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Sample records for abnormalities clinical history

  1. Diffuse white matter tract abnormalities in clinically normal ageing retired athletes with a history of sports-related concussions.

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    Tremblay, Sebastien; Henry, Luke C; Bedetti, Christophe; Larson-Dupuis, Camille; Gagnon, Jean-François; Evans, Alan C; Théoret, Hugo; Lassonde, Maryse; De Beaumont, Louis

    2014-11-01

    Sports-related concussions have been shown to lead to persistent subclinical anomalies of the motor and cognitive systems in young asymptomatic athletes. In advancing age, these latent alterations correlate with detectable motor and cognitive function decline. Until now, the interacting effects of concussions and the normal ageing process on white matter tract integrity remain unknown. Here we used a tract-based spatial statistical method to uncover potential white matter tissue damage in 15 retired athletes with a history of concussions, free of comorbid medical conditions. We also investigated potential associations between white matter integrity and declines in cognitive and motor functions. Compared to an age- and education-matched control group of 15 retired athletes without concussions, former athletes with concussions exhibited widespread white matter anomalies along many major association, interhemispheric, and projection tracts. Group contrasts revealed decreases in fractional anisotropy, as well as increases in mean and radial diffusivity measures in the concussed group. These differences were primarily apparent in fronto-parietal networks as well as in the frontal aspect of the corpus callosum. The white matter anomalies uncovered in concussed athletes were significantly associated with a decline in episodic memory and lateral ventricle expansion. Finally, the expected association between frontal white matter integrity and motor learning found in former non-concussed athletes was absent in concussed participants. Together, these results show that advancing age in retired athletes presenting with a history of sports-related concussions is linked to diffuse white matter abnormalities that are consistent with the effects of traumatic axonal injury and exacerbated demyelination. These changes in white matter integrity might explain the cognitive and motor function declines documented in this population. © The Author (2014). Published by Oxford University

  2. [Arthritis and clinical history].

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    Silva, Lígia; Sampaio, Luzia; Pinto, José; Ventura, Francisco S

    2011-01-01

    In front of a patient with arthritis, clinical good-sense tells that the most probable diagnosis are the most prevalent ones. Nevertheless, we have to exclude a multiplicity of other aetiologies, less frequent, but with highest implications in the therapeutic conduct. Infections by Brucella and by Borrelia are rare causes of chronic arthritis, yet are diagnosis to consider, even when the clinical manifestations aren't the most typical, as there still exist endemic areas in Portugal. Here we report two clinical cases about patients with arthritis for more than one year, subject to ineffective exams ant treatments. Only the clinical history could put on evidence clinical-epidemiological data, suggestive of Brucellosis and Lyme Disease, namely the professional contact with infected animals, and the history of probable erythema migrans, that pointed toward the correct diagnosis. So, with directed therapeutic, there was complete resolution of the inflammatory symptoms.

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

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

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    Susanti Halim

    2015-11-01

    Full Text Available Background An electroencephalogram (EEG is an electroimaging tool used to determine developmental and electrical problems in the brain. A history of severe asphyxia is a risk factor for these brain problems in infants. Objective To evaluate the prevalence of abnormal EEGs infull term neonates and to assess for an association with severe asphyxia, hypoxic ischemic encephalopathy (HIE, and spontaneous delivery. Methods This cross-sectional study was conducted at the Pediatric Outpatient Department of Sanglah Hospital, Denpasar, from November 2013 to January 2014. Subjects were fullterm infants aged 1 month who were delivered and/or hospitalized at Sanglah Hospital. All subjects underwent EEG. The EEGs were interpreted by a pediatric neurology consultant, twice, with a week interval between readings. Clinical data were obtained from medical records. Association between abnormal ECG and severe asphyxia were analyzed by Chi-square and multivariable logistic analyses. Results Of 55 subjects, 27 had a history of severe asphyxia and 28 were vigorous babies. Forty percent (22/55 of subjects had abnormal EEG findings, 19/22 of these subjects having history of severe asphyxia, 15/22 had history of hypoxic-ischemic encephalopathy (HIE, and 20/22 were delievered vaginally. There were strong correlations between the prevalence of abnormal EEG and history of severe asphyxia, HIE, and spontaneous delivery. Conclusion Prevalence of abnormal EEG among full-term neonates referred to neurology/growth development clinic is around 40%, with most of them having a history of severe asphyxia. Abnormal EEG is significantly associated to severe asphyxia, HIE, and spontaneous delivery.

  5. [The concept of tic in the history of abnormal movements].

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    Dordain, G

    1986-01-01

    History of abnormal movements started during the 14th century. At that time the St Vitus' Dance was described, but the nosology of dyskinesias remained confusing during the next five centuries. The concept of tic was elaborated in France during the 18th century. It remained too large a concept however. Definitive semiologies appeared at the end of the 19th century, thus allowing tics to emerge from the "chaos of choreas". The etymology of the word "tic" still remains mysterious. In 1905, Meige thought that the word tic was used for the first time by reference to horses. He referred to the tic of the bear in the horse described by Rudler and Chomel at The Société de Neurologie de Paris in 1903. Veterinarians were thus probably the first to describe the word. If so, however, the horse must leave anteriority to the goat. The word Ticq was used in 1611 as mentioned by the French dictionary Robert. The word is said to be an onomatopea and is compared to the italian word ticchio which means caprice. Another dictionary (Littré) suggest the german word "ticken", which means "to touch slightly", the galic word tacaid (sudden pain) and the german ziki (young goat), a word which could have lead to ticchio as capra, goat in italian, gave capricio.

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

    NARCIS (Netherlands)

    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

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

    NARCIS (Netherlands)

    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

  8. Family History Correlates of Digit Ratio Abnormalities in Schizophrenia

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    Anjith Divakaran

    2012-01-01

    Full Text Available Background: The differences in digit ratio are proposed to arise due to differential effects of sex steroids on the growth of finger bones. In this study, we sought to examine the sex differences and the influence of family history of psychosis on digit ratio in patients with schizophrenia compared to matched healthy controls (HCs. Materials and Methods: Digit ratio (2D: 4D was examined for a large sample of schizophrenia patients (n=200 and HC (n=177 to evaluate the potential effects of family history. Results: The right hand 2D: 4D digit ratio was lesser in schizophrenia patients compared to HC (0.97±0.05 vs 0.98±0.04, t=2.2, P=0.02. There was a significant difference in the right hand 2D: 4D digit ratio of female patients with schizophrenia when compared to female HCs (0.96±0.05 vs 0.98±0.03, t=2.1, P=0.03 while males showed no such difference on either hands. On the contrary, family history‑positive males showed a significantly greater digit ratio for the left hand (FH present (0.99±0.04 vs HC (0.97±0.04, t=2.15, P=0.03, while there was no difference between family history‑positive females and HC. Conclusion: Overall, in patients, reversal of expected "directionality" in digit ratio was observed in our study with greater left 2D: 4D in male patients having a family history of schizophrenia being a novel finding. Reversal of sexual dimorphism has been linked to the pathogenesis of schizophrenia. It is possible that such reversal might have a putative genetic basis, perhaps only in men with schizophrenia.

  9. Sperm DNA fragmentation abnormalities in men from couples with a history of recurrent miscarriage.

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    Leach, Mikaela; Aitken, Robert J; Sacks, Gavin

    2015-08-01

    Previous studies have described an association between sperm with DNA damage and a history of recurrent miscarriage (RM), although it is not clear whether there is benefit in screening for sperm DNA fragmentation and to what extent DNA fragmentation impacts upon RM. To identify what proportion of couples experiencing RM are affected by DNA fragmentation abnormalities. In this retrospective study, between 2008 and 2013, couples with a history of recurrent miscarriage (≥3 first trimester miscarriages) were investigated comprehensively for known causes (karyotype, uterine, antiphospholipid syndrome, thrombophilia) and also by semen analysis, including DNA fragmentation [sperm chromatin structure analysis (SCSA)]. Statistical analysis was performed on SPSS software with significance taken as P fragmentation index (DFI) of 9.50%. Normal levels were found in 70.5% of men (DFI 30%). Couples with otherwise unexplained recurrent miscarriage had significantly higher DFI than those with other causes identified on routine screening (P = 0.012). In couples experiencing RM, 30% (32/108) of men had sperm with high levels of DNA fragmentation (DFI > 15%). This may be a contributing factor to the clinical syndrome of RM, and future clinical trials of therapies for these couples are warranted. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  10. Fixed and dilated: the history of a classic pupil abnormality.

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    Koehler, Peter J; Wijdicks, Eelco F M

    2015-02-01

    The aim of this study was to investigate the development of ideas about the nature and mechanism of the fixed dilated pupil, paying particular attention to experimental conditions and clinical observations in the 19th century. Starting from Kocher's standard review in 1901, the authors studied German, English, and French texts for historical information. Medical and neurological textbooks from the 19th and 20th centuries were reviewed to investigate when and how this information percolated through neurological and neurosurgical practices. Cooper experimented with intracranial pressure (ICP) in a dog in the 1830s, but did not mention the pupils. He described dilated pupils in clinical cases without referring to the effect of light. Bright demonstrated to have some knowledge of the pupil sign (clinical observations). Realizing the unreliability of the pupil sign, Hutchinson in 1867-1868 tried to reason in which cases trepanation would be advisable. Von Leyden's 1866 animal experiments, in which he increased CSF volume by injecting protein solutions intracranially, was the first observation in which the association between fixed dilated pupils and increased ICP was established. Along with bradycardia and motor and respiratory effects, he noticed wide pupils were usually present in a comatose state. Asymmetrical dilation could not always be attributed to increased ICP, but to an oculomotor nerve lesion. Pagenstecher in 1871 extended knowledge by meticulously studying consecutive pupil phenomena with increasing pressure. In 1880, von Bergmann emphasized the significance of the ipsilateral dilation in experiments as well as in clinical cases. He distinguished the extent of pressure increase and its duration. Probably confusing irritation (epileptic head turning to the other side with pupil dilation) and lesion effects, he suggested a cortical area responsible for oculomotor phenomena, indicating what is now known as the frontal eye field. Naunyn and Schreiber (1881

  11. Clinical predictors of abnormal head computed tomography scan in patients who are conscious after head injury

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    Mishra, Rakesh Kumar; Munivenkatappa, Ashok; Prathyusha, Vasuki; Shukla, Dhaval P.; Devi, Bhagavatula Indira

    2017-01-01

    Background: Indication of a head computed tomography (CT) scan in a patient who remains conscious after head injury is controversial. We aimed to determine the clinical features that are most likely to be associated with abnormal CT scan in patients with a history of head injury, and who are conscious at the time of presentation to casualty. Materials and Methods: This is a prospective observation study of patients presented to casualty with history of head injury, and who were conscious, i.e., Glasgow Coma Scale (GCS) 15 at the time of evaluation. All patients underwent head CT scan. The CT scan was reported as abnormal if it showed any pathology ascribed to trauma. The following variables were used: age, gender, mode of injury (road traffic accident, fall, assault, and others), duration since injury, and history of transient loss of consciousness, headache, vomiting, ear/nose bleeding, and seizures. Logistic regression analysis was used to identify the clinical features that predicted an abnormal CT scan. Results: During the observation period, a total of 1629 patients with head injury were evaluated, out of which 453 were in GCS 15. Abnormal CT scan was present in 195 (43%) patients. Among all the variables, the following were found significantly associated with abnormal CT scan: duration since injury (>12 h) P < 0.001; vomiting odds, ratio (OR) 1.89 (1.23, 2.80), P < 0.001; and presence of any symptom, OR 2.36 (1.52, 3.71), P < 0.001. Conclusion: A patient with GCS 15 presenting after 12 hours of injury with vomiting or combination of symptoms has a significant risk of abnormal head CT scan.

  12. Clinical predictors of abnormal head computed tomography scan in patients who are conscious after head injury

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    Rakesh Kumar Mishra

    2017-01-01

    Full Text Available Background: Indication of a head computed tomography (CT scan in a patient who remains conscious after head injury is controversial. We aimed to determine the clinical features that are most likely to be associated with abnormal CT scan in patients with a history of head injury, and who are conscious at the time of presentation to casualty. Materials and Methods: This is a prospective observation study of patients presented to casualty with history of head injury, and who were conscious, i.e., Glasgow Coma Scale (GCS 15 at the time of evaluation. All patients underwent head CT scan. The CT scan was reported as abnormal if it showed any pathology ascribed to trauma. The following variables were used: age, gender, mode of injury (road traffic accident, fall, assault, and others, duration since injury, and history of transient loss of consciousness, headache, vomiting, ear/nose bleeding, and seizures. Logistic regression analysis was used to identify the clinical features that predicted an abnormal CT scan. Results: During the observation period, a total of 1629 patients with head injury were evaluated, out of which 453 were in GCS 15. Abnormal CT scan was present in 195 (43% patients. Among all the variables, the following were found significantly associated with abnormal CT scan: duration since injury (>12 h P< 0.001; vomiting odds, ratio (OR 1.89 (1.23, 2.80, P< 0.001; and presence of any symptom, OR 2.36 (1.52, 3.71, P< 0.001. Conclusion: A patient with GCS 15 presenting after 12 hours of injury with vomiting or combination of symptoms has a significant risk of abnormal head CT scan.

  13. Clinical Prediction of Fall Risk and White Matter Abnormalities

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    Koo, Bang-Bon; Bergethon, Peter; Qiu, Wei Qiao; Scott, Tammy; Hussain, Mohammed; Rosenberg, Irwin; Caplan, Louis R.; Bhadelia, Rafeeque A.

    2015-01-01

    Background The Tinetti scale is a simple clinical tool designed to predict risk of falling by focusing on gait and stance impairment in elderly persons. Gait impairment is also associated with white matter (WM) abnormalities. Objective To test the hypothesis that elderly subjects at risk for falling, as determined by the Tinetti scale, have specific patterns of WM abnormalities on diffusion tensor imaging. Design, Setting, and Patients Community-based cohort of 125 homebound elderly individuals. Main Outcome Measures Diffusion tensor imaging scans were analyzed using tract-based spatial statistics analysis to determine the location of WM abnormalities in subjects with Tinetti scale scores of 25 or higher (without risk of falls) and lower than 25 (with risk of falls). Multivariate linear least squares correlation analysis was performed to determine the association between Tinetti scale scores and local fractional anisotropy values on each skeletal voxel controlling for possible confounders. Results In subjects with risk of falls (Tinetti scale score scores, while the other locations were unrelated to these scores. Conclusions Elderly individuals at risk for falls as determined by the Tinetti scale have WM abnormalities in specific locations on diffusion tensor imaging, some of which correlate with cognitive function scores. PMID:22332181

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

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    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…

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

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    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.

  16. History of clinical pharmacy and clinical pharmacology.

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    Miller, R R

    1981-04-01

    The purpose of the Symposium on Clinical Pharmacy and Clinical Pharmacology is to describe the present and future functional roles of clinical pharmacists and clinical pharmacologists in drug research, professional education, and patient care. Clinical pharmacy is a relatively new professional discipline, being only about 15 years old. This new breed of pharmacists is patient rather than drug product oriented. The discipline arose out of dissatisfaction with old practice norms and the pressing need for a health professional with a comprehensive knowledge of the therapeutic use of drugs. The clinical pharmacy movement began at the University of Michigan in the early 1960s, but much of the pioneering work was done by David Burkholder, Paul Parker, and Charles Walton at the University of Kentucky in the latter part of the 1960s. Clinical pharmacology is a professional discipline that combines basic pharmacology and clinical medicine. Its development began in the early 1950s, primarily as a result of the efforts of Harry Gold. It has had a slower growth than clinical pharmacy but it has made many important contributions to our knowledge of human pharmacology and the rational use of drugs.

  17. The role of Histopathology, Endometrium Thickness and Obstetric History in Abnormal Uterine Bleeding

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    Turkan Cengiz

    2016-09-01

    Full Text Available Aim: To evaluate the clinical manifestations of abnormal uterine bleeding (AUB, ultrasonography findings and compare with histopathological results.Material and Method: A total of 404 women with AUB were classified as; Group I: 18-39 years, Group II: 40-50 years, Group III: >50 years old. Age, parity, bleeding pattern, menstrual history, laboratory results, ultrasonography and histopathological findings were evaluated. Results: Almost half presented with AUB were in the premenopausal group [196 (48.51%], followed by 150(37.13% postmenopausal group and 58(14.36% reproductive age group. The most common bleeding pattern was menometrorrhagia followed by metrorrhagia. Endometrial pathologies were observed in 306 (75.74% and normal menstrual pattern in 98 (24.26% participants of AUB. Endometrium cancer was seen in 7 (1.7% women. In the reproductive period most common pathology was hormonal imbalance pattern. Endometrial polyp was the dominant pathology in premenopausal and postmenopausal age groups. All malignancy cases were in the postmenopausal age group. Malignancy was in 4(19.04% women who gave birth < 3 and in 1(4.76% who had %u22653 children. Four women with vaginal delivery had malignancy whereas no malignancy was seen in women with only cesarean history. Among 109 women who had endometrial thickness 4mm, 30 (10.17% had endometrial hyperplasia, 6(2.03% had endometrium cancer. Discussion: Transvaginal ultrasonography can be used as diagnostic method to evaluate endometrial thickness and differentiate uterine pathologies. However in the case of recurrent uterine bleeding, endometrial sampling should be performed disregarding ultrasonography findings.

  18. Clinical enzymology: an autobiographical history.

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    Goldberg, David M

    2005-07-24

    In this paper, I review the origins of Clinical Enzymology with special emphasis on the years between 1960 and 1980 when the greatest advances in the subject took place. These are described in relation to my own research interests and contributions, focusing upon subclinical hepatic damage caused by viral infection and by alcohol; myocardial infarction; detection of cervical carcinoma by vaginal fluid analysis; evaluation of pancreatic function; and the clinical implications of microsomal enzyme induction. Reasons are proposed for the failure of enzymology to attain the status of an autonomous medical specialty, in contrast to the success of similar fields of knowledge that grew up in the same era.

  19. Prenatal diagnosis of congenital fetal heart abnormalities and clinical analysis

    Institute of Scientific and Technical Information of China (English)

    LI Hui; WEI Jun; MA Ying; SHANG Tao

    2005-01-01

    Objective: To study the value of detecting fetal congenital heart disease (CHD) using the five transverse planes technique of fetal echocardiography. Methods: Nine hundred and eighty-two high-risk pregnancies for fetal CHD were included in this study, the fetal heart was scanned with the five transverse planes technique of fetal echocardiography described by yagel, autopsy was conducted when pregnancy was terminated. Blood from fetal heart was collected for fetal chromosome analysis. A close follow-up was given for normal fetal heart pregnancies and neconatal echocardiography was performed to check the accuracy of prenatal diagnosis. Results: (1) Forty-six cases(4.68%) were found to have fetal heart abnormalities in this study, 69.56% of them were diagnosed by single four-chamber view, another 30.43% fetal CHD were found by combining other views; (2) Fotry-one parents of prenatal fetuses with CHD chose to terminate pregnancy, thirty-two of them gave consent to conduct autopsy, 93.75% of which yielded unanimous conclusion between prenatal fetal echocardiography and autopsy; (3) Thirty-two of 46 cases underwent fetal chromosome analysis, 8 cases (25%) were found to have abnormal chromosome; (4) Five cases were found to have right ventricle and atrium a little bigger than those on the left side, with the unequal condition being the same after birth, but there were no clinical manifestations and they are healthy for the time being; (5) Nine hundred and thirty-six cases were not found with abnormality in this study, but one case was diagnosed with ventricular septal defect after birth, one case was diagnosed with patent ductus arteriosus, one case had atrial septal defect after birth. Conclusions: (1) The detected CHD rate was 4.68% by screening fetal heart with five transverse planes according to Yagel's description of high risk population basis for CHD. The coinciding rate of prenatal diagnosis and autopsy was 93.75%; (2) The sensitivity of detecting fetal heart

  20. Abnormal Congenital Location of Stapes’ Superstructure: Clinical and Embryological Implications

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    Vânia Henriques

    2016-01-01

    Full Text Available Congenital middle ear malformations are rare. Most part of them are usually associated with other malformations, such as aural atresia, microtia, and dysmorphic craniofacial features. A clinical case of a 24-year-old male with a right-sided conductive hearing loss since his childhood, without craniofacial malformation, is presented. He was proposed for exploratory tympanotomy under the suspicious diagnosis of otosclerosis. The surgery revealed an abnormal location of stapes’ superstructure, which was attached to the promontory and had an isolated and mobile osseous footplate in the oval window. A stapes prosthesis was inserted and resulted in closure of the air-bone gap by 25 dB. A review of the literature was also performed using MEDLINE. Two theories diverge on the embryologic origin of the stapes. Our findings seem to be in favour of the theory that defines two different embryologic origins to the stapes.

  1. Abnormal Congenital Location of Stapes' Superstructure: Clinical and Embryological Implications

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    Teles, Rafaela; Sousa, Ana; Estevão, Roberto; Rodrigues, Jorge; Gomes, Alexandra; Silva, Francisco; Fernandes, Ângelo; Fernandes, Fausto

    2016-01-01

    Congenital middle ear malformations are rare. Most part of them are usually associated with other malformations, such as aural atresia, microtia, and dysmorphic craniofacial features. A clinical case of a 24-year-old male with a right-sided conductive hearing loss since his childhood, without craniofacial malformation, is presented. He was proposed for exploratory tympanotomy under the suspicious diagnosis of otosclerosis. The surgery revealed an abnormal location of stapes' superstructure, which was attached to the promontory and had an isolated and mobile osseous footplate in the oval window. A stapes prosthesis was inserted and resulted in closure of the air-bone gap by 25 dB. A review of the literature was also performed using MEDLINE. Two theories diverge on the embryologic origin of the stapes. Our findings seem to be in favour of the theory that defines two different embryologic origins to the stapes. PMID:27648330

  2. Hemifacial spasm and postural abnormalities; clinical and posturographical analyses.

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    Degirmenci, Eylem; Oguzhanoglu, Attila; Atalay, Nilgun; Sahin, Fusun

    2015-09-01

    Hemifacial spasm (HFS) is defined as an involuntary, irregular clonic, or tonic movement of muscles innervated by the ipsilateral seventh cranial nerve. It is reported that the coexistence of non-motor- and motor-related symptoms can be seen in patients with HFS. Postural disturbances were investigated in some movement disorders; however, postural abnormalities due to HFS had not been reported before. In this study, we aimed to investigate the postural abnormalities in patients with HFS. In this cross-sectional, controlled study, Tinetti Balance and Gait Test (TBGT) scores and static posturography were performed on fifteen patients with HFS and fifteen healthy age- and sex-matched controls. The total TBGT score and TBGT-balance score were found to be significantly lower in the patient group than in the control group (p values were, respectively, 0.046 and 0.011). The ratio of the patients with high risk of falling was 40 %, and the difference was found to be significantly higher in the patient group (p value = 0.008). In Fourier analyses, a significant difference was found in the medium to high frequencies (F5-6) when the posturographic evaluation was performed on a solid ground with closed eyes, head rotated to right, and head rotated to the left positions (p values were, respectively, 0.045 and 0.007). The stability index of the HFS group was significantly higher than the control group when tested on the neutral, head right, and head left positions (p values were, respectively, 0.004, 0.049, and 0.003). In conclusion, our study showed that the patients with HFS have more balance and falling problems than the controls, which can be both clinically and posturographically determined.

  3. Abnormal Bleeding During Menopause Hormone Therapy: Insights for Clinical Management

    OpenAIRE

    2013-01-01

    Objective Our objective was to review the involved mechanisms and propose actions for controlling/treating abnormal uterine bleeding during climacteric hormone therapy. Methods A systemic search of the databases SciELO, MEDLINE, and Pubmed was performed for identifying relevant publications on normal endometrial bleeding, abnormal uterine bleeding, and hormone therapy bleeding. Results Before starting hormone therapy, it is essential to exclude any abnormal organic condition, identify women a...

  4. Carpenter syndrome: natural history and clinical spectrum.

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    Robinson, L K; James, H E; Mubarak, S J; Allen, E J; Jones, K L

    1985-03-01

    Recently, we evaluated three sibs with Carpenter syndrome, permitting further clinical, orthopedic, radiographic, and psychometric delineation of this disorder. All three patients were operated on for craniostenosis at or before 2 months. Although all had gross motor delay in early infancy, two had normal intelligence at 12 months and 10 years, respectively. Bony abnormalities contributed to functional impairment especially in the older children. Preaxial polydactyly of feet was present in all three affected sibs and in all other reported individuals with this condition, allowing differentiation of Carpenter syndrome from the other autosomal-recessive acrocephalopolysyndactyly syndromes.

  5. Diffusion abnormality maps in demyelinating disease: correlations with clinical scores.

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    Onu, Mihaela; Roceanu, Adina; Sboto-Frankenstein, Uta; Bendic, Robert; Tarta, Eugen; Preoteasa, Florentin; Bajenaru, Ovidiu

    2012-03-01

    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. Eight patients and 12 matched healthy controls were recruited. The Multiple Sclerosis Functional Composite was administered. For MR-DTI acquisitions, a Genesis Signa 1.5 T MR system, an EP/SE scanning sequence, 25 gradient directions were used. 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 25 FW score; between λ2 and: P100 (r&l), 9-HPT(NON)DOM and 25 FW; between λ3 and: 9-HPT(NON)DOM and 25 FW score. 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. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  6. Natural History of the Central Structural Abnormalities in Choroideremia: A Prospective Cross-Sectional Study.

    Science.gov (United States)

    Aleman, Tomas S; Han, Grace; Serrano, Leona W; Fuerst, Nicole M; Charlson, Emily S; Pearson, Denise J; Chung, Daniel C; Traband, Anastasia; Pan, Wei; Ying, Gui-Shuang; Bennett, Jean; Maguire, Albert M; Morgan, Jessica I W

    2017-03-01

    To describe in detail the central retinal structure of a large group of patients with choroideremia (CHM). A prospective, cross-sectional, descriptive study. Patients (n = 97, age 6-71 years) with CHM and subjects with normal vision (n = 44; ages 10-50 years) were included. Subjects were examined with spectral-domain optical coherence tomography (SD OCT) and near-infrared reflectance imaging. Visual acuity (VA) was measured during their encounter or obtained from recent ophthalmic examinations. Visual thresholds were measured in a subset of patients (n = 24) with automated static perimetry within the central regions (±15°) examined with SD OCT. Visual acuity and visual thresholds; total nuclear layer, inner nuclear layer (INL), and outer nuclear layer (ONL) thicknesses; and horizontal extent of the ONL and the photoreceptor outer segment (POS) interdigitation zone (IZ). Earliest abnormalities in regions with normally appearing retinal pigment epithelium (RPE) were the loss of the POS and ellipsoid zone associated with rod dysfunction. Transition zones (TZs) from relatively preserved retina to severe ONL thinning and inner retinal thickening moved centripetally with age. Most patients (88%) retained VAs better than 20/40 until their fifth decade of life. The VA decline coincided with migration of the TZ near the foveal center. There were outer retinal tubulations in degenerated, nonatrophic retina in the majority (69%) of patients. In general, RPE abnormalities paralleled photoreceptor degeneration, although there were regions with detectable but abnormally thin ONL co-localizing with severe RPE depigmentation and choroidal thinning. Abnormalities of the POS and rod dysfunction are the earliest central abnormalities observed in CHM. Foveal function is relatively preserved until the fifth decade of life. Migration of the TZs to the foveal center with foveal thinning and structural disorganization heralded central VA loss. The relationships established may help

  7. Video Taping and Abnormal Psychology: Dramatized Clinical Interviews.

    Science.gov (United States)

    Lyons, Michael J.; And Others

    1984-01-01

    Students in an abnormal psychology course worked in teams to produce dramatizations of diagnostic interviews and then presented them in class. Positive and negative aspects of the activity are discussed. (RM)

  8. Abnormal Bleeding During Menopause Hormone Therapy: Insights for Clinical Management

    Science.gov (United States)

    de Medeiros, Sebastião Freitas; Yamamoto, Márcia Marly Winck; Barbosa, Jacklyne Silva

    2013-01-01

    Objective Our objective was to review the involved mechanisms and propose actions for controlling/treating abnormal uterine bleeding during climacteric hormone therapy. Methods A systemic search of the databases SciELO, MEDLINE, and Pubmed was performed for identifying relevant publications on normal endometrial bleeding, abnormal uterine bleeding, and hormone therapy bleeding. Results Before starting hormone therapy, it is essential to exclude any abnormal organic condition, identify women at higher risk for bleeding, and adapt the regimen to suit eachwoman’s characteristics. Abnormal bleeding with progesterone/progestogen only, combined sequential, or combined continuous regimens may be corrected by changing the progestogen, adjusting the progestogen or estrogen/progestogen doses, or even switching the initial regimen to other formulation. Conclusion To diminish the occurrence of abnormal bleeding during hormone therapy (HT), it is important to tailor the regimen to the needs of individual women and identify those with higher risk of bleeding. The use of new agents as adjuvant therapies for decreasing abnormal bleeding in women on HT awaits future studies. PMID:24665210

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Vascular and baroreceptor abnormalities in young males with a family history of hypertension.

    Science.gov (United States)

    Boutcher, Yati N; Park, Young J; Boutcher, Stephen H

    2009-12-01

    Vascular and baroreceptor abnormalities in 44 young males, mean age 21 years, comprising of offspring with (FH(+); n = 22) and without (FH(-); n = 22) hypertensive parents, were investigated. Peak forearm blood flow (FBF), which was defined as the highest blood flow obtained following reactive hyperaemia, was assessed using strain gauge plethysmography following 5 min of ischemia. Cardiopulmonary baroreceptor sensitivity was assessed using lower body negative pressure for 5 min at -20 mmHg and was determined by calculating change of stroke volume and forearm vascular resistance (FVR) to lower body negative pressure. Carotid baroreceptor sensitivity was assessed using neck suction at -20, -40, -60, and -80 mmHg and was calculated by dividing RR interval by systolic blood pressure. Augmentation index, a measure of wave reflection, was assessed using applanation tonometry and was calculated as the ratio of augmented pressure and pulse pressure. Peak FBF of FH(+) was 19% lower than the FH(-) (p = 0.02). Also FH(+) had 17% higher peak FVR compared to FH(-) (p = 0.04). However, there were no significant differences between groups for cardiopulmonary, carotid baroreceptor sensitivity, and augmentation index. These results suggest that peripheral vascular dysfunction appears earlier than abnormal baroreceptor sensitivity in young males with a family history of hypertension.

  11. Abnormal echocardiography in patients with type 2 diabetes and relation to symptoms and clinical characteristics

    DEFF Research Database (Denmark)

    Jørgensen, Peter Godsk; Jensen, Magnus Thorsten; Mogelvang, Rasmus

    2016-01-01

    OBJECTIVES: We aimed to determine the prevalence of echocardiographic abnormalities and their relation to clinical characteristics and cardiac symptoms in a large, contemporary cohort of patients with type 2 diabetes. RESULTS: A total of 1030 patients with type 2 diabetes participated....... Echocardiographic abnormalities were present in 513 (49.8%) patients, mainly driven by a high prevalence of diastolic dysfunction 178 (19.4%), left ventricular hypertrophy 213 (21.0%) and left atrial enlargement, 200 (19.6%). The prevalence increased markedly with age from 31.1% in the youngest group (... with abnormal echocardiography along with dyspnoea and characteristic chest pain (p patients with abnormal echocardiography. CONCLUSION: Echocardiographic abnormalities...

  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.

    Science.gov (United States)

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

    2013-03-01

    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. Natural history of splenic vascular abnormalities after blunt injury: A Western Trauma Association multicenter trial.

    Science.gov (United States)

    Zarzaur, Ben L; Dunn, Julie A; Leininger, Brian; Lauerman, Margaret; Shanmuganathan, K; Kaups, Krista; Zamary, Kirellos; Hartwell, Jennifer L; Bhakta, Ankur; Myers, John; Gordy, Stephanie; Todd, Samuel R; Claridge, Jeffrey A; Teicher, Erik; Sperry, Jason; Privette, Alicia; Allawi, Ahmed; Burlew, Clay Cothren; Maung, Adrian A; Davis, Kimberly A; Cogbill, Thomas; Bonne, Stephanie; Livingston, David H; Coimbra, Raul; Kozar, Rosemary A

    2017-05-30

    Following blunt splenic injury (BSI) there is conflicting evidence regarding the natural history and appropriate management of patients with vascular injuries of the spleen such as pseudoaneurysms or blushes. The purpose of this study was to describe the current management and outcomes of patients with PSA or BLUSH. Data was collected on adult (≥18) patients with BSI and a splenic vascular injury from 17 trauma centers. Demographic, physiologic, radiographic, and injury characteristics were gathered. Management and outcomes were collected. Univariate and multivariable analyses were used to determine factors associated with splenectomy. Two hundred patients with a vascular abnormality on CT scan were enrolled. Of those, 14.5% were managed with early splenectomy. Of the remaining, 59% underwent angiography and embolization (ANGIO) and 26.5% were observed. Of those who underwent ANGIO, 5.9% had a repeat ANGIO and 6.8% had splenectomy. Of those observed, 9.4% had a delayed ANGIO and 7.6% underwent splenectomy. There were no statistically significant differences between those observed and those who underwent ANGIO. There were 111 CT scans with splenic vascular injuries available for review by an expert trauma radiologist. The concordance between the original classification of the type of vascular abnormality and the expert radiologist's interpretation was 56.3%. Based on expert review the presence of an actively bleeding vascular injury was associated with a 40.9% risk of splenectomy. This was significantly higher than those with a non-bleeding vascular injury. In this series, the vast majority of patients are managed with ANGIO and usually embolization while splenectomy remains a rare event. However, patients with a bleeding vascular injury of the spleen are at high risk of non-operative failure no matter the strategy used for management. This group may warrant closer observation or an alternative management strategy. Prognostic Level III.

  14. Clinical neurophysiological correlates of histopathological abnormalities in epilepsy surgery

    NARCIS (Netherlands)

    Ferrier, C.H.

    2006-01-01

    In search for variables that determine outcome in patients with pharmacoresistant epilepsy who undergo epilepsy surgery, we identified specific combinations of clinical neurophysiological findings with their underlying histopathology. These findings may have important surgical consequences. In a

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

    Directory of Open Access Journals (Sweden)

    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

  16. [Heterogenous abnormality polymorphism of gene PDGFRB in myeloid neoplasms and its clinical characteristics].

    Science.gov (United States)

    Wang, Quan-Shun; Gao, Li; Jing, Yu; Zhu, Hai-Yan; Yang, Hua; Yu, Li

    2012-04-01

    Myeloid neoplasms with eosinophilia and abnormalities of PDGFRB gene are a new kind of myeloid disorders in the revised 2008 WHO classification. Out of detected 2000 cases of myeloid cell abnormalities in our hospital, 12 cases of myeloid neoplasms with eosinophilia and abnormalities of PDGFRB were found. This study was purposed to summarize and analyze the clinical and laboratorial characteristics of the 12 cases with PDGFRB gene abnormalities. The results indicated that among 12 cases of myeloid neoplasms with PDGFRB abnormalities, 5 cases with TEL/PDGFRB fusion gene, 2 cases with HEPI/PDGFRB, 1 case with PDGFRB mutation, 1 case with RABAPTIN-5/PDGFRB, 1 case with GIT2/PDGFRB, 1 case with TP53/PDGFRB, 1 case with WDR43/PDGFRB fusion gene were detected, showing the polymorphism of PDGFRB gene abnormalities. Among this kind of myeloid neoplasm patients, almost all patients manifested monocytosis and eosinophilia in different degree, the thrombocytosis mainly was observed in atypical myeloid neoplasms, acute leukemia, chromic myelo-monocytic leukemia patients. The treatment with imatinib mesylate for this kind of patients was effective in some cases. It is concluded that the myeloid neoplasms with PDGFRB gene abnormalities are a kind of heterogenetic myeloid neoplasms, their gene abnormal types and clinical manifestations show polymorphism too. The monocytosis and eosinophilia appear in this kind myeloid neoplasms which may be treated with tyrosine kinase inhibitors such as imatinib mesylate.

  17. Update on Clinical Features and Brain Abnormalities in Neurogenetics Syndromes

    Science.gov (United States)

    Jackowski, Andrea Parolin; Laureano, Maura Regina; Del'Aquilla, Marco Antonio; de Moura, Luciana Monteiro; Assuncao, Idaiane; Silva, Ivaldo; Schwartzman, Jose Salomao

    2011-01-01

    Neuroimaging methods represent a critical tool in efforts to join the study of the neurobiology of genes with the neurobiology of behaviour, and to understand the neurodevelopmental pathways that give rise to cognitive and behavioural impairments. This article reviews the clinical features and highlights studies with a focus on the relevant…

  18. Clinical factors associated with abnormal postures in Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Tomoko Oeda

    Full Text Available BACKGROUND: Abnormal posture (AP is often seen in Parkinson's disease (PD, and marked forms known as dropped head syndrome and camptocormia encumber daily living activities. Unlike other motor disabilities such as bradykinesia or muscular rigidity, AP is not always improved but rather deteriorated by PD medication. PURPOSE: To clarify factors associated with neck and thoracolumbar AP. METHODS: Neck flexion (NF and thoracolumbar (TL angles were measured in 216 consecutive PD patients and 175 elderly healthy controls. The differences in NF and TL angles between PD patients and controls were designated as ΔNFA and ΔTLA, respectively. The association of ΔNFA or ΔTLA and predictable factors such as age, sex, duration of PD, Hoehn Yahr (H-Y stage, Unified Parkinson's Disease Rating Scale Part 3 (UPDRS-3, daily dose of dopamine agonists, and comorbid orthopedic spinal lesions was investigated in PD patients. Patients were divided into quartiles according to ΔNFA or ΔTLA. The association between predictable factors and ΔNFA or ΔTLA was estimated as odds ratio (OR, comparing with the lowest quartile as the reference by multivariate regression analysis. RESULTS: Compared with controls, distributions of all three posture angles were significantly shifted rightward in PD patients. Although there were no difference in UPDRS-3 scores in the quartiles of ΔNFA, the highest quartile was associated with H-Y stage ≥3 [OR 2.99, 95% confidence interval (CI 1.33-6.70, p = 0.008] after adjustment for age, sex and comorbid orthopedic spinal lesions. The highest quartile of ΔTLA was associated with comorbid orthopedic spinal lesions [OR 5.83 (1.42-23.8, p = 0.014], and UPDRS-3 score [OR 3.04 (1.80-5.15/10 points, p<0.0001]. CONCLUSION: Thoraco-lumbar AP was associated with UPDRS-3 scores and orthopedic spinal lesions, and in contrast, neck AP was not associated with these factors, suggesting that they had different pathomechanisms.

  19. Is a history of cesarean section a risk factor for abnormal uterine bleeding in patients with uterine leiomyoma?

    OpenAIRE

    2016-01-01

    Objectives: To determine whether a history of cesarean section was a risk factor for abnormal uterine bleeding in patients with uterine leiomyomas, and to identify other risk factors for this symptom. Methods: We analyzed retrospectively, the medical records of patients who underwent hysterectomies due to the presence of uterine leiomyomas during a 6-year period (2009 and 2014) at Etlik Zubeyde Hanim Women’s Health Training and Research Hospital, Ankara, Turkey. Uterine leiomyoma was diagnose...

  20. [Abnormality of blood coagulation indexes in patients with de novo acute leukemia and its clinical significance].

    Science.gov (United States)

    Xiao, Fang-Fang; Hu, Kai-Xun; Guo, Mei; Qiao, Jian-Hui; Sun, Qi-Yun; Ai, Hui-Sheng; Yu, Chang-Lin

    2013-04-01

    To explore hemorrhage risk and the clinical significance of abnormal change of prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen (FIB), plasma thrombin time (TT) and d-dimer (D-D) in de novo acute leukemia (except for APL), the different bleeding manifestations of 114 cases of de novo acute leukemia with different coagulation indexes were analyzed retrospectively. The correlation between these blood coagulation indexes and the possible correlative clinical characteristics were analysed, including age, sex, type of acute leukemia, initial white blood cell(WBC) and platelet(Plt) count, the proportion of blast cells in bone marrow and cytogenetic abnormality of patients at diagnosis. The results indicated that the incidence of abnormal blood coagulation was as high as 78.1% for de novo AL patients. These patients with 5 normal blood coagulation indexes may have mild bleeding manifestation, but the more abnormal indexes, the more severe bleeding. Both PT and D-D were sensitive indexes for diagnosis of level II bleeding. Incidence of abnormal blood coagulation significantly correlates with the proportion of blast cells in bone marrow (χ(2) = 4.184, OR = 1.021, P coagulation. It is concluded that the coagulation and fibrinolysis are abnormal in most patients with de novo acute leukemia. More abnormal indexes indicate more severe bleeding, and both PT and D-D are sensitive indexes for diagnosis of level II bleeding. Higher proportion of blast cells in bone marrow predicts higher incidence of abnormal blood clotting. Acute leukemia with elderly age, high white blood cell count and adverse cytogenetics do not predict severer abnormal blood clotting. Detection of PT, APTT, TT, FIB, and D-D may help to judge whether the patients are in a state of hypercoagulability or disseminated intravenous coagulation, which will provide experiment evidences for early intervention and medication.

  1. [Clinical characteristics of splenic marginal zone lymphoma with abnormal complete blood count].

    Science.gov (United States)

    Yang, Shen-Miao; Jiang, Qian; Jiang, Bin; Chen, Ding-Bao; Wang, Jing; Jiang, Hao; Lu, Jin; Lu, Xi-Jing; Bao, Li; Shi, Hong-Xia; Liu, Yan-Rong; Huang, Xiao-Jun

    2013-02-01

    The aim of this study was to investigate the clinical and laboratorial characteristics of splenic marginal zone lymphoma (SMZL) with an abnormal complete blood count (CBC). Data of 19 newly diagnosed SMZL patients with abnormal CBC were analyzed retrospectively. Seven patients were diagnosed by using splenic histology, 12 patients who did not undergo splenectomy were diagnosed on the basis of typical clinical presentation and cytologic, immunophenotypic and histologic characteristics of peripheral blood and bone marrow, according to SBLG guidelines. The results showed that leukocytosis (≥ 10.0×10(9)/L) was seen in 5 cases (26.3%); leukocytopenia (complete response was achieved in 9 out of 11 (81.8%) patients. It is concluded that SMZL with abnormal CBC has a higher incidence of cytopenia, bone marrow involvement and autoimmune phenomena. Therapeutic strategies consisting of Rituximab show a better efficacy.

  2. Cytogenetic abnormalities and clinical stage in testicular nonseminomatous germ cell tumors

    NARCIS (Netherlands)

    de Graaff, W E; van Echten-Arends, J; Oosterhuis, J W; de Jong, B; te Meerman, G J; Wiersema-Buist, J; Sleijfer, D T; Schraffordt Koops, H

    1993-01-01

    To study the impact of chromosomal abnormalities on the clinical behavior of testicular nonseminomatous germ cell tumors (TNSGCTs), we compared the chromosomal constitution of primary tumors of patients who initially presented and remained without metastases to those with metastatic disease. Further

  3. Clinical prediction of fall risk and white matter abnormalities: a diffusion tensor imaging study

    Science.gov (United States)

    The Tinetti scale is a simple clinical tool designed to predict risk of falling by focusing on gait and stance impairment in elderly persons. Gait impairment is also associated with white matter (WM) abnormalities. Objective: To test the hypothesis that elderly subjects at risk for falling, as deter...

  4. Clinical Spectrum, Risk Factors, and Behavioral Abnormalities among Dementia Subtypes in a North Indian Population: A Hospital-Based Study

    Directory of Open Access Journals (Sweden)

    Suman Kushwaha

    2017-07-01

    Full Text Available Background: As variability in the clinical profile of dementia subtypes had been reported with regional differences across the world, we conducted a retrospective hospital-based study in a North Indian population. Methods: We retrieved patient records from 2007 to 2014 for details of clinical evaluation, diagnosis, neuroimaging, biochemical investigations, and follow-up of 1,876 patients with dementia (PwD, and the data were analyzed using descriptive statistics. Results: Of the total PwD, Alzheimer disease (AD accounted for 30% followed by vascular dementia (VaD 26%, mixed dementia (MD 21%, Parkinson-related dementia 11%, frontotemporal dementia (FTD 7%, and infective dementia 5%. Of all PwD excluding the infective group (n = 1,777, 63% were men, 39% were from rural areas, 87% had behavioral abnormalities along with cognitive deficits, and 73% had impaired ADLs. Among dementia subtypes, a positive family history, cardiovascular and metabolic risk factors, and behavioral abnormalities were found to be distributed. However, there existed a predominance of specific behavioral pattern in each subtype. The mean duration of follow-up varied from 2.9 ± 2.3 (VaD to 3.6 ± 2.1 (AD and greater than 30% were found to be stable on treatment (except in dementia with Lewy body. Conclusions: This large hospital-based study provides a distribution pattern and clinical spectrum of dementia subtypes in a North Indian population.

  5. [Paraffinomas: history, clinical features and treatment. A case report].

    Science.gov (United States)

    Mounios-Perchenet, A S; Le Fourn, B; Hepner-Lavergne, D; Pannier, M

    1997-02-01

    One case of paraffinoma is reported on a 60 years old man following injections of paraffin fourty years ago. The authors recalled with this observation history of paraffin, clinical aspect and surgical treatment of the paraffinoma.

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

    Science.gov (United States)

    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.

  7. [Clinical and cytogenetic analysis of patients with lymphoid malignancies carrying 14q32 abnormality].

    Science.gov (United States)

    Liu, S; Qin, S; Wang, J

    2001-11-01

    To investigate the clinical and cytogenetic characteristics of patients with lymphoid malignancies (LM) harboring 14q32 abnormalities. The cases with 14q32 aberrations in 225 patients with various LM were analyzed by clinical data. Fifteen (6.67%) patients with abnormalities involving 14q32 were found and the pattern of 14q32 aberration was associated with different types of LM. t(8;14)(q24;q32) was the commonest karyotypic aberration and predominant in acute leukemias. There was no consistent profile morphologically and immunophenotypically in the involving leukemias, however there were common clinical and prognostic features and often with an additional characteristic abnormality of ins(1;6)(q11;q23q27). One case of myelodysplasia (MDS) secondary to multiple myeloma displayed t(7;14)(q34;q32) in primary clone and additional 7q- and 20q- in derivative clone that was frequently involved in MDS. 14q32 abnormalities and additional chromosomal alterations can facilitate the diagnosis and prognostic assessment for the involving LMs.

  8. [Obsessions before Freud: history and clinical practice].

    Science.gov (United States)

    Huertas, Rafael

    2014-01-01

    The article analyses the significance of the concept of "obsession" in nineteenth-century alienism. From a clinical point of view, Esquirol's description was completed by other authors (Jules Falret, Legrand du Saulle). In the area of psychopathological studies, French alienism, with Morel's emotional delirium or Janet's psychasthenia, defended the emotional theory, as opposed to the intellectual disorder proposed by German doctors. Lastly, the importance of the cultural framework is stressed in the appearance of obsessive symptoms and their interpretation. Along these lines, the article discusses the relationship of religious scruples to melancholy or the appearance of diagnostic categories subject to fin de siècle codes and mentalities.

  9. Detection of dermatological abnormalities in the rheumatology clinic using a standardized screening exam.

    Science.gov (United States)

    Wong, Newton Wai Kwan; Towheed, Tanveer Ezad; Hopman, Wilma; Kirchhof, Mark Gajda

    2017-06-14

    To develop a standardized practical screening tool for rheumatologists to assess for underlying dermatological manifestations of rheumatic conditions. A relevant screening tool was developed by consensus between dermatology and rheumatology authors. Patients visiting the general rheumatology clinic for routine care were systematically assessed based on the standardized screening tool. One hundred patients were recruited with 76 being female. The most prevalent rheumatic conditions seen in the clinic were rheumatoid arthritis, psoriatic arthritis and systemic lupus erythematosus. The standardized integumentary assessment took a mean of 2.75 (SD 1.61) min. Most patients, 74%, reported no concerns with their hair or nails, while 60% reported no concerns with their skin. The majority of patients had one abnormality identified, 65%, and of those diagnoses, most affected the skin with 71% of patients having an identified skin abnormality, compared with the hair (10%) or nails (13%). The standardized integumentary assessment tool can be successfully incorporated into routine clinical practice for rheumatologists without significant extension of consultation time and may detect relevant abnormalities important for diagnosis which may have been unnoticed by patients. It may encourage collaborative care and enhance clinical outcomes. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  10. Examination history and abnormal thyroid and breast lesions according to residential distance from nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Young Khi [Dept. of Radiological Science, Gachon University, Incheon (Korea, Republic of)

    2016-12-15

    Ascertainment bias are common in epidemiologic studies to assess the association between thyroid cancer risk and living near nuclear power plants because many thyroid cancers are diagnosed by chance through health examination. We surveyed the ultra sonography (USG) examination history and conducted thyroid and breast USG in residents living near nuclear power plants. The study population comprised 2,421 residents living near nuclear power plants in Korea. Information on demographic characteristics, including diagnostic examination history, was collected by interview using questionnaires. USG examination was conducted to evaluate the presence of thyroid nodules and breast lesion. Study participants were divided into 3 groups according to the distance of their respective villages from a nuclear power plant. The proportions of USG examination history and prevalence of thyroid nodules and breast lesions were compared between groups. Examination histories of thyroid USG were 23.1%, 13.7%, and 10.5% in men and 31.3%, 26.7%, 18.3% in women in the short, intermediate, and long distance groups, respectively. There were significant inverse associations between thyroid USG history and the distance from nuclear power plants (P for trend=0.001 for men and 0.017 for women). However, there was no association between the distance of villages from nuclear power plants and prevalence of thyroid nodules. Our results suggest that there may be an ascertainment bias in population-based studies examining the harmful effects of NPPs examination and researchers should pay attention to ascertainment bias resulted from differential health examination. Correction for ascertainment bias, active follow-up and examination for all study population to remove differential health examination is needed.

  11. Clinical and EEG features of ischemic stroke patients with abnormal discharges

    Directory of Open Access Journals (Sweden)

    Jia-lei YANG

    2016-05-01

    Full Text Available Objective To investigate the clinical and EEG features of ischemic stroke patients with abnormal discharges.  Methods Clinical data and 24-hour EEG monitoring of 162 ischemic stroke patients were analyzed retrospectively. One-year follow-up was carried out and post-ischemic epilepsy was diagnosed.  Results Among 162 ischemic stroke patients, 24-hour EEG was abnormal in 87 cases (53.70%. According to the correspondence of site of infarcts and abnormal discharges, these 87 cases were classified into 2 groups: matched group (N = 24, 27.59% and unmatched group (N = 63, 72.41%. There was no significant difference between 2 groups in terms of Oxfordshire Community Stroke Project (OCSP and TOAST classification (P = 0.792, 0.111, while there was significant difference between 2 groups on the site of infarcts (P = 0.000. In matched group, the infarcts were mainly located in cortex (N = 23, 95.83%. However, in unmatched group, the infarcts were mainly located in cortex and basal ganglia (N = 27, 42.86%, or in basal ganglia only (N = 24, 38.10%. In matched group, 24-hour EEG showed slowing of background activities, and sharp waves and sharp and slow wave complex which were corresponding to the infarct sites. The abnormal discharges could only be recorded around the infarct unilaterally. In unmatched group, the epileptiform discharges were recorded in both contralateral and ipsilateral ischemic hemispheres, usually with widespread slow waves and asymmetric background. The infarcts were limited, but abnormal discharges were widespread. For example, the infarct was located in deep brain, while scalp abnormal discharges were recorded. Although there was no significant difference in terms of epilepsy incidence between 2 groups (P = 0.908, the types of epilepsy were statistically different between 2 groups (P = 0.000. In matched group, the main type was partial seizure. But in unmatched group, the main types of epilepsy were secondary generalized seizure and

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  14. A brief history of clinical xenotransplantation.

    Science.gov (United States)

    Cooper, David K C; Ekser, Burcin; Tector, A Joseph

    2015-11-01

    Between the 17th and 20th centuries, blood was transfused from various animal species into patients with a variety of pathological conditions. Skin grafts were carried out in the 19th century, with grafts from a variety of animals, with frogs being the most popular. In the 1920s, Voronoff advocated the transplantation of slices of chimpanzee testis into elderly men, believing that the hormones produced by the testis would rejuvenate his patients. In 1963-4, when human organs were not available and dialysis was not yet in use, Reemtsma transplanted chimpanzee kidneys into 13 patients, one of whom returned to work for almost 9 months before suddenly dying from what was believed to be an electrolyte disturbance. The first heart transplant in a human ever performed was by Hardy in 1964, using a chimpanzee heart, but the patient died within 2 h. Starzl carried out the first chimpanzee-to-human liver transplantation in 1966; in 1992 he obtained patient survival for 70 days following a baboon liver transplant. The first clinical pig islet transplant was carried out by Groth in 1993. Today, genetically-modified pigs offer hope of a limitless supply of organs and cells for those in need of a transplant.

  15. Colloidal oatmeal: history, chemistry and clinical properties.

    Science.gov (United States)

    Kurtz, Ellen S; Wallo, Warren

    2007-02-01

    Oatmeal has been used for centuries as a soothing agent to relieve itch and irritation associated with various xerotic dermatoses. In 1945, a ready to use colloidal oatmeal, produced by finely grinding the oat and boiling it to extract the colloidal material, became available. Today, colloidal oatmeal is available in various dosage forms from powders for the bath to shampoos, shaving gels, and moisturizing creams. Currently, the use of colloidal oatmeal as a skin protectant is regulated by the U.S. Food and Drug Administration (FDA) according to the Over-The-Counter Final Monograph for Skin Protectant Drug Products issued in June 2003. Its preparation is also standardized by the United States Pharmacopeia. The many clinical properties of colloidal oatmeal derive from its chemical polymorphism. The high concentration in starches and beta-glucan is responsible for the protective and water-holding functions of oat. The presence of different types of phenols confers antioxidant and anti-inflammatory activity. Some of the oat phenols are also strong ultraviolet absorbers. The cleansing activity of oat is mostly due to saponins. Its many functional properties make colloidal oatmeal a cleanser, moisturizer, buffer, as well as a soothing and protective anti-inflammatory agent.

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

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    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.

  17. [Longjintonglin Capsules for type IIIA prostatitis accompanied by abnormal semen liquefaction: A clinical observation].

    Science.gov (United States)

    Cai, Hong-cai; Wan, Chang-chun; Geng, Qiang; Liu, Wei; Zhang, Guo-wei; Shang, Xue-jun; Huang, Yu-feng

    2016-01-01

    To evaluate the therapeutic effect of Longjintonglin Capsules on type IIIA prostatitis accompanied by abnormal semen liquefaction. We selected 140 patients with type IIIA prostatitis accompanied by abnormal semen liquefaction according to the diagnostic standards of the American Institutes of Health (NIH) and treated them with Longjintonglin Capsules orally 3 capsules once tid for 12 weeks. We obtained the NIH Chronic Prostatitis Symptom Indexes (NIH-CPSI), traditional Chinese medicine (TCM) syndrome scores, leukocyte count in the expressed prostatic secretion (EPS), semen liquefaction time, and the results of semen analysis and compared these indicators before and after the treatment. Of the 140 cases, 132 were included in this study, excluding 8 due to their incomplete case histories. Before and after 4, 8 and 12 weeks of medication, the total NIH-CPSI scores were 24.52 ± 5.43, 21.28 ± 4.85, 18.01 ± 4.28, and 14.49 ± 3.65 (P Capsules, with its advantages of safety, effectiveness and no obvious adverse effects, deserve to be recommended for the treatment of type IIIA prostatitis accompanied by abnormal semen liquefaction.

  18. CLINICAL AND GENETIC ASPECTS OF ABNORMAL TORTUOSITY OF PRECEREBRAL ARTERIES IN ISCHEMIC STROKE

    Directory of Open Access Journals (Sweden)

    N. M. Poplavskaya

    2015-01-01

    Full Text Available Background: Inherited connective tissue pathology is the most frequent genetic abnormality. Weakness of connective tissue in this group of disorders is manifested not only by excessive joint mobility, but also by abnormalities in other organs and systems, including vessels. In inherited connective tissue disorders brain artery aneurysms and abnormal vascular tortuosity is found that can be a risk factor for stroke.Aim: To study frequency of abnormal tortuosities of brachiocephalic vessels in post-ischemic stroke patients, as well as efficacy of secondary stroke prevention in such patients.Materials and methods: One hundred and seventy two adult patients with ischemic stroke were examined. Neurological deficiency was assessed with the National Institute of Health Stroke Scale (NIHSS and with the modified Rankin scale. Abnormalities of precerebral arteries were found by ultrasound dopplerography and duplex scanning. To diagnose any abnormalities of connective tissue, clinical and genetic analysis, dermatoglyphic assessment and scoring of excessive joint mobility (Beyton scale were used.Results: Abnormal tortuosity of precerebral arteries is found in 47% of patients with ischemic stroke. The screening performed in 25 of such patients showed connective tissue disorders in one third of them (in 2 patients, Ehlers-Danlos syndrome, in 2 patients, connective tissue dysplasia, in 4 patients, mild symptoms of abnormal connective tissue, such as excessive joint mobility scoring to 1–2. In patients without inherited syndromes, some dermatoglyphic traits were found, i.e., distal shift of the axial palmar triradius, higher frequency of patterns on the skin of the thenar, lower pattern frequency on the skin of the hypothenar, higher frequency of simple digital patterns (A and T, lower frequency of complex patterns, such as whorls (W, lower palmar and digital ridgecounts. The results of secondary stroke prevention with antiplatelet agents, antihypertensives

  19. Clinical prediction of fall risk and white matter abnormalities: a diffusion tensor imaging study.

    Science.gov (United States)

    Koo, Bang-Bon; Bergethon, Peter; Qiu, Wei Qiao; Scott, Tammy; Hussain, Mohammed; Rosenberg, Irwin; Caplan, Louis R; Bhadelia, Rafeeque A

    2012-06-01

    The Tinetti scale is a simple clinical tool designed to predict risk of falling by focusing on gait and stance impairment in elderly persons. Gait impairment is also associated with white matter (WM) abnormalities. To test the hypothesis that elderly subjects at risk for falling, as determined by the Tinetti scale, have specific patterns of WM abnormalities on diffusion tensor imaging. Community-based cohort of 125 homebound elderly individuals. Diffusion tensor imaging scans were analyzed using tract-based spatial statistics analysis to determine the location of WM abnormalities in subjects with Tinetti scale scores of 25 or higher (without risk of falls) and lower than 25 (with risk of falls).Multivariate linear least squares correlation analysis was performed to determine the association between Tinetti scale scores and local fractional anisotropy values on each skeletal voxel controlling for possible confounders. In subjects with risk of falls (Tinetti scale score scores, while the other locations were unrelated to these scores. Elderly individuals at risk for falls as determined by the Tinetti scale have WM abnormalities in specific locations on diffusion tensor imaging, some of which correlate with cognitive function scores.

  20. Abnormal visual experiences in individuals with histories of hallucinogen use: a Web-based questionnaire.

    Science.gov (United States)

    Baggott, M J; Coyle, J R; Erowid, E; Erowid, F; Robertson, L C

    2011-03-01

    Despite longstanding reports of prolonged or reoccurring perceptual changes in a subset of hallucinogen users, very little is known about Hallucinogen Persisting Perception Disorder and related visual abnormalities in hallucinogen users. We used an online questionnaire to document the symptoms and relationship to drug use of unusual visual phenomena in hallucinogen users. 16,192 individuals viewed the information sheet and 2679 were included in the study. Of these, 224 reported having unrelated diagnoses associated with unusual visual experiences and were excluded from main analyses. Most (60.6%) of the remaining 2455 participants reported having experienced drug-free visual experiences that resembled hallucinogen effects. Probability of experiencing constant or near-constant symptoms was predicted by greater past exposure to specific hallucinogens, including lysergic acid diethylamide (LSD). Although symptoms were common, few (104, or 4.2% of the sample) found them distressing or impairing enough to consider seeking treatment. Visual changes in hallucinogen users may be more common than previously suspected and are worthy of further study.

  1. Clinical, histopathological and therapeutic considerations in non-neoplastic abnormal uterine bleeding in menopause transition.

    Science.gov (United States)

    Corniţescu, F I; Tănase, Florentina; Simionescu, Cristiana; Iliescu, D

    2011-01-01

    With the decline of ovarian hormonal function, from the fifth decade of life, women enter the menopause transition, during which bleeding becomes irregular in duration and time of occurrence. Secondary to ovarian dysfunction, developmental and maturation endometrial anomalies occur, which are clinically translated by abnormal uterine bleeding, which in many cases at this age can be caused by organic lesions (fibroma, polyps, endometritis, endometrial hyperplasia, adenomyosis, etc.). The retrospective study included a total of 256 patients with abnormal uterine bleeding in menopause transition. Statistics showed that the incidence of these types of bleeding increases with age (64.5%) and parity (30.5%), with symptoms consisting mostly in different clinical forms of abnormal uterine bleeding (62.1%), and leiomyomas prevailing at histopathological examination (49.6%). Progesterone replacement therapy was the first therapeutic choice for correcting these types of bleeding. Progesterone therapy is useful not only for therapeutic purposes to amend the bleeding, but also as a precaution against the development of endometrial carcinoma. Progestogens cancel the proliferative and mitogenic effect of estrogens, even when administered in sequential regimen 10-12 days per month.

  2. Relationship between Capillary Refill Time at Triage and Abnormal Clinical Condition: A Prospective Study.

    Science.gov (United States)

    Sansone, Claudia M; Prendin, Fabiano; Giordano, Greta; Casati, Paola; Destrebecq, Anne; Terzoni, Stefano

    2017-01-01

    Capillary refill time has been studied in literature as a perfusion indicator. Two pilot studies have proposed possible reference values in healthy adults. No data exist regarding capillary refill time as an indicator of abnormal clinical conditions in adults, which might be of help for triage nurses. We wanted to assess if any relationships existed, between altered capillary refill time and abnormal clinical conditions in the emergency department. We investigated relations between capillary refill time and vital signs recorded in triage and blood tests, by analyzing the clinical records. Mortality at 24 hours, 7 days and over 14 days was investigated by calling the patients after discharge. Observational, single-center study on a sample of consecutive patients aged ≥ 18 years in the Emergency Department of a major Milan hospital, from June to October 2014. Multivariate logistic regression was used to investigate the impact of clinical variables on capillary refill time. 1001 patients were enrolled, aged 59 ± 21 (473 aged 65 or more). Longer refill times were found in patients admitted to hospital units after medical consultations in the emergency department compared to those discharged or sent to outpatients. In elderly patients, statistically significant association was found between increased capillary refill time and sepsis (sensitivity 100%, specificity 83.33%, area under the receiver operating characteristics curve 65.95% CI 47-83), oxygen saturation, mean blood pressure, and lactates. In persons aged 45 to 64, altered refill times were associated with abnormal values of glicemia, platelets, and urea. Capillary refill time can be used by nurses at triage as a complementary parameter to normal vital signs. This is one of the few studies investigating refill time in adult patients.

  3. Clinical and electroencephalographic abnormalities during the full duration of a sporadic hemiplegic migraine attack.

    Science.gov (United States)

    Chastan, Nathalie; Lebas, Axel; Legoff, Floriane; Parain, Dominique; Guyant-Marechal, Lucie

    2016-11-01

    Electroencephalographic (EEG) abnormalities have been reported during migraine attacks but their spatial and temporal distributions are not well known. We report the temporospatial dynamics of EEG during the full duration of a migraine attack with aura in a 19-year-old woman. She experienced episodes of hemiplegic migraine since the age of 2.5 years, with right hemibody paralysis preceded by visual symptoms. She reported severe pain of the right hemibody just before hemiplegia that was enventually suggestive of possible epileptic seizure, justifying diagnostic video-EEG monitoring. Sporadic hemiplegic migraine was diagnosed in the absence of family history. EEG was normal at the beginning of visual aura. After 15minutes, posterior slow waves appeared over the migrainous hemisphere, spreading progressively towards anterior regions: first the central region (5minutes after onset of contralateral hemiplegia), then the frontal region and over both hemispheres. A new de novo mutation was identified in the SCN1A gene.

  4. Clinical profile of patients with abnormal uterine bleeding at a tertiary care hospital

    OpenAIRE

    2015-01-01

    Background: Abnormal uterine bleeding is a very common gynecological condition that affects all age groups. One third of patients attending gynaecology OPD present with complaints of abnormal uterine bleeding. Bleeding is said to be abnormal when the pattern is irregular, abnormal duration (>7 days), or menorrhagia or abnormal amount (>80 ml/menses). Methods: All patients in the perimenopausal age group (45+/- 5 years) with symptoms of abnormal uterine bleeding presenting at department of ...

  5. Early clinical signs in neonates with hypoxic ischemic encephalopathy predict an abnormal amplitude-integrated electroencephalogram at age 6 hours

    OpenAIRE

    Horn, Alan R; Swingler, George H; Myer, Landon; Linley, Lucy L; Raban, Moegammad S; Joolay, Yaseen; Harrison, Michael C; Chandrasekaran, Manigandan; Rhoda, Natasha R; Robertson, Nicola J.

    2013-01-01

    Background An early clinical score predicting an abnormal amplitude-integrated electroencephalogram (aEEG) or moderate-severe hypoxic ischemic encephalopathy (HIE) may allow rapid triage of infants for therapeutic hypothermia. We aimed to determine if early clinical examination could predict either an abnormal aEEG at age 6 hours or moderate-severe HIE presenting within 72 hours of birth. Methods Sixty infants ≥ 36 weeks gestational age were prospectively enrolled following suspected intrapar...

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

    Science.gov (United States)

    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.

  7. EEG abnormalities in clinically diagnosed brain death organ donors in Iranian tissue bank.

    Science.gov (United States)

    Tavakoli, Seyed Amir Hossein; Khodadadi, Abbas; Azimi Saein, Amir Reza; Bahrami-Nasab, Hasan; Hashemi, Behnam; Tirgar, Niloufar; Nozary Heshmati, Behnaz

    2012-01-01

    Brain death is defined as the permanent, irreversible and concurrent loss of all brain and brain stem functions. Brain death diagnosis is based on clinical criteria and it is not routine to use paraclinical studies. In some countries, electroencephalogram (EEG) is performed in all patients for the determination of brain death while there is some skepticism in relying on EEG as a confirmatory test for brain death diagnosis. In this study, we assessed the validity of EEG and its abnormalities in brain death diagnosis. In this retrospective study, we used 153 EEGs from medical records of 89 brain death patients in organ procurement unit of the Iranian Tissue Bank admitted during 2002-2008. We extracted and analyzed information including EEGs, which were examined by a neurologist for waves, artifacts and EEG abnormalities. The mean age of the patients was 27.2±12.7 years. The most common cause of brain death was multiple traumas due to accident (65%). The most prevalent artifact was electrical transformer. 125 EEGs (82%) were isoelectric (ECS) and seven EEGs (5%) were depictive of some cerebral activity which upon repeat EEGs, they showed ECS patterns too. There was no relationship between cause of brain death and cerebral activity in EEGs of the patients. In this study, we could confirm ECS patterns in all brain death patients whose status had earlier been diagnosed clinically. Considering the results of this study, it seems sensible to perform EEG as a final confirmatory test as an assurance to the patients' families.

  8. Clinical features and associated abnormalities in children and adolescents with corpus callosal anomalies.

    Science.gov (United States)

    Kim, Young Uhk; Park, Eun Sook; Jung, Soojin; Suh, Miri; Choi, Hyo Seon; Rha, Dong-Wook

    2014-02-01

    Callosal anomalies are frequently associated with other central nervous system (CNS) and/or somatic anomalies. We retrospectively analyzed the clinical features of corpus callosal agenesis/hypoplasia accompanying other CNS and/or somatic anomalies. We reviewed the imaging and clinical information of patients who underwent brain magnetic resonance imaging in our hospital, between 2005 and 2012. Callosal anomalies were isolated in 13 patients, accompanied by other CNS anomalies in 10 patients, associated with only non-CNS somatic anomalies in four patients, and with both CNS and non-CNS abnormalities in four patients. Out of 31 patients, four developed normally, without impairments in motor or cognitive functions. Five of nine patients with cerebral palsy were accompanied by other CNS and/or somatic anomalies, and showed worse Gross Motor Function Classification System scores, compared with the other four patients with isolated callosal anomaly. In addition, patients with other CNS anomalies also had a higher seizure risk.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  10. Nonfamilial Hypertrophic Cardiomyopathy: Prevalence, Natural History, and Clinical Implications.

    Science.gov (United States)

    Ingles, Jodie; Burns, Charlotte; Bagnall, Richard D; Lam, Lien; Yeates, Laura; Sarina, Tanya; Puranik, Rajesh; Briffa, Tom; Atherton, John J; Driscoll, Tim; Semsarian, Christopher

    2017-04-01

    Yield of causative variants in hypertrophic cardiomyopathy (HCM) is increased in some probands, suggesting different clinical subgroups of disease occur. We hypothesized that a negative family history and no sarcomere mutations represent a nonfamilial subgroup of HCM. We sought to determine the prevalence, natural history, and potential clinical implications of this nonfamilial subgroup of HCM. Four hundred and thirteen unrelated probands with HCM seen in a specialized HCM center between 2002 and 2015 and genetic testing performed were included in this retrospective cohort study. There were 251 (61%) probands with no reported family history of HCM, including 166 (40% of total) probands with no sarcomere mutation, that is, nonfamilial HCM. Quantified family pedigree data revealed no difference in mean number of first-degree relatives screened between nonfamilial and sarcomere-positive groups. Adjusted predictors of nonfamilial status were older age (odds ratio, 1.04; 95% confidence interval, 1.02-1.06; P=0.0001), male sex (odds ratio, 1.96; 95% confidence interval, 1.11-3.45; P=0.02), hypertension (odds ratio, 2.80; 95% confidence interval, 1.57-5.00; P=0.0005), and nonasymmetric septal morphology (odds ratio, 3.41; 95% confidence interval, 1.64-7.08; P=0.001). They had a less severe clinical course with greater event-free survival from major cardiac events (P=0.04) compared with sarcomere-positive HCM probands. Genotype prediction scores showed good performance in identifying genotype-positive patients (area under the curve, 0.71-0.75) and, in combination with pedigree characteristics, were further improved. Approximately 40% of HCM probands have a nonfamilial subtype, with later onset and less severe clinical course. We propose a revised clinical pathway for management, highlighting the role of genetic testing, a detailed pedigree, and refined clinical surveillance recommendations for family members. © 2017 American Heart Association, Inc.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. Clinical efficacy of levonorgestrel and norethisterone for the treatment of chronic abnormal uterine bleeding.

    Science.gov (United States)

    Ashraf, Muhammad Nadeem; Habib-Ur-Rehman, Agha; Shehzad, Zahid; AlSharari, Shakir DakheelAllah; Murtaza, Ghulam

    2017-09-01

    To compare the clinical efficacy of levonorgestrel intrauterine system with oral norethisterone for the treatment of idiopathic chronic abnormal uterine bleeding. This cross-sectional study was conducted at Bahawal Victoria Hospital, Jubilee Female Hospital, Civil Hospital and private clinics of consultant gynaecologists in Bahawalpur, Pakistan, from March to August 2014, and comprised patients presenting with abnormal uterine bleeding. The patients were equally and randomly divided into two groups, i.e. intrauterine levonorgestrel administered (group A) and norethisterone administered (group B). Mean age, duration of the disease and parity were determined using a predesigned questionnaire. The primary outcomes of the treatments, i.e. reduction in menstrual blood loss assessed by the pictorial blood assessment chart score, were recorded before the initiation of therapy, at 3 months and at 6months of the study. SPSS 16 was used for data analysis. There were 76 subjects; 38(50%) in each group. In group A, the mean age and mean duration of the disease was 34.16±6.327 years and 6.18±2.415 years compared to 34.21±3.595 years and 6.21±2.418 years in group B. The reduction in menstrual blood loss did not differ significantly between the groups after 3 months (p= 0.321). However, levonorgestrel intrauterine system was found more effective in reducing menstrual blood loss in 36(94.73%) patients, compared to norethisterone-treated patients 28(73.68%) after 6 months of the treatment (p=0.041). The response of both the treatments was found independent of patient's age, parity and chronicity of the disease. The levonorgestrel intrauterine system was better than norethisterone with marked clinical benefit of profound reduction in menstrual blood loss.

  13. About the need of organization of clinical examination of young people with small developmental heart abnormalities

    Directory of Open Access Journals (Sweden)

    Lyulka Y.P.

    2014-03-01

    Full Text Available Due to the signifi¬cant increase of complications developing in young people suffering from low cardiac abnormalities, detection of this disease is important. The aim of the study was to analyze the prevalence and structure of cardiovascular diseases in persone aged 18-21 years who have referred to the medical center of Dnepropetrovsk Medical Academy in the period from 2012 to 2013 in order to determine the mode of physicol exercises. We examined 268 students of 1-2 courses of medical academy, who, along with the clinical examination underwent standard echocardiography 2 times a year. It is established that in the structure of cardiovascular diseases in the studied group small anomalies of the heart occupy the first place; valve pathology the second place. In the structure of small abnormality of the heart, mitral valve prolapse is detected the most frequently. Since this anomaly affects the level of tolerance to physical stress and can lead to heart disorder, routine screening of patients with this disease is mandatory and must be carried out to address the choice of the level of physical activity.

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

    Directory of Open Access Journals (Sweden)

    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

  15. Clinical neuropsychology in Israel: history, training, practice and future challenges.

    Science.gov (United States)

    Vakil, Eli; Hoofien, Dan

    2016-11-01

    This is an invited paper for a special issue on international perspectives on training and practice in clinical neuropsychology. We provide a review of the status of clinical neuropsychology in Israel, including the history of neuropsychological, educational, and accreditation requirements to become a clinical neuropsychologist and to practice clinical neuropsychology. The information is based primarily on the personal knowledge of the authors who have been practicing clinical neuropsychology for over three decades and hold various administrative and academic positions in this field. Second, we conducted three ad hoc surveys among clinical and rehabilitation psychologists; heads of academic programs for rehabilitation and neuropsychology; and heads of accredited service providers. Third, we present a literature review of publications by clinical neuropsychologists in Israel. Most of the clinical neuropsychologists are graduates of either rehabilitation or clinical training programs. The vast majority of neuropsychologists are affiliated with rehabilitation psychology. The training programs (2-3 years of graduate school) provide solid therapeutic and diagnostic skills to the students. Seventy-five percent of the participants in this survey are employed at least part-time by public or state-funded institutions. Israeli neuropsychologists are heavily involved in case management, including vocational counseling, and rehabilitation psychotherapy. Conclusions and future goals: Although clinical neuropsychologists in Israel are well educated and valued by all health professionals, there are still several challenges that must be addressed in order to further advance the field and the profession. These included the need for Hebrew-language standardized and normalized neuropsychological tests and the application of evidence-based interventions in neuropsychological rehabilitation.

  16. Adolescent chronic fatigue syndrome; a follow-up study displays concurrent improvement of circulatory abnormalities and clinical symptoms

    OpenAIRE

    Sulheim Dag; Hurum Harald; Helland Ingrid B; Thaulow Erik; Wyller Vegard

    2012-01-01

    Background The pathophysiology of chronic fatigue syndrome (CFS) in adolescents is unknown, and the clinical course and prognosis is still questioned. Recent research indicates that abnormalities of autonomic cardiovascular control may play an important role. The aim of this research project was to perform a follow-up study of adolescents with chronic fatigue syndrome, focusing on clinical symptoms and autonomic cardiovascular control. ...

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

    Directory of Open Access Journals (Sweden)

    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.

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

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    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.

  19. Phenobarbitone-induced haematological abnormalities in idiopathic epileptic dogs: prevalence, risk factors, clinical presentation and outcome.

    Science.gov (United States)

    Bersan, E; Volk, H A; Ros, C; De Risio, L

    2014-09-13

    The aim of this retrospective study was to assess prevalence, risk factors, clinical presentation and outcome of phenobarbitone induced haematological abnormalities (PBIHA) in dogs. The medical records of two veterinary referral institutions were searched for dogs diagnosed with idiopathic epilepsy and treated with PB as monotherapy or polytherapy between March 2003 and September 2010. Sixteen dogs had PBIHA; the median age at diagnosis was 69.5 months. Phenobarbitone was administered at a median dose of 3 mg/kg twice a day for a median period of 100.5 days and the median serum phenobarbitone level was 19 μg/ml. Two dogs had neutropenia, three had anaemia and thrombocytopenia, two had anaemia and neutropenia; the remaining nine had pancytopenia. All dogs were referred for non-specific clinical signs. Phenobarbitone was discontinued after diagnosis, and the median time to resolution of PBIHA was 17 days. The prevalence and risk factors for PBIHA were evaluated from a questionnaire survey of referring practices to obtain more detailed follow-up on cases diagnosed with idiopathic epilepsy. The prevalence rate of PBIHA was 4.2%, and the condition occurred in dogs treated with standard therapeutic doses often within the first three months after starting treatment. Serial haematological evaluations should be therefore considered from the beginning of phenobarbitone therapy to allow early diagnosis and treatment of PBIHA.

  20. Clinical evaluation of plasma abnormal prothrombin (PIVKA-II) in patients with hepatocellular carcinoma.

    Science.gov (United States)

    Fujiyama, S; Morishita, T; Sagara, K; Sato, T; Motohara, K; Matsuda, I

    1986-10-01

    The clinical usefulness of plasma abnormal prothrombin, defined as a protein induced by vitamin K absence or antagonist-II: PIVKA-II, as a tumor marker for hepatocellular carcinoma (HCC), was evaluated. Plasma PIVKA-II concentration was determined by an enzyme-linked immunosorbent assay (ELISA) using a monoclonal antibody specific for PIVKA-II. Forty-one (65%) out of 63 patients with HCC had an abnormal PIVKA-II level above 0.13 arbitrary units (AU)/ml; the level was above 0.3 AU/ml in 33 patients (52%) and above 0.5 AU/ml in 27 patients (43%). On the other hand, most of the 282 patients with various liver diseases other than HCC had normal or slightly elevated levels of PIVKA-II. Their values were all below 0.5 AU/ml, with the exception of 2 patients with decompensated liver cirrhosis. The patients with PIVKA-II values above 0.5 AU/ml were strongly suspected of having HCC. Plasma PIVKA-II levels were not related to serum alpha-fetoprotein (AFP) levels, but were above 0.5 AU/ml in 14 (44%) out of the 32 patients whose serum AFP levels were below 400 ng/ml. In some patients with HCC, PIVKA-II was increased throughout the course of the disease, and in others it normalized after surgical resection of the tumor. We conclude that the plasma PIVKA-II assay by the ELISA method using a monoclonal antibody is a useful diagnostic tool for monitoring HCC, particularly in HCC patients with low AFP levels.

  1. A history of the American Society for Clinical Investigation.

    Science.gov (United States)

    Howell, Joel D

    2009-04-01

    One hundred years ago, in 1909, the American Society for Clinical Investigation (ASCI) held its first annual meeting. The founding members based this new society on a revolutionary approach to research that emphasized newer physiological methods. In 1924 the ASCI started a new journal, the Journal of Clinical Investigation. The ASCI has also held an annual meeting almost every year. The society has long debated who could be a member, with discussions about whether members must be physicians, what sorts of research they could do, and the role of women within the society. The ASCI has also grappled with what else the society should do, especially whether it ought to take a stand on policy issues. ASCI history has reflected changing social, political, and economic contexts, including several wars, concerns about the ethics of biomedical research, massive increases in federal research funding, and an increasingly large and specialized medical environment.

  2. A history of the American Society for Clinical Investigation

    Science.gov (United States)

    Howell, Joel D.

    2009-01-01

    One hundred years ago, in 1909, the American Society for Clinical Investigation (ASCI) held its first annual meeting. The founding members based this new society on a revolutionary approach to research that emphasized newer physiological methods. In 1924 the ASCI started a new journal, the Journal of Clinical Investigation. The ASCI has also held an annual meeting almost every year. The society has long debated who could be a member, with discussions about whether members must be physicians, what sorts of research they could do, and the role of women within the society. The ASCI has also grappled with what else the society should do, especially whether it ought to take a stand on policy issues. ASCI history has reflected changing social, political, and economic contexts, including several wars, concerns about the ethics of biomedical research, massive increases in federal research funding, and an increasingly large and specialized medical environment. PMID:19348041

  3. Evaluation of clinical characteristics of Kawasaki syndrome and risk factors for coronary artery abnormalities among children in Denmark.

    Science.gov (United States)

    Patel, Amy; Holman, Robert C; Callinan, Laura S; Sreenivasan, Nandini; Schonberger, Lawrence B; Fischer, Thea K; Belay, Ermias D

    2013-04-01

    To examine clinical characteristics, treatment and outcome of Kawasaki syndrome patients in Denmark. A retrospective chart review of hospitalization records for children Kawasaki syndrome discharge diagnosis identified through the Danish National Patient Registry during 1994 through June 2008 was conducted. A total of 284 cases Kawasaki syndrome (n = 279) and atypical Kawasaki syndrome (n = 5); 70.4% were Kawasaki syndrome patients were diagnosed with coronary artery abnormalities. Not receiving intravenous immunoglobulin treatment before the 10th day of illness, young age and male sex were significantly associated with the development of coronary artery abnormalities. In Denmark, more than one in 10 children with Kawasaki syndrome develop coronary artery abnormalities. Physicians should increase their index of suspicion for early diagnosis and treatment of Kawasaki syndrome among patients susceptible to increased risk of coronary artery abnormalities, particularly in infants who may have a more atypical presentation of the illness. ©2012 The Author(s)/Acta Paediatrica ©2013 Foundation Acta Paediatrica.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Clinical predictors of abnormal computed tomography scan in minor head trauma in children under 2 years old

    Directory of Open Access Journals (Sweden)

    Sepideh Lotfi Sadigh

    2015-03-01

    Full Text Available Introduction: Minor blunt head trauma is a common reason for children to present to the emergency department (ED. Crania computed tomography (CT is the choice for evaluating children with blunt head trauma in the ED, but few shows abnormal findings. In this study, we aim to evaluate CT findings in children with blunt head trauma and clinical symptoms to identify clinical predictors of abnormal CT scans. Methods: In this prospective study, 218 children under 2 years of age (121 male and 97 female with mean age of 11.24 ± 4.31 months with compliant of minor blunt head trauma visiting the ED between April 2011 and April 2014 were included. Physical examination and clinical symptoms, as well as CT findings and patients’ outcome were evaluated. Results: Physical examinations were normal in 95.9%, and clinical symptoms were present only in 25.7% including vomiting in 16.1%, loss of consciousness (LOC in 8.3%, ear/nose bleeding in 4.1% and seizure in 5.5%. CT scan was requested in 189 cases (86.7% of which, 7.9% were abnormal including linear fracture in 5.3%, subgaleal hematoma in 1.1% and depressed fracture, subcutaneous hematoma and intracranial hemorrhage (ICH each in 0.5%. Among all cases, 89.0% were discharged from ED with no further observation, 6.0% discharged after 48 h observation and 5.0% were hospitalized. There was a significant correlation between abnormal CT findings and having any clinical symptoms, vomiting and Ear/nose bleeding. Conclusion: In children under 2 years old with minor blunt head trauma, most CT scans are unnecessary. Considering clinical symptoms as predictors of abnormal CT scans we can reduce unnecessary ones.

  6. Clinical Significance of Abnormal Heart Rate Recovery after Treadmill Exercise Test in Patients With Coronary Artery Disease

    Institute of Scientific and Technical Information of China (English)

    Li-feng HONG; Hao ZHANG; Ye-xin MA; He-song ZENG; Yuan WEN

    2009-01-01

    Objectives To evaluate the values of abnormal heart rate recovery (HRR) after treadmill exercise test in patients with coronary artery disease (CAD). Methods One hundred and seventy-eight consecutive cases of suspected CAD who underwent symptom-limited treadmill exercise test (TET) and coronary angiography (CAG) were enrolled and di-vided into normal and abnormal HRR group based on the status of the values of HRR one or two minutes after TET. The clinical characteristics, TET parameters and CAG results of the two groups were compared attempted to assess the value of HRR on patients with CAD. Results (1) The cases of smoking, diabetes mellitus (DM) and ST segment de-viation at rest in abnormal HRR group were more significantly than those in normal HRR group (all P < 0. 05). (2) The subjects of abnormal HRR usually had higher basal heart rate, more cases exhibited ST segment abnormality and or exercise-limited angina during or after TET(P<0.01 and P<0.05, respectively), but lower level of peak heart rate attained (P<0.05) than those in normal group. The values of metabolism equivalents and duration of TET between the two groups displayed phenomenal difference (P<0.05). There were more samples acquired moderate to high level of Duke test score and chronotropic incompetence in the group of abnormal HRR, compared to the normal HRR group (P<0.01). (3) The cases of negative CAG results in the group of normal and abnormal HRR group were 73 (66.97 % ) and 24 (34.78 %). Cases of significant coronary lesions (at least one major coronary vessel ≥ 50 % stenosis) a-mongst the subgroup of positive CAG were 36 (33.03 % ) and 45 (65.22 %), severe coronary lesions (three-vessel, left main or the equivalents of left main) were 10 (9.17 % ) and 17 (24.64 %) for normal and abnormal HRR respec-tively (P<0.01). Accordingly, the Gensini scores in the subunit of abnormal HRR increased. (4)Linear correlation analysis indicate there was a negative correlation between the values of HRR in

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

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    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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  9. Clinical characterization of cardiovascular abnormalities associated with feline mucopolysaccharidosis I and VI

    Science.gov (United States)

    Sleeper, Meg M.; Kusiak, Catherine M.; Shofer, Frances S.; O’Donnell, Patricia; Bryan, Caroline; Ponder, Katherine P.; Haskins, Mark E.

    2009-01-01

    Summary Objective The purpose of this study was to define the cardiovascular abnormalities present in young and adult cats affected with the lysosomal storage diseases mucopolysaccharidosis (MPS) I and MPS VI. Method Eighteen cats affected with MPS I and fifteen cats affected with MPS VI were evaluated by physical examination, electrocardiography and echocardiography. Electrocardiograms were performed on all MPS I and all but 7 of the MPS VI cats. Ten unaffected cats underwent complete examinations for comparison purposes. Results No cardiovascular physical examination abnormalities were noted. ECG intervals were normal in affected cats; however, changes consistent with aberrant conduction were noted more frequently than in unaffected cats. Significant echocardiographic abnormalities included valve thickening and regurgitation (aortic and mitral) and aortic root dilation, particularly in the older cats. Conclusion As affected animals increased in age, more cardiac abnormalities were found with increasing severity. MPS I and MPS VI cats have similar cardiovascular findings to those seen in children and MPS VII dogs. PMID:18509743

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

    Science.gov (United States)

    Lin, Hsiang-Yu; Chuang, Chih-Kuang; Chen, Ming-Ren; Chiu, Pao Chin; Ke, Yu-Yuan; Niu, Dau-Ming; Tsai, Fuu-Jen; Hwu, Wuh-Liang; Lin, Ju-Li; Lin, Shuan-Pei

    2014-02-10

    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. 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. 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. 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.

  11. Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features.

    Science.gov (United States)

    Marra, Christina M; Maxwell, Clare L; Smith, Stacy L; Lukehart, Sheila A; Rompalo, Anne M; Eaton, Molly; Stoner, Bradley P; Augenbraun, Michael; Barker, David E; Corbett, James J; Zajackowski, Mark; Raines, Charles; Nerad, Judith; Kee, Romina; Barnett, Scott H

    2004-02-01

    To define clinical and laboratory features that identify patients with neurosyphilis. Subjects (n=326) with syphilis but no previous neurosyphilis who met 1993 Centers for Disease Control and Prevention criteria for lumbar puncture underwent standardized history, neurological examination, venipuncture, and lumbar puncture. Neurosyphilis was defined as a cerebrospinal fluid (CSF) white blood cell count >20 cells/ microL or reactive CSF Venereal Disease Research Laboratory (VDRL) test result. Sixty-five subjects (20.1%) had neurosyphilis. Early syphilis increased the odds of neurosyphilis in univariate but not multivariate analyses. In multivariate analyses, serum rapid plasma reagin (RPR) titer > or =1 : 32 increased the odds of neurosyphilis 10.85-fold in human immunodeficiency virus (HIV)-uninfected subjects and 5.98-fold in HIV-infected subjects. A peripheral blood CD4+ T cell count < or =350 cells/ microL conferred 3.10-fold increased odds of neurosyphilis in HIV-infected subjects. Similar results were obtained when neurosyphilis was more stringently defined as a reactive CSF VDRL test result. Serum RPR titer helps predict the likelihood of neurosyphilis. HIV-induced immune impairment may increase the risk of neurosyphilis.

  12. Leukocyte abnormalities.

    Science.gov (United States)

    Gabig, T G

    1980-07-01

    Certain qualitative abnormalities in neutrophils and blood monocytes are associated with frequent, severe, and recurrent bacterial infections leading to fatal sepsis, while other qualitative defects demonstrated in vitro may have few or no clinical sequelae. These qualitative defects are discussed in terms of the specific functions of locomotion, phagocytosis, degranulation, and bacterial killing.

  13. Natural History and Clinical Consequences of Hepatitis B Virus Infection.

    Science.gov (United States)

    Pan, Calvin Q; Zhang, Jin X

    2005-01-01

    Despite the existence of Hepatitis B vaccination, hepatitis B virus (HBV) infection is still prevalent worldwide and accounts for significant morbidity and mortality. It is encouraging that majority of patients do recover from the acute infection, however, those that progress to chronic disease state is at great risk of developing complications such as hepatocellular carcinoma, cirrhosis and liver failure. Hepatitis B virus infection can be influenced by many factors such as host immune status, age at infection, and level of viral replication. The discovery about the existence of various genotypes and its association with different geographic distribution as well as the knowledge regarding mutant species has aid us in better understanding the nature of HBV infection and in delivering better care for patients. It is especially important to recognize those individuals with HBeAg-negative chronic HBV as they have a poorer prognosis compare with their counterparts, HBeAg-positive. Tremendous progress has been made over the years in understanding the behavior and clinical course of the disease; however, the natural history of HBV is complex and we still have much to explore and learn.

  14. A brief history of placebos and clinical trials in psychiatry.

    Science.gov (United States)

    Shorter, Edward

    2011-04-01

    The history of placebos in psychiatry can be understood only in the context of randomized controlled trials (RCTs). Placebo treatments are as old as medicine itself, and are particularly effective in dealing with psychosomatic symptoms. In psychiatry, placebos have mainly been featured in clinical drug trials. The earliest controlled trial in psychiatry (not involving drugs) occurred in 1922, followed by the first crossover studies during the 1930s. Meanwhile the concept of randomization was developed during the interwar years by British statistician Ronald A Fisher, and introduced in 3 trials of tuberculosis drugs between 1947 and 1951. These classic studies established the RCT as the gold standard in pharmaceutical trials, and its status was cemented during the mid-1950s. Nevertheless, while the placebo became established as a standard measure of drug action, placebo treatments became stigmatized as unethical. This is unfortunate, as they constitute one of the most powerful therapies in psychiatry. In recent years, moreover, the dogma of the placebo-controlled trial as the only acceptable data for drug licensing is also being increasingly discredited. This backlash has had 2 sources: one is the recognition that the US Food and Drug Administration has been too lax in permitting trials controlled with placebos alone, rather than also using an active agent as a test of comparative efficacy. In addition, there is evidence that in the hands of the pharmaceutical industry, the scientific integrity of RCTs themselves has been degraded into a marketing device. The once-powerful placebo is thus threatened with extinction.

  15. Clinical history and hematological findings among canines with monocytic ehrlichiosis.

    Science.gov (United States)

    Moonarmart, Walasinee; Sungpradit, Sivapong; Rawangchue, Thanakorn; Suphaphiphat, Karuna; Suksusieng, Sineenart; Jirapattharasate, Charoonluk

    2014-01-01

    Canine monocytic ehrlichiosis is a tick borne disease caused by Ehrlichia canis, an obligate intracellular rickettsial organism belonging to the family Anaplasmataceae. Canine ehrlichiosis causes hemaotological changes among infected animals which could be used as a potential predictor for diagnosing canine monocytic ehrlichiosis (CME). Ninety-four blood samples were obtained from canines that either presented for a routine health check-up or for clinical illness. A history, physical and laboratory test were conducted on each animal. All samples were examined for E. canis using a 16S rDNA polymerase chain reaction (PCR) amplification to confirm CME infection. Thirty-six of the samples were positive for E. canis using PCR and the rest were negative. The Mann-Whitney and chi-square test were used to compare the differences between the PCR-positive and negative animals. PCR-positive animals had a higher mean body temperature than PCR-negative animals. The following were significantly lower in PCR-positive animals: white blood cell count, eosinophil count, red blood cell count, hemoglobin, hematocrit, platelet count, and the random distribution of width (RDW) of the red blood cells. We evaluated complete blood cell count findings to determine factors associated with CME using multivariable logistic regression analysis and found thrombocytopenia was significantly associated with CME (OR = 0.085; 95% CI: 0.78-0.92, p < 0.001). For every decrease in the platelet count of 10,000 there was a 15% increase in the likelihood of having CME.

  16. The prevalence of chromosomal abnormalities in subgroups of infertile men.

    Science.gov (United States)

    Dul, E C; Groen, H; van Ravenswaaij-Arts, C M A; Dijkhuizen, T; van Echten-Arends, J; Land, J A

    2012-01-01

    The prevalence of chromosomal abnormalities is assumed to be higher in infertile men and inversely correlated with sperm concentration. Although guidelines advise karyotyping infertile men, karyotyping is costly, therefore it would be of benefit to identify men with the highest risk of chromosomal abnormalities, possibly by using parameters other than sperm concentration. The aim of this study was to evaluate several clinical parameters in azoospermic and non-azoospermic men, in order to assess the prevalence of chromosomal abnormalities in different subgroups of infertile men. In a retrospective cohort of 1223 azoospermic men and men eligible for ICSI treatment, we studied sperm parameters, hormone levels and medical history for an association with chromosomal abnormalities. The prevalence of chromosomal abnormalities in the cohort was 3.1%. No association was found between chromosomal abnormalities and sperm volume, concentration, progressive motility or total motile sperm count. Azoospermia was significantly associated with the presence of a chromosomal abnormality [15.2%, odds ratio (OR) 7.70, P chromosomal abnormalities (OR 2.96, P = 0.013). Azoospermic men with a positive andrologic history had a lower prevalence of chromosomal abnormalities than azoospermic men with an uneventful history (OR 0.28, P = 0.047). In non-azoospermic men, we found that none of the studied variables were associated with the prevalence of chromosomal abnormalities. We show that the highest prevalence of chromosomal abnormalities is found in hypergonadotrophic azoospermic men with an uneventful andrologic history.

  17. Abnormal surface EMG during clinically normal wrist movement in cervical dystonia

    NARCIS (Netherlands)

    de Vries, P. M.; Leenders, K. L.; van der Hoeven, J. H.; de Jong, B. M.; Kuiper, A. J.; Maurits, N. M.

    2007-01-01

    We investigated whether patients with cervical dystonia (CD) have abnormal muscle activation in non-dystonic body parts. Eight healthy controls and eight CD patients performed a flexion-extension movement of the right wrist. Movement execution was recorded by surface electromyography (EMG) from fore

  18. Analysis of chromosome abnormality in 261 couples with aderverse pregnancy outcome history in Guangzhou%广州地区不良孕产史夫妇外周血异常核型分析

    Institute of Scientific and Technical Information of China (English)

    夏冰; 叶长烂; 张中芬; 郑霖; 江悦华; 王捷

    2011-01-01

    Objective: To explore the types of chromosome abnormality in the couples with aderveree pregnancy outcome history. Method: Cytogenetic analysis with C -staining method was performed on the peripheral blood lymphocyte cultures of 261 couples with abnormal pregnancy - labor history. Results: Chromosome abnormalities were found in 80 patients, including 9 of reciprocal transloca-tion, 1 mosaic Turner syndrome, 70 of chromosome heteromorphism which included 10 of small pericentric inversion of chromosome 9, 16 of increase in length of heterochromatin on long arm of chromosomes, 36 of increase/decrease in satellite length or double satellites on short arms of chromosomes in D and C groups, and 8 of increase/decrease in length of Y chromosome. Conclusion; The chromosome abnormalities of the couples with adverse pregnancy outcome history are mainly balanced reciprocal translocations and chromosome heteromorphism, and the high incidence of the latter in such couples suggests that it has some clinical effects.%目的 观察不良孕产夫妇异常染色体分布类型及其与不良孕产的关系.方法 对261对不良孕产夫妇外周血淋巴细胞进行细胞遗传学分析,采用G显带方法.结果 261对不良孕产史夫妇染色体异常80例(15.3%),其中相互易位9例;Turner嵌合体1例;染色体异态70例,包括9号染色体小臂间倒位10例,次缢痕长度增加16例,D组、G组短臂的随体长度增加或减少或双随体共36例,大Y、小Y共8例.结论 不良孕产夫妇染色体异常主要为平衡易位和多种染色体异态,后者在不良孕产史夫妇中的高发生率提示其具有一定临床效应.

  19. [Directed clinical history and physical examination in patients with erectile dysfunction. Clinical features we cannot forget].

    Science.gov (United States)

    Tejero, Emilio José Emmanuel; Chicharro, Raul Vozmediano; Vargas, Eloy Vivas; Morales, Antonio Martín

    2010-10-01

    We aim in this work to establish directions for data collection in the chart of the patient with erectile dysfunction (ED), to characterize the presenting problem, reveal possible associated risk factors, evaluate the need of additional complementary tests, and decide if a multidisciplinary approach is necessary. Bibliographic review about directions and recommendations on initial and clinical management of ED. Sexual history is the most important part of the basic routine with a patient with ED, and the purpose of the andrologist is to identify the type of sexual dysfunction, time of start, severity, duration, and treatment expectations.

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. The pattern of abnormalities on sperm analysis: A study of 1186 infertile male in Yasmin IVF clinic Jakarta

    Science.gov (United States)

    Aulia, S. N.; Lestari, S. W.; Pratama, G.; Harzief, A. K.; Sumapraja, K.; Hestiantoro, A.; Wiweko, B.

    2017-08-01

    A declined in semen quality resulted an increase of male infertility has been reported. The pattern of abnormalities differs from one country to another. Conflicting results from different studies may be influenced by many factor. The aims are to evaluate the pattern of semen analysis of male partners of infertile couples and identify the current status of the contribution of male factor towards the infertility in our environment. The study is a descriptive analysis of the semen analysis of male partners in infertile couples, who were present at Yasmin IVF Clinic, infertility clinic of a Tertiary Care University Teaching Hospital between 1st January 2012 and 31st December 2015. A total of 1186 consenting male partners of infertile couple were recruited into the study. According to 2010 WHO normal reference values for semen parameters, 795 (67%) of patients were normozoospermia which had normal semen parameters and 391 (33%) patients had abnormal semen parameters. Oligozospermia was evident in 155 (39.5%) patients, being the most common disorder observed. It is followed by azoospermia (24.4%), oligoasthenozospermia (17.8%), asthenozospermia (5.9%), oligoasthenotera-tozospermia (5,7%), teratozospermia (2.6%), asthenoteratozospermia (2.8%), cryptozoospermia (0.8%), necrozospermia (0.3%), and oligoteratozospermia (0.3%). Abnormal semen quality remains a significant contribution to the overall infertility with oligozospermia being the most common semen quality abnormality. This condition is an indication for the need to focus on the prevention and management of male infertility. In addition, further studies are needed to address possible etiologies and treatment in order to improve fertility rates.

  3. Karyotypic abnormalities and clinical aspects of patients with multiple myeloma and related paraproteinemic disorders

    Energy Technology Data Exchange (ETDEWEB)

    Liang, W.; Hopper, J.E.; Rowley, J.D.

    1979-08-01

    Karyotypic abnormalities were detected in the malignant cells of 6 of 18 patients with multiple myeloma (MM). Six patients with benign monoclonal gammopathy, one with amyloidosis of immunoglobulin origin, and two with Waldenstroem's macroglobulinemia had normal karyotypes. All six MM patients with aneuploidy were in a group of 10 patients in an accelerated or relapse phase of their disease and four had high serum paraprotein levels when their abnormal karyotypes were detected. Five of the 6 MM patients with aneuploidy had received prior chemotherapy. Aneuploidy was not observed in 8 stable MM patients. Abnormalities of chromosome 14 were present in all 6 patients. A translocation between Nos. 11 and 14 was found in aneuploid cells of 2 patients who had plasma cell leukemia (PCL). A deletion of chromosome 6 was detected in 2 MM patients and a pericentric inversion of No. 6 was seen in the patient with PCL. Three of 4 MM patients had a nonrandom loss of one chromosome 8. Two other MM patients developed acute nonlymphocytic leukemia (ANLL) after the diagnosis of MM. Marrow cells of one patient showed a 5q- chromosome and a constitutional translocation involving Nos. 13 and 14 during the preleukemic stage; during the leukemic phase, the karyotype evolved to 50 chromosomes including extra chromosomes 1, 6, 8, 10, and 21 and a missing 7, in addition to the originally detected 5q- and the 13/14 translocation.The peripheral blood from the other patient was hypodiploid, with a missing chromosome 7 and a translocation between 3q and 9p. These patterns of chromosome change resemble those of ANLL rather than MM and are similar to the changes seen in ANLL after treated malignant lymphoma.

  4. 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

    Directory of Open Access Journals (Sweden)

    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

  5. Historie

    DEFF Research Database (Denmark)

    Poulsen, Jens Aage

    Historie i serien handler om læreplaner og læremidler og deres brug i skolefaget historie. Bogen indeholder nyttige redskaber til at analysere og vurdere læremidler......Historie i serien handler om læreplaner og læremidler og deres brug i skolefaget historie. Bogen indeholder nyttige redskaber til at analysere og vurdere læremidler...

  6. Nail abnormalities in patients with vitiligo*

    Science.gov (United States)

    Topal, Ilteris Oguz; Gungor, Sule; Kocaturk, Ozgur Emek; Duman, Hatice; Durmuscan, Mustafa

    2016-01-01

    Background Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. Objective We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the correlations between nail abnormalities and various clinical parameters. Methods This study included 100 vitiligo patients and 100 healthy subjects. Full medical histories were collected from the subjects, who underwent thorough general and nail examinations. All nail changes were noted. In the event of clinical suspicion of a fungal infection, additional mycological investigations were performed. Results Nail abnormalities were more prevalent in the patients (78%) than in the controls (55%) (p=0.001). Longitudinal ridging was the most common finding (42%), followed by (in descending order): leukonychia, an absent lunula, onycholysis, nail bed pallor, onychomycosis, splinter hemorrhage and nail plate thinning. The frequency of longitudinal ridging was significantly higher in patients than in controls (p<0.001). Conclusions Nail abnormalities were more prevalent in vitiligo patients than in controls. Systematic examination of the nails in such patients is useful because nail abnormalities are frequent. However, the causes of such abnormalities require further study. Longitudinal ridging and leukonychia were the most common abnormalities observed in this study. PMID:27579738

  7. Computer aided diagnosis of bone tumours and tumour-like skeletal abnormalities: Critical evaluation of its clinical use

    Energy Technology Data Exchange (ETDEWEB)

    Fotter, R.; Gell, G.; Melzer, G.; Kopp, W.; Lehnert, M.; Weybora, W.

    1988-05-01

    Thirty-four patients with bone tumours and tumour-like abnormalities of the skeleton, of varying ages, were examined by a computer-aided diagnostic programm; the accuracy, clinical usefullness and specific advantages and disadvantages of the programm have been evaluated. This was done by two statistical methods, both with showed high accuracy and reliability of the system (97% and 88,2%). In addition to the diagnostic results, the growth rate of the lesion could be estimated. This indicates the biological behaviour of the tumour independently of the histological diagnosis.

  8. 胎儿染色体核型异常的临床分析%Clinical analysis of fetal chromosomes karyotype abnormalities

    Institute of Scientific and Technical Information of China (English)

    林晓娟; 孙庆梅; 何晓春; 吴菊; 葛婷婷; 代维斯

    2016-01-01

    Objective To study the indications of prenatal diagnosis of fetal chromosome karyotype abnormalities,and provide the basis for prenatal diagnosis and clinical genetic counseling. Methods From October 2010 to April 2014,a total of 5 655 cases of pregnant women who received prenatal diagnosis of fetal karyotype analysis in Prenatal Diagnosis Center,Gansu Provincial Maternity and Child-care Hospital were selected as research subjects.The indications of prenatal diagnosis of the 5 655 cases of pregnant women contained high-risk indications of antenatal serological screening,such as trisomy 21 syndrome risk≥1/270 or trisomy 18 syndrome risk≥1/350 (2 482 cases),age ≥35 years old (1 889 cases),adverse pregnancy history (675 cases),chromosomal abnormalities of one of the couple (49 cases),prenatal ultrasound abnormalities (465 cases),and exposure to the poisonous and harmful substance,drugs that may cause teratogenicity and radical line (95 cases ).All the indications of prenatal diagnosis were uncrossed.Fetal chromosome karyotype abnormalities were diagnosed by amniocentesis. Different kinds of fetal chromosomes karyotype abnormalities, the number and detection rate,the relationship between fetal chromosome karyotype abnormalities and prenatal ultrasound abnormalities were analyzed by retrospective method.And the fetal chromosomes karyotype abnormalities detection rates of different indications of prenatal diagnosis were analyzed by statistical methods.The study protocol was approved by the Ethical Review Board of Investigation in Gansu Provincial Maternity and Child-care Hospital.Informed consent was obtained from each patient before receiving invasive prenatal diagnosis.Results ①Among the 5 655 cases of pregnant women who received invasive prenatal diagnosis,124 cases were detected as fetal chromosomal karyotype abnormalities,and the detection rate was 2.2%.Among 2 482 cases of pregnant women with high-risk indications,1 889 cases with age ≥ 35 years old,675

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

    Science.gov (United States)

    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…

  10. Radiological and scintigraphic findings in patients with a clinical history of chronic inflammatory back pain.

    Science.gov (United States)

    Goei The, H S; Lemmens, A J; Goedhard, G; Lokkerbol, H; Rahmy, A; Steven, M M; van der Linden, S M; Cats, A

    1985-01-01

    The prevalence of radiological abnormalities of the sacroiliac joints, the manubriosternal joint, and the lumbar spine were assessed, and quantitative sacroiliac scintigraphy was performed in 151 patients with a history of chronic inflammatory back pain and in 31 controls with non-inflammatory back pain. Sacroiliitis was found in 124 patients (82%), manubriosternal lesions in 84 patients (56%), and lesions of the lumbar spine in 58 patients (38%). In 19 patients (13%), manubriosternal lesions provided the sole radiological abnormality and in five patients (3%) no radiological abnormality could be demonstrated at any of these sites. Quantitative sacroiliac scintigraphy showed increased values in 69 of 137 patients examined (50%), but also in 10 out of 12 control patients with disc degeneration (83%) and is, therefore, nonspecific for inflammatory lesions. Radiological examination of the manubriosternal joint is recommended in patients with inflammatory back pain without radiographic evidence of sacroiliitis.

  11. Radiological and scintigraphic findings in patients with a clinical history of chronic inflammatory back pain

    Energy Technology Data Exchange (ETDEWEB)

    Goei The, H.S.; Lemmens, A.J.; Goedhard, G.; Lokkerbol, H.; Rahmy, A.; Linden, S.M. van der; Cats, A.; Steven, M.M.

    1985-10-01

    The prevalence of radiological abnormalities of the sacroiliac joints, the manubriosternal joint, and the lumbar spine were assessed, and quantitative sacroiliac scintigraphy was performed in 151 patients with a history of chronic inflammatory back pain and in 31 controls with non-inflammatory back pain. Sacroiliitis was found in 124 patients (82%), manubriosternal lesions in 84 patients (56%), and lesions of the lumbar spine in 58 patients (38%). In 19 patients (13%), manubriosternal lesions provided the sole radiological abnormality and in five patients (3%) no radiological abnormality could be demonstrated at any of these sites. Quantitative sacroiliac scintigraphy showed increased values in 69 of 137 patients examined (50%), but also in 10 out of 12 control patients with disc degeneration (83%) and is, therefore, nonspecific for inflammatory lesions. Radiological examination of the manubriosternal joint is recommended in patients with inflammatory back pain without radiographic evidence of sacroiliitis. (orig.).

  12. Clinical significance of abnormal protein bands in multiple myeloma treated with bortezmib-based induction regimen and autologous stem cell transplantation

    Institute of Scientific and Technical Information of China (English)

    王荷花

    2013-01-01

    Objective To study the clinical significance of abnormal protein bands(APB)in multiple myeloma(MM) patients treated with bortezomib-based induction regimen and autologous stem cell transplantation(ASCT)

  13. Clinical Presentation of a Patient with Congenital Cutis Laxa and Abnormal Thyroid Hormone Levels

    Directory of Open Access Journals (Sweden)

    Yan Ma

    2014-02-01

    Full Text Available We describe a case of generalized cutis laxa (CL in a 7-year-old female child. At 2 months of age, she was found to have a hoarse voice, and at 3 years, she was much smaller than her peers. Her aging face and short stature caught our attention, and the treatment of the patient was accepted by our hospital. She underwent a thorough examination. X-ray of the wrist bone showed a markedly delayed bone age, and thyroid function tests revealed significantly elevated free triiodothyronine 3 and free thyroxine 4 levels, but thyrotropin was within the normal range. Thyroid dysfunction and CL can be associated with lagged growth and development. Whether her abnormal development was due to thyroid dysfunction or CL could not be ascertained. CL is possibly more complex than it has been supposed so far, and is therefore worth to be further studied.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  15. Clinical observation of the abnormality of inferior oblique tendon in congenital superior oblique muscle paralytic patients

    Directory of Open Access Journals (Sweden)

    Wei Xiao

    2013-11-01

    Full Text Available AIM: To measure the abnormality of the inferior oblique tendon in patients with congenital superior oblique muscle paralysis.METHODS: In this cross-sectional, self-control designed study, the tensity of the inferior oblique tendon of both the paralytic and nonparalytic eye were measured during the operations in 30 patients who were diagnosed with exotropia(including intermittent exotropia and constant exotropia accompanied with single superior oblique muscle paralysis. The tensity of the tendon was measured as the maximal distance of which the inferior oblique tendon could be lifted from the scleraRESULTS: Inferior oblique had different degrees of thickness, but was tougher and tighter than that of nonparalytic eye. There was a significant difference(PCONCLUSION: The inferior oblique tendon is stronger and less relaxant in the paralytic eyes.

  16. History and current use of clinical photography in orthodontics.

    Science.gov (United States)

    Galante, Donna L

    2009-03-01

    The history of dentistry and photography began in 1840 when the first dental school was opened, and the world's first photographic gallery was opened and operated by a dentist turned photographer. Since that time, photography and dentistry have been partners as photography has become an integral part of a patient's record and treatment plan. The specialty of orthodontics has led the way in this model of recording patient data.

  17. Adolescent chronic fatigue syndrome; a follow-up study displays concurrent improvement of circulatory abnormalities and clinical symptoms.

    Science.gov (United States)

    Sulheim, Dag; Hurum, Harald; Helland, Ingrid B; Thaulow, Erik; Wyller, Vegard Bruun

    2012-03-21

    The pathophysiology of chronic fatigue syndrome (CFS) in adolescents is unknown, and the clinical course and prognosis is still questioned. Recent research indicates that abnormalities of autonomic cardiovascular control may play an important role. The aim of this research project was to perform a follow-up study of adolescents with chronic fatigue syndrome, focusing on clinical symptoms and autonomic cardiovascular control. 47 adolescents (12-18 years old) with CFS were recruited from the outpatient clinic at the Department of Pediatrics, Oslo University Hospital. In a primary visit and a follow-up visit (3-17 months later), we evaluated: a) a wide range of complaints and symptoms and b) cardiovascular variables at baseline and during a 20° head-up tilt-test (HUT). At the second visit, patients reported significant improvement regarding functional impairments, fatigue severity, muscular pain, concentration problems, post-exertional malaise and the problem of non-relieving rest. Also, at the second visit, baseline heart rate (HR), blood pressure, total peripheral resistance index (TPRI) and LF/HF (low-frequency:high-frequency heart rate variability ratio, an index of sinus node sympathovagal balance derived from spectral analyses of heart rate) were significant lower, and the increases in HR, mean blood pressure (MBP), diastolic blood pressure (DBP) and TPRI during tilt were significantly less pronounced as compared to the first visit. There was a significant correlation between changes in autonomic symptom score, fatigue severity score and functional impairment score from the first to the second visit. The majority of adolescents with CFS experienced an improvement over time in functional impairment, self-reported fatigue and additional symptoms, and a concurrent improvement of autonomic cardiovascular control. A possible connection between clinical symptoms and abnormal autonomic control in CFS might represent a focus for further research.

  18. Adolescent chronic fatigue syndrome; a follow-up study displays concurrent improvement of circulatory abnormalities and clinical symptoms

    Directory of Open Access Journals (Sweden)

    Sulheim Dag

    2012-03-01

    Full Text Available Abstract Background The pathophysiology of chronic fatigue syndrome (CFS in adolescents is unknown, and the clinical course and prognosis is still questioned. Recent research indicates that abnormalities of autonomic cardiovascular control may play an important role. The aim of this research project was to perform a follow-up study of adolescents with chronic fatigue syndrome, focusing on clinical symptoms and autonomic cardiovascular control. Methods 47 adolescents (12-18 years old with CFS were recruited from the outpatient clinic at the Department of Pediatrics, Oslo University Hospital. In a primary visit and a follow-up visit (3-17 months later, we evaluated: a a wide range of complaints and symptoms and b cardiovascular variables at baseline and during a 20° head-up tilt-test (HUT. Results At the second visit, patients reported significant improvement regarding functional impairments, fatigue severity, muscular pain, concentration problems, post-exertional malaise and the problem of non-relieving rest. Also, at the second visit, baseline heart rate (HR, blood pressure, total peripheral resistance index (TPRI and LF/HF (low-frequency:high-frequency heart rate variability ratio, an index of sinus node sympathovagal balance derived from spectral analyses of heart rate were significant lower, and the increases in HR, mean blood pressure (MBP, diastolic blood pressure (DBP and TPRI during tilt were significantly less pronounced as compared to the first visit. There was a significant correlation between changes in autonomic symptom score, fatigue severity score and functional impairment score from the first to the second visit. Conclusions The majority of adolescents with CFS experienced an improvement over time in functional impairment, self-reported fatigue and additional symptoms, and a concurrent improvement of autonomic cardiovascular control. A possible connection between clinical symptoms and abnormal autonomic control in CFS might

  19. Accident involving a 2-year-old child and Lonomia obliqua venom: clinical and coagulation abnormalities

    Directory of Open Access Journals (Sweden)

    Daniela Nasu Monteiro Medeiros

    2014-12-01

    Full Text Available Poisons of caterpillars have different effects on inflammatory and coagulation systems. This is a case report of a 2-year-old child that accidentally came in contact with several caterpillars of the species Lonomia obliqua. At first, the patient's exams presented abnormal coagulation and decreased fibrinogen, but the patient did not evolve to active bleeding or acute renal failure. The patient received antilonomic serum 15 h after the accident and the treatment was repeated after another 12 h due to persistent alterations shown by the coagulation exams. The venom of L. obliqua has several substances that act on the coagulation and inflammatory systems. The event is characterized by a hemorrhagic syndrome with decreases in fibrinogen. L. obliqua Stuart-factor activator (Losac and L. obliqua prothrombin activator protease (Lopap are components that act with procoagulatory effects. The pro-inflammatory action occurs due to metalloproteases, hyaluronidases and other substances with inflammatory activity. Studies on caterpillar venom can give new perspectives on the treatment of cancer and other diseases that cause dysfunction of the extra-cellular matrix.

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

    NARCIS (Netherlands)

    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

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

    Science.gov (United States)

    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.

  2. COMP mutations: domain-dependent relationship between abnormal chondrocyte trafficking and clinical PSACH and MED phenotypes.

    Science.gov (United States)

    Chen, Tung-Ling L; Posey, Karen L; Hecht, Jacqueline T; Vertel, Barbara M

    2008-02-15

    Mutations in cartilage oligomeric matrix protein (COMP) produce clinical phenotypes ranging from the severe end of the spectrum, pseudoachondroplasia (PSACH), which is a dwarfing condition, to a mild condition, multiple epiphyseal dysplasia (MED). Patient chondrocytes have a unique morphology characterized by distended rER cisternae containing lamellar deposits of COMP and other extracellular matrix proteins. It has been difficult to determine why different mutations give rise to variable clinical phenotypes. Using our in vitro cell system, we previously demonstrated that the most common PSACH mutation, D469del, severely impedes trafficking of COMP and type IX collagen in chondrocytic cells, consistent with observations from patient cells. Here, we hypothesize that PSACH and MED mutations variably affect the cellular trafficking behavior of COMP and that the extent of defective trafficking correlates with clinical phenotype. Twelve different recombinant COMP mutations were expressed in rat chondrosarcoma cells and the percent cells with ER-retained COMP was assessed. For mutations in type 3 (T3) repeats, trafficking defects correlated with clinical phenotype; PSACH mutations had more cells retaining mutant COMP, while MED mutations had fewer. In contrast, the cellular trafficking pattern observed for mutations in the C-terminal globular domain (CTD) was not predictive of clinical phenotype. The results demonstrate that different COMP mutations in the T3 repeat domain have variable effects on intracellular transport, which correlate with clinical severity, while CTD mutations do not show such a correlation. These findings suggest that other unidentified factors contribute to the effect of the CTD mutations. J. Cell. Biochem. 103: 778-787, 2008. (c) 2007 Wiley-Liss, Inc. Copyright 2007 Wiley-Liss, Inc.

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

    NARCIS (Netherlands)

    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

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

    DEFF Research Database (Denmark)

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 异常子宫出血临床与病理特点分析%Clinical and Pathological Features of Abnormal Uterine Bleeding Analysis

    Institute of Scientific and Technical Information of China (English)

    宋清玲; 薛莎

    2015-01-01

    Objective: To analyze abnormal uterine bleeding clinical and pathological features.Methods:A retrospective gynecological hospital in January 2011 to January 2013 admitted 400 patients with abnormal uterine bleeding clinical data,summarize the pathological type of abnormal uterine bleeding and pathological diagnosis of women at different stages.Results:Abnormal uterine bleeding is mainly divided into dysfunctional uterine bleeding,bleeding with normal menstrual cycle organic endometrial three categories,of which the latter is the most,and accounting for 60.25% of all patients.Dysfunctional uterine bleeding and endometrial hyperplasia is simple to most,accounting for 71.08% of dysfunctional uterine bleeding;organic disease during pregnancy bleeding to most,accounting for 46.05% organic uterine bleeding;normal menstrual cycle film with atypical endometrial hyperplasia most,accounting for 71.37 percent of the normal menstrual cycle endometrial.Conclusion:The diagnosis and treatment of patients with abnormal uterine bleeding,in conjunction with the patient's medical history and laboratory examinations,timely diagnostic curettage and pathological examination as soon as possible to make a definitive diagnosis and targeted treatment options.%目的:分析异常子宫出血的临床与病理特点。方法:回顾我院妇科2011年1月~2013年1月收治的400例异常子宫出血患者的临床资料,总结不同阶段的女性的异常子宫出血的病理类型以及病理诊断结果。结果:异常子宫出血中主要分为功能性子宫出血、器质性子宫出血与正常月经周期内膜三类,其中以后者为最多,占全部患者的60.25%。功能性子宫出血中以单纯性内膜增生为最多,占功能性子宫出血的71.08%;器质性子宫出血中以妊娠期疾病为最多,占器质性子宫出血的46.05%;正常月经周期内膜中以子宫内膜不典型增生为最多,占正常月经周期内膜的71.37%

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

    Directory of Open Access Journals (Sweden)

    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

  8. Chest radiographs in subjects with asbestos-related abnormalities: comparison between ILO categorizations and clinical reading.

    Science.gov (United States)

    Hilt, B; Borgerson, A; Lien, J T; Langård, S

    1992-01-01

    The findings of a previous chest X-ray screening, determined without using standardized criteria, were reassessed by means of the ILO classification. Of 470 radiographs that had been determined as showing asbestos-related changes, 430 were categorized according to the ILO Classification. Small opacities with profusion greater than or equal to 1/0 were described in 39 (52%) of 75 participants who, on the original clinical reading, had been determined as having lung fibrosis, and in 45 (12.7%) of 355 who were determined as having pleural changes only. When considering circumscribed pleural thickening at the chest wall or diaphragm, as categorized by the ILO Classification, such changes were present in 401 (93.7%) of 428 subjects with pleural changes as determined on the clinical reading. In addition to the improved sensitivity and specificity achieved, the ILO Classification also allows comparison with other studies. The most apparent disadvantage of the ILO system is that it cannot firmly separate the various types of asbestos-related pleural changes. The study revealed that the previous asbestos exposure of the case subjects had occurred in many different workplaces and occupations.

  9. Renal Vein Thrombosis in a Newborn With Abnormal Factor VIII Level: Clinical Case Report.

    Science.gov (United States)

    Szafranska, Agnieszka; Pajak, Agata; Kilis-Pstrusinska, Katarzyna; Królak-Olejnik, Barbara

    2015-08-01

    Renal vein thrombosis (RVT) in neonates is a rare condition of low mortality but significant morbidity due to renal impairment.We report the case of a male term newborn with left RVT and elevated serum factor VIII (FVIII).The main symptoms of the patient and the important clinical findings: prompt diagnosis of RVT was possible because the classic clinical presentation of macroscopic hematuria, thrombocytopenia, and palpable flank mass were present in this newborn infant.The main diagnoses: finally, the reason of RVT was established when the infant was 3 months of age: the increased level of FVIII was confirmed. We discuss the diagnosis, therapy, and outcome of the patient and compare with the literature.Therapeutics interventions: however, despite anticoagulant therapy the left kidney developed areas of scarring and then atrophy.Conclusions and outcomes: Prothrombotic defects should be considered in all patients with perinatal RVT. Elevated factor VIII as a reason of RVT in neonatal period is particularly rare. Given a poor renal outcome in children associated with elevated levels of factor VIII, consideration could be given to more aggressive antithrombotic therapy in such cases.

  10. 不良孕产史与子痫前期发病关系的研究%ASSOCIATION OF ABNORMAL PREGNANCY HISTORY WITH PREECLAMPSIA

    Institute of Scientific and Technical Information of China (English)

    史丽; 赵喜娃; 赵艳玲; 王彦莉; 李青梅; 尹洁

    2014-01-01

    ABSTRACT:Objective To explore the relationship of abnormal pregnancy history with preeclampsia.Methods Correlation factors were studied retrospectively in 200 cases of preeclampsia and 200 cases of normal gravida with case-control study.The relationship between gravidity,parity,induced abortion,early abortion,late abortion,fetal death and preeclampsia were evaluated.Results The morbidility of gravidity,parity,induced abortion had no significant difference between two groups.The morbidility of early abortion,late abortion,fetal death in preeclampsia women were significantly higher than those of normal women (P < 0.05 ).Early abortion,late abortion,unclear fetal death were the risk factors of preeclampsia after logistic regression.Conclusion Abnormal pregnancy history was the risk factor of preeclampsia.%目的:探讨不良孕产史与子痫前期发病的关系。方法回顾性分析200例子痫前期孕妇及同期200例健康孕妇的临床资料,评估孕次、产次、人工流产次、早期流产、晚期流产、不明原因死胎与子痫前期发病的关系。结果正常妊娠组孕次、产次、人工流产次与子痫前期组差异无统计学意义,而子痫前期组中早期流产、晚期流产、不明原因死胎的发生率明显高于正常妊娠组(P <0.05);Logistic 回归分析显示,早期流产、晚期流产、不明原因死胎是子痫前期发病的高危因素。结论不良孕产史可能为子痫前期发病的高危因素。

  11. Abnormal expression of CD43 in patients with systemic lupus erythematosus and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    XIA Li-xia; DING Xin; LI Xin; ZHANG Feng-chun; TANG Fu-lin; ZHANG Xuan; BA De-nian; HE Wei

    2012-01-01

    Background Previous studies indicate that CD43 plays a role in regulating the adhesion of lymphocytes,cell mutation and activation,however,little is known about its effect on systemic lupus erythematousus (SLE).This study was designed to explore the clinical significance of CD43 in SLE patients.@@Methods We used microarray and real-time PCR to detect the mRNA and protein expression of magnetic bead sorted T cells and B cells from peripheral blood mononuclear cells (PBMCs) of SLE patients,and analyzed the relationship between CD43 and the clinical indexes.@@Results Both microarray and real-time PCR results showed that CD43 mRNA was significantly decreased in PBMCs of SLE patients compared with healthy controls (P <0.001).There were no significant differences between lupus nephritis and non-lupus nephritis patients,and neuropsychiatric and non-neuropsychiatric patients.CD43 mRNA expression was significantly reduced in T cells but not in B-cells in SLE patients compared to healthy controls (P <0.01).Compared with healthy controls,the percentage of CD43+ cells in the PBMCs of SLE was significantly decreased (P=0.004),and the CD43 fluorescence intensity in CD3+/CD43+ cells and CD19+/CD43+ cells was also significantly weaker than in healthy controls (P=0.039 and 0.003).There was no significant difference in the percentage of CD3+/CD43+ cells,CD19+/CD43+ cells between the two groups.The CD43 fluorescence intensity in CD3+/CD43+ cells was inversely correlated with the levels of IgG and IgM (r=-0.8 and -0.6).@@Conclusions Compared to healthy controls,both CD43 mRNA and protein expressions were reduced in T cells from patients with SLE,and were inversely correlated with IgG.

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

    LENUS (Irish Health Repository)

    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.

  13. A cervical abnormality risk prediction model: can we use clinical information to predict which patients with ASCUS/LSIL Pap tests will develop CIN 2/3 or AIS?

    Science.gov (United States)

    Charlton, Brittany M; Carwile, Jenny L; Michels, Karin B; Feldman, Sarah

    2013-07-01

    Human papillomavirus (HPV) infections and abnormal Pap test results are common, and most do not progress to cervical cancer. Because it is difficult to predict which mild Pap abnormalities will develop into precancerous lesions, many women undergo painful and costly evaluations and even unnecessary treatment. The objective of this study was to develop a risk prediction model based on clinical and demographic information to identify women most likely to develop significant precancerous lesions (cervical intraepithelial neoplasia grades 2/3 [CIN 2/3] or adenocarcinoma in situ [AIS]) among women with mild Pap abnormalities (atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion). The Abnormal Pap Smear Registry includes women who received treatment at the Brigham and Women's Hospital/Dana Farber Cancer Institute Pap Smear Evaluation Center beginning in 2006. It includes 1,072 women with mild cervical dysplasia (atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion) on their referral Pap test. We derived a clinical prediction model to predict the probability of developing CIN 2/3 or AIS using multivariate logistic regression with a split-sample approach. By the end of the follow-up, 93 of the 1,072 women developed CIN 2/3 or AIS (8.7%). There were several differences between women who developed CIN 2/3 or AIS and women who did not. However, once we put these into the regression model, the only variable that was significantly associated with CIN 2/3 or AIS was having a history of an abnormal Pap or biopsy result (odds ratio = 2.44; 95% CI =1.03-5.76). The resulting prediction model had poor discriminative ability and was poorly calibrated. Despite accounting for known risk factors, we were unable to predict individual patients' probability for progression on the basis of available data.

  14. Distinctive Menkes disease variant with occipital horns: Delineation of natural history and clinical phenotype

    Energy Technology Data Exchange (ETDEWEB)

    Proud, V.K.; Mussell, H.G.; Percy, A.K. [Univ. of Alabama School of Medicine, Birmingham, AL (United States)] [and others

    1996-10-02

    To delineate further the clinical spectrum of Menkes disease, an X-linked recessive disorder of copper transport, we studied 4 related males, ranging in age from 4-38 years, with a unique phenotype that combines manifestations of classical and mild Menkes disease and occipital horn syndrome (OHS). The propositus, an 18-year-old man, was evaluated following an intracerebral hemorrhage at age 15 years and was noted to have marked hypotonia, motor delay with mental retardation, bladder diverticula, failure to thrive, and diarrhea from infancy; seizures from age 3 years; and abnormal hair (pili torti) and face, cutis laxa, and multiple joint dislocations. Radiographic abnormalities included occipital exostoses, tortuous cerebral blood vessels with multiple branch occlusions, and hammer-shaped clavicles. Biochemical studies demonstrated reduced copper and ceruloplasmin levels in serum, and abnormal plasma catecholamine ratios. We reported previously the molecular defect in this family, a splice-site mutation that predicts formation of approximately 20% of the normal Menkes gene product. Here, we detail the clinical course and physical features and radiographic findings in these 4 individuals, and compare their phenotype with classical and mild Menkes and OHS. Unusual Menkes disease variants such as this may escape recognition due to anomalies that appear inconsistent with the diagnosis, particularly prolonged survival and later onset of seizures. Males with mental retardation and connective tissue abnormalities should be evaluated for biochemical evidence of defective copper transport. 28 refs., 8 figs.

  15. Breast MRI BI-RADS assessments and abnormal interpretation rates by clinical indication in US community practices.

    Science.gov (United States)

    Lee, Christoph I; Ichikawa, Laura; Rochelle, Michele C; Kerlikowske, Karla; Miglioretti, Diana L; Sprague, Brian L; DeMartini, Wendy B; Wernli, Karen J; Joe, Bonnie N; Yankaskas, Bonnie C; Lehman, Constance D

    2014-11-01

    As breast magnetic resonance imaging (MRI) use grows, benchmark performance parameters are needed for auditing and quality assurance purposes. We describe the variation in breast MRI abnormal interpretation rates (AIRs) by clinical indication among a large sample of US community practices. We analyzed data from 41 facilities across five Breast Cancer Surveillance Consortium imaging registries. Each registry obtained institutional review board approval for this Health Insurance Portability and Accountability Act compliant analysis. We included 11,654 breast MRI examinations conducted in 2005-2010 among women aged 18-79 years. We categorized clinical indications as 1) screening, 2) extent of disease, 3) diagnostic (eg, breast symptoms), and 4) other (eg, short-interval follow-up). We characterized assessments as positive (ie, Breast Imaging Reporting and Data System [BI-RADS] 0, 4, and 5) or negative (ie, BI-RADS 1, 2, and 6) and provide results with BI-RADS 3 categorized as positive and negative. We tested for differences in AIRs across clinical indications both unadjusted and adjusted for patient characteristics and registry and assessed for changes in AIRs by year within each clinical indication. When categorizing BI-RADS 3 as positive, AIRs were 21.0% (95% confidence interval [CI], 19.8-22.3) for screening, 31.7% (95% CI, 29.6-33.8) for extent of disease, 29.7% (95% CI, 28.3-31.1) for diagnostic, and 27.4% (95% CI, 25.0-29.8) for other indications (P assurance and auditing purposes. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  16. Early permanent disappearance of abnormal muscle response during microvascular decompression for hemifacial spasm: a retrospective clinical study.

    Science.gov (United States)

    Jiang, Chengrong; Xu, Wu; Dai, Yuxiang; Lu, Tianyu; Jin, Wei; Liang, Weibang

    2016-12-15

    The objective of this study is to explore the cause of early abnormal muscle response (AMR) disappearance during microvascular decompression for hemifacial spasm and the clinical outcomes of these patients. Three hundred seventy-two patients received microvascular decompression (MVD) under intraoperative electrophysiological monitoring in Nanjing Drum Tower Hospital in 2014; the characteristic AMR of HFS was observed in 359 patients during the operation. And the 359 patients were divided into two groups based on whether AMR had remained before the beginning of the decompression procedure for offending vessels. Thirty-three patients who showed a permanent disappearance of AMR before the beginning of decompression were regarded as group I. Dural opening and the succeeding CSF drainage produced a permanent disappearance of AMR in 13. During the dissection of lateral cerebellomedullary cistern, a permanent disappearance of AMR was found in 20 patients. Thirty-two patients were cured immediately; delayed resolution (7 days after surgery) was found in one patient. No complications were observed and no recurrence was found during the follow-up period in the 33 patients. In the other 326 patients (group II), AMR disappeared temporarily before the beginning of the decompression procedure for offending vessels in 42 patients. After decompression, AMR disappeared completely in 305 patients. Two hundred sixty-seven patients were cured immediately and 57 patients got a delayed resolution (2 days to 45 weeks after surgery). The two left did not get a complete abolition of spasm. Three cases of hearing loss, one hoarseness, and nine delayed facial paralysis were observed. The reason of early abnormal muscle response disappearance may be that the degree of neurovascular compression was not serious; these patients were more likely to get an immediate cure. Continuous intraoperative electrophysiological monitoring of AMR is necessary.

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

    Institute of Scientific and Technical Information of China (English)

    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

  18. International year of Chemistry 2011. A guide to the history of clinical chemistry.

    Science.gov (United States)

    Kricka, Larry J; Savory, John

    2011-08-01

    This review was written as part of the celebration of the International Year of Chemistry 2011. In this review we provide a chronicle of the history of clinical chemistry, with a focus on North America. We outline major methodological advances and trace the development of professional societies and journals dedicated to clinical chemistry. This review also serves as a guide to reference materials for those interested in the history of clinical chemistry. The various resources available, in sound recordings, videos, moving images, image and document archives, museums, and websites dedicated to diagnostic company timelines, are surveyed. These resources provide a map of how the medical subspecialty of clinical chemistry arrived at its present state. This information will undoubtedly help visionaries to determine in which direction clinical chemistry will move in the future.

  19. Preliminary findings of cortical thickness abnormalities in blast injured service members and their relationship to clinical findings.

    Science.gov (United States)

    Tate, D F; York, G E; Reid, M W; Cooper, D B; Jones, L; Robin, D A; Kennedy, J E; Lewis, J

    2014-03-01

    Though cortical abnormalities have been demonstrated in moderate and severe traumatic brain injured (TBI) patients, there have been no studies examining cortical changes following blast related mild TBI (mTBI). The purpose of this study was to determine the effects and functional relevance of blast mTBI on cortical thickness in a small cohort of carefully screened blast injured US Service Members (SM). Twelve SM with mTBI acquired through blast injury were compared to 11 demographically matched control SM without TBI. Both mTBI and control participants were active duty and had completed a combat deployment. Subjects underwent MRI examination and the T1 weighted anatomic images were processed using the FreeSurfer suite of tools. Cortical thickness maps were compared between groups and examined for relationships with time since injury (TSI). Utilizing a large database of functional imaging results (BrainMap), significant regions of interest (ROI) were used to determine the behavioral profiles most consistently associated with the specific ROI. In addition, clinical variables were examined as part of post-hoc analysis of functional relevance. Group comparisons controlling for age demonstrated several significant clusters of cortical thinning for the blast injured SM. After multiple comparisons correction (False Discovery Rate (FDR)), two left hemisphere clusters remained significant (left superior temporal (STG) and frontal (SFG) gyri). No clusters were significantly correlated with TSI after FDR correction. Behavioral analysis for the STG and SFG clusters demonstrated three significant behavioral/cognitive sub-domains, each associated with audition and language. Blast injured SMs demonstrated distinct areas of cortical thinning in the STG and SFG. These areas have been previously shown to be associated with audition and language. Post-hoc analyses of clinical records demonstrated significant abnormal audiology reports for the blast injured SM suggesting that the

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Comparison of clinical features of left-sided infective endocarditis involving previously normal versus previously abnormal valves.

    Science.gov (United States)

    Olmos, Carmen; Vilacosta, Isidre; Fernández, Cristina; Sarriá, Cristina; López, Javier; Del Trigo, María; Ferrera, Carlos; Vivas, David; Maroto, Luis; Hernández, Miguel; Rodríguez, Enrique; San Román, José Alberto

    2014-07-15

    Native valve infective endocarditis (IE) in patients with normal valves has increased in the last decades. Whether patients with normal valves present a similar prognosis to those with pathologic valves is unresolved. Our aim is to describe epidemiologic and clinical differences between patients with left-sided IE and normal valves and those with native pathologic valves. We analyzed 945 consecutive episodes of IE, 435 of which involved left-sided nonprosthetic IE. They were classified into 2 groups: episodes in normal valves (normal group, n=173) and episodes in pathologic valves (abnormal group, n=262). Patients in the normal group were younger, Staphylococcus aureus and Streptococcus bovis were more frequently isolated, and vegetations were more frequently found. Heart failure, septic shock, and the need for surgery or death were more common. Multivariate analysis identified the following as factors independently associated with normal valve IE: agevalve IE, patients with IE on normal valves were younger, had a more virulent microbiological profile, developed heart failure and septic shock more frequently, needed more surgical procedures, and had worse prognosis.

  3. The history and clinical application of a chairside CAD/CAM dental restoration system.

    Science.gov (United States)

    Stutes, Richard D

    2006-10-01

    Since its introduction by Sirona Dental Systems (Charlotte, North Carolina, USA and Bensheim, Germany) in 1985, the CEREC Chairside CAD/CAM restoration system has steadily earned a loyal following among dentists. This article describes the history and evolution of the CEREC System, its clinical application and treatment modality, the restorative materials used to fabricate the restorations and an overview of clinical findings regarding the in vivo performance of the materials.

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

    Directory of Open Access Journals (Sweden)

    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

  5. Foot and ankle history and clinical examination: A guide to everyday practice

    Science.gov (United States)

    Alazzawi, Sulaiman; Sukeik, Mohamed; King, Daniel; Vemulapalli, Krishna

    2017-01-01

    This review summarises the key points in taking a history and performing a comprehensive clinical examination for patients with foot and/or ankle problems. It is a useful guide for residents who are preparing for their specialty exams, as well as family doctors and any other doctor who has to deal with foot and ankle problems in adults. PMID:28144575

  6. The Impact of Clinical History on the Threshold Estimation of Auditory Brainstem Response Results for Infants

    Science.gov (United States)

    Zaitoun, Maha; Cumming, Steven; Purcell, Alison; O'Brien, Katie

    2017-01-01

    Purpose: This study assesses the impact of patient clinical history on audiologists' performance when interpreting auditory brainstem response (ABR) results. Method: Fourteen audiologists' accuracy in estimating hearing threshold for 16 infants through interpretation of ABR traces was compared on 2 occasions at least 5 months apart. On the 1st…

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

    NARCIS (Netherlands)

    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

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

    Science.gov (United States)

    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…

  9. 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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Science.gov (United States)

    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.

  11. Comparative validation of a novel risk score for predicting bleeding risk in anticoagulated patients with atrial fibrillation: the HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) score.

    Science.gov (United States)

    Lip, Gregory Y H; Frison, Lars; Halperin, Jonathan L; Lane, Deirdre A

    2011-01-11

    The purpose of this study was to investigate predictors of bleeding in a cohort of anticoagulated patients and to evaluate the predictive value of several bleeding risk stratification schemas. The risk of bleeding during antithrombotic therapy in patients with atrial fibrillation (AF) is not homogeneous, and several clinical risk factors have been incorporated into clinical bleeding risk stratification schemas. Current risk stratification schemas for bleeding during anticoagulation therapy have been based on complex scoring systems that are difficult to apply in clinical practice, and few have been derived and validated in AF cohorts. We investigated predictors of bleeding in a cohort of 7,329 patients with AF participating in the SPORTIF (Stroke Prevention Using an ORal Thrombin Inhibitor in Atrial Fibrillation) III and V clinical trials and evaluated the predictive value of several risk stratification schemas by multivariate analysis. Patients were anticoagulated orally with either adjusted-dose warfarin (target international normalized ratio 2 to 3) or fixed-dose ximelagatran 36 mg twice daily. Major bleeding was centrally adjudicated, and concurrent aspirin therapy was allowed in patients with clinical atherosclerosis. By multivariate analyses, significant predictors of bleeding were concurrent aspirin use (hazard ratio [HR]: 2.10; 95% confidence interval [CI]: 1.59 to 2.77; p HR: 1.98; 95% CI: 1.42 to 2.76; p HR: 1.63; 95% CI: 1.23 to 2.17; p = 0.0008); diabetes (HR: 1.47; 95% CI: 1.10 to 1.97; p = 0.009), and heart failure or left ventricular dysfunction (HR: 1.32; 95% CI: 1.01 to 1.73; p = 0.041). Of the tested schemas, the new HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) score performed best, with a stepwise increase in rates of major bleeding with increasing HAS-BLED score (p(trend) <0.0001). The c statistic for bleeding varied between 0.50 and 0.67 in

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Meiotic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-12-31

    Chapter 19, describes meiotic abnormalities. These include nondisjunction of autosomes and sex chromosomes, genetic and environmental causes of nondisjunction, misdivision of the centromere, chromosomally abnormal human sperm, male infertility, parental age, and origin of diploid gametes. 57 refs., 2 figs., 1 tab.

  14. Correlation of lung abnormalities on high-resolution CT with clinical graft-versus-host disease after allogeneic versus autologous bone marrow transplantation in children

    Energy Technology Data Exchange (ETDEWEB)

    Merlini, Laura; Borzani, Irene Maria Olivia; Anooshiravani, Mehrak; Hanquinet, Sylviane [University of Geneva Children' s Hospital, Paediatric Radiology Unit, Geneva (Switzerland); Rochat, Isabelle [University of Geneva Children' s Hospital, Paediatric Pneumology Unit, Geneva (Switzerland); Ozsahin, Ayse Hulya [University of Geneva Children' s Hospital, Paediatric Oncology Unit, Geneva (Switzerland)

    2008-11-15

    Late-onset noninfectious pulmonary complications (LONIPCs) are life-threatening complications of bone marrow transplantation (BMT). Several pathological patterns are described in the literature with different prognoses, and with different relationships to graft-versus-host disease (GVHD). The role of high-resolution CT (HRCT) is not yet well established. To illustrate different patterns of LONIPCs on HRCT in allogeneic versus autologous BMT in order to investigate the correlation with chronic GVHD (cGVHD). A total of 67 HRCT scans were performed in 24 patients with noninfectious pulmonary disease at least 3 months after BMT (16 allogeneic, 8 autologous). Abnormality patterns and extension on HRCT images were correlated with the clinical outcome and with the severity of cGVHD. Of 24 patients, 9 showed LONIPCs (1 autologous, 8 allogeneic). There was a significant association between abnormalities on HRCT and severe cGVHD (P = 0.038), with no specific pattern. Prognosis seemed to be related to the severity of cGVHD and not to the extent of abnormalities on HRCT. The significant association between abnormalities on HRCT and severe GVHD suggests that LONIPCs can be a pulmonary manifestation of the disease. HRCT is a useful tool when combined with clinical data. (orig.)

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

    OpenAIRE

    Wilson, Richard A.; Chapman, Wendy W.; Shawn J DeFries; Becich, Michael J; Chapman, Brian E.

    2010-01-01

    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 mesoth...

  16. 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

    Institute of Scientific and Technical Information of China (English)

    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).

  17. Clinical History-Driven Diagnosis of Allergic Diseases: Utilizing in vitro IgE Testing.

    Science.gov (United States)

    Adkinson, N Franklin; Hamilton, Robert G

    2015-01-01

    This case illustrates the importance of a thorough clinical history in providing an interpretation of previously collected IgE antibody serology as part of a workup for allergic disease. Although a yellow-jacket sting was the allergenic insult that led the patient to the emergency department, nonindicated IgE antibody serology tests were ordered that subsequently required interpretation. This report systematically evaluates the relative significance of previously measured IgE antibody serology responses to 4 major allergen groups (inhalants [aeroallergens], foods, venoms, and drugs) within the context of the patient's history. An algorithm that takes into account the pretest likelihood of disease and diagnostic sensitivity and specificity of the available IgE antibody tests is proposed for decisions about further IgE testing. This case study concludes that selection of testing methods, extract and molecular allergen specificities, and the final interpretation of the results from tests of sensitization such as serological (in vitro) IgE antibody assays requires knowledge of test parameters and clinical judgments based largely on a carefully collected clinical history and physical examination.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    Wilson, Richard A; Chapman, Wendy W; Defries, Shawn J; Becich, Michael J; Chapman, Brian E

    2010-10-11

    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. 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. 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. 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, perform reference resolution and determine the experiencer. Results

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

    Directory of Open Access Journals (Sweden)

    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

  1. Factors predictive of abnormal semen parameters in male partners of couples attending the infertility clinic of a tertiary hospital in south-western Nigeria

    Directory of Open Access Journals (Sweden)

    Peter Olusola Aduloju

    2016-11-01

    Full Text Available Background: Infertility is a common gynaecological problem and male factor contributes significantly in the aetiology of infertility. Semen analysis has remained a useful investigation in the search for male factor infertility. Aim: This study assessed the pattern of semen parameters and predictive factors associated with abnormal parameters in male partners of infertile couples attending a Nigerian tertiary hospital. Methods: A descriptive study of infertile couples presenting at the clinic between January 2012and December 2015 was done at Ekiti State University Teaching Hospital, Ado-Ekiti. Seminal fluid from the male partners were analysed in the laboratory using the WHO 2010 criteria for human semen characteristics. Data was analysed using SPSS 17 and logistic regression analysis was used to determine the predictive factors associated with abnormal semen parameters. Results: A total of 443 men participated in the study and 38.2% had abnormal sperm parameters. Oligozoospermia (34.8% and asthenozoospermia (26.9% are leading single factor abnormality found, astheno-oligozoospermia occurred in 14.2% and oligo-astheno-teratozoospermia in 3.6% of cases. The prevalence of azoospermia was 3.4%. Smoking habit, past infection with mumps and previous groin surgery significantly predicted abnormal semen parameters with p values of 0.025, 0.040 and 0.017 respectively. Positive cultures were recorded in 36.2% of cases and staph aureus was the commonest organism. Conclusion: Male factor abnormalities remain significant contributors to infertility and men should be encouraged through advocacy to participate in investigation of infertility to reduce the level of stigmatization and ostracizing of women with infertility especially in sub-Saharan Africa.

  2. Abnormal production of tumor necrosis factor (TNF) -- alpha and clinical efficacy of the TNF inhibitor etanercept in a patient with PAPA syndrome [corrected].

    Science.gov (United States)

    Cortis, Elisabetta; De Benedetti, Fabrizio; Insalaco, Antonella; Cioschi, Stefania; Muratori, Flaminia; D'Urbano, Leila E; Ugazio, Alberto G

    2004-12-01

    We report a family with pyogenic sterile arthritis, pyoderna and acne syndrome (PAPA). The proband presented several episodes of sterile pyogenic arthritis and became unresponsive to glucocorticoids. After treatment with the tumor necrosis factor inhibitor etanercept, the disease underwent rapid and sustained clinical remission. Production of tumor necrosis factor-alpha by mononuclear cells of the proband and of the affected relatives was abnormally elevated.

  3. The role of the second heart field in pulmonary vein development : new insights in the origin of clinical abnormalities

    NARCIS (Netherlands)

    Douglas, Yvonne Louise

    2010-01-01

    In this thesis we describe normal and abnormal pulmonary vein development in human and mouse hearts, and focus on the histo(patho)logy of the pulmonary venous and left atrial dorsal wall, in order to elucidate the role of the posterior heart field in the formation and differentiation of the pulmonar

  4. Saccades and vergence performance in a population of children with vertigo and clinically assessed abnormal vergence capabilities.

    Directory of Open Access Journals (Sweden)

    Maria Pia Bucci

    Full Text Available PURPOSE: Early studies reported some abnormalities in saccade and vergence eye movements in children with vertigo and vergence deficiencies. The purpose of this study was to further examine saccade and vergence performance in a population of 44 children (mean age: 12.3±1.6 years with vertigo symptoms and with different levels of vergence abnormalities, as assessed by static orthoptic examination (near point of convergence, prism bar and cover-uncover test. METHODS: Three groups were identified on the basis of the orthoptic tests: group 1 (n = 13 with vergence spasms and mildly perturbed orthoptic scores, group 2 (n = 14 with moderately perturbed orthoptic scores, and group 3 (n = 17 with severely perturbed orthoptic scores. Data were compared to those recorded from 28 healthy children of similar ages. Latency, accuracy and peak velocity of saccades and vergence movements were measured in two different conditions: gap (fixation offset 200 ms prior to target onset and simultaneous paradigms. Binocular horizontal movements were recorded by a photoelectric device. RESULTS: Group 2 of children with vergence abnormalities showed significantly longer latency than normal children in several types of eye movements recorded. For all three groups of children with vergence abnormalities, the gain was poor, particularly for vergence movement. The peak velocity values did not differ between the different groups of children examined. INTERPRETATION: Eye movement measures together with static orthoptic evaluation allowed us to better identify children with vergence abnormalities based on their slow initiation of eye movements. Overall, these findings support the hypothesis of a central deficit in the programming and triggering of saccades and vergence in these children.

  5. Lacrimal system abnormalities.

    Science.gov (United States)

    Moore, B D

    1994-03-01

    This report outlines several of the more important abnormalities of the lacrimal system in infants and young children. Although rare, alacrima can be a very difficult clinical problem to treat. The most common cause of alacrima is the Riley-Day syndrome. Nasolacrimal duct obstruction is a very common anomaly in children. The clinical appearance and treatment of this disorder are discussed.

  6. A COMPARATIVE STUDY OF CLINICAL EXAMINATION, ULTRASOUND FINDINGS, DIAGNOSTIC HYSTEROSCOPY WITH HISTOPATHOLOGICAL EXAMINATION REPORT OF ENDOMETRIUM IN PATIENTS WITH ABNORMAL UTERINE BLEEDING

    Directory of Open Access Journals (Sweden)

    Sathenahalli Devegowda Prathibha

    2016-08-01

    Full Text Available BACKGROUND AND OBJECTIVES Abnormal Uterine Bleeding (AUB is a very frequent gynaecological complaint and occurs across the entire age spectrum, approximately 75000 hysterectomies are carried out each year with 30% of these for menstrual problems alone. These menstrual aberrations occur more commonly at extremes of reproductive life. The introduction of hysteroscopy has opened a new dimension in evaluation of patient with AUB replacing the blind technique of Dilatation and Curettage. The present study was undertaken to know the accuracy of various tests with Histopathology. MATERIALS AND METHODS The present prospective study was carried out on 100 patients from reproductive, perimenopausal and postmenopausal age group with abnormal uterine bleeding in Dr. B. R. Ambedkar Medical College and Hospital. RESULTS In the present study, in relation to histopathological examination, clinical findings and hysteroscopy had better accuracy (72% as compared to ultrasound findings (41% in diagnosis of abnormal uterine bleeding. CONCLUSION Hysteroscopy guided biopsy and histopathology complements each other in the evaluation of patient with abnormal uterine bleeding for accurate diagnosis and further treatment.

  7. Derivation and Validation of Predictive Factors for Clinical Deterioration after Admission in Emergency Department Patients Presenting with Abnormal Vital Signs Without Shock

    Directory of Open Access Journals (Sweden)

    Daniel J. Henning

    2015-12-01

    Full Text Available Introduction: Strategies to identify high-risk emergency department (ED patients often use markedly abnormal vital signs and serum lactate levels. Risk stratifying such patients without using the presence of shock is challenging. The objective of the study is to identify independent predictors of in-hospital adverse outcomes in ED patients with abnormal vital signs or lactate levels, but who are not in shock. Methods: We performed a prospective observational study of patients with abnormal vital signs or lactate level defined as heart rate ≥130 beats/min, respiratory rate ≥24 breaths/min, shock index ≥1, systolic blood pressure 4.0mmol/L (OR 5.1, 95% CI [2.1–12.2], age ≥80 yrs (OR 1.9, CI [1.0–3.7], bicarbonate <21mEq/L (OR 2.5, CI [1.3–4.9], and initial HR≥130 (OR 3.1, CI [1.5–6.1]. Conclusion: Patients exhibiting abnormal vital signs or elevated lactate levels without shock had significant rates of deterioration after hospitalization. ED clinical data predicted patients who suffered adverse outcomes with reasonable reliability.

  8. Abnormal Uterine Bleeding: American College of Nurse-Midwives.

    Science.gov (United States)

    2016-07-01

    Variations in uterine bleeding, termed abnormal uterine bleeding, occur commonly among women and often are physiologic in nature with no significant consequences. However, abnormal uterine bleeding can cause significant distress to women or may signify an underlying pathologic condition. Most women experience variations in menstrual and perimenstrual bleeding in their lifetimes; therefore, the ability of the midwife to differentiate between normal and abnormal bleeding is a key diagnostic skill. A comprehensive history and use of the PALM-COEIN classification system will provide clear guidelines for clinical management, evidence-based treatment, and an individualized plan of care. The purpose of this Clinical Bulletin is to define and describe classifications of abnormal uterine bleeding, review updated terminology, and identify methods of assessment and treatment using a woman-centered approach.

  9. Longitudinal Analysis of Carcinogenic Human Papillomavirus Infection and Associated Cytologic Abnormalities in the Guanacaste Natural History Study: Looking Ahead to Cotesting

    Science.gov (United States)

    Rodriguez, Ana C.; Burk, Robert D.; Hildesheim, Allan; Herrero, Rolando; Wacholder, Sholom; Hutchinson, Martha; Schiffman, Mark

    2012-01-01

    Background. Few studies have addressed the timing of cervical cytologic abnormalities and human papillomavirus (HPV) positivity during the course of an infection. It remains largely unknown how infections detected by HPV and cytology wax and wane relative to each other. The aim of this analysis was to assess the longitudinal relationship of abnormal cytology and HPV positivity in a 7-year prospective study of 2500 women in Guanacaste, Costa Rica. Methods. At each semiannual or annual visit, cervical specimens were screened using liquid-based cytology and tested for >40 HPV types with use of MY09/MY11 L1 degenerate primer polymerase chain reaction–based methods. On the basis of previous work, we separated prevalent and newly detected infections in younger and older women. Results. Among newly detected HPV- and/or cytology-positive events, HPV and cytology appeared together ∼60% of the time; when discordant, HPV tended to appear before cytology in younger and older women. Combining newly and prevalently detected events, HPV and cytology disappeared at the same time >70% of the time. When discordant, HPV tended to disappear after cytology in younger and older women. Conclusions. Detection of HPV DNA and associated cytological abnormalities tend to come and leave together; however, when discordant, detection of HPV DNA tends to precede and/or last longer than associated cytologic abnormalities. PMID:22147792

  10. [Hair shaft abnormalities].

    Science.gov (United States)

    Itin, P H; Düggelin, M

    2002-05-01

    Hair shaft disorders may lead to brittleness and uncombable hair. In general the hair feels dry and lusterless. Hair shaft abnormalities may occur as localized or generalized disorders. Genetic predisposition or exogenous factors are able to produce and maintain hair shaft abnormalities. In addition to an extensive history and physical examination the most important diagnostic examination to analyze a hair shaft problem is light microscopy. Therapy of hair shaft disorders should focus to the cause. In addition, minimizing traumatic influences to hair shafts, such as dry hair with an electric dryer, permanent waves and dyes is important. A short hair style is more suitable for such patients with hair shaft disorders.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    Hughes, Jacqueline A.; Cook, Jane V.; Warren, Mary E. [Radiology Department, Queen Mary' s Hospital for Children, Epsom and St Helier NHS Trust, Carshalton, Surrey SM5 1AA (United Kingdom); Churchill, Mark A. [Orthopaedic Department, Queen Mary' s Hospital for Children, Epsom and St Helier NHS Trust, Carshalton (United Kingdom)

    2003-06-01

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  16. Health literacy and the perception of risk in a breast cancer family history clinic.

    Science.gov (United States)

    Rutherford, E J; Kelly, J; Lehane, E A; Livingstone, V; Cotter, B; Butt, A; O'Sullivan, M J; O Connell, F; Redmond, H P; Corrigan, M A

    2016-11-28

    Informed consent is an essential component of medical practice, and especially so in procedural based specialties which entail varying degrees of risk. Breast cancer is one of the most common cancers in women, and as such is the focus of extensive research and significant media attention. Despite this, considerable misperception exists regarding the risk of developing breast cancer. This study aims to examine the accuracy of risk perception of women attending a breast cancer family history clinic, and to explore the relationship between risk perception accuracy and health literacy. A cross-sectional study of women attending a breast cancer family history clinic (n = 86) was carried out, consisting of a patient survey and a validated health literacy assessment. Patients' perception of personal and population breast cancer risk was compared to actual risk as calculated by a validated risk assessment tool. Significant discordance between real and perceived risks was observed. The majority (83.7%) of women overestimated their personal lifetime risk of developing breast cancer, as well as that of other women of the same age (89.5%). Health literacy was considered potentially inadequate in 37.2% of patients; there was a correlation between low health literacy and increased risk perception inaccuracy across both personal ten-year (rs = 0.224, p = 0.039) and general ten-year population estimations. (rs = 0.267, p = 0.013). Inaccuracy in risk perception is highly prevalent in women attending a breast cancer family history clinic. Health literacy inadequacy is significantly associated with this inaccuracy. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  17. Ataxia rating scales--psychometric profiles, natural history and their application in clinical trials.

    Science.gov (United States)

    Saute, Jonas Alex Morales; Donis, Karina Carvalho; Serrano-Munuera, Carmen; Genis, David; Ramirez, Luís Torres; Mazzetti, Pilar; Pérez, Luis Velázquez; Latorre, Pilar; Sequeiros, Jorge; Matilla-Dueñas, Antoni; Jardim, Laura Bannach

    2012-06-01

    We aimed to perform a comprehensive systematic review of the existing ataxia scales. We described the disorders for which the instruments have been validated and used, the time spent in its application, its validated psychometric properties, and their use in studies of natural history and clinical trials. A search from 1997 onwards was performed in the MEDLINE, LILACS, and Cochrane databases. The web sites ClinicalTrials.gov and Orpha.net were also used to identify the endpoints used in ongoing randomized clinical trials. We identified and described the semiquantitative ataxia scales (ICARS, SARA, MICARS, BARS); semiquantitative ataxia and non-ataxia scales (UMSARS, FARS, NESSCA); a semiquantitative non-ataxia scale (INAS); quantitative ataxia scales (CATSYS 2000, AFCS, CCFS and CCFSw, and SCAFI); and the self-performed ataxia scale (FAIS). SARA and ICARS were the best studied and validated so far, and their reliability sustain their use. Ataxia and non-ataxia scores will probably provide a better view of the overall disability in long-term trials and studies of natural history. Up to now, no clear advantage has been disclosed for any of them; however, we recommend the use of specific measurements of gait since gait ataxia is the first significant manifestation in the majority of ataxia disorders and comment on the best scales to be used in specific ataxia forms. Quantitative ataxia scales will be needed to speed up evidence from phase II clinical trials, from trials focused on the early phase of diseases, and for secondary endpoints in phase III trials. Finally, it is worth remembering that estimation of the actual minimal clinically relevant difference is still lacking; this, together with changes in quality of life, will probably be the main endpoints to measure in future therapeutic studies.

  18. Clinical Analysis on Endoscopic Diagnosis and Treatment of Abnormal Uterine Bleeding%宫腔镜诊治异常子宫出血临床分析

    Institute of Scientific and Technical Information of China (English)

    刘岚

    2015-01-01

    Objective: To investigate the effect of clinical application of hysteroscopy in the diagnosis and treatment of abnormal uterine bleeding.Method: The clinical data of 86 cases in our hospital in 2014 the use of hysteroscopy in the diagnosis and treatment of abnormal uterine bleeding were retrospectively analyzed, and compared with pathological examination.Result: Hysteroscopy in 86 cases of abnormal uterine bleeding, 80 cases of positive detection, according to resection, 83 cases of which biopsy, diagnostic curettage and electric, scraping and excised tissue all sent pathology the examination, the diagnostic accordance rate was 92.8% and the pathological diagnosis of microscopic. Conclusion: Hysteroscopy in diagnosis of abnormal uterine bleeding with high accuracy rate, and has double functions of treatment.%目的:探讨宫腔镜诊治异常子宫出血的临床应用效果。方法:对本院2014年利用宫腔镜诊治异常子宫出血的86例患者的临床资料进行回顾性分析,并与病理检查做对比。结果:86例异常子宫出血患者经宫腔镜检查,检出阳性80例,根据情况对其中的83例取活检、行诊断性刮宫术及电切术,刮出及切除组织全部送病理检查,镜下诊断与病理诊断符合率92.8%。结论:宫腔镜对异常子宫出血的诊断准确率高,并且兼有治疗的双重作用。

  19. Bench-to-bedside review: A brief history of clinical acid–base

    OpenAIRE

    Story, David A

    2004-01-01

    The history of assessing the acid–base equilibrium and associated disorders is intertwined with the evolution of the definition of an acid. In the 1950s clinical chemists combined the Henderson–Hasselbalch equation and the Bronsted–Lowry definition of an acid to produce the current bicarbonate ion-centred approach to metabolic acid–base disorders. Stewart repackaged pre-1950 ideas of acid–base in the late 1970s, including the Van Slyke definition of an acid. Stewart also used laws of physical...

  20. Clinical stories and medical histories recorded by Rhazes (865-925), the Iranian-Islamic physician in the medieval period.

    Science.gov (United States)

    Zohalinezhad, Mohammad E; Askari, Alireza; Farjam, Mojtaba

    2015-01-01

    Recording medical histories of patients is not a new issue in clinical medicine. However, the method practiced by the Iranian chemist physician, Rhazes, in the ninth century A.D is incredible. Rhazes has written several textbooks in clinical medicine, but a particular one, "Clinical Stories and Medical Histories" (Qesas va hekayat al-marazi), is a classical case book describing precise clinical courses of thirty three patients. Each chapter includes a title, the name and demographic data about a patient, his/her history of present illness, past medical and family history, findings of physical exam, impression and interventions by the physician, including pharmacological or surgical management. The reasons for each decision made by Rhazes as well as the outcomes are clearly discussed. This book review will shed light on the unknown medical practice methods in Islamic-Iranian golden era.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Neonatal disruption of serine racemase causes schizophrenia-like behavioral abnormalities in adulthood: clinical rescue by d-serine.

    Directory of Open Access Journals (Sweden)

    Hiroko Hagiwara

    Full Text Available BACKGROUND: D-Serine, an endogenous co-agonist of the N-methyl-D-aspartate (NMDA receptor, is synthesized from L-serine by serine racemase (SRR. Given the role of D-serine in both neurodevelopment and the pathophysiology of schizophrenia, we examined whether neonatal disruption of D-serine synthesis by SRR inhibition could induce behavioral abnormalities relevant to schizophrenia, in later life. METHODOLOGY/PRINCIPAL FINDINGS: Neonatal mice (7-9 days were injected with vehicle or phenazine methosulfate (Met-Phen: 3 mg/kg/day, an SRR inhibitor. Behavioral evaluations, such as spontaneous locomotion, novel object recognition test (NORT, and prepulse inhibition (PPI were performed at juvenile (5-6 weeks old and adult (10-12 weeks old stages. In addition, we tested the effects of D-serine on PPI deficits in adult mice after neonatal Met-Phen exposure. Finally, we assessed whether D-serine could prevent the onset of schizophrenia-like behavior in these mice. Neonatal Met-Phen treatment reduced D-serine levels in the brain, 24 hours after the final dose. Additionally, this treatment caused behavioral abnormalities relevant to prodromal symptoms in juveniles and to schizophrenia in adults. A single dose of D-serine improved PPI deficits in adult mice. Interestingly, chronic administration of D-serine (900 mg/kg/day from P35 to P70 significantly prevented the onset of PPI deficits after neonatal Met-Phen exposure. CONCLUSIONS/SIGNIFICANCE: This study shows that disruption of D-serine synthesis during developmental stages leads to behavioral abnormalities relevant to prodromal symptoms and schizophrenia, in later life. Furthermore, early pharmacological intervention with D-serine may prevent the onset of psychosis in adult.

  3. 青少年首发精神分裂症患者脑结构异常及其相关因素研究%structural brain abnormalities and clinical features in childhood-onset schizophrenia

    Institute of Scientific and Technical Information of China (English)

    杨春林; 潘伟刚; 马俊芳; 李军

    2016-01-01

    Objective To investigate the clinical features and structural brain abnormalities in childhood-onset schizophrenia. Methods Retrospective analysis clinical features and brain CT images of 379 patients diagnosed with schizophrenia from January 2013 to April 2016. The patients were divided into 2 groups;with(n = 39)and without(n = 340)structural brain abnormalities. Socio-demographic and clinical data were compared between two groups. To observe the abnormality rate of structure CT and the types of structural brain abnormalities and analyze the clinical features in childhood-onset schizophrenia. Results The abnormality rate of structure CT scan was 10. 3% . There were 17 cases with ventricular dilatation,11 cases with broadening of cerebral sulci,7 cases with enlarged cisterna magna,4 cases with arachnoid cyst. Compared to without structural brain abnormalities,childhood-onset schizophrenia with structural brain abnormalities significantly had younger age,more fre-quent abnormal maternal pregnancy( P 0.05).结论 青少年首发精神分裂症脑结构异常检出率较高,并且脑结构异常者起病年龄更小、母孕期异常更多,青少年精神分裂症脑结构异常可能为其神经生物学基础.

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

    DEFF Research Database (Denmark)

    Cicala, S.; Simone, G. de; Wachtell, K.;

    2008-01-01

    to analyze the primary composite endpoint of cardiovascular death, MI, or stroke and, separately, for fatal and nonfatal MI and hospitalized heart failure. Results During a mean follow-up of 4.8 years, an event was recorded in 67 ( 9%) patients. In Cox models after adjusting for age, gender, treatment, blood......, however, never been investigated. We examined whether 'in- treatment' wall motion abnormalities predicted outcome in the Losartan Intervention For Endpoint ( LIFE) reduction in hypertension echocardiographic substudy. Methods We studied 749 patients without coronary artery disease, myocardial infarction...

  5. A history of HbA1c through Clinical Chemistry and Laboratory Medicine.

    Science.gov (United States)

    Gillery, Philippe

    2013-01-01

    HbA(1c) was discovered in the late 1960s and its use as marker of glycemic control has gradually increased over the course of the last four decades. Recognized as the gold standard of diabetic survey, this parameter was successfully implemented in clinical practice in the 1970s and 1980s and internationally standardized in the 1990s and 2000s. The use of standardized and well-controlled methods, with well-defined performance criteria, has recently opened new directions for HbA(1c) use in patient care, e.g., for diabetes diagnosis. Many reports devoted to HbA1c have been published in Clinical Chemistry and Laboratory Medicine (CCLM) journal. This review reminds the major steps of HbA(1c) history, with a special emphasis on the contribution of CCLM in this field.

  6. Thyroid function testing in primary care: overused and under-evidenced? A study examining which clinical features correspond to an abnormal thyroid function result.

    Science.gov (United States)

    Werhun, Alexander; Hamilton, William

    2015-04-01

    Diagnostic testing is increasing in primary care, including for thyroid disease. This study examined which clinical features were associated with an abnormal thyroid stimulating hormone (TSH) result. This was a cross-sectional study in one general practice of 16,487 patients in Exeter, Devon, UK. We examined the primary care records relating to every TSH test taken in the year from August 2012, and extracted symptoms and/or the indication for testing. Associations with an abnormal result were tested using multivariable logistic regression. A cohort study was then performed of 100 patients newly recorded with each of the six features associated with an abnormal test result in the cross-sectional study, and the proportions tested for TSH and the results of that testing identified. Two thousand thirty-five patients (12% of the practice population) had TSH testing in the year. Of these 35 (1.7%) had a TSH >4.5 mIU/l, suggesting hypothyroidism, and 7 (0.3%) had TSH <0.01 mIu/l suggesting hyperthyroidism. Features associated with an abnormal TSH were: pregnancy, odds ratio 41 (95% confidence interval 9.3-180), constipation 9.7 (2.1-45), palpitations 23 (3.4-150), hair loss, 21 (2.0-230), weight gain, 18 (1.6-190) and diarrhoea, 13 (1.2-130); in separate analyses only pregnancy and constipation were associated with a raised TSH, and the remaining four features with a low TSH. The diagnostic yield of thyroid disease in this study was 2.1% suggests testing could be better targeted without missing diagnoses. The symptoms associated with thyroid disease differ from those generally reported. This may represent fewer patients presenting with advanced disease. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  8. Outcome prediction in mild traumatic brain injury : age and clinical variables are stronger predictors than CT abnormalities

    NARCIS (Netherlands)

    Jacobs, Bram; Beems, Tjemme; Stulemeijer, Maja; van Vugt, Arie B; van der Vliet, Ton M; Borm, George F; Vos, Pieter E

    2010-01-01

    Mild traumatic brain injury (mTBI) is a common heterogeneous neurological disorder with a wide range of possible clinical outcomes. Accurate prediction of outcome is desirable for optimal treatment. This study aimed both to identify the demographic, clinical, and computed tomographic (CT) characteri

  9. Natural history and clinical features of sporadic amyotrophic lateral sclerosis in China.

    Science.gov (United States)

    Chen, Lu; Zhang, Bin; Chen, Ru; Tang, Lu; Liu, Rong; Yang, Yan; Yang, Yi; Liu, Xiaolu; Ye, Shan; Zhan, Siyan; Fan, Dongsheng

    2015-10-01

    To describe the natural history and clinical features of sporadic amyotrophic lateral sclerosis (ALS) in Chinese patients, and to report data on the prognostic factors for survival. All patients referred to our ALS centre between 2003 and 2012 were followed up every 3 months. Survival and tracheotomy were predefined as primary outcome measures. Group differences were analysed using parametric and non-parametric tests as appropriate. Survival was analysed using the Kaplan-Meier method and Cox regression analysis. Of the 1624 patients with ALS, 75.1% had limb-onset, 14.0% had bulbar-onset, 7.8% had flail-arm syndrome (FAS), 2.6% had progressive muscular atrophy and 0.5% had primary lateral sclerosis. The male:female ratio was 1.7:1, and the mean age at onset was 49.8 years. The median diagnostic delay was 14 months, and the median survival time after symptom onset was 71 months. Male gender, older age at symptom onset, lower body mass index, shorter diagnostic delay, bulbar-onset ALS phenotype, higher Airlie House category at presentation, rural place of residence, use of traditional Chinese medicine and a history of contact with pesticides were associated with poorer survival, whereas female gender or an FAS phenotype may have a better prognosis. The clinical characteristics and outcomes of Chinese patients with sporadic ALS were different compared with patients from other countries. Compared with other studies, the age at onset of Chinese patients was earlier, the percentage of bulbar-onset ALS was lower and the prognosis was better. This study substantially advances the understanding of the clinical features and epidemiology of this rare disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Reliability and clinical utility of a Portuguese version of the Abnormal Involuntary Movements Scale (AIMS for tardive dyskinesia in Brazilian patients

    Directory of Open Access Journals (Sweden)

    H. Tonelli

    2003-04-01

    Full Text Available The objective of the present study was to evaluate the reliability and clinical utility of a Portuguese version of the Abnormal Involuntary Movements Scale (AIMS. Videotaped interviews with 16 psychiatric inpatients treated with antipsychotic drugs for at least 5 years were evaluated. Reliability was assessed by the intraclass correlation coefficient (ICC between three raters, two with and one without clinical training in psychopathology. Clinical utility was assessed by the difference between the scores of patients with (N = 11 and without (N = 5 tardive dyskinesia (TD. Patients with TD exhibited a higher severity of global evaluation by the AIMS (sum of scores: 4.2 ± 0.9 vs 0.4 ± 0.2; score on item 8: 2.3 ± 0.3 vs 0.4 ± 0.2, TD vs controls. The ICC for the global evaluation was fair between the two skilled raters (0.58-0.62 and poor between these raters and the rater without clinical experience (0.05-0.29. Thus, we concluded that the Portuguese version of the AIMS shows an acceptable inter-rater reliability, but only between clinically skilled raters, and that it is clinically useful.

  11. Chromosomal abnormalities and autism

    African Journals Online (AJOL)

    Farida El-Baz

    2015-06-19

    Jun 19, 2015 ... Received 19 April 2015; accepted 11 May 2015 ... Methods: This cross sectional study was conducted at the Child Psychiatry Clinic, ... Males are affected more than females, only one case had ... communication, repetitive behavior, abnormal movement ... course, age, sex and consanguinity of the patients.

  12. Characterisation of liver chemistry abnormalities associated with pazopanib monotherapy: a systematic review and meta-analysis of clinical trials in advanced cancer patients.

    Science.gov (United States)

    Powles, Thomas; Bracarda, Sergio; Chen, Mei; Norry, Elliot; Compton, Natalie; Heise, Mark; Hutson, Thomas; Harter, Philipp; Carpenter, Christopher; Pandite, Lini; Kaplowitz, Neil

    2015-07-01

    Drug-induced liver chemistry abnormalities, primarily transaminase elevations, are commonly observed in pazopanib-treated patients. This meta-analysis characterises liver chemistry abnormalities associated with pazopanib. Data of pazopanib-treated patients from nine prospective trials were integrated (N=2080). Laboratory datasets were used to characterise the incidence, timing, recovery and patterns of liver events, and subsequent rechallenge with pazopanib. Severe cases of liver chemistry abnormalities were clinically reviewed. Multivariate analyses identified predisposing factors. Twenty percent of patients developed elevated alanine aminotransferase (ALT) >3×ULN. Incidence of peak ALT >3-5×ULN, >5-8×ULN, >8-20×ULN and >20×ULN was 8%, 5%, 5% and 1%, respectively. Median time to onset for all events was 42days; 91% of events were observed within 18weeks. Recovery rates based on peak ALT >3-5×ULN, >5-8×ULN, >8-20×ULN and >20×ULN were 91%, 90%, 90% and 64%, respectively. Median time from onset to recovery was 30days, but longer in patients without dose interruption. Based on clinical review, no deaths were associated with drug-induced liver injury. Overall, 38% of rechallenged patients had ALT elevation recurrence, with 9-day median time to recurrence. Multivariate analysis showed that older age was associated with development of ALT >8×ULN. There was no correlation between hypertension and transaminitis. Our data support the current guidelines on regular liver chemistry tests after initiation of pazopanib, especially during the first 9 or 10weeks, and also demonstrate the safety of rechallenge with pazopanib.

  13. Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study.

    Science.gov (United States)

    Haring, Catharina M; Cools, Bernadette M; van Gurp, Petra J M; van der Meer, Jos W M; Postma, Cornelis T

    2017-08-29

    During their clerkships, medical students are meant to expand their clinical reasoning skills during their patient encounters. Observation of these encounters could reveal important information on the students' clinical reasoning abilities, especially during history taking. A grounded theory approach was used to analyze what expert physicians apply as indicators in their assessment of medical students' diagnostic reasoning abilities during history taking. Twelve randomly selected clinical encounter recordings of students at the end of the internal medicine clerkships were observed by six expert assessors, who were prompted to formulate their assessment criteria in a think-aloud procedure. These formulations were then analyzed to identify the common denominators and leading principles. The main indicators of clinical reasoning ability were abstracted from students' observable acts during history taking in the encounter. These were: taking control, recognizing and responding to relevant information, specifying symptoms, asking specific questions that point to pathophysiological thinking, placing questions in a logical order, checking agreement with patients, summarizing and body language. In addition, patients' acts and the course, result and efficiency of the conversation were identified as indicators of clinical reasoning, whereas context, using self as a reference, and emotion/feelings were identified by the clinicians as variables in their assessment of clinical reasoning. In observing and assessing clinical reasoning during history taking by medical students, general and specific phenomena to be used as indicators for this process could be identified. These phenomena can be traced back to theories on the development and the process of clinical reasoning.

  14. Behavioral Abnormalities in Lagotto Romagnolo Dogs with a History of Benign Familial Juvenile Epilepsy: A Long‐Term Follow‐Up Study

    OpenAIRE

    Jokinen, T S; Tiira, K.; Metsähonkala, L.; Seppälä, E.H.; Hielm‐Björkman, A.; Lohi, H.; Laitinen‐Vapaavuori, O.

    2015-01-01

    Background Lagotto Romagnolo (LR) dogs with benign juvenile epilepsy syndrome often experience spontaneous remission of seizures. The long‐term outcome in these dogs currently is unknown. In humans, behavioral and psychiatric comorbidities have been reported in pediatric and adult‐onset epilepsies. Hypothesis/Objectives The objectives of this study were to investigate possible neurobehavioral comorbidities in LR with a history of benign familial juvenile epilepsy (BFJE) and to assess the occu...

  15. Sexsomnia: abnormal sexual behavior during sleep.

    Science.gov (United States)

    Andersen, Monica L; Poyares, Dalva; Alves, Rosana S C; Skomro, Robert; Tufik, Sergio

    2007-12-01

    This review attempts to assemble the characteristics of a distinct variant of sleepwalking called sexsomnia/sleepsex from the seemingly scarce literature into a coherent theoretical framework. Common features of sexsomnia include sexual arousal with autonomic activation (e.g. nocturnal erection, vaginal lubrication, nocturnal emission, dream orgasms). Somnambulistic sexual behavior and its clinical implications, the role of precipitating factors, diagnostic, treatment, and medico-legal issues are also reviewed. The characteristics of several individuals described in literature including their family/personal history of parasomnia as well as the abnormal behaviors occurring during sleep are reported.

  16. Atypical endometrial cells and atypical glandular cells favor endometrial origin in Papanicolaou cervicovaginal tests: Correlation with histologic follow-up and abnormal clinical presentations

    Directory of Open Access Journals (Sweden)

    Longwen Chen

    2014-01-01

    Full Text Available The 2001 Bethesda system recommends further classifying atypical glandular cells (AGCs as either endocervical or endometrial origin. Numerous studies have investigated the clinical significance of AGC. In this study, we investigated the incidence of clinically significant lesions among women with liquid-based Papanicolaou cervicovaginal (Pap interpretations of atypical endometrial cells (AEMs or AGC favor endometrial origin (AGC-EM. More importantly, we correlated patients of AEM or AGC-EM with their clinical presentations to determine if AEM/AGC-EM combined with abnormal vaginal bleeding is associated with a higher incidence of significant endometrial pathology. All liquid-based Pap tests with an interpretation of AEM and AGC-EM from July, 2004 through June, 2009 were retrieved from the database. Women with an interpretation of atypical endocervical cells, AGC, favor endocervical origin or AGC, favor neoplastic were not included in the study. The most severe subsequent histologic diagnoses were recorded for each patient. During this 5-year period, we accessioned 332,470 Pap tests of which 169 (0.05% were interpreted as either AEM or AGC-EM. Of the 169 patients, 133 had histologic follow-up within the health care system. The patients ranged in age from 21 to 71 years old (mean 49.7. On follow-up histology, 27 (20.3% had neoplastic/preneoplastic uterine lesions. Among them, 20 patients were diagnosed with adenocarcinoma (18 endometrial, 1 endocervical, and 1 metastatic colorectal, 3 with atypical endometrial hyperplasia, and 4 with endometrial hyperplasia without atypia. All patients with significant endometrial pathology, except one, were over 40 years old, and 22 of 25 patients reported abnormal vaginal bleeding at the time of endometrial biopsy or curettage. This study represents a large series of women with liquid-based Pap test interpretations of AEM and AGC-EM with clinical follow-up. Significant preneoplastic or neoplastic endometrial

  17. Cardiac abnormalities in the acquired immunodeficiency syndrome. A prospective study with a clinical-pathological correlation in twenty-one adult patients

    Directory of Open Access Journals (Sweden)

    Herdy Gesmar Volga Haddad

    1999-01-01

    Full Text Available OBJECTIVE - To evaluate the cardiac abnormalities and their evolution during the course of the acquired immunodeficiency syndrome, as well as to correlate clinical and pathological data. METHODS - Twenty-one patients, admitted to the hospital with the diagnosis of acquired immunodeficiency syndrome, were prospectively studied and followed until their death. Age ranged from 19 to 42 years (17 males. ECG and echocardiogram were also obtained every six months. After death, macro- and microscopic examinations were also performed. RESULTS - The most frequent causes of referral to the hospital were: diarrhea or repeated pneumonias, tuberculosis, toxoplasmosis or Kaposi sarcoma. The most frequent findings were acute or chronic pericarditis (42% and dilated cardiomyopathy (19%. Four patients died of cardiac problems: infective endocarditis, pericarditis with pericardial effusion, bacterial myocarditis and infection by Toxoplasma gondii. CONCLUSION - Severe cardiac abnormalities were the cause of death in some patients. In the majority of the patients, a good correlation existed between clinical and anatomical-pathological data. Cardiac evaluation was important to detect early manifestations and treat them accordingly, even in asymptomatic patients.

  18. Radiology clinical synopsis: a simple solution for obtaining an adequate clinical history for the accurate reporting of imaging studies on patients in intensive care units.

    Science.gov (United States)

    Cohen, Mervyn D; Alam, Khurshaid

    2005-09-01

    Lack of clinical history on radiology requisitions is a universal problem. We describe a simple Web-based system that readily provides radiology-relevant clinical history to the radiologist reading radiographs of intensive care unit (ICU) patients. Along with the relevant history, which includes primary and secondary diagnoses, disease progression and complications, the system provides the patient's name, record number and hospital location. This information is immediately available to reporting radiologists. New clinical information is immediately entered on-line by the radiologists as they are reviewing images. After patient discharge, the data are stored and immediately available if the patient is readmitted. The system has been in routine clinical use in our hospital for nearly 2 years.

  19. Radiology clinical synopsis: a simple solution for obtaining an adequate clinical history for the accurate reporting of imaging studies on patients in intensive care units

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, Mervyn D. [Riley Hospital for Children, Indianapolis, IN (United States); Alam, Khurshaid [Indiana University, School of Medicine, Indianapolis, IN (United States)

    2005-09-01

    Lack of clinical history on radiology requisitions is a universal problem. We describe a simple Web-based system that readily provides radiology-relevant clinical history to the radiologist reading radiographs of intensive care unit (ICU) patients. Along with the relevant history, which includes primary and secondary diagnoses, disease progression and complications, the system provides the patient's name, record number and hospital location. This information is immediately available to reporting radiologists. New clinical information is immediately entered on-line by the radiologists as they are reviewing images. After patient discharge, the data are stored and immediately available if the patient is readmitted. The system has been in routine clinical use in our hospital for nearly 2 years. (orig.)

  20. The use of psychometrists in clinical neuropsychology: history, current status, and future directions.

    Science.gov (United States)

    Malek-Ahmadi, Michael; Erickson, Tom; Puente, Antonio E; Pliskin, Neil; Rock, Rachel

    2012-01-01

    In recent years, the National Academy of Neuropsychology and other professional neuropsychological organizations have published a number of articles and position papers regarding the use, education, and training of psychometrists ("technicians"). Although these documents provide guidelines for the suggested qualifications and training procedures of psychometrists, none make any mention of the need for a standardized credentialing process, which is commonly required of technicians in similar fields, especially in medical settings. Given the recent changes in current procedural Terminology codes used to bill for neuropsychological services and the interpretation of legislation disallowing the use of psychometrists in New York, the need for a standard credential for psychometrists is apparent. This article will review the history and current use of psychometrists in clinical neuropsychology and highlight the need and rationale for the credentialing of psychometrists.

  1. 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?

    Science.gov (United States)

    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.

  2. 'Crescent Sign': Phase abnormality in radionuclide multigated study in tricuspid regurge: Description and clinical evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Ziada, G.; Abdel-Dayem, H.M.; Shafy, M.Z.; Constantinides, C.; Yousif, A.M.; Nair, N.

    1987-08-01

    A phase abnormality in radionuclide multigated studies (MUGA) in patients with tricuspid regurge (TR) is being described. In this condition of TR, as the right ventricle contracts, if causes the blood to regurge through the tricuspid valve to the right atrium and through the inferior Vena cava and hepatic veins to the adjacent liver tissue. As a result the right atrium and the liver will be in the same delayed phase forming a Crescent to the right side of the heart representing the right atrium and extending below the heart into the region of the liver. This Crescent has been graded according to how far it is extending in the liver and below the heart. In 15 patients with cardiac cath finding of TR (done within 2-3 days of the MUGA study), the phase displays of the radionuclide MUGA studies were analysed in order to find out the sensitivity of the Crescent Sign in the detection of TR and whether there is a relationship between the grade of the Crescent and the severity of the regurgitation. The Crescent was found in 13 of the 15 patients (sensitivity = 87%). We have not found a correlation between the severity of TR and the grade of the Crescent. We conclude that the presence of the Crescent Sign in phase display of the MUGA study should direct the attention of the clinician towards the recognition of TR, a condition which is sometimes difficult to diagnose non-invasively.

  3. Cross-sectional study of Pfizer-sponsored clinical trials: assessment of time to publication and publication history

    OpenAIRE

    Mooney, LaVerne A; Fay, Lorna

    2016-01-01

    Objective To estimate the proportion of Pfizer-sponsored clinical trials that completed in 2010 and are published as manuscripts in the peer-reviewed literature, and to assess the manuscript development history. Design Retrospective, cross-sectional analysis. Setting Clinical trials registered in ClinicalTrials.gov that completed in 2010 for approved, Pfizer prescription products in patients or vaccines in healthy participants. Main outcome measures The proportion of studies for which the pri...

  4. A review on the clinical spectrum and natural history of human influenza.

    Science.gov (United States)

    Punpanich, Warunee; Chotpitayasunondh, Tawee

    2012-10-01

    The objective of this review is to provide updated information on the clinical spectrum and natural history of human influenza, including risk factors for severe disease, and to identify the knowledge gap in this area. We searched the MEDLINE database of the recent literature for the period January 2009 to August 17, 2011 with regard to the abovementioned aspects of human influenza, focusing on A(H1N1)pdm09 and seasonal influenza. The clinical spectrum and outcomes of cases of A(H1N1)pdm09 influenza have been mild and rather indistinguishable from those of seasonal influenza. Sporadic cases covering a wide range of neurological complications have been reported. Underlying predisposing conditions considered to be high-risk for A(H1N1)pdm09 infections are generally similar to those of seasonal influenza, but with two additional risk groups: pregnant women and the morbidly obese. Co-infections with bacteria and D222/N variants or 225G substitution of the viral genome have also been reported to be significant factors associated with the severity of disease. The current knowledge gap includes: (1) a lack of clarification regarding the relatively greater severity of the Mexican A(H1N1)pdm09 influenza outbreak in the early phase of the pandemic; (2) insufficient data on the clinical impact, risk factors, and outcomes of human infections caused by resistant strains of influenza; and (3) insufficient data from less developed countries that would enable them to prioritize strategies for influenza prevention and control. Clinical features and risk factors of A(H1N1)pdm09 are comparable to those of seasonal influenza. Emerging risk factors for severe disease with A(H1N1)pdm09 include morbid obesity, pregnancy, bacterial co-infections, and D222/N variants or 225G substitution of the viral genome. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  5. Relationship of white and gray matter abnormalities to clinical and genetic features in myotonic dystrophy type 1

    Directory of Open Access Journals (Sweden)

    Stefano Zanigni

    2016-01-01

    Conclusion: In patients with DM1, the combined smaller overall gray matter volume and white matter alterations seem to be the main morpho-structural substrates of CNS involvement in this condition. The correlation of white matter differences with both clinical and genetic findings lends support to this notion.

  6. SERIAL NECK ULTRASOUND IS MORE LIKELY TO IDENTIFY FALSE-POSITIVE ABNORMALITIES THAN CLINICALLY SIGNIFICANT DISEASE IN LOW-RISK PAPILLARY THYROID CANCER PATIENTS.

    Science.gov (United States)

    Yang, Samantha Peiling; Bach, Ariadne M; Tuttle, R Michael; Fish, Stephanie A

    2015-12-01

    American Thyroid Association (ATA) low-risk papillary thyroid cancer (PTC) patients without structural evidence of disease on initial posttreatment evaluation have a low risk of recurrence. Despite this, most patients undergo frequent surveillance neck ultrasound (US). The objective of the study was to evaluate the clinical utility of routine neck US in ATA low-risk PTC patients with no structural evidence of disease after their initial thyroid surgery. We performed a retrospective review of 171 ATA low-risk PTC patients after total thyroidectomy, with or without radioactive iodine (RAI) ablation, who had a neck US without suspicious findings after therapy. The main outcome measure was a comparison of the frequency of finding false-positive US abnormalities and the frequency of identifying structural disease recurrence. Over a median follow-up of 8 years, 171 patients underwent a median of 5 neck US (range 2-17). Structural recurrence with low-volume disease (≤1 cm) was identified in 1.2% (2/171) of patients at a median of 2.8 years (range 1.6-4.1 years) after their initial diagnosis. Recurrence was associated with rising serum thyroglobulin (Tg) level in 1 of the 2 patients and was detected without signs of biochemical recurrence in the other patient. Conversely, false-positive US abnormalities were identified in 67% (114/171) of patients after therapy, leading to additional testing without identifying clinically significant disease. In ATA low-risk patients without structural evidence of disease on initial surveillance evaluation, routine screening US is substantially more likely to identify false-positive results than clinically significant structural disease recurrence.

  7. From Appearance of Adrenal Autoantibodies to Clinical Symptoms of Addison's Disease: Natural History.

    Science.gov (United States)

    Betterle, Corrado; Garelli, Silvia; Presotto, Fabio; Furmaniak, Jadwiga

    2016-01-01

    Recent progress in the immunopathology field has greatly improved our understanding of the natural history of autoimmune diseases, particularly of Addison's disease. Addison's disease is known to be a chronic illness characterized by adrenocortical gland insufficiency that develops following a long and mainly asymptomatic period, characterized by the presence of circulating autoantibodies directed to adrenal cortex antigens. In this chapter we describe the groups of subjects at risk of developing Addison's disease, together with the diagnostic tests considered the most appropriate for evaluating adrenal function: determination of basal plasma adrenocorticotropic hormone (ACTH) levels, plasma renin activity, plasma aldosterone and cortisol levels, and cortisol levels after intravenous stimulation with ACTH (ACTH test). The employment of specific clinical, immunological and functional criteria in the subjects with autoantibodies to the adrenal cortex allows identifying those at risk of developing overt disease. The independent risk factors for the progression to adrenal failure have also been identified and they contribute to different risks of developing clinical Addison's disease. Based on the risk level, the subjects should be monitored over time to observe early signs of adrenal dysfunction, and start substitutive treatment as soon as possible. For patients presenting with high risk, prevention strategies and trials might be available. © 2016 S. Karger AG, Basel.

  8. Clinical prediction of postoperative seizure control: structural, functional findings and disease histories.

    Science.gov (United States)

    Stefan, H; Hildebrandt, M; Kerling, F; Kasper, B S; Hammen, T; Dörfler, A; Weigel, D; Buchfelder, M; Blümcke, I; Pauli, E

    2009-02-01

    Mesial temporal lobe epilepsy (MTLE) constitutes a heterogenic entity with different clinical histories, pathomorphological hippocampal findings and varying postoperative outcome. 64 patients with MTLE, scheduled for hippocampal resection, were included. Initial precipitating injuries (IPI), structural and functional findings and neuropathological classification of hippocampal specimens were related to prediction of surgical outcome. Patients with severe hippocampal sclerosis (mesial temporal sclerosis (MTS) type 1b) became completely seizure free (80% Engel Ia) significantly more often compared with approximately 40% of seizure freedom in other types of MTS or in patients without hippocampal cell loss (non-MTS), irrespective of the extent of hippocampal resection. Age at IPI was found to be related to MTS variants (psilent period of about 5 years; (3) unequivocal unilateral EEG localisation; (4) MRI signs of MTS; and (5) Wada Test indicates contralateral memory compensation and ipsilateral reduced memory capacity. MTS type 1b, characterised by severe cell loss in all hippocampal subfields including the dentate gyrus, and associated with optimal postoperative seizure control, was preoperatively clinically best differentiated from other MTS types by the Wada Memory Test.

  9. Gating Deficit Heritability and Correlation With Increased Clinical Severity in Schizophrenia Patients With Positive Family History.

    Science.gov (United States)

    Greenwood, Tiffany A; Light, Gregory A; Swerdlow, Neal R; Calkins, Monica E; Green, Michael F; Gur, Raquel E; Gur, Ruben C; Lazzeroni, Laura C; Nuechterlein, Keith H; Olincy, Ann; Radant, Allen D; Seidman, Larry J; Siever, Larry J; Silverman, Jeremy M; Stone, William S; Sugar, Catherine A; Tsuang, Debby W; Tsuang, Ming T; Turetsky, Bruce I; Freedman, Robert; Braff, David L

    2016-04-01

    The Consortium on the Genetics of Schizophrenia Family Study evaluated 12 primary and other supplementary neurocognitive and neurophysiological endophenotypes in schizophrenia probands and their families. Previous analyses of prepulse inhibition (PPI) and P50 gating measures in this sample revealed heritability estimates that were lower than expected based on earlier family studies. Here the authors investigated whether gating measures were more heritable in multiply affected families with a positive family history compared with families with only a single affected proband (singleton). A total of 296 nuclear families consisting of a schizophrenia proband, at least one unaffected sibling, and both parents underwent a comprehensive endophenotype and clinical characterization. The Family Interview for Genetic Studies was administered to all participants and used to obtain convergent psychiatric symptom information for additional first-degree relatives. Among the families, 97 were multiply affected, and 96 were singletons. Both PPI and P50 gating displayed substantially increased heritability in the 97 multiply affected families (47% and 36%, respectively) compared with estimates derived from the entire sample of 296 families (29% and 20%, respectively). However, no evidence for heritability was observed for either measure in the 96 singleton families. Schizophrenia probands derived from the multiply affected families also displayed a significantly increased severity of clinical symptoms compared with those from singleton families. PPI and P50 gating measures demonstrate substantially increased heritability in schizophrenia families with a higher genetic vulnerability for illness, providing further support for the commonality of genes underlying both schizophrenia and gating measures.

  10. The clinical features of myasthenia gravis associated with thyroid abnormalities%重症肌无力伴发甲状腺异常的临床分析

    Institute of Scientific and Technical Information of China (English)

    陈玉萍; 魏东宁; 陈兵

    2010-01-01

    目的 分析重症肌无力(MG)合并甲状腺异常患者的临床特点.方法 回顾性分析2008年7月-2009年9月同期住院的300例MG患者临床资料,比较260例甲状腺正常及40例伴甲状腺异常的MG患者临床特点,血清甲状腺抗体与乙酰胆碱受体抗体水平的相关性及外周血T淋巴细胞亚群百分比情况.结果 (1)合并甲状腺异常的MG占13.3%,MG伴甲状腺异常以出现甲状腺抗体阳性为多见(30例,占10.0%);(2)甲状腺正常与异常的MG患者在发病性别构成、年龄分布、病程、临床分型及胸腺病理上差异均无统计学意义;(3)伴有甲状腺抗体阳性MG患者血突触后膜乙酰胆碱受体水平(1.15±0.11)显著高于甲状腺抗体阴性者(1.01±0.11);(4)甲状腺异常组CD8+T淋巴细胞百分比(21.63±5.17)%明显低于甲状腺正常组(24.28±5.79)%,P<0.05,CD4+/CD8+比值甲状腺异常组明显高于正常组(2.10±0.67比1.81±0.61,P<0.05).结论 MG合并甲状腺异常以甲状腺抗体阳性多见,伴有甲状腺抗体阳性MG患者血突触后膜乙酰胆碱受体水平显著升高;MG合并甲状腺异常者其外周血T淋巴细胞亚群紊乱更为明显.%Objective To analyze the clinical characteristics of myasthenia gravis(MG) associated with thyroid abnormalities.Methods A total of 300 MG patients admitted to the department of neurology from July 2008 to September 2009 were reviewed retrospectively.Based on the thyroid function and abnormality of thyroid related antibodies (thyroglobulin antibody and peroxidase antibody), the patients with MG were divided into two groups (260 cases without thyroid disease and 40 cases with thyroid abnormalities).The different clinical features, the relationship between the antithyroid antibodies and antiacetylcholine receptor antibody (AChRAb) and the distribution of T cell subsets between the two groups were compared.Results ( 1 ) Among the 300 MG patients, 13.3% of them was accompanied with thyroid disease and the

  11. Structural brain abnormalities correlate with clinical features in patients with drug-naïve OCD: A DARTEL-enhanced voxel-based morphometry study.

    Science.gov (United States)

    Tang, Wanjie; Huang, Xiaoqi; Li, Bin; Jiang, Xiaoyu; Li, Fei; Xu, Jiuping; Yang, Yanchun; Gong, Qiyong

    2015-11-01

    Abnormal brain structure has been reported in obsessive-compulsive disorder (OCD), but findings from these reports have been inconsistent. This study aimed to gain more detailed insights into gray matter structure and correlate this structure with clinical features in patients with drug-naïve OCD using voxel-based morphometry (VBM). Voxel-based morphometry and tools of Diffeomorphic Anatomical Registration through Exponentiated Lie Algebra (DARTEL) were used to investigate structural differences in gray matter volume between 26 drug-naïve OCD patients and 32 healthy controls. Partial correlation analysis was used to analyze associations of gray matter abnormalities with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores and illness duration. Compared to healthy controls, drug-naïve OCD patients showed significantly smaller gray matter volume in the right dorsolateral prefrontal cortex (DLPFC), left superior temporal gyrus, left precuneus and right precentral gyrus, as well as significantly greater gray matter volume in the left anterior insula and right parahippocampal gyrus (psuperior temporal gyrus and connected limbic structures such as the parahippocampal gyrus and anterior insula. Longitudinal studies are needed that integrate anatomical, functional and diffusion MRI data. Copyright © 2015 Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Abnormalities of gonadal differentiation.

    Science.gov (United States)

    Berkovitz, G D; Seeherunvong, T

    1998-04-01

    Gonadal differentiation involves a complex interplay of developmental pathways. The sex determining region Y (SRY) gene plays a key role in testis determination, but its interaction with other genes is less well understood. Abnormalities of gonadal differentiation result in a range of clinical problems. 46,XY complete gonadal dysgenesis is defined by an absence of testis determination. Subjects have female external genitalia and come to clinical attention because of delayed puberty. Individuals with 46,XY partial gonadal dysgenesis usually present in the newborn period for the valuation of ambiguous genitalia. Gonadal histology always shows an abnormality of seminiferous tubule formation. A diagnosis of 46,XY true hermaphroditism is made if the gonads contain well-formed testicular and ovarian elements. Despite the pivotal role of the SRY gene in testis development, mutations of SRY are unusual in subjects with a 46,XY karyotype and abnormal gonadal development. 46,XX maleness is defined by testis determination in an individual with a 46,XX karyotype. Most affected individuals have a phenotype similar to that of Klinefelter syndrome. In contrast, subjects with 46,XX true hermaphroditism usually present with ambiguous genitalia. The majority of subjects with 46,XX maleness have Y sequences including SRY in genomic DNA. However, only rare subjects with 46,XX true hermaphroditism have translocated sequences encoding SRY. Mosaicism and chimaerism involving the Y chromosome can also be associated with abnormal gonadal development. However, the vast majority of subjects with 45,X/46,XY mosaicism have normal testes and normal male external genitalia.

  14. Clinical Evaluation of Tinnitus.

    Science.gov (United States)

    Hertzano, Ronna; Teplitzky, Taylor B; Eisenman, David J

    2016-05-01

    The clinical evaluation of patients with tinnitus differs based on whether the tinnitus is subjective or objective. Subjective tinnitus is usually associated with a hearing loss, and therefore, the clinical evaluation is focused on an otologic and audiologic evaluation with adjunct imaging/tests as necessary. Objective tinnitus is divided into perception of an abnormal somatosound or abnormal perception of a normal somatosound. The distinction between these categories is usually possible based on a history, physical examination, and audiogram, leading to directed imaging to identify the underlying abnormality.

  15. Schizophrenia, abnormal connection, and brain evolution.

    Science.gov (United States)

    Randall, P L

    1983-03-01

    Abnormalities of functional connection between specialized areas in the human brain may underlie the symptoms which constitute the schizophrenia syndrome. Callosal and intrahemispheric fibres may be equally involved. The clinical emergence of symptoms in the later stages of brain maturation may be dependent on myelination of these fibre groups, both of which have extended myelination cycles. Ontogenetically earlier variants of the same mechanism could theoretically result in dyslexia and the syndromes of Kanner and Gilles de la Tourette. As new and unique extensions of specialized function emerge within the evolving brain, biological trial and error of connection both within and between them may produce individuals possessing phylogenetically advanced abilities, or equally, others possessing a wide range of abnormalities including those which comprise the schizophrenia syndrome. A dormant phenotypic potential for schizophrenia may exist in individuals who never develop symptoms during the course of a lifetime though some of these may become clinically apparent under the influence of various precipitating factors. It is concluded that abnormal functional connection and its normal and "supernormal" counterparts may be natural, essential, and inevitable consequences of brain evolution, and that this may have been so throughout the history of vertebrate brain evolution.

  16. Theory of Mind and social functioning in schizophrenia: correlation with figurative language abnormalities, clinical symptoms and general intelligence.

    Science.gov (United States)

    Piovan, Cristiano; Gava, Laura; Campeol, Mara

    2016-01-01

    Over past few decades, studies displayed Theory of Mind (ToM) as a system, including cognitive and affective features, rather than an unitary process. Within domains defining social cognition, ToM stands for the best predictor of poor social functioning in schizophrenia. The current study aimed to explore competence in ToM tasks, in metaphorical and idiomatic language identification tasks and in a conversational rules observance test, as well as relationship with social functioning, in a group of outpatients suffering from schizophrenia. METHODS.: 30 outpatients diagnosed with schizophrenia and 24 healthy subjects have been recruited. Both groups underwent TIB as premorbid IQ evaluation, PANSS, Theory of Mind Picture Sequencing Task, a metaphors and idiomatic expressions comprehension test and a conversational test. Social functioning was assessed with PSP. Results.Mean values of premorbid IQ showed no significant difference between patients and control group. In ToM and pragmatic competence tasks, differences between groups resulted in high significance, due to patients' lower performance. A correlation between metaphors and idiomatic expressions comprehension and second order false beliefs was detected. PSP showed a correlation with PANSS and cognitive-ToM, whereas leaving aside affective-ToM. Results showed how people affected with schizophrenia, in stable clinical condition, do have clear impairments in ToM and figurative language comprehension assignments. In our theoretical framework, correlation arisen between cognitive-ToM, pragmatic deficits, clinical status and social functioning level suggests usefulness of rehabilitative interventions to recover metacognitive functions and pragmatic abilities, in order to reduce social disability in schizophrenia.

  17. PREVALENCE OF NAIL ABNORMALITIES IN PATIENTS WITH PSORIASIS

    Directory of Open Access Journals (Sweden)

    Nermina Ovcina-Kurtovic

    2013-07-01

    Full Text Available Introduction: Psoriasis is a chronic inflammatory skin disease that affects about 2% of general population. Cllinicaly, disease can present with cutaneous and nails lesions. Nail abnormalities can be seen in up to two-thirds of patients with psoriasis and both fingernails and toenails may be affected.Objective: The objectives of our study were to evaluate the frequency and clinical presentations of nail abnormalities in patients with psoriasis. Also, we aimed to find correlation between nail changes and some clinical parameters.Methods: One hundred and ten patients with psoriasis were included in this study. A detailed history and examination was recorded for all study subjects, including the age and gender of the patients, type of psoriasis, duration, and extent of disease. Finger and toe nails were clinically examined and nail changes were noted. In the case of clinicaly suspected of fungal infection, further mycological investigations were performed.Results: Nail abnormalities were present in 67 patients (60.9% with psoriasis. Nail pitting was the most common lesion observed on fingernails, followed by discoloration of nail plate. Subungual hyperkeratosis of nail plates were significantly more frequent on the toenails. Positive mycological culture was in 14 (20.8% psoriatic patients with nail involvement. Also, positive correlation between nail abnormalities and duration of psoriasis was found.Conclusions: Nail involvement is common in patients with psoriasis and accompanies skin lesions on the body surface. Pitting and subungual hyperkeratosis are the most frequent nail abnormality in psoriatic patients.

  18. Abnormal pressure in hydrocarbon environments

    Science.gov (United States)

    Law, B.E.; Spencer, C.W.

    1998-01-01

    Abnormal pressures, pressures above or below hydrostatic pressures, occur on all continents in a wide range of geological conditions. According to a survey of published literature on abnormal pressures, compaction disequilibrium and hydrocarbon generation are the two most commonly cited causes of abnormally high pressure in petroleum provinces. In young (Tertiary) deltaic sequences, compaction disequilibrium is the dominant cause of abnormal pressure. In older (pre-Tertiary) lithified rocks, hydrocarbon generation, aquathermal expansion, and tectonics are most often cited as the causes of abnormal pressure. The association of abnormal pressures with hydrocarbon accumulations is statistically significant. Within abnormally pressured reservoirs, empirical evidence indicates that the bulk of economically recoverable oil and gas occurs in reservoirs with pressure gradients less than 0.75 psi/ft (17.4 kPa/m) and there is very little production potential from reservoirs that exceed 0.85 psi/ft (19.6 kPa/m). Abnormally pressured rocks are also commonly associated with unconventional gas accumulations where the pressuring phase is gas of either a thermal or microbial origin. In underpressured, thermally mature rocks, the affected reservoirs have most often experienced a significant cooling history and probably evolved from an originally overpressured system.

  19. Natural history of premacular hemorrhage due to severe acute anemia: clinical and anatomical features in two untreated patients.

    Science.gov (United States)

    Turco, Claudia Del; La Spina, Carlo; Mantovani, Elena; Gagliardi, Marco; Lattanzio, Rosangela; Pierro, Luisa

    2014-03-01

    Premacular retrohyaloid hemorrhage is a rare complication of acute severe anemia. The authors report two cases of premacular hemorrhage in which no treatment other than clinical and spectral-domain optical coherence tomography observation was performed. The natural history of this condition reveals that complete clinical resolution is not accompanied by full anatomical restoration. [Ophthalmic Surg Lasers Imaging Retina. 2014;45:E5-E7.]. Copyright 2014, SLACK Incorporated.

  20. [History of clinical pharmacology in France: adaptation, evaluation, defense and illustration of drug in France 1978-1981].

    Science.gov (United States)

    Montastruc, Paul

    2014-01-01

    This text illustrates some unknown aspects of the history and beginnings of clinical pharmacology in France in the late 1970s and early 1980s From the current situation, development and objectives of clinical pharmacology are recalled as well as obstacles necessary to overcome to change the paradigm in the field of drug evaluation and appropriate use in France. The text recalls this important moment where French medicine and medical pharmacology entered the modern era.

  1. Clinical Utility of Subtyping Binge Eating Disorder by History of Anorexia or Bulimia Nervosa in a Treatment Sample

    Science.gov (United States)

    Utzinger, Linsey M.; Mitchell, James E.; Cao, Li; Crosby, Ross D.; Crow, Scott J.; Wonderlich, Stephen A.; Peterson, Carol B.

    2016-01-01

    Objective This study examined whether having a history of anorexia nervosa (AN) or bulimia nervosa (BN) is associated with response to treatment in adults with binge eating disorder (BED). Method Data from 189 adults diagnosed with BED who were randomly assigned to one of three group cognitive-behavioral (CBT) treatments were analyzed to compare those with and without a history of AN/BN. Results A total of 16% of the sample had a history of AN/BN. The BED subgroup with a history of AN/BN presented with higher rates of mood disorders and greater eating-related symptom severity at baseline. Participants with a history of AN/BN also had higher global eating disorder (ED) symptoms at end of treatment (EOT), and more frequent objective binge-eating episodes at EOT and 12-month follow-up. Discussion These findings suggest that in adults with BED, a history of AN/BN is predictive of greater eating-related symptom severity following group-based CBT and poorer short- and long-term binge-eating outcomes. These findings suggest that considering ED history in the treatment of adults with BED may be clinically useful. PMID:25959549

  2. Clinical utility of subtyping binge eating disorder by history of anorexia or bulimia nervosa in a treatment sample.

    Science.gov (United States)

    Utzinger, Linsey M; Mitchell, James E; Cao, Li; Crosby, Ross D; Crow, Scott J; Wonderlich, Stephen A; Peterson, Carol B

    2015-09-01

    This study examined whether having a history of anorexia nervosa (AN) or bulimia nervosa (BN) is associated with response to treatment in adults with binge eating disorder (BED). Data from 189 adults diagnosed with BED who were randomly assigned to one of three group cognitive-behavioral (CBT) treatments were analyzed to compare those with and without a history of AN/BN. A total of 16% of the sample had a history of AN/BN. The BED subgroup with a history of AN/BN presented with higher rates of mood disorders and greater eating-related symptom severity at baseline. Participants with a history of AN/BN also had higher global eating disorder (ED) symptoms at end of treatment (EOT), and more frequent objective binge-eating episodes at EOT and 12-month follow-up. These findings suggest that in adults with BED, a history of AN/BN is predictive of greater eating-related symptom severity following group-based CBT and poorer short- and long-term binge-eating outcomes. These findings suggest that considering ED history in the treatment of adults with BED may be clinically useful. © 2015 Wiley Periodicals, Inc.

  3. Laboratory hematology in the history of Clinical Chemistry and Laboratory Medicine.

    Science.gov (United States)

    Hoffmann, Johannes J M L

    2013-01-01

    For the occasion of the 50th anniversary of the journal Clinical Chemistry and Laboratory Medicine (CCLM), an historic overview of papers that the journal has published in the field of laboratory hematology (LH) is presented. All past volumes of CCLM were screened for papers on LH and these were categorized. Bibliographic data of these papers were also analyzed. CCLM published in total 387 LH papers. The absolute number of LH papers published annually showed a significant increase over the years since 1985. Also the share of LH papers demonstrated a steady increase (overall mean 5%, but mean 8% over the past 4 years). The most frequent category was coagulation and fibrinolysis (23.5%). Authors from Germany contributed the most LH papers to the journal (22.7%), followed by the Netherlands and Italy (16.3 and 13.2%, respectively). Recent citation data indicated that other publications cited LH review papers much more frequently than other types of papers. The history of the journal reflects the emergence and development of laboratory hematology as a separate discipline of laboratory medicine.

  4. Recent Clinical History and Cognitive Dysfunction for Attention and Executive Function among Human Immunodeficiency Virus-Infected Patients

    Science.gov (United States)

    Tate, David F.; DeLong, Allison; McCaffrey, Daniel E.; Kertesz, Kinga; Paul, Robert H.; Conley, Jared; Russell, Troy; Coop, Kathleen; Gillani, Fizza; Flanigan, Timothy; Tashima, Karen; Hogan, Joseph W.

    2011-01-01

    This study examined the association between recent trends in CD4 and viral loads and cognitive test performance with the expectation that recent history could predict cognitive performance. Eighty-three human immunodeficiency virus (HIV)-infected patients with a mean CD4 count of 428 copies/ml were examined in this study (62% with undetectable plasma viral load [PVL]). We investigated the relationships between nadir CD4 cell count, 1-year trends in immunologic function/PVLs, and cognitive performance across several domains using linear regression models. Nadir CD4 cell count was predictive of current executive function (p = .004). One year clinical history for CD4 cell counts and/or PVLs were predictive of executive function, attention/working memory, and learning/memory measures (p < .05). Models that combined recent clinical history trends and nadir CD4 cell counts suggested that recent clinical trends were more important in predicting current cognitive performance for all domains except executive function. This research suggests that recent CD4 and viral load history is an important predictor of current cognitive function across several cognitive domains. If validated, clinical variables and cognitive dysfunction models may improve our understanding of the dynamic relationships between disease evolution and progression and CNS involvement. PMID:21873325

  5. Clinical abnormalities, early intervention program of Down syndrome children: Queen Sirikit National Institute of Child Health experience.

    Science.gov (United States)

    Fuengfoo, Adidsuda; Sakulnoom, Kim

    2014-06-01

    Queen Sirikit National Institute of Child Health is a tertiary institute of children in Thailand, where early intervention programs have been provided since 1990 by multidisciplinary approach especially in Down syndrome children. This aim of the present study is to follow the impact of early intervention on the outcome of Down syndrome children. The school attendance number of Down syndrome children was compared between regular early intervention and non-regular early intervention. The present study group consists of 210 Down syndrome children who attended early intervention programs at Queen Sirikit National Institute of Child Health between June 2008 and January 2012. Data include clinical features, school attendance developmental quotient (DQ) at 3 years of age using Capute Scales Cognitive Adaptive Test/Scale (CAT/CLAMS). Developmental milestones have been recorded as to the time of appearance of gross motor, fine motor, language, personal-social development compared to those non-regular intervention patients. Of 210 Down syndrome children, 117 were boys and 93 were girls. About 87% received regular intervention, 68% attended speech training. Mean DQ at 3 years of age was 65. Of the 184 children who still did follow-up at developmental department, 124 children (59%) attended school: mainstream school children 78 (63%) and special school children 46 (37%). The mean age at entrance to school was 5.8 ± 1.4 years. The school attendance was correlated with maternal education and regular early intervention attendance. Regular early intervention starts have proven to have a positive effect on development. The school attendance number of Down syndrome children receiving regular early intervention was statistically and significantly higher than the number of Down syndrome children receiving non-regular early intervention was. School attendance correlated with maternal education and attended regularly early intervention. Regular early intervention together with maternal

  6. [Amyoplasia congenita: a serious congenital abnormality with a relatively favorable prognosis

    NARCIS (Netherlands)

    Petru, R.; Verrips, A.; Ravenswaaij-Arts, C.M.A. van

    2002-01-01

    After an uneventful pregnancy a girl was born with serious joint contractures and several fractures of the long bones. The family history was negative for congenital abnormalities. Based on the distinct clinical presentation the diagnosis was 'amyoplasia', which is a partial aplasia of skeletal

  7. [Amyoplasia congenita: a serious congenital abnormality with a relatively favorable prognosis

    NARCIS (Netherlands)

    Petru, R.; Verrips, A.; Ravenswaaij-Arts, C.M.A. van

    2002-01-01

    After an uneventful pregnancy a girl was born with serious joint contractures and several fractures of the long bones. The family history was negative for congenital abnormalities. Based on the distinct clinical presentation the diagnosis was 'amyoplasia', which is a partial aplasia of skeletal musc

  8. The influence of Multiwave Locked System (MLS) laser therapy on clinical features, microcirculatory abnormalities and selected modulators of angiogenesis in patients with Raynaud's phenomenon.

    Science.gov (United States)

    Kuryliszyn-Moskal, Anna; Kita, Jacek; Dakowicz, Agnieszka; Chwieśko-Minarowska, Sylwia; Moskal, Diana; Kosztyła-Hojna, Bożena; Jabłońska, Ewa; Klimiuk, Piotr Adrian

    2015-03-01

    The aim of this study was to investigate the influence of the Multiwave Locked System (MLS) laser therapy on clinical features, microvascular changes in nailfold videocapillaroscopy (NVC) and circulating modulators releasing as a consequence of vascular endothelium injury such as vascular endothelial growth factor (VEGF) and angiopoietin 2 (Ang-2) in patients with primary and secondary Raynaud's phenomenon. Seventy-eight RP patients and 30 healthy volunteers were recruited into the study. All patients with RP received MLS laser irradiation for 3 weeks. Clinical, NVC and laboratory investigations were performed before and after the MLS laser therapy. The serum concentration of VEGF and Ang-2 were determined by an enzyme-linked immunosorbent assay (ELISA). After 3 weeks of MLS laser therapy, the clinical improvement manifested by decreasing of the number of RP attacks, mean duration of Raynaud's attack and pain intensity in RP patients was observed. After MLS laser therapy in 65% of patients with primary and in 35% with secondary RP, an increase in the loop number and/or a reduction in avascular areas in NVC were observed. In comparison with a control group, higher serum concentration of VEGF and Ang-2 in RP patients was demonstrated. After MLS laser therapy, a reduction of Ang-2 in both groups of RP patients was found. Our results suggest that NVC may reflect microvascular changes associated with clinical improvement after MLS laser therapy in patients with primary and secondary RP. Ang-2 serum levels may be a useful marker of microvascular abnormalities in RP patients treated with MLS laser therapy.

  9. Abnormal expression of vascular endothelial growth factor (VEGF) and its clinical features in tissues of human lung cancer

    Institute of Scientific and Technical Information of China (English)

    Xinhua Wu; Dengfu Yao; Gongshen Shi; Liwei Qiu; Wei Wu; Songshi Ni; Xueguang Zhang

    2005-01-01

    Objective: Angiogennesis, the formation of new blood vessels from the existing vascular bed, is essential step for growth and invasion of primary tumor. Vascular endothelial growth-factor (VEGF) is known to play crucial role in tumor angiogenesis. In the present study, we investigate the expression of VEGF and VEGF-mRNA in the angiogennesis, metastasis and prognosis of lung cancer.Methods: The VEGF cellular distributions and expression in 38 specimens of patients with lung cancer were investigated with immunohistochemistry stain technology. The total RNAs in 38 tissues of lung cancer was measured, then the levels of VEGF-mRNA expression were analyzed by a reverse-transcription polymerase chain reaction (RT-PCR) assay. The levels of VEGF in sera of patients with lung cancer, benign lung diseases and healthy controls were detected through Enzyme linked immunosorbent assay (ELISA) method. Results: The VEGF positive stain was 76% in 38 cases of lung cancer specimens. The 89% rate of VEGF stain was found for clinical stage Ⅲ cases and 92%for stage Ⅳ lung cancers. The significantly higher expression of VEGF was evidenced in patients with lymph node metastasis (84 % ), distant metastasis (90%), and lung cancers with lower histological differentiation (89%), respectively. The expression level of total RNA was significantly higher in patients with lung cancers than that in their paracancerous or distant lung tissues. The VEGF expressions were tightly correlated with total RNA concentration of lung carcinoma ( P < 0.01 ). The predominant expressions of VEGF121 and VEGF165 gene fragments were found in lung cancer specimens by RT-PCR analysis. No significant difference of serum VEGF levels was detected between cases with lung cancer and patients with benign diseases. However, the VEGF level of cases with benign diseases was decreased significantly after patients with anti-inflammation medication. Conclusion: The present data suggested that the tumor tissue VEGF

  10. Clinical exploration of diagnosis and treatment of adolescent abnormal uterine bleeding%青春期异常子宫出血诊治临床探讨

    Institute of Scientific and Technical Information of China (English)

    罗奕巾

    2016-01-01

    目的:分析青春期异常子宫出血诊治临床方法和效果。方法随机选取2013年6月~2015年6月于本院就诊的71例青春期异常子宫出血患者作为研究对象,随机分组。雌孕激素组患者予以雌孕激素联合治疗,去氧孕烯炔雌醇组患者予以去氧孕烯炔雌醇片治疗;比较两组患者的临床疗效以及用药副作用、出血初步控制时间和出血完全控制时间。结果去氧孕烯炔雌醇组患者的临床总治疗效率明显高于雌孕激素组,其中雌孕激素组总有效率为96.67%,雌孕激素组总有效率为77.42%,差异有统计学意义(P<0.05)。去氧孕烯炔雌醇组治疗过程用药副作用发生率跟雌孕激素组相似,雌孕激素组发生率为9.68%,去氧孕烯炔雌醇组发生率为10.00%,差异无统计学意义(P>0.05)。去氧孕烯炔雌醇组患者出血初步控制时间和出血完全控制时间明显短于雌孕激素组,差异无统计学意义(P>0.05)。结论去氧孕烯炔雌醇片治疗青春期异常子宫出血的临床效果好,可推广应用。%Objective To analyze the clinical methods and effects of the diagnosis and treatment of adolescent abnormal uterine bleeding. Methods 71 patients with adolescent abnormal uterine bleeding who were admitted to our hospital from June 2013 to June 2015 were randomly selected as research objects and they were randomly allocated to the estrogen and progesterone group and the desogestrel ethinylestradiol group.Patients in the estrogen and progesterone group were received combined treatment of estrogen and progesterone while patients in the desogestrel ethinylestradiol group were received treatment of desogestrel ethinylestradiol tablets.Clinical curative effect,side effects of drugs, bleeding preliminary control time and bleeding complete control time of patients in two groups were compared. Results Clinical total effective rate of the desogestrel ethinylestradiol group was

  11. A phase II clinical study to assess the feasibility of self and partner anal examinations to detect anal canal abnormalities including anal cancer.

    Science.gov (United States)

    Nyitray, Alan G; Hicks, Joseph T; Hwang, Lu-Yu; Baraniuk, Sarah; White, Margaret; Millas, Stefanos; Onwuka, Nkechi; Zhang, Xiaotao; Brown, Eric L; Ross, Michael W; Chiao, Elizabeth Y

    2017-08-23

    Anal cancer is a common cancer among men who have sex with men (MSM); however, there is no standard screening protocol for anal cancer. We conducted a phase II clinical trial to assess the feasibility of teaching MSM to recognise palpable masses in the anal canal which is a common sign of anal cancer in men. A clinician skilled in performing digital anorectal examinations (DARE) used a pelvic manikin to train 200 MSM, aged 27-78 years, how to do a self-anal examination (SAE) for singles or a partner anal examination (PAE) for couples. The clinician then performed a DARE without immediately disclosing results, after which the man or couple performed an SAE or PAE, respectively. Percentage agreement with the clinician DARE in addition to sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for the SAE, PAE and overall. Men had a median age of 52 years, 42.5% were African American and 60.5% were HIV positive. DARE detected abnormalities in 12 men while the men's SAE/PAEs detected 9 of these. A total of 93.0% of men classified the health of their anal canal correctly (95% CI 89.5 to 96.5). Overall percentage agreement, sensitivity and specificity were 93.0%, 75.0% and 94.2%, respectively, while PPV and NPV were 45.0% and 98.3%, respectively. The six men who detected the abnormality had nodules/masses ≥3 mm in size. More than half of men (60.5%) reported never checking their anus for an abnormality; however, after performing an SAE/PAE, 93.0% said they would repeat it in the future. These results suggest that tumours of ≥3 mm may be detectable by self or partner palpation among MSM and encourage further investigation given literature suggesting a high cure rate for anal cancer tumours ≤10 mm. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. 畸形子宫早孕药物流产的临床观察%Clinical Observation on Drug Induced Abortion in Abnormal Uterine Pregnancy

    Institute of Scientific and Technical Information of China (English)

    赵童; 张立红

    2016-01-01

    Objective:To investigate the clinical effect of drug induced abortion in abnormal uterine preg-nancy (the uterine septum,uterus bicornis,bicorbate uterus and uterus unicornis).Methods:37 patients with abnormal uterine pregnancy received drug induced abortion (mifepristone combined with misoprostol) termination of pregnancy.Results:Among the 37 patients,28 patients were complete abortion,8 patients were incomplete abortion,1 case was abortion failure.Incomplete abortion and abortion failure patients un-derwent curettage,the postoperative course was uneventful,no accidents such as uterine perforation or suc-tion leaks occurred.The complete abortion rate was 75.7%,the curettage rate was 24.3%.Conclusion:The success rate of drug induced abortion in abnormal uterine pregnancy is high,and for incomplete abortion and medical abortion failure patients,because early drug effects enable embryo stripping,uterine contraction ex-trusion blastocyst and uterine luminal contents of depression or partial discharge,it can effectively reduce the risk of abortion.%目的::针对药物流产终止畸形子宫(子宫纵隔、双角子宫及鞍状子宫、单角子宫)早孕的临床效果展开探讨。方法:37名畸形子宫早孕患者用药物流产(米非司酮联合米索前列醇口服)终止妊娠。结果:37名患者中完全流产28名,未完全流产8名,流产失败1名。而后为不全流产及流产失败患者均行清宫术,手术过程顺利,未产生子宫穿孔、漏吸等情况。完全流产率为75.7%,清宫率为24.3%。结论:畸形子宫早孕应用药物流产成功概率较高,对不全流产及药流失败者因前期药物作用使胚胎剥离,子宫收缩挤压胚囊及宫腔内容物下移或部分排出,可有效降低清宫术的风险。

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

    Institute of Scientific and Technical Information of China (English)

    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。

  14. The long-term clinical implications of clonal chromosomal abnormalities in newly diagnosed chronic phase chronic myeloid leukemia patients treated with imatinib mesylate.

    Science.gov (United States)

    Lee, Sung-Eun; Choi, Soo Young; Bang, Ju-Hee; Kim, Soo-Hyun; Jang, Eun-Jung; Byeun, Ji-Young; Park, Jin Eok; Jeon, Hye-Rim; Oh, Yun Jeong; Kim, Myungshin; Kim, Dong-Wook

    2012-11-01

    The aim of this study was to evaluate the long-term clinical significance of an additional chromosomal abnormality (ACA), variant Philadelphia chromosome (vPh) at diagnosis, and newly developed other chromosomal abnormalities (OCA) in patients with chronic myeloid leukemia (CML) on imatinib (IM) therapy. Sequential cytogenetic data from 281 consecutive new chronic phase CML patients were analyzed. With a median follow-up of 78.6 months, the 22 patients with vPh (P = 0.034) or ACA (P = 0.034) at diagnosis had more events of IM failure than did the patients with a standard Ph. The 5-year overall survival (OS), event-free survival (EFS), and failure-free survival (FFS) rates for patients with vPh at diagnosis were 77.8%, 75.0%, and 53.3%, respectively; for patients with ACA at diagnosis, 100%, 66.3%, and 52.1%, respectively; and for patients with a standard Ph, 96.0%, 91.3%, and 83.7%, respectively. During IM therapy, eight patients developed an OCA, which had no impact on outcomes as a time-dependent covariate in our Cox proportional hazards regression models. This study showed that vPh was associated with poor OS and FFS and that ACA had adverse effects on EFS and FFS. In addition, no OCA, except monosomy 7, had any prognostic impact, suggesting that the development of OCA may not require a change in treatment strategy. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Inherited erythromelalgia due to mutations in SCN9A: natural history, clinical phenotype and somatosensory profile.

    Science.gov (United States)

    McDonnell, Aoibhinn; Schulman, Betsy; Ali, Zahid; Dib-Hajj, Sulayman D; Brock, Fiona; Cobain, Sonia; Mainka, Tina; Vollert, Jan; Tarabar, Sanela; Waxman, Stephen G

    2016-04-01

    Inherited erythromelalgia, the first human pain syndrome linked to voltage-gated sodium channels, is widely regarded as a genetic model of human pain. Because inherited erythromelalgia was linked to gain-of-function changes of sodium channel Na(v)1.7 only a decade ago, the literature has mainly consisted of reports of genetic and/or clinical characterization of individual patients. This paper describes the pattern of pain, natural history, somatosensory profile, psychosocial status and olfactory testing of 13 subjects with primary inherited erythromelalgia with mutations of SCN9A, the gene encoding Na(v)1.7. Subjects were clinically profiled using questionnaires, quantitative sensory testing and olfaction testing during the in-clinic phase of the study. In addition, a detailed pain phenotype for each subject was obtained over a 3-month period at home using diaries, enabling subjects to self-report pain attacks, potential triggers, duration and severity of pain. All subjects reported pain and heat in the extremities (usually feet and/or hands), with pain attacks triggered by heat or exercise and relieved mainly by non-pharmacological manoeuvres such as cooling. A large proportion of pain attacks (355/1099; 32%) did not involve a specific trigger. There was considerable variability in the number, duration and severity of pain attacks between subjects, even those carrying the same mutation within a family, and within individuals over the 12-13 week observation period. Most subjects (11/13) had pain between attacks. For these subjects, mean pain severity between pain attacks was usually lower than that during an attack. Olfaction testing using the Sniffin'T test did not demonstrate hyperosmia. One subject had evidence of orthostatic hypotension. Overall, there was a statistically significant correlation between total Hospital Anxiety and Depression Scale scores (P= 0.005) and pain between attacks and for Hospital Anxiety and Depression Scale Depression scores and pain

  16. Clinical Management of Adult Patients with a History of Nonsteroidal Anti-Inflammatory Drug-Induced Urticaria/Angioedema: Update

    Directory of Open Access Journals (Sweden)

    Asero Riccardo

    2007-03-01

    Full Text Available In the large majority of previous studies, patients with a history of acute urticaria induced by nonsteroidal anti-inflammatory drugs (NSAIDs seeking safe alternative drugs have undergone tolerance tests uniquely with compounds exerting little or no inhibitory effect on the cyclooxygenase 1 enzyme. In light of recently published studies, however, this approach seems inadequate and should be changed. The present article critically reviews the clinical management of patients presenting with a history of urticaria induced by a single NSAID or multiple NSAIDs and suggests a simple, updated diagnostic algorithm that may assist clinicians in correctly classifying their patients.

  17. Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy.

    Science.gov (United States)

    Gjeorgjievski, Mihajlo; Cappell, Mitchell S

    2016-02-08

    To describe the pathophysiology, clinical presentation, natural history, and therapy of portal hypertensive gastropathy (PHG) based on a systematic literature review. Computerized search of the literature was performed via PubMed using the following medical subject headings or keywords: "portal" and "gastropathy"; or "portal" and "hypertensive"; or "congestive" and "gastropathy"; or "congestive" and "gastroenteropathy". The following criteria were applied for study inclusion: Publication in peer-reviewed journals, and publication since 1980. Articles were independently evaluated by each author and selected for inclusion by consensus after discussion based on the following criteria: Well-designed, prospective trials; recent studies; large study populations; and study emphasis on PHG. PHG is diagnosed by characteristic endoscopic findings of small polygonal areas of variable erythema surrounded by a pale, reticular border in a mosaic pattern in the gastric fundus/body in a patient with cirrhotic or non-cirrhotic portal hypertension. Histologic findings include capillary and venule dilatation, congestion, and tortuosity, without vascular fibrin thrombi or inflammatory cells in gastric submucosa. PHG is differentiated from gastric antral vascular ectasia by a different endoscopic appearance. The etiology of PHG is inadequately understood. Portal hypertension is necessary but insufficient to develop PHG because many patients have portal hypertension without PHG. PHG increases in frequency with more severe portal hypertension, advanced liver disease, longer liver disease duration, presence of esophageal varices, and endoscopic variceal obliteration. PHG pathogenesis is related to a hyperdynamic circulation, induced by portal hypertension, characterized by increased intrahepatic resistance to flow, increased splanchnic flow, increased total gastric flow, and most likely decreased gastric mucosal flow. Gastric mucosa in PHG shows increased susceptibility to gastrotoxic

  18. Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy

    Science.gov (United States)

    Gjeorgjievski, Mihajlo; Cappell, Mitchell S

    2016-01-01

    AIM: To describe the pathophysiology, clinical presentation, natural history, and therapy of portal hypertensive gastropathy (PHG) based on a systematic literature review. METHODS: Computerized search of the literature was performed via PubMed using the following medical subject headings or keywords: “portal” and “gastropathy”; or “portal” and “hypertensive”; or “congestive” and “gastropathy”; or “congestive” and “gastroenteropathy”. The following criteria were applied for study inclusion: Publication in peer-reviewed journals, and publication since 1980. Articles were independently evaluated by each author and selected for inclusion by consensus after discussion based on the following criteria: Well-designed, prospective trials; recent studies; large study populations; and study emphasis on PHG. RESULTS: PHG is diagnosed by characteristic endoscopic findings of small polygonal areas of variable erythema surrounded by a pale, reticular border in a mosaic pattern in the gastric fundus/body in a patient with cirrhotic or non-cirrhotic portal hypertension. Histologic findings include capillary and venule dilatation, congestion, and tortuosity, without vascular fibrin thrombi or inflammatory cells in gastric submucosa. PHG is differentiated from gastric antral vascular ectasia by a different endoscopic appearance. The etiology of PHG is inadequately understood. Portal hypertension is necessary but insufficient to develop PHG because many patients have portal hypertension without PHG. PHG increases in frequency with more severe portal hypertension, advanced liver disease, longer liver disease duration, presence of esophageal varices, and endoscopic variceal obliteration. PHG pathogenesis is related to a hyperdynamic circulation, induced by portal hypertension, characterized by increased intrahepatic resistance to flow, increased splanchnic flow, increased total gastric flow, and most likely decreased gastric mucosal flow. Gastric mucosa

  19. Enigmatic human tails: A review of their history, embryology, classification, and clinical manifestations.

    Science.gov (United States)

    Tubbs, R Shane; Malefant, Jason; Loukas, Marios; Jerry Oakes, W; Oskouian, Rod J; Fries, Fabian N

    2016-05-01

    The presence of a human tail is a rare and intriguing phenomenon. While cases have been reported in the literature, confusion remains with respect to the proper classification, definition, and treatment methods. We review the literature concerning this anatomical derailment. We also consider the importance of excluding underlying congenital anomalies in these patients to prevent neurological deficits and other abnormal manifestations.

  20. Penicillin hypersensitivity: value of clinical history and skin testing in daily practice.

    Science.gov (United States)

    Kalogeromitros, Dimitrios; Rigopoulos, Dimitrios; Gregoriou, Stamatios; Papaioannou, Dimitrios; Mousatou, Vassiliki; Katsarou-Katsari, Alexandra

    2004-01-01

    Penicillin often is excluded as a treatment option based on patients' self-reported history of an adverse reaction to penicillin. The objective of this prospective study was to determine the likelihood of true penicillin allergy in patients with vague and convincing histories of penicillin allergy and to evaluate the diagnostic value added by appropriate skin testing. Six hundred thirty-eight patients with prior beta-lactam intake had a current indication for penicillin therapy and were referred for testing with the major (benzylpenicilloyl polylysine) and minor (minor determinant mixture) penicillin determinants from the inpatient and outpatient service of Athens University Dermatological hospital from January 2000 to December 2002. The prevalence of positive skin tests in the total group and in those patients with vague and convincing histories of penicillin allergy was determined. Positive skin tests were observed in 19/638 (3%) of the total group, 5 out of 542 (0.9%) patients without any history of penicillin allergy, 14 out of 96 (14.6%) patients with vague history (confidence interval [CI] 95% = 5.95-59.92), and 13 out of 18 (72.2%) patients with a convincing history of type I hypersensitivity reaction (chi2 = 286.3: odds ratio = 281.3: CI 95% = 62.19-1440.8). Patients with a vague history of penicillin allergy are 18 times more likely to have a positive penicillin skin test, and a convincing reaction history increases the likelihood by 281-fold compared with patients without a history of penicillin allergy. However, the fact that 5 of 18 (27.8%) patients with a convincing history were negative when skin tested points out that skin testing is helpful if the need for penicillin administration is compelling.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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.

    LENUS (Irish Health Repository)

    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.

  3. A brief history of the development of mannequin simulators for clinical education and training

    National Research Council Canada - National Science Library

    J B Cooper; V R Taqueti

    2004-01-01

      Simulation for medical and healthcare applications, although still in a relatively nascent stage of development, already has a history that can inform the process of further research and dissemination...

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

    LENUS (Irish Health Repository)

    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.

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

    LENUS (Irish Health Repository)

    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.

  6. History of foreign clinical forensic medicine%国外法医临床学发展史

    Institute of Scientific and Technical Information of China (English)

    杨天潼; 姜竹青

    2016-01-01

    法医临床学是法医学的重要分支学科,正处于蓬勃发展阶段。研究法医临床学的发展史,对明确其定义和实践范畴,维护司法公正,具有重要意义。本文将从“简介、历史溯源、18世纪之后的法医临床学发展、现代法医临床学、世界法医临床学司法实践现状和结语”六个部分介绍法医临床学在国外,尤其是英国的发展历史,促进我国法医临床学的学科建设和发展。%Clinical forensic medicine is a branch of forensic medical practice. Clinical forensic medicine has evolved into a rapidly growing era. Launching a research on the history of clinical forensic medicine is signiifcant to define the discipline boundary of clinical forensic medicine. To demonstrate the historical development of the foreign clinical forensic medicine, this article mainly contains six parts, including“Introduction, Historical References, Clinical Forensic Medicine in Post-Eighteenth Century, Contemporary Clinical Forensic Medicine, Global Clinical Forensic Medicine, and Conclusion”. The history outlined in this article will assist the construction and development of clinical forensic medicine in China.

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

    Institute of Scientific and Technical Information of China (English)

    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

  8. Clinical usefulness of myocardial iodine-123-15-(p-iodophenyl)-3(R,S)-methyl-pentadecanoic acid distribution abnormality in patients with mitochondrial encephalomyopathy based on normal data file in bull`s-eye polar map

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Nobukazu; Mitani, Isao; Sumita, Shinichi [Yokohama City Univ. (Japan). School of Medicine] [and others

    1998-01-01

    Visual interpretation of iodine-123-beta-15-(p-iodophenyl)-3(R,S)-methyl-pentadecanoic acid ({sup 123}I-BMIPP) myocardial images cannot easily detect mild reduction in tracer uptake. Objective assessment of myocardial {sup 123}I-BMIPP maldistributions at rest was attempted using a bull`s-eye map and its normal data file for detecting myocardial damage in patients with mitochondrial encephalomyopathy. Six patients, two with Kearns-Sayre syndrome and four with mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes (MELAS), and 10 normal subjects were studied. Fractional myocardial uptake of 1{sup 23}I-BMIPP was also measured by dynamic static imaging to assess the global myocardial free fatty acid. These data were compared with the cardiothoracic ratio measured by chest radiography and left ventricular ejection fraction assessed by echocardiography. Abnormal cardiothoracic ratio and lower ejection fraction were detected in only one patient with Kearns-Sayre syndrome. Abnormal fractional myocardial uptake was detected in two patients (1.61%, 1.91%), whereas abnormal regional {sup 123}I-BMIPP uptake assessed by the bull`s-eye map was detected in five patients (83%). All patients showed abnormal uptake in the anterior portion, and one showed progressive atrioventricular conduction abnormality and systolic dysfunction with extended {sup 123}I-BMIPP abnormal uptake. The results suggest that assessment based on the normal data file in a bull`s-eye polar map is clinically useful for detection of myocardial damage in patients with mitochondrial encephalomyopathy. (author)

  9. Clinical Observation of Patients with Cardiovascular Medicine Sugar Metabolic Abnormality%心血管内科患者糖代谢异常的临床观察

    Institute of Scientific and Technical Information of China (English)

    高学军

    2014-01-01

    Objective To analyze the clinical study of carbohydrate metabolism in Department of internal medicine, cardiovascular abnormality. Methods 82 patients of this hospital cardiovascular department of internal medicine patients, in which 32 cases were diagnosed as diabetic patients, 50 cases of non diabetic patients, wil give a fasting blood glucose test results as the control group, wil give the oral glucose tolerance test results as the study group, recording and analysis of two groups of diagnostic rate and accuracy. Results The study group detection diagnosis rate was significantly higher than the control group, with significant dif erence ( <0.05);the study group detection accuracy higher than that of the control group, with significant dif erence ( < 0.05). Conclusion The application of oral glucose tolerance test diagnosis rate and accuracy rate of abnormal glucose metabolism is high, can avoid missed diagnosis and misdiagnosis.%目的:分析心血管内科患者糖代谢异常的临床研究。方法对本院诊治的心血管内科患者82例,其中32例被确诊为糖尿病患者,非糖尿病患者有50例,将给予空腹血糖测试结果作为对照组,将给予口服葡萄糖耐量试验测试结果作为研究组,记录并分析两组诊断确诊率和准确性情况。结果研究组检测确诊率明显高于对照组,比较差异具有统计学意义(P<0.05);研究组检测准确性比对照组高,比较差异具有统计学意义(P<0.05)。结论应用口服葡萄糖耐量试验测试糖代谢异常的确诊率和准确性均较好,能够避免漏诊和误诊。

  10. Fixed full-arch implant-supported prostheses in a patient with epidermolysis bullosa: a clinical case history report.

    Science.gov (United States)

    Agustín-Panadero, Rubén; Gomar-Vercher, Sonia; Peñarrocha-Oltra, David; Guzmán-Letelier, Marcelo; Peñarrocha-Diago, Miguel

    2015-01-01

    Epidermolysis bullosa (EB) is a rare skin disorder characterized by blister formation in response to minor trauma and accompanied by extracutaneous manifestations. The use of endosseous implants to support fixed prostheses for the rehabilitation of patients with recessive dystrophic EB might provide a considerably better clinical treatment outcome than traditional prosthodontic interventions. This case history report describes the clinical management of such an afflicted patient. Implants were placed immediately following teeth extractions and subsequently loaded with fixed full-arch prostheses. This treatment option is proposed for patients with recessive dystrophic EB to preclude mucosal irritation associated with wearing removable prostheses.

  11. Clinical management of patients with a history of urticaria/angioedema induced by multiple NSAIDs: an expert panel review.

    Science.gov (United States)

    Asero, Riccardo; Bavbek, Sevim; Blanca, Miguel; Blanca-Lopez, Natalia; Cortellini, Gabriele; Nizankowska-Mogilnicka, Ewa; Quaratino, Donato; Romano, Antonino; Sanchez-Borges, Mario; Torres-Jaen, Maria Josè

    2013-01-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) represent one of the most frequent causes of drug-induced urticaria/angioedema worldwide. Recent review articles have classified patients experiencing NSAID-induced urticaria/angioedema into different categories, including single reactors, multiple reactors, and multiple reactors with underlying chronic urticaria. Each of these categories requires a different clinical approach. The present article, written by a panel of experts, reports the main recommendations for the practical clinical management of patients with a history of urticaria/angioedema induced by multiple NSAID based on current knowledge.

  12. Abnormal Uterine Bleeding FAQ

    Science.gov (United States)

    ... FREQUENTLY ASKED QUESTIONS FAQ095 GYNECOLOGIC PROBLEMS Abnormal Uterine Bleeding • What is a normal menstrual cycle? • When is bleeding abnormal? • At what ages is abnormal bleeding more ...

  13. Study on patterns and prevalence of EEG abnormalities in children presenting with behavioural disturbances in psychiatry OPD, Gauhati Medical College and Hospital

    Directory of Open Access Journals (Sweden)

    Bobby Hmar

    2016-01-01

    Full Text Available Background of the study: Children with behavioural abnormalities and developmental disorders are often advised electroencephalography (EEG for evaluation of electrophysiological process of the brain to rule out any organic pathology. Various studies have reported abnormal EEG in these groups of children without history of clinical seizure on routine EEG and sleep EEG. Aim of the study: To study pattern and prevalence of EEG abnormalities in children with behavioural abnormalities without history of clinical seizure. Materials and methods: The study is a retrospective study. Ethical clearance has been obtained from institutional ethical committee for the study. To collect data, socio-demographic and clinical data proforma has been used. Data has been evaluated during the period from June 2011 to June 2014 as per selection criteria from the case history record of children with behavioural abnormalities attending child guidance clinic (CGC. Associations of abnormal EEG with various psychiatric diagnoses has been analysed and chi-square test has been used. p value <0.05 has been taken as test of significance. Result: Total 2011 children attended CGC from 2011 June to 2014 June. One hundred and ninety two children of various psychiatric diagnoses as per the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10 criteria had fulfilled the selection criteria and 113 children had done EEG. Abnormal EEG was found in 26.54% of children with various psychiatric diagnoses. Association was statistically significant (p<0.05. The EEG abnormalities were found more in male gender than female (p<0.05 and more in younger age group (four to ten years, p<0.05. Conclusion: Children with various psychiatric diagnoses have significant association with abnormal EEG without history of clinical seizure.

  14. A COMPARATIVE STUDY ABOUT THE INCIDENCE OF CONGENITAL ABNORMALITIES OF THE NEW BORN CHILDREN AT OBSTETRICS AND GYNAECOLOGY CLINICAL HOSPITAL OF ORADEA, BIHOR COUNTY, IN THE YEARS OF 1987 AND 2002

    Directory of Open Access Journals (Sweden)

    Ioana Mihaela Tomulescu

    2003-01-01

    Full Text Available This study is about the incidence of congenital abnormalities in two populations of new born children at Obstetrics and Gynaecology Clinical Hospital of Oradea. First population is represented by the children that were born in the year of 1987. The second population is represented by the children that were born in the year of 2002. We selected these years for this study, because the policy about births is different in the two mentined years. Comparatively with 1987, the abortion is legal. The results are meaningful, because we observed that number of children with congenital abnormalities is bigger in 2002 comparatively with 1987. In spite of all this, the birth rate is smaller in 2002 comparatively with 1987. also, we obtained a significant increased frequency of digestive apparatus congenital abnormalities in comparison with 1987.

  15. The Natural History and Prognosis of Primary Biliary Cirrhosis with Clinical Features of Autoimmune Hepatitis.

    Science.gov (United States)

    Yang, Fan; Wang, Qixia; Wang, Zhaoyue; Miao, Qi; Xiao, Xiao; Tang, Ruqi; Chen, Xiaoyu; Bian, Zhaolian; Zhang, Haiyan; Yang, Yue; Sheng, Li; Fang, Jingyuan; Qiu, Dekai; Krawitt, Edward L; Gershwin, M Eric; Ma, Xiong

    2016-02-01

    Although a variant of primary biliary cirrhosis (PBC) characterized by features of autoimmune hepatitis (AIH) has been recognized for many years, few studies with ample numbers of patients have focused on its natural history. This study aimed to clarify the natural history, prognosis, and response to therapy in a cohort of patients with PBC with AIH features. We retrospectively analyzed 277 PBC patients without AIH features and 46 PBC patients with AIH features seen between September 2004 and April 2014. The 5-year adverse outcome-free survival of PBC patients with AIH features was 58% compared to 81% in PBC patients without AIH features. Multivariate analysis in the patients with AIH features indicated that total bilirubin ≥ 2.70× the upper limit of normal predicted a poor prognosis (p = 0.008, relative risk 8.39, 95% confidence interval (CI) 1.73, 40.73). Combination therapy with ursodeoxycholic acid (UDCA) and immunosuppression provided better short-term responses in PBC patients with AIH features, defined by multiple criteria. Higher aspartate aminotransferase (AST) level at accession suggested better prognosis for PBC patients with AIH features while worse prognosis for PBC patients without AIH features. PBC patients with AIH features differ from those without AIH features in terms of natural history, prognostic indicators, and response to therapy.

  16. Research of the detection rate of fetal structural abnormalities with two special historys in the ultrasound screening%复发性流产史与IVF助孕孕妇早孕末期超声筛查胎儿结构异常检出率研究

    Institute of Scientific and Technical Information of China (English)

    黎少华; 周力学; 张莘; 狄娜; 潘锐柯

    2012-01-01

    Objective: To evaluate the necessity of ultrasound screening in fetus at 11 -13 +6 weeks in unselected pregnant women who have the history of Recurrent Pregnancy Loss and IVF, and to evaluate the focus of screening. Methods: From January 2007 to December 2010, the Prenatal ultrasound examination were Preformed for 2 139 pregnant women who can track the history at 11 to 13 +6 gestational weeks in the Sun Yat - sen Memorial Hospital of Sun Yat - sen University, including 1 500 cases of the control group ( excluding something special histories, following is the same) , 329 cases of a history of recurrent pregnancy loss, 301 cases of a history of FVF, and 9 cases of the two histories. On the other hand, the early ultrasound screenings for fetal structural abnormalities were 97 cases , including 57 cases of the control group, 21 cases of a history of recurrent pregnancy loss, and 19 cases of history of IVF, but there were no cases of the two histories. Results: In the control group, the early ultrasound screening for fetal structural abnormality detection rate was 3. 80% (57/1 500) , and 6. 38% (21/329) in the second group with a history of recurrent pregnancy loss, and 6. 31% ( 19/ 301) in the third group with a history of IVF. The top three structural abnormalities were neck abnormalities (increased nuchal translu-cency thickness and cystic hydroma) , urinary tract abnormalities (renal pelvis expansion, urethra] atresia and giant bladder) , anterior abdominal wall abnormalities (omphalocele, abdominal swelling and abdominal crack) in the control group, neck abnormalities (increased nuchal translucency thickness and cystic hydroma), urinary tract abnormalities (renal Pelvis expansion, urethral atresia and giant bladder) and single umbilical artery in the second group and neck abnormalities (increased nuchal translucency thickness and cystic hydroma) , central nervous system abnormalities (ventricular dilatation with hydrocephalus and spinal cysts) , and urinary tract

  17. [Molecular abnormalities in lymphomas].

    Science.gov (United States)

    Delsol, G

    2010-11-01

    . Gene profiling analysis shows that the expression of several genes is deregulated including PDGFRA (platelet-derived growth factor receptor) gene, encoding a receptor with tyrosine kinase activity. In angio-immunoblastic T-cell lymphomas molecular abnormalities are found in follicular helper T-cell (TFH) that express some distinctive markers such as CD10, PD-1, CXCR5 and the CXCL13 chemokine. ALK-positive anaplastic large cell lymphoma is a paradigme of T-cell lymphoma since it is associated with an X-ALK oncogenic fusion protein due to a translocation involving ALK gene at 2p23. ALK tyrosine kinase activates downstream pathways (Stat3/5b, Src kinases, PLCγ, PI3 kinase) implicated in lymphomagenesis, proliferation and protection against apoptosis. Specific ALK inhibitors are currently in clinical evaluation. Lastly several lymphomas are associated with infectious agents that play a direct (EB virus, HTLV1) or indirect role (e.g. Helicobacter pylori in MALT lymphoma) in lymphomagenesis.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Low-shrink composite resins: a review of their history, strategies for managing shrinkage, and clinical significance.

    Science.gov (United States)

    Pitel, Mark L

    2013-09-01

    Despite numerous advances in composite resin technology over the course of many decades, shrinkage behavior and the resultant stresses inherent to direct placed composite restorations continue to challenge clinicians. This overview of composite resins includes a review of their history and development along with a discussion of strategies for reducing polymerization shrinkage. An assessment of the clinical significance of these materials is also provided, including a discussion of the differences between polymerization shrinkage and stress, incremental layering versus bulk placement, and the emergence of lower shrinkage stress monomer chemistry.

  20. Schizophrenia clinical symptom differences in women vs. men with and without a history of childhood physical abuse.

    Science.gov (United States)

    Kelly, Deanna L; Rowland, Laura M; Patchan, Kathleen M; Sullivan, Kelli; Earl, Amber; Raley, Heather; Liu, Fang; Feldman, Stephanie; McMahon, Robert P

    2016-01-01

    Childhood abuse has been implicated as an environmental factor that increases the risk for developing schizophrenia. A recent large population-based case-control study found that abuse may be a risk factor for schizophrenia in women, but not men. Given the sex differences in onset and clinical course of schizophrenia, we hypothesized that childhood abuse may cause phenotypic differences in the disorder between men and women. We examined the prevalence of childhood physical abuse in a cohort of men and women with schizophrenia and schizoaffective disorder. Specifically, we examined differences in positive, negative, cognitive and depressive symptoms in men and women who reported a history of childhood physical abuse. We recruited 100 subjects for a single visit and assessed a history of childhood physical abuse using the childhood trauma questionnaire (CTQ) and clinical symptoms and cognition using the brief psychiatric rating scale (BPRS), the calgary depression scale (CDS) and the repeatable battery of the assessment of neuropsychological status (RBANS) for cognition. Ninety-two subjects completed the full CTQ with abuse classified as definitely present, definitely absent or borderline. Twelve subjects who reported borderline abuse scores were excluded. Of the 80 subjects whose data was analyzed, 10 of 24 (41.6 %) women and 11 of 56 (19.6 %) men reported a history of childhood physical abuse (χ(2) = 4.21, df = 1, p = 0.04). Women who reported such trauma had significantly more psychotic (sex by abuse interaction; F = 4.03, df = 1.76, p = 0.048) and depressive (F = 4.23, df = 1.76, p = 0.04) symptoms compared to women who did not have a trauma history and men, regardless of trauma history. There were no differences in negative or cognitive symptoms. Women with schizophrenia and schizoaffective disorder may represent a distinct phenotype or subgroup with distinct etiologies and may require different, individually tailored treatments.

  1. Chapter 13: the contributions of neurophysiology to clinical neurology an exercise in contemporary history.

    Science.gov (United States)

    Berlucchi, Giovanni

    2010-01-01

    This chapter reviews a number of historical contributions of neurophysiology to clinical neurology in the hundred years that have elapsed since the publication of Sherrington's The Integrative Action of the Nervous System, a book generally considered the neurophysiologist's bible. In the past, many normal nervous functions have been inferred from disorderly functions in animals by neurophysiologists and in humans by clinical neurologists. If neurophysiologists have undoubtedly learned much from experimental lesions in animals, it has been the clinical neurologists who have obtained first-hand information on the effects of pathology on the functioning of the most complex and interesting of all nervous systems, that of man. Currently this division of labor is less clear, and convergent evidence from neurophysiology and clinical neurology alike has set our current knowledge about brain functions on a firm comparative foundation. This review of the relations between neurophysiology and clinical neurology reports contributions that have been recognized as "historical" by the scientific community because of their documented impact on the development of the entire field of neurosciences. The inclusion of further less famous neurophysiological achievements is justified by their potential influence on the advancement of neuroscience, as seen from the author's personal viewpoint.

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

    Science.gov (United States)

    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.

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

    DEFF Research Database (Denmark)

    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 hy...

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

    DEFF Research Database (Denmark)

    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...

  5. Friedreich Ataxia Clinical Outcome Measures: Natural History Evaluation in 410 Participants

    Science.gov (United States)

    Regner, Sean R.; Wilcox, Nicholas; Friedman, Lisa S.; Seyer, Lauren; Schadt, Kim; Brigatti, Karlla W.; Perlman, Susan; Delatycki, Martin; Wilmot, George R.; Gomez, Christopher M.; Bushara, Khalaf O.; Mathews, Katherine D.; Subramony, S.H.; Ashizawa, Tetsuo; Ravina, Bernard; Brocht, Alicia; Farmer, Jennifer M.; Lynch, David R.

    2013-01-01

    Friedreich ataxia is an autosomal recessive neurodegenerative disorder characterized by ataxia, dysarthria, and areflexia. We report the progress of a large international non-interventional cohort (n = 410), tracking the natural history of disease progression using the neurological exam-based Friedreich Ataxia Rating Scale. We analyzed the rate of progression with cross-sectional analysis and longitudinal analysis over a 2-year period. The Friedreich Ataxia Rating Scale captured disease progression when used at 1 and 2 years following initial evaluation, with a lower ratio of standard deviation of change to mean change over 2 years of evaluation. However, modeling of disease progression identified substantial ceiling effects in the Friedreich Ataxia Rating Scale, suggesting this measure is most useful in patients before maximal deficit is approached. PMID:22752494

  6. Clinical study of asbestos-related lung cancer in Japan with special reference to occupational history.

    Science.gov (United States)

    Kishimoto, Takumi; Gemba, Kenichi; Fujimoto, Nobukazu; Onishi, Kazuo; Usami, Ikuji; Mizuhashi, Keiichi; Kimura, Kiyonobu

    2010-05-01

    A total of 152 patients with asbestos-related lung cancer recognized by the criteria of Japanese compensation law for asbestos-related diseases were examined and compared with 431 patients with non-asbestos-related lung cancer. Male comprised 96% of patients. Ages ranged from 50 to 91 years with a median of 72 years. Eighty-nine percent were smokers or ex-smokers. Almost all patients had occupational histories of asbestos exposure. The median duration of asbestos exposure was 31 years and the median latency period was 47 years. Thirty-four percent of patients exhibited asbestosis and 81% exhibited pleural plaques by radiography. Regarding asbestos particles in the lung for 73 operated or autopsied patients, 62% had more than 5,000 particles per gram. On the other hand, 100% of non-asbestos-related lung cancer patients had <5000 particles per gram with a median of 554 particles. The number of asbestos bodies in the lung, male gender, absence of symptoms, smoking index, and early stage of cancer were significantly much more than those of non-asbestos-related lung cancer. In this study, a diagnosis of asbestos-related lung cancer was made in 34% of patients by asbestosis, in 62% by presence of both pleural plaques and more than 10 years' occupational asbestos exposure, and in 4% by more than 5000 asbestos particles per gram of lung tissue. Occupational histories, duration of asbestos exposure, and pleural plaques are common categories for the recognition of asbestos-related lung cancer in Japan.

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

    Science.gov (United States)

    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.

  8. Anatomy and history of an external quality assessment program for interpretative comments in clinical biochemistry.

    Science.gov (United States)

    Vasikaran, Samuel D

    2015-05-01

    The provision of clinical interpretation of results, either verbally or in the printed report, may be considered an integral part of clinical biochemistry diagnostic service. Proficiency testing or external quality assessment (EQA) of such activity may be useful in education, training, continuing professional development and ensuring the quality of such service. Details of the Patient Report Comments Program (RPCProgram) developed by the Royal College of Pathologists of Australasia (RCPA) Chemical Pathology Quality Assurance Programs Pty Ltd (QAP) is described in this review. The program is aimed at pathologists, clinical scientists and trainees. Registered participants are provided a report with case details and a set of clinical biochemistry results at monthly intervals and submit an interpretative comment for the report. Comments received are broken up into components that are translated into common key phrases. An expert panel evaluates the key phrases, classifies them according to appropriateness and drafts a suggested comment, a case summary and a rationale, which are included in a summary report returned to participants. There is considerable diversity in the quality of interpretative comments received from participants of the PRCProgram. The primary purpose of EQA of interpretative commenting is educational self-assessment, and they are recognized as a continuing professional development activity. Whilst there is some evidence for the utility of interpretative comments in improving patient outcomes, evidence for the utility of EQA in improving quality of comments is awaited.

  9. Pancreatic islet fibrosis in rock hyraxes (Procavia capensis), Part 1: Case histories, clinical pathology, and epizootiology.

    Science.gov (United States)

    Gamble, Kathryn C; Garner, Michael M; Krause, Laura; Alvarado, Thomas P

    2004-09-01

    Two adult female rock hyraxes (Procavia capensis) at the Dallas Zoo were confirmed with spontaneous diabetes mellitus from 1997-2000, whereas a third animal with a similar clinical presentation never became hyperglycemic. The pancreas in all three animals showed pancreatic islet fibrosis (PIF). Retrospective examination of medical records for rock hyraxes acquired by this collection or born into it from 1991-2002 identified eight more animals affected with PIE All affected animals, including three males and eight females, were 1-7 yr of age and presented either with vague clinical signs of soft feces and rough hair coat or were acutely moribund or dead. Clinical pathology data was available for seven of the animals before onset of overt clinical signs and revealed inappropriate hyperglycemia in six, as well as elevated serum concentrations of creatine phosphokinase, amylase, and lipase in all seven animals. Pedigree evaluation did not support a familial pattern for PIE Review of the histopathology findings from nine other zoologic collections with rock hyrax deaths during the study period identified six institutions with 12 additional cases genetically unrelated to the incident collection. Histopathology and viral serology did not support an infectious cause. Analysis of serum anti-islet and anti-insulin antibodies did not suggest autoimmune disease, and none of the animals had known exposure to toxic substances. Limited nutritional analyses did not support a nutritional basis for the condition, and the cause for PIF remains unknown.

  10. Influence of family history of major depression, bipolar disorder, and suicide on clinical features in patients with major depression and bipolar disorder.

    Science.gov (United States)

    Serretti, Alessandro; Chiesa, Alberto; Calati, Raffaella; Linotte, Sylvie; Sentissi, Othman; Papageorgiou, Konstantinos; Kasper, Siegfried; Zohar, Joseph; De Ronchi, Diana; Mendlewicz, Julien; Amital, Daniela; Montgomery, Stuart; Souery, Daniel

    2013-03-01

    The extent to which a family history of mood disorders and suicide could impact on clinical features of patients suffering from major depression (MD) and bipolar disorder (BD) has received relatively little attention so far. The aim of the present work is, therefore, to assess the clinical implications of the presence of at least one first- and/or second-degree relative with a history of MD, BD and suicide in a large sample of patients with MD or BD. One thousand one hundred and fifty-seven subjects with MD and 686 subjects with BD were recruited within the context of two large projects. The impact of a family history of MD, BD, and suicide-considered both separately and together-on clinical and socio-demographic variables was investigated. A family history of MD, BD, and suicide was more common in BD patients than in MD patients. A positive family history of mood disorders and/or suicide as well as a positive family history of MD and BD separately considered, but not a positive history of suicide alone, were significantly associated with a comorbidity with several anxiety disorders and inversely associated with age of onset. The clinical implications as well as the limitations of our findings are discussed.

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

    Science.gov (United States)

    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). © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Electrocardiographic and Echocardiographic Abnormalities in Chronic Alcoholics

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    H.D. Attar

    2017-01-01

    Full Text Available Objective: Alcohol is most commonly abused drug worldwide. It has been shown to produce toxic effects in almost every organ system in the body. Many of these medical conditions can be attributed to direct effects of alcohol whereas others are indirect sequelae that may result from nutritional deficiencies or predisposition to trauma. Alcohol consumption has been associated with a variety of cardio vascular disorders this study was thus undertaken to know the Electrocardiographic and Echocardiographic abnormalities in asymptomatic chronic alcoholic patients. Materials and Methods: 50 Patients attending the out-patient clinic & who were admitted in Al Ameen Medical College Hospital and District hospital, Bijapur were selected for the study. It was a prospective study design subjects in age group 20-40, having history of chronic alcoholism as defined, for more than 5 years were evaluated by electrocardiography and echocardiography. Patients with known diabetics, hypertensive and cardiovascular disorders were excluded from the study group. Results: The prevalence of cardiovascular abnormalities in patients of chronic alcoholism is 37% in our study. Most common ECG changes are sinus tachycardia (18%, and Non specific ST-T changes (9%. Most common 2D ECHO changes was increased posterior wall thickness (11% and followed by increased interventricular septum thickness and decreased ejection fraction (<40%. The prevalence of cardio vascular abnormalities are more with increased duration of alcohol consumption and also high in advanced age group. Conclusions: This study confirms that many electrocardiographic as well as echocardiographic changes occur prior to symptomatic cardiac disorders established to be caused by chronic alcohol intake such as alcoholic cardiomyopathy .which probably are early indictors of ongoing effects of alcohol and are reversible during the early stages detected by non invasive investigations like Electrocardiography and

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Imran, Mohammed; Najmi, Abul K.; Rashid, Mohammad F.; Tabrez, Shams; Shah, Mushtaq A.

    2013-01-01

    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 59threport 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. PMID:23559817

  15. Abnormal Uterine Bleeding

    Science.gov (United States)

    ... first few months of a normal pregnancy. Some birth control pills or the intrauterine device (IUD) can also cause ... this type can significantly reduce abnormal bleeding. Like birth control pills, sometimes IUDs can actually cause abnormal bleeding. Tell ...

  16. Urine - abnormal color

    Science.gov (United States)

    ... 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 ...

  17. Abnormal Grief: Should We Consider a More Patient-Centered Approach?

    Science.gov (United States)

    Moayedoddin, Babak; Markowitz, John C

    2015-01-01

    Grief, the psychological reaction to the loss of a significant other, varies complexly in its cause, experience, evolution, and prognosis. Although most bereaved individuals experience a normal grieving process, some develop complicated grief (CG) or major depressive disorder (MDD). The DSM-5, which controversially altered the nosology, recognizes grief-related major depression (GRMD) as a diagnostic subtype if a patient meets MDD criteria two weeks post bereavement. The (DSM-5) tries to distinguish between grief and MDD, but remains a symptom-based, centered approach to grief that is not patient centered. This article reviews grief in its normal and abnormal dimensions. Using an illustrative clinical case in which interpersonal psychotherapy (IPT) was employed, we discuss the need for a more patient-centered approach to treating abnormal grief, considering the patient's personal history, perceptions, experiences of bereavement, and interpersonal environment. Clinical studies need to better identify subgroups of individuals susceptible to abnormal grief and to evaluate their response to early interventions.

  18. [QEEG and brain mapping. Historial develoment, clinical practices and epistemological issues].

    Science.gov (United States)

    Matusevich, Daniel; Ruiz, Martín; Vairo, María Carolina

    2002-01-01

    Although it has been more than two decades since brain mapping was introduced in medicine, its scientific value and clinical practice have not been proved. This paper makes an overview about the historical development of brain mapping, its usefulness in psychiatry and lays epistemological issues concerning the role of technology in medical settings. Both historical and technological development of qEEG gives us the opportunity to think about complexity between ethics, science, technology and medicine.

  19. A history of deep brain stimulation: Technological innovation and the role of clinical assessment tools

    Science.gov (United States)

    2013-01-01

    Deep brain stimulation involves using a pacemaker-like device to deliver constant electrical stimulation to problematic areas within the brain. It has been used to treat over 40,000 people with Parkinson’s disease and essential tremor worldwide and is currently undergoing clinical trials as a treatment for depression and obsessive–compulsive disorder. This article will provide an historical account of deep brain stimulation in order to illustrate the plurality of interests involved in the development and stabilization of deep brain stimulation technology. Using Latour’s notion of immutable mobiles, this article will illustrate the importance of clinical assessment tools in shaping technological development in the era of medical device regulation. Given that such tools can serve commercial and professional interests, this article suggests that it is necessary to scrutinise their application in research contexts to ensure that they capture clinical changes that are meaningful for patients and their families. This is particularly important in relation to potentially ethically problematic therapies such as deep brain stimulation for psychiatric disorders.

  20. Neuroendocrine abnormalities in Parkinson's disease.

    Science.gov (United States)

    De Pablo-Fernández, Eduardo; Breen, David P; Bouloux, Pierre M; Barker, Roger A; Foltynie, Thomas; Warner, Thomas T

    2017-02-01

    Neuroendocrine abnormalities are common in Parkinson's disease (PD) and include disruption of melatonin secretion, disturbances of glucose, insulin resistance and bone metabolism, and body weight changes. They have been associated with multiple non-motor symptoms in PD and have important clinical consequences, including therapeutics. Some of the underlying mechanisms have been implicated in the pathogenesis of PD and represent promising targets for the development of disease biomarkers and neuroprotective therapies. In this systems-based review, we describe clinically relevant neuroendocrine abnormalities in Parkinson's disease to highlight their role in overall phenotype. We discuss pathophysiological mechanisms, clinical implications, and pharmacological and non-pharmacological interventions based on the current evidence. We also review recent advances in the field, focusing on the potential targets for development of neuroprotective drugs in Parkinson's disease and suggest future areas for research.

  1. Clinical history for diagnosis of dementia in men: Caerphilly Prospective Study.

    Science.gov (United States)

    Creavin, Sam; Fish, Mark; Gallacher, John; Bayer, Antony; Ben-Shlomo, Yoav

    2015-08-01

    Diagnosis of dementia often requires specialist referral and detailed, time-consuming assessments. To investigate the utility of simple clinical items that non-specialist clinicians could use, in addition to routine practice, to diagnose all-cause dementia syndrome. Cross-sectional diagnostic test accuracy study. Participants were identified from the electoral roll and general practice lists in Caerphilly and adjoining villages in South Wales, UK. Participants (1225 men aged 45-59 years) were screened for cognitive impairment using the Cambridge Cognitive Examination, CAMCOG, at phase 5 of the Caerphilly Prospective Study (CaPS). Index tests were a standardised clinical evaluation, neurological examination, and individual items on the Informant Questionnaire for Cognitive Disorders in the Elderly (IQCODE). Two-hundred and five men who screened positive (68%) and 45 (4.8%) who screened negative were seen, with 59 diagnosed with dementia. The model comprising problems with personal finance and planning had an area under the curve (AUC) of 0.92 (95% confidence interval [CI] = 0.86 to 0.97), positive likelihood ratio (LR+) of 23.7 (95% CI = 5.88 to 95.6), negative likelihood ratio (LR-) of 0.41 (95% CI = 0.27 to 0.62). The best single item for ruling out was no problems learning to use new gadgets (LR- of 0.22, 95% CI = 0.11 to 0.43). This study found that three simple questions have high utility for diagnosing dementia in men who are cognitively screened. If confirmed, this could lead to less burdensome assessment where clinical assessment suggests possible dementia. © British Journal of General Practice 2015.

  2. A survey of obesity and abnormal glucose tolerance in first degree relatives of women with polycystic ovarian syndrome referred to gynaecology clinics of Shiraz university of medical sciences

    Directory of Open Access Journals (Sweden)

    marziye Akbarzadeh

    2011-03-01

    Full Text Available Polycystic ovarian (pco syndrome is one of the most prevalent( 4-8% endocrine glands disorders among premenopause women. Polycystic ovary syndrome as a form of functional ovarian hyperandrogenemia may has characteristics such as choronic anovulation, infertility, abnormal menstruation and android obesity. This diseas has genetic aspect and in different studies similar abnormalities have been seen in their first degree relatives. Materials and Methods: This research is a case-control study carried out on 107 individuals as case group and 107 individuals as control group selected by simple random sampling in 2009. After recognition patients with PCO syndrome , their first degree relatives (Father,mother,sister and brother have been interviewed. BMI and WHR indices of the both blood samples were taken to study their serum glucose tolerance. Results: Case group, from view point of obesity (BMI≥30 and centeral obesity , ITG level and diabetes regarding WHO standards was higher than similar individuals in control group,but this difference was not statistically significant . The mean of fasting blood sugar in fathers , mothers , brothers and sisters of cas group was significantly higher (p=0.001. Regarding Chi-square test there was no significant relation between obesity diabetes in the both groups. , (BMI≥30kg/m2, centeral obesity and lack of impaired glucose tolerance and type2 diabetes in the both groups. Conclusion: The first degree relatives of the women suffering from polycystic ovarian syndrome are exposed to abnormal glucose tolerance and android obesity.

  3. Kidney transplantation in abnormal bladder

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    Shashi K Mishra

    2007-01-01

    Full Text Available Structural urologic abnormalities resulting in dysfunctional lower urinary tract leading to end stage renal disease may constitute 15% patients in the adult population and up to 20-30% in the pediatric population. A patient with an abnormal bladder, who is approaching end stage renal disease, needs careful evaluation of the lower urinary tract to plan the most satisfactory technical approach to the transplant procedure. Past experience of different authors can give an insight into the management and outcome of these patients. This review revisits the current literature available on transplantation in abnormal bladder and summarizes the clinical approach towards handling this group of difficult transplant patients. We add on our experience as we discuss the various issues. The outcome of renal transplant in abnormal bladder is not adversely affected when done in a reconstructed bladder. Correct preoperative evaluation, certain technical modification during transplant and postoperative care is mandatory to avoid complications. Knowledge of the abnormal bladder should allow successful transplantation with good outcome.

  4. Clinical features and pregnancy outcome in antiphospholipid syndrome patients with history of severe pregnancy complications.

    Science.gov (United States)

    Matsuki, Yuko; Atsumi, Tatsuya; Yamaguchi, Koushi; Hisano, Michi; Arata, Naoko; Oku, Kenji; Watanabe, Noriyoshi; Sago, Haruhiko; Takasaki, Yoshinari; Murashima, Atsuko

    2015-03-01

    Abstract Objective. To clarify the clinical significance of antiphospholipid antibody (aPL) profile in patients with obstetric antiphospholipid syndrome (APS). Methods. Clinical records of 13 pregnant patients (15 pregnancies) with obstetrical APS were reviewed over 10 years. Patients who met the Sapporo Criteria fully were studied, whereas those with only early pregnancy loss were excluded. In addition to classical aPL: lupus anticoagulant (LA), anticardiolipin antibody (aCL), and anti-β2-glycoprotein I (aβ2GPI); phosphatidylserine-dependent anti-prothrombin antibody (aPS/PT) and kininogen-dependent anti-phosphatidylethanolamine antibody (aPE) were also examined in each case. Results. Cases were divided into two groups according to patient response to standard treatment: good and poor outcome groups. All cases with poor outcome presented LA, with IgG aβ2GPI and IgG aPS/PT were also frequently observed. IgG aPE did not correlate with pregnancy outcome. Conclusion. aPL profile may predict pregnancy outcome in patients with this subset of obstetric APS.

  5. Betahistine in the treatment of vertigo. History and clinical implications of recent pharmacological researches.

    Science.gov (United States)

    Mira, E

    2001-06-01

    A short profile of betahistine and its activity in treatment of Menière's disease and other forms of peripheral vertigo is presented. The clinical efficacy of betahistine is documented by a series of more than twenty controlled clinical studies, performed in the years 1966-2000. Basic researches initially proved that bethaistine acts trough a vasodilating action on inner ear and cerebral blood flow (Suga and Snow, 1969; Martinez, 1972). In the following years this activity was confirmed using the modern laser doppler flowmetry technique (Laurikainen et al, 1998). Further recent studies proved that betahistine acts on the central vestibular histaminergic system as a weak H1 agonist and a strong H3 antagonist (Arrang et al., 1985), improving the process of vestibular compensation (Tighilet et al., 1995) as well as on peripheral labyrinthine receptors, reducing the spontaneous firing rate but not the activity induced by thermal or mechanical stimulation (Botta et al., 1998). More than forty years after its discovery, this series of studies carried out in the second half of the 90s leads to the conclusion that betahistine is a drug which maintains its scientific interest and its pharmacological potential in the treatment of vertigo.

  6. Andrea Pasta (1706-1782), eclectic scholar of anatomy and clinical medicine, communication and the history of art.

    Science.gov (United States)

    Clerici, Carlo Alfredo; Veneroni, Laura; Patriarca, Carlo

    2014-11-01

    Andrea Pasta was an eclectic visionary light years ahead of his time. He made numerous contributions to the field of medicine, some recognized by his contemporaries and others so visionary that they are being applied only in modern times. His contributions spanned the disciplines of psychology, gynaecology, haematology, infectious diseases and the doctor-patient relationship. Well known among his contemporaries, he combined a passion for clinical medicine and a keen interest in history and art with a strict research methodology and an approach to caring for patients as human beings. By studying his life and works, we can better understand the magnitude and significance of his innovative method and its applicability in modern times and also the significance of his many contributions.

  7. Piranha attacks on humans in southeast Brazil: epidemiology, natural history, and clinical treatment, with description of a bite outbreak.

    Science.gov (United States)

    Haddad, Vidal; Sazima, Ivan

    2003-01-01

    There are many tales describing ferocious schools of piranha attacking humans, but there are few scientific data supporting such behavior. The very few documented instances of humans attacked and eaten by piranha schools include 3 that occurred after death by other causes (eg, heart failure and drowning). These predaceous fishes, however, do occasionally injure bathers and swimmers in lakes and rivers. The characteristic profile of most injuries is a single bite per victim, generally related to the fish defending its brood. This paper describes an outbreak of piranha bites in a dammed river portion in southeast Brazil. The outbreak was caused by the speckled piranha, Serrasalmus spilopleura, a widespread species which benefits from the growing tendency of damming rivers all over Brazil. This article focuses on the epidemiological and clinical aspects of the injuries, as well as on piranha biology, to gain a better understanding of the natural history of bite outbreaks.

  8. Anamnesis project- development of a mobile and web application to manage a unified clinical history in Colombia

    Directory of Open Access Journals (Sweden)

    Luis Armando Cobo Campo

    2016-06-01

    Full Text Available The problems of the Colombian health sector are diverse and have unique features. These problems can be of different types showing lack of health services coverage, deep economic crisis of national health institutions as well as their managerial insufficiency. In 2004, the Department of Sciences, Technology and Innovation launched the 675 Call which looked for the strengthening of ICT innovation nodes in public health institutions and it was under this call that a project was made to solve one of these problems such as accessing information contained in the clinical histories of Colombian patients in a unified and fast way. This article aims at describing a solution which suggests the implementation of a mobile and web app toconsult primary medical information of patients in emergency by using their identity card number to accessit, thus guaranteeing organizational efficiency.

  9. [History, current state and future perspective of tuberculosis research and clinical medicine].

    Science.gov (United States)

    Ito, Yutaka; Mishima, Michiaki

    2011-08-01

    Since Robert Koch identified Mycobacterium tuberculosis as causative agent of tuberculosis (TB) in 1882, TB research has developed in various fields, such as bacteriology, immunology, genomic study and genetic susceptibility. These research results have led to the knowledge concerning cellular immunity and the development of biochemical and gene diagnostic approach for M. tuberculosis, interferon-gamma release assay for latent TB infection and epidemiologic study using variable numbers of tandem repeats. After Selman A. Waksman isolated streptomycin, various drugs came to be used. Standard of the TB treatments has been revised several times up to now. Discovery of the novel drugs potential for multidrug-resistant TB is challenged. Close relationships among basic research, clinical medicine and health service are crucial to improving global control of TB.

  10. From clinical judgment to odds: a history of prognostication in anoxic-ischemic coma.

    Science.gov (United States)

    Wijdicks, Eelco F M

    2012-08-01

    Persistent coma from a major anoxic-ischemic injury to the brain may indicate there is less chance for full recovery. The tools of prognostication to assess comatose survivors of cardiopulmonary resuscitation have developed over several decades. Physicians would initially base their judgment on experience and data on outcome in these patients in the early years were merely on awakening not on disability. In the late 1970s, a large multicenter prospective study was performed on outcome in nontraumatic coma. The impetus for this study was the result of Plum and Jennet's collaboration. In 1981--for the first time--complex statistics were used to improve the accuracy of prognosis and became known as the "Levy algorithms." These early seminal studies shaped the prediction models and implied that clinical information alone could assist physicians in making a prediction. Later, probabilistic methods became more commonplace.

  11. Coexistence of systemic lupus erythematosus and multiple sclerosis: prevalence, clinical characteristics, and natural history.

    Science.gov (United States)

    Fanouriakis, Antonis; Mastorodemos, Vasileios; Pamfil, Cristina; Papadaki, Efrosini; Sidiropoulos, Prodromos; Plaitakis, Andreas; Amoiridis, George; Bertsias, George; Boumpas, Dimitrios T

    2014-06-01

    The coexistence of systemic lupus erythematosus (SLE) and multiple sclerosis (MS) in the same individual has rarely been described. Our objective was to report on the prevalence, clinical characteristics, and prognosis of cases fulfilling the criteria for both SLE and MS. We utilized existing patient cohorts from the Departments of Rheumatology and Neurology, University of Crete, and screened patients diagnosed with either SLE (n = 728) or MS (n = 819) for features of both diseases. The clinical, laboratory, and neuroimaging findings were assessed. We identified nine patients who fulfilled the diagnostic criteria for both SLE and MS, corresponding to a prevalence rate of 1.0-1.2% in each cohort. All patients were women, with an average age at SLE diagnosis of 42.1 years (range: 34-56 years). The diagnosis of SLE preceded the development of MS in five patients, with a time lag ≤ 5 years in four of them. Initial presentation of MS included spinal symptoms in seven patients. All patients had features of mild SLE with predominantly cutaneous, mucosal, and musculoskeletal manifestations. Accordingly, therapeutic decisions were mainly guided by the severity of the neurological syndrome. During the median follow-up of 4 years (range: 1-10 years), three patients remained stable and the remaining experienced gradual deterioration in their neurological status. SLE remained quiescent in all patients while on standard immunomodulatory MS therapy. Occurrence of both diseases in the same individual is rare, corroborating data that suggest distinct molecular signatures. SLE and MS coexistence was not associated with a severe phenotype for either entity. © 2013 Published by Elsevier Inc.

  12. Frequent screening with serial neck ultrasound is more likely to identify false-positive abnormalities than clinically significant disease in the surveillance of intermediate risk papillary thyroid cancer patients without suspicious findings on follow-up ultrasound evaluation.

    Science.gov (United States)

    Peiling Yang, Samantha; Bach, Ariadne M; Tuttle, R Michael; Fish, Stephanie A

    2015-04-01

    American Thyroid Association (ATA) intermediate-risk thyroid cancer patients who achieve an excellent treatment response demonstrate a low risk of structural disease recurrence. Despite this fact, most patients undergo frequent surveillance neck ultrasound (US) during follow-up. The objective of the study was to evaluate the clinical utility of routine screening neck US in ATA intermediate-risk patients documented to have a nonstimulated thyroglobulin less than 1.0 ng/mL and a neck US without suspicious findings after therapy. Retrospective review of 90 ATA intermediate-risk papillary thyroid carcinoma patients treated with total thyroidectomy and radioactive iodine ablation in a tertiary referral center. A comparison between the frequency of finding false-positive US abnormalities and the frequency of identifying structural disease recurrence in the study cohort was measured. Over a median of 10 years, 90 patients had a median of six US (range 2-16). Structural disease recurrence was identified in 10% (9 of 90) at a median of 6.3 years. Recurrence was associated with other clinical indicators of disease in 5 of the 90 patients (5.6%, 5 of 90) and was detected without other signs of recurrence in four patients (4.8%, 4 of 84). False-positive US abnormalities were identified in 57% (51 of 90), leading to additional testing, which failed to identify clinically significant disease. In ATA intermediate-risk patients who have a nonstimulated thyroglobulin less than 1.0 ng/mL and a neck US without suspicious findings after therapy, frequent US screening during follow-up is more likely to identify false-positive abnormalities than clinically significant structural disease recurrence.

  13. Thyroid abnormality in perimenopausal women with abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    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. 冠心病糖代谢异常患者血浆Ghrelin水平及临床意义%Plasma ghrelin level in patients with coronary heart disease with abnormal glucose metabolism and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    庞军刚; 徐新; 唐良秋; 张社兵; 江志平

    2012-01-01

    目的:探讨冠心病糖代谢异常患者血浆胃饥饿素(Ghrelin)水平及其相关临床意义.方法:将纳入研究对象依据相关检验及检查结果分为正常对照组、冠心病组(冠心病糖代谢正常组和冠心病糖代谢异常组)、单纯糖代谢异常组.收集所有入选对象人院第2天清晨空腹血样,采用ELISA方法同批检测血浆Ghrelin水平.结果:①冠心病组及单纯糖代谢异常组血浆Ghrelin水平均显著低于正常对照组.②冠心病糖代谢异常组血浆Ghrelin水平显著低于冠心病糖代谢正常组及单纯糖代谢异常组.③析因分析结果显示:冠心病与糖代谢异常在对血浆Ghrelin水平影响方面不存在交互作用.然而,糖代谢异常比冠心病对血浆Ghrelin水平的影响更明显.结论:冠心病糖代谢异常患者血浆Ghrelin水平显著下降,且糖代谢异常对Ghrelin的影响更明显.%AIM: To study plasma ghrelin level distribution in patients with coronary heart disease (CHD) with abnormal glucose metabolism and to discuss its clinical significance. METHODS; According to laboratory examination results, subjects were divided into control group, coronary heart disease with normal glucose metabolism group, coronary heart disease with abnormal glucose metabolism group and abnormal glucose metabolism group. Fasting blood samples were collected the morning after admission with EDTA-2K anticoagulation tubes. Blood samples were then transferred to centrifuge tubes containing aprotinin and were centrifuged to extract plasma for cryopreservation. All blood plasma ghrelin levels were tested with ELISA. RESULTS: Compared with those in control group, ghrelin levels were significantly reduced in the group with CHD with normal glucose metabolism, group of CHD with abnormal glucose metabolism and group with abnormal glucose metabolism. Compared with those in the group of CHD with normal glucose metabolism, levels of ghrelin were significantly reduced in patients with

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    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 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.......80)], and also tended to be associated with lower beta cell function. In contrast, patients both with and without a parental history had similar occurrence of central obesity [91% vs. 91%], weight gain ≥30 kg since age 20 [52% vs. 53%], and lack of regular physical activity [60% vs. 58%]. Presence of diabetes...

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

    Directory of Open Access Journals (Sweden)

    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

  17. In utero stem cell transplantation and gene therapy: rationale, history, and recent advances toward clinical application.

    Science.gov (United States)

    Almeida-Porada, Graça; Atala, Anthony; Porada, Christopher D

    2016-01-01

    Recent advances in high-throughput molecular testing have made it possible to diagnose most genetic disorders relatively early in gestation with minimal risk to the fetus. These advances should soon allow widespread prenatal screening for the majority of human genetic diseases, opening the door to the possibility of treatment/correction prior to birth. In addition to the obvious psychological and financial benefits of curing a disease in utero, and thereby enabling the birth of a healthy infant, there are multiple biological advantages unique to fetal development, which provide compelling rationale for performing potentially curative treatments, such as stem cell transplantation or gene therapy, prior to birth. Herein, we briefly review the fields of in utero transplantation (IUTx) and in utero gene therapy and discuss the biological hurdles that have thus far restricted success of IUTx to patients with immunodeficiencies. We then highlight several recent experimental breakthroughs in immunology, hematopoietic/marrow ontogeny, and in utero cell delivery, which have collectively provided means of overcoming these barriers, thus setting the stage for clinical application of these highly promising therapies in the near future.

  18. How useful is a history of rubella vaccination for determination of disease susceptibility? A cross-sectional study at a public funded health clinic in Malaysia

    OpenAIRE

    Cheong Ai Theng; Tong Seng Fah; Khoo Ee Ming

    2013-01-01

    Abstract Background Identification of pregnant women susceptible to rubella is important as vaccination can be given postpartum to prevent future risks of congenital rubella syndrome. However, in Malaysia, rubella antibody screening is not offered routinely to pregnant women in public funded health clinics due to cost constraint. Instead, a history of rubella vaccination is asked to be provided to establish the women’s risk for rubella infection. The usefulness of this history, however, is no...

  19. Clinical course of postthrombotic syndrome in children with history of venous thromboembolism.

    Science.gov (United States)

    Creary, Susan; Heiny, Mark; Croop, James; Fallon, Robert; Vik, Terry; Hulbert, Monica; Knoderer, Holly; Kumar, Manjusha; Sharathkumar, Anjali

    2012-01-01

    Postthrombotic syndrome (PTS) is a chronic morbidity of venous thromboembolism (VTE) in children. Information about the evolution of PTS is lacking in children. Present study was aimed to evaluate the time-course of extremity PTS in children who were serially followed in a hematology clinic. This retrospective cohort study included 69 consecutive children with documented VTEs that presented with symptoms of extremity VTE: 67 extremity VTEs with or without extension to vena cava, 2 inferior vena cava VTEs. Severity of PTS was assessed using modified Villalta scale. Median age of the cohort was 12.6 years (interquartile range 1.6-15 years) while median follow-up was 28.7 months (interquartile range 13.3-33.4 months. PTS prevalence was 46.8% [95% confidence interval (CI) 37.9-57.7%]. Lower extremity VTE was associated with development of PTS compared to upper extremity VTE regardless of catheter use (P = 0.002). The time-course of PTS fluctuated in 11 of 33 children (33%; 95% CI 20-47%) at a median interval of 12 months from diagnosis of VTE (range 4-14 months): three progressed from mild/moderate to severe, one improved from moderate to mild, seven fluctuated between mild and moderate. Recurrence and incomplete resolution of VTE were associated with variability in PTS severity (P course of PTS was not static in one third of children. Future research should focus on identifying the predictors contributing to the worsening of PTS and developing risk-stratified treatment interventions so as to improve the outcome of children with VTE.

  20. Clinical, histopathological and metabolic responses following exercise in Arabian horses with a history of exertional rhabdomyolysis.

    Science.gov (United States)

    McKenzie, E C; Eyrich, L V; Payton, M E; Valberg, S J

    2016-10-01

    A previous report suggests a substantial incidence of exertional rhabdomyolysis (ER) in Arabian horses performing endurance racing. This study compared formalin histopathology and clinical and metabolic responses to a standardised field exercise test (SET) between Arabians with and without ER. Arabian horses with (n = 10; age 15.4 ± 5.6 years) and without (n = 9; 12.9 ± 6.1 years) prior ER were stall-rested for 24-48 h, after which paired ER and control horses were fitted with a telemetric ECG and performed a 47 min submaximal SET. Plasma glucose, lactate, electrolyte and total protein concentrations and packed cell volume were measured before and immediately after exercise. Blood and percutaneous gluteal muscle samples were also obtained before and 3 h after exercise for measurement of plasma creatine kinase (CK) activity and muscle glycogen concentration, respectively. Histopathologic analysis of formalin-fixed pre-exercise muscle sections was performed. Data were analyzed by ANOVA and non-parametric tests (P exercise, and plasma CK increased similarly in ER and control Arabians. Muscle glycogen, heart rate, and remaining plasma variables did not differ between horses with ER and control horses. Horses with ER had more internalised nuclei in mature myofibers, more aggregates of cytoplasmic glycogen and desmin, and higher myopathic scores than control horses. Although many horses with ER had histopathologic evidence of chronic myopathy, muscle glycogen concentrations and metabolic exercise responses were normal. Results did not support a consistent metabolic myopathy or a glycogen storage disorder in Arabians with ER.

  1. Cognitive functioning throughout the treatment history of clinical late-life depression

    Science.gov (United States)

    Dzierzewski, Joseph M.; Potter, Guy G.; Jones, Richard N.; Rostant, Ola S.; Ayotte, Brian; Yang, Frances M.; Sachs, Bonnie C.; Feldman, Betsy J.; Steffens, David C.

    2015-01-01

    Objective Previous investigations into the relationship between late-life depressive symptoms and cognitive functioning have resulted in mixed findings concerning whether or not depressive symptoms and cognitive functioning are related. The mixed reports may be due in part to differences in clinical and nonclinical samples and to inadequate consideration of the dynamic nature (i.e., fluctuating course) of depressive symptoms and cognitive functioning in older adults. The current study examined the chronic, acute, and longitudinal relationships between depressive symptoms and cognitive functioning in older adults in an ongoing treatment study of major depressive disorder (MDD). Methods The neurocognitive outcomes of depression in the elderly study operates in a naturalistic treatment milieu using a pharmacological treatment algorithm and regular psychiatric assessment. Four hundred and fifty-three older adults [mean age 70 years, standard deviation (SD) = 7.2] meeting criteria for MDD at study enrollment received annual neuropsychological testing and depressive symptom monitoring for an average of 8.5 years (SD = 4.5). Results Hierarchical linear modeling revealed that higher age, lower education, and higher average/chronic levels of depressive symptoms were related to lower cognitive functioning. Additionally, results revealed that when an individual’s depressive symptoms are higher than is typical for a specific individual, general cognitive function was worse than average. There was no evidence of lagged/longitudinal relationships between depressive symptoms and cognitive functioning in older adults in treatment for MDD. Conclusions Cognitive functioning and depressive symptoms are concurrently associated in older adults with MDD, highlighting the potential importance for stabilizing mood symptoms as a means to manage cognitive deficits in late-life depression. PMID:25703072

  2. Clinical analysis and treatment of 5 cases of nonstrabmistic binocular vision abnormalities%非斜视性双眼视觉异常临床分析

    Institute of Scientific and Technical Information of China (English)

    艾丽珍

    2014-01-01

    Objective To analyze the test results of abnormal visual function of 5 cases of nonstrabmistic binocular vision.Methods Based on the general optometry,using Von Graefe method the phoria of direction and scope in the distance,convergence magnitude,AC/A ratio,Risley prism measurement of distance with variable levels of positive and negative fusional vergence,positive and negative fusional vergence,amplitude of convergence and state of feeling with Worth4 lighting and RDS stereo vision chart were measured.Refer Morgan analysis method to analyze and take appropriate visual training.Results (1) The feature of convergence insufficiency was distance phoria normal,and closed high exophoria and low positive relative convergence (PRC) in near distance,AC/A low.(2) Esophoria for near,far from normal and low negative relative convergence (NRC) in convergence excess.high AC/A.(3) Divergence excess that was distance high exophoria,near phoria normal and high AC/A.(4) The feature of fusional vergence diminution was far and near distance phoria normal,AC/A normal,near point of convergence (NPC) of distal movement.(5) Simple esophoria was distance esophoria near phoria beyond the normal range,AC/A normal.Conclusions The 5 cases belong to the nonstrabmistic binocular vision anomalies and their clinical symptoms are similar,however,inspection results are different,the diagnosis and treatment are also different.%目的 对5例不同的非斜视性双眼视觉异常的视功能检测结果进行综合分析.方法 对2012年4月至2013年4月在南昌大学附属眼科医院在验光基础上,应用综合验光仪测量集合幅度、调节幅度以及正负相对调节,用Von Graefe法测量在远近距离的隐斜方向和隐斜度、调节集合/调节值(AC/A)比率(调节性集合与调节量之比),用Risley可变棱镜测量远近水平正负融像聚散,用Worth4点灯和R.D.S立体视觉图测量立体视觉.参照Morgan分析法加以分析并

  3. Music for the dying: a personal account of the new field of music-thanatology--history, theories, and clinical narratives.

    Science.gov (United States)

    Schroeder-Sheker, T

    1994-03-01

    Music-thanatology is a palliative medical modality employing prescriptive music to tend the complex physical and spiritual needs of the dying. "Infirmary music" was an intimate expression of French monastic medicine in 11th-century Cluny and anticipated the holism of both the hospice and palliative medical movements by almost 800 years. Although no longer an expression of any institutional religious identity, music-thanatology is nevertheless concerned with the possibility of a blessed death and the gift that conscious dying can bring to the fullness of life. Music-thanatology interns seek to integrate and model these contemplative and clinical values in daily practice: 18 interns deliver prescriptive music in bedside vigils serving the dying in home, hospital, and hospice settings with great effectiveness in oncology, respiratory illnesses, the slow degenerative diseases, and AIDS. This article is submitted to nurses to serve as an introduction to the field of music-thanatology, providing readers with a brief history, meaningful clinical narratives, some of the musical theories involved, research concerns (archival and medical), and milestones to be addressed for the future implementation of music-thanatology in hospitals and hospices and communities across the nation.

  4. The medical management of abnormal uterine bleeding in reproductive-aged women.

    Science.gov (United States)

    Bradley, Linda D; Gueye, Ndeye-Aicha

    2016-01-01

    In the treatment of women with abnormal uterine bleeding, once a thorough history, physical examination, and indicated imaging studies are performed and all significant structural causes are excluded, medical management is the first-line approach. Determining the acuity of the bleeding, the patient's medical history, assessing risk factors, and establishing a diagnosis will individualize their medical regimen. In acute abnormal uterine bleeding with a normal uterus, parenteral estrogen, a multidose combined oral contraceptive regimen, a multidose progestin-only regimen, and tranexamic acid are all viable options, given the appropriate clinical scenario. Heavy menstrual bleeding can be treated with a levonorgestrel-releasing intrauterine system, combined oral contraceptives, continuous oral progestins, and tranexamic acid with high efficacy. Nonsteroidal antiinflammatory drugs may be utilized with hormonal methods and tranexamic acid to decrease menstrual bleeding. Gonadotropin-releasing hormone agonists are indicated in patients with leiomyoma and abnormal uterine bleeding in preparation for surgical interventions. In women with inherited bleeding disorders all hormonal methods as well as tranexamic acid can be used to treat abnormal uterine bleeding. Women on anticoagulation therapy should consider using progestin-only methods as well as a gonadotropin-releasing hormone agonist to treat their heavy menstrual bleeding. Given these myriad options for medical treatment of abnormal uterine bleeding, many patients may avoid surgical intervention.

  5. CHROMOSOME ABNORMALITIES IN INFERTILITY

    Directory of Open Access Journals (Sweden)

    Mateja Smogavec

    2009-08-01

    Conclusions Chromosomal analysis is an important method in diagnostic procedures of infertility, because 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. Sex chromosome aneuploidies are highly correlated to infertility of females and males.

  6. Hereditary urea cycle abnormality

    Science.gov (United States)

    ... vitro so the specific genetic cause is known. Teamwork between parents, the affected child, and doctors can help prevent severe illness. Alternative Names Abnormality of the urea cycle - hereditary; Urea cycle - hereditary abnormality Images Male urinary system Urea cycle References Lichter-Konecki ...

  7. 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

    Institute of Scientific and Technical Information of China (English)

    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

  8. Clinical Analysis of Hysteroscopic Electrotomy Treatment of Abnormal Uterine Bleeding%宫腔镜电切术治疗异常子宫出血的临床分析

    Institute of Scientific and Technical Information of China (English)

    刘云梅; 左溢华; 陶立安

    2015-01-01

    Objective Discussion hysteroscopic electrotomy treatment of abnormal uterine bleeding clinical results.Methods Select our hospital 80 cases of abnormal uterine bleeding were randomly divided into observation group and the control group,the control group underwent hysteroscopy,lesion site,routine curettage treatment,observation group underwent hysteroscopic resection,observe the operation time,complications,postoperative recovery. Results Efficacy of observation group is better than the control group,the recurrence rate is lower than in the control group(P<0.05). Conclusion Hysteroscopic surgery is effective in treating abnormal uterine bleeding,with a smal surgical trauma,conducive to patient recovery, worthy of clinical application of the promotion.%目的:探讨宫腔镜电切术治疗异常子宫出血的临床效果。方法选取我院收治的80例异常子宫出血患者,随机分为观察组和对照组,对照组行宫腔镜检查,明确病变部位,常规刮宫术治疗,观察组行宫腔镜电切术治疗,观察手术时间、并发症情况、术后患者恢复情况。结果观察组疗效明显优于对照组,复发率低于对照组(P<0.05)。结论宫腔镜电切术治疗异常子宫出血的疗效确切,手术创伤小,有利于患者恢复。

  9. Medpor义眼座植入术矫正眼窝凹陷畸形临床观察%Clinical observation of Medpor ocular prosthesis implantation to correct sunken socket abnormality

    Institute of Scientific and Technical Information of China (English)

    杜刚; 李贵刚; 谈清明

    2011-01-01

    Objective To discuss clinical effect observation of porous polythene ocular prosthesis ( Medpor ) implantation to correct sunken socket abnormality. Methods Optionality conduct Medpor or HA ocular prosthesis implantation to 55 cases of patients without eyeball or contracted eyeball or anophthalmia or eyeball atrophy resulting in socket sinking deformity. After postoperative follow-up over 6 months, Both of the clinical effectiveness in all cases were analyzed from complications, such as extrusion, migration or infection of the implant, etc. Results Both of the therapeutic effect of the ocular prosthesis implantation to correct sunken socket abnormality is good, but Medpor has less complications. Conclusion The overall of therapeutic effect of Medpor implantation to treat sunken Socket abnormality is better. Medpor is shown to be biocompatible and an ideal material for socket sinking defomity.%目的 探讨多孔聚乙烯义眼座(Medpor)植入矫正眼窝凹陷畸形手术效果.方法 55例(55只眼)包括眼球萎缩、眼球摘除术后、眼内容摘除术后及合并结膜囊狭窄的患者,随机植入Medpor义眼座或羟基磷灰石义眼座,随访观察术后义眼座暴露、感染等并发症情况,比较手术疗效.结果 Medpor义眼座与羟基磷灰石义眼座能取得相同的良好的治疗效果,但前者并发症更少.结论 Medpor义眼座植入术疗效可靠,Medpor具有良好的组织相容性,是矫正眼窝凹陷畸形的理想材料.

  10. 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

    Institute of Scientific and Technical Information of China (English)

    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,

  11. Clinical Trial Using Sodium Pertechnetate 99mTc Produced with Medium-Energy Cyclotron: Biodistribution and Safety Assessment in Patients with Abnormal Thyroid Function.

    Science.gov (United States)

    Selivanova, Svetlana; Lavallée, Éric; Senta, Helena; Caouette, Lyne; McEwan, Alexander Jb; Guérin, Brigitte; Lecomte, Roger; Turcotte, Eric

    2016-10-13

    A single-site prospective open-label clinical study with cyclotron-produced sodium pertechnetate (99m)Tc ([(99m)Tc]NaTcO4, (99m)Tc-pertechnetate) was performed in patients with indication for a thyroid scan to demonstrate the clinical safety and diagnostic efficacy of the drug and confirm its equivalence with conventional sodium pertechnetate (99m)Tc eluted from a generator.

  12. Meiotic abnormalities in infertile males.

    Science.gov (United States)

    Egozcue, J; Sarrate, Z; Codina-Pascual, M; Egozcue, S; Oliver-Bonet, M; Blanco, J; Navarro, J; Benet, J; Vidal, F

    2005-01-01

    Meiotic anomalies, as reviewed here, are synaptic chromosome abnormalities, limited to germ cells that cannot be detected through the study of the karyotype. Although the importance of synaptic errors has been underestimated for many years, their presence is related to many cases of human male infertility. Synaptic anomalies can be studied by immunostaining of synaptonemal complexes (SCs), but in this case their frequency is probably underestimated due to the phenomenon of synaptic adjustment. They can also be studied in classic meiotic preparations, which, from a clinical point of view, is still the best approach, especially if multiplex fluorescence in situ hybridization is at hand to solve difficult cases. Sperm chromosome FISH studies also provide indirect evidence of their presence. Synaptic anomalies can affect the rate of recombination of all bivalents, produce achiasmate small univalents, partially achiasmate medium-sized or large bivalents, or affect all bivalents in the cell. The frequency is variable, interindividually and intraindividually. The baseline incidence of synaptic anomalies is 6-8%, which may be increased to 17.6% in males with a severe oligozoospermia, and to 27% in normozoospermic males with one or more previous IVF failures. The clinical consequences are the production of abnormal spermatozoa that will produce a higher number of chromosomally abnormal embryos. The indications for a meiotic study in testicular biopsy are provided.

  13. Genetic counselors' current use of personal health records-based family histories in genetic clinics and considerations for their future adoption.

    Science.gov (United States)

    Widmer, Chaney; Deshazo, Jonathan P; Bodurtha, Joann; Quillin, John; Creswick, Heather

    2013-06-01

    Given the widespread adoption of electronic medical records and recent emergence of electronic family history tools, we examined genetic counselors' perspectives on the emerging technology of the personal health record (PHR)-based family history tool that links to an electronic medical record (EMR). Two-hundred thirty-three genetic counselors responded to an on-line survey eliciting current use of electronic family history (EFH) tools and familiarity with PHR-based family history tools. Additionally, after being shown a series of screen shots of a newly developed PHR-based family history tool based on the U.S. Surgeon General's My Family Health Portrait (United States Department of Health and Human Services 2009), participants were surveyed about the perceived usefulness, ease of use, and impact on current workflow that this kind of tool would have in their practices. Eighty-three percent reported that their institution has an EMR, yet only 35 % have a dedicated space for family history. Eighty-two percent reported that less than 5 % of their patients have a PHR, and only 16 % have worked with patients who have a PHR. Seventy-two percent or more agreed that a PHR-based family history tool would facilitate communication, increase accuracy of information, ensure consistency in recording information, increase focus on actual counseling, reduce repetitive questions, improve efficiency, and increase the legibility and clarity. Our findings suggest that participants were familiar with existing EFH tools, but that the majority did not use them in practice. Genetic counselors' adoption of such tools is limited due to non-existence of this kind of technology or inability to integrate it into their clinics. They are also strongly in favor of adopting a PHR-based family history tool in genetics clinics, but have practical concerns that must be addressed before the tool can be implemented.

  14. Abnormal immune parameters in HIV-seronegative haemophilic patients

    NARCIS (Netherlands)

    Allersma, DP; Smid, WM; Briet, E

    In HIV-seronegative haemophiliac patients abnormal immune parameters have been demonstrated. In this review data on these abnormalities, their aetiology and clinical consequences are summarized and discussed. The data reviewed show abnormalities at different levels of the adaptive immune system.

  15. Abnormal immune parameters in HIV-seronegative haemophilic patients

    NARCIS (Netherlands)

    Allersma, DP; Smid, WM; Briet, E

    1996-01-01

    In HIV-seronegative haemophiliac patients abnormal immune parameters have been demonstrated. In this review data on these abnormalities, their aetiology and clinical consequences are summarized and discussed. The data reviewed show abnormalities at different levels of the adaptive immune system. Mos

  16. RED BLOOD CELL ABNORMALITIES IN DECOMPENSATED CHRONIC LIVER DISEASE (DCLD

    Directory of Open Access Journals (Sweden)

    Anbazhagan

    2015-02-01

    Full Text Available BACKGROUND: Liver plays an important role in normal erythropoiesis, especially in formation and destruction of RBC’s. Chronic liver diseases are frequently associated with hematological abnormalities. Anemia of diverge etiology occurs in about 75% patients with DCLD ( 36. This can ultimately culminate in grave complications. AIM OF THE STUDY: To detect various abnormalities in Red Blood Cells and to assess the type of anemia in DCLD. METHODS: The study was conducted in 50 patients of DCLD, in Meenakshi Medical College. A detailed History, clinical examination and also Ultrasound Abdomen, GI endoscopy to establish DCLD and complete Red Blood Cell assessment was done. RESULTS AND OBSERVATION : Among the 50 patients, 40 patients (80% had anemia and only 10 pts had normal h emoglobin above 13 gms%. About 15 patients (30% had severe Anemia of less than 6 gm%. Among the 40 patients, 25 patients had normocytic normochronic anemia, 10 patients had microcytic anemia, and 4 patients had macrocytosis and only one had dimorphic anem ia. CONCLUSION : Most common Red Blood Cell abnormality in DCLD is anemia (80% and most common anemia is normochronic normocytic anemia (62.5%, while microcytic anemia and macrocytosis were common among females and Alcoholics, respectively

  17. Comparison of Patient Health History Questionnaires Used in General Internal and Family Medicine, Integrative Medicine, and Complementary and Alternative Medicine Clinics.

    Science.gov (United States)

    Laube, Justin G R; Shapiro, Martin F

    2017-05-01

    Health history questionnaires (HHQs) are a set of self-administered questions completed by patients prior to a clinical encounter. Despite widespread use, minimal research has evaluated the content of HHQs used in general internal medicine and family medicine (GIM/FM), integrative medicine, and complementary and alternative medicine (CAM; chiropractic, naturopathic, and Traditional Chinese Medicine [TCM]) clinics. Integrative medicine and CAM claim greater emphasis on well-being than does GIM/FM. This study investigated whether integrative medicine and CAM clinics' HHQs include more well-being content and otherwise differ from GIM/FM HHQs. HHQs were obtained from GIM/FM (n = 9), integrative medicine (n = 11), naturopathic medicine (n = 5), chiropractic (n = 4), and TCM (n = 7) clinics in California. HHQs were coded for presence of medical history (chief complaint, past medical history, social history, family history, surgeries, hospitalizations, medications, allergies, review of systems), health maintenance procedures (immunization, screenings), and well-being components (nutrition, exercise, stress, sleep, spirituality). In HHQs of GIM/FM clinics, the average number of well-being components was 1.4 (standard deviation [SD], 1.4) compared with 4.0 (SD, 1.1) for integrative medicine (p medicine (p = 0.04), 2.0 (SD, 1.4) for chiropractic (p = 0.54), and 2.0 (SD, 1.5) for TCM (p = 0.47). In HHQs of GIM/FM clinics, the average number of medical history components was 6.4 (SD, 1.9) compared with 8.3 (SD, 1.2) for integrative medicine (p = 0.01), 9.0 (SD, 0) for naturopathic medicine (p = 0.01), 7.1 (SD, 2.8) for chiropractic (p = 0.58), and 7.1 (SD, 1.7) for TCM (p = 0.41). Integrative and naturopathic medicine HHQs included significantly more well-being and medical history components than did GIM/FM HHQs. Further investigation is warranted to determine the optimal HHQ content to support the clinical and preventive

  18. 宫腔镜检查在诊断异常子宫出血中的临床价值%Clinical value of hysteroscopy in the diagnosis of abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    吴汝芳

    2012-01-01

    Objective: To explore the clinical value of hysteroscopy in the diagnosis of abnormal uterine bleeding. Methods; The clinical data of 287 patients who underwent hysteroscopy because of abnormal uterine bleeding, received treatment under hysteroscope, endo-metrial location and biopsy were analyzed retrospectively. Results; The total coincidence rate of hysteroscopic diagnosis and histopathological diagnosis for 287 patients with abnormal uterine bleeding was 80. 84% , the coincidence rates of hysteroseopic diagnosis and histopathological diagnosis for submucous myoma, endometrial polyps, endometrial hyperplasia, endometrilis, atrophic endometrium, and endometrial cancer were 100. 00% , 96. 83% , 68.42% , 77. 27% , 100.00% , and 100.00% , respectively. CamMon: Hysteroscope can observe the morphologies and structures of uterine cavity and cervical canal clearly, which has the incomparable advantages compared to diagnostic curettage and ultrasonography, hysteroscope is a gold standard for the diagnosis of abnormal uterine bleeding.%目的:探讨宫腔镜检查在诊断异常子宫出血中的临床价值.方法:回顾性分析因异常子宫出血行宫腔镜检查,同时在宫腔镜下进行相应治疗和子宫内膜定位活检的287例患者资料.结果:287例异常子宫出血患者的宫腔镜诊断与病理组织学诊断总符合率为80.84%,其中子宫黏膜下肌瘤100.00%、子宫内膜息肉96.83%、子宫内膜增生68.42%、子宫内膜炎77.27%、萎缩性子宫内膜100.00%、子宫内膜癌100.00%.结论:宫腔镜能直接清晰地观察宫腔内及宫颈管的形态与结构,具有诊断性刮宫和超声检查不可比拟的优点,是诊断异常子宫出血的金标准.

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

    Science.gov (United States)

    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. British Veterinary Association.

  20. Equine clinical cytogenetics: the past and future.

    Science.gov (United States)

    Lear, T L; Bailey, E

    2008-01-01

    Cytogenetic analyses of horses have benefited the horse industry by identifying chromosomal aberrations causing congenital abnormalities, embryonic loss and infertility. Technical advances in cytogenetics enabled the identification of chromosome specific aberrations. More recently, advances in genomic tools have been used to more precisely define chromosome abnormalities. In this report we review the history of equine clinical cytogenetics, identify historical landmarks for equine clinical cytogenetics, discuss how the current use of genomic tools has benefited this area, and how future genomics tools may enhance clinical cytogenetic studies in the horse.

  1. Altered fetal growth, placental abnormalities, and stillbirth.

    Science.gov (United States)

    Bukowski, Radek; Hansen, Nellie I; Pinar, Halit; Willinger, Marian; Reddy, Uma M; Parker, Corette B; Silver, Robert M; Dudley, Donald J; Stoll, Barbara J; Saade, George R; Koch, Matthew A; Hogue, Carol; Varner, Michael W; Conway, Deborah L; Coustan, Donald; Goldenberg, Robert L

    2017-01-01

    stillbirths and live births. The patterns of association between placental abnormalities, fetal growth, and stillbirth provide insights into the mechanism of impaired placental function and stillbirth. They also suggest implications for clinical care, especially for placental findings amenable to prenatal diagnosis using ultrasound that may be associated with term stillbirths.

  2. [CHROMOSOMAL ABNORMALITIES IN PATIENTS WITH INFERTILITY].

    Science.gov (United States)

    Pylyp, L Y; Spinenko, L O; Verhoglyad, N V; Kashevarova, O O; Zukin, V D

    2015-01-01

    To assess the frequency and structure of chromosomal abnormalities in patients with infertility, a retrospective analysis of cytogenetic studies of 3414 patients (1741 females and 1673 males), referred to the Clinic of reproductive medicine "Nadiya" from 2007 to 2012, was performed. Chromosomal abnormalities were detected in 2.37% patients: 2.79% in males and 1.95% in females. Balanced structural chromosomal abnormalities prevailed over numerical abnormalities and corresponded to 80.2% of all chromosomal abnormalities detected in the studied group. Sex chromosome abnormalities made up 23.5% of chromosomal pathology (19/81) and included gonosomal aneuploidies in 84% of cases (16/19) and structural abnormalities of chromosome Y in 16% of cases (3/19). The low level sex chromosome mosaicism was detected with the frequency of 0.55%. Our results highlight the importance of cytogenetic studies in patients seeking infertility treatment by assisted reproductive technologies, since an abnormal finding not only provide a firm diagnosis to couples with infertility, but also influences significantly the approach to infertility treatment in such patients.

  3. Abnormal menstrual periods (image)

    Science.gov (United States)

    ... may have a variety of causes, such as endometrial hyperplasia, endometrial polyps, uterine fibroids, and abnormal thyroid or ... the endometrium becomes unusually thick it is called endometrial ... Hyperplasia may cause profuse or extended menstrual bleeding.

  4. "Jeopardy" in Abnormal Psychology.

    Science.gov (United States)

    Keutzer, Carolin S.

    1993-01-01

    Describes the use of the board game, Jeopardy, in a college level abnormal psychology course. Finds increased student interaction and improved application of information. Reports generally favorable student evaluation of the technique. (CFR)

  5. Chromosomal Abnormalities in ADHD

    Directory of Open Access Journals (Sweden)

    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.

  6. Chromosomal abnormalities and autism

    Directory of Open Access Journals (Sweden)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  8. Thrombelastography is Better Than PT, aPTT, and Activated Clotting Time in Detecting Clinically Relevant Clotting Abnormalities After Hypothermia, Hemorrhagic Shock and Resuscitation in Pigs

    Science.gov (United States)

    2008-09-01

    samples were taken for measurements of coagulation and hemodynamics. Animals were euthanized afterward with an overdose of a veterinary euthanasia ...clinical outcomes.34–38 Thus, although the insensitivity of PT or aPTT under some circumstances is not appreciated, it should be recognized that

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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. 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.

    Directory of Open Access Journals (Sweden)

    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.

  12. Relation between the persistence of an abnormal muscle response and the long-term clinical course after microvascular decompression for hemifacial spasm.

    Science.gov (United States)

    Tobishima, Hana; Hatayama, Toru; Ohkuma, Hiroki

    2014-06-17

    Mentalis muscle responses to electrical stimulation of the zygomatic branch of the facial nerve are considered abnormal muscle responses (AMRs) and can be used to monitor the success of decompression in microvascular decompression (MVD) surgery. The aim of this study was to compare the long-term outcome of MVD surgery in which the AMR disappeared to the outcome of surgery in which the AMR persisted. From 2005 to 2009, 131 patients with hemifacial spasm received MVD surgery with intraoperative monitoring of AMR. At 1 week postsurgery, spasms had resolved in 82% of cases in the AMR-disappearance group and 46% of cases in the persistent-AMR group, mild spasms were present in 10% of cases in the AMR-disappearance group and 31% of cases in the persistent-AMR group, and moderate were present spasms in 8% of cases in the AMR-disappearance group and 23% of cases in the persistent-AMR group (P spasms had resolved in 92% of cases in the AMR-disappearance group and 84% of cases in the persistent-AMR group, mild spasms were present in 6% of cases in the AMR-disappearance group and 8% of cases in the persistent-AMR group, and moderate spasms were present in 3% of cases in the AMR-disappearance group and 8% of the cases in the persistent-AMR group (P = 0.56). These results indicate that the long-term outcome of MVD surgery in which the AMR persisted was no different to that of MVD surgery in which the AMR disappeared.

  13. Abnormal protein aggregationand neurodegenerativediseases

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Abnormal protein aggregation or amyloid is the major cause ofmany neurodegenerative disorders. The present review focuses on the correlation between sequence and structure features of proteins related to the diseases and abnormal protein aggregation. Recent progress has improved our knowledge on understand-ing the mechanism of amyloid formation. We suggest a nucleation model for ordered protein aggregation, which can also explain pathogenesis mechanisms of these neurodegenerative diseases in vivo.

  14. Nail abnormalities in patients with vitiligo

    OpenAIRE

    Topal, Ilteris Oguz; Gungor, Sule; Kocaturk, Ozgur Emek; Duman, Hatice; Durmuscan, Mustafa

    2016-01-01

    Abstract: Background: Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. Objective: We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the corre...

  15. American College of Medical Genetics recommendations for the design and performance expectations for clinical genomic copy number microarrays intended for use in the postnatal setting for detection of constitutional abnormalities.

    Science.gov (United States)

    Kearney, Hutton M; South, Sarah T; Wolff, Daynna J; Lamb, Allen; Hamosh, Ada; Rao, Kathleen W

    2011-07-01

    Genomic copy number microarrays have significantly increased the diagnostic yield over a karyotype for clinically significant imbalances in individuals with developmental delay, intellectual disability, multiple congenital anomalies, and autism, and they are now accepted as a first tier diagnostic test for these indications. As it is not feasible to validate microarray technology that targets the entire genome in the same manner as an assay that targets a specific gene or syndromic region, a new paradigm of validation and regulation is needed to regulate this important diagnostic technology. We suggest that these microarray platforms be evaluated and manufacturers regulated for the ability to accurately measure copy number gains or losses in DNA (analytical validation) and that the subsequent interpretation of the findings and assignment of clinical significance be determined by medical professionals with appropriate training and certification. To this end, the American College of Medical Genetics, as the professional organization of board-certified clinical laboratory geneticists, herein outlines recommendations for the design and performance expectations for clinical genomic copy number microarrays and associated software intended for use in the postnatal setting for detection of constitutional abnormalities.

  16. Age at menopause, reproductive history, and venous thromboembolism risk among postmenopausal women: the Women's Health Initiative Hormone Therapy clinical trials.

    Science.gov (United States)

    Canonico, Marianne; Plu-Bureau, Geneviève; O'Sullivan, Mary Jo; Stefanick, Marcia L; Cochrane, Barbara; Scarabin, Pierre-Yves; Manson, Joann E

    2014-03-01

    This study aims to investigate venous thromboembolism (VTE) risk in relation to age at menopause, age at menarche, parity, bilateral oophorectomy, and time since menopause, as well as any interaction with randomized hormone therapy (HT) assignment, among postmenopausal women. Using pooled data from the Women's Health Initiative HT clinical trials including 27,035 postmenopausal women aged 50 to 79 years who had no history of VTE, we assessed the risk of VTE in relation to age at menopause, age at menarche, parity, bilateral oophorectomy, and time since menopause by Cox proportional hazards models. Linear trends, quadratic relationships, and interactions of reproductive life characteristics with HT on VTE risk were systematically tested. During follow-up, 426 women reported a first VTE, including 294 non-procedure-related events. No apparent interaction of reproductive life characteristics with HT assignment on VTE risk was detected, and there was not a significant association between VTE and age at menarche, age at menopause, parity, oophorectomy, or time since menopause. However, analyses restricted to non-procedure-related VTE showed a U-shaped relationship between age at menopause and thrombotic risk that persisted after multivariable analysis (P menopause, those who had early menopause (age menopause (age >55 y) had a significantly increased VTE risk (hazard ratio [95% CI]: 1.8 [1.2-2.7] and 1.5 [1.0-2.4], respectively). Reproductive life characteristics have little association with VTE and do not seem to influence the effect of HT on thrombotic risk among postmenopausal women. Nevertheless, early and late onset of menopause might be newly identified risk factors for non-procedure-related VTE.

  17. Natural history of anal dysplasia in an HIV-infected clinical care cohort: estimates using multi-state Markov modeling.

    Directory of Open Access Journals (Sweden)

    William C Mathews

    Full Text Available (1 To model the natural history of anal neoplasia in HIV-infected patients using a 3-state Markov model of anal cancer pathogenesis, adjusting for cytology misclassification; and (2 to estimate the effects of selected time-varying covariates on transition probabilities.A retrospective cytology-based inception screening cohort of HIV-infected adults was analyzed using a 3-state Markov model of clinical pathogenesis of anal neoplasia.Longitudinally ascertained cytology categories were adjusted for misclassification using estimates of cytology accuracy derived from the study cohort. Time-varying covariate effects were estimated as hazard ratios.(1 There was a moderate to high probability of regression of the high grade squamous intraepithelial lesion (HSIL state (27-62% at 2 years after initial cytology screening; (2 the probability of developing invasive anal cancer (IAC during the first 2 years after a baseline HSIL cytology is low (1.9-2.8%; (3 infrared coagulation (IRC ablation of HSIL lesions is associated with a 2.2-4.2 fold increased probability of regression to

  18. Free and Cued Memory in relation to Biomarker-Defined Abnormalities in Clinically Normal Older Adults and Those at Risk for Alzheimer’s Disease

    Science.gov (United States)

    Papp, Kathryn V.; Amariglio, Rebecca E.; Mormino, Elizabeth; Hedden, Trey; Dekhytar, Maria; Johnson, Keith A.; Sperling, Reisa A.; Rentz, Dorene M.

    2015-01-01

    Objectives Furthering our understanding of the relationship between amyloidosis (Aβ), neurodegeneration (ND), and cognition is imperative for early identification and early intervention of Alzheimer’s disease (AD). However, the subtle cognitive decline differentially associated with each biomarker-defined stage of preclinical AD has yet to be fully characterized. Recent work indicates that different components of memory performance (free and cued recall) may be differentially specific to memory decline in prodromal AD. We sought to examine the relationship between free and cued recall paradigms, in addition to global composites of memory, executive functioning, and processing speed in relation to stages of preclinical AD. Methods A total of 260 clinically normal (CN) older adults (CDR=0) from the Harvard Aging Brain study were grouped according to preclinical AD stages including Stage 0 (Aβ−/ND−), Stage 1 (Aβ+/ND−), Stage 2 (Aβ+/ND+), and suspected non-Alzheimer’s associated pathology (SNAP; Aβ−/ND+). General linear models controlling for age, sex, and education were used to assess for stage-based performance differences on cognitive composites of executive functioning, processing speed, and memory in addition to free and cued delayed recall on the Selective Reminding Test (SRT) and Memory Capacity Test (MCT). Results Global memory performance differed between preclinical stages with Stage 2 performing worse compared with Stage 0. When examining free and cued paradigms by memory test, only the MCT (and not the SRT) revealed group differences. More specifically, Stage 1 was associated with decrements in free recall compared with Stage 0 while Stage 2 was associated with decrements in both free and cued recall. There was a trend for the SNAP group to perform worse on free recall compared with Stage 0. Finally, there was no association between preclinical stage and global composites of executive functioning or processing speed. Conclusions Clinically

  19. The Fra(X) syndrome: neurological, electrophysiological, and neuropathological abnormalities.

    Science.gov (United States)

    Wisniewski, K E; Segan, S M; Miezejeski, C M; Sersen, E A; Rudelli, R D

    1991-01-01

    We have evaluated 62 fragile X syndrome [fra(X)] individuals (55 males and 7 females) with different degrees of developmental disabilities that were clinically non-progressive and non-focal in character. The mean age for the 55 males was 23.1 years +/- 14.3 SD with a range of 2-70: for the 7 females, the mean age was 15.7 years +/- 3.5 SD with a range of 10-20 years. Mental retardation (MR) was found in 53 males (8/53 [15.1%] mild, 26/53 [49.1%] moderate, 14/53 [26.4%] severe, and 5/53 [9.4%] profound). Learning disabilities were found in 2/55 (3.6%) of males. One of the 7 females had mild and one had moderate MR: the other 5 were learning disabled. Autistic stigmata were present in 10/62 (16%) of the patients. Only 14/62 (23%) had a history of seizures, all of which were controlled with anticonvulsants. In 36/62 cases, an electroencephalogram (EEG) was performed. We compared these data with that of others. Brain stem auditory evoked response (BAER) was performed in 12 cases. Abnormalities were found in only 5/12. Neuroimaging and computerized cranial transaxial tomography (CT scan) were performed on 21/62 (34%) of the patients. Only 8 of these 21 (38%) studies were abnormal. One patient died; neuropathological studies showed mild brain atrophy, with light microscopic and ultrastructural abnormalities. Rapid Golgi dendritic spine patterns showed that the proximal apical segments were abnormally developed. Very thin, long tortuous spines with prominent terminal heads and irregular dilatations were present. Marked reductions in the length of the synapses, as determined on EPTA-postfixed tissue where noted.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Stowaways in the history of science: the case of simian virus 40 and clinical research on federal prisoners at the US National Institutes of Health, 1960.

    Science.gov (United States)

    Stark, Laura; Campbell, Nancy D

    2014-12-01

    In 1960, J. Anthony Morris, a molecular biologist at the US National Institutes of Health conducted one of the only non-therapeutic clinical studies of the cancer virus SV40. Morris and his research team aimed to determine whether SV40 was a serious harm to human health, since many scientists at the time suspected that SV40 caused cancer in humans based on evidence from in vivo animal studies and experiments with human tissue. Morris found that SV40 had no significant effect but his claim has remained controversial among scientists and policymakers through the present day--both on scientific and ethical grounds. Why did Morris only conduct one clinical study on the cancer-causing potential of SV40 in healthy humans? We use the case to explain how empirical evidence and ethical imperatives are, paradoxically, often dependent on each other and mutually exclusive in clinical research, which leaves answers to scientific and ethical questions unsettled. This paper serves two goals: first, it documents a unique--and uniquely important--study of clinical research on SV40. Second, it introduces the concept of "the stowaway," which is a special type of contaminant that changes the past in the present moment. In the history of science, stowaways are misfortunes that nonetheless afford research that otherwise would have been impossible specifically by creating new pasts. This case (Morris' study) and concept (the stowaway) bring together history of science and philosophy of history for productive dialog. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Approach to Investigating Congenital Skeletal Abnormalities in Livestock.

    Science.gov (United States)

    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.

  2. Clinical study of two kinds of endometrial ablation in the treatment of abnormal uterine bleeding%两种子宫内膜祛除术治疗异常子宫出血的临床研究

    Institute of Scientific and Technical Information of China (English)

    刘海绒

    2016-01-01

    Objective:To study the clinical effect of two kinds of endometrial ablation in the treatment of abnormal uterine bleeding.Methods:65 patients with abnormal uterine bleeding were selected.They were divided into two groups Hysteroscopy in the treatment of endometrial resection;the NovaSure group with NovaSure endometrial ablation.Clinical effect was compared. Results:The NovaSure group 1 year amenorrhea rate was significantly higher than that of hysteroscopy group;electrolyte disorder was lower than that of hysteroscopy group(P<0.05).Conclusion:The NovaSure endometrial removal surgery and hysteroscopic endometrial resection in treatment of abnormal uterine bleeding all have certain effect,but the NovaSure endometrial removal surgery can decrease the trauma,reduce interfere with the body,increase the rate of amenorrhea,combined with actual choice suitable operation.%目的:研究两种子宫内膜祛除术治疗异常子宫出血的临床效果。方法:收治异常子宫出血患者65例,分两组。宫腔镜组以宫腔镜子宫内膜切除术治疗;诺舒组以诺舒子宫内膜祛除术治疗。比较临床效果。结果:诺舒组1年闭经率明显高于宫腔镜组,电解质紊乱率低于宫腔镜组(P<0.05)。结论:诺舒子宫内膜祛除术和宫腔镜子宫内膜切除术治疗异常子宫出血均有一定效果,但诺舒子宫内膜祛除术可减轻创伤,减轻机体干扰,提高闭经率,需结合患者实际选择合适术式。

  3. Cynergy双波长激光治疗儿童皮肤血管异常性疾病的临床观察%Clinical observation of cynergy multiplex laser to treat skin vascular abnormalities in children

    Institute of Scientific and Technical Information of China (English)

    陈萍; 吴倩; 王静; 郝迪; 王博鹤

    2015-01-01

    目的:评价Cynergy双波长激光治疗儿童皮肤血管异常性疾病的临床疗效和安全性。方法采用Cynergy双波长激光治疗352例儿童皮肤血管异常性疾病,其中血管瘤296例,鲜红斑痣16例,蜘蛛痣23例,化脓性肉芽肿17例。治疗半年后,对其临床疗效和不良反应进行评价。结果352例患儿治疗的总有效率为67.0%,不同疾病的有效率比较差异无统计学意义(P>0.05)。皮损部位与疗效的关系差异有统计学意义(P<0.05)。总体不良反应发生率为8.5%。结论 Cynergy双波长激光治疗儿童皮肤血管异常性疾病临床疗效好,安全性高,痛苦小,不良反应发生率低,可在临床上推广使用。%Objective To assess the clinical efficacy and safety of Cynergy multiplex laser to treat skin vascular ab-normalities in children.Methods A total of 352 patients with skin vascular abnormalities were treated with Cynergy multiplex laser, including 296 haemangioma children, 16 naevus flammeus children, 23 spider telangiectasia children and 17 purulent granuloma children.The clinical efficacy and adverse rections were analyzed after 6 mouths of treatment. Results The total effective rate was 67.0%.No significant difference was found among the effective rates of haemangio-ma, naevus flammeus, spider telangiectasia and purulent granuloma (P>0.05).The efficacy were remarkably related with the site of skin lesions (P<0.05).The total adverse reaction rate was 8.5%.Conclusion Cynergy multiplex la-ser is an effective, safe method to treat skin vascular abnormalities in children, with low adverse reactions.

  4. Chromosomal abnormalities and polymorphic variants in couples with repeated miscarriage in Mexico.

    Science.gov (United States)

    De la Fuente-Cortés, Beatriz E; Cerda-Flores, Ricardo M; Dávila-Rodríguez, Martha I; García-Vielma, Catalina; De la Rosa Alvarado, Rosa M; Cortés-Gutiérrez, Elva I

    2009-04-01

    Cytogenetic studies have an important role in the evaluation of couples with repeated miscarriages and poor obstetric history. To estimate the prevalence of chromosomal abnormalities and polymorphic variants in 158 couples with repeated miscarriages, a cross-sectional study was conducted in Monterrey, Mexico from 1995 to 2003. Peripheral blood lymphocytes were cultured for chromosomal studies using standard methods. Twelve couples showed chromosomal abnormalities (7.60%), two Robertsonian translocations (1.27%), two balanced translocations (1.27%), one inversion (0.63%), and one a novel insertion (0.63%). This insertion [46, XX, ins (15;8) (q26;p11p23)] is unique, and is the third reported in association with repeated abortion. Mosaicism was observed in six couples (3.80%, three with structural abnormalities and three with numerical abnormalities). A female to male ratio of 1.4:1 was observed. In addition to these chromosomal abnormalities, polymorphic variants in constitutive heterochromatin of the 1qh+, 9qh+, and 16qh+ chromosomes were observed in 25 couples (15.82%), of the Yqh+ chromosome in 21 couples (13.29%), and of satellite in 35 couples (22.15%). In conclusion, chromosome analysis is necessary for appropriate clinical management of these patients.

  5. 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

    Institute of Scientific and Technical Information of China (English)

    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

  6. Clinical study in diagnosis placental implantation abnormality with Transvaginal Doppler ul-trasound%经腹彩超诊断胎盘植入的临床研究

    Institute of Scientific and Technical Information of China (English)

    卜凡文; 沈树娜

    2015-01-01

    Objective To evaluate the ultra sonographic charateristics and the diagnostic value in placental implanta-tion abnormality ( PIA) with transvaginal Doppler ultrasound, improve the rate of diagnosis accuracy in the prenatal and postnatal of PIA with transvaginal Doppler ultrasound, for early diagnosis and treatment,to avoid hysterectomy beacuse of fatally and heavy bleeding. Method There were 61 cases complicated with PIA by operation and patho-logically confirmed in our hospital. 33 cases were Prenatal PIA, 28 cases were postnatal PIA. To discuss sonograph-ic charateristics, and analysis the Sensitivity and missed diagnosis of transvaginal Doppler ultrasound contrasted with surgery pathology. Result Muscular layer of the placenta has abundant signals of blood flow, this was major sono-graphic performance in prenatal PIA, incidence rate was 85. 7%, followed by whirlpool in placenta and plancental invasion;placental remnants was major sonographic performance in postpartum PIA, incidence rate was 100%, fol-lowed by abundant signals of blood flow in muscular layer of the placenta and boundary was disappear between mus-cular layer and placenta. There were 14 cases by transvaginal Doppler ultrasound diagnosed prenatal PIA accurate-ly, sensitivity was 42. 4%, false negative rate was 57. 6%. There were 21 cases by transvaginal Doppler ultrasound diagnosed postnatal PIA accurately, sensitivity was 75. 0%, false negative rate was 25. 0%. Conclusion Specificity is low in Prenatal PIA by transvaginal Doppler ultrasound, false negative rate is higher. if necessary,to improve the diagnostic accuracy combination with MRI. Specificity is higher in postnatal PIA, false negative rate is low. The Ul-trasonography of PIA has certain characteristics, strengthen the consciousness of the diagnosis in PIA, especially in the prenatal, To do a good job of auxiliary diagnosis in PIA.%目的:探讨经腹彩超诊断胎盘植入的声像图特点和诊断价值,提高经腹彩超在产前

  7. 子宫瘢痕憩室致异常子宫出血156例临床分析%Clinical analysis of 156 abnormal uterine bleeding cases due to cesarean section scar diverticulum

    Institute of Scientific and Technical Information of China (English)

    龙英丽; 孙亚玲; 于景荣; 秦玉静

    2015-01-01

    目的:分析子宫瘢痕憩室引起异常子宫出血患者的临床表现、检查方法,为预防及治疗提供依据。方法回顾性分析因剖宫产术后子宫憩室引起异常子宫出血患者156例的临床资料,对检出率、患者临床症状出现时间及相关影响因素、检查情况、误诊情况进行分析。结果2010年异常出血者中发现憩室12例(5.6%),2011年发现憩室30例(10.5%),2012年发现憩室26例(8.6%),2013年发现憩室37例(14.4%),2014年发现憩室51例(17.7%)。48例患者症状出现时间为术后恢复月经1~6个月,89例为术后恢复月经6个月至2年,19例为术后恢复月经2年后。98例(62.82%)患者多次超声检查未发现明显异常,43例患者行诊断性刮宫,后位子宫与前位、中位子宫相比阴道流血时间明显延长。结论剖宫产子宫切口憩室致异常子宫出血发病率虽低,但是有较高的误诊、漏诊率,需进一步提高其诊断率,进一步研究其预防及治疗方法。%Objective To investigate the clinical manifestation and inspection method about abnormal uter-ine bleeding due to cesarean section scar diverticulum.Methods retrospective analysis of 156 abnormal uterine bleeding cases due to cesarean section scar diverticulum.Analysis the relevance ratio,the starting time of clinical symptom,related influencing factors,the information of examine and misdiagnose.Results there are 12 cases cesare-an section scar diverticulum in 2010;30 cases in 2011;26 cases in 2012;37 cases in 2013;51 cases in 2014.The starting time of clinical symptom is 1 ~6 month pose menstrual in 48 cases;6 months to 2 years pose menstrual in 89 cases,2 years later pose menstrual in 19 cases.98 cases don′t have evidential abnormality even through many times ultrasonograph.43 patients subjected diagnosis curettage.The uterine bleeding time obviously longer comparing retro-position of uterus with

  8. Diagnostic values of chest pain history, ECG, troponin and clinical gestalt in patients with chest pain and potential acute coronary syndrome assessed in the emergency department.

    Science.gov (United States)

    Mokhtari, Arash; Dryver, Eric; Söderholm, Martin; Ekelund, Ulf

    2015-01-01

    In the assessment of chest pain patients with suspected acute coronary syndrome (ACS) in the emergency department (ED), physicians rely on global diagnostic impressions ('gestalt'). The aim of this study was to determine the diagnostic value of the ED physician's overall assessment of ACS likelihood, and the values of the main diagnostic modalities underlying this assessment, namely the chest pain history, the ECG and the initial troponin result. 1,151 consecutive ED chest pain patients were prospectively included. The ED physician's interpretation of the chest pain history, the ECG, and the global likelihood of ACS were recorded on special forms. The discharge diagnoses were retrieved from the medical records. A chart review was carried out to determine whether patients with a non-ACS diagnosis at the index visit had ACS or suffered cardiac death within 30 days. The gestalt was better than its components both at ruling in ("Obvious ACS", LR 29) and at ruling out ("No Suspicion of ACS", LR 0.01) ACS. In the "Strong suspicion of ACS" group, 60% of the patients did not have ACS. A positive TnT (LR 24.9) and an ischemic ECG (LR 8.3) were strong predictors of ACS and seemed superior to pain history for ruling in ACS. In patients with a normal TnT and non-ischemic ECG, chest pain history typical of AMI was not a significant predictor of AMI (LR 1.9) while pain history typical of unstable angina (UA) was a moderate predictor of UA (LR 4.7). Clinical gestalt was better than its components both at ruling in and at ruling out ACS, but overestimated the likelihood of ACS when cases were assessed as strong suspicion of ACS. Among the components of the gestalt, TnT and ECG were superior to the chest pain history for ruling in ACS, while pain history was superior for ruling out ACS.

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

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    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.

  10. Dento-maxillofacial abnormalities caused by radiotherapy and chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    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.

  11. 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

    Directory of Open Access Journals (Sweden)

    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.

  12. Analysis of homeobox gene action may reveal novel angiogenic pathways in normal placental vasculature and in clinical pregnancy disorders associated with abnormal placental angiogenesis.

    Directory of Open Access Journals (Sweden)

    Padma eMurthi

    2014-06-01

    Full Text Available Homeobox genes are essential for both the development of the blood and lymphatic vascular systems, as well as for their maintenance in the adult. Homeobox genes comprise an important family of transcription factors, which are characterised by a well conserved DNA binding motif; the homeodomain. The specificity of the homeodomain allows the transcription factor to bind to the promoter regions of batteries of target genes and thereby regulates their expression. Target genes identified for homeodomain proteins have been shown to control fundamental cell processes such as proliferation, differentiation and apoptosis. We and others have reported that homeobox genes are expressed in the placental vasculature, but our knowledge of their downstream target genes is limited. This review highlights the importance of studying the cellular and molecular mechanisms by which homeobox genes and their downstream targets may regulate important vascular cellular processes such as proliferation, migration, and endothelial tube formation, which are essential for placental vasculogenesis and angiogenesis. A better understanding of the molecular targets of homeobox genes may lead to new therapies for aberrant angiogenesis associated with clinically important pregnancy pathologies, including fetal growth restriction and preeclampsia.

  13. 鼻咽癌染色体1p末端结构异常及其临床意义的初步研究%Structural abnormalities of chromosome 1p termination in nasopharyngeal carcinoma and its clinical implications

    Institute of Scientific and Technical Information of China (English)

    黄铁军; 黄必军; 张林杰; 黄楚文; 梁启万; 方嬿

    2004-01-01

    BACKGROUND:Correlations between the structural abnormalities of chromosome 1pter in nasopharyngeal carcinoma(NPC) and its tumorigenesis and clinical significance are still unclear. OBJECTIVE: To investigate the correlations between the structural abnormalities of chromosome 1pter in NPC and the tumorigenesis of NPC. DESIGN:A retrospective study was performed to the control group according to the diagnosis. SETTING and PARTICIPANTS: The experiment was collected and completed in Reaearch Department of Sun Yat-Sen Cancer Center.Biopsy specimens from the nasopharynx of 65 cases of pathologically confirmed primary NPC without any therapy in the Sun Yat-Sen Univrsity Cancer Center were collected between the year 1998 and 2000 to survey. INTERVENTION: After the purification of cancerous cells from NPC biopsies with many noncancerous lymphocytes, interphase fluorescent in situ hybridization(FISH) and PCR-LOH/MI analysis of the somatic alterations of chromosomes 1pter in 65 cases of NPC biopsies were performed by using 1pter-related probe, TelVysion 1p, and telomere-linked microsatellite polymorphism site, D1S243,respectively. MAIN TOUCOME MEASURES: The abnormalities such as chromosome deletion, amplification and microsatellite instabilities(MI) and their clinical implications were examined and investigated. RESULTS:The somatic alterations of chromosome 1pter of NPC were detected in 20 of 65 cases with NPC, 8 of which showed allelic deletion,7 amplification and 5 both simultaneously.In available 44 patients with clinical stages, 2 of the 4 NPC cases in the early clinical stage were proved to be aberrations in chromosome 1pter, whereas 30.0% (12/40) of NPC patients in advanced clinical stage showed somatic structural aberrations of chromosome 1pter(χ 2=0.0655,P >0.05).PCR-LOH/MI analysis indicated that, out of the matched 31 NPC biopsies,16 had detectable aberrations, including 13 microsatellite instability(MI),2 homozygous deletion(HD) and 1 loss of heterozygosity

  14. Prevalence of asymptomatic urinary abnormalities among adolescents

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    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.

  15. Spectrum of lithium induced thyroid abnormalities: a current perspective

    Directory of Open Access Journals (Sweden)

    Kibirige Davis

    2013-02-01

    Full Text Available Abstract Background Lithium is an integral drug used in the management of acute mania, unipolar and bipolar depression and prophylaxis of bipolar disorders. Thyroid abnormalities associated with treatment with lithium have been widely reported in medical literature to date. These include goitre, hypothyroidism, hyperthyroidism and autoimmune thyroiditis. This current review explores the varied thyroid abnormalities frequently encountered among patients on lithium therapy and their management, since lithium is still a fundamental and widely drug used in psychiatry and Internal Medicine. Methods PubMed database and Google scholar were used to search for relevant English language articles relating to lithium therapy and thyroid abnormalities up to December 2012. The search terms used were lithium treatment, thyroid abnormalities, thyroid dysfunction, goitre, hypothyroidism, hyperthyroidism, thyrotoxicosis, autoimmune thyroiditis, lithium toxicity, treatment of affective disorders and depression and side effects of antipsychotic drugs. Reference lists of the identified articles were further used to identify other studies. Results Lithium affects normal thyroid functioning through multiple mechanisms. At the cellular level, it decreases thyroid hormone synthesis and release. It also decreases peripheral deiodination of tetraiodothyronine (T4 or thyroxine by decreasing the activity of type I 5’ de-iodinase enzyme. Hypothyroidism and goitre (clinically and/ultrasonographically detected are the most prevalent thyroid abnormalities among patients on long term lithium therapy. Lithium induced hyperthyroidism is very infrequent. Lithium increases the propensity to thyroid autoimmunity in susceptible individuals due to its effect of augmenting the activity of B lymphocytes and reducing the ratio of circulating suppressor to cytotoxic T cells. Conclusions Thyroid function tests (serum thyroid stimulating hormone, free thyroid hormones-T4 and

  16. Cortical Abnormalities in ADHD

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-12-01

    Full Text Available Grey-matter abnormalities at the cortical surface and regional brain size were mapped by high-resolution MRI and surface-based, computational image analytical techniques in a group of 27 children and adolescents with attention deficit hyperactivity disorder (ADHD and 46 controls, matched by age and sex, at the University of California at Los Angeles.

  17. Neurological abnormalities predict disability

    DEFF Research Database (Denmark)

    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...

  18. Chromosomal abnormalities in patients with sperm disorders

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  20. 围绝经期异常子宫出血200例的临床与病理分析%Clinical and pathological analysis of 200 cases of perimenopausal abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    马辉平; 吕淑兰; 周扬

    2013-01-01

    目的 探讨围绝经期异常子宫出血的发病原因及病理变化.方法 对200例39~55岁围绝经期异常子宫出血患者的临床及病理资料进行回顾性分析,总结不同年龄组病理类型分布特点,分析各种病理类型的临床相关因素.结果 200例患者中,功能失调性子宫出血占74.5%,其中39~45岁占56.2%;子宫内膜不典型增生占7.5%,其中51~55岁占40%;子宫内膜癌占5.0%,其中51~55岁占60.0%;其他良性病变占13%.患者的年龄、出血时间、高危因素与子宫内膜病理分型存在关联性(χ2值分别为37.32、2 118.45、10.04,均P<0.01).结论 功能失调性子宫出血是围绝经期39~50岁年龄阶段异常子宫出血的主要原因,但51~55岁年龄阶段在子宫内膜不典型增生及子宫内膜癌发病比例较高.存在高危因素的围绝经期异常子宫出血妇女其发生子宫内膜癌的危险性明显高于无高危因素的患者,随着年龄增大、出血时间延长,子宫内膜癌发病危险性增加.%Objective To explore the causes and pathological changes of perimenopausal abnormal uterine bleeding. Methods Retrospective analysis was conducted to analyze the clinical and pathological data of 200 cases aged 39-55 years old with perimenopausal abnormal uterine bleeding. Distribution characteristics of pathological types of different age group were summarized and clinical related factors of each pathological type were analyzed. Results In 200 patients, patients with dysfunctional uterine bleeding occupied 74. 5% , among whom 56. 2% were patients aged 39-45 years old. Patients with endometrial atypical hyperplasia occupied 7. 5% , and those aged 51-55 years old accounted for 40%. Patients with endometrial carcinoma accounted 5. 0% , among whom 60. 0% were aged 51-55 years old. Other benign lesions accounted for 13%. Age, bleeding time and risk factors were correlated with endometrial pathological type(χ2 value was 37.32, 2 118.45 and 10. 04, respectively, all P

  1. 宫腔镜联合B超诊断异常子宫出血124例临床分析%Clinical Analysis of Hysteroscopy plusB Ultrasound in Diagnosis of 124 Cases of Abnormal Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    吴俊改; 韩红敬; 黄秀兰; 李彦军; 刘宝芝; 李红华

    2011-01-01

    Objective: To study hysteroscopy combinedType-B ultrasonic exceeds abnormal uterine bleeding in the diagnosis and treatment of clinical value. Methods: A total of 124 cases of abnormal uterine bleeding were retrospectively analyzed. All the patients were performed hysteroscopy plus Bultrasound detection. The materials removed or scraped off from theuterine cavity were sent for histologi-calexamination. Results: 124 patients were diagnosed by pathological examination for endometrial polyps 84 cases (67.7%), combined with cervical polyp 10 cases; Endome- trial hyperplasia disease in 16 (12.9%), including simple hyperplasia in 12 cases, complexity hyperplasia in 4; Endometriosis dysplasia 1 cases (0.8%); Submucosal uterine fibroids in 12 cases (9.7%); Sample endometrial adenocar-cinoma 6 patients (4.8%); Endometritis 3 cases (2.4%); Embryos residues in 2 cases (1.6%). Conclusion: Hysteroscopy plus Bultrasound is the best detection for diagnosis of abnormal uterine bleeding.%目的:探讨宫腔镜联合B超在诊治异常子宫出血的临床价值.方法:对124例异常子宫出血的病例进行回顾性分析,所有患者作B超及宫腔镜检查,宫腔内切除物或刮出物均送病理检查.结果:124例患者经病理检查确诊为子宫内膜息肉84例(67.7%),合并宫颈息肉10例;子宫内膜增生症16例(12.9%),其中单纯性增生12例,复杂性增生4例;子宫内膜不典型增生l例(0.8%);子宫粘膜下肌瘤12例(9.7%);子宫内膜样腺癌6例(4.8%);子宫内膜炎3例(2.4%);胚物残留2例(1.6%).结论:宫腔镜联合B超检查是诊断异常子宫出血最好的方法.

  2. The Clinical Effect Observation on the Treatment of Abnormal Uterine Bleeding by Hysteroscopy%宫腔镜治疗子宫异常出血的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    栾立娟

    2015-01-01

    目的:观察宫腔镜对子宫异常出血患者的临床治疗效果。方法搜集2013年6月~2014年6月我院收治子宫异常出血患者36例,按照不同治疗方式进行分组。对观察组18例进行宫腔镜治疗,对照组18例进行常规治疗,观察两组疗效,并分析对比。结果与对照组相比,观察组治疗有效率较高,月经改善有差异,有统计学意义(P<0.05)。结论宫腔镜治疗子宫异常出血的临床效果较好。%Objective To observe the clinical treatment of the abnormal uterine bleeding by hysteroscopy. Methods We divided the 36 cases patients into the control group(18 cases)and the observation group(18 cases). Al the patients were chosen from June 2013 to June 2014,the observation group adopted the hysteroscope treatment and the control group adopted the conventional treatment,we compared the difference between the two groups. Results The treatment effectiveness in the observation group was much higher than the control group,the menstrual also improved,it was in a high treatment efficiency and obvious difference between the two groups and the statistical y significant(P<0.05). Conclusion It is good to adopt the hysteroscope treatment on abnormal uterine bleeding.

  3. Misoprostol for pre-term labor induction in the second trimester: Role of medical history and clinical parameters for prediction of time to delivery.

    Science.gov (United States)

    di Liberto, Alexander; Endrikat, Jan; Frohn, Sandra; Solomayer, Erich; Ertan, Kubilay

    2014-01-01

    Serious fetal malformations and/or chromosome aberrations detected by modern diagnostic tools in early pregnancy require discussions on induced abortion with pregnant women. Competent counseling includes prediction of the time needed for the whole abortion process. In an attempt to refine our predictions, we evaluated the impact of 11 medical history and clinical variables on time to delivery. We performed a retrospective chart analysis on 79 women submitted for pre-term abortion because of fetal anomalies. Abortion was induced by vaginal application of misoprostol (prostaglandine E1, Cytotec™, Pfizer, New York, USA). We investigated 11 medical history and clinical variables for their impact on the percentage of women delivering within 24 hours (primary endpoint) and on the mean induction-delivery time interval (secondary endpoint). Fifty-three percent (42/79) of women delivered within 24 hours; 83.6% (66/79) delivered within 48 hours. A total of 83.3% of women with a history of late abortion delivered within 24 hours, whereas 50.7% without this history did. Mean induction-delivery time interval was 12.3 hours versus 35.5 hours, respectively. For history of early abortion, the figures were 65.2% versus 48.2% for delivery within 24 hours and 15.6 hours versus 32.5 hours for mean induction-delivery time interval. Current weight of fetus >500 g, weight of last previous newborn of ≤3500 g, previous pregnancies, premature rupture of membranes, and an elevated CRP of >0.5 mg/dL also cut time to delivery. Surprisingly, maternal and gestational age had no remarkable or consistent impact on the mean induction-delivery time interval. None of the differences reached statistical significance. Eighty-three percent of women needed 1000 μg or less for successful delivery. Neither variables of medical history nor specific clinical variables allow for precise prediction of time to delivery in the second trimester. Certain parameters, however, show a trend to reduce the

  4. Splanchnic Artery Stenosis and Abdominal Complaints : Clinical History Is of Limited Value in Detection of Gastrointestinal Ischemia

    NARCIS (Netherlands)

    ter Steege, R. W. F.; Sloterdijk, H. S.; Geelkerken, R. H.; Huisman, A. B.; van der Palen, J.; Kolkman, J. J.

    Splanchnic artery stenosis is common and mostly asymptomatic and may lead to gastrointestinal ischemia (chronic splanchnic syndrome, CSS). This study was designed to assess risk factors for CSS in the medical history of patients with splanchnic artery stenosis and whether these risk factors can be

  5. Splanchnic artery stenosis and abdominal complaints: clinical history is of limited value in detection of gastrointestinal ischemia

    NARCIS (Netherlands)

    ter Steege, R.W.; Sloterdijk, H.S.; Geelkerken, R.H.; Huisman, A.B.; van der Palen, Jacobus Adrianus Maria; Kolkman, J.J.

    2012-01-01

    BACKGROUND: Splanchnic artery stenosis is common and mostly asymptomatic and may lead to gastrointestinal ischemia (chronic splanchnic syndrome, CSS). This study was designed to assess risk factors for CSS in the medical history of patients with splanchnic artery stenosis and whether these risk

  6. Liver abnormalities in pregnancy.

    Science.gov (United States)

    Than, Nwe Ni; Neuberger, James

    2013-08-01

    Abnormalities of liver function (notably rise in alkaline phosphatase and fall in serum albumin) are common in normal pregnancy, whereas rise in serum bilirubin and aminotransferase suggest either exacerbation of underlying pre-existing liver disease, liver disease related to pregnancy or liver disease unrelated to pregnancy. Pregnant women appear to have a worse outcome when infected with Hepatitis E virus. Liver diseases associated with pregnancy include abnormalities associated hyperemesis gravidarum, acute fatty liver disease, pre-eclampsia, cholestasis of pregnancy and HELLP syndrome. Prompt investigation and diagnosis is important in ensuring a successful maternal and foetal outcome. In general, prompt delivery is the treatment of choice for acute fatty liver, pre-eclampsia and HELLP syndrome and ursodeoxycholic acid is used for cholestasis of pregnancy although it is not licenced for this indication. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Nitrofurantoin and congenital abnormalities

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Sørensen, Henrik Toft;

    2001-01-01

    Objective: To study human teratogenic potential of oral nitrofurantoin treatment during pregnancy. Materials and Methods: Pair analysis of cases with congenital abnormalities and matched population controls in the population-based dataset of the Hungarian Case-Control Surveillance of Congenital...... or fetuses with Down’s syndrome (patient controls), 23 (2.8%) pregnant women were treated with nitrofurantoin. The above differences between population controls and cases may be connected with recall bias, because the case-control pair analysis did not indicate a teratogenic potential of nitrofurantoin use...... during the second and the third months of gestation, i.e. in the critical period for major congenital abnormalities. Conclusion: Treatment with nitrofurantoin during pregnancy does not present detectable teratogenic risk to the fetus....

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Clinical value of prenatal ultrasound diagnosis of fetal central nervous system abnormalities%产前超声诊断胎儿神经系统畸形的临床价值

    Institute of Scientific and Technical Information of China (English)

    韩磊; 沈亚梅; 彭建美; 管湘平; 王珍芳; 邹荣莉

    2016-01-01

    Objective To evaluate the clinical value of prenatal routine ultrasound examination in screening of fetal central nervous system abnormalities.Methods Ultrasound imaging features of 27 cases of abnormalities in central nervous system confirmed by autopsy or follow-up were analyzed retrospectively.Results Among these cases, there were 11 cases of spine bifida and meningomyelocele, 3 cases of Dandy-Walker syndrome ( DWS) , 3 cases of cephalocele, 3 cases of hydrocephalus, 1 case of anencephaly, 2 cases of holoprosencephaly, 2 cases of agenesis of corpus callosum, 1 cases of choroid plexus cysts, and 1 case of arachnoid cyst.The accuracy, misdiagnosis rate and missed diagnosis rate of prenatal ultrasound examination was 88.90%, 7.40%and 7.40%, respectively.Conclusion Prenatal ultrasound examination has high diagnostic accuracy for fetal central nervous system malformations, and it has very important clinical value.%目的 探讨产前常规超声检查在胎儿神经系统畸形筛查方面的临床应用价值.方法 对27例经随访及引产证实的中枢神经系统畸形胎儿进行回顾性分析.结果 27例畸形儿中,其中脊柱裂和脊髓脊膜膨出11例,Dandy-Walker畸形3例,脑脊膜膨出3例,脑积水3例,无脑儿1例,全前脑2例,胼胝体发育不全2例,脉络丛囊肿1例,蛛网膜囊肿1例,产前超声诊断准确率为88.90%,误诊率7.40%,漏诊率7.40%.结论 产前超声检查对胎儿中枢神经系统畸形诊断准确率高,具有十分重要的临床应用价值.

  10. Clinical assessment of fluorescence in situ hybridization for prenatal diagnosis of chromosomal abnormalities%荧光原位杂交技术在胎儿染色体异常产前诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    傅文婷; 潘小英; 尹爱华; 卢健; 郭莉; 吴菁

    2011-01-01

    Objective; To analyze the clinical application of fluorescence in situhybridization (FISH) on the prenatal diagnosis of chromosomal abnormalities. Methods; To assay, the prenatal diagnosis of chromosome aneuploidies by FISH analysis of chromosome -specific probes (Chromosome 13, 21, 18, X, Y) in interphase amniocytes of 1128 pregnant women of 16 -22weeks of gestational age, comparing with the assay of with control group which the amniotic cell chromosome karyotyping. Results; All the 1128 cases had been successfully detected by FISH, including 1081 normal cases and 20 cases of numerical abnormality, which were consistent with the karyotype analysis. What is more, 27 cases of chromosomal structural abnomalities were failed to detected by FISH. Conclusion; With the advantages of speediness, simplicity, high accuracy, strong specificity, et al, FISH had a broad scope in future clinical applications, and had great significances in cytogenetic pregnatal diagnosis.%目的 探讨荧光原位杂交(FISH)技术在检测胎儿染色体异常的临床应用.方法 选用13、21、18、X、Y特异性探针对1128例孕16-22周有产前诊断指征的妊娠妇女羊水间期细胞进行分析,并与同时进行的羊水细胞培养核型分析结果进行对照.结果 被检1128例羊水间期细胞FISH检测均成功,其中检出正常核型1081例,数目异常核型20例,与常规细胞染色体核型分析结果一致,另外27例结构异常FISH技术未能检出.结论 FISH技术检测胎儿染色体数目异常具有快速、简便、准确性高、特异性强等优点,有较大的临床应用价值,并对产前细胞遗传学诊断有重要意义.

  11. Chromosomal phenotypes and submicroscopic abnormalities

    Directory of Open Access Journals (Sweden)

    Devriendt Koen

    2004-01-01

    Full Text Available Abstract The finding, during the last decade, that several common, clinically delineated syndromes are caused by submicroscopic deletions or, more rarely, by duplications, has provided a powerful tool in the annotation of the human genome. Since most microdeletion/microduplication syndromes are defined by a common deleted/duplicated region, abnormal dosage of genes located within these regions can explain the phenotypic similarities among individuals with a specific syndrome. As such, they provide a unique resource towards the genetic dissection of complex phenotypes such as congenital heart defects, mental and growth retardation and abnormal behaviour. In addition, the study of phenotypic differences in individuals with the same microdeletion syndrome may also become a treasury for the identification of modifying factors for complex phenotypes. The molecular analysis of these chromosomal anomalies has led to a growing understanding of their mechanisms of origin. Novel tools to uncover additional submicroscopic chromosomal anomalies at a higher resolution and higher speed, as well as the novel tools at hand for deciphering the modifying factors and epistatic interactors, are 'on the doorstep' and will, besides their obvious diagnostic role, play a pivotal role in the genetic dissection of complex phenotypes.

  12. Heterotaxy syndromes and abnormal bowel rotation

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  13. Prevalence of asymptomatic urinary abnormalities among adolescents.

    Science.gov (United States)

    Fouad, Mohamed; Boraie, Maher

    2016-05-01

    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 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. Asymptomatic 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%) individuals had adolescents from rural than urban areas (P adolescents in our population.

  14. Abnormal pressures as hydrodynamic phenomena

    Science.gov (United States)

    Neuzil, C.E.

    1995-01-01

    So-called abnormal pressures, subsurface fluid pressures significantly higher or lower than hydrostatic, have excited speculation about their origin since subsurface exploration first encountered them. Two distinct conceptual models for abnormal pressures have gained currency among earth scientists. The static model sees abnormal pressures generally as relict features preserved by a virtual absence of fluid flow over geologic time. The hydrodynamic model instead envisions abnormal pressures as phenomena in which flow usually plays an important role. This paper develops the theoretical framework for abnormal pressures as hydrodynamic phenomena, shows that it explains the manifold occurrences of abnormal pressures, and examines the implications of this approach. -from Author

  15. Semen abnormalities :Clinical investigation(Ⅱ)

    Institute of Scientific and Technical Information of China (English)

    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.

  16. Clinical Study of Respiratory Function and Difference in Pneumonia History between Alzheimer’s Disease and Vascular Dementia Groups

    OpenAIRE

    2014-01-01

    [Purpose] This study compared respiratory function and differences in pneumonia history between Alzheimer’s disease and vascular dementia groups. [Subjects] Fifty-eight inpatients in the dementia treatment ward in a psychiatric facility were enrolled. [Methods] Patients underwent respiratory function testing twice using an 80-cm party horn. The Mini-Mental State Examination was also performed and motor functions were evaluated. Patient characteristics were obtained from medical records. [Resu...

  17. Feeling Abnormal: Simulation of Deviancy in Abnormal and Exceptionality Courses.

    Science.gov (United States)

    Fernald, Charles D.

    1980-01-01

    Describes activity in which student in abnormal psychology and psychology of exceptional children classes personally experience being judged abnormal. The experience allows the students to remember relevant research, become sensitized to the feelings of individuals classified as deviant, and use caution in classifying individuals as abnormal.…

  18. The natural history of medium-chain acyl CoA dehydrogenase deficiency in the Netherlands : Clinical presentation and outcome

    NARCIS (Netherlands)

    Derks, Terry G J; Reijngoud, Dirk-Jan; Waterham, Hans R; Gerver, Willem-Jan M; van den Berg, Maarten P; Sauer, Pieter J J; Smit, G Peter A

    2006-01-01

    OBJECTIVES: To describe the clinical presentation and long-term follow-up of a large cohort of patients with medium-chain acyl-CoA dehydrogenase (MCAD) deficiency. STUDY DESIGN: A nationwide, retrospective analysis of clinical presentation and follow-up in 155 Dutch patients with MCAD deficiency. RE

  19. Estimating the risk of gestational diabetes mellitus : a clinical prediction model based on patient characteristics and medical history

    NARCIS (Netherlands)

    van Leeuwen, M.; Opmeer, B. C.; Zweers, E. J. K.; van Ballegooie, E.; ter Brugge, H. G.; de Valk, H. W.; Visser, G. H. A.; Mol, B. W. J.

    2010-01-01

    Objective To develop a clinical prediction rule that can help the clinician to identify women at high and low risk for gestational diabetes mellitus (GDM) early in pregnancy in order to improve the efficiency of GDM screening. Design We used data from a prospective cohort study to develop the clinic

  20. Menstrual abnormalities in the adolescent abuse of the birth control pill.

    Science.gov (United States)

    Spence, J E

    1983-01-01

    This paper reviews the physiology of menstrual abnormalities in the adolescent and suggests a management protocol based on this pathophysiological framework. Initial discussion covers the physiology of puberty and menstruation. Menstrual abnormalities occur often in the adolescent. Excessive bleeding is the most dramatic symptom, but the most common complaints concern the frequency, duration, and variability of menstrual flow. Often the oral contraceptive (OC) pill is the panacea for the patient, her family, and the physician. This solution has several advantages. It is attractive, inexpensive, easy to use, and regulates the menstrual cycle. Although menstrual abnormalities are seemingly corrected, the treatment is not physiological. This use of the OC pill may mask the underlying problem and delay the diagnosis of a medical disorder and will interfere with the normal maturation of the hypothalamic-pituitary-ovarian axis, which is necessary for regular menses to occur. The diagnosis of anovulatory bleeding is one of exclusion. Both local and systemic problems can mimic dysfunctional bleeding. Pregnancy must always be considered but is often overlooked in the young teenager. A satisfactory history and physical examination, including a vaginal and/or rectal examination, is paramount to rule out other causes. Coagulation defects may play a significant role in adolescent bleeding abnormalities. Endocrine disorders, including thyroid disease, Cushing's syndrome, hypoprolactinemia, and acromegaly, can result in menstrual abnormalities. After a meticulous history and physical examination, any teenager presenting with abnormal vaginal bleeding should not exhibit any physical abnormality other than the signs and symptoms of blood loss. The initial laboratory tests need not be extensive but must include a hemoglobin estimation, blood smear, platelet count, bleeding time, prothrombin time, partial thromboplastin time, and thyroid function tests. Only the simplest

  1. Clinical application of hysteroscopy in the diagnosis and therapy of pa-tients with abnormal uterine bleeding%宫腔镜在异常子宫出血诊治中的临床应用

    Institute of Scientific and Technical Information of China (English)

    厉霞玲; 刘德佩; 张月存; 冷丽丽

    2015-01-01

    Objective To explore the clinical value of hysteroscopy in the diagnosis and treatment of patients with ab-normal uterine bleeding. Methods Clinic date of 65 cases of abnormal uterine bleeding admitted in Nanjing Integrated Traditional Chinese and Western Medicine Hospital, Nanjing University of Chinese Medicine from January to November 2014 were retrospectively analyzed. The patients were checked by hysteroscopy, lesion removal, biopsy for diagnosis and treatment. Through the comparative analysis of the above methods, the clinical application of hysteroscopy in the diagnosis and treatment of abnormal uterine bleeding was analyzed. Results Hysteroscopy found that various degree of endometrial hyperplasia in 20 cases,13 cases of endometrial polyps, 16 cases of endometritis, 9 cases of endometrial hyperplasia or secretory phase change, 4 cases of uterine fibroids, 3 cases of pregnancy residues. After hysteroscopy, all patients were given biopsy,curettage, lesion removal (large polyps and submucosal fibroids were givn hysteroscopic polypectomy). Pathology showed that 27 cases of various degree of endometrial hyperplasia, 10 cases of endometrial polyps, 9 cases of endometritis, 4 cases of endometrial hyperplasia or secretory phase change, submucous myoma of uterus 2 cases, 3 cases of pregnancy residues. The coincidence rate of diagnosis between pathology and pathological examination was 78.46%. Postoperative follow-up, 5 cases of recurence, recurence rate was 9.09%; 50 cases of cure, the cure rate was 93.85%. Conclusion Hysteroscopy can directly observe the intrauterine pathologies, and to assist pathological examination in the diagnosis and treatment of abnormal uterine bleeding, achieve the goal of comprehen-sive, detailed and accurate, is worthy of clinical promotion.%目的:探讨宫腔镜在异常子宫出血诊治中的临床价值。方法回顾分析2014年1~11月南京中医药大学附属南京市中西医结合医院异常子宫出血患者65例的临床

  2. Electrocardiographic abnormalities in patients with subarachnoid hemorrhage.

    Science.gov (United States)

    Sommargren, Claire E

    2002-01-01

    Subarachnoid hemorrhage is a serious neurological disorder that is often complicated by the occurrence of electrocardiographic abnormalities unexplained by preexisting cardiac conditions. These morphological waveform changes and arrhythmias often are unrecognized or misinterpreted, potentially placing patients at risk for inappropriate management. Many previous investigations were retrospective and relied on data collected in an unsystematic manner. More recent studies that included use of serial electrocardiograms and Holter recordings have provided new insight into the high prevalence of electrocardiographic changes in subarachnoid hemorrhage. Research on the prevalence, duration, and clinical significance of these electrocardiographic abnormalities and on associated factors and etiological theories is reviewed.

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

    Institute of Scientific and Technical Information of China (English)

    赵献平; 徐芳

    2015-01-01

    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。%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.

  4. Russia: An Abnormal Country

    Directory of Open Access Journals (Sweden)

    Steven Rosefielde

    2005-06-01

    Full Text Available Andrei Shleifer and Daniel Treisman recently rendered a summary verdict on the post Soviet Russian transition experience finding that the Federation had become a normal country with the west's assistance, and predicting that it would liberalize and develop further like other successful nations of its type. This essay demonstrates that they are mistaken on the first count, and are likely to be wrong on the second too. It shows factually, and on the norms elaborated by Pareto, Arrow and Bergson that Russia is an abnormal political economy unlikely to democratize, westernize or embrace free enterprise any time soon

  5. Abnormal ionization in sonoluminescence

    Science.gov (United States)

    Zhang, Wen-Juan; An, Yu

    2015-04-01

    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. Project supported by the Research Fund for the Doctoral Program of Higher Education of China (Grant No. 20120002110031) and the National Natural Science Foundation of China (Grant No. 11334005).

  6. Craniofacial abnormalities among patients with Edwards Syndrome

    Directory of Open Access Journals (Sweden)

    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.

  7. Relationship Between Migraine and Abnormal EEG Findings in Children

    Directory of Open Access Journals (Sweden)

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

    Directory of Open Access Journals (Sweden)

    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.

  9. [Pregnancy and delivery in patients with a personal history of cesarean section in Dakar: epidemiological, clinical, therapeutic and prognostic aspects].

    Science.gov (United States)

    Koulimaya-Gombet, Cyr Espérance; Diouf, Abdoul Aziz; Diallo, Moussa; Dia, Anna; Sène, Codou; Moreau, Jean Charles; Diouf, Alassane

    2017-01-01

    The aim of our study was to determine hospitalization rate for vaginal birth after cesarean section in Pikine, to evaluate the quality of the management of pregnant women with previous cesarean section and to determine prognostic factors of the outcome of a trial of scar. We conducted a retrospective study based on medical records and operational protocols of patients who underwent vaginal birth after cesarean section over the period 1 January 2010 - 31 December 2011. We analyzed socio-demographic data, pregnancy follow-up, therapeutic modalities and prognosis. Data were collected and analyzed using Microsoft Office Excel 2007 software and SPSS software 17.0. The frequency of vaginal births after cesarean section was 9.6%. The average age of our patients was 29.4 years. Primiparous women accounted for 54%. Short spacing interval between births was found in 52.6% of cases. Based on the number of cesarean sections, the breakdown was as follows: patients with a history of one previous cesarean section (79.8%), patients with a history of two previous caesarean sections (17.9%) and patients with a history of three previous caesarean sections (2.3%). The number of antenatal consultations performed was greater than or equal to 3 in 79.8% of cases. Patients undergoing evacuation accounted for 54.2% and they were already in labor at the time of admission in 81.7% of cases. Trial of scar was authorized in 177 patients (34.3%) and, at the end of this test, 147 patients (83%) had vaginal birth, of whom 21.7% by vacuum extraction. Cesarean section was performed in 71.4% of cases with 245 emergency cesarean sections and 93 scheduled cesarean sections. A history of vaginal birth was a determining factor in normal delivery (p = 0.0001). There was also a significant relationship between mode of admission and decision to perform a cesarean section (p = 0.0001). Maternal mortality was 0.4%. Perinatal mortality rate was 28.2‰ of live births. We are witnessing a dramatic increase of

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

    Institute of Scientific and Technical Information of China (English)

    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.

  11. Advances in understanding paternally transmitted Chromosomal Abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. Consumption of a cranberry juice beverage lowered the number of clinical urinary tract infection episodes in women with a recent history of urinary tract infection.

    Science.gov (United States)

    Maki, Kevin C; Kaspar, Kerrie L; Khoo, Christina; Derrig, Linda H; Schild, Arianne L; Gupta, Kalpana

    2016-06-01

    Urinary tract infections (UTIs) are among the most common bacterial infections and are often treated with antibiotics. Concerns about multidrug-resistant uropathogens have pointed to the need for safe and effective UTI-prevention strategies such as cranberry consumption. We assessed the effects of the consumption of a cranberry beverage on episodes of clinical UTIs. In this randomized, double-blind, placebo-controlled, multicenter clinical trial, women with a history of a recent UTI were assigned to consume one 240-mL serving of cranberry beverage/d (n = 185) or a placebo (n = 188) beverage for 24 wk. The primary outcome was the clinical UTI incidence density, which was defined as the total number of clinical UTI events (including multiple events per subject when applicable) per unit of observation time. The dates of the random assignment of the first subject and the last subject's final visit were February 2013 and March 2015, respectively. The mean age was 40.9 y, and characteristics were similar in both groups. Compliance with study product consumption was 98%, and 86% of subjects completed the treatment period in both groups. There were 39 investigator-diagnosed episodes of clinical UTI in the cranberry group compared with 67 episodes in the placebo group (antibiotic use-adjusted incidence rate ratio: 0.61; 95% CI: 0.41, 0.91; P = 0.016). Clinical UTI with pyuria was also significantly reduced (incidence rate ratio: 0.63; 95% CI: 0.40, 0.97; P = 0.037). One clinical UTI event was prevented for every 3.2 woman-years (95% CI: 2.0, 13.1 woman-years) of the cranberry intervention. The time to UTI with culture positivity did not differ significantly between groups (HR: 0.97; 95% CI: 0.56, 1.67; P = 0.914). The consumption of a cranberry juice beverage lowered the number of clinical UTI episodes in women with a recent history of UTI. This study was registered at clinicaltrials.gov as NCT01776021. © 2016 American Society for Nutrition.

  13. A study on the relationship with 61 rare cases of abnormal chromosome karyotype and clinical diseases%61例国内外首报的染色体异常核型与临床关系研究

    Institute of Scientific and Technical Information of China (English)

    涂向东; 张宝珍; 曾健; 丛学文; 王志红; 周游

    2011-01-01

    目的 了解国内外首报的染色体异常与生育缺陷和小儿智力低下的关系.方法 抽取6784例患有生育缺陷和小儿智力低下患者外周血,进行常规染色体分析,部份患者孕中期抽取羊水、脐带血进行染色体核型分析.结果 发现染色体异常核型714例,其中61例为国内外首次发现的染色体异常核型.通过对61例特殊患者进行临床病例分析,发现29例患者有习惯性流产史,占总数48%,10例患者为无精子或严重少精子症,占总数16%,5例患者为不育症,占总数0.8%,5例患者精子畸形率>30%,占总数0.8%,3例表现为原发性闭经,占总数0.5%,2例生育畸形儿,占总数0.3%,2例智力低下,占总数0.3%,3例胎儿发育畸形,占总数0.5%,2例平衡易位携带者,占总数0.3%.结论 染色体异常是导致生育缺陷和小儿智力低下的遗传因素之一.%Objective: To study the relationship of chromosome aberration to birth defects and infantile mental retardation. Methods: Peripheral blood from 6784 patients with infertility, habitual abortion, dead fetus or abnormal birth and amniotic fluid of the middle stage of pregnancy or cord blood from part of those patients was sampled. Chromosome analysis was performed on cultured lymphocytes. Results: There were 714 cases of abnormal chromosome karyotype including 61 rare cases reported firstly in the world. Further clinical analysis showed 29 cases of spontaneous abortion (48%), 10 cases of oligospermia or azoospermia ( 16% ), 5 cases of infertility (0.8% ), 5 cases of teratospermia (0.8% ) , 3 cases of primary amenorrhea (0.5% ) , 2 cases of congenital malformation (0.3% ), 2 cases of mental retardation (0.3% ), 3 cases of fetal development malformation (0.5% ) and 2 carrier of chromosomal balanced translocation (0.3% ). Conclusion: Chromosomal abnormality is one of the genetic factors leading to birth defects and infantile mental retardation.

  14. 一次性宫腔组织吸引管在异常子宫出血诊断中的临床价值%Clinical value of disposable uterine cavity tissue suction tube in diagnosing abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    郑妮; 孙奇; 韦静

    2015-01-01

    Objective To explore the clinical value of the disposable uterine cavity tissue suction tube in diagnosing abnormal u‐terine bleeding .Methods Seventy‐five patients ,who needed an endometrial biopsy because of abnormal uterine bleeding ,were se‐lected for this study .An endometrial biopsy was performed by a disposable uterine cavity tissue suction tube before the conventional suction dilatation and curettage (D&C) .The sample satisfactory rate and the diagnose accordance rate of the two methods were compared .Results The sample satisfactory rate of the disposable uterine cavity tissue suction tube and of the D&C was 85 .3%(64/75) and 94 .7% (71/75) respectively .The difference was not statistically significant(P>0 .05) .The diagnose accordance rate of the disposable uterine cavity tissue suction tube and the D&C was 90 .3% (56/62) and 93 .5% (58/62) respectively .The differ‐ence was not statistically significant(P>0 .05) .Conclusion To a certain extent ,endometrial biopsy performed by disposable uter‐ine cavity tissue suction tube can be a substitute for D&C as the initial inspection to assess abnormal uterine bleeding ,for its econo‐my ,efficiency and safety .%目的:探讨一次性宫腔组织吸引管在异常子宫出血诊断中的临床价值。方法选取因异常子宫出血需进行子宫内膜活检的患者75例,在接受常规分段诊刮术前利用一次性宫腔组织吸引管先获取子宫内膜组织。比较两种方法的取材标本满意率和诊断符合率。结果一次性宫腔组织吸引管取材标本满意率为85.3%(64/75),常规分段诊刮术取材标本满意率为94.7%(71/75),差异无统计学意义(P>0.05);一次性宫腔组织吸引管取材诊断符合率为90.3%(56/62),常规分段诊刮术取材诊断符合率为93.5%(58/62),差异无统计学意义(P>0.05)。结论一次性宫腔组织吸引管经济、有效、安全,可在一定程度上

  15. 除湿液化汤联合前列安栓治疗精液液化异常的临床观察%Clinical Observation of Abnormal Sperm Liquefaction Treated with Chushi Yehua Tang and Qianlieanshuan

    Institute of Scientific and Technical Information of China (English)

    王旭初; 郑加涛

    2013-01-01

    Objective To observe the clinical efficacy on abnormal sperm liqueiaction treated with chushi yehua tang and qianlieanshuan. Methods One hundred and twenty patients of abnormal sperm liqueiaction were randomized into a treatment group( 60 cases )and a control group( 60 cases ). They were treated with the allied therapy of chushi yehua tang and qianlieanshuan and single application of qianlieanshuan respectively. One session of treatment was 30 days. The two sessions were observed continuously. The sperm liquefaction time and the other parameters were recorded. Results After two sessions of treatment, 11 cases were cured,27 cases effective remarkably, 16 cases effective and 6 cases failed in the treatment group;4 cases were cured, 12 cases effective remarkably, 14 cases effective and 30 cases failed in the control group. The difference in the total effective rate was significant statistically between the two groups( P 0. 05 ). Conclusion The allied therapy of chushi yehua tang and qianlieanshuan shortens significantly sperm liquefaction time. It achieves the significant, safe and reliable effects on abnormal sperm liquefaction.%目的 观察除湿液化汤联合前列安栓治疗精液液化异常的临床疗效.方法 将120例精液液化异常的患者,随机分为治疗组60例,对照组60例,分别选用除湿液化汤联合前列安栓和单独应用前列安栓作为治疗方法,30 d为1个疗程,连续观察2个疗程,记录精液液化时间及其他参数变化情况.结果 2个疗程后,治疗组痊愈11例,显效27例,有效16例,无效6例;对照组痊愈4例,显效12例,有效14例,无效30例,两组总有效率比较,差异有统计学意义(P<0.01).治疗组精液密度、精子活力、液化时间与治疗前比较差异有统计学意义(P<0.05);治疗组明显优于对照组,各项指标差异均有统计学意义(P<0.01);治疗后两组EPS中WBC含量比较治疗组优于对照组,差异有统计学意义(P<0.05).治疗后两

  16. Improving Clinical Practice: What Dentists Need to Know about the Association between Dental Fear and a History of Sexual Violence Victimisation

    Science.gov (United States)

    Larijani, Houman Hadad

    2015-01-01

    Anecdotal evidence suggests lack of dentist knowledge and uncertainty about how clinical practice can be improved when dealing with victims of sexual violence. This systematic review presents a synthesis of the available literature, which examined the association between dental fear and a history of sexual violence victimisation. All studies indicated, to various degrees, that dental fear is associated with a history of sexual violence victimisation. The analysis identified several common themes including a perception of lack of control, avoidance behaviours, experiences of flashbacks, feelings of embarrassment, difficulties with the physical proximity to the dentist, the sex of the dentist reminding patients of the perpetrator, being placed into a horizontal body position, the specific impact of fellatio, the smell of latex, experienced lack of knowledge of dental professionals leading to insensitive treatment as well as revictimisation experiences, and the occurrence of disproportionate dental problems among patients who had experienced event(s) of sexual violence. All these themes are discussed in detail. Specific strategies are offered to assist dental practitioners in providing sensitive treatment for patients with a history of sexual violence. Additionally, several suggestions are made that may assist both researchers and dental practitioners alike. PMID:25663839

  17. Improving Clinical Practice: What Dentists Need to Know about the Association between Dental Fear and a History of Sexual Violence Victimisation.

    Science.gov (United States)

    Larijani, Houman Hadad; Guggisberg, Marika

    2015-01-01

    Anecdotal evidence suggests lack of dentist knowledge and uncertainty about how clinical practice can be improved when dealing with victims of sexual violence. This systematic review presents a synthesis of the available literature, which examined the association between dental fear and a history of sexual violence victimisation. All studies indicated, to various degrees, that dental fear is associated with a history of sexual violence victimisation. The analysis identified several common themes including a perception of lack of control, avoidance behaviours, experiences of flashbacks, feelings of embarrassment, difficulties with the physical proximity to the dentist, the sex of the dentist reminding patients of the perpetrator, being placed into a horizontal body position, the specific impact of fellatio, the smell of latex, experienced lack of knowledge of dental professionals leading to insensitive treatment as well as revictimisation experiences, and the occurrence of disproportionate dental problems among patients who had experienced event(s) of sexual violence. All these themes are discussed in detail. Specific strategies are offered to assist dental practitioners in providing sensitive treatment for patients with a history of sexual violence. Additionally, several suggestions are made that may assist both researchers and dental practitioners alike.

  18. Improving Clinical Practice: What Dentists Need to Know about the Association between Dental Fear and a History of Sexual Violence Victimisation

    Directory of Open Access Journals (Sweden)

    Houman Hadad Larijani

    2015-01-01

    Full Text Available Anecdotal evidence suggests lack of dentist knowledge and uncertainty about how clinical practice can be improved when dealing with victims of sexual violence. This systematic review presents a synthesis of the available literature, which examined the association between dental fear and a history of sexual violence victimisation. All studies indicated, to various degrees, that dental fear is associated with a history of sexual violence victimisation. The analysis identified several common themes including a perception of lack of control, avoidance behaviours, experiences of flashbacks, feelings of embarrassment, difficulties with the physical proximity to the dentist, the sex of the dentist reminding patients of the perpetrator, being placed into a horizontal body position, the specific impact of fellatio, the smell of latex, experienced lack of knowledge of dental professionals leading to insensitive treatment as well as revictimisation experiences, and the occurrence of disproportionate dental problems among patients who had experienced event(s of sexual violence. All these themes are discussed in detail. Specific strategies are offered to assist dental practitioners in providing sensitive treatment for patients with a history of sexual violence. Additionally, several suggestions are made that may assist both researchers and dental practitioners alike.

  19. Chromosomal Abnormalities Associated with Neural Tube Defects (I: Full Aneuploidy

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2007-12-01

    Full Text Available Fetuses with neural tube defects (NTDs carry a risk of chromosomal abnormalities. The risk varies with maternal age, gestational age at diagnosis, association with other structural abnormalities, and family history of chromosome aberrations. This article provides an overview of chromosomal abnormalities associated with NTDs in embryos, fetuses, and newborn patients, and a comprehensive review of numerical chromosomal abnormalities associated with NTDs, such as trisomy 18, trisomy 13, triploidy, trisomy 9, trisomy 2, trisomy 21, trisomy 7, trisomy 8, trisomy 14, trisomy 15, trisomy 16, trisomy 5 mosaicism, trisomy 11 mosaicism, trisomy 20 mosaicism, monosomy X, and tetraploidy. NTDs may be associated with aneuploidy. Perinatal identification of NTDs should alert one to the possibility of chromosomal abnormalities and prompt a thorough cytogenetic investigation and genetic counseling.

  20. 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.

    Directory of Open Access Journals (Sweden)

    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.

  1. Routine history as compared to audio computer-assisted self-interview for prenatal care history taking.

    Science.gov (United States)

    Mears, Molly; Coonrod, Dean V; Bay, R Curtis; Mills, Terry E; Watkins, Michelle C

    2005-09-01

    To compare endorsement rates obtained with audio computer-assisted self-interview versus routine prenatal history. A crosssectional study compared items captured with the routine history to those captured with a computer interview (computer screen displaying and computer audio reading questions, with responses entered by touch screen). The subjects were women (n=174) presenting to a public hospital clinic for prenatal care. The prevalence of positive responses using the computer interview was significantly greater (p history for induced abortion (16.8% versus 4.0%), lifetime smoking (12.8% versus 5.2%), intimate partner violence (10.0% versus 2.4%), ectopic pregnancy (5.2% versus 1.1%) and family history of mental retardation (6.7% versus 0.6%). Significant differences were not found for history of spontaneous abortion, hypertension, epilepsy, thyroid disease, smoking during pregnancy, gynecologic surgery, abnormal Pap test, neural tube defect or cystic fibrosis family history. However, in all cases, prevalence was equal or greater with the computer interview. Women were more likely to report sensitive and high-risk behavior, such as smoking history, intimate partner violence and elective abortion, with the computer interview. The computer interview displayed equal or increased patient reporting of positive responses and may therefore be an accurate method of obtaining an initial history.

  2. Clinical feature and molecular diagnosis of abnormal Hb Shaare Zedek in a Chinese family%异常血红蛋白Hb Shaare Zedek家系的临床特征和分子诊断

    Institute of Scientific and Technical Information of China (English)

    黄健云; 杨新怀; 陈光辉; 李璐琳; 宋志彬; 莫和国; 林俊; 孙红; 曼志丹

    2012-01-01

    Objective To diagnose a rare variant Hb Shaare Zedek in a Chinese family,and describe its clinical feature.Methods Blood samples of seven members of three generation were collected.Standard blood routine analysis,hemoglobin electrophoresis and blood gas analysis were used for phenotype analysis.Gap-PCR and reverse dot blot analysis were used to detect common thalassemia mutations.DNA sequence analysis of the human α and β globin genes were used to identify the mutation site of these samples.Results The result of blood routine analysis was normal in the proband,but a abnormal hemoglobin band (22.4%,capillary assay) was found by hemoglobin electrophoresis.In the blood gas analysis,the partial pressure of oxygen and blood oxygen saturation were 72.0 mm Hg ( 1 mm Hg =0.133 kPa) and 93.0% in the proband.The heterozygous mutations in αl globin gene at codon 56 ( AAG > GAG)which leaded Glu substitution to Lys were identified in the proband.Other family members who carried the same mutation showed similar phenotype,with abnormal hemoglobin band ( 22.4% - 23.9%,capillary assay),low partial pressure of oxygen (59.0 - 72.0 mm Hg) and blood oxygen saturation (91.0% -93.0%).Conclusions The heterozygote of Hb Shaare Zedek leads to slight symptoms with abnormal hemoglobin band,decreased partial pressure of oxygen and blood oxygen saturation.Discovery of this mutation enriches the abnormal hemoglobin spetrum of Chinese people,and it is useful for the clinical diagnosis and genetic counseling of hemoglobinopathies.%目的 对1个罕见的异常血红蛋白Hb Shaare Zedek家系进行分子诊断,并探讨其临床特征.方法 采集该家系3代共7名成员的外周血标本,采用血常规、血红蛋白电泳和血气分析的方法分析临床特征;采用跨越断裂点PCR( gap-PCR)方法和反向点杂交方法检测常见地中海贫血基因突变;采用α、β珠蛋白基因全长测序确定突变位点.结果 该家系先证者的血常规结果正

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

    Science.gov (United States)

    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.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    , plasma-derived VWF/FVIII medicinal product, which was first licensed in Germany in 1981 for the treatment of HA-associated bleeding. It has since then come to be accepted as the gold standard for both the treatment and prophylaxis of bleeding in VWD, especially in cases where desmopressin [1-deamino-8-D...... 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...

  5. A Rare Stapes Abnormality

    Directory of Open Access Journals (Sweden)

    Hala Kanona

    2015-01-01

    Full Text Available The aim of this study is to increase awareness of rare presentations, diagnostic difficulties alongside management of conductive hearing loss and ossicular abnormalities. We report the case of a 13-year-old female reporting progressive left-sided hearing loss and high resolution computed tomography was initially reported as normal. Exploratory tympanotomy revealed an absent stapedius tendon and lack of connection between the stapes superstructure and footplate. The footplate was fixed. Stapedotomy and stapes prosthesis insertion resulted in closure of the air-bone gap by 50 dB. A review of world literature was performed using MedLine. Middle ear ossicular discontinuity can result in significant conductive hearing loss. This can be managed effectively with surgery to help restore hearing. However, some patients may not be suitable or decline surgical intervention and can be managed safely conservatively.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Chromosomal abnormalities in azoospermic and non-azoospermic infertile men: numbers needed to be screened to prevent adverse pregnancy outcomes.

    Science.gov (United States)

    Dul, E C; van Echten-Arends, J; Groen, H; Dijkhuizen, T; Land, J A; van Ravenswaaij-Arts, C M A

    2012-09-01

    How many infertile men who wish to conceive need to be screened for chromosomal abnormalities to prevent one miscarriage or the birth of one child with congenital anomalies (CAs)? In azoospermic men, the prevalence of chromosomal abnormalities is 15.2% and the number needed to be screened (NNS; minimum-maximum estimate) for a miscarriage is 80-88 and for a child with CAs is 790-3951. The prevalence of chromosomal abnormalities in non-azoospermic men is 2.3% and the NNS are 315-347 and 2543-12 723, respectively. Guidelines advise the screening of infertile men for chromosomal abnormalities to prevent miscarriages and children with congenital abnormalities, but no studies have been published on the effectiveness of this screening strategy. Retrospective cohort study of 1223 infertile men between 1994 and 2007. Men with azoospermia and men eligible for ICSI treatment visiting a university hospital fertility clinic in The Netherlands who underwent chromosomal analysis between 1994 and 2007 were identified retrospectively in a registry. Only cases of which at least one sperm analysis was available were included. Data were collected by chart review, with a follow-up of pregnancies and their outcomes until 2010. The chromosomal abnormalities were categorized according to their risk of unbalanced offspring, i.e. miscarriage and/or child with CAs. Multi-level analysis was used to estimate the impact of chromosomal abnormalities on the outcome of pregnancies in the different subgroups of our cohort. NNS for miscarriages and children with CAs were calculated based on data from our cohort and data published in the literature. A chromosomal abnormality was found in 12 of 79 men with azoospermia (15.2%) and in 26 of 1144 non-azoospermic men (2.3%). The chromosomal abnormalities were categorized based on the literature, into abnormalities with and abnormalities without increased risk for miscarriage and/or child with CAs. In our study group, there was no statistically significant

  8. Factors predictive of abnormal semen parameters in male partners ...

    African Journals Online (AJOL)

    of couples attending the infertility clinic of a tertiary hospital in south-western ... treatment targeted at the identified aetiological factors. .... that prognosis is inversely proportional to the number of abnormal .... Semen parameters and hormone.

  9. Using an imaginary scrapbook for neurolinguistic programming in the aftermath of a clinical depression: a case history.

    Science.gov (United States)

    Hossack, A; Standidge, K

    1993-04-01

    We employed neurolinguistic programming (NLP) principles to develop a positive self-identity in an elderly male patient in England recovering from clinical depression. This novel technique encouraged recall of intrinsically rewarding past experiences. Each experience was conceptualized in an image and compiled chronologically in an imaginary book, providing continuity to what were chaotic and fragmented recollections during the immediate postdepressive stage. The patient's anxiety and depression were alleviated and his own functional goals largely realized.

  10. Ketosis-prone type 2 diabetes in patients of sub-Saharan African origin: clinical pathophysiology and natural history of beta-cell dysfunction and insulin resistance.

    Science.gov (United States)

    Mauvais-Jarvis, Franck; Sobngwi, Eugène; Porcher, Raphaël; Riveline, Jean-Pierre; Kevorkian, Jean-Philippe; Vaisse, Christian; Charpentier, Guillaume; Guillausseau, Pierre-Jean; Vexiau, Patrick; Gautier, Jean-François

    2004-03-01

    Nonautoimmune ketosis-prone diabetic syndromes are increasingly frequent in nonwhite populations. We have characterized a cohort of patients of sub-Saharan African origin who had ketosis-prone type 2 diabetes (n = 111), type 1 diabetes (n = 21), and type 2 diabetes (n = 88) and were admitted to a hospital for management of uncontrolled diabetes. We compared epidemiological, clinical, and metabolic features at diabetes onset and measured insulin secretion (glucagon-stimulated C-peptide) and insulin action (short intravenous insulin tolerance test) during a 10-year follow-up. Ketosis-prone type 2 diabetes shows a strong male predominance, stronger family history, higher age and BMI, and more severe metabolic decompensation than type 1 diabetes. In ketosis-prone type 2 diabetes, discontinuation of insulin therapy with development of remission of insulin dependence is achieved in 76% of patients (non-insulin dependent), whereas only 24% of patients remain insulin dependent. During evolution, ketosis-prone type 2 diabetes exhibit specific beta-cell dysfunction features that distinguish it from type 1 and type 2 diabetes. The clinical course of non-insulin-dependent ketosis-prone type 2 diabetes is characterized by ketotic relapses followed or not by a new remission. Progressive hyperglycemia precedes and is a strong risk factor for ketotic relapses (hazard ratio 38). The probability for non-insulin-dependent ketosis-prone type 2 diabetes to relapse is 90% within 10 years, of whom approximately 50% will become definitively insulin dependent. Insulin sensitivity is decreased in equal proportion in both ketosis-prone type 2 diabetes and type 2 diabetes, but improves significantly in non-insulin-dependent ketosis-prone type 2 diabetes, only after correction of hyperglycemia. In conclusion, ketosis-prone type 2 diabetes can be distinguished from type 1 diabetes and classical type 2 diabetes by specific features of clinical pathophysiology and also by the natural history of

  11. Prediction of transition from ultra-high risk to first-episode psychosis using a probabilistic model combining history, clinical assessment and fatty-acid biomarkers

    Science.gov (United States)

    Clark, S R; Baune, B T; Schubert, K O; Lavoie, S; Smesny, S; Rice, S M; Schäfer, M R; Benninger, F; Feucht, M; Klier, C M; McGorry, P D; Amminger, G P

    2016-01-01

    Current criteria identifying patients with ultra-high risk of psychosis (UHR) have low specificity, and less than one-third of UHR cases experience transition to psychosis within 3 years of initial assessment. We explored whether a Bayesian probabilistic multimodal model, combining baseline historical and clinical risk factors with biomarkers (oxidative stress, cell membrane fatty acids, resting quantitative electroencephalography (qEEG)), could improve this specificity. We analyzed data of a UHR cohort (n=40) with a 1-year transition rate of 28%. Positive and negative likelihood ratios were calculated for predictor variables with statistically significant receiver operating characteristic curves (ROCs), which excluded oxidative stress markers and qEEG parameters as significant predictors of transition. We clustered significant variables into historical (history of drug use), clinical (Positive and Negative Symptoms Scale positive, negative and general scores and Global Assessment of Function) and biomarker (total omega-3, nervonic acid) groups, and calculated the post-test probability of transition for each group and for group combinations using the odds ratio form of Bayes' rule. Combination of the three variable groups vastly improved the specificity of prediction (area under ROC=0.919, sensitivity=72.73%, specificity=96.43%). In this sample, our model identified over 70% of UHR patients who transitioned within 1 year, compared with 28% identified by standard UHR criteria. The model classified 77% of cases as very high or low risk (P>0.9, <0.1) based on history and clinical assessment, suggesting that a staged approach could be most efficient, reserving fatty-acid markers for 23% of cases remaining at intermediate probability following bedside interview. PMID:27648919

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. Saxagliptin efficacy and safety in patients with type 2 diabetes mellitus stratified by cardiovascular disease history and cardiovascular risk factors: analysis of 3 clinical trials.

    Science.gov (United States)

    Cook, William; Minervini, Gianmaria; Bryzinski, Brian; Hirshberg, Boaz

    2014-10-01

    To test the effectiveness and safety of saxagliptin 5 mg/d in patients with type 2 diabetes mellitus (T2DM) with and without history of cardiovascular disease (CVD) or cardiovascular (CV) risk factors. The authors conducted a post hoc analysis of data from 3 randomized studies that compared saxagliptin versus placebo as initial combination therapy with metformin for 24 weeks (N = 648) and versus placebo as an add-on to insulin with and without metformin for 24 weeks (N = 455), and assessed noninferiority to glipizide as an add-on to metformin for 52 weeks (N = 858). Efficacy outcomes were the adjusted mean change from baseline in glycated hemoglobin (HbA1c) level, fasting plasma glucose concentration, and body weight and the proportion of patients achieving an HbA1c level history/no history of CVD, 2) ≥ 2 versus 0 to 1 CV risk factors, 3) hypertension/no hypertension, and 4) statin use/no statin use. Adverse events (AE) and hypoglycemia were monitored. In the initial combination therapy study, reductions in HbA1c level from baseline were greater with saxagliptin versus placebo in all subgroups (difference [saxagliptin - placebo], -0.38% to -0.67%). In the add-on to insulin ± metformin study, differences in adjusted mean change in HbA1c level versus placebo ranged from -0.23% to -0.58% across subgroups. In the noninferiority to glipizide study, adjusted mean changes in HbA1c level were comparable between saxagliptin and glipizide, across subgroups (difference, 0.08%-0.21%). No evidence suggested clinically relevant treatment-by-subgroup interactions in pairwise comparison. Incidences of ≥ 1 AE were comparable across subgroups. Incidences of confirmed hypoglycemia with saxagliptin were 0 in both metformin add-on studies and 1.2% to 7.8% with saxagliptin + insulin ± metformin. In patients with T2DM, saxagliptin 5 mg/d was similarly effective in improving glycemic control, with an AE profile similar to that of placebo, irrespective of CVD history, number of CV

  14. The role of genealogy and clinical family histories in documenting possible inheritance patterns for diabetes mellitus in the pre-insulin era: part 1. The clinical case of Josephine Imperato.

    Science.gov (United States)

    Imperato, Pascal James; Imperato, Gavin H

    2009-10-01

    Establishing the role of heredity in type 2 diabetes mellitus (type 2 DM) is challenging. While type 2 DM frequently displays a pattern of familial aggregation, many other risk factors are responsible for the clinical expression of the disease. This paper reviews a number of the early twentieth-century studies of inheritance patterns for type 2 DM and presents in detail the history of Josephine Foniciello Imperato (Maria Giuseppa Foniciello) who died from the disease in New York City at the age of 52 years on 14 November 1921, ten months before commercial insulin became available.

  15. Migraine and structural abnormalities in the brain

    DEFF Research Database (Denmark)

    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-type, attack...

  16. Autoshaping of abnormal children.

    Science.gov (United States)

    Deckner, C W; Wilcox, L M; Maisto, S A; Blanton, R L

    1980-09-01

    Three experimentally naive abnormal children were exposed to a terminal operant contingency, i.e., reinforcement was delivered only if the children pressed a panel during intervals when it was lighted. Despite the absence of both successive approximation and manual shaping, it was found that each child began to respond discriminatively within a small number of trials. These data replicated previous animal studies concerned with the phenomena of autoshaping and signal-controlled responding. It was also found, however, that one type of autoshaping, the classical conditioning procedure, had a powerful suppressive effect on the discriminative responding. An experimental analysis that consisted procedure, had a powerful suppressive effect on discriminative responding. An experimental analysis that consisted of intrasubject reversal an multiple baseline designs established the internal validity of the findings. The finding of rapid acquisition of signal-controlled responding obtained with the initial procedure is suggessted to have practical significance. The disruptive effects of the classical form of autoshaping are discussed in terms of negative behavioral contrast.

  17. Communication and abnormal behaviour.

    Science.gov (United States)

    Crown, S

    1979-01-01

    In this paper the similarities between normal and abnormal behaviour are emphasized and selected aspects of communication, normal and aberrant, between persons are explored. Communication in a social system may be verbal or non-verbal: one person's actions cause a response in another person. This response may be cognitive, behavioural or physiological. Communication may be approached through the individual, the social situation or social interaction. Psychoanalysis approaches the individual in terms of the coded communications of psychoneurotic symptoms or psychotic behaviour; the humanist-existential approach is concerned more with emotional expression. Both approaches emphasize the development of individual identity. The interaction between persons and their social background is stressed. Relevant are sociological concepts such as illness behaviour, stigma, labelling, institutionalization and compliance. Two approaches to social interactions are considered: the gamesplaying metaphor, e.g. back pain as a psychosocial manipulation--the 'pain game'; and the 'spiral of reciprocal perspectives' which emphasizes the interactional complexities of social perceptions. Communicatory aspects of psychological treatments are noted: learning a particular metaphor such as 'resolution' of the problem (psychotherapy), learning more 'rewarding' behaviour (learning theory) or learning authenticity or self-actualization (humanist-existential).

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

    Institute of Scientific and Technical Information of China (English)

    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.

  19. Abnormally dark or light skin

    Science.gov (United States)

    Hyperpigmentation; Hypopigmentation; Skin - abnormally light or dark ... Normal skin contains cells called melanocytes. These cells produce melanin , the substance that gives skin its color. Skin with ...

  20. 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

    Institute of Scientific and Technical Information of China (English)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Occult intraspinal abnormalities and congenital scoliosis

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Erfani

    2007-06-01

    Full Text Available

    BACKGROUND: Congenital scoliosis occurs because of either the failure of formation or the failure of segmentation or both. Evaluation of the incidence and the types of occult intraspinal abnormalities in congenital scoliosis is the subject of this study.

    METHODS: During a period of 29 years, 103 patients with congenital scoliosis were studied. MRI was used in 46 patients, myelography or CT myelography was used in 64 patients and both MRI and myelography or CT myelography were used in 7 patients for intraspinal abnormalities.

    RESULTS: In the MRI group, among the 46 patients, 19 patients (41.3% had intraspinal abnormalities consisting syringomyelia in 9 (19.5% diastematomyelia in 8 (17.4%, tethered cord syndrome in 6 (13%, low conus in 5 (10.8% and diplomyelia in 3 (6.5% of the patients. In the myelography group, among the 64 patients, 17 (26.5% had intraspinal abnormalities and diastematomyelia was the most common one found in 14 (21.8% patients.

    CONCLUSIONS: Intraspinal abnormalities are frequent in congenital scoliosis. Syringomyelia may be associated with congenital scoliosis. In congenital scoliosis, rib fusion may be an indicator of intraspinal abnormalities in MRI. A significant difference between clinical findings and intraspinal anomalies (P<0.05 was noted. Moreover, we believe that total spinal MRI with coronal, sagittal and axial views is a valuable tool in determining the intraspinal abnormalities in congenital scoliosis. This method is highly

  3. Semen abnormalities with SSRI antidepressants.

    Science.gov (United States)

    2015-01-01

    Despite decades of widespread use, the adverse effect profile of "selective" serotonin reuptake inhibitor (SSRI) antidepressants has still not been fully elucidated. Studies in male animals have shown delayed sexual development and reduced fertility. Three prospective cohort studies conducted in over one hundred patients exposed to an SSRI for periods ranging from 5 weeks to 24 months found altered semen param-eters after as little as 3 months of exposure: reduced sperm concentration, reduced sperm motility, a higher percentage of abnormal spermatozoa, and increased levels of sperm DNA fragmentation. One clinical trial showed growth retardation in children considered depressed who were exposed to SSRls. SSRls may have endocrine disrupting properties. Dapoxetine is a short-acting serotonin reuptake inhibitor that is chemically related to fluoxetine and marketed in the European Union for men complaining of premature ejaculation. But the corresponding European summary of product characteristics does not mention any effects on fertility. In practice, based on the data available as of mid-2014, the effects of SSRI exposure on male fertility are unclear. However, it is a risk that should be taken into account and pointed out to male patients who would like to father a child or who are experiencing fertility problems.

  4. Hemostatic abnormalities in liver cirrhosis

    Directory of Open Access Journals (Sweden)

    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.

  5. The Natural History of Left Ventricular Geometry in the Community: Clinical Correlates and Prognostic Significance of Change in LV Geometric Pattern

    Science.gov (United States)

    Lieb, Wolfgang; Gona, Philimon; Larson, Martin G.; Aragam, Jayashri; Zile, Michael R.; Cheng, Susan; Benjamin, Emelia J.; Vasan, Ramachandran S.

    2014-01-01

    Objectives We evaluated pattern and clinical correlates of change in left ventricular (LV) geometry over a 4-year period in the community; we also assessed whether the pattern of change in LV geometry over 4 years predicts incident cardiovascular disease (CVD), including myocardial infarction, heart failure and cardiovascular death during an additional subsequent follow-up period. Background It is unclear how LV geometric patterns change over time and whether changes in LV geometry have prognostic significance. Methods We evaluated 4492 observations (2604 unique Framingham Study participants attending consecutive examinations) to categorize LV geometry at baseline and after 4 years. Four groups were defined based on the sex-specific distributions of LV mass (LVM) and relative wall thickness (RWT) (normal: LVM and RWTgeometric pattern over 4 years was associated with increased CVD risk (140 events) during a subsequent median follow-up of 12.0 years (adjusted-hazards ratio, 1.59; 95%CI, 1.04–2.43). Conclusions Our longitudinal observations in the community suggest that dynamic changes in LV geometric pattern over time are common. Higher blood pressure and greater BMI are modifiable factors associated with the development of abnormal LV geometry, and such progression portends an adverse prognosis. PMID:25129518

  6. Differences in various biochemical and clinical parameters with respect to family history of Non Communicable Diseases in fourth year MBBS students of Karachi, Pakistan

    Science.gov (United States)

    Basit, Khalid Abdul; Fawwad, Asher; Munir, Muhammad Asadullah; Siddiqui, Iftikhar Ahmed; Siddiqui, Sidra; Basit, Abdul

    2015-01-01

    Objective: To observe the differences of various biochemical and clinical parameters with respect to Family History (FH) of Non-communicable Diseases (NCDs) in fourth year Bachelor of Medicine, Bachelor of Surgery (MBBS) students. Methods: This observational study was conducted at Baqai Institute of Diabetology & Endocrinology from December 2013 to January 2014. Total 50 medical students from Dow University of Health Sciences (DUHS) participated in the study. Statistical Package for Social Sciences (SPSS) version 13 was used to analyze the data. For cross tabulation and mean comparison z-test and t test were applied. Results: Out of 50 subjects, there were 26 (52%) females. Mean age of the study population was 21.56 ± 0.90 years. Mean serum cholesterol levels with positive FH of NCDs was significantly higher than negative FH of NCDs (p=0.005). Mean value of low density lipoprotein (LDL) of positive family history of NCDs was found higher than those with negative FH (p=0.006) being statistically significant. The insulin levels in subjects with positive FH of NCDs were higher than subjects with negative FH of NCDs (p=0.685). However, serum leptin and plasma renin showed no significant difference with the negative FH of NCDs being higher compared to positive FH of NCDs (p=0.068) and (p=0.884) respectively. However, Waist circumference, Body mass index and central obesity in subjects with positive FH of NCDs shows increasing trend but no statistically significant difference (p > 0.05) was observed. Conclusion: In our study of various biochemical and clinical parameters with respect to FH of NCDs, Serum Cholesterol and LDL levels were observed higher and statistically significant. PMID:26430439

  7. Differences in various biochemical and clinical parameters with respect to family history of Non Communicable Diseases in fourth year MBBS students of Karachi, Pakistan.

    Science.gov (United States)

    Basit, Khalid Abdul; Fawwad, Asher; Munir, Muhammad Asadullah; Siddiqui, Iftikhar Ahmed; Siddiqui, Sidra; Basit, Abdul

    2015-01-01

    To observe the differences of various biochemical and clinical parameters with respect to Family History (FH) of Non-communicable Diseases (NCDs) in fourth year Bachelor of Medicine, Bachelor of Surgery (MBBS) students. This observational study was conducted at Baqai Institute of Diabetology & Endocrinology from December 2013 to January 2014. Total 50 medical students from Dow University of Health Sciences (DUHS) participated in the study. Statistical Package for Social Sciences (SPSS) version 13 was used to analyze the data. For cross tabulation and mean comparison z-test and t test were applied. Out of 50 subjects, there were 26 (52%) females. Mean age of the study population was 21.56 ± 0.90 years. Mean serum cholesterol levels with positive FH of NCDs was significantly higher than negative FH of NCDs (p=0.005). Mean value of low density lipoprotein (LDL) of positive family history of NCDs was found higher than those with negative FH (p=0.006) being statistically significant. The insulin levels in subjects with positive FH of NCDs were higher than subjects with negative FH of NCDs (p=0.685). However, serum leptin and plasma renin showed no significant difference with the negative FH of NCDs being higher compared to positive FH of NCDs (p=0.068) and (p=0.884) respectively. However, Waist circumference, Body mass index and central obesity in subjects with positive FH of NCDs shows increasing trend but no statistically significant difference (p > 0.05) was observed. In our study of various biochemical and clinical parameters with respect to FH of NCDs, Serum Cholesterol and LDL levels were observed higher and statistically significant.

  8. 机械刺激子宫内膜对内膜形态不良者IVF-ET临床结局的影响%Effect of Mechanical Stimulation on IVF-ET Clinical Outcome in Women with Abnormal Endometrium

    Institute of Scientific and Technical Information of China (English)

    罗国群; 邓伟芬; 马文敏

    2012-01-01

    Objective: To study the influence of mechanical stimulation on IVF-ET clinical outcome. Methods: In the cycle of in vitro fertilization-embryo transfer (IVF-ET), 63 patients were studied who were with abnormal endometrial echoes by ultrasound in follicular phase in natural period. They were devided into two groups: 30 patients (experimental group) were mechanical stimulated to the endometrium during 1-2 weeks before embryo transfer. The remaining 33 patients (control group) were not treated. Results: There were no statistical differences between the two groups on the dose of Gn use, the impact of serum progesterone / estratiol ratio on hCG administration day, the number of oocytes retrieved, the rate of fertilization and the number of good embryos transferred (P>0.05). After mechanical stimulation to the endometrium, endometrial pattern, endometrial and subendometrial blood flows on the day of hCG administration were improved than those of the control (P<0.01). Embryo implantion rate, clinical pregnancy rate were significantly improved, while early spontaneous abortion rate was delated than that in the control (P<0.0l). Conclusion: Mechanical stimulation to the endometrium significantly improves the rates of embryo implantation, clinical pregnancy in patients undergoing in vitro fertilization while decrease the rate of early spontaneous abortion perhaps through affecting endometrial and subendometrial blood flows.%目的:探讨机械刺激子宫内膜对临床结局的影响及机制.方法:选取行体外受精-胚胎移植(IVF-ET)且其自然月经周期卵泡晚期超声提示子宫内膜形态不良的不育患者63例,随机分为研究组(n=30)和对照组(n=33).研究组在胚胎移植前1~2周对子宫内膜行机械刺激,对照组未行机械刺激为,统计分析IVF-ET的临床结局.结果:Gn用量、hCG注射日P/E2值、平均获卵数、受精率及移植优质胚胎数组间无统计学差异(P>0.05);研究组子宫内膜形态及子宫内膜

  9. Investigation on clinical outcomes of reproductive abnormalities with secondary constric﹣ tion increase polymorphism of chromosome long arm%染色体多态性qh+与临床生殖异常关系的探讨

    Institute of Scientific and Technical Information of China (English)

    王桂玲; 任春娥; 姜爱芳

    2015-01-01

    目的::目的:分析染色体长臂次缢痕增加( qh+)与生殖异常的临床效应关系。方法:对2080例不孕不育患者进行常规外周血染色体核型分析。结果:2080例不孕不育患者共检出染色体多态性208例,检出率为10.0%,其中qh+患者88例,占42.31%。88例qh+患者中,男性72例,女性16例。1 qh+22例;9 qh+17例;16 qh+14例;Yqh+(46,XY,大Y)29例;46,XY,Yqh+,9qh+5例;46,XY,Yqh+,16qh+患者1例。72例男性患者中存在精子质量问题者60例,占83.33%。配偶有胚胎停育史者共12例,占16.7%,其中2次以上胚胎停育史者共8例,占11.11%;配偶有畸形儿生育史者3例。16例女性患者中有胚胎停育史者7例(43.12%),其中2次以上胚胎停育史者5例(31.25%)。结论:染色体qh+与不孕不育、复发性流产、生育畸形儿等生殖异常存在明显的相关性,不能忽视其临床效应。%Objective:To investigate the association between secondary constriction polymorphisms of chromosome long arm and clinical effects of reproductive abnormalities. Methods:Karyotypes were analyzed from peripheral blood of 2080 patients suffering infertility. Results:Detection rate of chromosomal polymorphism was 10. 0% (208/2080) of patients suf—fering infertility. 88 cases of secondary constriction increase ( qh +) were checked out (42. 31%,88/208). In 88 cases of qh+,there were 22 cases of 1qh+,17 cases of 9qh+,14 ca—ses of 16 qh+,29 cases of large Y chromosome ( Yqh+) ,5 cases of Yqh+ and 9 qh+ simultane—ously and 1 case of Yqh+ and 9qh+ simultaneously. In 72 cases of male patients,60cases of dysspermia were checked out (83. 33%,60/72). There were 12 female cases of nearly embry—onic death,the spouses of 72 male patients (16. 7%,12/72),in which 8 cases of recurrent miscarriage were detected(11. 11%,8/72),and in which 3 cases have a child with a birth de—fect. In 16 cases of female patients, 7 cases of nearly embryonic death were checked out (43. 12%,7/16),in which

  10. Esophageal motility abnormalities in gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Irene; Martinucci; Nicola; de; Bortoli; Maria; Giacchino; Giorgia; Bodini; Elisa; Marabotto; Santino; Marchi; Vincenzo; Savarino; Edoardo; Savarino

    2014-01-01

    Esophageal motility abnormalities are among the main factors implicated in the pathogenesis of gastroesophageal reflux disease. The recent introduction in clinical and research practice of novel esophageal testing has markedly improved our understanding of the mechanisms contributing to the development of gastroesophageal reflux disease, allowing a better management of patients with this disorder. In this context, the present article intends to provide an overview of the current literature about esophageal motility dysfunctions in patients with gastroesophageal reflux disease. Esophageal manometry, by recording intraluminal pressure, represents the gold standard to diagnose esophagealmotility abnormalities. In particular, using novel techniques, such as high resolution manometry with or without concurrent intraluminal impedance monitoring, transient lower esophageal sphincter (LES) relaxations, hypotensive LES, ineffective esophageal peristalsis and bolus transit abnormalities have been better defined and strongly implicated in gastroesophageal reflux disease development. Overall, recent findings suggest that esophageal motility abnormalities are increasingly prevalent with increasing severity of reflux disease, from nonerosive reflux disease to erosive reflux disease and Barrett’s esophagus. Characterizing esophageal dysmotility among different subgroups of patients with reflux disease may represent a fundamental approach to properly diagnose these patients and, thus, to set up the best therapeutic management. Currently, surgery represents the only reliable way to restore the esophagogastric junction integrity and to reduce transient LES relaxations that are considered to be the predominant mechanism by which gastric contents can enter the esophagus. On that ground, more in depth future studies assessing the pathogenetic role of dysmotility in patients with reflux disease are warranted.

  11. Esophageal motility abnormalities in gastroesophageal reflux disease.

    Science.gov (United States)

    Martinucci, Irene; de Bortoli, Nicola; Giacchino, Maria; Bodini, Giorgia; Marabotto, Elisa; Marchi, Santino; Savarino, Vincenzo; Savarino, Edoardo

    2014-05-06

    Esophageal motility abnormalities are among the main factors implicated in the pathogenesis of gastroesophageal reflux disease. The recent introduction in clinical and research practice of novel esophageal testing has markedly improved our understanding of the mechanisms contributing to the development of gastroesophageal reflux disease, allowing a better management of patients with this disorder. In this context, the present article intends to provide an overview of the current literature about esophageal motility dysfunctions in patients with gastroesophageal reflux disease. Esophageal manometry, by recording intraluminal pressure, represents the gold standard to diagnose esophageal motility abnormalities. In particular, using novel techniques, such as high resolution manometry with or without concurrent intraluminal impedance monitoring, transient lower esophageal sphincter (LES) relaxations, hypotensive LES, ineffective esophageal peristalsis and bolus transit abnormalities have been better defined and strongly implicated in gastroesophageal reflux disease development. Overall, recent findings suggest that esophageal motility abnormalities are increasingly prevalent with increasing severity of reflux disease, from non-erosive reflux disease to erosive reflux disease and Barrett's esophagus. Characterizing esophageal dysmotility among different subgroups of patients with reflux disease may represent a fundamental approach to properly diagnose these patients and, thus, to set up the best therapeutic management. Currently, surgery represents the only reliable way to restore the esophagogastric junction integrity and to reduce transient LES relaxations that are considered to be the predominant mechanism by which gastric contents can enter the esophagus. On that ground, more in depth future studies assessing the pathogenetic role of dysmotility in patients with reflux disease are warranted.

  12. Abnormal mucociliary transport study in a patient with Kartagener syndrome.

    Science.gov (United States)

    Taylor, R E Russell

    2006-04-01

    Mucociliary transport can be assessed by monitoring the clearance rate of inhaled, dried, and crushed technetium-99m labeled sulfur colloid. A case is described of a patient who had a history of recurrent sinusitis, purulent sputum production, and infertility. It was thought he might have Kartagener syndrome, and his mucociliary clearance was shown to be abnormal.

  13. Chromosomal abnormalities are associated with aging and cancer

    Science.gov (United States)

    Two new studies have found that large structural abnormalities in chromosomes, some of which have been associated with increased risk of cancer, can be detected in a small fraction of people without a prior history of cancer. The studies found that these

  14. Cytogenetic Analysis for Suspected Chromosomal Abnormalities; A Five Years Experience

    Science.gov (United States)

    Karra, Vijay Kumar; Jindal, Ankur; Puppala, Madhavi; Singh, Pratiksha; Rawat, Kanchan; Kapoor, Seema

    2016-01-01

    Introduction Chromosomal abnormalities are the results of alterations in the number or structure of chromosomes causing significant human morbidity and mortality. They are responsible for a large proportion of miscarriages, developmental delay, disorders of sexual development, congenital malformations and mental retardation. Aim The aim of this study was to describe the prevalence of different chromosomal abnormalities in North Indian patients referred for cytogenetic analysis. Materials and Methods Total of 859 patients ranging from newborn to 37 years of age were referred to the division of genetics, Department of Paediatrics between 2010 and 2015, with a variety of clinical disorders; Down syndrome (DS), Turner’s syndrome (TS) and Klinefelter syndrome; amenorrhea; ambiguous sex and multiple congenital malformations. Chromosomal analysis was performed on lymphocyte culture according to standard methods. Results Of the 859 cases studied, 371 (43.1%) had chromosomal abnormalities. The most common autosomal abnormalities were DS 302 (81.4%) and sex chromosomal abnormalities were TS 51 (13.7%). Numerical abnormalities were accounted for 353 (41.0%) and structural abnormalities 18 (2.0%), respectively. Various other chromosomal anomalies were also reported. Conclusion We have reviewed the incidence and distribution of chromosomal abnormalities and found higher rate of chromosomal abnormalities 43.1% in the referred cases. Our data suggest that chromosomal analysis is important tool in the evaluation of genetic disorders and helps clinicians to provide accurate diagnosis and proper genetic counselling. PMID:27790464

  15. [Renal abnormalities in ankylosing spondylitis].

    Science.gov (United States)

    Samia, Barbouch; Hazgui, Faiçal; Abdelghani, Khaoula Ben; Hamida, Fethi Ben; Goucha, Rym; Hedri, Hafedh; Taarit, Chokri Ben; Maiz, Hedi Ben; Kheder, Adel

    2012-07-01

    We will study the epidemiologic, clinical, biological, therapeutic, prognostic characteristics and predictive factors of development of nephropathy in ankylosing spondylitis patients. We retrospectively reviewed the medical record of 32 cases with renal involvement among 212 cases of ankylosing spondylitis followed in our service during the period spread out between 1978 and 2006. The renal involvement occurred in all patients a mean of 12 years after the clinical onset of the rheumatic disease. Thirty-two patients presented one or more signs of renal involvement: microscopic hematuria in 22 patients, proteinuria in 23 patients, nephrotic syndrome in 11 patients and decreased renal function in 24 patients (75%). Secondary renal amyloidosis (13 patients), which corresponds to a prevalence of 6,1% and tubulointerstitial nephropathy (7 patients) were the most common cause of renal involvement in ankylosing spondylitis followed by IgA nephropathy (4 patients). Seventeen patients evolved to the end stage renal disease after an average time of 29.8 ± 46 months. The average follow-up of the patients was 4,4 years. By comparing the 32 patients presenting a SPA and renal disease to 88 with SPA and without nephropathy, we detected the predictive factors of occurred of nephropathy: tobacco, intense inflammatory syndrome, sacroileite stage 3 or 4 and presence of column bamboo. The finding of 75% of the patients presented a renal failure at the time of the diagnosis of renal involvement suggests that evidence of renal abnormality involvement should be actively sought in this disease. Copyright © 2011 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  16. 分娩期体位护理干预对矫正胎方位异常的临床分析%Clinical analysis on body posture attendance of lying-in women with abnormal fetal position during delivery

    Institute of Scientific and Technical Information of China (English)

    姚伟英

    2014-01-01

    Objective: To investigate the clinical effect of body posture attendance during delivery for abnormal fetal position.Methods: 60 cases in observation group were given nursing intervention during delivery,and 60 cases in control group were guided for general comfortable natural childbirth.Results: The the rate of natural childbirth in observation group were higher than control group(81.7% vs.53.3%,P<0.01),the rate of cesarean section was significantly lower than the control group(13.3% vs.38.3%,P<0.01).Compared with control group,the experimental group had shorter first stage,expulsive stage, placental stage as wel as total stage of labor(P<0.05 or 0.01).And the incidence of neonatal asphyxia in observation group were significantly lower than those of control group(1.7% vs.10.0%,P<0.01).Conclusion: Body posture attendance during delivery can raised delivery quality,it’s worthy popularization.%目的:探讨分娩期体位护理干预对矫正胎方位异常的临床效果。方法:选择观察组60例产妇给予分娩期体位护理干预,对照组60例指导常规舒适的体位自然分娩。结果:观察组顺产率明显高于对照组(81.7%vs.53.3%),剖宫产率明显低于对照组(13.3%vs.38.3%)(P<0.01)。观察组阴道分娩产妇第一产程、第二产程及总产程时间均较对照组明显缩短(P<0.05或0.01)。观察组新生儿窒息发生率显著低于对照组(1.7%vs.10.0%,P<0.01)。结论:实施分娩期体位护理有利于提高分娩质量,值得推广应用。

  17. Systemic abnormalities in liver disease

    Institute of Scientific and Technical Information of China (English)

    Masami Minemura; Kazuto Tajiri; Yukihiro Shimizu

    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.

  18. Musculo-skeletal abnormalities in patients with Marfan syndrome.

    Science.gov (United States)

    Al Kaissi, Ali; Zwettler, Elisabeth; Ganger, Rudolf; Schreiner, Simone; Klaushofer, Klaus; Grill, Franz

    2013-01-01

    A leptosomic body type is tall and thin with long hands. Marfanoid features may be familial in nature or pathological, as occurs in congenital contractual arachnodactyly (Beal's syndrome) and Shprintzen-Goldberg syndrome mimicking some of the changes of Marfan syndrome, although not accompanied by luxation of lens and dissecting aneurysm of aorta. In this article we collected eight patients who were consistent with the diagnosis of Marfan syndrome via phenotypic and genotypic characterization. Our patients manifested a constellation of variable presentations of musculo-skeletal abnormalities ranging from developmental dysplasia of the hip, protrusio acetabuli, leg length inequality, patellar instability, scoliosis, to early onset osteoarthritis. Each abnormality has been treated accordingly. This is the first paper which includes the diagnosis and the management of the associated musculo-skeletal abnormalities in patients with Marfan syndrome, stressing that patients with Marfan syndrome are exhibiting great variability in the natural history and the severity of musculo-skeletal abnormalities.

  19. The spectrum of epilepsy and electroencephalographic abnormalities due to SHANK3 loss-of-function mutations.

    Science.gov (United States)

    Holder, J Lloyd; Quach, Michael M

    2016-10-01

    The coincidence of autism with epilepsy is 27% in those individuals with intellectual disability.(1) Individuals with loss-of-function mutations in SHANK3 have intellectual disability, autism, and variably, epilepsy.(2-5) The spectrum of seizure semiologies and electroencephalography (EEG) abnormalities has never been investigated in detail. With the recent report that SHANK3 mutations are present in approximately 2% of individuals with moderate to severe intellectual disabilities and 1% of individuals with autism, determining the spectrum of seizure semiologies and electrographic abnormalities will be critical for medical practitioners to appropriately counsel the families of patients with SHANK3 mutations. A retrospective chart review was performed of all individuals treated at the Blue Bird Circle Clinic for Child Neurology who have been identified as having either a chromosome 22q13 microdeletion encompassing SHANK3 or a loss-of-function mutation in SHANK3 identified through whole-exome sequencing. For each subject, the presence or absence of seizures, seizure semiology, frequency, age of onset, and efficacy of therapy were determined. Electroencephalography studies were reviewed by a board certified neurophysiologist. Neuroimaging was reviewed by both a board certified pediatric neuroradiologist and child neurologist. There is a wide spectrum of seizure semiologies, frequencies, and severity in individuals with SHANK3 mutations. There are no specific EEG abnormalities found in our cohort, and EEG abnormalities were present in individuals diagnosed with epilepsy and those without history of a clinical seizure. All individuals with a mutation in SHANK3 should be evaluated for epilepsy due to the high prevalence of seizures in this population. The most common semiology is atypical absence seizure, which can be challenging to identify due to comorbid intellectual disability in individuals with SHANK3 mutations; however, no consistent seizure semiology

  20. SERUM CHEMISTRY ABNORMALITIES IN CHILDREN WITH UNPROVOKED SEIZURES

    Directory of Open Access Journals (Sweden)

    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

  1. SERUM CHEMISTRY ABNORMALITIES IN CHILDREN WITH UNPROVOKED SEIZURES

    Directory of Open Access Journals (Sweden)

    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.

  2. Trial end points and natural history in patients with G11778A Leber hereditary optic neuropathy : preparation for gene therapy clinical trial.

    Science.gov (United States)

    Lam, Byron L; Feuer, William J; Schiffman, Joyce C; Porciatti, Vittorio; Vandenbroucke, Ruth; Rosa, Potyra R; Gregori, Giovanni; Guy, John

    2014-04-01

    IMPORTANCE Establishing the natural history of G11778A Leber hereditary optic neuropathy (LHON) is important to determine the optimal end points to assess the safety and efficacy of a planned gene therapy trial. OBJECTIVE To use the results of the present natural history study of patients with G11778A LHON to plan a gene therapy clinical trial that will use allotopic expression by delivering a normal nuclear-encoded ND4 gene into the nuclei of retinal ganglion cells via an adeno-associated virus vector injected into the vitreous. DESIGN, SETTING, AND PARTICIPANTS A prospective observational study initiated in 2008 was conducted in primary and referral institutional practice settings. Participants included 44 individuals with G11778A LHON, recruited between September 2008 and March 2012, who were evaluated every 6 months and returned for 1 or more follow-up visits (6-36 months) as of August 2012. EXPOSURES Complete neuro-ophthalmic examination and main measures. MAIN OUTCOMES AND MEASURES Visual acuity, automated visual field testing, pattern electroretinogram, and spectral-domain optical coherence tomography. RESULTS Clinical measures were stable during the follow-up period, and visual acuity was as good as or better than the other visual factors used for monitoring patients. Based on a criterion of 15 or more letters from the Early Treatment Diabetic Retinopathy Study chart, 13 eyes of 8 patients (18%) improved, but 24 months after the onset of symptoms, any further improvements were to no better than 20/100. Acuity recovery occurred in some patients despite continued marked retinal nerve fiber layer thinning indistinguishable from that in patients who did not recover visual acuity. CONCLUSIONS AND RELEVANCE Spontaneous improvement of visual acuity in patients with G11778A LHON is not common and is partial and limited when it occurs, so improvements in vision with adeno-associated virus-mediated gene therapy of a synthetic wild-type ND4 subunit gene should be

  3. XT-2000i血细胞分析仪白细胞分类异常报警的临床分析%Clinical analysis of abnormal alarm in white blood cell classification of XE-2000i blood cell analyzer

    Institute of Scientific and Technical Information of China (English)

    张书永

    2013-01-01

    Objective: To investigate the Sysmex XE-2000i blood cell analyzer leukocyte classification anomaly reliability. Methods; Random XT-2000i detected no abnormal alarm specimens in 300 cases and abnormal alarm specimens from 285 patients, respectively, making blood smears with Wright's staining after artificial microscopy, analytical instruments detection results with artificial microscopy results the coincidence rate. Results: XT-2000i blood cell analyzer for alarm and manual analysis of abnormal cells positive rate was 73.3%, no abnormal alarm apparatus and its classification and artificial microscopy are basically the same, with the rate of 99%. Conclusion: XT-2000i blood cell analyzer as a morphologic abnormalities warnings of the initial screening tools, high sensitivity, white blood cell classification without abnormal alarm when the result is credible, abnormal alarm and declaration nuclear cell high alarm specimens should be artificial lens review.%目的:探讨sysmex XT-2000i血细胞分析仪白细胞分类异常报警的可靠性.方法:随机抽取XT-2000i检测无异常报警标本300例及异常报警标本285例,分别制作血涂片经瑞氏染色后人工镜检,分析仪器检测结果与人工镜检结果的符合率.结果:XT-2000i血细胞分析仪对异常细胞报警与人工分析阳性符合率为73.3%,仪器无异常报警时其分类与人工镜检基本一致,符合率为99%.结论:XT-2000i血液细胞分析仪作为异常细胞报警的初筛工具,灵敏度极高,白细胞分类无异常报警时结果可信,有异常报警及报单核细胞过高报警的标本应人工镜检复查.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Developmental pragmatics in normal and abnormal children.

    Science.gov (United States)

    Bara, B G; Bosco, F M; Bucciarelli, M

    1999-07-01

    We propose a critical review of current theories of developmental pragmatics. The underlying assumption is that such a theory ought to account for both normal and abnormal development. From a clinical point of view, we are concerned with the effects of brain damage on the emergence of pragmatic competence. In particular, the paper deals with direct speech acts, indirect speech acts, irony, and deceit in children with head injury, closed head injury, hydrocephalus, focal brain damage, and autism. Since no single theory covers systematically the emergence of pragmatic capacity in normal children, it is not surprising that we have not found a systematic account of deficits in the communicative performance of brain injured children. In our view, the challenge for a pragmatic theory is the determination of the normal developmental pattern within which different pragmatic phenomena may find a precise role. Such a framework of normal behavior would then permit the systematic study of abnormal pragmatic development.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  7. Imaging findings of sternal abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Franquet, T. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Gimenez, A. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Alegret, X. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Sanchis, E. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Rivas, A. [Dept. of Radiology, Hospital Vall d`Hebron, Universidad Autonoma de Barcelona (Spain)

    1997-05-01

    Radiographic findings in the sternal abnormalities are often nonspecific, showing appearances from a localized benign lesion to an aggressive lesion as seen with infections and malignant neoplasms. A specific diagnosis of sternal abnormalities can be suggested on the basis of CT and MR characteristics. Familiarity with the presentation and variable appearance of sternal abnormalities may aid the radiologist is suggesting a specific diagnosis. We present among others characteristic radiographic findings of hemangioma, chondrosarcoma, hydatid disease, and SAPHO syndrome. In those cases in which findings are not specific, cross-sectional imaging modalities may help the clinician in their management. (orig.)

  8. Perfusion abnormalities in hemimegalencephaly.

    Science.gov (United States)

    Wintermark, P; Roulet-Perez, E; Maeder-Ingvar, M; Moessinger, A C; Gudinchet, F; Meuli, R

    2009-04-01

    Cerebrovascular changes are rarely discussed in patients with hemimegalencephaly. These alterations have previously been associated with epileptical activity. We report the case of a 36-week gestation neonate presenting with total right hemimegalencephaly, as demonstrated by a magnetic resonance imaging (MRI) performed in the first days of life. Perfusion-weighted imaging displayed a clear hypervascularization of the right hemisphere. Diffusion-tensor imaging showed an arrangement of white matter fibers concentrically around the ventricle on the right hemisphere. AngioMRI showed an obvious asymmetry in the size of the middle cerebral arteries, with the right middle cerebral artery being prominent. The baby was free of clinical seizures during his first week of life. An electroencephalogram at that time displayed an asymmetric background activity, but no electrical seizures. Perfusion anomalies in hemimegalencephaly may not necessarily be related to epileptical activity, but may be related to vessel alterations. (c) Georg Thieme Verlag KG Stuttgart, New York.

  9. The risk of menstrual abnormalities after tubal sterilization: a case control study

    OpenAIRE

    AtashKhoii Simin; shobeiri Mehri

    2005-01-01

    Abstract Background Tubal sterilization is the method of family planning most commonly used. The existence of the post-tubal-ligation syndrome of menstrual abnormalities has been the subject of debate for decades. Methods In a cross-sectional study, 112 women with the history of Pomeroy type of tubal ligation achieved by minilaparatomy as the case group and 288 women with no previous tubal ligation as the control group were assessed for menstrual abnormalities. Results Menstrual abnormalities...

  10. Genetic Counselors’ Current Use of Personal Health Records-Based Family Histories in Genetic Clinics and Considerations for Their Future Adoption

    OpenAIRE

    Widmer, Chaney; DeShazo, Jonathan P.; Bodurtha, Joann; Quillin, John; Creswick, Heather

    2012-01-01

    Given the widespread adoption of electronic medical records and recent emergence of electronic family history tools, we examined genetic counselors’ perspectives on the emerging technology of the personal health record (PHR)-based family history tool that links to an electronic medical record (EMR). Two-hundred thirty-three genetic counselors responded to an on-line survey eliciting current use of electronic family history (EFH) tools and familiarity with PHR-based family history tools. Addit...

  11. 腰椎间盘相关MRI异常征象的诊断价值%Clinical significances of abnormal lumbar disc MRI signs in low back pain patients

    Institute of Scientific and Technical Information of China (English)

    黄靖; 李曼; 袁慧书; 李选

    2013-01-01

    目的 研究腰痛患者腰椎间盘相关MRI异常征象的表现特征,评价其对腰痛的诊断价值.方法 收集216例以腰痛为主诉的患者为病例组,91例无腰痛症状的正常志愿者作为对照组,2组被试者均行常规腰椎MRI检查,对其椎间盘信号改变、椎间盘纤维环后方高信号区(HIZ)征、终板下骨质退变、许莫氏结节这些征象进行评价,并分析其与腰痛相关的程度.结果 病例组与对照组椎间盘退变分级:Ⅰ级0.00%/5.50%,Ⅱ级20.09%/65.93%,Ⅲ级48.70%/16.92%,Ⅳ级30.00%/8.13%,Ⅴ级1.11%/3.52%.2组HIZ的发生率分别为30.1%及14.3%.病例组67例(31.0%)存在终板Modic改变,其中Modic改变Ⅰ型5例(7.5%),Ⅱ型59例(88.1%),Ⅲ型3例(4.5%);对照组中22例(24.2%)存在终板Modic改变,Modic改变Ⅰ型0例(0%),Ⅱ型22例(95.4%),Ⅲ型1例(4.6%).2组许莫氏结节的发生率分别为20.83%和19.78%.经Logistic回归分析,椎间盘信号改变与腰痛显著相关(χ2=40.303,P=0.000),其他征象与腰痛无显著相关性.结论腰椎间盘信号改变是导致腰痛的危险因素.%Objective To analyze imaging findings of lumbar spine MRI of low back pain patients,in order to study the clinic value of abnormal lumbar disc MRI signs in low back pain patients. Methods 216 patients whose main manifestation was low back pain were examined by lumbar spine MRI scan,in which there were 100 cases of men, 1 16 cases of women, age ranged 20 - 74 years old. 91 employees in which none of them complained of low back pain were selected as control group, there were 51 cases of male, 40 cases of female, age ranged 26 - 75 years old. The abnormal lumbar MRI signs in patients group and control group were evaluated respectively, including disc signal change, high intensity zonc(HlZ) sign, Modic's change, Schmorl nodules, which relationship with low back pain were analyzed. Results Disc degeneration classification between the case group and the control group were: level Ⅰ 0. 00% / 5

  12. Community History.

    Science.gov (United States)

    Lewis, Helen M.

    1997-01-01

    Recounts the experience of researching community history in Ivanhoe, Virginia, between 1987 and 1990. The Ivanhoe History Project involved community members in collecting photographs, memorabilia, and oral histories of their town. Subsequent published volumes won the W. D. Weatherford Award and inspired a quilt exhibit and a theatrical production.…

  13. Pregnancy Complications: Umbilical Cord Abnormalities

    Science.gov (United States)

    ... defects. These tests may include a detailed ultrasound, amniocentesis (to check for chromosomal abnormalities) and in some ... the provider may recommend additional tests, such as amniocentesis and a detailed ultrasound, to diagnose or rule ...

  14. Systemic abnormalities associated with retinal vein occlusion in young patients

    Science.gov (United States)

    Sinawat, Suthasinee; Bunyavee, Chavisa; Ratanapakorn, Tanapat; Sinawat, Supat; Laovirojjanakul, Wipada; Yospaiboon, Yosanan

    2017-01-01

    Objectives To study the systemic abnormalities associated with retinal vein occlusion in patients aged ≤50 years with a particular emphasis on atherosclerotic diseases and thrombophilic disorders. Methods Medical charts of patients, aged ≤50 years whose diagnoses were retinal vein occlusions during the period 1995–2015 were retrospectively reviewed. The primary outcome was the number of systemic abnormalities associated with these patients. Secondary outcomes included types of retinal vein occlusion and sites of occlusion. Results Atherosclerotic diseases were the most common systemic abnormalities associated with retinal vein occlusion and accounted for 55.1% of the patients in the study. Hypertension in 27.55%, diabetes mellitus in 16.33%, and 5.1% with dyslipidemia were noted. The number of thrombophilic disorders seemed to be less than expected and were noted in only 5.1%. Other systemic abnormalities included viral hepatitis infection, systemic lupus erythematosus, and acquired immunodeficiency syndrome. Oral contraceptives were used by some patients. Conclusion Atherosclerotic diseases remained the most commonly associated systemic diseases in the majority of these patients. Approach to these patients should include a screening for hypertension, diabetes mellitus, and lipid abnormalities. Thrombophilia should also be considered where no obvious atherosclerotic diseases are found or if the patient is <40 years old, a history of thrombosis or a family history of thrombosis is possible. PMID:28260858

  15. [The natural history of cervical intraepithelial neoplasia I and the clinical significance of p16(INK4a) protein as a marker of progression in cervical intraepithelial neoplasia I].

    Science.gov (United States)

    Wang, Rongmin; Li, Xuejie; Qian, Min; Niu, Jianghua; You, Zhixue

    2015-03-01

    To describe the natural history of cervical intraepithelial neoplasia (CIN) I and the biologic factors associated with the progression of CIN I and to analyze the predictive values of p16(INK4a) protein for the progression of CIN I. From August 2010 to July 2013, 104 patients referred for abnormal cytology [≤ low-grade squamous intraepithelial lesion (LSIL); including negative for intraepithelial lesion or malignancy (NILM), atypical squamous cells of undetermined significance (ASCUS), LSIL] and high-risk (HR) HPV positive, and were diagnosed CIN I by colposcopy-assisted biopsy and followed at 1-year intervals in the First Affiliated Hospital of Nanjing Medical University. In order to analyze the relationship between the progression of CIN I with clinical biologic factors, including patient age, cervical cytology before colposcopy, loads of HR HPV, HPV L1 capsid protein, p16(INK4a) protein, χ(2) tests was used to compare the different frequencies of factors in groups of progressed and persisted/regressed CIN I, then five factors with progressed CIN I were processed into binary logistic regression analysis. (1) In the first year of follow-up, among 104 patients (including 15 cases NILM, 78 cases ASCUS, 11 cases LSIL), 52 cases of them were NILM and HR HPV negative, 30 cases were negative for intraepithelial lesion, 10 cases were CIN I, 5 cases were CIN II and 7 cases were CIN III. In total, 82 cases (78.8%, 82/104) cases had regressed, 10 cases (9.6%, 10/104) persisted, 12 cases (11.5%, 12/104) progressed [including 5 cases (4.8% , 5/104) progressed to CIN II, 7 cases (6.7% , 7/104) progressed to CIN III, none progressed to invasive cancer]. (2) All patients, 88 cases of them accepted immunohistochemical detection the expression of p16(INK4a) protein. The result shown that 30 cases (34%, 30/88) were positive and 58 cases (66%, 58/88) were negative. And 94 cases accepted immunocytochemical detection the expression of HPV L1 capsid protein, 49 cases (52% , 49

  16. Neurofibromatosis: chronological history and current issues*

    Science.gov (United States)

    Antônio, João Roberto; Goloni-Bertollo, Eny Maria; Trídico, Lívia Arroyo

    2013-01-01

    Neurofibromatosis, which was first described in 1882 by Von Recklinghausen, is a genetic disease characterized by a neuroectodermal abnormality and by clinical manifestations of systemic and progressive involvement which mainly affect the skin, nervous system, bones, eyes and possibly other organs. The disease may manifest in several ways and it can vary from individual to individual. Given the wealth of information about neurofibromatosis, we attempted to present this information in different ways. In the first part of this work, we present a chronological history, which describes the evolution of the disease since the early publications about the disorder until the conclusion of this work, focusing on relevant aspects which can be used by those wishing to investigate this disease. In the second part, we present an update on the various aspects that constitute this disease. PMID:23793209

  17. Neurofibromatosis: chronological history and current issues.

    Science.gov (United States)

    Antônio, João Roberto; Goloni-Bertollo, Eny Maria; Trídico, Lívia Arroyo

    2013-01-01

    Neurofibromatosis, which was first described in 1882 by Von Recklinghausen, is a genetic disease characterized by a neuroectodermal abnormality and by clinical manifestations of systemic and progressive involvement which mainly affect the skin, nervous system, bones, eyes and possibly other organs. The disease may manifest in several ways and it can vary from individual to individual. Given the wealth of information about neurofibromatosis, we attempted to present this information in different ways. In the first part of this work, we present a chronological history, which describes the evolution of the disease since the early publications about the disorder until the conclusion of this work, focusing on relevant aspects which can be used by those wishing to investigate this disease. In the second part, we present an update on the various aspects that constitute this disease.

  18. PREVALENCE OF NAIL ABNORMALITIES IN PATIENTS WITH PSORIASIS

    OpenAIRE

    Nermina Ovcina-Kurtovic; Emina Kasumagic-Halilovic

    2013-01-01

    Introduction: Psoriasis is a chronic inflammatory skin disease that affects about 2% of general population. Cllinicaly, disease can present with cutaneous and nails lesions. Nail abnormalities can be seen in up to two-thirds of patients with psoriasis and both fingernails and toenails may be affected.Objective: The objectives of our study were to evaluate the frequency and clinical presentations of nail abnormalities in patients with psoriasis. Also, we aimed to find correlation between nail ...

  19. Endocrine abnormalities in dilated cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Ankit Jain

    2015-01-01

    Full Text Available Background: Progress has been made in the understanding of cellular and molecular mechanisms of hormone action and its effects on the cardiac tissue. There is evidence from observational studies that patients with postpartum cardiomyopathy improve after inhibition of release of prolactin from the pituitary by bromocriptine. This has renewed interest in the role of hormones in the pathogenesis of cardiomyopathy, especially in women. We intended to assess the hormonal changes in female patients with dilated cardiomyopathy (DCM. Methods: Twenty female patients aged 20-40 years old (mean age 29 ΁ 5.6 years with a diagnosis of idiopathic DCMP with left ventricular ejection fraction [EF] <35% and a stable clinical course in the last 3 months were included in the study. All the patients were in New York Heart Association (NYHA Class II or III. All the patients underwent clinical evaluation followed by blood sampling for hormonal analysis. Blood was taken after overnight fasting and analyzed for thyroid stimulating hormone (TSH, T3, T4, insulin-like growth factor I (IGF-I, prolactin, insulin, parathyroid hormone (PTH, and 25 (OH Vitamin D. The results were compared with twenty age and sex matched controls. Results: The mean EF of the twenty patients was 24.4 ΁ 5.3% and duration of symptoms was 29.1 ΁ 24 months. Insulin growth factor 1 levels were significantly lower than normal. Fifty percent of the patients had levels lower than normal, but there was no correlation of IGF-I with NYHA class and EF. Testing of the thyroid hormones revealed that TSH levels were similar between patient and controls though 40% of the patients had elevated TSH levels. Of these patients, 5% (1 had hypothyroid. In addition to this, 10% (2 had isolated low T3, suggestive of the low T3 syndrome. None of the thyroid abnormalities showed a correlation with NYHA class or EF. All other hormone concentrations were comparable in both groups. Conclusion: In this cohort of female

  20. Factors predictive of abnormal results for computed tomography of the head in horses affected by neurologic disorders: 57 cases (2001-2007).

    Science.gov (United States)

    Sogaro-Robinson, Cristina; Lacombe, Véronique A; Reed, Stephen M; Balkrishnan, Rajesh

    2009-07-15

    To determine neurologic indications associated with abnormal results for computed tomography (CT) imaging of the head of horses affected by neurologic disorders. Retrospective case series. 57 horses. Signalment, history, clinical abnormalities, and clinicopathologic findings were obtained from medical records of horses examined because of neurologic disorders, and precontrast and postcontrast CT images of the head were reviewed. Data were analyzed by use of univariate and multivariate logistic regression. For a horse with abnormal mentation, odds of having abnormal results for CT imaging of the head was 30 times (95% confidence interval [CI], 2.36 to 374.63) the odds for a similar horse without abnormal mentation. For a horse with cranial nerve deficits, odds of having abnormal results for CT imaging of the head was 11 times (95% CI, 1.00 to 127.96) the odds for a similar horse without cranial nerve deficits. For a horse with seizure-like activity, odds of having abnormal results for CT imaging of the head was 0.05 times (95% CI, 0 to 0.90) the odds for a similar horse without seizures. These results suggested that alterations in consciousness and cranial nerve deficits were strong predictors of abnormal CT findings for the head of affected horses. Thus, CT can be a useful complementary diagnostic test in horses with these neurologic deficits. In contrast, alternative diagnostic tests (eg, electroencephalography and magnetic resonance imaging) should be considered in horses with seizure-like activity that do not have head trauma or cranial nerve deficits.

  1. Hereditary gingival fibromatosis with distinct dental, skeletal and developmental abnormalities.

    Science.gov (United States)

    Katz, Joseph; Guelmann, Marcio; Barak, Shlomo

    2002-01-01

    A case of a 9-year-old child with hereditary gingival fibromatosis, supernumerary tooth, chest deformities, auricular cartilage deformation, joint laxity and undescended testes is described. The exact mode of inheritance is unclear; a new mutation pattern is possible. These features resemble but differ from the previously reported Laband syndrome. The dental treatment consisted of surgical removal of the fibrous tissue and conservative restorative treatment under general anesthesia. The dental practitioner should be alert for developmental abnormalities such as supernumerary teeth and delayed tooth eruption. A comprehensive medical history and physical systemic evaluation is essential to rule out other systemic abnormalities. Genetic consultation is mandatory for future family planing.

  2. The effect of experimental low back pain on lumbar muscle activity in people with a history of clinical low back pain: a muscle functional MRI study.

    Science.gov (United States)

    Danneels, Lieven; Cagnie, Barbara; D'hooge, Roseline; De Deene, Yves; Crombez, Geert; Vanderstraeten, Guy; Parlevliet, Thierry; Van Oosterwijck, Jessica

    2016-02-01

    In people with a history of low back pain (LBP), structural and functional alterations have been observed at several peripheral and central levels of the sensorimotor pathway. These existing alterations might interact with the way the sensorimotor system responds to pain. We examined this assumption by evaluating the lumbar motor responses to experimental nociceptive input of 15 participants during remission of unilateral recurrent LBP. Quantitative T2 images (muscle functional MRI) were taken bilaterally of multifidus, erector spinae, and psoas at several segmental levels (L3 upper and L4 upper and lower endplate) and during several conditions: 1) at rest, 2) upon trunk-extension exercise without pain, and 3) upon trunk-extension exercise with experimental induced pain at the clinical pain-side (1.5-ml intramuscular hypertonic saline injections in erector spinae). Following experimental pain induction, muscle activity levels similarly reduced for all three muscles, on both painful and nonpainful sides, and at multiple segmental levels (P = 0.038). Pain intensity and localization from experimental LBP were similar as during recalled clinical LBP episodes. In conclusion, unilateral and unisegmental experimental LBP exerts a generalized and widespread decrease in lumbar muscle activity during remission of recurrent LBP. This muscle response is consistent with previous observed patterns in healthy people subjected to the same experimental pain paradigm. It is striking that similar inhibitory patterns in response to pain could be observed, despite the presence of preexisting alterations in the lumbar musculature during remission of recurrent LBP. These results suggest that motor output can modify along the course of recurrent LBP.

  3. CYTO - HISTO CORRELATION OF ATYPICAL GLANDULAR CELLS OF ENDOMETRIAL ORIGIN ON CERVICAL CYTOLOGY IN ABNORMAL UTERINE BLEEDING CASES

    Directory of Open Access Journals (Sweden)

    Lopa Mudra

    2015-02-01

    Full Text Available BACKGROUND: An association has been reported with presence of endometrial cells on cervical smears and clinically significant uterine lesions. Hence for early detection of endometrial pathology , t he 2001 Bethesda system has suggested the mandatory reporting of presence of any atypical endometrial cells regardless of age and menstrual status and out of phase normal looking endometrial cells in women aged 40 years or more. OBJECTIVES: To assess the association between atypical glandular cells of endometrial origin in cervical cytology and histopathological findings in abnormal uterine bleeding cases . SETTINGS AND DESIGN : The study was conducted at JSS hospital , Mysore in the department of pathology. This was a descriptive type of study. The sample was collected fro m patients attending the gynecology OPD with the complaints of abnormal uterine bleeding in JSS hospital . MATERIALS AND METHODS : Smears for cervical cytology are collected using either pap smear or manual liquid based smear from 82 patients in the age grou p of 20 - 75 years with complaints of abnormal bleeding history. The results of cervical cytology were compared and confirmed with the endometrial pathology. RESULTS : Out of 82 abnormal uterine bleeding cases 14 showed atypical endometrial cells. On follow u p of these cases , the results indicated an association between atypical endometrial cells in cervical cytology with endometrial carcinoma in 8 cases (60% , 1 case with complex hyperplasia with atypia (10% . CONCLUSION : Presence of atypical endometrial cell s in all women with abnormal uterine bleeding has considerable clinical implications & further diagnostic evaluation by endometrial sampling is of utmost importance.

  4. Abnormal parietal encephalomalacia associated with schizophrenia

    Science.gov (United States)

    Pan, Fen; Wang, Jun-Yuan; Xu, Yi; Huang, Man-Li

    2017-01-01

    Abstract Rationale: It is widely believed that structural abnormalities of the brain contribute to the pathophysiology of schizophrenia. The parietal lobe is a central hub of multisensory integration, and abnormities in this region might account for the clinical features of schizophrenia. However, few cases of parietal encephalomalacia associated with schizophrenia have been described. Patient concerns and Diagnoses: In this paper, we present a case of a 25-year-old schizophrenia patient with abnormal parietal encephalomalacia. The patient had poor nutrition and frequently had upper respiratory infections during childhood and adolescence. She showed severe schizophrenic symptoms such as visual hallucinations for 2 years. After examining all her possible medical conditions, we found that the patient had a lesion consistent with the diagnosis of encephalomalacia in her right parietal lobe and slight brain atrophy. Interventions: The patient was prescribed olanzapine (10 mg per day). Outcomes: Her symptoms significantly improved after antipsychotic treatment and were still well controlled 1 year later. Lessons: This case suggested that parietal encephalomalacia, which might be caused by inflammatory and infectious conditions in early life and be aggravated by undernutrition, might be implicated in the etiology of schizophrenia. PMID:28272261

  5. Evaluating the Referring Physician's Clinical History and Indication as a Means for Communicating Chronic Conditions That Are Pertinent at the Point of Radiologic Interpretation.

    Science.gov (United States)

    Obara, Piotr; Sevenster, Merlijn; Travis, Adam; Qian, Yuechen; Westin, Charles; Chang, Paul J

    2015-06-01

    The clinical history and indication (CHI) provided with a radiological examination are critical components of a quality interpretation by the radiologist. A patient's chronic conditions offer the context in which acute symptoms and findings can be interpreted more accurately. Seven pertinent (potentially diagnosis altering) chronic conditions, which are fairly prevalent at our institution, were selected. We analyze if and how in 140 CHIs there was mention of a patient's previously reported chronic condition and if and how the condition was subsequently described in the radiology report using a four-item scheme (Mention/Specialization, Generalization, Common comorbidity, No mention). In 40.7% of CHIs, the condition was rated Mention/Specialization. Therefore, we reject our first hypothesis that the CHI is a reliable source for obtaining pertinent chronic conditions (≥ 90.0%). Non-oncological conditions were significantly more likely rated No mention in the CHI than oncological conditions (58.7 versus 8.3%, P radiology report (χ(2) test, P radiology department to the care chain.

  6. Effect of Fertilization Mode, the Woman's Age, Reproductive History and Numbers of Retrieved Oocytes on Abnormal Fertilization in Human IVF/ICSI%受精方式、女方年龄、生育史和取卵数对体外异常受精的影响

    Institute of Scientific and Technical Information of China (English)

    习海涛; 陈华; 葛红山; 单丹; 吕杰强

    2011-01-01

    Objective: To explore the affecting factors of abnormal fertilization in human IVF/ICSI. Methods: The 15 364 oocytes from 1 004 IVF cycles and 250 ICSI cycles were retrospectively analyzed by the fertilization mode, the age of women, reproductive history, the number of retrieved oocytes of the incidence of normal fertilization rate (2 pronuclear, 2PN) and abnormal fertilization rate (1PN, 3PN, 4PN). Results: 1) The incidence of 1PN rate was lower in the ICSI group than that in the IVF group, however, the incidence of 3PN/4PN fertilization rate was higher in the ICSI group than that in the IVF group. 2) In the ICSI group the incidence of 3PN/4PN was significantly increased when the age of female was older than 35 (P<0.05). 3) The incidence of 1PN in the group of primary infertility was obviously more than that in the group of secondary infertility. 4) Total normal fertility rate in the group of 6-10 retrieved oocytes was higher than that in the other groups(P<0.05), and the incidence rate of abnormal fertilization (1PN, 3PN, 4PN) in the group of 11-15 oocytes was singnificantly higher than that in the other groups (P<0.05). Conclusion: The affecting factors and fertilization mechanism are different between IVF and ICSI: considering multiple factors for every couple of infertility and optimal fertilization modality in IVF may decline the incidence of abnormal fertilization and improve the normal fertilizaton rate.%目的:探讨人卵子体外受精后单原核(PN)和多原核胚胎形成的影响因素,为提高正常受精率探寻可行的方法.方法:回顾性分析1 004个IVF周期和250个ICSI周期,共计15 364个卵细胞资料,研究胚胎原核形成与体外受精方式、女方年龄、生育史、获卵数的关系.结果:①ICSI周期的1PN率明显高于IVF周期,而3PN和4PN形成率则明显低于IVF(P<0.05).②当女方年龄>35岁时,1PN、3PN和4PN形成率均显著高于年龄≤35岁者(P<0.05);当女方年龄在28~35岁时2PN(-正-

  7. Memetics clarification of abnormal behavior

    Institute of Scientific and Technical Information of China (English)

    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

  8. [Diagnosticum of abnormalities of plant meiotic division].

    Science.gov (United States)

    Shamina, N V

    2006-01-01

    Abnormalities of plant meiotic division leading to abnormal meiotic products are summarized schematically in the paper. Causes of formation of monads, abnormal diads, triads, pentads, polyads, etc. have been observed in meiosis with both successive and simultaneous cytokinesis.

  9. [ECG abnormalities in the MONICA Gent-Charleroi study population].

    Science.gov (United States)

    De Backer, G

    1989-01-01

    In a survey of a random sample of the adult population (aged 25-64 yr) from Ghent and Charleroi (n = 1693), 103 (6.1%) showed ECG-abnormalities suggestive of coronary heart disease (Minnesota code I, IV, or V); prevalence was equal in men (6.2%) as in women (6.0%). In men, 30% of ECG-abnormalities suggested an old myocardial infarction as compared to 23.4% in women. Men with abnormal ECG had a positive history of acute myocardial infarction in 23%, as compared to 23.4% in women. Multivariate discriminant function analysis shows that men with abnormal ECG are older, have a higher systolic blood pressure and were more often married. Women with ECG abnormalities were significantly older, had a lower HDL-level and were less educated. So, although the prevalence of ECG abnormalities is almost similar between sexes, they correlate differently with antecedents of infarction and are poorly related to different sets of risk factors in men as compared to women.

  10. Chromosome abnormalities in Indonesian patients with short stature

    Directory of Open Access Journals (Sweden)

    Paramayuda Chrysantine

    2012-08-01

    Full Text Available Abstract Background Short stature is associated with several disorders including wide variations of chromosomal disorders and single gene disorders. The objective of this report is to present the cytogenetic findings in Indonesian patients with short stature. Methods G-banding and interphase/metaphase FISH were performed on short stature patients with and without other clinical features who were referred by clinicians all over Indonesia to our laboratory during the year 2003–2009. Results The results of chromosomal analysis of ninety seven patients (mean age: 10.7 years old were collected. The group of patients with other clinical features showed sex chromosome abnormalities in 45% (18/40 and autosomal abnormalities in 10% (4/40, whereas those with short stature only, 42.1% (24/57 had sex chromosome abnormalities and 1.75% (1/57 had autosomal abnormalities. The autosomal chromosomal abnormalities involved mostly subtelomeric regions. Results discrepancies between karyotype and FISH were found in 10 patients, including detection of low-level monosomy X mosaicism in 6 patients with normal karyotype, and detection of mosaic aneuploidy chromosome 18 in 1 patient with 45,XX,rob(13;14(q10;q10. Statistical analysis showed no significant association between the groups and the type of chromosomal abnormalities. Conclusion Chromosome abnormalities account for about 50% of the short stature patients. Wide variations of both sex and autosomal chromosomes abnormalities were detected in the study. Since three out of five patients had autosomal structural abnormalities involving the subtelomeric regions, thus in the future, subtelomeric FISH or even a more sensitive method such as genomic/SNP microarray is needed to confirm deletions of subtelomeric regions of chromosome 9, 11 and 18. Low-level mosaicism in normal karyotype patients indicates interphase FISH need to be routinely carried out in short stature patients as an adjunct to karyotyping.

  11. 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

    Institute of Scientific and Technical Information of China (English)

    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

  12. Abnormal Presentation of Choriocarcinoma and Literature Review

    Science.gov (United States)

    Yousefi, Zohreh; Mottaghi, Mansorhe; Rezaei, Alireza; Ghasemian, Sedighe

    2016-01-01

    Introduction Gestational trophoblastic neoplasms have highly been malignant potential, which usually occurred in child-bearing age women. Unusual feature of this malignancy would be rare, it was important to take in mind the possibility of GTN in different manifestation. Based on the above mentioned, the aim of this presentation would be the management and outcome of a case series of choriocarcinoma patients with abnormal manifestation. Case Presentation We have presented four patients, first who initially manifestation with signs of septic shock, the second case with severe gastrointestinal hemorrhage, the third case with postpartum infection and the forth case was a postmenopausal bleeding patient. Conclusions In case of metastatic choriocarcinoma with precise history, accurate diagnosis and appropriate treatment have led us to curable results. PMID:27482332

  13. Hereditary sideroblastic anemia with associated platelet abnormalities.

    Science.gov (United States)

    Soslau, G; Brodsky, I

    1989-12-01

    A 62 year old male (R.H.) presented with a mild anemia (Hb 11-12 gm%) and a history of multiple hemorrhagic episodes. The marrow had 40-50% sideroblasts. Marrow chromosomes were normal. His wife was hematologically normal, while one daughter, age 30 years, had a sideroblastic anemia (Hb 11-12 gm%) with 40-50% sideroblasts in the marrow. Her anemia was first noted at age 15 years. Administration of vitamin B6 did not correct the anemia in either the father or daughter. Platelet abnormalities inherited jointly with this disorder are described for the first time. Both R.H. and his daughter had prolonged bleeding times, with normal PTT, PT times, fVIII:C, fVIII:Ag levels, and vWF multimers, which may rule out a von Willebrand's disease. They have normal platelet numbers but abnormally low platelet adhesiveness and greatly depressed ADP, collagen, and epinephrine responsiveness. Response to ristocetin was in the low normal range, and aggregation with thrombin was normal. While desmopressin completely normalized R.H.'s bleeding time, none of these platelet parameters were improved. No differences in the SDS PAGE protein patterns of RH platelets could be detected in comparison to normal samples. His platelets took up and released serotonin (5HT) normally, and electron micrographs defined no morphological abnormalities. However, no ATP was released from platelets activated with collagen, and when followed by thrombin about fourfold greater ATP was released by control platelets as compared to RH platelets. The dense granule fraction derived from RH platelets contained about 20% the level of ATP, 40% the level of ADP, and 50% the level of 5HT detected in a normal sample. The results indicate that the bleeding disorder is related to a non-classical heritable storage pool defect. The connection between the inherited sideroblastic anemia and platelet defects is obscure.

  14. The psychosocial impact of an abnormal cervical smear result.

    Science.gov (United States)

    Drolet, Mélanie; Brisson, Marc; Maunsell, Elizabeth; Franco, Eduardo L; Coutlée, François; Ferenczy, Alex; Fisher, William; Mansi, James A

    2012-10-01

    Data on the impact of abnormal cervical smear results on health-related quality of life (HrQoL) are scarce. We aimed to (i) prospectively assess the HrQoL of women who were informed of an abnormal smear result; (ii) identify predictors of greater negative psychosocial impact of an abnormal result; and (iii) prospectively estimate the quality-adjusted life-years (QALYs) lost following an abnormal result. Between 08/2006 and 08/2008, 492 women with an abnormal result and 460 women with a normal result, frequency matched for age and clinic, were recruited across Canada. HrQoL was measured at recruitment and 4 and 12 weeks later with the EuroQol, Short Form-12, short Spielberg State-Trait Anxiety Inventory (STAI) and HPV Impact Profile. Three blocks of potential predictors of higher psychosocial impact were tested by hierarchical modeling: (i) socio-demographics; (ii) sexual activity; and (iii) smear result severity, communication, and understanding. Receiving an abnormal result significantly increased anxiety (STAI mean difference between both groups = 8.3). Initial anxiety decreased over time for the majority of women. However, 35% of women had clinically meaningful anxiety at 12 weeks (i.e. STAI scores ≥0.5 standard deviation of the controls). These women reported a lower socio-economic level, did not completely understand the information about their result and perceived themselves at higher risk of cancer. QALY lost following an abnormal result were between 0.007 and 0.009. Receiving an abnormal smear has a statistically significant and clinically meaningful negative impact on mental health. However, this negative impact subsides after 12 weeks for the majority of women. Copyright © 2011 John Wiley & Sons, Ltd.

  15. Natural history of Barrett's esophagus

    Institute of Scientific and Technical Information of China (English)

    Rao Milind; Stephen E Attwood

    2012-01-01

    The natural history of Barrett's esophagus (BE) is difficult to quantify because,by definition,it should describe the course of the condition if left untreated.Pragmatically,we assume that patients with BE will receive symptomatic treatment with acid suppression,usually a proton pump inhibitor,to treat their heartburn.This paper describes the development of complications of stricture,ulcer,dysplasia and adenocarcinoma from this standpoint.Controversies over the definition of BE and its implications in clinical practice are presented.The presence of intestinal metaplasia and its relevance to cancer risk is discussed,and the need to measure the extent of the Barrett's epithelium (long and short segments) using the Prague guidelines is emphasized.Guidelines and international consensus over the diagnosis and management of BE are being regularly updated.The need for expert consensus is important due to the lack of randomized trials in this area.After searching the literature,we have tried to collate the important studies regarding progression of Barrett's to dysplasia and adenocarcinoma.No therapeutic studies yet reported show a clear reduction in the development of cancer in BE.The effect of pharmacological and surgical intervention on the natural history of Barrett's is a subject of ongoing research,including the Barrett's Oesophagus Surveillance Study and the aspirin and esomeprazole cancer chemoprevention trial with interesting results.The geographical variation and the wide range of outcomes highlight the difficulty of providing an individualized risk profile to patients with BE.Future studies on the interaction of genome wide abnormalities in Barrett's and their interaction with environmental factors may allow individualization of the risk of cancer developing in BE.

  16. High prevalence of abnormal glucose tolerance and metabolic disturbances in first degree relatives of NIDDM patients. A study in Catalonia, a mediterranean community.

    Science.gov (United States)

    Costa, A; Rios, M; Casamitjana, R; Gomis, R; Conget, I

    1998-09-01

    Our study aimed to analyse clinical and metabolic characteristics of first degree relatives of patients with non-insulin-dependent diabetes mellitus (NIDDM) in Catalonia. Two hundred and five subjects (39.8 +/- 14.2 year-old, 61% women) were included in the study. An oral glucose tolerance test (OGTT) was performed, obtaining basal plasma glucose and insulin, in order to calculate, %B (HOMA beta cell function) and %S (HOMA insulin sensitivity). A 30.7% of subjects showed an abnormal glucose tolerance, either as impaired glucose tolerance (IGT) (20.5%) or as NIDDM (10.2%). Glycaemia after the OGTT (120 min) was independently determined by fasting glycaemia and age (R2 = 0.50; P history of NIDDM (log %S, 3.6 +/- 0.4 vs. 3.9 +/- 0.4; P = 0.000; log-insulin 2.4 +/- 0.4 vs. 2.1 +/- 0.6 mU/l; P history of NIDDM. Interestingly, the rates, of abnormal g