads to a new stable spiral wave. On the other hand, the pathological abnormal excitation destroys the spiral wave and results in the spatiotemporal chaos, which agrees with the clinical conclusion that the early after depolarization is the pro-arrhythmic mechanism of some anti-arrhythmic drugs. The mechanisms underlying these phenomena are analyzed. Project supported by the National Natural Science Foundation of China (Grant Nos. 11365003 and 11165004).

  10. Eye movement abnormalities in anorexia nervosa.

    Pallanti, S; Quercioli, L; Zaccara, G; Ramacciotti, A B; Arnetoli, G

    1998-03-20

    The aim of the present study is to investigate smooth pursuit eye movement and saccadic performance in anorexia nervosa during a restored weight period and to determine if functional links can be made between eye movement performance and clinical features. SPEM parameters were recorded for 28 female anorectic out-patients (DSM IV), who had a body weight loss of up to 20% of ideal body weight. Twenty-eight comparison subjects were also tested. Clinically, each patient was assessed using the Eating Disorder Inventory (EDI), the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Structured Interview for Personality Disorders (SCID II), the Symptom Checklist-90-Revised (SCL-90-R) and the Hamilton Scale for Depression (HRSD). The anorectic patients performed slightly worse than the comparison subjects on a number of SPEM measures. No relationship was found between SPEM impairment and a global severity index of psychopathology (SCL 90-R GSI) or depressive symptoms. Moreover, OCD symptoms and scores on some EDI scales (such as perfectionism) appear related to the severity of the eye movement alterations. The evidence of SPEM abnormalities in a subgroup of anorectic patients during the remitted state and the relationship of the abnormalities to obsessive-compulsive symptoms are discussed. Results are in agreement with the hypothesis regarding the persistence of neurophysiological as well as psychopathological traits of disorder in anorectic patients. PMID:9579703

  11. Neuroimaging abnormalities in Griscelli's disease

    Griscelli's disease is a rare autosomal recessive immunodeficiency syndrome. We report a 7-1/2-month-old white girl who presented with this syndrome, but initially without neurological abnormalities. Initial CT of the brain was normal. Despite haematological remission with chemotherapy, she developed neurological symptoms, progressing to coma. At this time, CT showed areas of coarse calcification in the globi pallidi, left parietal white matter and left brachium pontis. Hypodense areas were present in the genu and posterior limb of the internal capsule on the right side, as well as posterior aspects of both thalami, together with minimal generalised atrophy. MRI revealed areas of increased T2 signal and a focal area of abnormal enhancement in the subcortical white matter. Griscelli's disease should be added to the list of acquired neuroimaging abnormalities in infants. (orig.)

  12. Environmental illness. A clinical review of 50 cases

    Terr, A.I.

    1986-01-01

    A review of 50 patients with a clinical ecology diagnosis of environmentally induced illness is reported. Histories were extremely heterogeneous. Eight patients had no symptoms or disease, 11 had symptoms caused by preexisting nonenvironmental disease, and 31 had multiple subjective symptoms. No consistent physical findings or laboratory abnormalities were found. Serum levels of immunoglobulins and complement, and circulating lymphocyte, B-cell, T-cell, and T-cell subset counts were not significantly abnormal. The diagnostic provocation-neutralization procedure, environmental restrictions, and dietary advice of clinical ecology produced further symptoms and fear of environmental and food contaminants. The patients with chronic multisystem complaints had characteristic symptoms of psychosomatic illness, but this study does not support the clinical ecology theory that psychosomatic illness may be an expression of food and chemical sensitivities induced by the toxic effect of environmental chemicals on the immune system.

  13. The Clinical Relevance of Various Hypersensitivity Tests in Patients with Atopic Dermatitis as Assessed by Their History, SCORAD Changes, and Number of Days with Need of Anti-Inflammatory Treatment

    Liska, Martin; Gutova, Vaclava; Panzner, Petr; Brodska, Petra

    2015-01-01

    Immediate and delayed hypersensitivity reactions can play a role in the pathogenesis of atopic dermatitis (AD). We tested 71 patients (median age 5 years) with AD for hypersensitivity to grass and birch pollen, Dermatophagoides pteronyssinus, and Dermatophagoides farinae using atopy patch test (APT), skin prick test (SPT), and specific IgE measurement. The sensitivity (SE) and specificity (SP) of the tests were calculated on the basis of personal history of AD exacerbation, clinical AD score ...

  14. Sperm abnormalities in exposed humans

    Šrám, Radim; Rubeš, J.

    Cambridge : Issue in Toxicology, Royal Society of Chemistry Publ.,, 2007, s. 247-258. ISBN 978-0-85404-847-2 R&D Projects: GA MŽP SL/740/5/03 Institutional research plan: CEZ:AV0Z50390512 Keywords : air pollution exposure * sperm abnormalities * male reproductive health Subject RIV: DN - Health Impact of the Environment Quality

  15. Impact of maternal metabolic abnormalities in pregnancy on human milk and subsequent infant metabolic development: methodology and design

    Hamilton Jill K

    2010-10-01

    Full Text Available Abstract Background Childhood obesity is on the rise and is a major risk factor for type 2 diabetes later in life. Recent evidence indicates that abnormalities that increase risk for diabetes may be initiated early in infancy. Since the offspring of women with diabetes have an increased long-term risk for obesity and type 2 diabetes, the impact of maternal metabolic abnormalities on early nutrition and infant metabolic trajectories is of considerable interest. Human breast milk, the preferred food during infancy, contains not only nutrients but also an array of bioactive substances including metabolic hormones. Nonetheless, only a few studies have reported concentrations of metabolic hormones in human milk specifically from women with metabolic abnormalities. We aim to investigate the impact of maternal metabolic abnormalities in pregnancy on human milk hormones and subsequently on infant development over the first year of life. The objective of this report is to present the methodology and design of this study. Methods/Design The current investigation is a prospective study conducted within ongoing cohort studies of women and their offspring. Pregnant women attending outpatient obstetrics clinics in Toronto, Canada were recruited. Between April 2009 and July 2010, a total of 216 pregnant women underwent a baseline oral glucose tolerance test and provided medical and lifestyle history. Follow-up visits and telephone interviews are conducted and expected to be completed in October 2011. Upon delivery, infant birth anthropometry measurements and human breast milk samples are collected. At 3 and 12 months postpartum, mothers and infants are invited for follow-up assessments. Interim telephone interviews are conducted during the first year of offspring life to characterize infant feeding and supplementation behaviors. Discussion An improved understanding of the link between maternal metabolic abnormalities in pregnancy and early infant nutrition may

  16. MRI abnormalities and related risk factors of the brain in patients with neuromyelitis optica

    Objective: To investigate the MRI features of the brain in patients with neuromyelitis optica (NMO), and to evaluate the correlation between the brain abnormalities and related risk factors. Methods: Fifty-four patients with definite NMO according to 2006 Wingerchuk diagnosis criteria were enrolled in this study. MRI scanning of the brain was performed in these patients. Distribution and signal features of all the lesions were analyzed. A Logistic regression analysis was used to evaluate the risk factors of brain abnormalities. Results: Twenty-four NMO patients (44.4%) showed unremarkable findings and thirty (55.6%) showed abnormalities on brain MRI. Multiple and non-specific small lesions in the subcortical white matter and grey-white matter junction were the most frequent abnormalities on brain MRI (13/30, 43.3%). Typical lesion locations included corpus callosum, subependyma of ventricles, hypothalamus and brain stem. The lesions showed punctate, patchy and linear abnormal signals. Post-contrast MRI showed no abnormal enhancement in 16 cases. Logistic regression analysis showed that coexisting autoimmune disease or infection. history had correlations with abnormalities of the brain on MRI (OR=3.519, P<0.05). Conclusions: There was a high incidence of brain abnormalities in NMO. Subependymal white matter, corpus callosum, hypothalamus and brain stem were often involved in NMO. NMO patients with coexisting autoimmune disease and infection history had higher risk of brain abnormalities. (authors)

  17. Hysteroscopic Findings in Patients with A History of Two Implantation Failures Following In Vitro Fertilization

    Ashraf Moini

    2012-01-01

    Full Text Available Background: This study was designed to evaluate the incidence of uterine pathologiesin infertile women with a history of two implantation failures after in vitro fertilization(IVF and estimate the effect of hysteroscopic correction on achieving a pregnancy inthese patients.Materials and Methods: The retrospective study population included 238 infertilewomen attended the outpatient infertility clinic between November 2007 and December2008. Patients with at least two previous IVF failures were eligible for this study.All patients had normal findings on hysterosalpingography performed prior their firstattempt for IVF. Standard transvaginal ultrasonography and diagnostic hysteroscopywere performed in patients before the subsequent IVF attempt.Results: Out of 238 patients with previous IVF failure who underwent hysteroscopicevaluation, 158 patients (66.4% showed normal uterine cavity. Abnormal cavity wasfound in 80 patients (33.6%. We found polyp as the most common abnormality (19.7%in the patients with previous history of IVF failure. The pregnancy rate was similar betweenIVF failure patients who treated by hysteroscopy for a detected uterine abnormality(24.6% and similar patients with normal uterine cavity (21.2% in hysteroscopicexaminations.Conclusion: The intrauterine lesions diagnosed by hysteroscopy in patients with previousIVF failure ranges from 0.8%-19.7%. Correction of abnormalities such as myoma and polypshowed good outcome, similar to that achieved in patients with a normal hysteroscopy.

  18. Genetic abnormality predicts benefit for a rare brain tumor

    A clinical trial has shown that addition of chemotherapy to radiation therapy leads to a near doubling of median survival time in patients with a form of brain tumor (oligodendroglioma) that carries a chromosomal abnormality called the 1p19q co-deletion.

  19. Proposal for standardised ultrasound descriptors of abnormally invasive placenta (AIP)

    Collins, Sally L; Ashcroft, Anna; Braun, Thorsten; Calda, Pavel; Langhoff-Roos, Jens; Morel, Olivier; Stefanovic, Vedran; Tutschek, Boris; Chantraine, Frederic

    2016-01-01

    Abnormally invasive placenta (AIP) is a clinical term used to describe a placenta that does not separate spontaneous during normal delivery and cannot be removed without causing high blood loss. Maternal outcome in cases with AIP is improved by antenatal diagnosis that currently relies on...

  20. Onychomycosis in Patients with Chronic Leg Ulcer and Toenail Abnormalities

    Cabete, J.; Apetato, M; Galhardas, C; Lestre, S

    2015-01-01

    Nails have a limited number of reactive patterns to disease. Accordingly, toenail changes of different etiologies may mimic onychomycosis. OBJECTIVE To determine the prevalence of toenail onychomycosis among patients with leg ulcer and toenail abnormalities attending a dermatology clinic. METHODS A cross-sectional study was conducted through the analysis of clinical records and results of mycological examination. RESULTS A total of 81 patients were included, with a median age of 76.0 years. M...

  1. Clinical and laboratory characteristics of 16 patients with acute lymphoblastic leukemia (ALL) harboring 19p13 abnormalities%16例伴19p13异常急性淋巴细胞白血病患者的临床和实验室研究

    贡金英; 竺晓凡; 刘旭平; 陈玉梅; 邹尧; 秘营昌; 王建祥

    2009-01-01

    Objective To investigate the clinical and laboratory characteristics of patients with acute lymphoblastie leukemia (ALL) bearing 19p13 abnormalities. Methods The morphologic, immunophenotyp- ic, cytogenetie, and clinal features as well as prognosis of 16 ALL patients with 19p13 abnormalities were retrospectively analyzed. The clinical features and laboratory findings between t(1;19) and der(19) groups were compared. Results Sixteen (4.02%)out of 398 ALL patients had 19p13 abnormalities, among them 15 cases were t (1 ; 19) (q23 ; p 13) [balanced t (1 ; 19) (q23 ; p 13} in 8 and unbalanced der (19) t (1 ; 19) (q23 ;p13} in 7] and 1 case t(17;19)(q22;p13). The W BC count and blast cell number were higher in the t (1 ; 19) group. The prognosis was better in der(19) t(1 ; 19) group than in balanced translocation t(1 ; 19) group. Conclusion The 19p13 abnormality is one of the non-random chromosomal aberration in patients with ALL. ALL patients with 19p13 abnormalities have unique clinical features and poor prognosis.%目的 分析伴19p13异常的急性淋巴细胞白血病(ALL)患者的临床和实验室特征:方法 对16例伴19p13异常的ALL患者的细胞形态学、免疫学、细胞遗传学和临床特点进行回顾性分析,并对t(1;19)组和der(19)组的临床和实验室资料进行对比分析.结果 伴19p13异常的ALL占同期ALL的4.02%,其中t(1;19)(q23;p13)15例[平衡易位t(1;19)(q23;p13)8例,不平衡易位der(19)t(1;19)(q23;p13)7例],t(17;19)(q22;p13)1例,t(1;19)组的外周血门细胞汁数和骨髓原始幼稚淋巴细胞比例明显高于der(19)组,而der(19)组的预后较t(1;19)组好.结论 19p13异常是ALL的一个非随机的染色体改变;伴有该异常的ALL患者具有独特的I临床特征和小良预后.

  2. Romerrigets historie

    Christiansen, Erik

    Romerrigets historie fra Roms legendariske grundlæggelse i 753 f.v.t. til Heraklios' tronbestigelse i 610 e.v.t.......Romerrigets historie fra Roms legendariske grundlæggelse i 753 f.v.t. til Heraklios' tronbestigelse i 610 e.v.t....

  3. Intellectual History

    In the 5 Questions book series, this volume presents a range of leading scholars in Intellectual History and the History of Ideas through their answers to a brief questionnaire. Respondents include Michael Friedman, Jacques le Goff, Hans Ulrich Gumbrecht, Jonathan Israel, Phiip Pettit, John Pocock...

  4. Combined cardiological and neurological abnormalities due to filamin A gene mutation

    de Wit, Marie Claire Y.; de Coo, Irenaeus F. M.; Lequin, Maarten H.; Halley, Dicky J. J.; Roos-Hesselink, Jolien W.

    2010-01-01

    Background Cardiac defects can be the presenting symptom in patients with mutations in the X-linked gene FLNA. Dysfunction of this gene is associated with cardiac abnormalities, especially in the left ventricular outflow tract, but can also cause a congenital malformation of the cerebral cortex. We noticed that some patients diagnosed at the neurogenetics clinic had first presented to a cardiologist, suggesting that earlier recognition may be possible if the diagnosis is suspected. Methods and results From the Erasmus MC cerebral malformations database 24 patients were identified with cerebral bilateral periventricular nodular heterotopia (PNH) without other cerebral cortical malformations. In six of these patients, a pathogenic mutation in FLNA was present. In five a cardiac defect was also found in the outflow tract. Four had presented to a cardiologist before the cerebral abnormalities were diagnosed. Conclusions The cardiological phenotype typically consists of aortic or mitral regurgitation, coarctation of the aorta or other left-sided cardiac malformations. Most patients in this category will not have a FLNA mutation, but the presence of neurological complaints, hyperlaxity of the skin or joints and/or a family history with similar cardiac or neurological problems in a possibly X-linked pattern may alert the clinician to the possibility of a FLNA mutation. PMID:20730588

  5. Clinical value and effectiveness of sonography screening for fetal chromosomal abnormalities in the middle and late pregnancy%中晚孕期超声筛查胎儿染色体异常的有效性及应用价值研究

    马喆; 陶国伟; 展新风; 刘村; 程琳; 宋瑶; 刘芳; 刘韶平

    2009-01-01

    目的 研究中晚孕期超声筛查胎儿染色体异常的有效性及应用价值.方法 经超声筛查为结构异常的中晚孕期胎儿和经孕母血清筛查为高风险的中期妊娠胎儿,行羊膜腔或脐静脉穿刺取羊水或脐血,作染色体核型诊断.结果 ①超声筛查接受检查的结构异常胎儿31例,检出异常染色体8例,检出率为25.8%.31例中颈部淋巴囊肿伴水肿3例,全部染色体异常;单纯颈项皮肤增厚3例,其中2例染色体异常;多发畸形、Dandy-Walker畸形及前脑无裂畸形各1例,染色体均异常.②血清筛查接受检查的唐氏综合征和18-三体高风险孕妇516例,检出异常染色体14例,检出率为2.71%.14例中唐氏综合征7例,其他染色体异常7例.③单纯超声筛查和血清筛查共筛查为高危又接受诊断者544(516+28)例,检出异常染色体21(14+7)例,两种方法互补染色体异常检出率为3.86%.互补筛查检出率是血清筛查的1.42倍,比血清筛查提高42.43%.结论 ①中晚孕期超声显示的某些胎儿结构异常是提示胎儿染色体异常的有效指征.②超声和血清两种筛查方法互补,可以提高染色体异常的检出率,对于血清失筛查或筛查低危漏诊孕妇是有效的弥补措施.%Objective To evaluate the clinical value and effectiveness of ultrasound screening for fetal chromosomal abnormalitie in the middle and late pregnancy. Methods Fetuses who were detected with abnormal ultrasound findings during the middle and late pregnancy, and high risk of maternal serum screening underwent amnioeentesis or eordocentesis for fetal chromosome karyotypes. Results (1) A total of 31 cases with fetal malformation diagnosed by ultrasound were analysed for fetal chromosome karyotypes, and 8 (25.8%) cases were proved with fetal abnormal chromosome karyotypes. There were 3 cases of cervical springwater cyst accompany with edema,and all were fetal abnormal chromosome karyotypes. There were 3 cases of cervical

  6. Functional neuroimaging abnormalities in idiopathic generalized epilepsy

    Megan L. McGill

    2014-01-01

    Full Text Available Magnetic resonance imaging (MRI techniques have been used to quantitatively assess focal and network abnormalities. Idiopathic generalized epilepsy (IGE is characterized by bilateral synchronous spike–wave discharges on electroencephalography (EEG but normal clinical MRI. Dysfunctions involving the neocortex, particularly the prefrontal cortex, and thalamus likely contribute to seizure activity. To identify possible morphometric and functional differences in the brains of IGE patients and normal controls, we employed measures of thalamic volumes, cortical thickness, gray–white blurring, fractional anisotropy (FA measures from diffusion tensor imaging (DTI and fractional amplitude of low frequency fluctuations (fALFF in thalamic subregions from resting state functional MRI. Data from 27 patients with IGE and 27 age- and sex-matched controls showed similar thalamic volumes, cortical thickness and gray–white contrast. There were no differences in FA values on DTI in tracts connecting the thalamus and prefrontal cortex. Functional analysis revealed decreased fALFF in the prefrontal cortex (PFC subregion of the thalamus in patients with IGE. We provide minimum detectable effect sizes for each measure used in the study. Our analysis indicates that fMRI-based methods are more sensitive than quantitative structural techniques for characterizing brain abnormalities in IGE.

  7. MR evaluation of visceroatrial situs abnormality

    Thirteen patients with visceroatrial situs abnormalities were evaluated by magnetic resonance (MR) imaging. Eleven patients were confirmed surgically. Two patients were diagnosed by MRI and cardiac catheterization. Right isomerism was found in seven patients, left isomerism in two, and situs in versus in four. For the determination of situs, we evaluated the morphology of atrial appendages and main bronchi, the relationship between abdominal aorta and inferior vena cava (lVC), and the status of upper abdominal viscera. The bilateral atrial morphology was differentiated in 8 of 12 patients. The bronchial situs was determined in 11 of 12 patients. Juxtaposition of abdominal aorta and IVC was found in 6 of 7 with right isomerism. lVC interruption with azygos continuation was found in all two with left isomerism. Incidentally three cases of short pancreas were found. MR imaging showed all structures relevant for the assessment of situs, thus obvrating the need for performing additional diagnostic procedures. MR imaging, therefore, is a valuable tool in the clinical management of patients who are suspected of having a situs abnormality

  8. Genetic abnormalities associated with acute lymphoblastic leukemia.

    Yokota, Takafumi; Kanakura, Yuzuru

    2016-06-01

    Acute lymphoblastic leukemia (ALL) occurs with high frequency in childhood and is associated with high mortality in adults. Recent technical advances in next-generation sequencing have shed light on genetic abnormalities in hematopoietic stem/progenitor cells as the precursor to ALL pathogenesis. Based on these genetic abnormalities, ALL is now being reclassified into newly identified subtypes. Philadelphia chromosome-like B-lineage ALL is one of the new high-risk subtypes characterized by genetic alterations that activate various signaling pathways, including those involving cytokine receptors, tyrosine kinases, and epigenetic modifiers. Philadelphia chromosome-like ALL is essentially heterogeneous; however, deletion mutations in the IKZF1 gene encoding the transcription factor IKAROS underlie many cases as a key factor inducing aggressive phenotypes and poor treatment responses. Whole-genome sequencing studies of ALL patients and ethnically matched controls also identified inherited genetic variations in lymphoid neoplasm-related genes, which are likely to increase ALL susceptibility. These findings are directly relevant to clinical hematology, and further studies on this aspect could contribute to accurate diagnosis, effective monitoring of residual disease, and patient-oriented therapies. PMID:26991355

  9. Abnormal neurological exam findings in individuals with mild traumatic brain injury (mTBI) versus psychiatric and healthy controls.

    Silva, Marc A; Donnell, Alison J; Kim, Michelle S; Vanderploeg, Rodney D

    2012-01-01

    In those with a history of mild traumatic brain injury (mTBI), cognitive and emotional disturbances are often misattributed to that preexisting injury. However, causal determinations of current symptoms cannot be conclusively determined because symptoms are often nonspecific to etiology and offer virtually no differential diagnostic value in postacute or chronic phases. This population-based study examined whether the presence of abnormalities during neurological examination would distinguish between mTBI (in the chronic phase), healthy controls, and selected psychiatric conditions. Retrospective analysis of data from 4462 community-dwelling Army veterans was conducted. Diagnostically unique groups were compared on examination of cranial nerve function and other neurological signs. Results demonstrated that individuals with mTBI were no more likely than those with a major depressive disorder, generalized anxiety disorder, posttraumatic stress disorder, or somatoform disorder to show any abnormality. Thus, like self-reported cognitive and emotional symptoms, the presence of cranial nerve or other neurological abnormalities offers no differential diagnostic value. Clinical implications and study limitations are presented. PMID:23020281

  10. Echocardiographic abnormalities in hypertensive patients

    A descriptive cross-sectional study was carried out in 120 hypertensive patients with a course of 5 or more years, who went to the emergency room of 'Saturnino Lora' Provincial Teaching Hospital from November 2010 to November 2011 in order to determine the presence or absence of echocardiographic abnormalities typical of hypertension. Of these, 78,3 % was affected, most of whom reported not to continue with regular previous medical treatment, and 21,7 % had not these abnormalities. Age group of 50-60 years, males and blacks prevailed in the case material. The most significant echocardiographic findings were left ventricular hypertrophy and heart failure with ejection fraction of left ventricle preserved

  11. Pathophysiology of knee jerk reflex abnormalities in L5 root injury

    Ginanneschi, Federica; Mondelli, Mauro; Piu, Pietro; Rossi, Alessandro

    2015-01-01

    Although the knee jerk reflex is mediated by the L3 and L4 nerve roots, evidence exists that altered knee jerk expression may occur with exclusively L5 radiculopathy. The present study set out to identify the factors responsible for knee jerk reflex abnormalities in L5 monoradiculopathy. We analyzed clinical and electrophysiological data in 56 subjects affected by L5 monoradiculopathy. Seventeen patients (30.3%) showed an abnormal knee reflex. L5 patients with an abnormal knee reflex differed...

  12. Is Dark Energy Abnormally Weighting?

    Fuzfa, A.; Alimi, J. -M.

    2006-01-01

    We present a new interpretation of dark energy in terms of an \\textit{Abnormally Weighting Energy} (AWE). This means that dark energy does not couple to gravitation in the same way as ordinary matter, yielding a violation of the weak and strong equivalence principles on cosmological scales. The resulting cosmological mechanism accounts for the Hubble diagram of type Ia supernovae in terms of both cosmic acceleration and variation of the gravitational constant while still accounting for the pr...

  13. Computed tomography of thymic abnormalities

    Schnyder, P.; Candardjis, G.

    1987-05-01

    Computed tomographic examinations of 38 patients with surgically and histologically proven diagnosis were reviewed. Twenty subjects (52%) had an invasive thymoma and 16% an hyperplastic thymus. Myasthenia gravis was present in 6 cases (16%) of thymic abnormalities, four (10,5%) with invasive thymoma and two (5%) with thymic hyperplasia. Graves' disease was also present in one case of thymic hyperplasia. We emphasize the contribution of CT to the diagnosis and the prognosis.

  14. Mastoid abnormalities in Down syndrome

    Hearing loss and otitis media are commonly associated with Down syndrome. Hypoplasia of the mastoids is seen in many affected children and sclerosis of mastoid bones is not uncommon in Down syndrome. Awareness and early recognition of mastoid abnormality may lead to appropriate and timely therapy, thereby preserving the child's hearing or compensating for hearing loss; factors which are important for learning and maximum development. (orig.)

  15. Computed tomography abnormalities in hanging

    The CT pattern of bilateral and symmetrical round low density areas in the globi pallidi has been observed in a young man who attempted suicide by hanging. These CT abnormalities are similar to those described in other conditions such as carbon monoxide, hydrogen sulfide, cyanide and methanol poisoning, hypoglycaemia, drowning and acute global central nervous system hypoperfusion.The findings appear to be correlated with acute cerebral hypoxia. (orig.)

  16. Cardiac abnormalities after subarachnoid hemorrhage

    Bilt, I.A.C. van der

    2016-01-01

    Aneurysmal subarachnoid hemorrhage(aSAH) is a devastating neurological disease. During the course of the aSAH several neurological and medical complications may occur. Cardiac abnormalities after aSAH are observed often and resemble stress cardiomyopathy or Tako-tsubo cardiomyopathy(Broken Heart Syndrome) that has been described after acute stress. It is a reversible cardiac dysfunction with distinct imaging features(the echocardiographic or left ventricular angiographic image resembles a Tak...

  17. Abnormal uterine bleeding: a clinicohistopathological analysis

    Anupamasuresh Y

    2014-06-01

    Methods: In our prospective study of 359 Patients of the age between 46 and 73 years, clinical characteristics and the pattern of endometrial histopathology and their association in women, who present with abnormal uterine bleeding, are categorised into six groups. Results: In our study, a significant correlation of histopathology and BMI was observed with endometrial hyperplasia and malignancy in obese patient i.e. 37 out 96 and 13 out of 23 respectively. The incidence of malignancy has been increasing with the age being 1.6% in 46-50 years to 60% in 70-75 years. In our study 116 (32.3% had hypertension, 33 patients (9.2% had diabetes mellitus, 40 patients (11.1% had hypothyroidism. Conclusions: We found a maximum incidence of AUB in multiparous women. Clinicohistopathological analysis of AUB revealed endometrial hyperplasia in majority of patients. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 656-661

  18. A clinical analysis of abnormal gestational glucose metabolism and pregnancy outcome of the woman%妊娠期糖代谢异常与妊娠结局的临床分析

    米阳; 闫坤; 黄谱; 苟文丽

    2009-01-01

    Objective To investigate relationship between abnormal gestational glucose metabolism and pregnancy outcome of the woman. Methods 1 636 pregnant women who received antenatal examination in Shannxi Provincial Maternal and Child Health Hospital in a period from January to June, 2008 were screened at their 24~28 weeks of gestation with 50g glucose challenge test (GCT). Those pregnant women with abnormal GCT results further received oral 75g glucose tolerance test (OGTT). According to OGTT results, the pregnant women were divided into 2 groups: GDM group (n=69) and gestational impaired glucose tolerance group (GIGT group, n=124). 300 pregnant women with normal glucose metabolism were as controls. All of them were followed up untill delivery and the perinatal outcomes in the 3groups were compared. Results The incidence of GDM was 4.21% and that of GIGT was 7.58%. The incidences of hypertensive disorder complicating pregnancy, polyhydramnios, premature rupture of membrane and premature delivery in GDM group were higher than those in the control group (χ2=4.660,11.530,5.193,4.661 respectively,all P<0.05).In GIGT group ,the incidences of polyhydramnios and premature rupture of membrane were significantly higher than those in the control group(χ2=12.450,6.325,respectively,both P<0.05). Conclusion The pregnant women with GDM or GIGT have significantly high incidences of obstetric complications and rate of cesarean section. So, screening of GDM should be strengthened and early diagnosis, early treatment, gestational supervision and guidance should be carried out in order to reduce incidence rates of maternal and infantile complications.%目的 探讨妊娠期糖代谢异常与妊娠结局的关系.方法 选取2008年1~6月在陕西省妇幼保健院进行产前检查的1 636名孕妇,于24~28周进行50g葡萄糖筛查试验,异常者行75g糖耐量试验,按糖代谢异常情况分为妊娠期糖尿病组(69例)和妊娠期糖耐量受损组(124例);

  19. CARDIOVASCULAR ABNORMALITIES IN PATIENTS WITH HIV INFECTION: A BOLT IN BLUE

    Anita

    2015-12-01

    Full Text Available One of the consistent findings among various studies on HIV has been simultaneous multiorgan dysfunction. Cardiovascular disorders are now most common cause of mortality worldwide. With more effective and widespread treatment of HIV in resource-rich settings, morbidity and mortality from non-AIDS-related events have surpassed those from AIDS-related events with cardiovascular diseases emerging as an important cause of death in HIV-infected patients relative to the decreasing incidence of opportunistic disease. Various studies have reported a 1.5-fold increase in the rate of cardiovascular events in HIV-infected individuals compared to control populations. MATERIAL AND METHODS The aim of the study was to the find the prevalence and types of different cardiovascular abnormalities in HIV positive patients and assess their association with CD4 counts. Consecutive 82 patients, HIV positive patients fulfilling the inclusion criteria and giving informed consent were included in the study. All patients were subjected to history taking and a detailed physical examination. Blood counts, renal function tests, lipid profile and CD4 counts were estimated and patients were subjected to 12-lead ECG, chest X-ray and 2D/Colour Doppler Echocardiogram. RESULTS Of the 82 patients studied 47.46% had evidence of cardiovascular involvement, out of which 12% had clinical features of heart failure while electrocardiographic changes were seen in 35% of patients in the form of sinus tachycardia (27%, QTc prolongation (10% and left sided chamber enlargements (6%. Echocardiographic abnormalities were noted in 39 patients (47.56% including fractional shortening associated with systolic dysfunction (26.8%. The mean CD4 count in patients with echocardiographic abnormalities was found to be 58.87±29.80, whereas in patients without echocardiographic abnormalities it was 136.53±38.80 (p<0.0001. CONCLUSION High frequencies of cardiac abnormalities, both symptomatic and

  20. Kabuki Syndrome: a case report with severe ocular abnormalities

    Flavio Mac Cord Medina

    2013-10-01

    Full Text Available Kabuki syndrome is a rare congenital anomaly, characterized by five fundamental features, the "Pentad of Niikawa": dysmorphic facies, skeletal anomalies, dermatoglyphic abnormalities, mild to moderate mental retardation and postnatal growth deficiency. Patients present characteristic external ocular features, nonetheless they may also present significant ocular abnormalities. We report a case of a brazilian child diagnosed with Kabuki syndrome, addressing the clinical features observed, with emphasis on the ocular manifestations. This case highlights the existence of this syndrome and all of its complexity. The identification of preventable causes of loss of vision underlines the value of detailed ophthalmologic examination of Kabuki syndrome patients.

  1. Genomic SNP array as a gold standard for prenatal diagnosis of foetal ultrasound abnormalities

    Srebniak Malgorzata I

    2012-03-01

    Full Text Available Abstract Background We have investigated whether replacing conventional karyotyping by SNP array analysis in cases of foetal ultrasound abnormalities would increase the diagnostic yield and speed of prenatal diagnosis in clinical practice. Findings/results From May 2009 till June 2011 we performed HumanCytoSNP-12 array (HCS (http://www.Illumina.com analysis in 207 cases of foetal structural abnormalities. HCS allows detecting unbalanced genomic abnormalities with a resolution of about 150/200 kb. All cases were selected by a clinical geneticist after excluding the most common aneuploidies by RAD (rapid aneuploidy detection. Pre-test genetic counselling was offered in all cases. In 24/207 (11,6% foetuses a clinically relevant genetic abnormality was detected. Only 8/24 abnormalities would have been detected if only routine karyotyping was performed. Submicroscopic abnormalities were found in 16/207 (7,7% cases. The array results were achieved within 1-2 weeks after amniocentesis. Conclusions Prenatal SNP array testing is faster than karyotyping and allows detecting much smaller aberrations (~0.15 Mb in addition to the microscopic unbalanced chromosome abnormalities detectable with karyotyping (~ > 5 Mb. Since karyotyping would have missed 66% (16/24 of genomic abnormalities in our cohort, we propose to perform genomic high resolution array testing assisted by pre-test counselling as a primary prenatal diagnostic test in cases of foetal ultrasound abnormalities.

  2. Glucose abnormalities in hepatitis C virus infection.

    Huang, Jee-Fu; Yu, Ming-Lung; Dai, Chia-Yen; Chuang, Wan-Long

    2013-02-01

    Hepatitis C virus (HCV) infection is one of the most important causes of cirrhosis and hepatocellular carcinoma and has a tremendous impact on public health worldwide. HCV is both hepatotropic and lymphotropic. Replication of HCV in diseased extrahepatic organs and tissues may either trigger latent autoimmunity or induce autoimmune disorders. In addition to established liver injury, type 2 diabetes mellitus (T2DM) is an important feature of extrahepatic metabolic disorders which is attributed to HCV infection. It also has some impact on the disease activity, disease course, clinical outcomes, and treatment efficacy of antiviral therapy. Previous experimental and clinical findings have highly suggested that HCV per se is diabetogenic. The cause-effect interaction between a common endocrine disorder and an infectious disease is an important issue to elucidate. Although the precise mechanisms whereby HCV infection leads to insulin resistance (IR) and glucose abnormalities are not entirely clear, it differs from the usual pathogenesis of T2DM in those with non-HCV liver diseases. This review initially highlights epidemiological and pathophysiological studies addressing the mutual link between chronic HCV infection (CHC) and T2DM. The characteristics of glucose abnormalities in this special population are depicted from the current evidence. The mutual roles of IR and CHC with respect to the prediction of treatment efficacy, how treatment response affects IR, and the role of pancreatic beta cell function in the entire suite are discussed. With the rapid progression of antiviral therapy for CHC in the past decade, we have also listed some points of future perspective in this issue. PMID:23347806

  3. The Abnormal Choroidal Vessels in Aged Patients

    Shizhou Huang; Feng Wen; Dezheng Wu; Guangwei Luo; Caijiao Liu

    2002-01-01

    Background: To show the abnormal choroidal vessels in aged patients with indocyanine-green angiography (ICGA).Methods: ICGA was performed in 350 patients with TOPCON TRC-50IA fundus camera.The images were recorded and retrospectively reviewed.Results: Five aged patients out of 350 cases were found to have abnormal choroidalvessels. The incidence was 1.43%. The abnormal choroidal vessels showed round- shapet,focal enlargement, abnormal shape and entrance, satellite appearance, and vascularloops. These might be due to congenital abnormality of choroid.Conclusion: ICGA could be used to observe the abnormal choroidal vessels.

  4. The role of the standard EEG in clinical psychiatry.

    O'Sullivan, S S

    2012-02-03

    BACKGROUND: The EEG is a commonly requested test on patients attending psychiatric services, predominantly to investigate for a possible organic brain syndrome causing behavioural changes. AIMS: To assess referrals for EEG from psychiatric services in comparison with those from other sources. We determine which clinical factors were associated with an abnormal EEG in patients referred from psychiatric sources. METHODS: A retrospective review of EEG requests in a 1-year period was performed. Analysis of referral reasons for psychiatric patients was undertaken, and outcome of patients referred from psychiatric services post-EEG was reviewed. RESULTS: One thousand four hundred and seventy EEGs were reviewed, of which 91 (6.2%) were referred from psychiatry. Neurology service referrals had detection rates of abnormal EEGs of 27%, with psychiatric referrals having the lowest abnormality detection rate of 17.6% (p < 0.1). In psychiatric-referred patients the only significant predictors found of an abnormal EEG were a known history of epilepsy (p < 0.001), being on clozapine (p < 0.05), and a possible convulsive seizure (RR = 6.51). Follow-up data of 53 patients did not reveal a significant clinical impact of EEG results on patient management. CONCLUSIONS: Many patients are referred for EEG from psychiatric sources despite a relatively low index of suspicion of an organic brain disorders, based on reasons for referral documented, with an unsurprising low clinical yield.

  5. 中孕期系统超声筛查对检出异常胎儿的临床价值及产前超声筛查漏检病例初步分析%Clinical value of systematic ultrasound screening for fetal abnormality in second trimester and analyzing the Undetected cases of prenatal ultrasound screening preliminary

    荆春丽; 孙寒冰; 沙恩波; 王彦; 郭邑

    2011-01-01

    Objective To evaluate the clinical value of systematic ultrasound screening for fetal abnormality in second trimester, and to analyze the causes of misdiagnosis and medical malpractice. Methods By checking up 12 682 cases of 20-24 weeks pregnant women with using systematic ultrasound screening, storied the information in the workstation, and then did the evaluate, following-up interviews and statistics. Results Six hundred sixteen cases had been diagnosed out with abnormal structure or fetal abnormality. Detection rate 4. 86%( 616/12 682 ) and 18 cases with abnormal structure were failed. Failed rate 0. 14% ( 18/12 682 ), which were confirmed after birth. Including 2 cases with hand abnormality, 1 case with 1 degree cleft lip, 6 cases with ventricular septum defect( ≤4 mm ),1 case with tetralogy of fallot, 1 case with congenital defect of external ear, 1 case with abnormalities of the genitalia, 2 cases with cleft palate only, 1 case with strephenopodia,l case with caudal regression syndrome,l case with sacral spinal bifida with tethered cord fat, 1case with sacrococcygeal cystic spina bifida. 3 of above cases ( 1 case in caudal regression syndrome, 1 case in sacral spinal bifida with tethered cord fat, 1 case of sacrococcygeal cystic spina bifida ) caused medical malpractice after birth. There were 239 cases of the above 616 cases with fetal abnormality had abortions in our hospital,( 1 ) Necropsy 23 cases among the abortions were conformed to the ultrasound diagnosis. ( 2 ) Appearance of the abnormality 142( cleft lip 43 )cases among the abortions were conformed to the ultrasound diagnosis. ( 3 ) 61 cases had been diagnosed out with fetal visceral abnormality, without necropsy 13 cases among them were polyhydramnios or oligohydramnios. Three hundred seventy-seven exceptional cases were primary abortions, which also confirmed our diagnosis after the hospital' stelephone interview. Conclusion The systematic ultrasound screening can improve the detection rate

  6. Clinical effect of semen-storing cervical cap on artificial insemination outcome in patients with abnormal anatomical position of cervix%储精式宫颈帽用于宫颈解剖位置异常人工授精的临床效果观察

    陶国振; 胥玉梅; 李娟; 孙林; 刘锦云; 于建春

    2012-01-01

    目的:观察储精式宫颈帽用于宫颈解剖位置异常人工授精的临床效果.方法:将宫颈解剖位置异常导致不孕的妇女66例随机分成3组,实验组采用储精式宫颈帽夫精人工授精,对照A组采用宫颈管夫精人工授精,对照B组采用宫腔夫精人工授精,比较各组周期妊娠率.结果:周期妊娠率实验组(21.86%,14/65)高于对照A组(8.06%,5/62)(P <0.05),与对照B组(23.21%,13/56)比较无统计学差异(P>0.05).结论:储精式宫颈帽夫精人工授精治疗宫颈解剖位置异常所致不孕与宫腔夫精人工授精临床效果一致,明显高于宫颈管夫精人工授精,是一种简单、方便和有效的人工授精方法.%Objective: To explore the clinical use of self - made semen - storing cervical cap on the outcome of artificial insemination with husband sperm in infertile women with abnormal anatomical position of the cervix. Methods; Sixty - six infertile women with abnormal anatomical position of the cervix were prospectively randomized to 3 groups; the experimental group, control group A and B. Women in the experimental group received underwent artificial insemination with semen - storing cervical cap. And those in control group A and B received cervical artificial insemination and intrauterine insemination, respectively. The pregnancy rate was evaluated. Results o The pregnancy rate of the experimental group and was 21.86% (14/65), significantly higher than that of control group A (8.06% , 5/62, P0.05). Conclusion; The clinical effect of artificial insemination with semen - storing cervical cap is similar with that of intrauterine insemination and higher than that of cervical artificial insemination for patients with abnormal anatomical position of the cervix. It may be a simple, convenient and effective method for artificial insemination.

  7. MR characteristics of hippocampal sclerosis with ipsilateral anterior temporal abnormality in refractory temporal lobe epilepsy and the correlation with clinical manifestation%难治性颞叶癫痫海马和同侧前颞叶MRI特征及其与临床相关性

    曹惠霞; 林笑丰; 谭伟杰; 王俊; 杜渭清; 韩立新; 王蔚; 王伟

    2014-01-01

    Objective:To investigate the MRI features of hippocampal sclerosis (HS)with ipsilateral anterior tempo-ral abnormality and correlation between which and clinical manifestation in refractory temporal lobe epilepsy (TLE).Meth-ods:34 patients with TLE including 15 females and 19 males,aged (22.4±8.2)years were included,and all patients were diagnosed with HS by pathology and/or MRI.25 patients underwent surgical treatment and pathological diagnosis was ob-tained.MRI changes of hippocampus and ipsilateral anterior temporal lobe abnormalities were observed.All patients were divided into two groups according to the presence/absence of MRI signs indicative of anterior temporal abnormality.The group of ipsilateral anterior temporal abnormality was divided into two subgroups on the basis of whether grey/white matter blurring and temporal lobe atrophy were present concomitantly or not.The clinical features were compared between the two groups and two subgroups respectively.Results:Of the 34 patients,22 (64.7%)had ipsilateral anterior temporal abnormali-ties besides HS.The age of first onset of TLE was younger in the anterior temporal abnormality group than the normal group (t= -3.438,P= 0.002)and the duration of TLE was longer than the normal group (t= 2.453,P= 0.020).No sig-nificant difference was observed in other clinical features between the two groups and two subgroups.Conclusion:TLE pa-tients with ipsilateral anterior temporal abnormality often had earlier epilepsy onset and longer epilepsy duration.MRI fea-tures are closely related with clinical severity of epilepsy,which is of great importance in defining the culprit side of epilepsy.%目的:探讨难治性颞叶癫痫海马硬化(HS)与同侧前颞叶 MRI特征及其与临床的相关性。方法:搜集经影像学或病理诊断为难治性颞叶癫痫 HS的34例患者的临床和影像资料,其中25例行手术治疗。34例中女15例,男19例,平均年龄(22.4±8.2)岁。

  8. Family History

    Your family history includes health information about you and your close relatives. Families have many factors in common, including their genes, ... as heart disease, stroke, and cancer. Having a family member with a disease raises your risk, but ...

  9. Comprehensive Diagnostic Program for Medically Underserved Women With Abnormal Breast Screening Evaluations in an Urban Population

    Palmieri, Frances M.; Deperi, Elizabeth R.; Mincey, Betty A.; Smith, Judith A.; Wen, Lonnie K.; Chewar, Deborah M.; Abaya, Reza; Colon-Otero, Gerardo; Perez, Edith A.

    2009-01-01

    OBJECTIVE: To institute a patient navigator program for underinsured women to eliminate delays in diagnostic resolution of abnormal screening mammograms, provide services for abnormalities noted during breast cancer screening, describe demographic and clinical characteristics of enrollees, and assess postscreening follow-up care.

  10. Neurofibromatosis type 1: clinical and radiological aspects

    Neurofibromatosis type 1 is a genetic disease with an incidence of approximately 1 in 3,000 people, characterized mainly by systemic and progressive involvement, manifesting by physical deformity and compromising of neurological functions. The diagnosis of the neurofibromatosis type 1 must be performed the earliest possible through clinical exams and familiar history. The use of imaging diagnosis as radiography, computed tomography, and magnetic resonance imaging is valuable for diagnosis, treatment, follow-up of patients and control of lesions, preventing complications. In this study we describe the clinical and radiological aspects of the neurofibromatosis type 1, considering clinical features, genetics, bone alterations in chest, vertebral column, upper and lower limbs, and craniofacial abnormalities. (author)

  11. Identification of Abnormal Stem Cells Using Raman Spectroscopy

    Harkness, Linda; Novikov, Sergey M; Beermann, Jonas;

    2012-01-01

    microscopy is a label-free method for rapid and sensitive detection of changes in cells' bio-molecular composition. Here, we report that by using Raman spectroscopy, we were able to map the distribution of different biomolecules within 2 types of stem cells: adult human bone marrow-derived stromal stem cells...... and human embryonic stem cells and to identify reproducible differences in Raman's spectral characteristics that distinguished genetically abnormal and transformed stem cells from their normal counterparts. Raman microscopy can be prospectively employed as a method for identifying abnormal stem cells......The clinical use of stem cells in cell-based therapeutics for degenerative diseases requires development of criteria for defining normal stem cells to ensure safe transplantation. Currently, identification of abnormal from normal stem cells is based on extensive ex vivo and in vivo testing. Raman...

  12. Clinical course of fetal hydrocephalus: 40 cases.

    Pretorius, D H; Davis, K; Manco-Johnson, M L; Manchester, D; Meier, P R; Clewell, W H

    1985-04-01

    The clinical course and outcome of hydrocephalus diagnosed in utero is not well understood. To approach this problem 40 cases were reviewed of intrauterine fetal hydrocephalus diagnosed with sonography, and follow-up information was obtained regarding them. Sonograms were evaluated for cerebral dimensions, biparietal diameter, brain mantle size, ventricular ratio, amount of amniotic fluid, and associated abnormalities. Neonatal brain sonograms and computed tomographic (CT) scans were reviewed also. Clinical charts were reviewed for maternal age and parity, referral source, family history, fetal age at diagnosis and delivery, mode of delivery, physical examination and/or autopsy findings, karyotype, amniotic alpha 1 fetoprotein level, cause of death, shunt placement after birth, and status of live infants. The observations indicate that the prognosis for fetal hydrocephalus is poor. Only six infants (15%) were alive after an average follow-up of 13 months. Three children were normal and the other three had neurologic abnormalities ranging from severe (paralysis and incontinence) to minimal (2-3 months delayed motor development). Thirty-four fetuses or neonates died. Nine families elected to terminate pregnancy. Ten opted for decompression at delivery for progressive hydrocephalus. Neural tube defects were present in 12 of 23 infants at delivery. Fourteen other infants had additional significant congenital abnormalities. Other abnormal sonographic findings included polyhydramnios (13 of 38), oligohydramnios or decreased fluid (nine of 38), neural tube defect (nine of 40), and other congenital abnormalities (nine of 40). These findings indicate that hydrocephalus diagnosed in utero by sonography is caused by a heterogeneous group of disorders. In general, the prognosis for normal development is poor. Individual prognoses, however, depend on the specific malformations and the interventions used. PMID:3883714

  13. Clinical use of 99mTC-MDP scintigraphy in the equine mandible and maxilla

    99mTc-methylene diphosphonate (MDP) radionuclide imaging examinations were done in four horses having clinical evidence of skull trauma or infection. Radiographs were made of each horse prior to scintigraphy. Four case histories are presented. In each instance, scintigraphy provided complementary information to that obtainable through radiography, which aided in accurately localizing and characterizing the site and extent of abnormalities, and which proved particularly valuable as an aid for therapeutic planning

  14. Making chromosome abnormalities treatable conditions.

    Cody, Jannine DeMars; Hale, Daniel Esten

    2015-09-01

    Individuals affected by the classic chromosome deletion syndromes which were first identified at the beginning of the genetic age, are now positioned to benefit from genomic advances. This issue highlights five of these conditions (4p-, 5p-, 11q-, 18p-, and 18q-). It focuses on the increased in understanding of the molecular underpinnings and envisions how these can be transformed into effective treatments. While it is scientifically exciting to see the phenotypic manifestations of hemizygosity being increasingly understood at the molecular and cellular level, it is even more amazing to consider that we are now on the road to making chromosome abnormalities treatable conditions. PMID:26351122

  15. MR imaging of abnormal synovial processes

    MR imaging can directly image abnormal synovium. The authors reviewed over 50 cases with abnormal synovial processes. The abnormalities include Baker cysts, semimembranous bursitis, chronic shoulder bursitis, peroneal tendon ganglion cyst, periarticular abscesses, thickened synovium from rheumatoid and septic arthritis, and synovial hypertrophy secondary to Legg-Calve-Perthes disease. MR imaging has proved invaluable in identifying abnormal synovium, defining the extent and, to a limited degree, characterizing its makeup

  16. CHROMOSOMAL ABNORMALITIES IN PATIENTS WITH SPERM DISORDERS

    L. Y. Pylyp; L. A. Spinenko; V. D. Zukin; N. M. Bilko

    2013-01-01

    Chromosomal abnormalities are among the most common genetic causes of spermatogenic disruptions. Carriers of chromosomal abnormalities are at increased risk of infertility, miscarriage or birth of a child with unbalanced karyotype due to the production of unbalanced gametes. The natural selection against chromosomally abnormal sperm usually prevents fertilization with sperm barring in cases of serious chromosomal abnormalities. However, assisted reproductive technologies in general and intrac...

  17. A novel point mutation in the translation initiation codon of the pre-pro-vasopressin-neurophysin II gene: Cosegregation with morphological abnormalities and clinical symptoms in autosomal dominant neurohypophyseal diabetes insipidus

    Rutishauser, J.; Boeni-Schnetzler, M.; Froesch, E.R.; Wichmann, W.; Huisman, T. [Univ. of Zuerich (Switzerland)] [and others

    1996-01-01

    Autosomal dominant neurohypophyseal diabetes insipidus (ADNDI) is a rare variant of idiopathic central diabetes insipidus. Several different mutations in the human vasopressin-neurophysin II (AVP-NP II) gene have been described. We studied nine family members from three generations of an ADNDI pedigree at the clinical, morphological, and molecular levels. AVP concentrations were measured during diagnostic fluid restriction tests. Coronal and sagittal high resolution T1-weighted images of the pituitary were obtained from affected and healthy family members. PCR was used to amplify the AVP-NP II precursor gene, and PCR products were directly sequenced. Under maximal osmotic stimulation, AVP serum levels were close to or below the detection limit in affected individuals. Magnetic resonance imaging studies revealed the characteristic hyperintense ({open_quotes}bright spot{close_quotes}) appearance of the posterior pituitary in two healthy family members. This signal was absent in all four ADNDI patients examined. The coding sequences of AVP and its carrier protein, neurophysin II, were normal in all family members examined. Affected individuals showed a novel single base deletion (G 227) in the translation initiation codon of the AVP-NP II signal peptide on one allele. The mutation in the AVP-NP II leader sequence appears to be responsible for the disease in this kindred, possibly by interfering with protein translocation. The absence of the hyperintense posterior pituitary signal in affected individuals could reflect deficient posterior pituitary function. 56 refs., 4 figs., 3 tabs.

  18. Technologist assessment of abnormalities in mammography

    Clinical images must meet the needs of the radiologist in order to serve the patient well. Learning to fully appreciate and assess the range of potentially pathological concerns is an important part of the role of the mammographer within the breast imaging team: being sure of a complete study that serves the purpose for the radiologist goes beyond pure technical appreciation. It now requires some clinical knowledge in order to ensure the area of concern is appropriately imaged, clearly seen and readily characterized by the radiologist. The technologist's role in ensuring appropriate imaging to clarify the extent of potential disease becomes an integral part of the criteria for excellence. Application of our basic analytical skills to our patient history and clinical images should now be an expectation of the mammographic technologist. Assessing and demonstrating clearly an area of concern on our images is a long way from diagnosing disease. What is missed or obscured on our clinical images is not analyzed by the radiologist. Therefore it is essential that we recognize a possible concern and know how to demonstrate it clearly. To recognize what is potentially a concern, it helps to know a little about where and how pathology within the breast develops. There are three basic areas of concern when checking our images, clinical assessment, calcifications and masses. The mammographer within today's modern team oriented department must have the advanced positioning and clinical skills to ensure the area of concern is appropriately imaged, clearly seen and able to be characterized by the radiologist. To properly assess and demonstrate potential problems for our medical partner, the radiologist, we must understand well the three areas of clinical and pathological change that exposes early breast cancer. (author)

  19. The Correlation between Electroencephalography Amplitude and Interictal Abnormalities: Audit study

    Sami F. Al-Rawas

    2014-10-01

    Full Text Available Objectives: The aim of this study was to establish the relationship between background amplitude and interictal abnormalities in routine electroencephalography (EEG. Methods: This retrospective audit was conducted between July 2006 and December 2009 at the Department of Clinical Physiology at Sultan Qaboos University Hospital (SQUH in Muscat, Oman. A total of 1,718 electroencephalograms (EEGs were reviewed. All EEGs were from patients who had been referred due to epilepsy, syncope or headaches. EEGs were divided into four groups based on their amplitude: group one ≤20 μV; group two 21–35 μV; group three 36–50 μV, and group four >50 μV. Interictal abnormalities were defined as epileptiform discharges with or without associated slow waves. Abnormalities were identified during periods of resting, hyperventilation and photic stimulation in each group. Results: The mean age ± standard deviation of the patients was 27 ± 12.5 years. Of the 1,718 EEGs, 542 (31.5% were abnormal. Interictal abnormalities increased with amplitude in all four categories and demonstrated a significant association (P <0.05. A total of 56 EEGs (3.3% had amplitudes that were ≤20 μV and none of these showed interictal epileptiform abnormalities. Conclusion: EEG amplitude is an important factor in determining the presence of interictal epileptiform abnormalities in routine EEGs. This should be taken into account when investigating patients for epilepsy. A strong argument is made for considering long-term EEG monitoring in order to identify unexplained seizures which may be secondary to epilepsy. It is recommended that all tertiary institutions provide EEG telemetry services.

  20. A history of coeliac disease.

    Losowsky, M S

    2008-01-01

    Coeliac disease may have an ancient history dating back to the 1st and 2nd centuries AD. The first clear description was given by Samuel Gee in 1888. He suggested that dietary treatment might be of benefit. In the early 20th century various diets were tried, with some success, but without clear recognition of the toxic components. The doctoral thesis of Wim Dicke of 1950 established that exclusion of wheat, rye and oats from the diet led to dramatic improvement. The toxicity was shown to be a protein component, referred to as gluten. Dicke's colleagues, Weijers and Van de Kamer, showed that measurement of stool fat reflected the clinical condition. Early studies were in children but stool fat measurements documented that the condition could be recognised in adults. Histological abnormalities of the lining of the small intestine were demonstrated beyond doubt by Paulley in 1954 and techniques of per-oral biopsy described by Royer in 1955 and Shiner in 1956 afforded reliable diagnosis. Concurrence in monozygotic twins suggested a genetic component, confirmed by studies of HLA antigens. Additional, non-genetic factors seem likely. Circulating antibodies suggest an immunological mechanism of damage and provide non-invasive screening tests. Lymphoma, adenocarcinoma and ulceration of the small intestine and a range of immunological disorders are associated. A relationship with dermatitis herpetiformis was suggested by Samman in 1955 and established by Shuster and Marks in 1965 and 1968. The Coeliac Society (now Coeliac UK) was founded in 1968 and similar societies now exist across the world. They provide an extremely valuable service. Present problems include definition of the tolerated levels of gluten, whether oats are toxic for some or all coeliacs and the likelihood that the condition is relatively common and frequently without classical symptoms. Hope for the future is that more convenient methods of treatment will follow better understanding. PMID:18431060

  1. Rare and Unusual Choroidal Abnormalities in a Patient with Systemic Lupus Erythematosus

    Makino, Shinji; Tampo, Hironobu

    2013-01-01

    Purpose To report a case of rare and unusual choroidal abnormalities in a 42-year-old woman with systemic lupus erythematosus (SLE). Methods Images were obtained using fundus photography, fluorescein angiography, near-infrared reflectance (NIR) imaging, and optical coherence tomography (OCT). Results The patient had a history of SLE and central retinal artery occlusion in her right eye. Fundus examination showed no specific retinochoroidal abnormalities, with the exception of optic disc atrop...

  2. Ventilation abnormalities in pulmonary embolus

    The ventilation scans of 11 patients with angiographically-proven PE were reviewed. All patients had one or more lung perfusion defects. The chest roentgenograph was abnormal in 11 of the patients. The ventilation studies were performed in the posterior positron prior to the perfusion lung scan using Xe-133. The ventilation study consists of washin, equilibrium, and washout images. In four patients with normal washin there was retention of the Xe-133 (delayed washout) at the site of the perfusion defect. All had roentgenographic abnormalities. Another pattern was observed at the sites of some perfusion defects in six patients. In these, there was decreased washin at the perfusion defect location. Two patients had both decreased washin and delayed washout. In only one case was the typical ventilation pattern of normal washin and normal washout. The method of retention is unclear, but may be due to decreased clearance of Xe-133 secondary to decreased blood flow in the area or deposition of some fat soluble component left at the site of embolization. The etiology of the reduced washin is unclear, but may be due to reduced surfactant production. This study suggests that more attention must be paid to the ventilation study, where there may be additional clues to the diagnosis of pulmonary embolus

  3. Examining the Role of Antisocial Personality Disorder in Intimate Partner Violence Among Substance Use Disorder Treatment Seekers With Clinically Significant Trauma Histories.

    Dykstra, Rita E; Schumacher, Julie A; Mota, Natalie; Coffey, Scott F

    2015-08-01

    This study examined the associations among posttraumatic stress disorder (PTSD) symptom severity, antisocial personality disorder (ASPD) diagnosis, and intimate partner violence (IPV) in a sample of 145 substance abuse treatment-seeking men and women with positive trauma histories; sex was examined as a moderator. ASPD diagnosis significantly predicted both verbal and physical aggression; sex moderated the association between ASPD diagnosis and physical violence. PTSD symptom severity significantly predicted engaging in verbal, but not physical, aggression. Overall, these results suggest that an ASPD diagnosis may be an important risk factor for engaging in IPV among women seeking treatment for a substance use disorder. PMID:26084544

  4. Neural correlates of abnormal sensory discrimination in laryngeal dystonia

    Pichet Termsarasab

    2016-01-01

    Full Text Available Aberrant sensory processing plays a fundamental role in the pathophysiology of dystonia; however, its underpinning neural mechanisms in relation to dystonia phenotype and genotype remain unclear. We examined temporal and spatial discrimination thresholds in patients with isolated laryngeal form of dystonia (LD, who exhibited different clinical phenotypes (adductor vs. abductor forms and potentially different genotypes (sporadic vs. familial forms. We correlated our behavioral findings with the brain gray matter volume and functional activity during resting and symptomatic speech production. We found that temporal but not spatial discrimination was significantly altered across all forms of LD, with higher frequency of abnormalities seen in familial than sporadic patients. Common neural correlates of abnormal temporal discrimination across all forms were found with structural and functional changes in the middle frontal and primary somatosensory cortices. In addition, patients with familial LD had greater cerebellar involvement in processing of altered temporal discrimination, whereas sporadic LD patients had greater recruitment of the putamen and sensorimotor cortex. Based on the clinical phenotype, adductor form-specific correlations between abnormal discrimination and brain changes were found in the frontal cortex, whereas abductor form-specific correlations were observed in the cerebellum and putamen. Our behavioral and neuroimaging findings outline the relationship of abnormal sensory discrimination with the phenotype and genotype of isolated LD, suggesting the presence of potentially divergent pathophysiological pathways underlying different manifestations of this disorder.

  5. Analysis the risk factors of coronary heart disease and clinical characters of coronary angiography in patients with abnormal glucose metabolism%冠心病合并糖代谢异常冠脉病变特点及其危险因素分析

    费利霞; 陈洁; 田刚

    2012-01-01

    目的:探讨糖代谢异常冠状动脉病变特点和冠心病的危险因素.方法:74例拟诊冠心病患者行冠脉造影(CAG),57例空腹血糖正常者行口服葡萄糖耐量试验(OGTT)检查.根据CAG结果分冠心病组(CAD)、非冠心病组(非CAD),分析危险因素的差异;冠心病组分为糖尿病组(DM)、糖调节受损组(IGR)、正常血糖组(NGT),观察冠状动脉病变的特点.结果:糖代谢异常在冠心病与非冠心病差异有统计学意义(χ2值为6.14,P<0.05).冠心病IGR组和DM组多支病变患病率,分别75%和50%,NGT组单支病变患病率55.6%,重度病变患病率DM组80%,NGT组77.8%.男性、DM、IGR、吸烟、危险因素累计数在CAD组与非CAD组差异有统计学意义(P<0.01).结论:冠心病合并糖代谢异常患病率高,48.6%通过OGTT诊断,OGTT应列为心血管病的常规检查;冠心病合并糖尿病和糖调节受损病变以多支病变为主,病变重而弥漫,正常血糖以单支病变多见,病变重而局限.%Objective: To analysis the risk factors of coronary heart disease and the clinical characters of coronary angiography in the patients who suffered with abnormal glucose metabolism. .Methods: 74 cases of patients who were preliminary diagnosed to coronary heart disease accepted coronary angiography (CAG),57 of them with normal fast blood glucose accepted the oral glucose tolerance test (OGTT). All the patients were divided into the CAD group and without CAD group according to the results of CAG. The CAD divided into three groups (DM, IGR and NGT) was compared with the difference of the clinical characters of coronary lesions. Results: The prevalence of abnormal glucose metabolism was 64% in patient with CAD.The prevalence of abnormal glucose metabolism in CAD was significantly higher than that of without CAD(was 6. 14,P<0. 05)). The coronary multivessel changes were more frequent in the IGR group and in the DM group than the NGT group (75%, 50% vs. 16.7%). The cor onary single

  6. Endocrine abnormalities in ring chromosome 11: a case report and review of the literature

    Lange, Renata; Von Linsingen, Caoê; Mata, Fernanda; Moraes, Aline Barbosa; Arruda, Mariana; Vieira Neto, Leonardo

    2015-01-01

    Summary Ring chromosomes (RCs) are uncommon cytogenetic findings, and RC11 has only been described in 19 cases in the literature. Endocrine abnormalities associated with RC11 were reported for two of these cases. The clinical features of RC11 can result from an alteration in the structure of the genetic material, ring instability, mosaicism, and various extents of genetic material loss. We herein describe a case of RC11 with clinical features of 11q-syndrome and endocrine abnormalities that h...

  7. Abnormal Event Detection Using Local Sparse Representation

    Ren, Huamin; Moeslund, Thomas B.

    2014-01-01

    We propose to detect abnormal events via a sparse subspace clustering algorithm. Unlike most existing approaches, which search for optimized normal bases and detect abnormality based on least square error or reconstruction error from the learned normal patterns, we propose an abnormality...... measurement based on the difference between the normal space and local space. Specifically, we provide a reasonable normal bases through repeated K spectral clustering. Then for each testing feature we first use temporal neighbors to form a local space. An abnormal event is found if any abnormal feature is...

  8. Linjefaget historie

    Rasch-Christensen, Andreas

    Afhandlingen er en undersøgelse af linjefaget historie ved læreruddannelsen. Med fokus på subjektperspektivet peger afhandlingen på en række afgørende udviklingsperspektiver for læreruddannelsen, uddannelsen af historielærere og folkeskolens historieundervisning.......Afhandlingen er en undersøgelse af linjefaget historie ved læreruddannelsen. Med fokus på subjektperspektivet peger afhandlingen på en række afgørende udviklingsperspektiver for læreruddannelsen, uddannelsen af historielærere og folkeskolens historieundervisning....

  9. Matematikkens historie

    Hansen, Vagn Lundsgaard

    2009-01-01

    Matematikkens historie i syv kapitler: 1. Matematik i støbeskeen; 2. Matematikkens græske arv; 3. Den gyldne tidsalder for hinduer og arabere; 4. Matematik i Kina; 5. Renæssancens matematik; 6. Regning med infinitesimaler ser dagens lys; 7. Matematik i det tyvende århundrede.......Matematikkens historie i syv kapitler: 1. Matematik i støbeskeen; 2. Matematikkens græske arv; 3. Den gyldne tidsalder for hinduer og arabere; 4. Matematik i Kina; 5. Renæssancens matematik; 6. Regning med infinitesimaler ser dagens lys; 7. Matematik i det tyvende århundrede....

  10. Environmental history

    Pawson, Eric; Christensen, Andreas Aagaard

    2016-01-01

    Environmental history is an interdisciplinary pursuit that has developed as a form of conscience to counter an increasingly powerful, forward-looking liberal theory of the environment. It deals with the relations between environmental ideas and materialities, from the work of the geographers George...... risks”. These are exposed by environmental history’s focus on long-run analysis and its narrative form that identifies the stories that we tell ourselves about nature. How a better understanding of past environmental transformations helps to analyse society and agency, and what this can mean...... for solutions and policies, is the agenda for an engaged environmental history from now on....

  11. Movement Disorders and Other Motor Abnormalities in Adults With 22q11.2 Deletion Syndrome

    Boot, Erik; Butcher, Nancy J; van Amelsvoort, Thérèse AMJ; Lang, Anthony E; Marras, Connie; Pondal, Margarita; Andrade, Danielle M; Fung, Wai Lun Alan; Bassett, Anne S

    2015-01-01

    Movement abnormalities are frequently reported in children with 22q11.2 deletion syndrome (22q11.2DS), but knowledge in this area is scarce in the increasing adult population. We report on five individuals illustrative of movement disorders and other motor abnormalities in adults with 22q11.2DS. In addition to an increased susceptibility to neuropsychiatric disorders, seizures, and early-onset Parkinson disease, the underlying brain dysfunction associated with 22q11.2DS may give rise to an increased vulnerability to multiple movement abnormalities, including those influenced by medications. Movement abnormalities may also be secondary to treatable endocrine diseases and congenital musculoskeletal abnormalities. We propose that movement abnormalities may be common in adults with 22q11.2DS and discuss the implications and challenges important to clinical practice. PMID:25684639

  12. Unidirectional abnormal eye movement without gaze nystagmus - Report of a case.

    Mizuno, Masahiro; Shibasaki, Osamu; Shindo, Susumu; Ito, Akinori; Kase, Yasuhiro

    2016-06-01

    We report here a case with unidirectional abnormalities of smooth eye movements without gaze nystagmus. Abnormalities of eye movements were confined to unidirectional (leftward) horizontal pursuit and slow phase of OKN; however, horizontal VOR (slow phase of caloric nystagmus) and saccade were normal, and vertical eye movements were also normal. No lesions were detected in the central nervous system, and any history of drug intake was denied. Although the cause of the unidirectional abnormality in eye movement of this case is still not clear, a congenital origin seems to be the most probable. PMID:26386498

  13. CHROMOSOMAL ABNORMALITIES IN PATIENTS WITH RECURRENT MISCARRIAGE

    Daniela Mierla

    2012-06-01

    Full Text Available Chromosomal abnormalities are involved in the etiology of recurrent spontaneous pregnancy loss and sub-fertility. The purpose of this study was to determine the frequency and contribution of chromosomal abnormalities in recurrent miscarriages. The results obtained and literature review are helpful in understanding the importance of cytogenetics analysis of female infertility. To investigate the distribution of chromosomal abnormalities in the Romanian population with recurrent miscarriage, karyotype analysis by G-banding was performed from peripheral blood in 967 women infertility. Results: Chromosomal abnormalities were found to 79 women (8,17%. The percentage of chromosomal abnormalities in the studied population correlates with the data in the literature. Chromosomal abnormalities could play the important role in etiology of infertility and are more frequently detected in this group of patients compared to general population. In the infertile couples balanced chromosomal abnormalities are the main cause of spontaneous abortions.

  14. Natural history of cardiovascular manifestations in Marfan syndrome

    van Karnebeek, C D M; Naeff, M; Mulder, B; Hennekam, R; Offringa, M

    2001-01-01

    AIMS—To investigate the natural history of mitral valve and aortic abnormalities in patients with Marfan syndrome during childhood and adolescence.
METHODS—Fifty two patients with Marfan syndrome were followed for a mean of 7.9 years. Occurrence of adverse cardiovascular outcomes was measured clinically and by ultrasound examination.
RESULTS—Mitral valve prolapse (MVP) was diagnosed in 46 patients at a mean age of 9.7 years, more than 80% of whom presented as "silent MVP". Mitral regurgitation (MR) occurred in 25 patients, aortic dilatation in 43, and aortic regurgitation (AR) in 13. Both MVP and aortic dilatation developed at a constant rate during the age period 5-20 years. In 23 patients MVP was diagnosed before aortic dilatation, in 18 the reverse occurred, and in 11 patients the two abnormalities were diagnosed simultaneously. During follow up, 21 patients showed progression of mitral valve dysfunction; progression of aortic abnormalities occurred in 13. Aortic surgery was performed in 10; two died of subsequent complications. Mitral valve surgery was performed in six. In sporadic female Marfan patients the age at initial diagnosis of MVP, MR, aortic dilatation, and AR was lowest, the grade of MR and AR most severe, the time lapse between the occurrence of MVP and subsequent MR as well as between dilatation and subsequent AR shortest, and the risk for cardiovascular associated morbidity and mortality highest.
CONCLUSIONS—During childhood and adolescence in Marfan syndrome, mitral valve dysfunction as well as aortic abnormalities develop and progress gradually, often without symptoms, but may cause considerable morbidity and mortality by the end of the second decade, especially in female sporadic patients.

 PMID:11159287

  15. Potted history

    Dijk, T. van

    2010-01-01

    The Jordan Valley was once populated by a people, now almost forgotten by historians, with whom the pharaoh of Egypt sought favour. That is the conclusion reached by Niels Groot, the first researcher to take a PhD at the Delft-Leiden Centre for Archaeology, Art History and Science.

  16. Family History

    ... risky behaviors (such as smoking) and increasing healthy behaviors (such as regular exercise). Learn more about heart attacts. Q: How can knowing my family health history help lower my risk of disease? A: You ... you can change behaviors that affect your health, such as smoking, inactivity ...

  17. Business History

    Hansen, Per H.

    2012-01-01

    This article argues that a cultural and narrative perspective can enrich the business history field, encourage new and different questions and answers, and provide new ways of thinking about methods and empirical material. It discusses what culture is and how it relates to narratives. Taking...

  18. Abnormal Returns and Contrarian Strategies

    Ivana Dall'Agnol

    2003-12-01

    Full Text Available We test the hypothesis that strategies which are long on portfolios of looser stocks and short on portfolios of winner stocks generate abnormal returns in Brazil. This type of evidence for the US stock market was interpreted by The Bondt and Thaler (1985 as reflecting systematic evaluation mistakes caused by investors overreaction to news related to the firm performance. We found evidence of contrarian strategies profitability for horizons from 3 months to 3 years in a sample of stock returns from BOVESPA and SOMA from 1986 to 2000. The strategies are more profitable for shorter horizons. Therefore, there was no trace of the momentum effect found by Jagadeesh and Titman (1993 for the same horizons with US data. There are remaing unexplained positive returns for contrarian strategies after accounting for risk, size, and liquidity. We also found that the strategy profitability is reduced after the Real Plan, which suggests that the Brazilian stock market became more efficient after inflation stabilization.

  19. Conclusion: These findings suggest impaired impulse control and abnormal error-monitoring functions in persons with a history of heroin dependence and add to the growing literature on the neurological mechanisms related to cognitive dysfunction in individ%康复期男性海洛因依赖者的错误相关负电位的病例对照研究

    陈红; 江海峰; 郭茜; 杜江; 王继军; 赵敏

    2013-01-01

    Background: There were 1.2 million registered heroin users in China by the end of 2011, but little research in the country has focused on the neuropsychological functioning of these individuals.Aim: Assess error-related negativity (ERN) - an important indicator of high-level cognitive functioning - among males with heroin dependence undergoing rehabilitation.Method: Twenty male patients in a rehabilitation center who met DSM-IV criteria for heroin dependence and 15 healthy male controls completed 800 trials of Erikson flanker tasks to provoke ERN waves on the 32-electrode electroencephalograph (EEG) when erroneous responses are induced by presenting incongruent flankers around the target stimulus. Mean error rates and reaction times for the task, and the amplitude and latency of crude ERN waves and standardized ERN waves (created by subtracting the wave for correct responses from that for incorrect responses) at three frontal midline EEG electrodes (Fz, FCz, and Cz) were compared between patients and controls.Results: There was no significant difference in error rates between patients and controls but the reaction times for both erroneous and correct responses were shorter in patients than controls. The amplitude of both crude and standardized ERN waves was lower in patients than controls, but this difference became non-significant after adjustment for the lower educational level in the patient group. The latency of the peak value in both the crude and standardized ERN waves was significantly shorter in the patient group; this difference remained significant after adjustment for educational level. There was a significant correlation between the negative amplitude of the standardized ERN wave and the duration of heroin use.Conclusion: These findings suggest impaired impulse control and abnormal error-monitoring functions in persons with a history of heroin dependence and add to the growing literature on the neurological mechanisms related to cognitive dysfunction in

  20. PIRIFORMIS SYNDROME: A CLINICAL REVIEW

    Samarjit

    2013-04-01

    Full Text Available ABSTRACT: Piriformis Syndrome is a cause for Low back pain whi ch is most of the times misdiagnosed as it may mimic with various other con ditions. Abnormal condition of the Piriformis muscle such as hypertrophy, inflammation, or anatomic variations may lead to this condition. Reported incidence rates for Piriformis S yndrome among patients with low back pain vary widely, from 5% to 36%. Etiology of Piriformis Syndrome is also variable. It can be primary due to anatomical problems or secondary due to vario us other causes like trauma, local ischemia, limb-length discrepancy etc. Diagnosis of Piriformis Syndrome is complex. History with various clinical tests along with MRI, EMG (El ectromyography and Diagnostic blocks may help to diagnose this condition. Here is a review of Piriformis syndrome for better understanding of the problem so that the diagnosis a nd management are appropriate. KEY WORDS:Piriformis Syndrome.

  1. Chromosomal abnormalities in spontaneous abortion after assisted reproductive treatment

    Kim You

    2010-11-01

    Full Text Available Abstract Background We evaluated cytogenetic results occurring with first trimester pregnancy loss, and assessed the type and frequency of chromosomal abnormalities after assisted reproductive treatment (ART and compared them with a control group. We also compared the rate of chromosomal abnormalities according to infertility causes in ICSI group. Methods A retrospective cohort analysis was made of all patients who were referred to the Genetics Laboratory of Fertility Center of CHA Gangnam Medical Center from 2005 to 2009 because of clinical abortion with a subsequent dilation and evacuation (D&E performed, and patients were grouped by type of conception as follows: conventional IVF (in vitro fertilization (n = 114, ICSI (intracytoplasmic sperm injection (n = 140, and control (natural conception or intrauterine insemination [IUI] (n = 128. Statistical analysis was performed using SPSS software. Results A total 406 specimens were referred to laboratory, ten abortuses were excluded, and in 14 cases, we did not get any spontaneous metaphase, chromosomal constitutions of 382 specimens were successfully obtained with conventional cytogenetic methods. Overall, 52.62% of the miscarriages were found to be cytogenetically abnormal among all patients, the frequency was 48.4% in the control group, 54.3% of miscarriages after ICSI and 55.3% after conventional IVF (p = 0.503. The most prevalent abnormalities were autosomal trisomy, however, nine (11.69% sex chromosome aneuploidy were noted in the ICSI group vs. four (6.45% and two (3.23% cases in the conventional IVF group and control group. We compared chromosomal abnormalities of miscarriages after ICSI according to infertility factor. 55.71% underwent ICSI due to male factors, 44.29% due to non-male factors. ICSI group having male factors showed significantly higher risk of chromosomal abnormalities than ICSI group having non-male factors (65.8% vs. 34.2%, p = 0.009, odds ratio = 1.529, 95% CI = 1

  2. Congenital pouch colon in girls: Genitourinary abnormalities and their management

    Chadha, Rajiv; Khan, Niyaz Ahmed; Shah, Shalu; Pant, Nitin; Gupta, Amit; Choudhury, Subhasis Roy; Debnath, Pinaki Ranjan; Puri, Archana

    2015-01-01

    Aims: To discuss the assessment and management of genitourinary (GU) tract abnormalities in 21 girls with Types I-III congenital pouch colon (CPC), studied over a period of 10 years. Materials and Methods: Assessment included clinical and radiological assessment, examination under anesthesia (EUA), endoscopy of the lower GU tract, and evaluation of the surgical findings, operative procedures for the GU anomalies, and the results of management. Results: Initial examination of the external geni...

  3. Neuronal migration abnormalities and its possible implications for schizophrenia

    Muraki, Kazue; Tanigaki, Kenji

    2015-01-01

    Schizophrenia is a complex mental disorder that displays behavioral deficits such as decreased sensory gating, reduced social interaction and working memory deficits. The neurodevelopmental model is one of the widely accepted hypotheses of the etiology of schizophrenia. Subtle developmental abnormalities of the brain which stated long before the onset of clinical symptoms are thought to lead to the emergence of illness. Schizophrenia has strong genetic components but its underlying molecular ...

  4. Absence of family history and phenotype-genotype correlation in pediatric Brugada syndrome: more burden to bear in clinical and genetic diagnosis.

    Daimi, Houria; Khelil, Amel Haj; Ben Hamda, Khaldoun; Aranega, Amelia; Chibani, Jemni B E; Franco, Diego

    2015-06-01

    Brugada syndrome (BrS) is an autosomal-dominant genetic cardiac disorder caused in 18-30 % of the cases by SCN5A gene mutations and manifested by an atypical right bundle block pattern with ST segment elevation and T wave inversion in the right precordial leads. The syndrome is usually detected after puberty. The identification of BrS in pediatric patients is thus a rare occurrence, and most of the reported cases are unmasked after febrile episodes. Usually, having a family history of sudden death represents the first reason to perform an ECG in febrile children. However, this practice makes the sporadic cases of cardiac disease and specially the asymptomatic ones excluded from this diagnosis. Here, we report a sporadic case of a 2-month-old male patient presented with vaccination-related fever and ventricular tachycardia associated with short breathing, palpitation and cold sweating. ECG changes were consistent with type 1 BrS. SCN5A gene analysis of the proband and his family revealed a set of mutations and polymorphisms differentially distributed among family members, however, without any clear genotype-phenotype correlation. Based on our findings, we think that genetic testing should be pursued as a routine practice in symptomatic and asymptomatic pediatric cases of BrS, with or without family history of sudden cardiac death. Similarly, our study suggests that pediatrician should be encouraged to perform an ECG profiling in suspicious febrile children and quickly manage fever since it is the most important factor unmasking BrS in children. PMID:25758664

  5. A 20 year history of clinical and genetic study of thyroid autoimmunity in a Tunisian multigenerational family: Evidence for gene interaction☆

    Bougacha-Elleuch, Noura; Charfi, Nadia; Kharrat, Najla; Ayadi, Fatma; Maalej, Abdellatif; Chabchoub, Ghazi; Rebai, Ahmed; Kammoun-Krichen, Maha; Belguith-Maalej, Salima; Abid, Mohamed; Mnif, Mouna; Ayadi, Hammadi

    2013-01-01

    Autoimmune thyroid diseases (AITD), which include Hashimoto thyroiditis (HT), Graves' disease (GD) and primary idiopathic myxoedema (PIM), are recognized by their clinical and genetic heterogeneity. In this study, we have carried on a global approach gathering 20 year genetic and clinical data on a Tunisian multigenerational family (Akr). Our purpose was search for a combined genotype involved in AITD susceptibility using 33 gene polymorphisms. The Akr pedigree is composed of more than 400 members distributed on 10 generations. Clinical follow-up was performed by appreciation of the thyroid gland and measurement of both thyroid hormone and auto antibody levels. We used FBAT software to test for association between gene polymorphisms and AITDs. Clinical follow-up has showed that the number of AITD patients has increased from 25 to 78 subjects subdivided on 51 cases of GD, 22 PIM and 5 HT. Concerning genetic analysis, our study has revealed new gene association when compared with our previous analysis (considering single genes). Thus, PTPN22, TG and VDR gene polymorphisms have became associated with p-values ranging from 4.6  10− 2 to 4  10− 3 when considered with other genes on the same chromosome; giving evidence for gene interaction. The most significant association was found with the MHC region (p = 7.15 10− 4). Moreover, and among gene polymorphisms explored, our analysis has identified some of them as AITD biomarkers. Indeed, PDS gene polymorphisms were associated with either exophthalmia or goiter (p-values from 10− 2 to 10− 3). In conclusion, our study gives evidence for gene interaction in AITD development confirming genetic complexity of these diseases. PMID:25606390

  6. A 20 year history of clinical and genetic study of thyroid autoimmunity in a Tunisian multigenerational family: Evidence for gene interaction

    Noura Bougacha-Elleuch

    2014-12-01

    Full Text Available Autoimmune thyroid diseases (AITD, which include Hashimoto thyroiditis (HT, Graves' disease (GD and primary idiopathic myxoedema (PIM, are recognized by their clinical and genetic heterogeneity. In this study, we have carried on a global approach gathering 20 year genetic and clinical data on a Tunisian multigenerational family (Akr. Our purpose was search for a combined genotype involved in AITD susceptibility using 33 gene polymorphisms. The Akr pedigree is composed of more than 400 members distributed on 10 generations. Clinical follow-up was performed by appreciation of the thyroid gland and measurement of both thyroid hormone and auto antibody levels. We used FBAT software to test for association between gene polymorphisms and AITDs. Clinical follow-up has showed that the number of AITD patients has increased from 25 to 78 subjects subdivided on 51 cases of GD, 22 PIM and 5 HT. Concerning genetic analysis, our study has revealed new gene association when compared with our previous analysis (considering single genes. Thus, PTPN22, TG and VDR gene polymorphisms have became associated with p-values ranging from 4.6   10−2 to 4   10−3 when considered with other genes on the same chromosome; giving evidence for gene interaction. The most significant association was found with the MHC region (p = 7.15 10−4. Moreover, and among gene polymorphisms explored, our analysis has identified some of them as AITD biomarkers. Indeed, PDS gene polymorphisms were associated with either exophthalmia or goiter (p-values from 10−2 to 10−3. In conclusion, our study gives evidence for gene interaction in AITD development confirming genetic complexity of these diseases.

  7. Magnetic resonance imaging of articular cartilage abnormalities of the far posterior femoral condyle of the knee

    Ogino, Shuhei; Huang, Thomas; Watanabe, Atsuya; Iranpour-Boroujeni, Tannaz; Yoshioka, Hiroshi (Dept. of Radiology, Brigham and Women' s Hospital, Boston, MA (United States)), e-mail: hiroshi@uci.edu

    2010-01-15

    Background: Incidental articular cartilage lesions of the far posterior femoral condyle (FPFC) are commonly detected. Whether or not these cartilage lesions are symptomatic or clinically significant is unknown. Purpose: To characterize and assess prevalence of articular cartilage abnormalities of the FPFC and associated bone marrow edema (BME) and/or internal derangements through magnetic resonance (MR) images. Material and Methods: 654 knee MR examinations were reviewed retrospectively. Sagittal fast spin-echo proton density-weighted images with and without fat suppression were acquired with a 1.5T scanner, and were evaluated by two readers by consensus. The following factors were assessed: 1) the prevalence of cartilage abnormalities, 2) laterality, 3) the type of cartilage abnormalities, 4) cartilage abnormality grading, 5) associated BME, 6) complications such as meniscal injury and cruciate ligament injury, and 7) knee alignment (femorotibial angle [FTA]). Results: Articular cartilage abnormalities of the FPFC were demonstrated in 157 of the 654 patients (24%). Of these, 40 patients demonstrated medial and lateral FPFC cartilage abnormalities and were thus counted as 80 cases. Focal lateral FPFC abnormalities were demonstrated in 117 of 197 cases (59.4%), while diffuse lateral FPFC abnormalities were demonstrated in 24 of 197 cases (12.2%). Focal medial FPFC abnormalities were demonstrated in 23 of 197 cases (11.6%), while diffuse medial FPFC abnormalities were demonstrated in 33 of 197 cases (16.8%). No statistically significant pattern of associated BME, FTA, or internal derangements including meniscal and cruciate ligament injury was demonstrated. Conclusion: Articular cartilage abnormalities of the FPFC are common and were demonstrated in 24% of patients or 30% of cases. Lateral FPFC abnormalities occur 2.5 times more frequently than medial FPFC abnormalities and were more frequently focal compared with medial cohorts. BME is associated in 36.5% of cases

  8. Abnormal cerebellar volume in acute and remitted major depression.

    Depping, Malte S; Wolf, Nadine D; Vasic, Nenad; Sambataro, Fabio; Hirjak, Dusan; Thomann, Philipp A; Wolf, Robert C

    2016-11-01

    Abnormal cortical volume is well-documented in patients with major depressive disorder (MDD), but cerebellar findings have been heterogeneous. It is unclear whether abnormal cerebellar structure relates to disease state or medication. In this study, using structural MRI, we investigated cerebellar volume in clinically acute (with and without psychotropic treatment) and remitted MDD patients. High-resolution structural MRI data at 3T were obtained from acute medicated (n=29), acute unmedicated (n=14) and remitted patients (n=16). Data from 29 healthy controls were used for comparison purposes. Cerebellar volume was investigated using cerebellum-optimized voxel-based analysis methods. Patients with an acute MDD episode showed increased volume of left cerebellar area IX, and this was true for both medicated and unmedicated individuals (pbrain functional network with known relevance to core depressive symptom expression, exhibits abnormal volume in patients independent of clinical severity or medication. Thus, the data imply a possible trait marker of the disorder. However, given bilaterality and an association with clinical scores at least in remitted patients, the current findings raise the possibility that cerebellar volume may be reflective of successful treatment as well. PMID:27321187

  9. Cortical thickness abnormalities associated with dyslexia, independent of remediation status

    Ma, Yizhou; Koyama, Maki S.; Milham, Michael P.; Castellanos, F. Xavier; Quinn, Brian T.; Pardoe, Heath; Wang, Xiuyuan; Kuzniecky, Ruben; Devinsky, Orrin; Thesen, Thomas; Blackmon, Karen

    2014-01-01

    Abnormalities in cortical structure are commonly observed in children with dyslexia in key regions of the “reading network.” Whether alteration in cortical features reflects pathology inherent to dyslexia or environmental influence (e.g., impoverished reading experience) remains unclear. To address this question, we compared MRI-derived metrics of cortical thickness (CT), surface area (SA), gray matter volume (GMV), and their lateralization across three different groups of children with a historical diagnosis of dyslexia, who varied in current reading level. We compared three dyslexia subgroups with: (1) persistent reading and spelling impairment; (2) remediated reading impairment (normal reading scores), and (3) remediated reading and spelling impairments (normal reading and spelling scores); and a control group of (4) typically developing children. All groups were matched for age, gender, handedness, and IQ. We hypothesized that the dyslexia group would show cortical abnormalities in regions of the reading network relative to controls, irrespective of remediation status. Such a finding would support that cortical abnormalities are inherent to dyslexia and are not a consequence of abnormal reading experience. Results revealed increased CT of the left fusiform gyrus in the dyslexia group relative to controls. Similarly, the dyslexia group showed CT increase of the right superior temporal gyrus, extending into the planum temporale, which resulted in a rightward CT asymmetry on lateralization indices. There were no group differences in SA, GMV, or their lateralization. These findings held true regardless of remediation status. Each reading level group showed the same “double hit” of atypically increased left fusiform CT and rightward superior temporal CT asymmetry. Thus, findings provide evidence that a developmental history of dyslexia is associated with CT abnormalities, independent of remediation status. PMID:25610779

  10. Cortical thickness abnormalities associated with dyslexia, independent of remediation status

    Yizhou Ma

    2015-01-01

    Full Text Available Abnormalities in cortical structure are commonly observed in children with dyslexia in key regions of the “reading network.” Whether alteration in cortical features reflects pathology inherent to dyslexia or environmental influence (e.g., impoverished reading experience remains unclear. To address this question, we compared MRI-derived metrics of cortical thickness (CT, surface area (SA, gray matter volume (GMV, and their lateralization across three different groups of children with a historical diagnosis of dyslexia, who varied in current reading level. We compared three dyslexia subgroups with: (1 persistent reading and spelling impairment; (2 remediated reading impairment (normal reading scores, and (3 remediated reading and spelling impairments (normal reading and spelling scores; and a control group of (4 typically developing children. All groups were matched for age, gender, handedness, and IQ. We hypothesized that the dyslexia group would show cortical abnormalities in regions of the reading network relative to controls, irrespective of remediation status. Such a finding would support that cortical abnormalities are inherent to dyslexia and are not a consequence of abnormal reading experience. Results revealed increased CT of the left fusiform gyrus in the dyslexia group relative to controls. Similarly, the dyslexia group showed CT increase of the right superior temporal gyrus, extending into the planum temporale, which resulted in a rightward CT asymmetry on lateralization indices. There were no group differences in SA, GMV, or their lateralization. These findings held true regardless of remediation status. Each reading level group showed the same “double hit” of atypically increased left fusiform CT and rightward superior temporal CT asymmetry. Thus, findings provide evidence that a developmental history of dyslexia is associated with CT abnormalities, independent of remediation status.

  11. Clinical analysis and countermeasures of cefoperazone sodium and sulbactam sodium-induced coagulation abnormalities%单用头孢哌酮钠舒巴坦钠致凝血功能异常的临床分析及对策

    王宇; 丁宁

    2015-01-01

    目的:回顾性分析单用头孢哌酮钠舒巴坦钠致凝血功能异常的临床资料,观察应用维生素 K1治疗后凝血指标的变化。方法选取2013年1月至2014年12月入住北京同仁医院急诊病房的经头孢哌酮钠舒巴坦钠治疗肺部感染后出现凝血功能异常的52例老年患者,分别记录患者入院当天血常规、肝肾功能和凝血功能指标,主要包括血浆凝血酶原时间(PT)和活化部分凝血活酶时间(APTT),出现凝血功能异常时使用头孢哌酮钠舒巴坦钠的剂量和累积时间,以及应用维生素 K1后凝血功能转为正常时间。观察维生素 K1治疗前后凝血指标变化情况。结果52例患者中40例患者头孢哌酮钠舒巴坦钠用量9 g/ d,12例根据肌酐清除率调整头孢哌酮钠舒巴坦钠用量6 g/ d。患者应用头孢哌酮钠舒巴坦钠后发现凝血异常时间波动在3~8 d,应用维生素 K1后凝血功能转为正常时间波动在3~12 d。52例患者中表现为皮肤淤点、淤斑19例(36.5%),消化道出血和大便潜血阳性8例(15.4%),尿路出血6例(11.5%),牙龈出血3例(5.8%),其余16例(30.8%)未见明显出血征象。与维生素 K1治疗前比较,治疗后 PT 和 APTT 有明显改善,差异有统计学意义( P ﹤0.05)。结论单用头孢哌酮钠舒巴坦钠治疗老年患者肺部感染可引起亚临床维生素 K 缺乏,表现为临床出血征象和化验凝血指标异常,而出现异常后尽早使用维生素 K1则可使凝血功能明显改善。%Objective To retrospective analyze the clinical data of coagulation abnormalities induced by cefoperazone sodium and sulbac-tam sodium,and observe changes in coagulation parameters after treatment with vitamin K1. Methods 52 patients with coagulation abnormalities due to sodium cefoperazone sodium and sulbactam sodium treatment for pulmonary infection were collected from emergency ward of Beijing Tongren

  12. Screening for fetal chromosome abnormalities during the second trimester

    Objective: To develop a pre -natal screening program for fetal chromosome abnormalities based on risk values calculated from maternal serum markers levels during the second trimester. Methods: Serum levels of AFP, β-HCG, uE3 were determined with CLIA in 1048 pregnant women during 14-21w gestation period and the results were analyzed with a specific software (screening program for Down' s syndrome developed by Beckman) for the risk rate. In those women defined as being of high risk rate, cells from amniotic fluid or umbilical cord blood were studied for karyotype analysis. Results: Of these 1048 women, 77 were designated as being of high risk rate for several chromosome abnormalities i.e. Down's syndrome, open spina bifida and trisomy -18 syndrome (overall positive rate 7.3%). Further fetal chromosome study in 31 of them revealed three proven cases of abnormality. Another cord blood study was performed in a calculated low risk rate case but with abnormal sonographic finding at 31 w gestation and proved to be abnormal (software study false negative). The remaining 46 high risk rate cases either refused future study (n=35) or were lost for follow-up (n=11). Fortunately, all the 35 women refused further study gave birth to normal babies without any chromosome abnormalities discovered on peripheral blood study. Besides, in a trial study, five high risk rate women were again evaluated a few weeks later but with tremendous difference between the results. Conclusion: The present program proves to be clinically useful but needs further study and revision. Many factors may influence the result of the analysis and the duration of gestation period in weeks should be as accurate as possible. At present, in order to avoid getting false negatives, we don't advise a second check in 'high risk' cases. (authors)

  13. The Left-Handed: "Their Sinister" History.

    Costas, Elaine Fowler

    The history of left-handedness can provide teachers and parents a better understanding of left-handed children and give those children more pride in their difference. No child should be made to feel that he or she is abnormal because of using the left hand, although some specific instruction for these students is necessary in handwriting. Many…

  14. Sommerferiens historie

    Lützen, Karin

    2011-01-01

    Summer holiday is a pleasure which did not become available to many people until the 20th Century. The article describes the early mountain rambles of the bourgeoisie and their holidays in seaside boarding houses. Outdoor pursuits and stays in boarding houses at bathing resorts also became favour...... pattern. Finally, the history of the special holiday camps is told, which were established by American Jews because they were excluded from many hotels....

  15. CHROMOSOMAL ABNORMALITIES IN PATIENTS WITH RECURRENT MISCARRIAGE

    Daniela Mierla; Viorica Radoi; Veronica Stoian

    2012-01-01

    Chromosomal abnormalities are involved in the etiology of recurrent spontaneous pregnancy loss and sub-fertility. The purpose of this study was to determine the frequency and contribution of chromosomal abnormalities in recurrent miscarriages. The results obtained and literature review are helpful in understanding the importance of cytogenetics analysis of female infertility. To investigate the distribution of chromosomal abnormalities in the Romanian population with recurrent miscarriage, ka...

  16. ABNORMAL CARDIOVASCULAR REFLEXES IN PATIENTS WITH ACHALASIA

    戈峰; 李泽坚; 柯美云

    1994-01-01

    Using 3 non-invasive tests,abnormalities of cardiovascular reflex function were found in 7 of 15 patients with achalasia.Abnormalities of heart rate responses to the Valsalva maneuver,deep breathing ,and standing were moted in patients with autonomic neuropathy defect.The findings are consistent with the hypothesis that an abnormality of vagal function may contribute to the pathogenesis of achalasia.

  17. Do Stock Dividends Generate Abnormal Returns?

    Torgal, Kishan

    2009-01-01

    In this paper I have studied and understood the concepts of stock dividends, stock splits and the announcement effects and the effective day effects by using the standard event studies methodology which measures the significance of the abnormal returns. The previous studies have significant positive abnormal returns. In my results its shown that the as there is some significant abnormal returns which are connected with the announcement and effective day of the stock splits but it changes...

  18. Phylogenetic analysis consistent with a clinical history of sexual transmission of HIV-1 from a single donor reveals transmission of highly distinct variants

    McClure Myra

    2011-07-01

    Full Text Available Abstract Background To combat the pandemic of human immunodeficiency virus 1 (HIV-1, a successful vaccine will need to cope with the variability of transmissible viruses. Human hosts infected with HIV-1 potentially harbour many viral variants but very little is known about viruses that are likely to be transmitted, or even if there are viral characteristics that predict enhanced transmission in vivo. We show for the first time that genetic divergence consistent with a single transmission event in vivo can represent several years of pre-transmission evolution. Results We describe a highly unusual case consistent with a single donor transmitting highly related but distinct HIV-1 variants to two individuals on the same evening. We confirm that the clustering of viral genetic sequences, present within each recipient, is consistent with the history of a single donor across the viral env, gag and pol genes by maximum likelihood and Bayesian Markov Chain Monte Carlo based phylogenetic analyses. Based on an uncorrelated, lognormal relaxed clock of env gene evolution calibrated with other datasets, the time since the most recent common ancestor is estimated as 2.86 years prior to transmission (95% confidence interval 1.28 to 4.54 years. Conclusion Our results show that an effective design for a preventative vaccine will need to anticipate extensive HIV-1 diversity within an individual donor as well as diversity at the population level.

  19. Clinical correlates with MR abnormalities of the brain in eclampsia

    This paper determines the typical MR lesions of the brain in patients with eclampsia and to correlate neurologic findings with MR findings. Cranial MR studies have been performed in seven patients with eclampsia. Follow-up MR studies were subsequently performed in all patients. All seven patients presented with generalized tonoclonic seizures. Neurologic symptoms ranged from blurred vision and headache in five patients to focal neurologic deficits, including total blindness, dystaxia, and dysarthria, in two patients. On T2-weighted images, MR revealed high-intensity lesions that were bilateral in each case. The lesions were predominantly cortical and subcortical, with occasional deep white matter lesions

  20. Clinical and subclinical neuropsychiatric abnormalities in rheumatoid arthritis patients

    Eman M Khedr

    2015-01-01

    Conclusion Cognitive impairment, depression, anxiety and peripheral neuropathy are common in RA patients. Early diagnosis and management of neuropsychiatric disorders in RA patients may greatly improve the patients′ health-related quality of life.

  1. Chromosomal Abnormalities Subdivide Ependymal Tumors into Clinically Relevant Groups

    Hirose, Yuichi; Aldape, Kenneth; Bollen, Andrew; James, C. David; Brat, Daniel; Lamborn, Kathleen; Berger, Mitchel; Feuerstein, Burt G.

    2001-01-01

    Ependymoma occurs most frequently within the central nervous system of children and young adults. We determined relative chromosomal copy-number aberrations in 44 ependymomas using comparative genomic hybridization. The study included 24 intracranial and 20 spinal cord tumors from pediatric and adult patients. Frequent chromosomal aberrations in intracranial tumors were gain of 1q and losses on 6q, 9, and 13. Gain of 1q and loss on 9 were preferentially associated with histological grade 3 tumors. On the other hand, gain on chromosome 7 was recognized almost exclusively in spinal cord tumors, and was associated with various other chromosomal aberrations including frequent loss of 22q. We conclude that cytogenetic analysis of ependymomas may help to classify these tumors and provide leads concerning their initiation and progression. The relationship of these aberrations to patient outcome needs to be addressed. PMID:11238062

  2. Laboratory Persistence and Clinical Progression of Small Monoclonal Abnormalities

    Murray, David L.; Seningen, Justin L.; Dispenzieri, Angela; Snyder, Melissa R.; Kyle, Robert A.; Rajkumar, S. Vincent; Katzmann, Jerry A.

    2012-01-01

    Monoclonal gammopathy of undetermined significance (MGUS) that presents with no quantifiable M spike on immunofixation electrophoresis (IFE) can be termed IFE MGUS. We retrospectively identified patients with IFE MGUS who were monitored with at least 1 subsequent assessment that included an IFE, and evaluated the persistence of the monoclonal protein and the progression of disease. Although the monoclonal proteins persisted in the majority of patients, 16% did not experience this persistence,...

  3. Clinical studies in dermatology require a post-treatment observation phase to define the impact of the intervention on the natural history of the complaint.

    Sinclair, Rodney; Turner, Graham A; Jones, D Andrew R; Luo, Shengjun

    2016-08-01

    The use of a post-treatment period of observation or "regression phase" is common in pharmaceutical and cosmetic clinical dermatology studies. Regression phases can be incorporated into a variety of study designs, ranging from simple post-treatment observation for a defined period, as has been used for moisturizers, antidandruff formulations, and treatments for acne, to more complex randomized intermittent-treatment designs, as used in studies of psoriasis pharmacotherapies. Extensive information can be derived from a regression phase. Notably, it can provide useful data on the persistence of effect and time to relapse after treatment cessation, which are particularly relevant to skin conditions in which consumer or patient adherence to treatment is suboptimal. By incorporating a regression phase, a clinical study can more closely reflect "real-world" behavior, e.g., the switching by consumers from antidandruff to beauty shampoos. The regression phase can also help to differentiate between products that show similar effectiveness during the treatment phase, and monitoring post-treatment physiological end points can provide valuable evidence on the safety and mechanism of action of the therapy. PMID:27025208

  4. The prevalence of abnormal results of annual investigations among diabetic patients with different risk factors

    The basic theme of this study was to promote the use of risk approach and encourage selectively in requesting laboratory investigations. The objective was to estimate the proportion of abnormal results obtained from routinely requested annual investigations among the whole study population and the odds ratio of abnormal test results among patients with certain risk factors. A total of 459 diabetic patients aged 12 years and over, attending the primary care clinics of a university hospitals in Riyadh, Saudi Arabia, were included in this study. In this cross-sectional study, analysis of associations between patient's demographic characteristics and clinical findings (independent variables), and the results of annual investigations were conducted. A multiple logistic regression analysis was carried to identify certain independent variables associated with abnormal investigations. The proportion of patients who had abnormal electrocardiogram (ECG) was 23%, chest X-ray (CXR) 26% and liver function test (LFT) 9%. High systolic blood pressure (BP) and age were found to be important determinants of abnormal ECG and CXR. Patients who had high systolic BP (>140mm Hg) were found to be 2.39 times more likely to have abnormal ECG (OR=2.39), and their odds ratio of abnormal CXR was 2.33. Furthermore, for each 10-year increment in age, there was a 43% increased likelihood of abnormal ECG and 295 increase of abnormal CXR. Smokers were nine times more likely to have abnormal LFT (OR=9.26, 95% CI=2.29 tp 37.5). The disease duration and obesity were not found to have and independent association with the possibility of having abnormal results. The study results led to some tentative suggestions on guidelines for clinicians in their decision either to request annual investigations for all diabetic patients, or to restrict some investigations to certain group of patients. This was discussed and compared with the findings from the literature and other authorities recommendations. (author)

  5. Sensorial abnormalities: Smell and taste

    Palheta Neto, Francisco Xavier

    2011-07-01

    Full Text Available Introduction: Taste and smell abnormalities have proven to be an extremely more complex subject than previously regarded. Wide-ranging nosologic entities arise along with smell and taste alterations, and they can be congenital or acquired. Objective: Analyze the main features of smell and taste dysfunctions. Method: Automated databases were used to collect data, by searching keywords like 'alteration', 'smell', and 'taste'. A non-systematic search was also made in scientific printings and medical books. Literature Review: Smell and taste dysfunctions have a vast etiology, the most significant of which are obstructive nasal and sinusal disease, infections of the upper respiratory tract, cranioencephalic trauma, aging, exposure to toxics and some drugs, nasal or intracranial neoplasias, psychiatric and neurological pathologies, iatrogenic disease, idiopathic and congenital causes. A detailed anamnesis, a careful physical examination and supplementary evaluations are important for the diagnosis of these alterations. Conclusion: As a rule, smell and taste dysfunctions occur in a combined way. The early discovery of such dysfunctions can lead to a more efficient treatment, making the progress of diseases causing them retard and the symptoms less severe. In many cases, treating these alterations is not easy and there needs to be a multidisciplinary cooperation among the otorhinolaryngologist, endocrinologist, neurologist, psychiatrist, among others.

  6. Radiologic atlas of pulmonary abnormalities in children

    This book is an atlas about thoracic abnormalities in infants and children. The authors include computed tomographic, digital subtraction angiographic, ultrasonographic, and a few magnetic resonance (MR) images. They recognize and discuss how changes in the medical treatment of premature infants and the management of infection and pediatric tumors have altered some of the appearances and considerations in these diseases. Oriented toward all aspects of pulmonary abnormalities, the book starts with radiographic techniques and then discusses the normal chest, the newborn, infections, tumors, and pulmonary vascular diseases. There is comprehensive treatment of mediastinal abnormalities and a discussion of airway abnormalities

  7. Characteristics of abnormal menstrual cycle and polycystic ovary syndrome in community and hospital populations

    MA Yan-min; LI Rong; QIAO Jie; ZHANG Xiao-wei; WANG Shu-yu; ZHANG Qiu-fang; LI Li; TU Bin-bin; ZHANG Xue

    2010-01-01

    Background Polycystic ovary syndrome (PCOS) is considered to be the most common endocrine disorder in women of reproductive age.The involvement of an abnormal menstrual cycle in the etiology of PCOS remains unclear.We aimed to analyze the characteristics of abnormal menstrual cycles and their association with PCOS in community and hospital patient populations.Methods Women with PCOS identified from 2111 permanent female residents in the community of Beijing and 506 outpatients obtained from the reproductive clinic of Peking University Third Hospital were recruited for this study,comprising the PCOS community group and the PCOS hospital group, respectively.Each group was further divided into four subgroups according to the length of menstrual cycles: <21 days; 21-34 days; 35-60 days; and >60 days.Women in each group were interviewed using a questionnaire to assess factors including age, age of menarche, menstrual cycle history, related family history, and modified Ferriman-Gallwey (mF-G) score.All women received transvaginal ultrasound scan and had fasting blood samples taken for endocrine evaluation.A two-tailed P value of <0.05 was considered significant.Results In the community population, the prevalence of abnormal menstrual cycle was 27.19% (574/2111).The prevalence of PCOS in the community was 6.11% (129/2111) according to Rotterdam criteria.In the community group,the most common menstrual cycle length was 35-60 days, whereas for the hospital group, it was >60 days.In both the community and hospital groups, the most common phenotype of PCOS was that of Oligo/amenorrhea+PCO+hyperandrogenism (HA) (O+P+H) (P=0.000).With increasing cycle length of 35-60 days to >60 days, the percentages of Oligo/amenorrhea+PCO (O+P) and O+P+H were found to significantly decrease in the community group and significantly increase in the hospital group (P=0.000 for each).In the hospital group, as the menstrual cycle length increased from 35-60 days to >60 days, the rate

  8. Gray matter volumetric abnormalities associated with the onset of psychosis

    Wi Hoon eJung

    2012-12-01

    Full Text Available Patients with psychosis display structural brain abnormalities in multiple brain regions. The disorder is characterized by a putative prodromal period called ultra-high-risk (UHR status, which precedes the onset of full-blown psychotic symptoms. Recent studies on psychosis have focused on this period. Neuroimaging studies of UHR individuals for psychosis have revealed that the structural brain changes observed during the established phases of the disorder are already evident prior to the onset of the illness. Moreover, certain brain regions show extremely dynamic changes during the transition to psychosis. These neurobiological features may be used as prognostic and predictive biomarkers for psychosis. With advances in neuroimaging techniques, neuroimaging studies focusing on gray matter abnormalities provide new insights into the pathophysiology of psychosis, as well as new treatment strategies. Some of these novel approaches involve antioxidants administration, because it is suggested that this treatment may delay the progression of UHR to a full-blown psychosis and prevent progressive structural changes. The present review includes an update on the most recent developments in early intervention strategies for psychosis and potential therapeutic treatments for schizophrenia. First, we provide the basic knowledge of the brain regions associated with structural abnormalities in individuals at UHR. Next, we discuss the feasibility on the use of magnetic resonance imaging (MRI-biomarkers in clinical practice. Then, we describe potential etiopathological mechanisms underlying structural brain abnormalities in prodromal psychosis. Finally, we discuss the potentials and limitations related to neuroimaging studies in individuals at UHR.

  9. Association Between Interstitial Lung Abnormalities and All-Cause Mortality

    Putman, Rachel K.; Hatabu, Hiroto; Araki, Tetsuro; Gudmundsson, Gunnar; Gao, Wei; Nishino, Mizuki; Okajima, Yuka; Dupuis, Josée; Latourelle, Jeanne C.; Cho, Michael H.; El-Chemaly, Souheil; Coxson, Harvey O.; Celli, Bartolome R.; Fernandez, Isis E.; Zazueta, Oscar E.; Ross, James C.; Harmouche, Rola; Estépar, Raúl San José; Diaz, Alejandro A.; Sigurdsson, Sigurdur; Gudmundsson, Elías F.; Eiríksdottír, Gudny; Aspelund, Thor; Budoff, Matthew J.; Kinney, Gregory L.; Hokanson, John E.; Williams, Michelle C; Murchison, John T.; MacNee, William; Hoffmann, Udo; O’Donnell, Christopher J.; Launer, Lenore J.; Harrris, Tamara B.; Gudnason, Vilmundur; Silverman, Edwin K.; O’Connor, George T.; Washko, George R.; Rosas, Ivan O.; Hunninghake, Gary M.

    2016-01-01

    .8, P=0.014), and ECLIPSE (HR=1.4, 95% CI, 1.1–2, P=0.022) cohorts. In the AGES-Reykjavik cohort the higher rate of mortality could be explained by a higher rate of death due to respiratory disease, specifically pulmonary fibrosis. CONCLUSIONS AND RELEVANCE In four separate research cohorts, interstitial lung abnormalities were associated with a higher risk of all-cause mortality. The clinical implications of this association require further investigation. PMID:26881370

  10. Hipnose e psicologia clínica: retomando a história não contada Hypnosis and clinical psychology: bringing back the untold history

    Maurício da Silva Neubern

    2006-01-01

    Full Text Available O presente artigo aponta várias relações entre a psicologia clínica e a hipnose, destacando que boa parte destas permaneceram e ainda se encontram pouco conhecidas da grande maioria dos psicólogos clínicos. Por um lado, visa destacar acontecimentos históricos dessa relação que, apesar da pertinência, foram marginalizados e esquecidos, o que remete, sobretudo, às práticas institucionais vigentes neste ramo da psicologia. Ao mesmo tempo, o artigo busca destacar brevemente que a reflexão sobre a hipnose pode levar a psicologia clínica a reformulações epistemológicas, institucionais e práticas da mais alta relevância, principalmente em termos de colocá-la em sintonia com importantes discussões atuais do panorama científico. Por fim, ressalta que, pelas próprias características da hipnose enquanto tema de reflexão e estudo, ela incita radicalmente a uma tomada de rumo na direção da construção de um conhecimento onde seja possível o auto-conhecimento, rompendo com as tradições modernas do pensamento científico.The present article points out various relations between clinic psychology and hypnosis, highlighting that a great part of both has remained well unknown by the great majority of clinic psychologists. On one hand, this article aims at historical outcomes of this relation, which despite having been put aside and forgotten, takes us back to the institutional practices taking place in this field of psychology. On the other hand, it intends to briefly bring about that the reflection over hypnosis might present clinic psychology with epistemological, institutional and practical reforms of the highest relevance, especially in terms of making hypnosis function in sync with important present discussions on the scientific scenery. Finally, this article states that for its own characteristics as a subject of study and reflection, hypnosis radically incites the building up of some knowledge where self-actualization is made

  11. Inguinal Abnormalities in Male Patients with Acetabular Fractures Treated Using an Ilioinguinal Exposure

    Reza Firoozabadi

    2015-09-01

    Full Text Available Purpose: Surgeons performing an ilioinguinal exposure for acetabular fracture surgery need to be aware of aberrant findings such as inguinal hernias and spermatic cord lesions. The purpose of this study is to report these occurrences in a clinical series of adult males undergoing acetabular fracture fixation and a series of adult male cadavers. The secondary aim is to characterize these abnormalities to aid surgeons in detecting these abnormalities preoperatively and coordinating a surgical plan with a general surgeon.Methods: Clinical study- Retrospective review of treated acetabular fractures through an ilioinguinal approach. Incidence of inguinal canal and spermatic cord abnormalities requiring general surgery consultation were identified. Corresponding CT scans were reviewed and radiographic characteristics of the spermatic cord abnormalities and/or hernias were noted.Cadaveric study- 18 male cadavers dissected bilaterally using an ilioinguinal exposure. The inguinal canal and the contents of the spermatic cord were identified and characterized.Results: Clinical Study- 5.7% (5/87 of patients had spermatic cord lesion and/or inguinal hernia requiring general surgical intervention. Preoperative pelvic CT scan review identified abnormalities noted intraoperatively in four of the five patients. Cord lipomas visualized as enlargements of the spermatic cord with homogeneous density. Hernias visualized as enlarged spermatic cords with heterogeneous density. Cadaver Study- 31% (11/36 of cadavers studied had spermatic cord and/or inguinal canal abnormalities. Average cord diameter in those with abnormalities was 24.9 mm (15-28 compared to 16 mm (11-22 in normal cords, which was statistically significant.Conclusion: The clinical and cadaveric findings emphasize the importance of understanding inguinal abnormalities and the value of detecting them preoperatively. The preoperative pelvic CT scans were highly sensitive in detecting inguinal abnormalities.

  12. History of Childhood Abuse, Drinking Motives, Alcohol Use, and Sexual Risk Behavior Among STD Clinic Patients in St. Petersburg, Russia: A Cross-Sectional Study.

    Abdala, Nadia; Li, Fangyong; Shaboltas, Alla V; Skochilov, Roman V; Krasnoselskikh, Tatiana V

    2016-03-01

    The relationship between level of childhood abuse (physical and emotional) and sexual risk behavior of sexually transmitted disease clinic patients in St. Petersburg, Russia was examined through path analyses. Mediating variables investigated were: Alcohol Use Disorder Identification Test (AUDIT), drinking motives (for social interaction, to enhance mood, to facilitate sexual encounters), intimate partner violence (IPV), anxiety, and depression symptoms. Results showed a significant indirect effect of childhood abuse on women's sexual risk behavior: higher level of childhood abuse was associated with a greater likelihood of IPV, motivations to drink, leading to higher AUDIT scores and correlated to higher likelihood of having multiple, new or casual sexual partner(s). No significant effect was identified in paths to condom use. Among men, childhood abuse had no significant effect on sexual risk behavior. Reduction in alcohol-related sexual risk behavior may be achieved by addressing the effects of childhood abuse among female participants. PMID:25801476

  13. Uncovering History for Future History Teachers

    Fischer, Fritz

    2010-01-01

    The art of history teaching is at a crossroads. Recent scholarship focuses on the need to change the teaching of history so students can better learn history, and insists that history teachers must move beyond traditional structures and methods of teaching in order to improve their students' abilities to think with history. This article presents…

  14. Ildens historier

    Lassen, Henrik Roesgaard

    In December 2012 a manuscript entitled "Tællelyset" ['The Tallow Candle'] was discovered in an archive. The story was subsequently presented to the world as Hans Christian Andersen's first fairy tale and rather bombastically celebrated as such. In this book it is demonstrated that the text cannot...... have been written by Andersen. In several chapters the curiously forgotten history of fire-lighting technology is outlined, and it is demonstrated that "Tællelyset" is written by a person with a modern perspective on how to light a candle - among other things. The central argument in the book springs...

  15. Wilson's disease: cranial MRI observations and clinical correlation

    Study of MRI changes may be useful in diagnosis, prognosis and better understanding of the pathophysiology of Wilson's disease (WD). We aimed to describe and correlate the MRI abnormalities of the brain with clinical features in WD. MRI evaluation was carried out in 100 patients (57 males, 43 females; mean age 19.3±8.9 years) using standard protocols. All but 18 patients were on de-coppering agents. Their history, clinical manifestations and scores for severity of disease were noted. The mean duration of illness and treatment were 8.3±10.8 years and 7.5±7.1 years respectively. MRI of the brain was abnormal in all the 93 symptomatic patients. The most conspicuous observations were atrophy of the cerebrum (70%), brainstem (66%) and cerebellum (52%). Signal abnormalities were also noted: putamen (72%), caudate (61%), thalami (58%), midbrain (49%), pons (20%), cerebral white matter (25%), cortex (9%), medulla (12%) and cerebellum (10%). The characteristic T2-W globus pallidal hypointensity (34%), ''Face of giant panda'' sign (12%), T1-W striatal hyperintensity (6%), central pontine myelinosis (7%), and bright claustral sign (4%) were also detected. MRI changes correlated with disease severity scores (P<0.001) but did not correlate with the duration of illness. MRI changes were universal but diverse and involved almost all the structures of the brain in symptomatic patients. A fair correlation between MRI observations and various clinical features provides an explanation for the protean manifestations of the disease. (orig.)

  16. Clinical and radiological analysis of severe acute respiratory syndrome

    Objective: To study the X-ray features of severe acute respiratory syndrome (SARS). Methods: The clinical data and X-ray appearances of 29 cases with SARS were analyzed retrospectively. Results: Epidemic outbreak of SARS has occurred at this area. 29 cases of SARS in this group began with a fever. 15 cases (51.7%) experienced mild respiratory symptoms. In 10 patients (34.5%) the antibacterial medication showed inefficacy before hospitalization. Leucocyte counting was normal in 18 cases (62.1%) and decreased in 11 cases (37.9%). Platelet counting slightly decreased in 7 cases (24.1%). Hepatic function test was abnormal in 16 patients (55.2%), mostly with a decrease of serum enzymology. Obvious abnormalities were seen on the chest films, which were in sharp contrast with the mild clinical respiratory signs. Chest X-ray findings were as follows: Exaggerated and indistinct lung markings with reticular shadow in 7 cases (24.1%), ground-glass opacity in 3 cases (10.4%), small patchy and multi-patchy imaging in 12 cases (41.4%), and large patchy shadow in 7 cases (24.1%). X-ray abnormality was presented later and absorbed slower. Conclusion: SARS carries a variety of X-ray appearances. The combined use of epidemiologic history, clinical situation, laboratory tests, and imaging examinations can make a definite diagnosis

  17. Complex radiation diagnosis of associated intracardiac abnormality

    It is shown that patients with congenital heart diseases having signs of cardiodismorphic complex in form of associated intercardiac abnormalities require special attention after surgical correction of the principal defect. It is connected with the fact that the associated abnormalities may become with time the basic factors influencing the progress and forecast of the disease

  18. An Abnormal Psychology Community Based Interview Assignment

    White, Geoffry D.

    1977-01-01

    A course option in abnormal psychology involves students in interviewing and observing the activities of individuals in the off-campus community who are concerned with some aspect of abnormal psychology. The technique generates student interest in the field when they interview people about topics such as drug abuse, transsexualism, and abuse of…

  19. An Abnormal Vibrational Mode of Torsion Pendulum

    赵亮; 涂英; 顾邦明; 胡忠坤; 罗俊

    2003-01-01

    In the experiment for the determination of the gravitational constant G, we found an abnormal vibrational mode of the torsion pendulum. The abnormal mode disappeared as a magnetic damper was introduced to the torsion pendulum system. Our experimental results also show that the magnetic damper can be used to suppress the high frequency vibrational noises to torsion pendulums effectively.

  20. Abnormal physiological conditions in acute schizophrenic patients on emergency admission: dehydration, hypokalemia, leukocytosis and elevated serum muscle enzymes.

    Hatta, K; Takahashi, T; Nakamura, H; Yamashiro, H; Endo, H; Fujii, S; Fukami, G; Masui, K; Asukai, N; Yonezawa, Y

    1998-01-01

    This study investigated varieties and incidence of abnormal physiological conditions in acute schizophrenic patients on emergency. Laboratory data obtained prior to treatment from patients, admitted on an emergency basis during an 18-month period, were evaluated retrospectively, as well as demographics and clinical characteristics. Of 259 male acute schizophrenic patients (ICD-10: F2), 6.9% revealed dehydration, a third had hypokalemia and leukocytosis, and two thirds showed elevated serum muscle enzymes. These percentages were statistically significant compared with those of outpatients. In addition, the former three of these conditions in the F2 group were as frequent as those in alcohol and/or psychoactive substance abusers (ICD-10: F1) on emergency admission, although elevated serum muscle enzymes in the F2 group was less frequent than that in the F1 group. In order to prevent these abnormal physiological conditions from worsening and becoming life-threatening, one fourth of the F2 group [dehydration, 6.9%, severe hypokalemia ( 1000 IU/l), 16.5%] required medical management such as fluid therapy and various types of monitoring. In cases of a behavioral emergency, laboratory screening and monitoring of urinary output were essential. Due to their lack of cooperation, case history, physical examination, and initial vital signs did not contribute to detection of their medical condition. PMID:9810481

  1. Natural history of rheumatoid arthritis

    In quantitative studies the authors found significant correlations between radiographic scores and physical and functional status in patients with rheumatoid arthritis (RA). The authors review data as it applies to the natural history of RA, with attention to the pathophysiology of specific radiographic features. Cross-sectional analysis in 200 patients demonstrated significant correlations between radiographic scores and duration of disease; longitudinal studies of serial films in 52 patients revealed progression of disease in 92%. The findings of substantial radiographic abnormality and rapid progression early in the disease may provide a rationale for early aggressive therapy of RA

  2. Injuries by marine and freshwater stingrays: history, clinical aspects of the envenomations and current status of a neglected problem in Brazil.

    Junior, Vidal Haddad; Cardoso, João Luiz Costa; Neto, Domingos Garrone

    2013-01-01

    Stingrays are a group of rays - cartilaginous fish related to sharks - that have whiplike tails with barbed, usually venomous spines and are found around the world, especially the marine species. Despite recent reports of accidents involving these fish, they are not aggressive, reacting only when stepped on or improperly handled. Injuries by stingrays are seldom mentioned by historians, although they have always been present in riverine communities of inland waters and in South American coasts. Indeed, envenomations by stingrays are quite common in freshwater and marine fishing communities. Although having high morbidity, such injuries are neglected because they have low lethality and usually occur in remote areas, which favor the use of folk remedies. In the present review article, historical aspects of injuries caused by stingrays in Brazil and their distribution on the coast of São Paulo state and riverine communities of the North, Midwest and Southeast regions were studied. In addition, other aspects were analyzed such as clinical features, therapeutic methods, preventive measures and trends in occurrence of these accidents in the country, particularly in areas in which freshwater stingrays had not been previously registered, being introduced after breaching of natural barriers. PMID:23895313

  3. [Abnormality in bone metabolism after burn].

    Gong, X; Xie, W G

    2016-08-20

    Burn causes bone metabolic abnormality in most cases, including the changes in osteoblasts and osteoclasts, bone mass loss, and bone absorption, which results in decreased bone mineral density. These changes are sustainable for many years after burn and even cause growth retardation in burned children. The mechanisms of bone metabolic abnormality after burn include the increasing glucocorticoids due to stress response, a variety of cytokines and inflammatory medium due to inflammatory response, vitamin D deficiency, hypoparathyroidism, and bone loss due to long-term lying in bed. This article reviews the pathogenesis and regularity of bone metabolic abnormality after burn, the relationship between bone metabolic abnormality and burn area/depth, and the treatment of bone metabolic abnormality, etc. and discusses the research directions in the future. PMID:27562160

  4. Clinical report on 62 cases of acute dimethyl sulfate intoxication.

    Wang, Y; Xia, J; Wang, Q W

    1988-01-01

    Sixty-two cases of accidental acute intoxication from the inhalation of dimethyl sulfate (DMS) are reported. To facilitate clinical evaluation and treatment, as well as identification of capacity for physical labor, a grading system was established according to the history of exposure to DMS, symptoms and signs of respiratory mucosal irritation, findings on chest radiographs, and abnormalities of leukocyte count. Emergency treatment included prophylactic use of glucocorticoids, supplemental oxygen, sedatives, and antibiotics for prevention and treatment of laryngeal and pulmonary edema, pulmonary infections, and other complications. Follow-up studies for 2-12 years have found only mild to moderate impairment in ventilatory capacity in eight cases, with no abnormal findings in ECG, chest films, and routine blood tests. Nearly all patients have resumed their usual work. PMID:3364423

  5. Myhre syndrome: Clinical features and restrictive cardiopulmonary complications.

    Starr, Lois J; Grange, Dorothy K; Delaney, Jeffrey W; Yetman, Anji T; Hammel, James M; Sanmann, Jennifer N; Perry, Deborah A; Schaefer, G Bradley; Olney, Ann Haskins

    2015-12-01

    Myhre syndrome, a connective tissue disorder characterized by deafness, restricted joint movement, compact body habitus, and distinctive craniofacial and skeletal features, is caused by heterozygous mutations in SMAD4. Cardiac manifestations reported to date have included patent ductus arteriosus, septal defects, aortic coarctation and pericarditis. We present five previously unreported patients with Myhre syndrome. Despite varied clinical phenotypes all had significant cardiac and/or pulmonary pathology and abnormal wound healing. Included herein is the first report of cardiac transplantation in patients with Myhre syndrome. A progressive and markedly abnormal fibroproliferative response to surgical intervention is a newly delineated complication that occurred in all patients and contributes to our understanding of the natural history of this disorder. We recommend routine cardiopulmonary surveillance for patients with Myhre syndrome. Surgical intervention should be approached with extreme caution and with as little invasion as possible as the propensity to develop fibrosis/scar tissue is dramatic and can cause significant morbidity and mortality. PMID:26420300

  6. Profile of hematological abnormalities of Indian HIV infected individuals

    Sharma Aman

    2009-08-01

    Full Text Available Abstract Background Hematological abnormalities are a common complication of HIV infection. These abnormalities increase as the disease advances. Bone marrow abnormalities occur in all stages of HIV infection. Methods Two hundred HIV infected individual were screened for hematological abnormalities from March 2007–March 2008. Absolute CD4 cell count analysis was carried out by flowcytometry. Depending on the results of the primary screening further investigations were performed, like iron studies, hemolytic work up, PNH work up and bone marrow evaluation. Other investigations included coagulation profile, urine analysis, blood culture (bacterial, fungal, mycobacterial, serology for Epstein Barr virus (EBV, Cytomegalovirus (CMV, Hepatitis B and C, and Parvo B19 infection. Results The most common hematological abnormality was anemia, seen in 65.5% (131/200 patients. Iron deficiency anemia was seen in 49.2% (/200 cases while anemia of chronic disease occurred in 50.7% (/200 cases. Bone marrow evaluation was carried out in 14 patients out of which staging marrow was performed in 2 cases of non-Hodgkin's lymphoma (NHL and did not show any bone marrow infiltration. In remaining12 cases bone marrow was done for evaluation of pancytopenia. Among patients with pancytopenia 50% (6/12 showed granulomas (4 were positive for AFB, 2 were positive for fungal cryptococci, 25% (3/12 showed hemophagocytosis. There was a strong negative correlation between anemia and CD4 counts in this study. Thrombocytopenia was seen in 7% (14/200 cases and had no significant correlation with CD4 counts. No patient had absolute neutrophil count (ANC Conclusion Anemia in HIV patients can be a good clinical indicator to predict and access the underlying immune status. Patients should be investigated for hematological manifestations and appropriate steps should be taken to identify and treat the reversible factors.

  7. Analysis of abnormalities of snubbers in nuclear-reactor service (Report 1)

    An investigation was conducted of malfunctions of snubbers (seismic-shock arrestors) in service in nuclear power plants. The construction and use of snubbers is summarized, and the history of snubber problems in nuclear service is reviewed. Reports of many hundreds of snubber malfunctions were found in the abnormal-occurrence reports of the docket literature. The great majority of these abnormal occurrences consisted of hydraulic snubbers whose hydraulic fluid had leaked out because of deteriorated seals; snubbers that were damaged in manufacture, shipping, installation, refitting, or use; and snubbers whose performance did not match service requirements. Additional information about the failures was obtained from the reactor operators, snubber manufacturers, reactor vendors, and independent laboratories. The abnormal occurrences were classified into 12 categories. Analyses of the causes of the individual abnormalities are presented, and preliminary comments on the current state of snubber manufacture and use are made

  8. Analysis of abnormalities of snubbers in nuclear-reactor service (Report 1)

    Butler, J.H.; O' Hara, F.M. Jr.

    1976-10-14

    An investigation was conducted of malfunctions of snubbers (seismic-shock arrestors) in service in nuclear power plants. The construction and use of snubbers is summarized, and the history of snubber problems in nuclear service is reviewed. Reports of many hundreds of snubber malfunctions were found in the abnormal-occurrence reports of the docket literature. The great majority of these abnormal occurrences consisted of hydraulic snubbers whose hydraulic fluid had leaked out because of deteriorated seals; snubbers that were damaged in manufacture, shipping, installation, refitting, or use; and snubbers whose performance did not match service requirements. Additional information about the failures was obtained from the reactor operators, snubber manufacturers, reactor vendors, and independent laboratories. The abnormal occurrences were classified into 12 categories. Analyses of the causes of the individual abnormalities are presented, and preliminary comments on the current state of snubber manufacture and use are made.

  9. True recurrence vs. new primary ipsilateral breast tumor relapse: An analysis of clinical and pathologic differences and their implications in natural history, prognoses, and therapeutic management

    had a significantly lower S phase fraction (NP 13.1 vs. TR 22.0, p < 0.05). The overall survival following breast relapse was 64% at 10 years and 49% at 15 years. With a mean follow-up of 10.4 years following breast relapse, patients with NP had better 10-year overall survival (TR 55% vs. NP 75%, p < 0.0001), distant disease-free survival (TR 41% vs. NP 85%, p < 0.0001), and cause-specific survival (TR 55% vs. NP 90%, p < 0.0001). Conclusion: It appears that a significant portion of patients who experience ipsilateral breast tumor relapse following conservative surgery and radiation therapy have new primary tumors as opposed to true local recurrences. True recurrence and new primary tumor ipsilateral breast tumor relapses have different natural histories, different prognoses, and, in turn, different implications for therapeutic management.

  10. PALM-COEIN Nomenclature for Abnormal Uterine Bleeding.

    Deneris, Angela

    2016-05-01

    Approximately 30% of women will experience abnormal uterine bleeding (AUB) during their life time. Previous terms defining AUB have been confusing and imprecisely applied. As a consequence, both clinical management and research on this common problem have been negatively impacted. In 2011, the International Federation of Gynecology and Obstetrics (FIGO) Menstrual Disorders Group (FMDG) published PALM-COEIN, a new classification system for abnormal bleeding in the reproductive years. Terms such as menorrhagia, menometrorrhagia, metrorrhagia, dysfunctional uterine bleeding, polymenorrhea, oligomenorrhea, and uterine hemorrhage are no longer recommended. The PALM-COEIN system was developed to standardize nomenclature to describe the etiology and severity of AUB. A brief description of the PALM-COEIN nomenclature is presented as well as treatment options for each etiology. Clinicians will frequently encounter women with AUB and should report findings utilizing the PALM-COEIN system. PMID:26969858

  11. Ossification of the Achilles tendon: imaging abnormalities in 12 patients

    Ossification of the Achilles tendon is a rare clinical entity that is characterized by the presence of an ossific mass contained within the fibrocartilaginous substance of the tendon. Because the radiographic features of this condition have not been documented entirely and the magnetic resonance (MR) imaging findings have not been determined, a review of 16 affected tendons in 12 patients was performed in an attempt to characterize the imaging abnormalities associated with this process. MR imaging was performed in three Achilles tendons which demonstrated thickening of the tendons at the level of the ossifications and a lack of intratendinous signal abnormalities compatible with acute tendinitis. Signal intensity similar to that of bone marrow was present in the ossifications. (orig.)

  12. Ossification of the Achilles tendon: imaging abnormalities in 12 patients

    Yu, J.S. [Dept. of Radiology, Veterans Administration Medical Center, San Diego, CA (United States); Witte, D. [Dept. of Radiology, Veterans Administration Medical Center, San Diego, CA (United States); Resnick, D. [Dept. of Radiology, Veterans Administration Medical Center, San Diego, CA (United States); Pogue, W. [Dept. of Radiology, AMI Valley Medical Center, El Cajon, CA (United States)

    1994-02-01

    Ossification of the Achilles tendon is a rare clinical entity that is characterized by the presence of an ossific mass contained within the fibrocartilaginous substance of the tendon. Because the radiographic features of this condition have not been documented entirely and the magnetic resonance (MR) imaging findings have not been determined, a review of 16 affected tendons in 12 patients was performed in an attempt to characterize the imaging abnormalities associated with this process. MR imaging was performed in three Achilles tendons which demonstrated thickening of the tendons at the level of the ossifications and a lack of intratendinous signal abnormalities compatible with acute tendinitis. Signal intensity similar to that of bone marrow was present in the ossifications. (orig.)

  13. Volumetric brain abnormalities in polysubstance use disorder patients

    Noyan, Cemal Onur; Kose, Samet; Nurmedov, Serdar; Metin, Baris; Darcin, Aslı Enez; Dilbaz, Nesrin

    2016-01-01

    Aim Polysubstance users represent the largest group of patients seeking treatment at addiction and rehabilitation clinics in Turkey. There is little knowledge about the structural brain abnormalities seen in polysubstance users. This study was conducted to examine the structural brain differences between polysubstance use disorder patients and healthy control subjects using voxel-based morphometry. Methods Forty-six male polysubstance use disorder patients in the early abstinence period and 30 healthy male controls underwent structural magnetic resonance imaging scans. Voxel-based morphometry analysis was performed to examine gray matter (GM) abnormality differences. Results Polysubstance use disorder patients displayed significantly smaller GM volume in the thalamus, temporal pole, superior frontal gyrus, cerebellum, gyrus rectus, occipital lobe, anterior cingulate cortex, superior temporal gyrus, and postcentral gyrus. Conclusion A widespread and smaller GM volume has been found at different regions of the frontal, temporal, occipital, and parietal lobes, cerebellum, and anterior cingulate cortex in polysubstance users. PMID:27358566

  14. Pathogeny and natural history of congenital dislocation of the hip.

    Seringe, R; Bonnet, J-C; Katti, E

    2014-02-01

    Based on a review of the literature, the authors have made a critical study of several etiological factors. Endogenous factors such as acetabular dysplasia, increased anteversion of the femoral neck, and capsular laxity support the genetic theory but are neither constant nor necessary and are only facilitating factors. The major factor seems to be a mechanical one linked to the position in the uterus: hyperflexion with adduction and external rotation constituting the dislocating foetal posture combined with abnormal pressure on the greater trochanter and leading to expulsion of the head upward and backward. This theory can explain the natural history of C D H which is first, at birth a hip instability followed by two possible evolutions: either persistent luxation becoming irreducible or spontaneous stabilisation leading sometimes to complete healing or to residual abnormalities (subluxation or dysplasia). This concept suggests practical conclusions: the importance of an early diagnosis, the selection of the signs of the hip at risk, the pattern of prevention, the role for non-clinical investigations, the principles of the treatment based on postures, the indications for the different types of treatment. PMID:24456762

  15. Abnormalities of uterine cervix in women with inflammatory bowel disease

    Jyoti Bhatia; Panayota Kotsali; Oana Vele; Jason Bratcher; Burton Korelitz; Katherine Vakher; Shlomo Mannor; Maria Shevchuk; Gworgia Panagopoulos; Adam Ofer; Ecaterina Tamas

    2006-01-01

    AIM: To evaluate the prevalence of abnormalities of the uterine cervix in women with inflammatory bowel disease (IBD) when compared to healthy controls.METHODS: One hundred and sixteen patients with IBD [64 with Crohn's disease (CD) and 52 with ulcerative colitis (UC)] were matched to 116 healthy controls by age (+/- 2 years) at the time of most recent papanicolaou (Pap) smear. Data collected consisted of age, race, marital status, number of pregnancies,abortions/miscarriages, duration and severity of IBD,Pap smear results within five years of enrollment, and treatment with immunosuppressive drugs. Pap smear results were categorized as normal or abnormal including atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LGSIL), and high-grade squamous intraepithelial lesion (HGSIL). RESULTS: The median age at the time of Pap smear was 46 (range: 17-74) years for the IBD group and matched controls (range: 19-72 years). There were more Caucasian subjects than other ethnicities in the IBD patient group (P = 0.025), as well as fewer abortions (P = 0.008), but there was no significant difference regarding marital status. Eighteen percent of IBD patients had abnormal Pap smears compared to 5% of controls (P = 0.004). Subgroup analysis of the IBD patients revealed no significant differences between CD and UC patients in age, ethnicity, marital status, number of abortions, disease severity, family history of IBD, or disease duration. No significant difference was observed in the number of abnormal Pap smears or the use of immunosuppressive medications between CD and UC patients (P = 0.793). No definitive observation could be made regarding HPV status, as this was not routinely investigated during the timeframe of our study.CONCLUSION: Diagnosis of IBD in women is related to an increased risk of abnormal Pap smear, while type of IBD and exposure to immunosuppressive medications are not. This has significant implications for

  16. Pay attention to history inquiry and clinical examination in diagnosis of uveitis%应重视葡萄膜炎的病史询问和临床检查

    杨培增

    2013-01-01

    Diagnosis of uveitis based on etiologies and entities is essential for the treatment of the uveitis patients.A careful and meticulous inquiry about history may provide important clue to the diagnosis.Careful and detailed clinical ocular examinations allow us to make a correct diagnosis in most uveitis patients.Auxiliary examinations and laboratory examinations chosen principally based on clinical manifestation enable us to make a definite diagnosis in almost all the uveitis patients.%葡萄膜炎病因和类型的确定对治疗策略和方法的制定具有重要价值.病史询问可为葡萄膜炎诊断可提供重要线索,认真细致的眼部检查可使大多数葡萄膜炎患者获得正确诊断,合理选择眼科辅助检查及实验室检查将使绝大多数葡萄膜炎患者获得病因或类型的诊断.

  17. Abnormal duodenal loop demonstrated by X-ray. Correlation to symptoms and prognosis of dyspepsia

    Thommesen, P.; Funch-Jensen, P.

    1986-01-01

    The occurrence of dyspeptic symptoms has previously been correlated with the shape of the duodenal loop in patients with X-ray-negative dyspepsia. An abnormal duodenal loop was associated with a significantly higher incidence of symtoms provoked by meals, vomiting, regurgitations, heartburn, and the irritable bowel syndrome. 89% of these patients (26 patients with a normal duodenal loop and 39 patients with abnormal duodenal loop) were available for a 5-year follow-up study of symptomatic outcome. The incidence of symptoms provoked by meals was still significantly higher in patients with an abnormal duodenal loop, and there was also a significant difference concerning symptomatic outcome. Approximately 75% of the patients with a normal duodenal loop had improved, and 25% had unchanged clinical conditions. Approximately 50% of the patients with an abnormal duodenal loop had improved, and 50% had an unchanged or even deteriorated clinical condition.

  18. A causal model of post-traumatic stress disorder: disentangling predisposed from acquired neural abnormalities.

    Admon, Roee; Milad, Mohammed R; Hendler, Talma

    2013-07-01

    Discriminating neural abnormalities into the causes versus consequences of psychopathology would enhance the translation of neuroimaging findings into clinical practice. By regarding the traumatic encounter as a reference point for disease onset, neuroimaging studies of post-traumatic stress disorder (PTSD) can potentially allocate PTSD neural abnormalities to either predisposing (pre-exposure) or acquired (post-exposure) factors. Based on novel research strategies in PTSD neuroimaging, including genetic, environmental, twin, and prospective studies, we provide a causal model that accounts for neural abnormalities in PTSD, and outline its clinical implications. Current data suggest that abnormalities within the amygdala and dorsal anterior cingulate cortex represent predisposing risk factors for developing PTSD, whereas dysfunctional hippocampal-ventromedial prefrontal cortex (vmPFC) interactions may become evident only after having developed the disorder. PMID:23768722

  19. Are interstitial lung abnormalities associated with COPD? A nested case–control study

    Bozzetti F

    2016-05-01

    Full Text Available Francesca Bozzetti,1 Ilaria Paladini,1 Enrico Rabaiotti,2 Alessandro Franceschini,1 Veronica Alfieri,3 Alfredo Chetta,3 Ernesto Crisafulli,3 Mario Silva,2 Ugo Pastorino,4 Nicola Sverzellati11Section of Radiology, Department of Surgical Sciences, University of Parma, 2Department of Radiology, Academic Hospital of Parma, 3Respiratory Disease and Lung Function Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, 4Division of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyPurpose: In this study, we tested the association between COPD and interstitial lung abnormality (ILA, notably in relation to the presence of computed tomography (CT signs of lung fibrosis.Patients and methods: COPD cases were selected from participants undergoing lung cancer screening (Multicentric Italian Lung Detection trial for airflow obstruction (n=311/2,303, 13.5% and 146 consecutive patients with clinical COPD. In all, 457 COPD cases were selected and classified according to the stages of Global Initiative for Chronic Obstructive Lung Disease. A nested matching (case:control =1:2 according to age, sex, and smoking history was operated between each COPD case and two control subjects from Multicentric Italian Lung Detection trial without airflow obstruction. Low-dose CT scans of COPD cases and controls were reviewed for the presence of ILA, which were classified into definite or indeterminate according to the presence of signs of lung fibrosis.Results: The frequency of definite ILA was similar between COPD cases and controls (P=0.2, independent of the presence of signs of lung fibrosis (P=0.07. Combined definite and indeterminate ILA was homogeneously distributed across Global Initiative for Chronic Obstructive Lung Disease stages (P=0.6. Definite ILA was directly associated with current smoker status (odds ratio [OR] 4.05, 95% confidence interval [CI]: 2.2–7.4 and increasing pack-years (OR 1.01, 95% CI: 1–1

  20. Saline infusion sonohysterography for uterine cavity evaluation in women with abnormal uterine bleeding

    Mohamed Abd El-Sattar; Ahmed M. Abbas; Mohamed K. Tawfik; Mahmoud A. Fouad

    2016-01-01

    Background: The aim of this study was to compare the diagnostic effectiveness of saline infusion sonohysterography (SIS) with hysteroscopy, as a gold standard diagnostic method, in detecting endometrial pathology in premenopausal women with abnormal uterine bleeding. Methods: A prospective study was conducted at Al-Azhar University hospital, Assiut, Egypt. Fifty patients were recruited from the gynecological outpatient clinic complaining of abnormal uterine bleeding. They were evaluated by...

  1. CLL: chromosomal abnormalities (FISH and their relation with clinical stage, CD38 and ZAP-70 Leucemia linfocítica crônica: anormalidades cromossômicas e a sua relação com o estágio clínico CD38 e o ZAP-70

    Marilia C. Nascimento

    2006-03-01

    Full Text Available Chronic lymphocytic leukemia is the most prevalent type of leukemia in the West. It is characterized by an extremely variable clinical course. The aim of the study was to detect the most frequent chromosomal abnormalities in patients with CLL using FISH, and assess them regarding age, gender, clinical stage and CD38 and ZAP-70 expressions. We found 51.7% of the patients with chromosome abnormalities. The most frequent one was del 13q14 in 34.5% of cases. It was associated to other alterations in 17.2%. 17p13 deletions were found in 17.2% and trisomy 12 in 13.8% (in isolation in 6.9% and associated to del 13q14, in 6.9% of the cases. An 11q22 deletion was found in one case associated to a 13q14 deletion. To better evaluate the relationship between chromosome aberrations and other prognostic factors in CLL, two cytogenetics groups were considered: favorable (13q deletion in isolation and no alteration and unfavorable outcomes (trisomy 12, 17p13 deletion, 11q22 deletion and two simultaneous alterations.The unfavorable alterations were more frequently seen among young individuals (A leucemia linfocítica crônica (LLC é o tipo de leucemia mais prevalente no Ocidente e é caracterizada por curso clínico extremamente variável. O objetivo deste estudo foi detectar as anomalias cromossômicas mais freqüentes em pacientes com LLC, empregando a técnica FISH, e correlacioná-las com idade, sexo, estádio clínico, expressão de CD 38 e ZAP-70. Foram encontradas alterações cromossômicas em 51,7% dos pacientes. A mais freqüente foi a del 13q14, observada em 34,5% dos casos e que esteve associada a outras anomalias em 17,2%. Deleção 17p13 foi encontrada em 17,2% e trissomia 12 em 13,8% (isolada em 6,9% e associada à del 13q14 em 6,9%. Deleção 11q22 foi observada em um caso em concomitância à del 13q14. Para melhor avaliar a relação entre alteração cromossômica e outros fatores prognósticos em LLC, dois grupos citogenéticos foram

  2. Incidental paranasal sinuses abnormalities in pediatric patients using computed tomography of the head and orbits

    Objective: To evaluate the prevalence and appearance of incidental paranasal sinuses abnormalities in children with no clinical evidence of rhino sinusitis using CT scans. Materials and methods: CT scans of the head or orbits of children between 0 and 18 years of age performed due to problems not related to rhino sinusitis were studied. Results: Sixty-four children were included (mean age 5.7 years; standard deviation = 3.9). Incidental sinuses abnormalities were found in 46 cases (72%). In most cases the abnormalities were mild (25/46) and mucosal thickening was the most common finding. Complete opacification and fluid levels occurred in 12 children. More than one cavity was affected in 33 patients and abnormalities were most frequently seen in maxillary sinuses, followed by ethmoid sinuses. Bilateral and symmetric findings were common. The prevalence and intensity of abnormalities were higher in children below three years of age. Conclusion: Incidental abnormalities are highly prevalent and tend to be mild in children without symptoms of rhino sinusitis. The most prevalent abnormality was mucosal thickening. Moderate and severe abnormalities occur in children below three years of age. (author)

  3. Angioedema hereditario: Historia familiar y manifestaciones clínicas en 58 pacientes Hereditary angioedema: Family history and clinical manifestations in 58 patients

    Diego S. Fernández Romero

    2009-12-01

    Full Text Available El angioedema hereditario (AEH es una enfermedad rara, autosómica dominante, caracterizada por episodios de angioedema que comprometen la piel, el tracto gastrointestinal y la laringe. Analizamos las características epidemiológicas y clínicas en una serie de 58 pacientes, 53 (91% con diagnóstico de AEH tipo I y 5 (9% con tipo II. La edad media al inicio fue de 10.8 ± 9.5 años (0.1 a 59 y de 25.8 ± 16.2 años (2 a 77 en el momento del diagnóstico, con un retraso diagnóstico de 15.3 ± 14.3 años. El promedio de ataques en los 6 meses previos a la consulta fue de 7.4 ± 7.6 (0 a 40. Cincuenta y cuatro (93% presentaron ataques cutáneos, 50 (86% abdominales, 24 (41% laríngeos y 24 (41% cutáneos y abdominales combinados. Veintisiete (46.5% nunca utilizaron medicación preventiva para la enfermedad y 17 (29% recibieron danazol en diferentes dosis por diferentes periodos de tiempo. Durante los ataques, 15 (26% pacientes recibieron C1 inhibidor endovenoso alguna vez, 7 (12% recibieron plasma fresco y 40 (69% tratamiento sintomático. Ansiedad o situaciones de estrés y traumatismos fueron los desencadenantes más frecuentes. Identificamos a 6 (10% pacientes como primera mutación y a 52 (90% con historia familiar previa. Analizamos 20 troncos familiares identificando 205 individuos en riesgo de heredar la enfermedad, 109 (53% de ellos con síntomas o diagnóstico AEH. El total de individuos con síntomas de AEH fue de 145, de los cuales 19 (13% murieron por asfixia. Disminuir el retraso diagnóstico y ofrecer una terapéutica adecuada son desafíos a afrontar en el AEH.Hereditary angioedema (HAE is a rare autosomal dominant disease, characterized by episodes of edema typically involving the skin, gastrointestinal tract and larynx. We here describe the epidemiologic and clinical characteristic of a series of 58 patients with diagnosis of HAE, 53 (91% type I and 5 (9% type II. The mean age at first symptom was 10.8 ± 9.5 years and the mean

  4. Numerically abnormal chromosome constitutions in humans

    NONE

    1993-12-31

    Chapter 24, discusses numerically abnormal chromosome constitutions in humans. This involves abnormalities of human chromosome number, including polyploidy (when the number of sets of chromosomes increases) and aneuploidy (when the number of individual normal chromosomes changes). Chapter sections discuss the following chromosomal abnormalities: human triploids, imprinting and uniparental disomy, human tetraploids, hydatidiform moles, anomalies caused by chromosomal imbalance, 13 trisomy (D{sub 1} trisomy, Patau syndrome), 21 trisomy (Down syndrome), 18 trisomy syndrome (Edwards syndrome), other autosomal aneuploidy syndromes, and spontaneous abortions. The chapter concludes with remarks on the nonrandom participation of chromosomes in trisomy. 69 refs., 3 figs., 4 tabs.

  5. Sleep physiology, abnormal States, and therapeutic interventions.

    Wickboldt, Alvah T; Bowen, Alex F; Kaye, Aaron J; Kaye, Adam M; Rivera Bueno, Franklin; Kaye, Alan D

    2012-01-01

    Sleep is essential. Unfortunately, a significant portion of the population experiences altered sleep states that often result in a multitude of health-related issues. The regulation of sleep and sleep-wake cycles is an area of intense research, and many options for treatment are available. The following review summarizes the current understanding of normal and abnormal sleep-related conditions and the available treatment options. All clinicians managing patients must recommend appropriate therapeutic interventions for abnormal sleep states. Clinicians' solid understanding of sleep physiology, abnormal sleep states, and treatments will greatly benefit patients regardless of their disease process. PMID:22778676

  6. Assessment of Molecular Cytogenetic Methods for the Detection of Chromosomal Abnormalities

    Une,Tomoka

    2006-10-01

    Full Text Available Some marker chromosomes and chromosome rearrangements are difficult to identify using G-bands by Giemsa staining after trypsin treatment (G-banding alone. Molecular cytogenetic techniques, such as spectral karyotyping (SKY and fluorescence in situ hybridization (FISH, can help to detect chromosomal aberrations precisely. We analyzed the karyotypes in 6 cases of multiple congenital abnormalities and 1 case of spontaneous abortion (case 2. Three cases (cases 1, 6, and 7 had marker chromosomes, and 4 cases (cases 2-5 had chromosomal rearrangements. The karyotypes in cases 1, 2, and 3 were determined using FISH with probes based on the clinical findings and family histories. Spectral karyotyping (SKY analysis in cases 4-7 showed that this method is useful and saves time. The combination of SKY and FISH analyses defi ned the range of the ring chromosome in case 7. We demonstrated that a combination of G-banding, FISH, and SKY can be applied effectively to the investigation of chromosomal rearrangement and to the detection of marker chromosome origins. We suggest the use of these methods for prenatal diagnosis, in which the inherent time limitations are particularly important.

  7. Natural history of ovarian cancer

    Vargas, Arturo Novoa

    2014-01-01

    Ovarian cancer is a disease laden with paradigms, and it is a serious health problem. It is important to know its natural history, as it is multifactorial in origin, and also to understand its behaviour given its risk factors which can lead to death from metastasis in patients. It continues to be a challenge for oncologists. An analytical literature review was performed to update the latest concepts of its origin, evolution, risk factors, pre-clinical horizon, and its clinical manifestations;...

  8. Subjetividade e clínica na atenção básica: narrativas, histórias de vida e realidade social Subjectivity and a clinical approach in primary healthcare: narratives, life histories and social reality

    Rebeca Silva de Barros

    2011-11-01

    Full Text Available O foco deste artigo é o cuidado em saúde bucal na Atenção Básica. Esta é lugar potencial para geração de encontros e produção de subjetividade. Por isso, discutiremos o tema tomando como foco a relação da escuta-acolhimento-vínculo debatendo sobre a existência de dicotomia entre clínica-saúde coletiva. Esta pesquisa-intervenção realizou-se de julho a dezembro de 2007 no município de Cotia-SP, a partir dos pressupostos: 1 atendimento ao problema bucal relevante para o usuário; 2 descentramento dentário; 3 constituição do caso clínico por meio da anamnese e 4 integração com os serviços da unidade. A escuta da queixa, o exame clínico bucal e o levantamento da história clínica foram registrados no prontuário, sem o uso de odontograma. Para discussão de abordagens na clínica, relataremos 08 `Hestórias Patográficas'. Os objetivos da comunicação na consulta são acolher, promover o diagnóstico seguro e interferir na evolução do sofrimento do outro restabelecendo a homeostasia corporal e produzindo vínculo, com modificação de referenciais teóricos e da linguagem clínica. O vínculo é resultado do diálogo, da assunção de responsabilidades tanto do profissional quanto do usuário e da resolução das suas queixas e necessidades.The focus of this article is on oral healthcare in Primary Healthcare. We discuss the issue taking the relationship of listening-host-link as a focus debating on the existence of a dichotomy between clinical-collective health. This investigation, took place in Cotia, São Paulo State between July and December 2007, based on the following assumptions: 1 answer the user's relevant oral care problem; 2 remove the dental focus; 3 establish the case through anamnesis; and 4 use electronic scheduling, medical files and sterilization of the health unit. Listening to the complaint, the oral clinical examination and compilation of the clinic history were recorded in the medical file, without

  9. Pneumonia lipóide exógena: importância da história clínica no diagnóstico Exogenous lipoid pneumonia: importance of clinical history to the diagnosis

    Alfredo Pereira Leite de Albuquerque Filho

    2006-12-01

    Full Text Available A pneumonia lipóide é uma doença rara, resultante da microaspiração de formulações lipídicas. Para seu diagnóstico, o grau de suspeição clínica deve ser elevado. Relata-se o caso de uma mulher com passado de câncer de mama, apresentando dispnéia e tosse progressivas e infiltrado pulmonar bilateral na radiografia. A suspeita de linfangite carcinomatosa com indicação de quimioterapia foi questionada por achados não usuais na tomografia computadorizada de alta resolução e história de ingestão crônica de laxantes contendo óleo mineral. A biópsia pulmonar confirmou pneumonia lipóide, que deve ser considerada em pacientes com pneumopatia difusa e exposição a potenciais agentes causadores.Lipoid pneumonia is a rare disease resulting from the micro-aspiration of lipid formulations. Making a diagnosis of lipoid pneumonia requires a high degree of clinical suspicion. Herein, we report the case of a female patient with a history of breast cancer, presenting progressive dyspnea and cough, together with radiological findings of bilateral pulmonary infiltrate. The working diagnosis of lymphangitic carcinomatosis, for which chemotherapy would be indicated, was called into question based on the high-resolution computed tomography findings and on the fact that the patient had a history of chronic ingestion of laxatives containing mineral oil. A lung biopsy confirmed a diagnosis of lipoid pneumonia, which should always be considered in patients with diffuse lung disease having been exposed to potential causative agents.

  10. Biomechanical abnormalities and ulcers of the great toe in patients with diabetes.

    Boffeli, Troy J; Bean, Jeffrey K; Natwick, James R

    2002-01-01

    A prospective analysis was conducted to identify structural and biomechanical first ray abnormalities in consecutive diabetic patients presenting with their first great toe ulcer. Twenty-six patients (33 feet) met the inclusion criteria, with seven patients having bilateral hallux ulcers. There was no other history of ulcer, trauma, or surgery on the respective limb. Data were obtained during the patients' initial presentation with a great toe ulcer and included verbal history, standardized weight bearing radiographs, and standardized objective clinical measurements. Four patients (four feet) with subungual ulcers were included because of mechanical etiology. Twenty-four of the remaining 29 involved limbs exhibited gastrocnemius/soleus equinus and two other limbs had gastrocnemius equinus. Twenty-eight of 29 had structural hallux limitus. Twenty-four had hallux interphalangeal abductus. Twenty of the 33 ulcers were located plantar-medially at the interphalangeal joint area. Other frequent findings were first ray elevatus or dorsiflexion deformity (18 of 29), functional hallux limitus (14 of 29), interphalangeal joint sesamoid bone (13 of 29), hyperextended interphalangeal joint (13 of 29), and a prominent plantar-medial condyle of the proximalaspect of the distalphalanx (7 of 29). Halluxmalleus was less common (4 of 29), but consistently associated with plantar-distal tip ulceration. Metatarsus primus adductus was also infrequent (6 of 29). This study identifies and illustrates the importance of several biomechanical and structural factors present on initial presentation of great toe ulcers. Addressing these factors may improve the success of treatment and lessen the occurrence of this common and complex problem. PMID:12500786

  11. Exploration of microstructural abnormalities in borderline personality disorder

    Fritzsche, Klaus H.; Brunner, Romuald; Henze, Romy; Meinzer, Hans-Peter; Stieltjes, Bram

    2012-03-01

    As with other mental disorders, the causes of borderline personality disorder (BPD) are complex and not fully understood. In this study we aimed to determine whether adults with BPD exhibit microstructural abnormalities using diffusion tensor imaging (DTI). 56 female right-handed individuals (age range, 14-18 years), 19 with a DSM-IV diagnosis of BPD, 18 patients with a DSM-IV defined current psychiatric disorder and 19 healthy control subjects were included. Groups were matched for age and IQ. DTI Images were analyzed using Tract-Based Spatial Statistics (TBSS). The analysis revealed significanty reduced fractional anisotropy (FA) values in the group of BPD patients compared to the normal controls. Similar FA reductions could not be found comparing BPD patients to clinical controls. Several clusters of increased radial (DR), axial (DA), and mean (MD) diffusivity were consistently identified when comparing the BPD patients to clinical as well as to healthy controls. None of the measures showed significant differences between the clinical and healthy controls. Diverse possible factors have been suggested to play a role in the disease, including environmental factors, neurobiological factors, or brain abnormalities. The presented results may play an important role in this ongoing debate.

  12. Low-set ears and pinna abnormalities

    ... because they do not affect hearing. However, sometimes cosmetic surgery is recommended. Skin tags may be tied off, ... 5 years old. More severe abnormalities may require surgery for cosmetic reasons as well as for function. Surgery to ...

  13. Abnormal Events for Emergency Trip in HANARO

    This report gathers abnormal events related to emergency trip of HANARO that happened during its operation over 10 years since the first criticality on February 1995. The collected examples will be utilized to the HANARO's operators as a useful guide

  14. The glycometabolism abnormality among schizophrenia patients

    吴小立

    2013-01-01

    Objective To explore the potential glycometabolism abnormality and the related factors of schizophrenia patients in China. Methods This cross-sectional study included 44 healthy controls(group 1) and 178 inpatient

  15. Amphibian abnormalities on National Wildlife Refuges

    US Fish and Wildlife Service, Department of the Interior — This fact sheet outlines a study done to 1 find the percentage of abnormal frogs and toads on the nations National Wildlife Refuges and 2 determine how the...

  16. Report to Congress on abnormal occurrences

    Section 208 of the Energy Reorganization Act of 1974 identifies an abnormal occurrence as an unscheduled incident or event that the Nuclear Regulatory Commission determines to be significant from the standpoint of public health or safety and requires a quarterly report of such events to be made to Congress. This report covers the period from April 1 through June 30, 1990. The report discusses six abnormal occurrences, none involving a nuclear power plant. There were five abnormal occurrences at NRC licensees: (1) deficiencies in brachytherapy program; (2) a radiation overexposure of a radiographer; (3) a medical diagnostic misadministration; (4) administration of iodine-131 to a lactating female with subsequent uptake by her infant; and (5) a medical therapy misadministration. An Agreement State (Arizona) reported an abnormal occurrence involving a medical diagnostic misadministration. The report also contains information that updates a previously reported occurrence

  17. Pinna abnormalities and low-set ears

    ... because they do not affect hearing. However, sometimes cosmetic surgery is recommended. Skin tags may be tied off, ... 5 years old. More severe abnormalities may require surgery for cosmetic reasons as well as for function. Surgery to ...

  18. Genetic abnormalities in pancreatic cancer

    Zamboni Giuseppe

    2003-01-01

    Full Text Available Abstract The incidence and mortality of pancreatic adenocarcinoma are nearly coincident having a five-year survival of less than 5%. Enormous advances have been made in our knowledge of the molecular alterations commonly present in ductal cancer and other pancreatic malignancies. One significant outcome of these studies is the recognition that common ductal cancers have a distinct molecular fingerprint compared to other nonductal or endocrine tumors. Ductal carcinomas typically show alteration of K-ras, p53, p16INK4, DPC4 and FHIT, while other pancreatic tumor types show different aberrations. Among those tumors arising from the exocrine pancreas, only ampullary cancers have a molecular fingerprint that may involve some of the same genes most frequently altered in common ductal cancers. Significant molecular heterogeneity also exists among pancreatic endocrine tumors. Nonfunctioning pancreatic endocrine tumors have frequent mutations in MEN-1 and may be further subdivided into two clinically relevant subgroups based on the amount of chromosomal alterations. The present review will provide a brief overview of the genetic alterations that have been identified in the various subgroups of pancreatic tumors. These results have important implications for the development of genetic screening tests, early diagnosis, and prognostic genetic markers.

  19. How abnormal is the behaviour of captive, zoo-living chimpanzees?

    Lucy P Birkett

    Full Text Available BACKGROUND: Many captive chimpanzees (Pan troglodytes show a variety of serious behavioural abnormalities, some of which have been considered as possible signs of compromised mental health. The provision of environmental enrichments aimed at reducing the performance of abnormal behaviours is increasing the norm, with the housing of individuals in (semi-natural social groups thought to be the most successful of these. Only a few quantitative studies of abnormal behaviour have been conducted, however, particularly for the captive population held in zoological collections. Consequently, a clear picture of the level of abnormal behaviour in zoo-living chimpanzees is lacking. METHODS: We present preliminary findings from a detailed observational study of the behaviour of 40 socially-housed zoo-living chimpanzees from six collections in the United States of America and the United Kingdom. We determined the prevalence, diversity, frequency, and duration of abnormal behaviour from 1200 hours of continuous behavioural data collected by focal animal sampling. RESULTS, CONCLUSION AND SIGNIFICANCE: Our overall finding was that abnormal behaviour was present in all sampled individuals across six independent groups of zoo-living chimpanzees, despite the differences between these groups in size, composition, housing, etc. We found substantial variation between individuals in the frequency and duration of abnormal behaviour, but all individuals engaged in at least some abnormal behaviour and variation across individuals could not be explained by sex, age, rearing history or background (defined as prior housing conditions. Our data support a conclusion that, while most behaviour of zoo-living chimpanzees is 'normal' in that it is typical of their wild counterparts, abnormal behaviour is endemic in this population despite enrichment efforts. We suggest there is an urgent need to understand how the chimpanzee mind copes with captivity, an issue with both

  20. Clinical arthrography

    Arndt, R.; Horns, J.W.; Gold, R.H.; Blaschke, D.D.

    1985-01-01

    This book deals with the method and interpretation of arthrography of the shoulder, knee, ankle, elbow, hip, wrist, and metacarpophalangeal, interphalangeal, and temporomandibular joints. The emphasis is on orthopaedic disorders, usually of traumatic origin, which is in keeping with the application of arthrography in clinical practice. Other conditions, such as inflammatory and degenerative diseases, congenital disorders and, in the case of the hip, arthrography of reconstructive joint surgery, are included. Each chapter is devoted to one joint and provides a comprehensive discussion on the method of arthrography, including single and double contrast techniques where applicable, normal radiographic anatomy, and finally, the interpretation of the normal and the abnormal arthrogram.

  1. Echocardiographic abnormalities in type IV mucopolysaccharidosis.

    John, R. M.; Hunter, D; Swanton, R. H.

    1990-01-01

    Cardiac involvement is well recognised in most forms of the mucopolysaccharidoses but there is poor documentation of abnormalities specific to Morquio's syndrome (type IV mucopolysaccharidosis). Ten patients with the classic form or type A Morquio's syndrome with a median age of 12.5 years underwent echocardiographic assessment. Abnormalities were detected in six (60%) cases with mitral valve involvement in five patients and aortic valve disease in four. One patient had severe mitral leaflet ...

  2. Abnormalities of gut vessels in Turner's syndrome.

    Reinhart, W H; Mordasini, C.; Stäubli, M.; Scheurer, U.

    1983-01-01

    We describe a 57-year-old patient with Turner's syndrome, iron deficiency anaemia and intestinal vascular abnormalities. Colonoscopy revealed 2 widely dilated, tortuous veins in the terminal ileum and several smaller ectatic veins and haemangioma-like malformations throughout the colon. Laparotomy for herniotomy showed only minimal vascular abnormalities of the serosal surface. Patients with Turner's syndrome and anaemia should be checked for these lesions by endoscopy, and conversely, in pat...

  3. Carbamazepine for acute psychosis with eeg abnormalities

    Ivković Maja; Damjanović Aleksandar; Marinković Dragan; Paunović Vladimir R.

    2004-01-01

    Aim. To investigate the efficacy of carbamazepine as adjuvant drug therapy in acute paranoid psychosis with associated EEG abnormalities, compared to sole antipsychotic treatment. Methods. Eleven medication-naive patients diagnosed with acute paranoid psychosis with associated EEG abnormalities were divided into two treatment groups: sole fluphenazine group, with flexible dosing of 5-10 mg/day (n=6), and carbamazepine group (n=5) with the addition of carbamazepine (600 mg/day) to fluphenazine...

  4. Remote disassembly of an abnormal multiplication system

    The method of abnormal multiplying systems remote disassembling is described. This method was worked through in actual operations as response to the nuclear accident at the RFNC-VNIIEF criticality test facility FKBN-2M on 17 June 1997. The abnormal assembly was a sphere of 235U (90%), surrounded by a copper reflector. The detailed information on the multiplying system disassembly operations could be of use to the experts at other institutions when they develop emergency response plans. (author)

  5. Holoprosencephaly due to Numeric Chromosome Abnormalities

    Solomon, Benjamin D.; Rosenbaum, Kenneth N.; Meck, Jeanne M.; Muenke, Maximilian

    2010-01-01

    Holoprosencephaly (HPE) is the most common malformation of the human forebrain. When a clinician identifies a patient with HPE, a routine chromosome analysis is often the first genetic test sent for laboratory analysis in order to assess for a structural or numerical chromosome anomaly. An abnormality of chromosome number is overall the most frequently identified etiology in a patient with HPE. These abnormalities include trisomy 13, trisomy 18, and triploidy, though several others have been ...

  6. Abnormal Head Position in Infantile Nystagmus Syndrome

    Susana Noval; Mar González-Manrique; José María Rodríguez-Del Valle; José María Rodríguez-Sánchez

    2011-01-01

    Infantile nystagmus is an involuntary, bilateral, conjugate, and rhythmic oscillation of the eyes which is present at birth or develops within the first 6 months of life. It may be pendular or jerk-like and, its intensity usually increases in lateral gaze, decreasing with convergence. Up to 64% of all patients with nystagmus also present strabismus, and even more patients have an abnormal head position. The abnormal head positions are more often horizontal, but they may also be vertical or ta...

  7. Breathing abnormalities in sleep in achondroplasia.

    Waters, K A; Everett, F; Sillence, D; Fagan, E.; Sullivan, C E

    1993-01-01

    Overnight sleep studies were performed in 20 subjects with achondroplasia to document further the respiratory abnormalities present in this group. Somatosensory evoked potentials (SEPs) were recorded in 19 of the subjects to screen for the presence of brainstem abnormalities, which are one of the potential aetiological mechanisms. Fifteen children aged 1 to 14 years, and five young adults, aged 20 to 31 years were included. All had upper airway obstruction and 15 (75%) had a pathological apno...

  8. Abnormal uterine bleeding: a clinicohistopathological analysis

    Anupamasuresh Y; Suresh YV; Prachi Jain*,

    2014-01-01

    Background: Abnormal uterine bleeding (AUB) is one of the most common problem for the patients and the gynecologists. It adversely effects on the quality of life and psychology of women. It is of special concern in developing country as it adds to the causes of anemia. Management of Abnormal Uterine Bleeding (AUB) is not complete without tissue diagnosis especially in perimenopausal and post-menopausal women. Histological characteristics of endometrial biopsy material as assessed by light mic...

  9. Evidence of portuguese stock market abnormal returns

    Duarte, Elisabete Mendes; Oliveira, Lisete Trindade

    2011-01-01

    According to the stock market efficiency theory, it is not possible to consistently beat the market. However, technical analysis is more and more spread as an efficient way to achieve abnormal returns. In fact there is evidence that momentum investing strategies provide abnormal returns in different stock markets, Jegadeesh, N. and Titman, S. (1993), George, T. and Hwang, C. (2004) and Du, D. (2009). In this work we study if like other markets, the Portuguese stock market also allows to obtai...

  10. Medical Costs of Abnormal Serum Sodium Levels

    Shea, Alisa M.; Hammill, Bradley G.; Curtis, Lesley H.; Szczech, Lynda A.; Schulman, Kevin A

    2008-01-01

    An abnormal serum sodium level is the most common electrolyte disorder in the United States and can have a significant impact on morbidity and mortality. The direct medical costs of abnormal serum sodium levels are not well understood. The impact of hyponatremia and hypernatremia on 6-mo and 1-yr direct medical costs was examined by analyzing data from the Integrated HealthCare Information Services National Managed Care Benchmark Database. During the period analyzed, there were 1274 patients ...

  11. CT and MR imaging of odontoid abnormalities: A pictorial review.

    Jain, Nishchint; Verma, Ritu; Garga, Umesh C; Baruah, Barinder P; Jain, Sachin K; Bhaskar, Surya N

    2016-01-01

    Odontoid process is the central pillar of the craniovertebral junction. Imaging of this small structure continues to be a challenge for the radiologists due to complex bony and ligamentous anatomy. A wide range of developmental and acquired abnormalities of odontoid have been identified. Their accurate radiologic evaluation is important as different lesions have markedly different clinical course, patient management, and prognosis. This article seeks to provide knowledge for interpreting appearances of odontoid on computed tomography (CT) and magnetic resonance imaging (MRI) with respect to various disease processes, along with providing a quick review of the embryology and relevant anatomy. PMID:27081234

  12. CT and MR imaging of odontoid abnormalities: A pictorial review

    Nishchint Jain

    2016-01-01

    Full Text Available Odontoid process is the central pillar of the craniovertebral junction. Imaging of this small structure continues to be a challenge for the radiologists due to complex bony and ligamentous anatomy. A wide range of developmental and acquired abnormalities of odontoid have been identified. Their accurate radiologic evaluation is important as different lesions have markedly different clinical course, patient management, and prognosis. This article seeks to provide knowledge for interpreting appearances of odontoid on computed tomography (CT and magnetic resonance imaging (MRI with respect to various disease processes, along with providing a quick review of the embryology and relevant anatomy.

  13. Diagnostic accuracy of post mortem MRI for abdominal abnormalities in foetuses and children

    Arthurs, Owen J., E-mail: owen.arthurs@gosh.nhs.uk [Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom); Institute of Child Health, UCL, London (United Kingdom); Thayyil, Sudhin, E-mail: s.thayyil@imperial.ac.uk [Perinatal Neurology and Neonatology, Imperial College London, London (United Kingdom); Owens, Catherine M., E-mail: Catherine.owens@gosh.nhs.uk [Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom); Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London (United Kingdom); Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom); Olsen, Oystein E., E-mail: oystein.olsen@gosh.nhs.uk [Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom); Institute of Child Health, UCL, London (United Kingdom); Wade, Angie, E-mail: a.wade@ucl.ac.uk [Clinical Epidemiology, Nutrition and Biostatistics Section, UCL Institute of Child health, London (United Kingdom); Addison, Shea, E-mail: shea.addison@imperial.ac.uk [Perinatal Neurology and Neonatology, Imperial College London, London (United Kingdom); Jones, Rod, E-mail: rod.jones@gosh.nhs.uk [Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London (United Kingdom); Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom); Norman, Wendy, E-mail: wendy.norman@gosh.nhs.uk [Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London (United Kingdom); Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom); Scott, Rosemary J., E-mail: rosemary.scott@uclh.nhs.uk [Department of Histopathology, University College London Hospital NHS Trust, London (United Kingdom); and others

    2015-03-15

    Highlights: •Postmortem MR imaging (PMMR) has high overall accuracy for abdominal pathology in foetuses, newborns and children. •PMMR is particularly good at detecting renal abnormalities, and relatively poor at detecting intestinal abnormalities. •In clinical practice, PMMR may be a useful alternative or adjunct to conventional autopsy in foetuses and children for detecting abdominal abnormalities. -- Abstract: Background: To compare the diagnostic accuracy of post-mortem magnetic resonance imaging (PMMR) specifically for abdominal pathology in foetuses and children, compared to conventional autopsy. Methods: Institutional ethics approval and parental consent was obtained. 400 unselected foetuses and children underwent PMMR using a 1.5 T Siemens Avanto MR scanner before conventional autopsy. PMMR images and autopsy findings were reported blinded to the other data respectively. Results: Abdominal abnormalities were found in 70/400 (12%) autopsies. Overall sensitivity and specificity (95% confidence interval) of PMMR for abdominal pathology was 72.5% (61.0, 81.6) and 90.8% (87.0, 93.6), with positive (PPV) and negative predictive values (NPV) of 64.1% (53.0, 73.9) and 93.6% (90.2, 95.8) respectively. PMMR was good at detecting renal abnormalities (sensitivity 80%), particularly in foetuses, and relatively poor at detecting intestinal abnormalities (sensitivity 50%). Overall accuracy was 87.4% (83.6, 90.4). Conclusions: PMMR has high overall accuracy for abdominal pathology in foetuses, newborns and children. PMMR is particularly good at detecting renal abnormalities, and relatively poor at detecting intestinal abnormalities. In clinical practice, PMMR may be a useful alternative or adjunct to conventional autopsy in foetuses and children for detecting abdominal abnormalities.

  14. Diagnostic accuracy of post mortem MRI for abdominal abnormalities in foetuses and children

    Highlights: •Postmortem MR imaging (PMMR) has high overall accuracy for abdominal pathology in foetuses, newborns and children. •PMMR is particularly good at detecting renal abnormalities, and relatively poor at detecting intestinal abnormalities. •In clinical practice, PMMR may be a useful alternative or adjunct to conventional autopsy in foetuses and children for detecting abdominal abnormalities. -- Abstract: Background: To compare the diagnostic accuracy of post-mortem magnetic resonance imaging (PMMR) specifically for abdominal pathology in foetuses and children, compared to conventional autopsy. Methods: Institutional ethics approval and parental consent was obtained. 400 unselected foetuses and children underwent PMMR using a 1.5 T Siemens Avanto MR scanner before conventional autopsy. PMMR images and autopsy findings were reported blinded to the other data respectively. Results: Abdominal abnormalities were found in 70/400 (12%) autopsies. Overall sensitivity and specificity (95% confidence interval) of PMMR for abdominal pathology was 72.5% (61.0, 81.6) and 90.8% (87.0, 93.6), with positive (PPV) and negative predictive values (NPV) of 64.1% (53.0, 73.9) and 93.6% (90.2, 95.8) respectively. PMMR was good at detecting renal abnormalities (sensitivity 80%), particularly in foetuses, and relatively poor at detecting intestinal abnormalities (sensitivity 50%). Overall accuracy was 87.4% (83.6, 90.4). Conclusions: PMMR has high overall accuracy for abdominal pathology in foetuses, newborns and children. PMMR is particularly good at detecting renal abnormalities, and relatively poor at detecting intestinal abnormalities. In clinical practice, PMMR may be a useful alternative or adjunct to conventional autopsy in foetuses and children for detecting abdominal abnormalities

  15. Neuronal migration abnormalities and its possible implications for schizophrenia

    Kenji eTanigaki

    2015-03-01

    Full Text Available Schizophrenia is a complex mental disorder that displays behavioral deficits such as decreased sensory gating, reduced social interaction and working memory deficits. The neurodevelopmental model is one of the widely accepted hypotheses of the etiology of schizophrenia. Subtle developmental abnormalities of the brain which stated long before the onset of clinical symptoms are thought to lead to the emergence of illness. Schizophrenia has strong genetic components but its underlying molecular pathogenesis is still poorly understood. Genetic linkage and association studies have identified several genes involved in neuronal migrations as candidate susceptibility genes for schizophrenia, although their effect size is small. Recent progress in copy number variation studies also has identified much higher risk loci such as 22q11. Based on these genetic findings, we are now able to utilize genetically-defined animal models. Here we summarize the results of neurodevelopmental and behavioral analysis of genetically-defined animal models. Furthermore, animal model experiments have demonstrated that embryonic and perinatal neurodevelopmental insults in neurogenesis and neuronal migrations cause neuronal functional and behavioral deficits in affected adult animals, which are similar to those of schizophrenic patients. However, these findings do not establish causative relationship. Genetically-defined animal models are a critical approach to explore the relationship between neuronal migration abnormalities and behavioral abnormalities relevant to Schizophrenia.

  16. Screening of inherited metabolic abnormalities in 56 children with intractable epilepsy

    LIU, XIAOMING; LI, RUI; CHEN, SHENGZHI; SANG, YAN; ZHAO, JIAQIANG

    2016-01-01

    Epilepsy is a common children's neural disease that is largely controlled by anti-epileptic drugs. Nevertheless, children experience repeated attacks that develop into intractable epilepsy (IE). The aim of the present study was to examine the inherited metabolic abnormalities in children with IE to provide early etiological and symptomatic treatment. Urine and blood samples of 56 children with IE served as the experimental group and 56 cases of children with IE, who were successfully treated served as the control group, and analyzed by gas chromatography-mass spectrometry and tandem mass spectrometry for the metabolic screening of amino, organic, and fatty acids. Urine routine, hepatic function, blood biochemistry, imageology of encephalon and brain stem-evoked potential (auditory and optical) were also examined. Of the 27 IE children confirmed as abnormal in urine and blood screening, there were 19 cases (70.3%) of hypoevolutism or retrogression of intelligence and motor function, 15 cases (55.5%) of brain stem-evoked potential and of encephalic computed tomography (CT) or magnetic resonance imaging (MRI) abnormality, 6 cases (22.2%) of abnormal family history and of abnormal blood biochemistry and blood gas analysis, and 5 cases (18.5%) with skin change and of abnormal hepatic function. Of the 27 cases, 11 cases (19.6%) were diagnosed with inherited metabolic diseases. Among the children in the control group, 3 cases showed abnormal urine test results, one of which had family history, one had hypoevolutism or retrogression of intelligence and motor function, one had brain stem-evoked potential and encephalic CT or MRI abnormality, while two of the 3 cases had inherited metabolic abnormalities. The correlation analysis revealed that abnormal urine test was significantly correlated with inherited metabolic abnormalities (P<0.05). Of the 56 IE patients, 25 cases (44.6%) were identified as abnormal under urine screening, and of the 25 cases, 6 cases had simple

  17. Electroencephalogram abnormalities in panic disorder patients: a study of symptom characteristics and pathology

    Hayashi Karin

    2010-08-01

    Full Text Available Abstract Background Since the 1980s, a high EEG abnormality rate has been reported for patients with panic disorder. However, how the EEG abnormalities of panic disorder patients are related to the clinical features and pathology of these patients has yet to be clarified. In this study we investigated whether or not EEG abnormalities are related to the 13 symptoms in the DSM-IV criteria for a diagnosis of panic attacks. Methods Subjects were 70 patients diagnosed with panic disorder. Logistic regression analysis was performed with EEG findings as dependent variables and age, sex and with or without the 13 symptoms as independent variables. Results (1EEG findings for panic disorder patients with EEG abnormalities: Of the 17 patients, 13 had repeated slow waves in the θ-band; the most prevalent EEG abnormality found in this study. Paroxysmal abnormality interpreted as epileptiform was found in only two cases. (2Nausea or abdominal distress (37.7% vs 82.45%, OR-12.5, derealization or depersonalization (7.5% vs 47.1%, OR = 13.9, and paresthesias (43.4% vs 64.7%, OR = 7.9, were extracted by multivariate analysis as factors related to EEG abnormalities. Conclusion Of the 70 patients studied, 17 had EEG abnormalities. Among these 17 cases, "repeated slow waves in the θ-band" was the most common abnormality. The factors identified as being related to EEG abnormalities are nausea or abdominal distress, derealization or depersonalization, and paresthesias. The study indicated that physiological predispositions are closely related to panic attacks.

  18. Abnormal Vasomotor System Function in Idiopathic Generalized Epileptic Patients

    Mehdi Maghbooli

    2014-12-01

    Full Text Available OBJECTIVE: Autonomic dysfunction is widely recognized in both partial and generalized epilepsies. The aim of this study was to evaluate the vasomotor response in patients with generalized idiopathic epilepsy by the clinical autonomic function tests. METHODS: 124 consecutive subjects including 62 idiopathic generalized epileptic patients diagnosed for more than 3 months receiving monotherapy and 62 matched for sex and age healthy controls were assessed in this case-control study. The evaluation of the vasomotor system was made using a questionnaire and autonomic function tests including Cold pressor, Valsalva maneuver, mental arithmetic and hand-grip tests. RESULTS: Abnormal score of the Cold pressor test was seen in 59.7%, Valsalva maneuver in 64.5% and 33.9% in mental arithmetic test of epileptic patients. These results were different significantly in comparison to control group. If abnormal hand grip test was defined as an increase less than 11 mmHg in diastolic pressure, there was found no significant difference between two groups of case and control, also a few people in control group was reported normal. While defining abnormal test was interpreted by increase in only one parameter or none of systolic blood pressure, diastolic blood pressure or heart rate, 43.5% in case group versus 14.5% in controls had abnormal results with significantly difference. CONCLUSION: Vasomotor dysfunction evaluated by cardiovascular tests was present commonly in the patients with generalized epilepsy. Further confirmation requires detailed reviewing of central and peripheral limbs to the breakdown of the system to be felt.

  19. Depressive symptoms among women with an abnormal mammogram.

    Alderete, Ethel; Juarbe, Teresa C; Kaplan, Celia Patricia; Pasick, Rena; Pérez-Stable, Eliseo J

    2006-01-01

    An abnormal mammography finding constitutes a stressful event that may increase vulnerability by developing or intensifying pre-existing psychological morbidity. We evaluated depressive symptoms using the Composite International Diagnostic Interview among women of four ethnic groups who had an abnormal mammography result controlling for the effect of demographic, psychosocial and medical factors on recent onset of depressive symptoms. Telephone surveys were conducted among women aged 40-80 years recruited from four clinical sites in the San Francisco Bay Area after receiving a screening mammography result that was classified as abnormal but probably benign, suspicious or highly suspicious, or indeterminate using standard criteria. Among the 910 women who completed the interview, mean age was 56 (S.D.=10), 42% were White, 19% Latina, 25% African American, and 14% Asian. Prevalence of lifetime depressive symptoms was 44%, and 11% of women had symptoms in the previous month. Multivariate logistic regression models showed that Asian ethnicity, annual income >$10 000 and weekly attendance at religious services were significantly associated with decreased depressive symptoms. Having an indeterminate result on mammography and being on disability were significantly associated with more depressive symptoms. Reporting a first episode of depression more than a year before the interview was associated with significant increase in depressive symptoms in the month prior to the interview regardless of mammography result. Women with an indeterminate interpretation on mammography were at greater risk of depressive episode in the month prior to the interview compared to women with probably benign results (odds ratio=2.41; 95% CI=1.09-5.31) or with a suspicious finding. Clinicians need to consider depression as a possible consequence after an abnormal mammography result. PMID:15816053

  20. Distribution and natural history of stress fractures in U.S. Marine recruits

    In a prospective study of stress injuries of the lower extremities of U.S. Marine recruits, researchers derived a frequency distribution of stress fractures. The most frequently fractured bone was the tibia (73%), while the single most common site was the posterior calcaneal tuberosity (21%). The natural history of stress fractures by scintigraphy and radiography has been outlined, showing the evolutionary changes on either study as a universal progression independent of injury site or type of stress. An identical spectrum of changes should be present within any group undergoing intense new exercise. The frequency distribution of stress fractures should be a function of differing forms and intensities of exercise, therefore, our figures should not be applied to other groups. Researchers used the presence of a scintigraphic abnormality at a symptomatic site as the criterion for diagnosis of stress fracture. Since the distribution of skeletal radiotracer uptake is directly dependent on local metabolic activity, it is expected that a focal alteration in bone metabolism will result in a scintigram approaching 100% sensitivity for the abnormality (9). In the proper clinical setting, the specificity should approximate this figure; however, a focal, nonstress-related bone abnormality which has not manifested any radiographic change, such as early osteomyelitis, could result in a false-positive examination. Specificity cannot, therefore, be accurately determined without an actual determination of the pathologic changes within the bone, necessarily involving biopsy

  1. Characterizing abnormal behavior in a large population of zoo-housed chimpanzees: prevalence and potential influencing factors

    Jacobson, Sarah L.; Bloomsmith, Mollie A.

    2016-01-01

    Abnormal behaviors in captive animals are generally defined as behaviors that are atypical for the species and are often considered to be indicators of poor welfare. Although some abnormal behaviors have been empirically linked to conditions related to elevated stress and compromised welfare in primates, others have little or no evidence on which to base such a relationship. The objective of this study was to investigate a recent claim that abnormal behavior is endemic in the captive population by surveying a broad sample of chimpanzees (Pan troglodytes), while also considering factors associated with the origins of these behaviors. We surveyed animal care staff from 26 accredited zoos to assess the prevalence of abnormal behavior in a large sample of chimpanzees in the United States for which we had information on origin and rearing history. Our results demonstrated that 64% of this sample was reported to engage in some form of abnormal behavior in the past two years and 48% of chimpanzees engaged in abnormal behavior other than coprophagy. Logistic regression models were used to analyze the historical variables that best predicted the occurrence of all abnormal behavior, any abnormal behavior that was not coprophagy, and coprophagy. Rearing had opposing effects on the occurrence of coprophagy and the other abnormal behaviors such that mother-reared individuals were more likely to perform coprophagy, whereas non-mother-reared individuals were more likely to perform other abnormal behaviors. These results support the assertion that coprophagy may be classified separately when assessing abnormal behavior and the welfare of captive chimpanzees. This robust evaluation of the prevalence of abnormal behavior in our sample from the U.S. zoo population also demonstrates the importance of considering the contribution of historical variables to present behavior, in order to better understand the causes of these behaviors and any potential relationship to psychological

  2. Characterizing abnormal behavior in a large population of zoo-housed chimpanzees: prevalence and potential influencing factors.

    Jacobson, Sarah L; Ross, Stephen R; Bloomsmith, Mollie A

    2016-01-01

    Abnormal behaviors in captive animals are generally defined as behaviors that are atypical for the species and are often considered to be indicators of poor welfare. Although some abnormal behaviors have been empirically linked to conditions related to elevated stress and compromised welfare in primates, others have little or no evidence on which to base such a relationship. The objective of this study was to investigate a recent claim that abnormal behavior is endemic in the captive population by surveying a broad sample of chimpanzees (Pan troglodytes), while also considering factors associated with the origins of these behaviors. We surveyed animal care staff from 26 accredited zoos to assess the prevalence of abnormal behavior in a large sample of chimpanzees in the United States for which we had information on origin and rearing history. Our results demonstrated that 64% of this sample was reported to engage in some form of abnormal behavior in the past two years and 48% of chimpanzees engaged in abnormal behavior other than coprophagy. Logistic regression models were used to analyze the historical variables that best predicted the occurrence of all abnormal behavior, any abnormal behavior that was not coprophagy, and coprophagy. Rearing had opposing effects on the occurrence of coprophagy and the other abnormal behaviors such that mother-reared individuals were more likely to perform coprophagy, whereas non-mother-reared individuals were more likely to perform other abnormal behaviors. These results support the assertion that coprophagy may be classified separately when assessing abnormal behavior and the welfare of captive chimpanzees. This robust evaluation of the prevalence of abnormal behavior in our sample from the U.S. zoo population also demonstrates the importance of considering the contribution of historical variables to present behavior, in order to better understand the causes of these behaviors and any potential relationship to psychological

  3. Abnormal fetal movements, micrognathia and pulmonary hypoplasia: a case report. Abnormal fetal movements

    Morokuma Seiichi

    2010-08-01

    Full Text Available Abstract Background Micrognathia is a facial malformation characterized by mandibular hypoplasia and a small, receding chin that fails to maintain the tongue in a forward position. We previously reported a system of prenatal screening that we developed to identify fetuses with compromised central nervous system function by observing fetal behavior. In this paper we report the case of a preterm infant with micrognathia and pulmonary hypoplasia who presented abnormal fetal movements. Case presentation A 27-year-old Japanese primigravida at 33 weeks of gestation was referred to our hospital. Ultrasonographic examination revealed clinical polyhydramnios. Micrognathia was evident on midsagittal and 3 D scan. The lung area was less than the mean -2.0 standard deviations for the gestational age. The infant had mandibular hypoplasia and glossoptosis. After emergency cesarean delivery for non-reasuring fetal status, required immediate tracheostomy and cardiopulmonary resuscitation with mechanical ventilatory support. However, the infant's cardiopulmonary condition did not improve and she died 21 hours after birth. Conclusions The findings of our ultrasound exam are suggestive of brain dysfunction. The observation of fetal behavior appears to be effective for the prediction of prognosis of cases with micrognathia.

  4. Are interstitial lung abnormalities associated with COPD? A nested case–control study

    Bozzetti, Francesca; Paladini, Ilaria; Rabaiotti, Enrico; Franceschini, Alessandro; Alfieri, Veronica; Chetta, Alfredo; Crisafulli, Ernesto; Silva, Mario; Pastorino, Ugo; Sverzellati, Nicola

    2016-01-01

    Purpose In this study, we tested the association between COPD and interstitial lung abnormality (ILA), notably in relation to the presence of computed tomography (CT) signs of lung fibrosis. Patients and methods COPD cases were selected from participants undergoing lung cancer screening (Multicentric Italian Lung Detection trial) for airflow obstruction (n=311/2,303, 13.5%) and 146 consecutive patients with clinical COPD. In all, 457 COPD cases were selected and classified according to the stages of Global Initiative for Chronic Obstructive Lung Disease. A nested matching (case:control = 1:2) according to age, sex, and smoking history was operated between each COPD case and two control subjects from Multicentric Italian Lung Detection trial without airflow obstruction. Low-dose CT scans of COPD cases and controls were reviewed for the presence of ILA, which were classified into definite or indeterminate according to the presence of signs of lung fibrosis. Results The frequency of definite ILA was similar between COPD cases and controls (P=0.2), independent of the presence of signs of lung fibrosis (P=0.07). Combined definite and indeterminate ILA was homogeneously distributed across Global Initiative for Chronic Obstructive Lung Disease stages (P=0.6). Definite ILA was directly associated with current smoker status (odds ratio [OR] 4.05, 95% confidence interval [CI]: 2.2–7.4) and increasing pack-years (OR 1.01, 95% CI: 1–1.02). Subjects with any fibrotic ILA were more likely to be older (OR 1.17, 95% CI: 1.10–1.25) and male (OR 8.58, 95% CI: 1.58–68.9). Conclusion There was no association between COPD and definite ILA. However, low-dose CT signs of lung fibrosis were also observed in COPD, and their clinical relevance is yet to be determined. PMID:27307724

  5. Coexistence of multiple rare spinal abnormalities in type 1 neurofibromatosis: a case report and literature review.

    Zhao, Chun-Ming; Zhang, Wen-Jie; Huang, Ai-Bing; Chen, Qian; He, Yuan-Long; Zhang, Wei; Yang, Hui-Lin

    2015-01-01

    Orthopaedic involvement is the most common clinical presentation of Neurofibromatosis type 1 (NF-1) patients with the spinal abnormalities more frequently affected. In the spinal deformities of NF-1 patients, despite the scoliosis is the most frequent finding, several distinctive radiographic features, such as dural ectasia, defective pedicles, and spondylolisthesis, are relatively less common. Here, we reported a 16-year-old boy diagnosed with NF-1 who presented with dural ectasia, defective pedicles, and spondylolisthesis concomitantly, described the surgical treatment and provided a literature review. The boy complained of low back and leg pain for two months. On clinical examination, the patient showed multiple café au lait spots on his back and no neurological deficit. He had a family history of neurofibromatosis as his father suffering from NF-1. Imaging results demonstrated mild scoliosis, posterior scalloping of the lumber spine, L5 spondylolisthesis on plain radiographs, and marked dural ectasia of L3-L5 on MRI. Furthermore, the CT scan showed presence of thin pedicles at L3, bilateral symmetrical pedicle clefts at L4, and pars interarticularis fractures at L5. The patient received a long level posterior fusion from L1 to S1 with pedicle screws. Iliac crest autogenous graft mixed with artificial bone were used to achieve solid arthrodesis. At nine-month follow-up, the patient was asymptomatic and able to live a normal life. Our observation demonstrated that familiarity with those distinctive features in NF-1 patients could be contributed to making an early diagnosis and optimizing treatment. PMID:26770321

  6. Abnormal oculocardiac reflex in two patients with Marcus Gunn syndrome

    Maitree Pandey

    2011-01-01

    Full Text Available Marcus Gunn phenomenon is seen in 4 to 6% of congenital ptosis patients. We report two cases of abnormal oculocardiac reflex during ptosis correction surgery. Marcus Gunn syndrome is an autosomal dominant condition with incomplete penetrance. It is believed to be a neural misdirection syndrome in which fibres of the motor division of the trigeminal nerve are congenitally misdirected into the superior pterygoid and the levator muscles. Anesthetic considerations include taking a detailed history about any previous anaesthetic exposure and any reaction to it as this syndrome has a high probability of being associated with malignant hyperthermia. It is also postulated that an atypical oculocardiac reflex might be initiated in these patients as seen in our patients, so precautions must be taken for its prevention and early detection.

  7. Identification of embryonic chromosomal abnormality using FISH-based preimplantaion genetic diagnosis

    叶英辉; 徐晨明; 金帆; 钱羽力

    2004-01-01

    Objective: Embryonic chromosomal abnormality is one of the main reasons for in vitro fertilization (IVF)failure. This study aimed at evaluating the value of Fluorescence in-situ Hybridization (FISH)-based Preimplantation Genetic Diagnosis (PGD) in screening for embryonic chromosomal abnormality to increase the successful rate of IVF. Method:Ten couples, four with high risk of chromosomal abnormality and six infertile couples, underwent FISH-based PGD during IVF procedure. At day 3, one or two blastomeres were aspirated from each embryo. Biopsied blastomeres were examined using FISH analysis to screen out embryos with chromosomal abnormalities. At day 4, embryos without detectable chromosomal abnormality were transferred to the mother bodies as in regular IVF. Results: Among 54 embryos screened using FISH-based PGD, 30 embryos were detected to have chromosomal abnormalities. The 24 healthy embryos were implanted,resulting in four clinical pregnancies, two of which led to successful normal birth of two healthy babies; one to ongoing pregnancy during the writing of this article; and one to ectopic pregnancy. Conclusion: FISH-based PGD is an effective method for detecting embryonic chromosomal abnormality, which is one of the common causes of spontaneous miscarriages and chromosomally unbalanced offsprings.

  8. Identification of embryonic chromosomal abnormality using FISH-based preimplantaion genetic diagnosis

    叶英辉; 徐晨明; 金帆; 钱羽力

    2004-01-01

    Objective: Embryonic chromosomal abnormality is one of the main reasons for in vitro fertilization (IVF) failure. This study aimed at evaluating the value of Fluorescence in-situ Hybridization (FISH)-based Preimplantation Genetic Diagnosis (PGD) in screening for embryonic chromosomal abnormality to increase the successful rate of IVF. Method: Ten couples, four with high risk of chromosomal abnormality and six infertile couples, underwent FISH-based PGD during IVF procedure. At day 3, one or two blastomeres were aspirated from each embryo. Biopsied blastomeres were examined using FISH analysis to screen out embryos with chromosomal abnormalities. At day 4, embryos without detectable chromosomal abnormality were transferred to the mother bodies as in regular IVF. Results: Among 54 embryos screened using FISH-based PGD, 30 embryos were detected to have chromosomal abnormalities. The 24 healthy embryos were implanted, resulting in four clinical pregnancies, two of which led to successful normal birth of two healthy babies; one to ongoing pregnancy during the writing of this article; and one to ectopic pregnancy. Conclusion: FISH-based PGD is an effective method for detecting embryonic chromosomal abnormality, which is one of the common causes of spontaneous miscarriages and chromosomally unbalanced offsprings.

  9. Dopaminergic system abnormalities Etiopathogenesis of dystonia

    Shuhui Wu; Huifang Shang; Xiaoyi Zou

    2008-01-01

    BACKGROUND: Much research has focused on the close relationship between etiopathogenesis of dystonia and abnormalities of the dopaminergic system. Nevertheless, details of the mechanism are still not clear.OBJECTIVE: To review studies from the past few years about pathogenesis and molecular interactions involved in the relationship between dystonia and abnormalities of the dopaminergic system.RETRIEVAL STRATEGY: Using the key words "dystonia" and "dopamine", PubMed database and SCI databases were searched from January 1990 to December 2005 for relevant English publications. A total of 73 articles were searched and, initially, all articles were selected. Inclusive criteria: studies based on pathogenesis and molecular interactions involved in the relationship between dystonia and abnormalities of the dopaminergic system. Exclusive criteria: duplicated studies. A total of 19 articles were extracted after preliminary screening.LITERATURE EVALUATION: The data sources were the PubMed and SCI databases. The types of articles chosen were reviews and original articles.DATA SYNTHESIS: Metabolism and function of dopamine in the central nervous system: the chemical constitution of dopamine is a single benzene ring. The encephalic regions of dopamine synthesis and their fiber projections comprise four nervous system pathways. One of these pathways is the substantia nigra-striatum dopamine pathway, which is a side-loop of the basal ganglia circuitry that participates in movement control and plays a main role in the adjustment of extracorticospinal tract movement. Dopamine can lead to the facilitation of movement. Dystonia and abnormalities of the dopaminergic system: different modes of dopamine abnormality exist in various forms of dystonia. Abnormalities of the dopaminergic system in several primary dystonias: at present, fifteen gene loci of primary dystonia have been reported (DYT1-DYT15). The relationship between abnormalities of the dopaminergic system and the

  10. HDL abnormalities in nephrotic syndrome and chronic kidney disease.

    Vaziri, Nosratola D

    2016-01-01

    Normal HDL activity confers cardiovascular and overall protection by mediating reverse cholesterol transport and through its potent anti-inflammatory, antioxidant, and antithrombotic functions. Serum lipid profile, as well as various aspects of HDL metabolism, structure, and function can be profoundly altered in patients with nephrotic range proteinuria or chronic kidney disease (CKD). These abnormalities can, in turn, contribute to the progression of cardiovascular complications and various other comorbidities, such as foam cell formation, atherosclerosis, and/or glomerulosclerosis, in affected patients. The presence and severity of proteinuria and renal insufficiency, as well as dietary and drug regimens, pre-existing genetic disorders of lipid metabolism, and renal replacement therapies (including haemodialysis, peritoneal dialysis, and renal transplantation) determine the natural history of lipid disorders in patients with kidney disease. Despite the adverse effects associated with dysregulated reverse cholesterol transport and advances in our understanding of the underlying mechanisms, safe and effective therapeutic interventions are currently lacking. This Review provides an overview of HDL metabolism under normal conditions, and discusses the features, mechanisms, and consequences of HDL abnormalities in patients with nephrotic syndrome or advanced CKD. PMID:26568191

  11. Hierarchical structure analysis describing abnormal base composition of genomes

    Ouyang, Zhengqing; Liu, Jian-Kun; She, Zhen-Su

    2005-10-01

    Abnormal base compositional patterns of genomic DNA sequences are studied in the framework of a hierarchical structure (HS) model originally proposed for the study of fully developed turbulence [She and Lévêque, Phys. Rev. Lett. 72, 336 (1994)]. The HS similarity law is verified over scales between 103bp and 105bp , and the HS parameter β is proposed to describe the degree of heterogeneity in the base composition patterns. More than one hundred bacteria, archaea, virus, yeast, and human genome sequences have been analyzed and the results show that the HS analysis efficiently captures abnormal base composition patterns, and the parameter β is a characteristic measure of the genome. Detailed examination of the values of β reveals an intriguing link to the evolutionary events of genetic material transfer. Finally, a sequence complexity (S) measure is proposed to characterize gradual increase of organizational complexity of the genome during the evolution. The present study raises several interesting issues in the evolutionary history of genomes.

  12. Thyroid abnormalities in paediatric patients with vitiligo: retrospective study

    Borlu, Murat; Çınar, Salih Levent; Kesikoğlu, Ayten; Utaş, Serap

    2016-01-01

    Introduction The association between vitiligo and thyroid disease is not fully investigated especially in paediatric patients. Aim To determine the incidence of vitiligo and thyroid disorders in children. This is the first report from middle Anatolia and the second report from Turkey. Material and methods A retrospective chart review was performed to examine the presence of thyroid abnormalities in paediatric patients who had been admitted to the dermatology department with vitiligo. Results A total of 155 paediatric patients, including 80 (52%) male and 75 (48%) female patients were included. The mean age was 8.6 years. Non segmental vitiligo was the most common type of the disease in 140 (90%) reviewed patients, while segmental vitiligo appeared only in 15 (10%) patients. The mean onset of vitiligo was 5.6 ±0.9 years. A family history of vitiligo was found in 14 (9%) children. Thirty-four (22%) patients had thyroid function tests and/or thyroid autoantibody abnormality. All of these patients had non segmental vitiligo. It was statistically significant (p vitiligo and thyroid disease parameters. Conclusions Our results show that it may be useful to screen thyroid in children with non segmental vitiligo.

  13. - Software para Historia clínica Veterinaria aplicada a la Medicina Natural Tradicional y Bioenergética (Software for Veterinary clinical History applied the Traditional Natural Medicine and Bioenergetics

    MsC. Florángel Vidal Fernández

    2005-12-01

    Full Text Available Las condiciones de la Cuba de hoy exigen del uso de la Medicina Natural y Bioenergética, en el tratamiento de las diversas enfermedades. Debido al desarrollo de las TIC nos propusimos desarrollar una Base de Datos para lo cual se utilizó el gestor de bases de datos Microsoft Access, aplicándose un enfoque sistémico y se empleó como base informativa del sistema, las entidades: Entrada de datos, Historia clínica, Examen físico, Resultado y evolución. La aplicación se denomina "Historia Clínica informatizada aplicada a la Medicina Natural y Bioenergética " y permite la actualización y consultas a la base de datos que contiene información relativa a la historia clínica para medicina Natural y Bioenergética. El lenguaje de programación que se emplea para la codificación de la aplicación es Microsoft Visual Basic 6.3. Para manipular los datos se utiliza el gestor de base de datos Microsoft Access 2003. Se realizaron las siguientes pruebas, búsqueda de un paciente, acceso para modificar información, lectura de Información, Duplicación de la información, acceso simultáneo, estudio clínico analítico, retrospectivo de cada paciente y lectura de Información. El usuario recupera la información que necesita por medio de opciones de menús que adoptan la forma de clasificaciones temáticas. Elimina la información redundante dentro de la base de datos, de manera tal que los datos de la base aparezcan solamente una vez. The conditions of the Cuba of today demand of the use of the Natural Medicine and Bioenergética, in the treatment of the diverse diseases, due to the development of the TIC we seted out to develop Data Base. For his preparation the database manager Microsoft was used Access, was applied a sistémico approach using as he bases informative of the system, the organizations: Entrance of data, clinical History, physical Examination, Result and evolution. The application that is being developed denominates "System of Data

  14. Clinical biochemistry

    Alexander, W. C.; Leach, C. S.; Fischer, C. L.

    1975-01-01

    The objectives of the biochemical studies conducted for the Apollo program were (1) to provide routine laboratory data for assessment of preflight crew physical status and for postflight comparisons; (2) to detect clinical or pathological abnormalities which might have required remedial action preflight; (3) to discover as early as possible any infectious disease process during the postflight quarantine periods following certain missions; and (4) to obtain fundamental medical knowledge relative to man's adjustment to and return from the space flight environment. The accumulated data presented suggest that these requirements were met by the program described. All changes ascribed to the space flight environment were subtle, whereas clinically significant changes were consistent with infrequent illnesses unrelated to the space flight exposure.

  15. Normal or abnormal? 'Normative uncertainty' in psychiatric practice.

    Bassett, Andrew M; Baker, Charley

    2015-06-01

    The 'multicultural clinical interaction' presents itself as a dilemma for the mental health practitioner. Literature describes two problematic areas where this issues emerges--how to make an adequate distinction between religious rituals and the rituals that may be symptomatic of 'obsessive compulsive disorder' (OCD), and how to differentiate 'normative' religious or spiritual beliefs, behaviours, and experiences from 'psychotic' illnesses. When it comes to understanding service user's 'idioms of distress', beliefs about how culture influences behaviour can create considerable confusion and 'normative uncertainty' for mental health practitioners. In the absence of clear diagnostic and assessment criteria on distinguishing between 'culture' and 'psychopathology', practitioners have had to rely on their own intuition and seek out possible 'strategies' or 'procedures' from a contradictory and cross-disciplinary evidence base. Decontextualisation of service users' experiences may result in the pathologisation of culturally 'normative' phenomenon, 'category fallacy' errors, and poor health care experiences and outcomes for service users.This paper situates this dilemma within a wider debate that has concerned both the biomedical and social sciences, namely, the unresolved question of 'normality' or 'abnormality'. Indeed, issues that arise from dilemmas surrounding the question of 'culture' or 'psychopathology' are intimately tied to wider cultural ideas about what is considered 'normal'. The disciplines of psychiatry, psychology, and medical anthropology have struggled to establish workable criteria against which to judge behaviour as 'normal', 'abnormal', or 'pathological'. Three models for understanding mental 'abnormality' are evident in 'transcultural psychiatry' (what is now commonly known as 'cultural psychiatry'), and these models have corresponded closely to the interpretive models used by anthropologists attempting to make sense of the apparent diversity of

  16. OPHTHALMOLOGIC ABNORMALITIES IN CHILDREN WITH IMPAIRED HEARING

    Inderjit

    2014-02-01

    Full Text Available AIM: To determine the nature of ophthalmologic abnormalities in severe and profound grades of hearing impaired children and to treat visual impairment if any at the earliest . MATERIAL AND METHODS: Study was conducted on100 children in the age group of 5 - 14 years with severe and profound hearing loss visiting outpatient department of Ram Lal Eye and ENT hospital Govt. Medical College Amritsar and subjected to detailed ophthalmological examination. RESULTS: 100 children in the age group 5 - 14 years with hearing impairment were enrolled for t he study , 68 had profound and 32 had severe hearing loss . Visual disorders were found to be as high as 71%. Highest percentage was seen in children aged 7 years. Majority of them (50% had refractive error. Out of these 50 children , 28(56% had myopia , 10 (20% hypermetropia and 12(24% had astigmatism . The other ophthalmic abnormalities in our study were conjunctivitis 14(19.71% , fundus abnormalities and squint 11(15.49% , blepharitis 5 (7.04% , vitamin A deficiency 6 (8.04% , amblyopia 8 (11.26% , pupil disorder 3 (4.22% , cataract 3 (4.22% and heterochromia iridis 7 (9.85%. CONCLUSION : The high prevalence of ophthalmic abnormalities in deaf children mandate screening them for possible ophthalmic abnormalities. Early diagnosis and correction of visual d isturbances would go a long way in social and professional performance of these children.

  17. Quantitation of abnormal Ga-67 uptake in idiopathic pulmonary fibrosis

    Gallium-67 is useful in differentiating active pneumonitis from the underlying changes of diffuse idiopathic pulmonary fibrosis (IPF), especially when advanced disease precludes detection of subtle radiographic changes. Diffuse Ga-67 uptake, however, is often difficult to estimate. For 22 patients with IPF, they employed both emission tomography (SPECT) of the thorax and a modified Ga-67 index technique for digital planar images basing lung regions on Tc-99m MAA outlines and background on thigh soft-tissue activity. The degree of abnormal Ga-67 uptake measured by these techniques correlated closely with disease activity by all clinical criteria. Repeat studies for six patients after steroid therapy paralleled clinical response (4+/2-)

  18. Evolution of Clinical Enzymology

    Büttner, J

    1981-01-01

    The evolution of clinical enzymology is discussed in relation to the history of general enzymology and clinical chemistry. The discussion is limited to the period from 1835 (definition of catalysis by Berzelius) to 1935 (description of the optical test by Warburg). In conclusion, a general account is given of the introduction of the concept of quantitative enzyme activity determination into clinical medicine.

  19. What is the value of ultrasound soft tissue measurements in the prediction of abnormal fetal growth?

    Farah, N

    2012-02-01

    Abnormal fetal growth increases the complications of pregnancy not only for the baby but also for the mother. Growth abnormalities also have lifelong consequences. These babies are at increased risk of insulin resistance, diabetes and hypertension later in life. It is important to identify these babies antenatally to optimise their clinical care. Although used extensively antenatally to monitor fetal growth, ultrasound has its limitations. Despite the use of more than 50 different formulae to estimate fetal weight, their performance has been poor at the extremes of fetal weight. Over the past 20 years there has been emerging interest in studying fetal soft tissue measurements to improve detection of growth abnormalities. This review paper outlines the value of soft tissue measurements in identifying fetal growth abnormalities, in estimating fetal weight and in managing diabetes mellitus in pregnancy.

  20. Magnetic resonance imaging abnormalities in multiple sclerosis: A review

    :During the last two decades, magnetic resonance imaging has been widely used In the diagnosis and treatment monitoring of multiple sclerosis. MRI, both conventional and non conventional methods, has transformed all aspects of M S research and clinical practice in recent years. Although advanced imaging methods have added much more to our knowledge about pathogenesis and natural history of the disease but their cost, availability, complexity and lack of validation have limited their use in routine clinical practice. Conventional MR techniques including proton density, T1/T2-Weighted images and fluid- attenuated inversion recovery sequences are now accepted in standard protocols for diagnosis and treatment outcome measures in clinical trials of multiple sclerosis. This review will focus on the type, morphology and evolution of M S lesions regarding conventional MRI and their use for treatment monitoring in daily clinical practice

  1. Onychomycosis in patients with chronic leg ulcer and toenail abnormalities.

    Cabete, Joana; Galhardas, Célia; Apetato, Margarida; Lestre, Sara

    2015-01-01

    Nails have a limited number of reactive patterns to disease. Accordingly, toenail changes of different etiologies may mimic onychomycosis. OBJECTIVE To determine the prevalence of toenail onychomycosis among patients with leg ulcer and toenail abnormalities attending a dermatology clinic. METHODS A cross-sectional study was conducted through the analysis of clinical records and results of mycological examination. RESULTS A total of 81 patients were included, with a median age of 76.0 years. Most ulcers were of venous etiology, followed by those of mixed and arterial pathogenesis. The mycological evaluation confirmed the diagnosis of onychomycosis in 27.2% of the patients. The etiologic agent was a dermatophyte in 59.1% of isolates in nail samples, while Trichophyton interdigitale was the most frequent fungal species (40.9%). CONCLUSIONS Most toenail abnormalities in patients with chronic leg ulcer were not onychomycosis. This study highlights the importance of systematic mycological examination in these patients, in order to avoid overtreatment with systemic antifungals, unnecessary costs and side effects. PMID:25672317

  2. Onychomycosis in patients with chronic leg ulcer and toenail abnormalities*

    Cabete, Joana; Galhardas, Célia; Apetato, Margarida; Lestre, Sara

    2015-01-01

    Nails have a limited number of reactive patterns to disease. Accordingly, toenail changes of different etiologies may mimic onychomycosis. OBJECTIVE To determine the prevalence of toenail onychomycosis among patients with leg ulcer and toenail abnormalities attending a dermatology clinic. METHODS A cross-sectional study was conducted through the analysis of clinical records and results of mycological examination. RESULTS A total of 81 patients were included, with a median age of 76.0 years. Most ulcers were of venous etiology, followed by those of mixed and arterial pathogenesis. The mycological evaluation confirmed the diagnosis of onychomycosis in 27.2% of the patients. The etiologic agent was a dermatophyte in 59.1% of isolates in nail samples, while Trichophyton interdigitale was the most frequent fungal species (40.9%). CONCLUSIONS Most toenail abnormalities in patients with chronic leg ulcer were not onychomycosis. This study highlights the importance of systematic mycological examination in these patients, in order to avoid overtreatment with systemic antifungals, unnecessary costs and side effects. PMID:25672317

  3. Anal cytological abnormalities and epidemiological correlates among men who have sex with men at risk for HIV-1 infection

    Donà Maria

    2012-10-01

    Full Text Available Abstract Background The incidence of anal cancer, a Human Papillomavirus (HPV-related neoplasia, has been increasing in recent decades, mainly in men who have sex with men (MSM. Cytological changes of the anal epithelium induced by HPV can be detected through an anal pap smear. This study aimed to evaluate the prevalence and epidemiological correlates of anal cytological abnormalities among relatively young MSM at risk for HIV-1 infection, to help clarify whether or not this population deserves further investigation to assess the presence of anal cancer precursor lesions. Methods MSM were recruited among attendees of a large STI clinic for a HIV-1 screening program. Anal samples, collected with a Dracon swab in PreservCyt, were used both for liquid-based cytology and HPV testing by the Linear Array HPV Genotyping Test. Data regarding socio-demographic characteristics and sexual behavior were collected in face-to-face interviews. Results A total of 346 MSM were recruited (median age 32 years. Overall, 72.5% of the individuals had an anal HPV infection, with 56.1% of them being infected by oncogenic HPV genotypes. Anal cytological abnormalities were found in 29.8% of the cases (16.7% ASC-US and 13.1% L-SIL. Presence of ASC-US+ was strongly associated with infection by any HPV type (OR=4.21, 95% CI: 1.97-9.23, and particularly by HPV 16 and/or 18 (OR=5.62, 95% CI: 2.33-13.81. A higher proportion of ASC-US+ was found in older MSM, in those with a higher number of lifetime partners and in those with a history of ano-genital warts. However, none of these variables or the others analyzed showed any significant association with abnormal cytological findings. Conclusions The presence of anal cytological abnormalities in about one third of the recruited MSM and their strong association with HPV infection, in particular that caused by HPV 16 and/or 18, might provide a further complement to the data that now support the introduction of HPV vaccination among

  4. Report on Congress on abnormal occurrences

    Section 208 of the energy Reorganization Act of 1974 identifies an abnormal occurrence as an unscheduled incident or event that the Nuclear Regulatory Commission determines to be significant from the standpoint of public health or safety and requires a quarterly report of such events to be made to Congress. This report covers the period from January 1 through March 31, 1991. The report discusses six abnormal occurrences, none of which involved a nuclear power plant. Five of the events occurred at NRC-licensed facilities: one involved a significant degradation of plant safety at a nuclear fuel cycle facility, one involved a medical diagnostic misadministration, and three involved medical therapy misadministrations. An Agreement State (Arizona) reported one abnormal occurrence that involved medical therapy misadministrations

  5. Cone photopigment bleaching abnormalities in diabetes.

    Elsner, A E; Burns, S A; Lobes, L A; Doft, B H

    1987-04-01

    We have used a color-matching technique to obtain estimates of the optical density of cone photopigments as a function of retinal illuminance in patients with insulin-dependent diabetes mellitus (IDDM). We found that the half-bleach illuminance of some patients is abnormally high. That is, it takes more light to bleach an equivalent amount of photopigment in these patients. Since low illuminance color matches for these patients are normal, this implies that these patients have normal amounts of photopigment, but the photopigment is not bleaching normally. This result clearly points to abnormalities in the outer retina of these diabetic patients. The most likely causes of this abnormality are either decreases in the ability of the cones to absorb light, or an increased rate of regeneration of the cone photopigments. PMID:3557875

  6. Isolated abnormal strict morphology is not a contraindication for intrauterine insemination.

    Lockwood, G M; Deveneau, N E; Shridharani, A N; Strawn, E Y; Sandlow, J I

    2015-11-01

    This study sought to investigate whether isolated abnormal strict morphology (intrauterine insemination (IUI). This was a retrospective study performed at an Academic Medical Center/Reproductive Medicine Center. Four hundred and eight couples were included for 856 IUI cycles. 70 IUI cycles were performed in couples with abnormal strict morphology and otherwise normal semen parameters. Outcomes were measured as clinical pregnancy rate per IUI cycle as documented by fetal heart activity on maternal ultrasound. Clinical pregnancy rate did not significantly differ between the group with abnormal strict morphology [11/70 (15.7%)] and the normal morphology group [39/281 (13.9%)]. Additionally, there was no significant difference between the pregnancy rate in the abnormal morphology group compared to that of our overall institutional IUI pregnancy rate [145/856 (16.9%)]. Furthermore, there was no significant difference between pregnancy rate in the very low morphology group [3/14 (21.4%)] compared to those with normal morphology or the overall IUI pregnancy rate. Patients with isolated abnormal strict morphology have clinical pregnancy rates similar to those with normal morphology for IUI. Even in those with very low normal forms, consideration of IUI for assisted reproduction should not be excluded. PMID:26384603

  7. Hemorheological abnormalities in human arterial hypertension

    Lo Presti, Rosalia; Hopps, Eugenia; Caimi, Gregorio

    2014-05-01

    Blood rheology is impaired in hypertensive patients. The alteration involves blood and plasma viscosity, and the erythrocyte behaviour is often abnormal. The hemorheological pattern appears to be related to some pathophysiological mechanisms of hypertension and to organ damage, in particular left ventricular hypertrophy and myocardial ischemia. Abnormalities have been observed in erythrocyte membrane fluidity, explored by fluorescence spectroscopy and electron spin resonance. This may be relevant for red cell flow in microvessels and oxygen delivery to tissues. Although blood viscosity is not a direct target of antihypertensive therapy, the rheological properties of blood play a role in the pathophysiology of arterial hypertension and its vascular complications.

  8. Nonpathologizing trauma interventions in abnormal psychology courses.

    Hoover, Stephanie M; Luchner, Andrew F; Pickett, Rachel F

    2016-01-01

    Because abnormal psychology courses presuppose a focus on pathological human functioning, nonpathologizing interventions within these classes are particularly powerful and can reach survivors, bystanders, and perpetrators. Interventions are needed to improve the social response to trauma on college campuses. By applying psychodynamic and feminist multicultural theory, instructors can deliver nonpathologizing interventions about trauma and trauma response within these classes. We recommend class-based interventions with the following aims: (a) intentionally using nonpathologizing language, (b) normalizing trauma responses, (c) subjectively defining trauma, (d) challenging secondary victimization, and (e) questioning the delineation of abnormal and normal. The recommendations promote implications for instructor self-reflection, therapy interventions, and future research. PMID:26460794

  9. Structural abnormalities of the brain in schizophrenia: sex differences in the Cantabria First Episode of Schizophrenia Study.

    Vázquez-Barquero, J L; Cuesta Núñez, M J; Quintana Pando, F; de la Varga, M; Herrera Castanedo, S; Dunn, G

    1995-11-01

    This paper examines structural brain abnormalities, as evaluated by the CT scan, in first episodes of schizophrenia and their association with sociodemographic, diagnostic and clinical variables. The investigation included all patients with a first episode of schizophrenia who, over a 2-year period, made contact with any of the public mental health services of the Autonomous Region of Cantabria in Northern Spain. Diagnostic and clinical characteristics were evaluated through the use of the Spanish version of the Present State Examination (PSE-9) and the Scales for the Assessment of Positive and Negative Symptoms (SANS and SAPS respectively). The study demonstrated the presence of structural brain abnormalities in this sample of first episode schizophrenics. These abnormalities were mainly expressed in the presence of larger VBR for schizophrenic patients than in the controls, these findings being more marked in women than in men. We failed to reveal, however, any evidence of an association of these brain abnormalities with diagnostic or clinical characteristics. PMID:8637954

  10. Hippocampal abnormalities after prolonged febrile convulsion: a longitudinal MRI study.

    Scott, Rod C; King, Martin D; Gadian, David G; Neville, Brian G R; Connelly, Alan

    2003-11-01

    Mesial temporal sclerosis (MTS) is the most common lesion in patients who require epilepsy surgery, and approximately 50% of patients with MTS have a history of prolonged febrile convulsion (PFC) in childhood. The latter led to the hypothesis that convulsive status epilepticus, including PFC, can cause MTS. Our recently published data on children investigated within 5 days of a PFC showed that children investigated by MRI within 48 h of a PFC had large hippocampal volumes and prolongation of T2 relaxation time. Patients investigated >48 h from a PFC had large hippocampal volumes and normal T2 relaxation time. These data are strongly suggestive of hippocampal oedema that is resolving within 5 days of a PFC, but do not exclude the possibility of a pre-existing hippocampal lesion. Fourteen children from the original study had follow-up investigations carried out 4-8 months after the acute investigations. Of the 14 patients, four have had further seizures. Two had short febrile convulsions, one had PFC and one had non-febrile seizures. There was a significant reduction in hippocampal volume and T2 relaxation time between the first and second investigations, and there is now no difference in hippocampal volume or T2 relaxation time in patients compared with a control population. Moreover, there is a significant increase in hippocampal volume asymmetry in patients at follow-up when compared with initial data. Five out of 14 patients had asymmetry outside the 95th percentile for control subjects and, of these, three had one hippocampal volume outside the lower 95% prediction limit for control subjects. A reduction in hippocampal volume or T2 relaxation time, into or below the normal range between the first and second scans, indicates that the earlier findings are temporary and are strongly suggestive of hippocampal oedema as the abnormality in the initial investigations. The change in hippocampal symmetry in the patient group is consistent with injury and neuronal loss

  11. Computerised triage in a prostate assessment clinic.

    Rajkumar, G N; Small, D R; Conn, I G

    2004-01-01

    An MS Office package has been developed to score IPSS, take a patient history, compare flows with nomograms and decide on interim management. This is based on these scores, residual volume and laboratory results. A clearly formatted GP letter is produced. The patient uses a touch screen to answer questions on the IPSS and other medical history. These questions and responses are stored in Excel spread sheets. Clinic staff then enter results of flow studies, urinalysis, U&E and PSA. Excel Visual Basic creates a detailed printout for the notes and the MS Office mail merge facility creates a summary printout, which also serves as a letter to the GP. Excel allows embedding of formulae and program code to implement the rules for management. Based on these rules, the program either generates a request for an urgent appointment in the clinic or recommends the use of either an alpha blocker (if not contraindicated by medical history) or 5 alpha reductase inhibitors in the interim period before they are reviewed in clinic. A total of 139 patients have been seen and the computer decisions compared with those of a consultant urologist. Agreement was found in 106, disagreement in 33. However, 21 of the 33 involved computer oversensitivity to flow results. We do not anticipate difficulty improving this and are investigating using an artificial neural network. Of the other 12 patients, the urologist departed from the fixed rules for IPSS, creatinine, PSA and residual urine when only one variable was slightly abnormal. To conclude, this novel user-friendly system shows great potential in the management of prostate outpatients. Some tuning is needed, with particular respect to uroflow results. PMID:15175663

  12. Vitamin D and Risk of Neuroimaging Abnormalities.

    Littlejohns, Thomas J; Kos, Katarina; Henley, William E; Lang, Iain A; Annweiler, Cedric; Beauchet, Olivier; Chaves, Paulo H M; Kestenbaum, Bryan R; Kuller, Lewis H; Langa, Kenneth M; Lopez, Oscar L; Llewellyn, David J

    2016-01-01

    Vitamin D deficiency has been linked with an increased risk of incident all-cause dementia and Alzheimer's disease. The aim of the current study was to explore the potential mechanisms underlying these associations by determining whether low vitamin D concentrations are associated with the development of incident cerebrovascular and neurodegenerative neuroimaging abnormalities. The population consisted of 1,658 participants aged ≥65 years from the US-based Cardiovascular Health Study who were free from prevalent cardiovascular disease, stroke and dementia at baseline in 1992-93. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were determined by liquid chromatography-tandem mass spectrometry from blood samples collected at baseline. The first MRI scan was conducted between 1991-1994 and the second MRI scan was conducted between 1997-1999. Change in white matter grade, ventricular grade and presence of infarcts between MRI scan one and two were used to define neuroimaging abnormalities. During a mean follow-up of 5.0 years, serum 25(OH)D status was not significantly associated with the development of any neuroimaging abnormalities. Using logistic regression models, the multivariate adjusted odds ratios (95% confidence interval) for worsening white matter grade in participants who were severely 25(OH)D deficient (vitamin D concentrations could not be shown to be associated with the development of cerebrovascular or neurodegenerative neuroimaging abnormalities in Cardiovascular Health Study participants. PMID:27166613

  13. Sensory Abnormalities in Autism: A Brief Report

    Klintwall Lars; Holm, Anette; Eriksson, Mats; Carlsson, Lotta Hoglund; Olsson, Martina Barnevik; Hedvall, Asa; Gillberg, Christopher; Fernell, Elisabeth

    2011-01-01

    Sensory abnormalities were assessed in a population-based group of 208 20-54-month-old children, diagnosed with autism spectrum disorder (ASD) and referred to a specialized habilitation centre for early intervention. The children were subgrouped based upon degree of autistic symptoms and cognitive level by a research team at the centre. Parents…

  14. Psychology Faculty Perceptions of Abnormal Psychology Textbooks

    Rapport, Zachary

    2011-01-01

    The problem. The purpose of the current study was to investigate the perceptions and opinions of psychology professors regarding the accuracy and inclusiveness of abnormal psychology textbooks. It sought answers from psychology professors to the following questions: (1) What are the expectations of the psychology faculty at a private university of…

  15. Dynamic Abnormal Grain Growth in Refractory Metals

    Noell, Philip J.; Taleff, Eric M.

    2015-11-01

    High-temperature plastic deformation of the body-centered cubic (BCC) refractory metals Mo and Ta can initiate and propagate abnormal grains at significantly lower temperatures and faster rates than is possible by static annealing alone. This discovery reveals a new and potentially important aspect of abnormal grain growth (AGG) phenomena. The process of AGG during plastic deformation at elevated temperatures, termed dynamic abnormal grain growth (DAGG), was observed at homologous temperatures between 0.52 and 0.72 in both Mo and Ta sheet materials; these temperatures are much lower than those for previous observations of AGG in these materials during static annealing. DAGG was used to repeatedly grow single crystals several centimeters in length. Investigations to date have produced a basic understanding of the conditions that lead to DAGG and how DAGG is affected by microstructure in BCC refractory metals. The current state of understanding for DAGG is reviewed in this paper. Attention is given to the roles of temperature, plastic strain, boundary mobility and preexisting microstructure. DAGG is considered for its potential useful applications in solid-state crystal growth and its possibly detrimental role in creating undesired abnormal grains during thermomechanical processing.

  16. Gastric emptying abnormal in duodenal ulcer

    To investigate the possibility that an abnormality of gastric emptying exists in duodenal ulcer and to determine if such an abnormality persists after ulcer healing, scintigraphic gastric emptying measurements were undertaken in 16 duodenal ulcer patients before, during, and after therapy with cimetidine; in 12 patients with pernicious anemia, and in 12 control subjects. No difference was detected in the rate or pattern of gastric emptying in duodenal ulcer patients before and after ulcer healing with cimetidine compared with controls, but emptying of the solid component of the test meal was more rapid during treatment with the drug. Comparison of emptying patterns obtained in duodenal ulcer subjects during and after cimetidine treatment with those obtained in pernicious anemia patients and controls revealed a similar relationship that was characterized by a tendency for reduction in the normal differentiation between the emptying of solid and liquid from the stomach. The similarity in emptying patterns in these groups of subjects suggests that gastric emptying of solids may be influenced by changes in the volume of gastric secretion. The failure to detect an abnormality of gastric emptying in duodenal ulcer subjects before and after ulcer healing calls into question the widespread belief that abnormally rapid gastric emptying is a feature with pathogenetic significance in duodenal ulcer disease

  17. Cerebral FDG-PET scanning abnormalities in optimally treated HIV patients

    Andersen, Ase B; Law, Ian; Krabbe, Karen S;

    2010-01-01

    no history of virological failure, a CD4 count above 200 x 106 cells/l and no other co-morbidities. The distribution of the regional cerebral metabolic rate of glucose metabolism was measured using fluorine-18-flourodeoxyglucose positron emission tomography (FDG-PET) scanning. The PET scans were...... frontal reduction in the relative metabolic rate of glucose. Compared to healthy subjects, the patients with abnormal FDG-PET scanning results had a shorter history of known HIV infection, fewer years on antiretroviral therapy and higher levels of circulating TNF alpha and IL-6 (p = 0.08). CONCLUSION: A...

  18. Clinical features and 123I-FP-CIT SPECT imaging in drug-induced parkinsonism and Parkinson's disease

    To determine clinical predictors and accuracy of 123I-FP-CIT SPECT imaging in the differentiation of drug-induced parkinsonism (DIP) and Parkinson's disease (PD). Several clinical features and 123I-FP-CIT SPECT images in 32 patients with DIP, 25 patients with PD unmasked by antidopaminergic drugs (PDu) and 22 patients with PD without a previous history of antidopaminergic treatment (PDc) were retrospectively evaluated. DIP and PD shared all clinical features except symmetry of parkinsonian signs which was more frequently observed in patients with DIP (46.9%) than in patients with PDu (16.0%, p123I-FP-CIT SPECT images were normal in 29 patients with DIP (90.6%) and abnormal in all patients with PD, and this imaging technique showed high levels of accuracy. DIP and PD are difficult to differentiate based on clinical signs. The precision of clinical diagnosis could be reliably enhanced by 123I-FP-CIT SPECT imaging. (orig.)

  19. Abnormal movement of the arytenoid region as a cause of upper airway obstruction.

    Nagai, A.; Kanemura, T; Konno, K.

    1992-01-01

    A 75 year old woman presented with a three week history of severe dyspnoea and cough. Auscultation and spirometry suggested extrathoracic inspiratory airway obstruction, and bronchoscopy showed abnormal motion of the arytenoid region (supraglottic area), causing upper airway obstruction only during forced inspiratory efforts. Sedatives improved the symptoms within a week. It is suggested that reversible malfunction of the arytenoid region can be responsible for upper airway obstruction.

  20. Glucometabolic abnormalities survey among outpatients without previous diabetes diagnosis and with coronary artery disease and hypertension

    陈韵岱

    2014-01-01

    Objective To explore the status of glucometabolic abnormalities in cardiological outpatients without previous diabetes diagnosis and with coronary artery disease(CAD)and hypertension.Methods Patients without previous diagnosis of diabetes but with hypertension and CAD aged 18 years or above were recruited from cardiology departments of 11 general hospitals in China.Demographic data,disease diagnosis and medical history were collected.Physical examination and questionnaire survey were

  1. Flow-volume loop abnormality detecting a previously unrecognized right upper lobe tracheal bronchus

    Shannon Ruzycki; Willis H. Tsai; Davidson, Warren J.

    2015-01-01

    Tracheal bronchus is a rare anatomic variant in which a bronchus originates from the trachea. Patients may be asymptomatic or present with a variety of respiratory symptoms. We present a case of a patient who presented with a history of poorly controlled asthma and a persistent abnormality of the flow-volume loop. Bronchoscopy revealed a tracheal bronchus with narrowed right-sided bronchial orifices. An unrecognized tracheal bronchus may result in serious complications during elective or emer...

  2. Abnormal position of lymph nodes in a freemartin sheep

    Salazar PA

    2012-03-01

    Full Text Available Angela M Gonella-Diaza, Luz Zoraya Duarte, Sergio Dominguez, Pedro A SalazarClínica de Grandes Animales, Facultad de Medicina Veterinaria y de Zootecnia, Universidad Cooperativa de Colombia, Bucaramanga, Santander, ColombiaAbstract: In this freemartin case report the authors present the clinical and morphological findings of a freemartin ewe with an abnormal position of two lymph nodes. Freemartins, infertile females from mixed-sex twin pregnancies, are chimeras, having two cell populations: one of their own (XX DNA and one from their male twin (XY DNA. Freemartins can have varying degrees of phenotypic masculinization, including, in some cases, having active male gonads and exhibiting male behaviors such as heat detection and aggressiveness. During the clinical examination of the freemartin ewe, a morphological abnormality of the vulva, the presence of scrotal sacs, and a lack of mammary tissue development were noted. On inspection of the vaginal channel, an extremely enlarged clitoris, resembling a penis, was found. The clinical evidence suggested freemartinism. After the karyotyping diagnosis confirmation, a necropsy was performed and samples were taken for histology and immunohistochemistry. There were two structures found in the scrotal sacs; however, these were found to be lymph nodes, not testicles, and this was confirmed by CD3 lymph protein coloration. On histological study, the phallic structure showed corpus cavernosum and tunica albuginea. The testicles were found retained inside the abdominal cavity, with the presence of atrophic seminiferous tubules. Although the position of the testicles in freemartins has been reported as highly variable, this is the first time, to the best of the authors' knowledge, that a case has been reported where lymph nodes have been found inside the scrotal sacs. It is possible that these were the inguinal lymph nodes, trapped inside the scrotum during fetal growth and development.Keywords: freemartinism

  3. Diagnosis of cauda equina abnormalities by using electromyography, discography, and epidurography in dogs

    Electromyography (EMG), L7-S1 discography and epidurography were investigated in 15 dogs with clinical signs of cauda equina dysfunction and in 7 control dogs without such clinical signs. Electromyography of paraspinal and pelvic limb muscles was done in 13 of 15 affected dogs. An L7-S1 discogram followed by an epidurogram was performed in all 22 dogs using 20% iopamidol. Results of discograms, epidurograms, and gross necropsy examinations were normal in six of seven control dogs. The one dog in which these studies were abnormal had a mild L7-S1 disc protrusion that did not result in nerve root compression at necropsy. Electromyographic analysis was 100% accurate in predicting the presence or absence of cauda equina disease. None of the results of discograms were falsely negative. Twelve of 15 discograms in clinically affected dogs indicated dorsal disc protrusion, but 2 of these protrusions were found to be noncompressive at surgery (13% error). Abnormal epidurograms occurred in 9 of 15 clinically affected dogs. There was one false positive and two false negatives (20% error). Electromyography was a sensitive screening technique for the presence of cauda equina disease. Discography may be more sensitive for detection of L7-S1 disc protrusion than epidurography. An abnormal radiographic contrast study of the cauda equina may only be useful when combined with an abnormal EMG

  4. Genomic SNP array as a gold standard for prenatal diagnosis of foetal ultrasound abnormalities

    M. Srebniak (Malgorzata); M. Boter (Marjan); G.G. Oudesluijs (Grétel); T.E. Cohen-Overbeek (Titia); L.C. Govaerts (Lutgarde); K.E.M. Diderich (Karin); R. Oegema (Renske); M.F.C.M. Knapen (Maarten); I.M.B.H. van de Laar (Ingrid); M. Joosten (Marieke); A.R.M. van Opstal (Diane); R-J.H. Galjaard (Robert-Jan)

    2012-01-01

    textabstractBackground: We have investigated whether replacing conventional karyotyping by SNP array analysis in cases of foetal ultrasound abnormalities would increase the diagnostic yield and speed of prenatal diagnosis in clinical practice. Findings/results. From May 2009 till June 2011 we perfor

  5. Robust and Reproducible Quantification of the Extent of Chest Radiographic Abnormalities (And It’s Free!)

    Ana Requena-Méndez; Edelweiss Aldasoro; Jose Muñoz; Moore, David A. J.

    2015-01-01

    RATIONALE: Objective, reproducible quantification of the extent of abnormalities seen on a chest radiograph would improve the user-friendliness of a previously proposed severity scoring system for pulmonary tuberculosis and could be helpful in monitoring response to therapy, including in clinical trials. METHODS: In this study we report the development and evaluation of a simple t...

  6. Differences in white matter abnormalities between bipolar I and II disorders

    Liu, Jia-Xiu; Chen, Yong-Sheng; Hsieh, Jen-Chuen; Su, Tung-Ping; Yeh, Tzu-Chen; Chen, Li-Fen

    2010-01-01

    Background: Although patients with bipolar I and II disorders exhibit heterogeneous clinical presentations and cognitive functions, it remains unclear whether these two subtypes have distinct neural substrates. This study aimed to differentiate the fiber abnormalities between bipolar I and II patien

  7. COGNITIVE TASK PERFORMANCE AND SYMPTOMS CONTRIBUTE TO PERSONALITY ABNORMALITIES IN FIRST HOSPITALIZED SCHIZOPHRENIA

    Gurrera, Ronald J.; McCarley, Robert W.; Salisbury, Dean

    2014-01-01

    Chronic schizophrenia patients have personality abnormalities and cognitive deficits that are associated with poor clinical, social, and vocational outcomes. Very few studies have examined relationships between personality and cognitive function, and chronic illness effects may have confounded those studies. In this study personality traits in clinically stable first episode schizophrenia patients (21M, 9F) and psychiatrically healthy controls (38M, 24F) were measured with the NEO-FFI, a self...

  8. Predictors of Abnormal Neuroimaging of the Brain in Children With Epilepsy Aged 1 Month to 2 Years: Useful Clues in a Resource-Limited Setting.

    Sanmaneechai, Oranee; Danchaivijitr, Nasuda; Likasitwattanakul, Surachai

    2015-10-01

    Neuroimaging should be performed on infants with seizure. However, there are economic limitations in performing neuroimaging in a resource-limited setting. The younger the age, the higher the risk of having abnormal neuroimaging. The aim was to determine frequency and predictors of abnormal neuroimaging in children with epilepsy aged 1 month to 2 years. History, physical examination, electroencephalogram (EEG), and neuroimaging were reviewed. Thirty-seven of 49 (76%) had neuroimaging studies; 19 computed tomography (CT), 14 magnetic resonance imaging (MRI), and 4 had both. Abnormal neuroimaging was found in 19 (51%). Predictors of abnormal neuroimages are developmental delay, abnormal head circumference, and abnormal neurologic examination. Eight children (21%) had lesions on neuroimaging studies that altered or influenced management. Of 8 patients with normal examination and EEG, 1 had a brain tumor and another had arteriovenous malformation. Neuroimaging should be considered as an essential aid in the evaluation of infants with epilepsy, even in a resource-limited setting. PMID:25792429

  9. Preliminary experience with fetal MRI for evaluation of intracranial abnormalities

    Full text: Modern MRI technologies allow the preparation of a multi-planar images as well as images showing the movement of the fetus for less than 1 sec. the methodology is particularly useful as a rendering intracranial lesions (at ventriculomegaly, lesions in the posterior cranial fossa, corpus callosum abnormalities, myelination, migration and sulcation) and in the body lesions of the fetus (diaphragmatic hernia, congenital cystic abnormalities, renal cystic lesions spinal anomalies) and the abdomen of the mother. We set a goal to prove the usefulness of MRI research in prenatal diagnosis of congenital malformations of the central nervous system. For a period of 24 months in City Clinic Hospital Sofia were studied 12 pregnant women and 13 fetuses in which there was doubt about intracranial fetal malformations. All studies were conducted as a supplementary diagnostic technique after ultrasound in the third trimester of pregnancy when the fetus is large enough and organogenesis is completed. MRI is held superconductive 3.0t magnet using single-shot fast-spin echo and half-Fourier acquisition turbo spin echo (HASTE) with a duration of under one minute scan, MRI study therefore does not require preparation of the mother. Does not require use of contrast. None reported harm to the fetus and the mother. Although ultrasound due to its low price and its wide accessibility as well as of its non-invasiveness and low time in some cases results were insufficient to determine condition and course of pregnancy. We believe that the MRI examination in the case of ambiguous results of the ultrasound has an important role to refine abnormalities prenatal and postnatal treatment planning

  10. Association between oronasopharyngeal abnormalities and malocclusion in Northeastern Brazilian preschoolers

    Gomes, Genara Brum; Vieira-Andrade, Raquel Gonçalves; de Sousa, Raulison Vieira; Firmino, Ramon Targino; Paiva, Saul Martins; Marques, Leandro Silva; Granville-Garcia, Ana Flávia

    2016-01-01

    Abstract Objective: Evidence is contradictory regarding the association between oronasopharyngeal abnormalities and malocclusion. The aim of the present study was to assess the association between oronasopharyngeal abnormalities and malocclusion (anterior open bite and posterior crossbite) in preschoolers. Methods: A cross-sectional study was conducted with a representative sample of 732 preschoolers aged 3-5 years old selected randomly from private and public preschools. Anterior open bite (AOB) and posterior crossbite (PC) were evaluated through a clinical exam. Parents/caregivers answered a questionnaire addressing sociodemographic indicators and oronasopharyngeal issues. Statistical analysis involved descriptive analysis and Poisson regression (p < 0.05). Results: The prevalences of AOB and PC were 21.0% and 11.6%, respectively. Being three years old (PR = 1.244; 95% CI = 1.110-1.394; p < 0.001), being four years old (PR = 1.144; 95% CI = 1.110 - 1.394; p = 0.015), absence of allergy (PR = 1.158; 95% CI = 1.057 - 1.269; p = 0.002), not having undergone nose surgery (PR = 1.152; 95% CI = 1.041 - 1.275; p = 0.006) and having a sore throat more than five times in the same year (PR = 1.118; 95% CI = 1.011 - 1.237; p = 0.030) were significantly associated with AOB. The absence of asthma (PR = 1.082; 95% CI = 1.012 - 1.156; p = 0.020), not having undergone throat surgery (PR = 1.112; 95% CI = 1.068 - 1.158; p < 0.001) and not having undergone nose surgery (PR = 1.114; 95% CI = 1.069 - 1.160; p < 0.001) remained associated with PC. Conclusion: Significant associations were found between oronasopharyngeal-reported abnormalities and the presence of AOB and PC in preschoolers. PMID:27409652

  11. Depth Determination of an Abnormal Heat Source in Biological Tissues

    WANG Qing-Hua; LI Zhen-Hua; LAI Jian-Cheng; HE An-Zhi

    2011-01-01

    We deduce the surface temperature distribution generated by the inner point heat source in biological tissues and propose a graphic method to retrieve the depth of the point heat source. The practical surface temperature distribution can be regarded as the convolution of the temperature distribution of the inner point heat source with the heat source shape function. The depth of an abnormal heat source in biological tissues can be retrieved by using the graphic method combined with the blind deconvolution scheme.%We deduce the surface temperature distribution generated by the inner point heat source in biological tissues and propose a graphic method to retrieve the depth of the point heat source.The practical surface temperature distribution can be regarded as the convolution of the temperature distribution of the inner point heat source with the heat source shape function.The depth of an abnormal heat source in biological tissues can be retrieved by using the graphic method combined with the blind deconvolution scheme.Surface temperature distribution of the biological tissues is closely related to the neighboring metabolic heat production,blood circulation in an organism and environmental temperature.[1] The abnormal metabolic performances of a local region in biological tissue imply malignant changes occurring,which can be distinguished from the variance of surface temperature.Modern development of thermal infrared (TIR) imaging has made the surface temperature measurement of biological tissue easier.Nowadays,several types of tumors,e.g.skin or breast can be recognized with TIR imaging.[2] The diagnostics with TIR imaging require more experienced operators and can not accurately ascertain the site of pathological changes,which limits the value of this technology.Therefore ascertaining the depth of inner heat source in biological body has the extremely important clinical value.

  12. Copy number variants and rasopathies: germline KRAS duplication in a patient with syndrome including pigmentation abnormalities.

    Gilbert-Dussardier, Brigitte; Briand-Suleau, Audrey; Laurendeau, Ingrid; Bilan, Frédéric; Cavé, Hélène; Verloes, Alain; Vidaud, Michel; Vidaud, Dominique; Pasmant, Eric

    2016-01-01

    RAS/MAPK pathway germline mutations were described in Rasopathies, a class of rare genetic syndromes combining facial abnormalities, heart defects, short stature, skin and genital abnormalities, and mental retardation. The majority of the mutations identified in the Rasopathies are point mutations which increase RAS/MAPK pathway signaling. Duplications encompassing RAS/MAPK pathway genes (PTPN11, RAF1, MEK2, or SHOC2) were more rarely described. Here we report, a syndromic familial case of a 12p duplication encompassing the dosage sensitive gene KRAS, whose phenotype overlapped with rasopathies. The patient was referred because of a history of mild learning disabilities, small size, facial dysmorphy, and pigmentation abnormalities (café-au-lait and achromic spots, and axillar lentigines). This phenotype was reminiscent of rasopathies. No mutation was identified in the most common genes associated with Noonan, cardio-facio-cutaneous, Legius, and Costello syndromes, as well as neurofibromatosis type 1. The patient constitutional DNA exhibited a ~10.5 Mb duplication at 12p, including the KRAS gene. The index case's mother carried the same chromosome abnormality and also showed development delay with short stature, and numerous café-au-lait spots. Duplication of the KRAS gene may participate in the propositus phenotype, in particular of the specific pigmentation abnormalities. Array-CGH or some other assessment of gene/exon CNVs of RAS/MAPK pathway genes should be considered in the evaluation of individuals with rasopathies. PMID:27450488

  13. Clinical care of two patients with Ebola virus disease in the United States.

    Lyon, G Marshall; Mehta, Aneesh K; Varkey, Jay B; Brantly, Kent; Plyler, Lance; McElroy, Anita K; Kraft, Colleen S; Towner, Jonathan S; Spiropoulou, Christina; Ströher, Ute; Uyeki, Timothy M; Ribner, Bruce S

    2014-12-18

    West Africa is currently experiencing the largest outbreak of Ebola virus disease (EVD) in history. Two patients with EVD were transferred from Liberia to our hospital in the United States for ongoing care. Malaria had also been diagnosed in one patient, who was treated for it early in the course of EVD. The two patients had substantial intravascular volume depletion and marked electrolyte abnormalities. We undertook aggressive supportive measures of hydration (typically, 3 to 5 liters of intravenous fluids per day early in the course of care) and electrolyte correction. As the patients' condition improved clinically, there was a concomitant decline in the amount of virus detected in plasma. PMID:25390460

  14. Coronary artery abnormalities in Kawasaki disease - Comparison between CT and MR coronary angiography

    Kim, Jong Woo; Goo, Hyun Woo [Dept. of Radiology and Research Inst. of Radiology, Univ. of Ulsan Coll. of Medicine, Asan Medical Center, Seoul (Korea, Republic of)], e-mail: hwoogoo@amc.seoul.kr

    2013-03-15

    Background: Although CT coronary angiography (CTCA) and MR coronary angiography (MRCA) are increasingly used in patients with Kawasaki disease, comparison of coronary artery assessability and diagnostic performance between the two imaging modalities has been rarely performed. Purpose: To investigate which imaging modality, CTCA or MRCA, is better for evaluating coronary artery abnormalities in patients with Kawasaki disease. Material and Methods: Between 2003 and 2011, 56 patients (38 boys/men; age range, 1-24 years) with Kawasaki disease underwent CTCA or MRCA (group A). Of these, 17 underwent both CTCA and MRCA (group B). Visibility of 11 coronary arterial segments in each patient was graded on a four-point scale. Coronary artery aneurysm, stenosis, and occlusion were evaluated by CTCA and MRCA, based on a reference standard obtained from cardiac catheterization, echocardiography, follow-up CTCA and MRCA, and clinical history. Coronary artery assessability and diagnostic performance were compared between CTCA and MRCA. Results: In per-segment analysis, more segments were assessable on CTCA than on MRCA in both groups. In per-patient analysis of group B, no significant difference in the assessability was found between CTCA (95.0%, 128.3/135 segments) and MRCA (92.4%, 124.8/135 segments) (P > 0.05). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CTCA vs. MRCA were 93.1% vs. 77.9% (P < 0.001), 99.2% vs. 99.7% (P = 0.65), 96.8% vs. 98.7% (P = 0.65), 98.2% vs. 94.1% (P < 0.001), and 98.0% vs. 94.9% (P = 0.008), respectively, in group A, and 91.8% vs. 70.4% (P < 0.001), 99.5% vs. 99.5% (P = 1.000), 98.5% vs. 98.0% (P = 1.000), 97.2% vs. 91.1% (P = 0.006), and 97.6% vs. 92.3% (P = 0.004), respectively, in group B. Conclusion: Although CTCA and MRCA show comparable assessability in per-patient analysis, CTCA shows higher diagnostic performance than MRCA for evaluating coronary artery abnormalities in patients with Kawasaki

  15. Chest CT abnormalities and quality of life: relationship in adult cystic fibrosis

    Kilcoyne, Aoife; Lavelle, Lisa P.; McCarthy, Colin J.; McEvoy, Sinead H.; Fleming, Hannah; Gallagher, Annika; Loeve, Martine; Tiddens, Harm; McKone, Edward; Gallagher, Charles C.

    2016-01-01

    Background To evaluate the relationship between lung parenchymal abnormalities on chest CT and health-related quality of life in adult cystic fibrosis (CF). Methods The chest CT scans of 101 consecutive CF adults (mean age 27.8±7.9, 64 males) were prospectively scored by two blinded radiologists in consensus using a modified Bhalla score. Health-related quality of life was assessed using the revised Quittner Cystic Fibrosis Questionnaire (CFQ-R). Multiple regressions were performed with each of the CFQ-R domains and all clinical and imaging findings to assess independent correlations. Results There were 18 inpatients and 83 outpatients. For the cohort of inpatients, CT abnormalities were significantly (P<0.005 for all) associated with Respiratory Symptoms (Air Trapping), and also with Social Functioning (Consolidation) and Role Functioning (Consolidation). For outpatients, CT abnormalities were significantly (P<0.005 for all) associated with Respiratory Symptoms (Consolidation) and also with Physical Functioning (Consolidation), Vitality (Consolidation, Severity of Bronchiectasis), Eating Problems (airway wall thickening), Treatment Burden (Total CT Score), Body Image (Severity of Bronchiectasis) and Role Functioning (Tree-in-bud nodules). Consolidation was the commonest independent CT predictor for both inpatients (predictor for 2 domains) and outpatients (predictor in 3 domains). Several chest CT abnormalities excluded traditional measures such as FEV1 and BMI from the majority of CFQ-R domains. Conclusions Chest CT abnormalities are significantly associated with quality of life measures in adult CF, independent of clinical or spirometric measurements. PMID:27047946

  16. Seizure-induced brain lesions: A wide spectrum of variably reversible MRI abnormalities

    Cianfoni, A., E-mail: acianfoni@hotmail.com [Neuroradiology, Neurocenter of Italian Switzerland–Ospedale regionale Lugano, Via Tesserete 46, Lugano, 6900, CH (Switzerland); Caulo, M., E-mail: caulo@unich.it [Department of Neuroscience and Imaging, University of Chieti, Via dei Vestini 33, 6610 Chieti. Italy (Italy); Cerase, A., E-mail: alfonsocerase@gmail.com [Unit of Neuroimaging and Neurointervention NINT, Department of Neurological and Sensorineural Sciences, Azienda Ospedaliera Universitaria Senese, Policlinico “Santa Maria alle Scotte”, V.le Bracci 16, Siena (Italy); Della Marca, G., E-mail: dellamarca@rm.unicatt.it [Neurology Dept., Catholic University of Rome, L.go F Vito 1, 00100, Rome (Italy); Falcone, C., E-mail: carlo_falc@libero.it [Radiology Dept., Catholic University of Rome, L.go F Vito 1, 00100, Rome (Italy); Di Lella, G.M., E-mail: gdilella@rm.unicatt.it [Radiology Dept., Catholic University of Rome, L.go F Vito 1, 00100, Rome (Italy); Gaudino, S., E-mail: sgaudino@sirm.org [Radiology Dept., Catholic University of Rome, L.go F Vito 1, 00100, Rome (Italy); Edwards, J., E-mail: edwardjc@musc.edu [Neuroscience Dept., Medical University of South Carolina, 96J Lucas st, 29425, Charleston, SC (United States); Colosimo, C., E-mail: colosimo@rm.unicatt.it [Radiology Dept., Catholic University of Rome, L.go F Vito 1, 00100, Rome (Italy)

    2013-11-01

    Introduction MRI abnormalities in the postictal period might represent the effect of the seizure activity, rather than its structural cause. Material and Methods Retrospective review of clinical and neuroimaging charts of 26 patients diagnosed with seizure-related MR-signal changes. All patients underwent brain-MRI (1.5-Tesla, standard pre- and post-contrast brain imaging, including DWI-ADC in 19/26) within 7 days from a seizure and at least one follow-up MRI, showing partial or complete reversibility of the MR-signal changes. Extensive clinical work-up and follow-up, ranging from 3 months to 5 years, ruled out infection or other possible causes of brain damage. Seizure-induced brain-MRI abnormalities remained a diagnosis of exclusion. Site, characteristics and reversibility of MRI changes, and association with characteristics of seizures were determined. Results MRI showed unilateral (13/26) and bilateral abnormalities, with high (24/26) and low (2/26) T2-signal, leptomeningeal contrast-enhancement (2/26), restricted diffusion (9/19). Location of abnormality was cortical/subcortical, basal ganglia, white matter, corpus callosum, cerebellum. Hippocampus was involved in 10/26 patients. Reversibility of MRI changes was complete in 15, and with residual gliosis or focal atrophy in 11 patients. Reversibility was noted between 15 and 150 days (average, 62 days). Partial simple and complex seizures were associated with hippocampal involvement (p = 0.015), status epilepticus with incomplete reversibility of MRI abnormalities (p = 0.041). Conclusions Seizure or epileptic status can induce transient, variably reversible MRI brain abnormalities. Partial seizures are frequently associated with hippocampal involvement and status epilepticus with incompletely reversible lesions. These seizure-induced MRI abnormalities pose a broad differential diagnosis; increased awareness may reduce the risk of misdiagnosis and unnecessary intervention.

  17. Gross congenital abnormality associated with an apparently balanced chromosomal translocation t(9;17)(q34;q11)

    Dockery, Heather E; Neale, H C; Fitzgerald, P H

    1982-01-01

    Gross mental and physical abnormality is described in an adult female who had some features similar to those of Ehlers-Danlos syndrome. There was no family history of the disorder. The patient also carried a balanced chromosomal translocation t(9;17)(q34;q11).

  18. Abnormal Default System Functioning in Depression: Implications for Emotion Regulation.

    Messina, Irene; Bianco, Francesca; Cusinato, Maria; Calvo, Vincenzo; Sambin, Marco

    2016-01-01

    Depression is widely seen as the result of difficulties in regulating emotions. Based on neuroimaging studies on voluntary emotion regulation, neurobiological models have focused on the concept of cognitive control, considering emotion regulation as a shift toward involving controlled processes associated with activation of the prefrontal and parietal executive areas, instead of responding automatically to emotional stimuli. According to such models, the weaker executive area activation observed in depressed patients is attributable to a lack of cognitive control over negative emotions. Going beyond the concept of cognitive control, psychodynamic models describe the development of individuals' capacity to regulate their emotional states in mother-infant interactions during childhood, through the construction of the representation of the self, others, and relationships. In this mini-review, we link these psychodynamic models with recent findings regarding the abnormal functioning of the default system in depression. Consistently with psychodynamic models, psychological functions associated with the default system include self-related processing, semantic processes, and implicit forms of emotion regulation. The abnormal activation of the default system observed in depression may explain the dysfunctional aspects of emotion regulation typical of the condition, such as an exaggerated negative self-focus and rumination on self-esteem issues. We also discuss the clinical implications of these findings with reference to the therapeutic relationship as a key tool for revisiting impaired or distorted representations of the self and relational objects. PMID:27375536

  19. Histopathological study of endometrium in cases of abnormal uterine bleeding

    Saroj A. Bolde

    2014-08-01

    Full Text Available Background: Abnormal uterine bleeding is one of the commonest complaints in women and when it occurs without organic lesions like tumor, inflammation, it is called as dysfunctional uterine bleeding. Aim of current study was to find out the histopathological pattern of endometrium in Abnormal Uterine Bleeding (AUB also to study organic causes of AUB. Methods: Specimens received as endometrial curettage and hysterectomy specimens were studied followed by correlation of histopathology with age and clinical presentation. Results: The patients were mainly from the age group of 30-49 years (74.24%. The most common menstrual disorder was menorrhagia (46.86%. In dysfunctional uterine bleeding the most common histological pattern of endometrium includes proliferative endometrium (22.8% followed by endometrial hyperplasia (19.40%, atrophic endometrium (7.16%, secretory endometrium (5.97%, irregular shedding [1.80%], irregular ripening (1.20% and anovulatory endometrium (0.59%. Organic lesions encountered in AUB cases were leiomyoma (17.92%, endometrial polyp (1.79%, endometrial carcinoma (1.50%, endometriosis (0.59% and choriocarcinoma (0.29%. Conclusion: It is important to know the histological pattern of the endometrium like proliferative endometrium, endometrial hyperplasia, atrophic endometrium, secretory endometrium, irregular ripening and shredding and organic lesions in patients diagnosed as AUB in different age groups since recognition of these conditions will help and will avoid further complications. [Int J Res Med Sci 2014; 2(4.000: 1378-1381

  20. Robotic palpation and mechanical property characterization for abnormal tissue localization.

    Ahn, Bummo; Kim, Yeongjin; Oh, Cheol Kyu; Kim, Jung

    2012-09-01

    Palpation is an intuitive examination procedure in which the kinesthetic and tactile sensations of the physician are used. Although it has been widely used to detect and localize diseased tissues in many clinical fields, the procedure is subjective and dependent on the experience of the individual physician. Palpation results and biomechanics-based mechanical property characterization are possible solutions that can enable the acquisition of objective and quantitative information on abnormal tissue localization during diagnosis and surgery. This paper presents an integrated approach for robotic palpation combined with biomechanical soft tissue characterization. In particular, we propose a new palpation method that is inspired by the actual finger motions that occur during palpation procedures. To validate the proposed method, robotic palpation experiments on silicone soft tissue phantoms with embedded hard inclusions were performed and the force responses of the phantoms were measured using a robotic palpation system. Furthermore, we carried out a numerical analysis, simulating the experiments and estimating the objective and quantitative properties of the tissues. The results indicate that the proposed approach can differentiate diseased tissue from normal tissue and can characterize the mechanical information of diseased tissue, which means that this method can be applied as a means of abnormality localization to diagnose prostate cancers. PMID:22772733