Identification d’une nouvelle molécule d’intérêt chez le cheval atteint d’obstruction récurrente des voies respiratoires: La Pentraxine 3

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Ramery, Eve

2010-01-01

L’ORVR ou obstruction récurrente des voies respiratoires (ORVR) est la cause la plus fréquente de maladie pulmonaire chronique chez le cheval adulte. La maladie se caractérise par une hyperréactivité bronchique, une production excessive de mucus et une inflammation neutrophilique pulmonaire qui ont pour effet de réduire la compliance dynamique du poumon et d’augmenter la résistance des voies respiratoires au débit aérien. Alors que la maladie est une entité documentée dans la littérature depu...

Etat de Stress Post-traumatique lié à l'accouchement et Algies pelviennes chroniques

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GEFFROY- GRECO , Gisele

2005-01-01

Objectif : Rechercher un lien entre un accouchement objectivement stressant (césarienne ou forceps pour anomalies du rythme cardiaque fœtal, hémorragie de la délivrance) et des algies pelviennes chroniques (dysménorrhées, douleurs pelviennes non cycliques, dyspareunies) dans le post-partum tardif (au-delà d'un an).Méthode : auto-questionnnaire ; enquête exposés/non-exposés ; comparaison entre accouchement stressant et accouchement normal. Résultats : taux de réponse 58,3%. 253 patientes dans ...

Estimation de la prévalence de la multimorbidité au moyen du Système canadien de surveillance des maladies chroniques

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Allison Feely

2017-01-01

Full Text Available Introduction : Le Système canadien de surveillance des maladies chroniques (SCSMC de l’Agence de la santé publique du Canada utilise une méthode validée et normalisée pour estimer la prévalence des maladies chroniques, par exemple le diabète. L’élargissement de la portée du SCSMC pour inclure la surveillance de la multimorbidité et de la présence concomitante de deux maladies chroniques ou plus pourrait mieux guider la promotion de la santé et la prévention des maladies. L’objectif de notre étude était de déterminer s’il était possible de recourir au SCSMC pour estimer la prévalence de la multimorbidité. Méthodologie : Nous avons utilisé les données administratives sur la santé de sept provinces et de trois territoires portant sur cinq affections chroniques validées (maladies cardiovasculaires, maladies respiratoires, maladies mentales, hypertension et diabète pour estimer la prévalence de la multimorbidité. Nous avons produit des estimations normalisées selon l'âge et spécifiques selon l’âge (à l’aide des données démographiques canadiennes de 1991 pour deux définitions de la multimorbidité, soit deux affections ou plus ou trois affections ou plus sur les cinq affections validées, selon le sexe, la période et la zone géographique. Résultats : Au cours de l’exercice 2011-2012, la prévalence d’au moins deux et d'au moins trois affections chroniques chez les Canadiens de 40 ans ou plus se situait à respectivement 26,5 % et 10,2 %, ce qui est comparable à d’autres estimations faites à partir des données administratives sur la santé. L'augmentation de la prévalence de la multimorbidité avec l’âge était similaire dans toutes les provinces. Les différences de prévalence entre hommes et femmes variaient selon les provinces et territoires. Nous avons également observé une variation importante des estimations au fil des années. Les résultats obtenus étaient comparables pour les

Oralité et écriture dans les chroniques dynastiques d’Afrique de l’Ouest

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Jean Boulègue

2010-04-01

Full Text Available Les chroniques dynastiques ouest-africaines, qu’elles soient écrites ou orales, sont construites sur la base du règne, qui en fournit le découpage, tandis que le roi est au cœur du récit. L’islamisation n’y a introduit ni l’ère hégirienne ni l’année lunaire. Elles utilisent l’année solaire, avec son rythme saisonnier, et un système chronologique dont la date-repère se situe à la fin de l’échelle du temps, à savoir l’avènement du roi régnant. La royauté est bien le principe régulateur de ces chroniques et le choix du mode de transmission (oralité ou écriture ne le dément pas : il ne dépend pas de la connaissance de l’écriture mais de rapports de force socio-politiques et des choix du pouvoir.West African dynastic chronicles, whether as written texts or oral traditions, are built according to the reigns, which give their internal division, while the king is at the heart of the account. Islamization did not introduce into them the Hegirian era or the lunar year. These chronicles are based on the solar year, with its seasonal rhythm, and a chronological system based on the end of the timeline, that is the enthronement of the reigning king. Thus kingship is the ruling principle of these chronicles and the choice of the mode of transmission (orality or writing does not deny it: it does not depend on the knowledge of writing but on social and political power struggles and the choices of the ruling power.

Short term effect of urban air pollution on respiratory disease, especially chronic obstructive pulmonary disease (COPD). Analysis of studies published from 1962 to january 2000; Impact a court terme de la pollution atmospherique urbaine sur l'insuffisance respiratoire par bronchopneumopathie chronique obstructive (BPCO). Synthese des etudes, publiees de 1962 a janvier 2000

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Desqueyroux, H.; Momas, I. [Universite Rene Descartes, Faculte des Sciences Pharmaceutiques et Biologiques, Lab. d' Hygiene et de Sante Publique, 75 - Paris (France)

2001-02-01

This review presents a synthesis of studies published from 1962 to 2000 on the relations between air pollution and chronic obstructive pulmonary disease (COPD): 12 ecological epidemiological studies, 6 epidemiological panel studies, and 11 controlled human exposure trials. The controlled trials, ecological time-based epidemiological studies and panels are examined successively followed by a discussion of their methodology and results. The controlled trials either do no highlight effects or show effects having no clinical significance since variations are similar to physiological variability. For epidemiological studies reporting individual data, the results point to a particle effect (two studies). This effect of particles is found in ecological studies which also describe an impact of ozone, sometimes of sulfur dioxide and less often of nitrogen dioxide. In conclusion, patients suffering from COPD are generally regarded as a group sensitive to air pollution, as suggested by the results of numerous ecological epidemiological studies. Rare individual studies provide a few arguments supporting this assumption. (authors)

Analyse de L'université et les TIC – Chronique d'une innovation annoncée

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Jean Uebersfeld

2013-04-01

Full Text Available Date de réception et d'acceptation : octobre 2010. 1. Champ couvert par l'ouvrage L'ouvrage, comme l'indique son sous-titre, se présente comme une chronique de l'introduction des TIC (technologies de l'information et de la communication dans l'enseignement universitaire. On remarquera d'emblée que, même si le titre est très général, il faut entendre qu'il s'agit d'analyser des expériences s'organisant dans le cadre précis du Ruca (réseau universitaire des centres d'autoformation et des proj...

Anomalies échocardiographiques chez l'hémodialysé chronique: prévalence et facteurs de risqué

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Ezziani, Mariam; Najdi, Adil; Mikou, Souad; Elhassani, Anis; Akrichi, Mohammed Amine; Hanin, Hakim; Arrayhani, Mohammed; Houssaini, Tarik Sqalli

2014-01-01

Introduction Les complications cardio-vasculaires sont la principale cause de mortalité et de morbidité chez les patients hémodialysés chroniques. Le but de cette étude est de décrire les différentes atteintes cardiaques à l’échocardiographie transthoracique et de dégager les facteurs associés aux principales atteintes. Méthodes Etude transversale monocentrique incluant des patients adultes hémodialysés depuis plus d'un an et ayant bénéficié d'une échocardiographie transthoracique durant l'an...

Encéphalopathie de Gayet-Wernicke compliquant des ...

African Journals Online (AJOL)

L'encéphalopathie de Gayet-Wernicke est une complication neuropsychiatrique aiguë secondaire à une carence en thiamine. Les vomissements incoercibles compliquant une obstruction intestinale chronique en sont une cause rare. Nous rapportons un cas d'encéphalopathie de Gayet-Wernicke compliquant des ...

Case report

African Journals Online (AJOL)

ebutamanya

3 juil. 2015 ... Abstract. L'encéphalopathie de Gayet-Wernicke est une complication neuropsychiatrique aiguë secondaire à une carence en thiamine. Les vomissements incoercibles compliquant une obstruction intestinale chronique en sont une cause rare. Nous rapportons un cas d'encéphalopathie de Gayet-.

L'eau et les liquides de dialyse dans le traitement de l'insuffisance rénale chronique terminale

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Kunegel , Edouard

2013-01-01

Non disponible / Not available; Seules trois méthodes de traitement, aujourd'hui, s'offrent au patient insuffisant rénal chronique (IRC) en phase terminale : la dialyse péritonéale, l'hémodialyse, et la transplantation rénale. L'esquisse de ces techniques sera dessinée au fil de ce travail, avec un focus particulier sur l'hémodialyse, méthode à ce jour encore la plus utilisée. À ses débuts, les résultats proposés par cette procédure, assortis d'une lourde mortalité, étaient peu concluants.Jus...

Les dysthyroïdies chez l’hémodialysé chronique

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Najoua Zbiti

2010-10-01

Full Text Available INTRODUCTION: Les dysthyroïdies chez l’hémodialysé chronique sont représentées par une hypothyroïdie: dite le syndrome de basse T3, actuellement nommée "le syndrome de la maladie euthyroïdienne". L’objectif de notre travail est de déterminer le profil thyroïdien de nos HDC afin de préciser la prévalence des différents troubles thyroïdiens dans notre population et de dégager les facteurs prédictifs, aussi on a précisé l’évolution sur une période de 3 ans. METHODES: Il s’agit d’une étude rétrospective réalisée en Mars 2007 concernant 68 patients adultes en hémodialyse périodique. Nous avons analysé les paramètres anthropométriques, cliniques et biologiques. Le dosage des hormones thyroïdiennes ((triiodothyronine libre FT3, (thyroxine libre FT4 et (thyréostimuline ultra-sensible TSHus s’est effectué selon la méthode radio-immunologique. Nous avons comparé 2 groupes de patients avec et sans dysthyroïdie (définie par un taux anormal de FT3 et/ou de FT4 et/ou de TSH afin de dégager les facteurs de risque. On a réalisé une surveillance biologique des hormones thyroïdiennes pendant 3 ans afin de préciser l’incidence des différents troubles thyroïdiens dans la même population. RESULTATS: Tous les patients sont en euthyroïdie clinique. On n’a noté aucun cas de goitre. Le profil thyroïdien est caractérisé par une hypothyroïdie biologique, la prévalence était de 28%. Nous n'avons pas trouvé des cas d'hyperthyroïdie. L'étude comparative des deux groupes de malades biologiquement euthyroïdiens et hypothyroïdiens a révèle le syndrome inflammatoire (p=0.001, l’âge avancé (p=0.003, et la durée prolongée en hémodialyse (p=0.04 comme des facteurs de risque liés à l’hypothyroïdie biologique. Deux HDC ont nécessité un traitement hormonal substitutif vu le contexte du diabète dans un cas et de la grossesse dans l’autre cas. Le suivi biologique pendant trois ans n’a r

Profil des diabétiques en hémodialyse chronique: étude multicentrique au Maroc

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Kabbali, Nadia; Mikou, Souad; El Pardiya, Nada Tazi; El Bardai, Ghita; Arrayhani, Mohamed; Houssaini, Tarik Sqalli

2014-01-01

Introduction Le diabète représente la première cause de mortalité par insuffisance rénale au Maroc. Sa prévalence selon l'Enquête Nationale sur la Population et la Santé Familiale de 2011 est de 3,3% [1]. Le but de ce travail est de déterminer la prévalence et d’étudier le profil clinique des diabétiques en hémodialyse chronique au Maroc. Méthodes Il s'agit d'une étude transversale multicentrique incluant 2066 hémodialysés chroniques dans les 39 centres d'hémodialyse de quatre régions marocaines. Résultats La prévalence du diabète en hémodialyse est 21,6%. L’âge moyen 59±13,2 ans (26-87). Le sex-ratio est de 1,9. L'IMC moyen est de 24,5 ± 4,4 kg/m2 (15-41). 42 patients sont porteurs d′une hépatite virale. La durée moyenne en HD est 39,3± 67 mois. 57% des patients gardent une diurèse résiduelle versus 43% chez les non diabétiques. Par rapport à ces derniers, nous avons noté plus d'HTA (64% versus 45%), plus de complications cardiovasculaires (23% versus 12%), un âge plus avancé à l'initiation de l'hémodialyse (55,5 versus 47 ans) et un taux de FAV proximales plus important. Conclusion La prévalence des diabétiques en hémodialyse est relativement élevée au Maroc sans tenir compte des patients qui ne bénéficient pas d’épuration extra-rénale pour des raisons socio-économiques. Le taux élevé de mortalité est imputable au retard et/ou à l'absence de la prise en charge néphrologique des diabétiques. Dans nos régions où le système sanitaire dispose de faible moyen, l'accent doit être mis sur le dépistage précoce de la néphropathie chez le diabétique. PMID:25374630

PLACE DU MEDECIN GENERALISTE, EN FRANCE, DANS LE PARCOURS DE SOINS DES MALADIES CHRONIQUES

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Claude JAFFIOL

2017-05-01

Full Text Available Les maladies chroniques sont la première cause de décès et la source principale des dépenses de santé. Leur dépistage précoce devrait permettre de limiter leur gravité évolutive et de réduire sensiblement leur coût.Le médecin généraliste est le mieux placé pour assurer la prise en charge de ces affections tout au long du parcours de soins. Mais plusieurs obstacles limitent cette évidence : la diminution régulière du nombre de praticiens de premier recours affectant de nombreux bassins de santé en France,  mais aussi, pour ceux en activité, des difficultés tenant au manque de formation, de temps médical et à une rémunération inadaptée à la prise en charge de ces pathologies. De ce fait, la prévention des maladies chroniques est insuffisante, leur diagnostic souvent trop tardif,  tandis que leur suivi se heurte au défaut d’observance du traitement par le patient et, plus rarement, à l’inertie thérapeutique médicale.   C'est pourquoi, il faut revoir fondamentalement la prise en charge des patients  pour les rendre autonomes dans la gestion de leur affection tout en donnant au praticien les moyens de gérer et de coordonner efficacement les diverses étapes du parcours de soin. Cela exige de changer les mentalités de part et d'autre, mais aussi de donner au médecin les moyens financiers lui permettant de consacrer à ses patients plus de temps, au centre d'une nouvelle organisation interprofessionnelle. La prévention et l’éducation thérapeutique du patient (ETP sont les clés de cette révolution thérapeutique. Il convient, en outre,  de revoir la formation des étudiants en privilégiant les sciences humaines et les stages chez le praticien, en favorisant  un accès accru au numérique et en assurant la reconnaissance, par des mesures concrètes, de la place du médecin généraliste dans un nouveau parcours de soins où il doit avoir un rôle central de coordinateur.

Accès aux soins des personnes originaires d&8217;Afrique subsaharienne vivant avec une hépatite B chronique

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Vignier, N.; Spira, R. D.; Lert, F.; Pannetier, J.; Ravalihasy, Andrainolo; Gosselin, A.; Lydie, N.; Bouchaud, O.; Desgrées du Loû, Annabel; Grp, Anrs-Parcours

2017-01-01

Objectif : L'objectif de cette étude est d'analyser l'accès aux soins des personnes originaires d'Afrique subsaharienne (ASS) vivant avec une hépatite B chronique (HBC) en France. Méthodes : L'enquête ANRS-Parcours est une étude biographique réalisée en 2012-2013 auprès de personnes originaires d'ASS recrutées dans des services de prise en charge de l'HBC en Ile-de-France. Les données ont été recueillies en face-à-face à l'aide d'une grille biographique et d'un questionnaire standardisé. ...

Lignes directrices canadiennes sur l’utilisation sécuritaire et efficace des opioïdes pour la douleur chronique non cancéreuse

Science.gov (United States)

Kahan, Meldon; Mailis-Gagnon, Angela; Wilson, Lynn; Srivastava, Anita

2011-01-01

Résumé Objectif Présenter aux médecins de famille un résumé clinique pratique des lignes directrices canadiennes sur l’utilisation sécuritaire et efficace des opioïdes pour la douleur chronique non cancéreuse, produites par le National Opioid Use Guideline Group. Qualité des données Pour produire les lignes directrices, les chercheurs ont effectué une synthèse critique de la littérature médicale sur l’efficacité et l’innocuité des opioïdes pour la douleur chronique non cancéreuse et ont rédigé une série de recommandations. Un panel de 49 cliniciens experts de toutes les régions du Canada ont passé en revue l’ébauche et ont atteint un consensus sur 24 recommandations. Message principal Il est recommandé de faire un dépistage du risque de dépendance avant de prescrire des opioïdes. On recommande des opioïdes faibles (codéine et tramadol) pour une douleur de légère à modérée qui n’a pas répondu aux traitements de première intention. On peut essayer l’oxycodone, l’hydromorphone et la morphine chez les patients qui n’ont pas eu de soulagement avec des opioïdes plus faibles. Une faible dose initiale et une lente hausse du titrage sont recommandées, ainsi qu’une étroite surveillance du patient qu’on a d’abord renseigné. Les médecins doivent surveiller l’apparition de complications comme l’apnée du sommeil. La dose optimale est celle qui améliore le fonctionnement ou atténue les cotes d’évaluation de la douleur d’au moins 30 %. Pour la grande majorité des patients, la dose optimale sera bien en deçà de l’équivalent de 200 mg de morphine par jour. On recommande le sevrage progressif pour les patients qui n’ont pas répondu à un essai d’opioïdes adéquat. Conclusion Les opioïdes jouent un rôle important dans la prise en charge de la douleur chronique non cancéreuse, mais il faut en prescrire avec prudence pour limiter les dommages potentiels. Les nouvelles lignes directrices

Obstructive Sleep Apnea

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... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ...

Obstructive Sleep Apnea

Medline Plus

Full Text Available ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ...

Adénome de prostate révélé par des hypoglycémies profondes: A ...

African Journals Online (AJOL)

shanker

Conclusion: L'insuffisance rénale obstructive peut constituer une complication de l'adénome de la prostate à un stade ultime. Elle est responsable .... Elle apparaît au stade de rétention vésicale chronique complète. La distension vésicale est majeure et ... terminale et d'hémodialyse. Ces molécules, de demi-vie courte et.

UPJ obstruction

Science.gov (United States)

... junction obstruction; Obstruction of the ureteropelvic junction Images Kidney anatomy References Elder JS. Obstruction of the urinary tract. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, St. Geme JW, Schor NF, eds. ... The Kidney . 10th ed. Philadelphia, PA: Elsevier; 2016:chap 38. ...

Obstructive Sleep Apnoea

African Journals Online (AJOL)

Cheyne-Stokes respiration), obstructive sleep apnoea and mixed or complex sleep apnoea.1. Obstructive sleep apnoea (OSA) is the most common of these three disorders and is defined as airway obstruction during sleep, accompanied by at least ...

Multidetector row computed tomography in bowel obstruction. Part 2. Large bowel obstruction

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Sinha, R. [Department of Radiology, Glenfield Hospital, Leicester (United Kingdom)]. E-mail: rakesh.sinha@uhl-tr.nhs.uk; Verma, R. [Department of Radiology, Glenfield Hospital, Leicester (United Kingdom)

2005-10-01

Large bowel obstruction may present as an emergency as high-grade colonic obstruction and can result in perforation. Perforated large bowel obstruction causes faecal peritonitis, which can result in high morbidity and mortality. Multidetector row computed tomography (MDCT) has the potential of providing an accurate diagnosis of large bowel obstruction. The rapid acquisition of images within one breath-hold reduces misregistration artefacts than can occur in critically ill or uncooperative patients. The following is a review of the various causes of large bowel obstruction with emphasis on important pathogenic factors, CT appearances and the use of multiplanar reformatted images in the diagnostic workup.

Aortic obstruction: anatomy and echocardiography

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Keirns Candace

2006-09-01

Full Text Available Abstract Echocardiography is a valuable non-invasive technique for identifying the site and type of aortic obstruction. Knowledge of the morphological details of each type of obstruction is the basis for correct interpretation of the diagnostic images and clinical decisions. This study was undertaken to correlate the echocardiographic images with anatomic specimens of equivalent valvular and supravalvular aortic obstruction. Specimens were part of the collection of the Department of Embryology. Fifty six patients were studied, and forty specimens with aortic obstruction were analyzed. Echocardiographic characteristics: Thirty one (55.3% patients were women and twenty five (44.7% men. Valvular aortic obstruction was found in Thirty six patients (64.3 % and supravalvular aortic obstruction in twenty (35.7%. Anatomic characteristics: Of the forty specimens examined, twenty one (52.5% had valvular aortic obstruction and nineteen (47.5% supravalvular aortic obstruction. The anatomoechocardiographic correlation clearly showed that the anatomic findings of the specimen hearts and aortas corresponded to echocardiographic images of valvular and supravalvular aortic obstruction and provided solid corroboration of echocardiographic diagnoses.

Acute GI obstruction.

Science.gov (United States)

Hucl, Tomas

2013-10-01

Acute gastrointestinal obstruction occurs when the normal flow of intestinal contents is interrupted. The blockage can occur at any level throughout the gastrointestinal tract. The clinical symptoms depend on the level and extent of obstruction. Various benign and malignant processes can produce acute gastrointestinal obstruction, which often represents a medical emergency because of the potential for bowel ischemia leading to perforation and peritonitis. Early recognition and appropriate treatment are thus essential. The typical clinical symptoms associated with obstruction include nausea, vomiting, dysphagia, abdominal pain and failure to pass bowel movements. Abdominal distention, tympany due to an air-filled stomach and high-pitched bowel sounds suggest the diagnosis. The diagnostic process involves imaging including radiography, ultrasonography, contrast fluoroscopy and computer tomography in less certain cases. In patients with uncomplicated obstruction, management is conservative, including fluid resuscitation, electrolyte replacement, intestinal decompression and bowel rest. In many cases, endoscopy may aid in both the diagnostic process and in therapy. Endoscopy can be used for bowel decompression, dilation of strictures or placement of self-expandable metal stents to restore the luminal flow either as a final treatment or to allow for a delay until elective surgical therapy. When gastrointestinal obstruction results in ischemia, perforation or peritonitis, emergency surgery is required. Copyright © 2013. Published by Elsevier Ltd.

Le syndrome de fatigue chronique et la fibromyalgie au Canada : prévalence et associations avec six indicateurs de l'état de santé

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C. Rusu

2015-01-01

Full Text Available Introduction : Peu d'études ont traité, à l'aide de données populationnelles, des facteurs associés de façon indépendante au syndrome de fatigue chronique (SFC et à la fibromyalgie (FM ou des répercussions de ces affections sur l'état de santé. Méthodologie : Nous avons utilisé les données de l'Enquête sur la santé dans les collectivités canadiennes de 2010 (n=59 101, représentative de la population à l'échelle nationale, pour décrire les cas autodéclarés de SFC et de FM diagnostiqués par un professionnel de la santé et pour déterminer les associations de ces affections avec six indicateurs de l'état de santé. Résultats : En 2010, 1,4 % (intervalle de confiance [IC] à 95 % : 1,3 % à 1,6 % des Canadiens de 12 ans ou plus vivant à domicile ont déclaré avoir reçu un diagnostic de SFC,1,5 % (IC à 95 %: 1,4 % à 1,7 % de FM, et 0,3 % (IC à 95 %: 0,3 % à 0,4 % a déclaré être atteinte à la fois de SFC et de FM. Les cas de SFC comme ceux de FM étaient plus fréquents chez les femmes, les adultes de 40 ans ou plus, les personnes à faible revenu et les personnes présentant certains facteurs de risque de maladie chronique (obésité, sédentarité et tabagisme. Après ajustement en fonction des différences existant entre les groupes, les personnes ayant déclaré être atteintes du SFC ou de FM ou des deux avaient un moins bon état de santé que les personnes atteintes d'aucune de ces affections pour cinq indicateurs de l'état de santé, mais aucune différence n'a été trouvée entre ces groupes par rapport à l'indicateur de santé mentale. Le fait d'être atteint à la fois du SFC et de FM et de présenter de multiples affections comorbides était associé à un moins bon état de santé. Conclusion : La présence concomitante du SFC, de la FM et d'autres affections chroniques était étroitement associée au fait d'avoir un moins bon état de santé, et les différences relatives à l'état de santé �

Association of chronic obstructive pulmonary disease and obstructive sleep apnea consequences

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Carlos Zamarrón

2009-01-01

Full Text Available Carlos Zamarrón1, Vanesa García Paz1, Emilio Morete1, Felix del Campo Matías21Servicio de Neumología, Hospital Clínico Universitario de Santiago, Santiago, Spain; 2Servicio de Neumologia, Hospital Universitario Rio Ortega de Vallaclolid, Vallaclolid, SpainAbstract: Obstructive sleep apnea syndrome (OSAS and chronic obstructive pulmonary disease (COPD are two diseases that often coexist within an individual. This coexistence is known as overlap syndrome and is the result of chance rather than a pathophysiological link. Although there are claims of a very high incidence of OSAS in COPD patients, recent studies report that it is similar to the general population. Overlap patients present sleep-disordered breathing associated to upper and lower airway obstruction and a reduction in respiratory drive. These patients present unique characteristics, which set them apart from either COPD or OSAS patients. COPD and OSAS are independent risk factors for cardiovascular events and their coexistence in overlap syndrome probably increases this risk. The mechanisms underlying cardiovascular risk are still unclear, but may involve systemic inflammation, endothelial dysfunction, and tonic elevation of sympathetic neural activity. The treatment of choice for overlap syndrome in stable patients is CPAP with supplemental oxygen for correction of upper airway obstructive episodes and hypoxemia during sleep.Keywords: chronic obstructive pulmonary disease, obstructive sleep apnea syndrome, overlap syndrome, sleep, cardiovascular disease

Within-breath respiratory impedance and airway obstruction in patients with chronic obstructive pulmonary disease.

Science.gov (United States)

Silva, Karla Kristine Dames da; Faria, Alvaro Camilo Dias; Lopes, Agnaldo José; Melo, Pedro Lopes de

2015-07-01

Recent work has suggested that within-breath respiratory impedance measurements performed using the forced oscillation technique may help to noninvasively evaluate respiratory mechanics. We investigated the influence of airway obstruction on the within-breath forced oscillation technique in smokers and chronic obstructive pulmonary disease patients and evaluated the contribution of this analysis to the diagnosis of chronic obstructive pulmonary disease. Twenty healthy individuals and 20 smokers were assessed. The study also included 74 patients with stable chronic obstructive pulmonary disease. We evaluated the mean respiratory impedance (Zm) as well as values for the inspiration (Zi) and expiration cycles (Ze) at the beginning of inspiration (Zbi) and expiration (Zbe), respectively. The peak-to-peak impedance (Zpp=Zbe-Zbi) and the respiratory cycle dependence (ΔZrs=Ze-Zi) were also analyzed. The diagnostic utility was evaluated by investigating the sensitivity, the specificity and the area under the receiver operating characteristic curve. ClinicalTrials.gov: NCT01888705. Airway obstruction increased the within-breath respiratory impedance parameters that were significantly correlated with the spirometric indices of airway obstruction (R=-0.65, pdisease patients presented significant expiratory-inspiratory differences (p90%). We conclude the following: (1) chronic obstructive pulmonary disease introduces higher respiratory cycle dependence, (2) this increase is proportional to airway obstruction, and (3) the within-breath forced oscillation technique may provide novel parameters that facilitate the diagnosis of respiratory abnormalities in chronic obstructive pulmonary disease.

Within-breath respiratory impedance and airway obstruction in patients with chronic obstructive pulmonary disease

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Karla Kristine Dames da Silva

2015-07-01

Full Text Available OBJECTIVE: Recent work has suggested that within-breath respiratory impedance measurements performed using the forced oscillation technique may help to noninvasively evaluate respiratory mechanics. We investigated the influence of airway obstruction on the within-breath forced oscillation technique in smokers and chronic obstructive pulmonary disease patients and evaluated the contribution of this analysis to the diagnosis of chronic obstructive pulmonary disease. METHODS: Twenty healthy individuals and 20 smokers were assessed. The study also included 74 patients with stable chronic obstructive pulmonary disease. We evaluated the mean respiratory impedance (Zm as well as values for the inspiration (Zi and expiration cycles (Ze at the beginning of inspiration (Zbi and expiration (Zbe, respectively. The peak-to-peak impedance (Zpp=Zbe-Zbi and the respiratory cycle dependence (ΔZrs=Ze-Zi were also analyzed. The diagnostic utility was evaluated by investigating the sensitivity, the specificity and the area under the receiver operating characteristic curve. ClinicalTrials.gov: NCT01888705. RESULTS: Airway obstruction increased the within-breath respiratory impedance parameters that were significantly correlated with the spirometric indices of airway obstruction (R=−0.65, p90%. CONCLUSIONS: We conclude the following: (1 chronic obstructive pulmonary disease introduces higher respiratory cycle dependence, (2 this increase is proportional to airway obstruction, and (3 the within-breath forced oscillation technique may provide novel parameters that facilitate the diagnosis of respiratory abnormalities in chronic obstructive pulmonary disease.

Méthodologie d’analyse des signaux et caractérisation hydrogéologique : application aux chroniques de données obtenues aux laboratoires souterrains du Mont Terri, Tournemire et Meuse/Haute-Marne

OpenAIRE

Fatmi, Hassane

2009-01-01

Ce rapport présente des méthodes de prétraitement, d'analyse statistique et d'interprétation de chroniques hydrogéologiques de massifs peu perméables (argilites) dans le cadre d'études sur le stockage profond de déchets radioactifs. Les séries temporelles analysées sont la pression interstitielle et la pression atmosphérique, en relation avec différents phénomènes (marées terrestres, effet barométrique, évolution de l'excavation des galeries). Les pré-traitements permetten...

Reduced upper obstructions in N3 and increased lower obstructions in REM sleep stage detected with manometry.

Science.gov (United States)

Wirth, Markus; Schramm, Juliane; Bautz, Maximilian; Hofauer, Benedikt; Edenharter, Günther; Ott, Armin; Heiser, Clemens

2018-01-01

In obstructive sleep apnea (OSA), airway obstruction occurs at different anatomic levels. The frequency and location of obstructions play a crucial role in the planning of surgical treatment. The aim of this study was to evaluate the pharyngeal obstruction levels in different sleep stages with manometry in OSA patients. In addition, the manometry results were compared with drug-induced sleep endoscopy (DISE). Forty-one patients with OSA received manometry measurements during one night of sleep. All patients were simultaneously evaluated with polysomnography. The frequency of obstructions in different sleep stages was assessed. Twenty patients were additionally studied with DISE. Obstruction levels detected with manometry were compared with DISE. The frequency of upper and to a lesser extent lower obstructions decreased in sleep stage N3. In rapid eye movement (REM) sleep, lower obstructions increased. The overall proportion of upper and lower obstructions detected with manometry corresponded with DISE in 13 of 20 cases. A significant change in the obstruction levels was detected with manometry in N3 and REM sleep. The reduction of both upper and to a lesser extent lower obstructions in N3 suggests more stable airways in slow-wave sleep. Relevant lower obstructions were not detected in DISE compared to manometry in 5 out of 20 examinations. This could be a potential reason for treatment failure of site-specific surgical OSA treatment when only performing DISE preoperatively. Therefore, manometry could be a useful complementary tool in the preoperative evaluation for OSA.

Obstructive Sleep Apnea

Medline Plus

Full Text Available ... can also invite bacteria that lead to gum disease. Click here to find out more. Obstructive Sleep Apnea (OSA) Download Download the ebook for further information Obstructive sleep ... high blood pressure, heart disease and decreased libido. In addition, OSA causes daytime ...

Severity of Airflow Obstruction in Chronic Obstructive Pulmonary Disease (COPD): Proposal for a New Classification.

Science.gov (United States)

Coton, Sonia; Vollmer, William M; Bateman, Eric; Marks, Guy B; Tan, Wan; Mejza, Filip; Juvekar, Sanjay; Janson, Christer; Mortimer, Kevin; P A, Mahesh; Buist, A Sonia; Burney, Peter G J

2017-10-01

Current classifications of Chronic Obstructive Pulmonary Disease (COPD) severity are complex and do not grade levels of obstruction. Obstruction is a simpler construct and independent of ethnicity. We constructed an index of obstruction severity based on the FEV 1 /FVC ratio, with cut-points dividing the Burden of Obstructive Lung Disease (BOLD) study population into four similarly sized strata to those created by the GOLD criteria that uses FEV 1 . We measured the agreement between classifications and the validity of the FEV 1 -based classification in identifying the level of obstruction as defined by the new groupings. We compared the strengths of association of each classification with quality of life (QoL), MRC dyspnoea score and the self-reported exacerbation rate. Agreement between classifications was only fair. FEV 1 -based criteria for moderate COPD identified only 79% of those with moderate obstruction and misclassified half of the participants with mild obstruction as having more severe COPD. Both scales were equally strongly associated with QoL, exertional dyspnoea and respiratory exacerbations. Severity assessed using the FEV 1 /FVC ratio is only in moderate agreement with the severity assessed using FEV 1 but is equally strongly associated with other outcomes. Severity assessed using the FEV 1 /FVC ratio is likely to be independent of ethnicity.

Nasal obstruction and human communication.

Science.gov (United States)

Malinoff, R; Moreno, C

1989-04-01

Nasal obstruction may cause a variety of communication disorders, particularly in children. The effects of nasal obstruction on hearing, speech, language, and voice are examined. Methods for assessing the effects of nasal obstruction are delineated, and recommendations for therapeutic interventions are described.

Radiation-induced recurrent intestinal pseudo-obstruction

International Nuclear Information System (INIS)

Conklin, J.L.; Anuras, S.

1981-01-01

The syndrome of intestinal pseudo-obstruction is a complex of signs and symptoms of intestinal obstruction without evidence of mechanical obstruction of the intestinal lumen. A patient with radiation-induced intestinal pseudoobstruction is described. The patient is a 74-year old woman with a history of chronic diarrhea, recurrent episodes of crampy abdominal pain, nausea and vomiting since receiving a 13,000 rad radiation dose to the pelvis in 1954. She has been hospitalized on many occasions for symptoms and signs of bowel obstruction. Upper gastrointestinal contrast roentgenograms with small bowel follow-through done during these episodes revealed multiple dilated loops of small bowel with no obstructing lesion. Barium enemas revealed no obstructing lesion. Each episode resolved with conservative therapy. Other secondary causes for intestinal pseudo-obstruction were ruled out in our patient. She gave no history of familial gastrointestinal disorders. Although postirradiation motility abnormalities have been demonstrated experimentally this is the first report of radiation induced intestinal pseudo-obstruction

Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

LENUS (Irish Health Repository)

Lee, Ruth

2011-03-01

Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome.

Collateral circulations in inferior vena cava obstruction

International Nuclear Information System (INIS)

Lee, Jong Beum; Park, Jae Hyung; Han, Man Chung; Park, Soo Soung

1985-01-01

Obstruction of the inferior vena cava (IVC) is an uncommon condition, and the collateral pathway varies according to the level, extent, duration and the cause of obstruction. Membranous obstruction of IVC in its hepatic portion might be one of the principle cause among Korean, though not reported till now. Analytical study was performed in 26 cases of IVC obstruction with various cause. 1. The level of the obstruction showed relatively even distribution as follows, upper caval in 11 cases, middle caval in 6 cases and infrarenal in 9 cases. 2. The main cause of upper caval obstruction was membranous obstruction. 3. As a whole, the main collateral pathway was the central route (22 cases: 85%). 4. Characteristic collateral pathway unique to upper caval obstruction was transhepatic venous collateral, developed between the obstructed segment and unobstructed segment of IVC. 5. Scalloping of left cardiac border produced by pericardiophrenic venous collateral was characteristic simple chest x-ray finding in IVC obstruction

Real time ultrasonography in obstructive jaundice

International Nuclear Information System (INIS)

Cho, Kyung Sik; Kim, Ho Kyun; Sung, Nak Kwan; Kim, Soon Yong

1982-01-01

Ultrasonography is a predominantly accurate, relatively simple unique diagnostic method of obstructive jaundice. The ultrasonographic findings of obstructive jaundice are dilated intra- and extrahepatic duct with intraluminal hyper reflective echo or mass in and/ or around the bile duct. The superiority of high resolution real time ultrasonography for the diagnosis of obstructive jaundice is bases on the easy detectability of extra- and intrahepatic bile ducts by its multiple sectional images in a short time, the flexibility of probe and small crystal size. Author evaluated real time sonographic findings 46 obstructive jaundice patients confirmed by surgery or radiographical examinations. The results were: 1. Diameter of extrahepatic duct in obstructive jaundice were varied from normal to 4.0 Cm, mostly 8 to 10 mm in diameter (26%). Degree of dilatation of biliary duct appeared more prominent in cancer patients than other causes of obstruction. 2. The site of obstruction was detected in 85% (39/46) and its common site was common bile duct in 63% (29/46). 3. The diagnostic accuracy of choledocholithiasis and cancer was 82% (22/27) and 44% (4/9), respectively. Diagnostic accuracy of the real time ultrasonography in obstructive jaundice was over all 75% (34/46)

Managing neonatal bowel obstruction: clinical perspectives

Directory of Open Access Journals (Sweden)

Desoky SM

2018-02-01

Full Text Available Sarah M Desoky,1 Ranjit I Kylat,2 Unni Udayasankar,1 Dorothy Gilbertson-Dahdal1 1Department of Medical Imaging, University of Arizona College of Medicine, Tucson, AZ, USA; 2Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Arizona College of Medicine, Tucson, AZ, USA Abstract: Neonatal intestinal obstruction is a common surgical emergency and occurs in approximately 1 in 2,000 live births. The causes of obstruction are diverse with varied embryological origins, and some underlying etiologies are not yet well described. Some findings of neonatal bowel obstruction can be detected prenatally on ultrasound imaging. The obstruction is classified as “high” when the level of obstruction is proximal to the ileum, and “low” when the level of obstruction is at the ileum or colon. Early diagnosis of the type of intestinal obstruction and localization of the obstructive bowel segment guides timely and appropriate management of the underlying pathologic entity. Neonatal bowel obstructions are ideally managed at specialized centers with a large volume of neonatal surgery and dedicated pediatric surgical and anesthesia expertise. Although surgical intervention is necessary in most cases, initial management strategies often target underlying metabolic, cardiac, or respiratory abnormalities. Imaging plays a key role in early and accurate diagnosis of the abnormalities. When bowel obstruction is suspected clinically, initial imaging workup usually involves abdominal radiography, which may direct further evaluation with fluoroscopic examination such as upper gastrointestinal (UGI contrast study or contrast enema. This article provides a comprehensive review of clinical and radiological features of common and less common causes of intestinal obstruction in the neonatal age group, including esophageal atresia, enteric duplication cysts, gastric volvulus, congenital microgastria, hypertrophic pyloric stenosis, duodenal atresia

Acquired Duodenal Obstruction in Children

Directory of Open Access Journals (Sweden)

Jen-Hung Chien

2008-10-01

Full Text Available Traumatic intramural hematoma of the duodenum is a rare cause of acquired duodenal obstruction in children, and a high degree of suspicion is therefore required to make an early and accurate diagnosis. We report a 6-year-old boy whose epigastrium was impacted by the handlebar of his bicycle during a traffic accident. The boy then experienced epigastralgia. Six days later, progressive bilious vomiting suggestive of gastrointestinal obstruction was noted. Imaging studies revealed a large hematoma extending from the fourth portion of the duodenum to the jejunum. Conservative methods of treatment failed to manage his condition. He underwent laparoscopic surgery to evacuate the hematoma. We also report a case of duodenal obstruction in a previously healthy 2-year-old girl who presented for the first time with acute symptoms of proximal intestinal obstruction. Contrast examinations showed apparent barium retention over the stomach and proximal duodenum. She underwent surgery due to persistent obstruction, and a mushroom-like foreign body was detected embedded in the orifice of the windsock duodenal web. After duodenoduodenostomy and removal of the bezoar, she had a smooth recovery and tolerated feeding well. We conclude that blunt abdominal trauma and incomplete duodenal obstruction, such as that caused by duodenal web, should be considered as possible causes of acquired proximal gastrointestinal obstruction in previously healthy children, despite their rarity.

Chronic intestinal pseudo-obstruction.

Science.gov (United States)

Gabbard, Scott L; Lacy, Brian E

2013-06-01

Chronic intestinal pseudo-obstruction (CIP) is a rare and serious disorder of the gastrointestinal (GI) tract characterized as a motility disorder with the primary defect of impaired peristalsis; symptoms are consistent with a bowel obstruction, although mechanical obstruction cannot be identified. CIP is classified as a neuropathy, myopathy, or mesenchymopathy; it is a neuropathic process in the majority of patients. The natural history of CIP is generally that of a progressive disorder, although occasional patients with secondary CIP note significant symptomatic improvement when the underlying disorder is identified and treated. Symptoms vary from patient to patient depending on the location of the luminal GI tract involved and the degree of involvement; however, the small intestine is nearly always involved. Common symptoms include dysphagia, gastroesophageal reflux, abdominal pain, nausea, vomiting, bloating, abdominal distension, constipation or diarrhea, and involuntary weight loss. Unfortunately, these symptoms are nonspecific, which can contribute to misdiagnosis or a delay in diagnosis and treatment. Since many of the symptoms and signs suggest a mechanical bowel obstruction, diagnostic tests typically focus on uncovering a mechanical obstruction, although routine tests do not identify an obstructive process. Nutrition supplementation is required for many patients with CIP due to symptoms of dysphagia, nausea, vomiting, and weight loss. This review discusses the epidemiology, etiology, pathogenesis, diagnosis, and treatment of patients with CIP, with an emphasis on nutrition assessment and treatment options for patients with nutrition compromise.

Obstructive sleep apnea therapy

NARCIS (Netherlands)

Hoekema, A.; Stegenga, B.; Wijkstra, P. J.; van der Hoeven, J. H.; Meinesz, A. F.; de Bont, L. G. M.

In clinical practice, oral appliances are used primarily for obstructive sleep apnea patients who do not respond to continuous positive airway pressure (CPAP) therapy. We hypothesized that an oral appliance is not inferior to CPAP in treating obstructive sleep apnea effectively. We randomly assigned

Surgical management of nasal obstruction.

Science.gov (United States)

Moche, Jason A; Palmer, Orville

2012-05-01

The proper evaluation of the patient with nasal obstruction relies on a comprehensive history and physical examination. Once the site of obstruction is accurately identified, the patient may benefit from a trial of medical management. At times however, the definitive treatment of nasal obstruction relies on surgical management. Recognizing the nasal septum, nasal valve, and turbinates as possible sites of obstruction and addressing them accordingly can dramatically improve a patient's nasal breathing. Conservative resection of septal cartilage, submucous reduction of the inferior turbinate, and structural grafting of the nasal valve when appropriate will provide the optimal improvement in nasal airflow and allow for the most stable results. Copyright © 2012. Published by Elsevier Inc.

Central Airway Obstruction: Benign Strictures, Tracheobronchomalacia, and Malignancy-related Obstruction.

Science.gov (United States)

Murgu, Septimiu Dan; Egressy, Katarine; Laxmanan, Balaji; Doblare, Guillermo; Ortiz-Comino, Rosamaria; Hogarth, D Kyle

2016-08-01

The purpose of this article is to provide an update on methods for palliating symptoms in patients with histologically benign and malignant central airway obstruction. We review the published literature within the past decade on postintubation, posttracheostomy, and TB- and transplant-related airway strictures; tracheobronchomalacia; and malignant airway obstruction. We review terminology, classification systems, and parameters that impact treatment decisions. The focus is on how airway stent insertion fits into the best algorithm of care. Several case series and cohort studies demonstrate that airway stents improve dyspnea, lung function, and quality of life in patients with airway obstruction. Airway stenting, however, is associated with high rates of adverse events and should be used only when curative open surgical interventions are not feasible or are contraindicated. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Inferior vena cava obstruction and shock

Directory of Open Access Journals (Sweden)

Megri Mohammed

2018-01-01

Full Text Available Shock is one of the most challenging life-threatening conditions with high mortality and morbidity; the outcomes are highly dependent on the early detection and management of the condition. Septic shock is the most common type of shock in the Intensive Care Unit. While not as common as other subsets of shock, obstructive shock is a significant subtype due to well defined mechanical and pathological causes, including tension pneumothorax, massive pulmonary embolism, and cardiac tamponade. We are presenting a patient with obstructive shock due to inferior vena cava obstruction secondary to extensive deep venous thrombosis. Chance of survival from obstructive shock in our patient was small; however, there was complete and immediate recovery after treatment of the obstruction on recognizing the affected vessels. This case alerts the practicing intensivist and the emergency medicine physician to consider occlusion of the great vessels other than the pulmonary artery or aorta as causes of obstructive shock.

Chronic obstructive pulmonary disease and obstructive sleep apnea. Association, consequences and treatment.

Science.gov (United States)

Pronzato, C

2010-12-01

Obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) are two diseases that often co-exist within an individual. This co-existence, known as overlap syndrome (OS), is the result of chance rather than a pathophysiological linkage and epidemiological studies indicate a prevalence of 1% in adult males. Patients vith OS have a more important sleep-related O2 desaturation than COPD patients with the same degree of bronchial obstruction and show an increased risk of developing hypercapnic respiratory failure and pulmonary hypertension when compared with patients affected by only one of he diseases. COPD and OSAS are independent risk factors for cardiovascular events and their co-existence in OS probably increases this risk. Evidence of systemic inflammation in COPD and sleep apnea and consequentely OS, is interesting because it may contribute to the pathogenesis of cardiovascular diseases. Treatment consists of continuous positive airway pressure (CPAP) or non-invasive positive pressure ventilation (NIPPV), with or without associated O2, for correction of the upper airway obstructive episodes and hypoxemia during sleep.

Ultrasonography of small intestinal obstructions: a contemporary approach.

Science.gov (United States)

Garcia, D A A; Froes, T R; Vilani, R G D O C; Guérios, S D; Obladen, A

2011-09-01

To assess the accuracy of intestinal ultrasound for diagnosis of intestinal obstruction in dogs and cats. A prospective clinical study was performed. Inclusion criteria were dogs and cats with clinical signs suggestive of gastrointestinal obstruction. Animals with no obstruction detected on ultrasound were excluded if they could not be monitored for 48 hours to confirm absence of obstruction. Sonographic diagnosis of small intestinal obstruction was based on identification of at least two findings suggestive of intestinal obstruction. Ninety-two patients suspected of having intestinal obstruction were included. Correct diagnosis of intestinal obstruction was made in 21 cases (23%), and in 68 (74%) this diagnosis was excluded. Interpretation of the images on prospective analysis had sensitivity, positive predictive, specificity and negative predictive values of 100%, 87.5%, 95.8% and 100%, respectively. Ultrasonography is an excellent method for investigation of animals with gastrointestinal disorders, and is particularly useful for excluding obstructive processes. © 2011 British Small Animal Veterinary Association.

Magnetic resonance in obstructive jaundice

International Nuclear Information System (INIS)

Gupta, R.K.; Jena, A.; Khushu, S.; Kakar, A.K.; Mishra, P.K.

1989-01-01

Twelve cases of obstructive jaundice in whom ultrasound failed to demonstrate the site and/or the cause of obstruction of the biliary tract were examined with magnetic resonance imaging (MRI), correctly diagnosing the site and cause of obstruction in 10 of 12 surgically proven cases. In one case of cholangiocarcinoma, the site of obstruction was well shown on MR but a definite cause could not be ascertained. In another patient who developed intermittent jaundice following surgery for choledochal cyst, MR demonstrated a solitary stone in the common hepatic duct. Surgical confirmation could not be achieved as the patient was lost to follow up. There were 6 cases of choledocholithiasis, 3 cases of gall bladder carcinoma and one case each of pancreatic adenocarcinoma and cholangiocarcinoma. It is believed that MRI will provide obstructive jaundice and will be able to minimize the use of percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP) in view of its ability to perform multiplanar imaging in multiple sequences. 11 refs., figs., 1 tab

The angiographic demonstration of hepatic vein obstruction

International Nuclear Information System (INIS)

Zu Maoheng; Xu Hao; Li Guojun; Gu Yuming; Wei Ning; Wang Cheng; Xu Wei

2004-01-01

Objective: To evaluate the angiographic feature of hepatic vein obstruction. Methods Forty-five patients (male 23, female 22, age 9-54 years) suffered from hepatic vein obstruction. The inferior vena cavography and the hepatic venography were performed in all cases. Results: IVC was free in 37 patients with hepatic vein obstruction, both IVC and HV were obstructed in 8 patients. The local or long stenosis of IVC was found in 31 inferior vena cavography. The diameter of IVC was normal in 12 patients. The sign of membranous dome was found in hepatic vein orifice in 5 cases and in accessory hepatic vein orifice in 4 cases. Intrahepatic venous collaterals were found in 45 cases. Conclusion: Hepatic vein obstruction can be reproached primarily in inferior vena cavography, the membranous dome is a direct sign of membranous obstruction of HV and AHV in inferior vena cavography. The selected hepatic venography can provide reliable evidence to diagnose hepatic vein obstruction

Occupational chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Omland, Oyvind; Würtz, Else Toft; Aasen, Tor Børvig

2014-01-01

Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures....

Unusual causes of mechanical small bowel obstruction

International Nuclear Information System (INIS)

Shatnawi, Nawaf J.; Bani-Hani, Kamal E.

2005-01-01

We herein report our experience regarding unusual causes of bowel obstruction to increase the awareness of surgeons regarding this disease. From 1991 to 2003, we had experience at the University affiliated hospitals, northern Jordan with 24 patients with small bowel obstruction resulting from unusual causes. We retrospectively reviewed the medical records of these patients with regards to the mode of presentation, cause of obstruction, radiological and operative findings, management and outcome. We recorded 15 patients who underwent previous abdominal surgery. Preoperative diagnosis was correct in only one patient with an internal hernia, but the abdominal CT scan suggested the diagnosis in 5 of the 9 patients who had the scan. The final diagnosis was internal hernias in 11 patients, foreign bodies in 5, ischemic strictures in 3, carcinoid tumors in 2, endometriosis in 2, and metastatic deposit from interstitial bladder carcinoma in one patient. Nine of the 12 patients with recurrent obstruction had either short course or recurrence obstruction during the same hospital admission. W carried out bowel resections in 15 patients (5 resections were due to bowel strangulation). Post operative death occurred in 4 patients. Awareness of these rare causes of intestinal obstruction even in patients with previous abdominal operation might improve the outcome. The tentative diagnosis of adhesion obstruction in patients with unusual obstructive etiology might lead to a higher rate of gangrenous complications. Rigorous preoperative evaluation including careful history and early abdominal CT may show the obstructive cause. (author)

A etiological factors in mechanical intestinal obstruction

International Nuclear Information System (INIS)

Asad, S.; Khan, H.; Khan, I.A.; Ghaffar, S.; Rehman, Z.U.

2012-01-01

Background: Intestinal obstruction occurs when the normal flow of intestinal contents is interrupted. The most frequent causes of intestinal obstruction are postoperative adhesions and hernias, which cause extrinsic compression of the intestine. Less frequently, tumours or strictures of the bowel can cause intrinsic blockage. Objective of the study was to find out the various a etiological factors of mechanical intestinal obstruction and to evaluate the morbidity and mortality in adult patients presenting to Surgical 'A' unit of Ayub teaching hospital with mechanical intestinal obstruction. Methods: This cross-sectional study was conducted from March 2009 to September, 2009. All patients presenting with intestinal obstruction and were above the age of 12 years were included in the study. Patients with non-mechanical obstruction were excluded from the study and those who responded to conservative measures were also excluded. Results: A total of 36 patients with age ranging from 12 to 80 years (Mean age 37.72+-19.74 years) and male to female ratio of 1.77:1, were treated for mechanical intestinal obstruction. The most common cause for mechanical intestinal obstruction was adhesions (36.1%). Intestinal tuberculosis was the second most common cause (19.4%), while hernias and sigmoid volvulus affected 13.9% patients each. Malignancies were found in 5.6% cases. Conclusion: Adhesions and Tuberculosis are the leading causes of mechanical intestinal obstruction in Pakistan. Although some patients can be treated conservatively, a substantial portion requires immediate surgical intervention. (author)

Unusual causes of obstructive jaundice. Computed tomography

International Nuclear Information System (INIS)

Rodriguez, E.; Pombo, F.; Cao, I.; Fernandez, R.; Riba da, M.

1998-01-01

The purpose of this study is to present selected computed tomography (CT) images showing unusual causes of obstructive jaundice. We reviewed retrospectively the Ct findings of obstructive jaundice in 227 patients. The most common causes of biliary obstruction were adenocarcinoma of the pancreatic head (n=77) and cholangiocarcinoma (n=65). In 13 cases (5.7%), the etiology of obstructive jaundice was unusual or exceptional: tuberculous adenitis (n=3), obstruction of afferent loop (n=2)signet ring cell adenocarcinoma (n=3); in duodenum, gallbladder and papilla of Water), Mirizzi syndrome (n=1), adenocarcinoma of the hepatic flexure (n=1), choledochal cyst (n=1) and pancreatic lymphoma (n=1). (Author) 13 refs

Subtotal obstruction of the male reproductive tract

NARCIS (Netherlands)

Pierik, F.H.; Dohle, G.R.; Roijen, J.H. van; Vreeburg, J.T.M.; Weber, R.F.A.

2003-01-01

Bilateral obstruction of the male reproductive tract is suspected in men with azoospermia, normal testicular volume and normal FSH. A testicular biopsy is required to differentiate between an obstruction and a testicular insufficiency. Unilateral or subtotal bilateral obstructions and epididymal

Obstructive sleep apnoea syndrome in children

Directory of Open Access Journals (Sweden)

Anna Włodarska

2016-09-01

Full Text Available Sleep-related breathing disorders in children are a clinical problem which is more and more often diagnosed by doctors nowadays. They can be the basis for diagnosing obstructive sleep apnoea syndrome that causes a number of complications: lowering the quality of life, behavioural problems, complications involving cardiovascular system. The incidence of obstructive sleep apnoea syndrome in the paediatric population is estimated to be at the level of 2%. The symptoms of obstructive sleep apnoea syndrome can be divided into daytime and night ones. Night symptoms in children include: snoring, apnoea, breathing with open mouth (both during the day and at night, dry tongue and mouth during sleep, agitated sleep in unnatural positions. Among daytime symptoms of obstructive sleep apnoea syndrome there are: irritability, aggressiveness, hyperactivity, attention deficit disorder, delayed development and growth pattern (mainly failure to thrive, learning problems, morning headaches. Parents often do not connect the night and daytime symptoms with the possible development of obstructive sleep apnoea syndrome in their children. The main predisposing factor of obstructive sleep apnoea syndrome in children is adenotonsillar hypertrophy. Effective and in most cases preferred treatment for the management of obstructive sleep apnoea syndrome in children is adenotonsillectomy. Polysomnography and polygraphy are diagnostic tools helpful in the study of sleep-related disorders. The objective of this study was to systematise the knowledge on the epidemiology, aetiology, clinical image and prevention of obstructive sleep apnoea syndrome in children.

Obstructive acute abdomen: reviewing important points

International Nuclear Information System (INIS)

Francisco, Marina Celli; Abud, Thiago Giansante; Reibscheid, Samuel; Szejnfeld, Jacob; Lederman, Henrique Manoel; Colleone Neto, Ramiro

2008-01-01

The obstructive acute abdomen is a common presentation, for which safe and effective management depends on a fast and accurate diagnosis. Conventional radiograph remains the first choice among the imaging exams because of its availability, low cost and the possibility to be done serially to follow the patient's clinical progression. The ultrasonography does not require ionizing radiation. It is a dynamic and in realtime exam. Computed tomography is used increasingly due to the provision of essential diagnostic information not apparent from radiographs, such as the confirmation of the obstruction, degree and place of the occlusion, presence of ischemia as well as the causes of the obstruction. Magnetic resonance imaging has presented great technological advances and it may play a role in the future of obstructive acute abdomen diagnosis. The objective of this pictorial essay is to review the different imaging techniques used on diagnosing obstructive acute abdomen. (author)

Percutaneous Transhepatic Duodenal Drainage as an Alternative Approach in Afferent Loop Obstruction with Secondary Obstructive Jaundice in Recurrent Gastric Cancer

International Nuclear Information System (INIS)

Yao, N.-S.; Wu, C.-W.; Tiu, Chui-Mei; Liu, Jacqueline M.; Whang-Peng, Jacqueline; Chen, L.-T.

1998-01-01

Two cases are reported of chronic, partial afferent loop obstruction with resultant obstructive jaundice in recurrent gastric cancer. The diagnosis was made by characteristic clinical presentations, abdominal computed tomography, and cholescintigraphy. Percutaneous transhepatic duodenal drainage (PTDD) provided effective palliation for both afferent loop obstruction and biliary stasis. We conclude that cholescintigraphy is of value in making the diagnosis of partial afferent loop obstruction and in differentiating the cause of obstructive jaundice in such patients, and PTDD provides palliation for those patients in whom surgical intervention is not feasible

Nonsurgical Fluoroscopically Guided Dacryocystoplasty of Common Canalicular Obstructions

Energy Technology Data Exchange (ETDEWEB)

Wilhelm, Kai E; Hofer, Ulrich; Textor, Hans J [Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Boeker, Thorsten [Department of Ophthalmology, University Hospital Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Strunk, Holger; Schild, Hans H [Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany)

2000-01-15

Purpose: To assess dacryocystoplasty in the treatment of epiphora due to obstructions of the common canaliculus.Methods: Twenty patients with severe epiphora due to partial (n = 16) or complete (n = 4) obstruction of the common canaliculus underwent fluoroscopically guided dacryocystoplasty. In all cases of incomplete obstruction balloon dilation was performed. Stent implantation was attempted in cases with complete obstruction. Dacryocystography and clinical follow-up was performed at intervals of 1 week, and 3, 6, 12, and 18 months after the procedure. The mean follow-up was 6 months (range 3-18 months).Results: Balloon dilation was technically successfully performed in all patients with incomplete obstructions (n = 16). In three of four patients with complete obstruction stent implantation was performed successfully. Subsequent to failure of stent implantation in one of these patients balloon dilation was performed instead. The long-term primary patency rate in patients with incomplete obstructions was 88% (n = 14/16). In three of four cases with complete obstruction long-term patency was achieved during follow-up. Severe complications, infections, or punctal splitting were not observed.Conclusion: Fluoroscopically guided balloon dacryocystoplasty is a feasible nonsurgical therapy in canalicular obstructions with good clinical results that may be used as an alternative to surgical procedures. In patients with complete obstructions stent placement is possible but further investigations are needed to assess the procedural and long-term results.

Nonsurgical Fluoroscopically Guided Dacryocystoplasty of Common Canalicular Obstructions

International Nuclear Information System (INIS)

Wilhelm, Kai E.; Hofer, Ulrich; Textor, Hans J.; Boeker, Thorsten; Strunk, Holger; Schild, Hans H.

2000-01-01

Purpose: To assess dacryocystoplasty in the treatment of epiphora due to obstructions of the common canaliculus.Methods: Twenty patients with severe epiphora due to partial (n = 16) or complete (n = 4) obstruction of the common canaliculus underwent fluoroscopically guided dacryocystoplasty. In all cases of incomplete obstruction balloon dilation was performed. Stent implantation was attempted in cases with complete obstruction. Dacryocystography and clinical follow-up was performed at intervals of 1 week, and 3, 6, 12, and 18 months after the procedure. The mean follow-up was 6 months (range 3-18 months).Results: Balloon dilation was technically successfully performed in all patients with incomplete obstructions (n = 16). In three of four patients with complete obstruction stent implantation was performed successfully. Subsequent to failure of stent implantation in one of these patients balloon dilation was performed instead. The long-term primary patency rate in patients with incomplete obstructions was 88% (n = 14/16). In three of four cases with complete obstruction long-term patency was achieved during follow-up. Severe complications, infections, or punctal splitting were not observed.Conclusion: Fluoroscopically guided balloon dacryocystoplasty is a feasible nonsurgical therapy in canalicular obstructions with good clinical results that may be used as an alternative to surgical procedures. In patients with complete obstructions stent placement is possible but further investigations are needed to assess the procedural and long-term results

Neonatal intestinal obstruction in Benin, Nigeria

Directory of Open Access Journals (Sweden)

Osifo Osarumwense

2009-01-01

Full Text Available Background: Intestinal obstruction is a life threatening condition in the newborn, with attendant high mortality rate especially in underserved subregion. This study reports the aetiology, presentation, and outcome of intestinal obstruction management in neonates. Materials and Methods: A prospective study of neonatal intestinal obstruction at the University of Benin Teaching Hospital, Benin, Nigeria, between January 2006-June 2008. Data were collated on a structured proforma and analysed for age, sex, weight, presentation, type/date of gestation/delivery, aetiology, clinical presentation, associated anomaly, treatment, and outcome. Results: There were 71 neonates, 52 were males and 19 were females (2.7:1. Their age range was between 12 hours and 28 days (mean, 7.9 ± 2.7 days and they weighed between 1.8 and 5.2 kg (average, 3.2 kg. The causes of intestinal obstruction were: Anorectal anomaly, 28 (39.4%; Hirschsprung′s disease, 8 (11.3%′ prematurity, 3 (4.2%; meconeum plug, 2 (2.8%; malrotation, 6 (8.5%; intestinal atresia, 8 (11.3%; necrotising enterocolitis (NEC, 4 (5.6%; obstructed hernia, 4 (5.6%; and spontaneous gut perforation, 3 (4.2%. Also, 27 (38% children had colostomy, 24 (33.8% had laparotomy, 9 (12.8% had anoplasty, while 11 (15.4% were managed nonoperatively. A total of 41 (57.7% neonates required incubator, 26 (36.6% needed total parenteral nutrition, while 15 (21.1% require d paediatric ventilator. Financial constraint, late presentation, presence of multiple anomalies, aspiration, sepsis, gut perforation, and bowel gangrene were the main contributors to death. Neonates with lower obstructions had a better outcome compared to those having upper intestinal obstruction ( P < 0.0001. Conclusion: Outcomes of intestinal obstruction are still poor in our setting; late presentation, financial constraints, poor parental motivation and lack of basic facilities were the major determinants of mortality.

Is ursodeoxycholic acid detrimental in obstructive cholestasis? A propos of a case of malignant biliary obstruction.

Science.gov (United States)

Bessone, Fernando; Roma, Marcelo Gabriel

2016-01-01

Ursodeoxycholic acid (UDCA) is the first choice medication for most cholestatic hepatopathies, due to its capability to counteract inflammation and bile-acid-induced liver damage, two common features in cholestasis. However, UDCA is usually contraindicated in obstructive cholestasis, due to the alleged risk of biliary integrity disruption due to its choleretic effect. We report on an 83-year-old man with an unsuspected malignant biliary obstruction who received moderate doses of UDCA (8-12 mg/kg/day) for 5 weeks, because the preliminary evidence suggested he had chemotherapy-induced cholestasis. Liver integrity was extensively protected by UDCA, as indicated by a marked decrease in serum liver enzymes, despite a steady increase in the levels of bilirubin and serum bile acids due to the obstructive process. In conclusion, this report shows, for the first time in humans, that moderate UDCA doses can reduce liver injury associated with complete biliary obstruction. This may contribute to a better understanding of the risk-benefit ratio of the use of UDCA in obstructive cholangiopathies.

Obstructive uropathy

Science.gov (United States)

... the kidney and causes it to become swollen ( hydronephrosis ). Obstructive uropathy can affect one or both kidneys. ... occurs during pregnancy. This condition is called idiopathic hydronephrosis of pregnancy.

Imaging of obstructed defecation

International Nuclear Information System (INIS)

Ganeshan, A.; Anderson, E.M.; Upponi, S.; Planner, A.C.; Slater, A.; Moore, N.; D'Costa, H.; Bungay, H.

2008-01-01

Constipation is a common problem in the western world, which occurs as a consequence of impaired colonic transit and/or due to obstructed defecation. Imaging plays an important role in distinguishing structural from functional causes of constipation. In this article a description of common imaging techniques for diagnosing structural causes of constipation with illustrations of abnormal defecographic findings in patients with obstructive defecation are presented

Imaging of obstructed defecation

Energy Technology Data Exchange (ETDEWEB)

Ganeshan, A. [Radiology Department, John Radcliffe Hospital, Oxford (United Kingdom); Anderson, E.M. [Radiology Department, John Radcliffe Hospital, Oxford (United Kingdom)], E-mail: eanderson@doctors.org.uk; Upponi, S.; Planner, A.C.; Slater, A.; Moore, N.; D' Costa, H.; Bungay, H. [Radiology Department, John Radcliffe Hospital, Oxford (United Kingdom)

2008-01-15

Constipation is a common problem in the western world, which occurs as a consequence of impaired colonic transit and/or due to obstructed defecation. Imaging plays an important role in distinguishing structural from functional causes of constipation. In this article a description of common imaging techniques for diagnosing structural causes of constipation with illustrations of abnormal defecographic findings in patients with obstructive defecation are presented.

MR cholangiography: usefulness in obstructive jaundice

International Nuclear Information System (INIS)

Bae, Sang Hoon; Lee, In Jae; Nam, Kung Sook; Hong, Myung Sun; Lee, Kyung Hwan; Yun, Ku Sub

1994-01-01

Three-dimensional(3D) magnetic resonance(MR) projection imaging was evaluated as a noninvasive alternative to direct cholangiography for the assessment of its reliability in patients with obstructive jaundice. A heavily T2-weighted gradient-echo sequence(PSIF) was used for 3D MR projection imaging of the biliary system in five healthy volunteers and 25 patients with obstructive jaundice. The 3D images of the bile ducts were formed by stacking consecutive coronal MR images obtained with a fast imaging method to a maximum-intensity projection algorithm. In the volunteers, MR cholangiography could demonstrate the anatomy of the biliary tract in only two subjects. The extrahepatic and intrahepatic bile ducts were well visualized in 23 patients with obstructive jaundice. The leve of obstruction and the grade of dilatation were depicted with MR cholangiography in all cases. And the cause of obstruction could be determined with MR cholangiography in 18 cases, MR cholangiography wa successful in two patients in whom ERCP failed. The gallbladder or dilated pancreatic duct not demonstrated by means of direct cholangiography was demonstrated with MR cholangiography in six cases. MR cholangiography may be a useful adjunctive tool for the noninvasive evaluation of patients with obstructive Jaundice

Computed tomography of obstructive jaundice

International Nuclear Information System (INIS)

Suh, Jung Hek; Lee, Joong Suk; Chun, Beung He; Suh, Soo Jhi

1982-01-01

It is well known that the computed tomography (CT) is very useful in the evaluation of obstructive jaundice. We have studied 55 cases of obstructive jaundice with whole body scanner from Jun.1980 to Jun. 1981. The results were as follows: 1. The sex distribution was 36 males and 19 females, and 40 cases of obstructive jaundice were seen in fifth, sixth, and seventh decades. 2. Causes of obstructive jaundice were 25 cases of pancreas cancer, 8 cases of common duct cancer, 4 cases of gallbladder cancer, 4 cases of ampulla vater cancer, 12 cases of common duct stone, and 2 cases of common duct stricture. 3. Levels of obstruction were 8 cases of hepatic portion, 15 cases of suprapancreatic portion, 28 cases of pancreatic portion, and 4 cases of ampullary portion. 4. In tumorous condition, CT demonstrated metastasis of other organs, 9 cases of the liver, 1 case of the lung, 3 cases of the pancreas, 3 cases of the common bile duct, 1 case of the stomach, and 12 cases of adjacent lymph nodes. 5. Associated diseases were 12 cases of intrahepatic stone, 4 cases of clonorchiasis, 2 cases of pancreas pseudocyst, 1 cases of hydronephrosis, and 1 case of renal cyst

Localizing obstructive sites with dynamic MRI and consequentially proper therapy selection for obstructive sleep apnea/hypopnea syndrome

International Nuclear Information System (INIS)

Oda, Makoto

2004-01-01

At present, selection of therapies for obstructive sleep apnea/hypopnea syndrome (OSAHS) relies on the localizing the obstructive sites and determination of its severity by polysomnography (PSG). Many methods have been applied to localize the obstructive sites. We attempted to evaluate the morphology of upper airway during sleep with dynamic MRI, and assessed the severity of OSAHS and results of therapies in groups classified by the patterns of obstructive sites. A categorizing system was set up, by which the obstructive sites were reviewed on axial and sagittal sections and accordingly classified into four patterns: front-to-back pattern, left-to-right pattern, circular pattern and epiglottis pattern. Comparison of apnea/hypopnea index (AHI), lowest SpO2 and BMI was performed between the different patterns. The results showed that the left-to-right pattern and circular pattern had a higher AHI and lower lowest SpO2, and more cases of obesity with higher BMI were found in these two groups. We also evaluated the results of different therapies for different obstructive site patterns. Radiofrequency coblation of soft palate was found to be effective for the front-to-back pattern. Improvement was found in 67% of all the cases that received uvulopalatopharyngoplasty (UPPP), while a significant postoperative improvement of AHI was confirmed in left-to-right pattern and circular pattern groups. No significant difference in the results was found between different obstructive sites or patterns when nasal continuous positive airway pressure (n-CPAP) was applied alone. Being completely free from CPAP (completed treatment with improvement of symptoms) was achieved in 71.4% of all the cases and 85.7% in the left-to-right pattern group who received UPPP. We conclude that an optimal treatment results could be achieved by selecting the therapies based on the severity of OSAHS and result of localizing the obstructive sites by dynamic MRI. (author)

Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

LENUS (Irish Health Repository)

Lee, Ruth

2012-02-01

PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome. RECENT FINDINGS: The severity of obstructive ventilatory impairment and hyperinflation, especially the inspiratory capacity to total lung capacity (TLC) ratio, correlates with the severity of sleep-related breathing disturbances. Early treatment with continuous positive airway pressure (CPAP) improves survival, reduces hospitalization and pulmonary hypertension, and also reduces hypoxemia. Evidence of systemic inflammation and oxidative stress in COPD and sleep apnea provides insight into potential interactions between both disorders that may predispose to cardiovascular disease. Long-term outcome studies of overlap patients currently underway should provide further evidence of the clinical significance of the overlap syndrome. SUMMARY: Studies of overlap syndrome patients at a clinical, physiological and molecular level should provide insight into disease mechanisms and consequences of COPD and sleep apnea, in addition to identifying potential relationships with cardiovascular disease.

Airways obstruction, coal mining, and disability.

OpenAIRE

Lapp, N L; Morgan, W K; Zaldivar, G

1994-01-01

It has recently been suggested that the inhalation of coal in the absence of complicated coal workers' pneumoconiosis (CWP) or smoking can lead to disabling airways obstruction. The cause of such obstruction has been variously attributed to emphysema or bronchitis. The frequency of significant airways obstruction in a group of United States coal miners seeking compensation for occupationally induced pulmonary impairment was therefore determined. In a sample of 611 "Black Lung" claimants there...

Obstruction, US, and the minimally dilated renal collecting system

International Nuclear Information System (INIS)

Kamholtz, R.G.; Cronan, J.J.; Dorfman, G.S.

1987-01-01

To assess the significance of grade 1 hydronephrosis in the diagnosis of renal obstruction, the authors retrospectively reviewed the abdominal or renal US scans in 395 patients. In 80 patients there was a question of renal obstruction. Grade I hydronephrosis was observed in 33 of the 80 patients and obstruction was confirmed in more than 45% of these. In 315 patients, US was performed for reasons other than renal obstruction. Grade I hydronephrosis was observed in 39 of 315 patients, and obstruction was confirmed in less than 6%. The authors conclude that grade I hydronephrosis is significant when the question of renal obstruction exists. As an incidental finding, however, it is unlikely to represent obstruction. In the recent radiologic and medical literature grade I hydroephrosis is often dismissed as ''normal'' even in the clinical setting of obstruction. This trend is clearly not justified

Chronic obstructive pulmonary disease - adults - discharge

Science.gov (United States)

... coughing up dark mucus Your fingertips or the skin around your fingernails are blue Alternative Names COPD - adults - discharge; Chronic obstructive airways disease - adults - discharge; Chronic obstructive lung disease - adults - discharge; ...

[Acid-base imbalance in acute obstructive uropathies].

Science.gov (United States)

Belyĭ, L E

2007-01-01

The aim of this study was to evaluate impairment of acid-base balance (ABB) in acute obstructive uropathies. Evaluation of acid-base balance was performed by pH, partial carbon dioxide pressure, plasma bicarbonate concentration, buffer bases, basis excess, hydrogen ion concentration. An automatic gas analyzer was used, plasma anion gap was calculated. Characteristic ABB alterations in different acute obstructive uropathies were detected. Acidotic shifts in acute obstruction of the upper urinary tracts and its inflammatory complications were assessed pathophysiologically. A comparative study of pathological acid-base disorders in acute supra- and infravesical obstructive uropathies was performed.

Ureteral valve masquerading as obstructive megaureter

Directory of Open Access Journals (Sweden)

Sushmita Bhatnagar

2017-05-01

Full Text Available Primary obstructed megaureter is a common urological condition in the pediatric age group. It is one of the differentials for congenital anomalies of the kidney and urinary tract that include a myriad of structural anomalies of the urinary tract. The obstructive conditions are usually managed conservatively unless there is deterioration in renal function, repeated urinary tract infection, or any other symptom such as abdominal pain on ipsilateral side and hypertension. Presented here is a case of left lower ureteral valve that was diagnosed as primary obstructed megaureter with pain in abdomen and reduced ipsilateral renal function wherein ureteral valve was detected incidentally intraoperatively. Excision of the valve with end to end uretero-ureteral anastomoses over a D-J stent, without resorting to ureteric reimplantation was successful in relieving the obstruction and hydronephrosis

Interventional therapy for congenital urinary obstruction in children

International Nuclear Information System (INIS)

Qin Zenhui; Huang Sui; Liu Fan; Yang Jinyuan

2005-01-01

Objective: To investigate the interventional therapy in children's congenital urinary obstruction and its efficacy. Methods: Thirty-three children with congenital obstruction of ureteropelvic junction were treated through percutaneous dilation and/or stent placement, and 42 cases with posterior urethral valves were treated through trans-urethra dilation. Results: Thirty-three cases with upper urinary obstruction were improved with symptoms disappeared and stable efficacy on long-term follow-up of 1-7 years. Another 2 cases with the upper urethral obstruction had not been relieved of symptoms and resorted to surgical operation. For patients with posterior urethral valves, the lower urethral obstruction was totally got rid of after interventional therapy with stable efficacy on long-term follow-up of 1-10 years. Conclusions: Interventional therapy is safe , micro-invasive and efficient in treating congenital urinary obstruction with stable efficacy on long-term follow-up. (authors)

Sonographic diagnosis of intestinal obstruction in the dog.

Science.gov (United States)

Manczur, F; Vörös, K; Vrabély, T; Wladár, S; Németh, T; Fenyves, B

1998-01-01

Ultrasonography was performed on 44 dogs to decide whether small bowel obstruction was present. The sonographic criteria for small bowel obstruction were (1) the presence of pendulous movement of the ingesta inside the dilated bowel, (2) observation of invaginated intestines or an ingested intraluminal foreign body, (3) observation of non-uniform peristaltic activity of the dilated intestines, or (4) observation of akinetic intestinal loops together with abdominal fluid accumulation. By using these criteria, obstruction was correctly diagnosed by ultrasonography in 11 of the 13 dogs with mechanical ileus, and obstruction was correctly excluded in 29 of the 31 non-obstructive cases. Thus, the above-mentioned sonographic criteria had 85% sensitivity and positive predictive value, and 94% specificity and negative predictive value. The present study suggests that ultrasonography is a valuable tool for diagnosing small intestinal obstruction in the dog.

Acute intestinal obstruction: an electromyographic study in dogs.

Science.gov (United States)

Summers, R W; Yanda, R; Prihoda, M; Flatt, A

1983-12-01

We have investigated the motility effects of acute experimental canine intestinal obstruction. A 30-min midjejunal obstruction was produced by clamping a Biebl loop or by inflating an intraluminal balloon. Spike bursts from serosal electrodes proximal to the site of obstruction increased markedly, while those from distal electrodes decreased. When the obstruction from an intraluminal Foley catheter was continued for 5.5 h, the inhibition persisted distally but the proximal contractile activity gradually fell to control levels. The reduced proximal activity after prolonged obstruction was largely due to clusters of regular intense spike bursts preceded and followed by lengthening periods of absent motor activity. Similar clustered contractions obliterated the lumen when the passage of barium through a Thiry-Vella loop was monitored fluoroscopically. Significant motility changes occur in intestinal obstruction, but an increased understanding of the mechanisms involved awaits future studies.

Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease: systematic review and meta-analysis

Energy Technology Data Exchange (ETDEWEB)

Xie, XueQian; Oudkerk, Matthijs; Vliegenthart, Rozemarijn [University of Groningen, University Medical Center Groningen, Center for Medical Imaging-North East Netherlands (CMI-NEN), Department of Radiology, Hanzeplein 1, P.O. Box 30.001, RB, Groningen (Netherlands); Jong, Pim A. de [University Medical Center Utrecht, University of Utrecht, Department of Radiology, Heidelberglaan 100, P.O. Box 85.500, CX, Utrecht (Netherlands); Wang, Ying [Tianjin Medical University General Hospital, Department of Radiology, Tianjin (China); Hacken, Nick H.T. ten [University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Hanzeplein 1, P.O. Box 30.001, RB, Groningen (Netherlands); Miao, Jingtao; Zhang, GuiXiang [Shanghai Jiao Tong University Affiliated First People' s Hospital, Department of Radiology, Shanghai (China); Bock, Geertruida H. de [University of Groningen, University Medical Center Groningen, Department of Epidemiology, Hanzeplein 1, P.O. Box 30.001, RB, Groningen (Netherlands)

2012-10-15

To determine the correlation between CT measurements of emphysema or peripheral airways and airflow obstruction in chronic obstructive pulmonary disease (COPD). PubMed, Embase and Web of Knowledge were searched from 1976 to 2011. Two reviewers independently screened 1,763 citations to identify articles that correlated CT measurements to airflow obstruction parameters of the pulmonary function test in COPD patients, rated study quality and extracted information. Three CT measurements were accessed: lung attenuation area percentage < -950 Hounsfield units, mean lung density and airway wall area percentage. Two airflow obstruction parameters were accessed: forced expiratory volume in the first second as percentage from predicted (FEV{sub 1} %pred) and FEV{sub 1} divided by the forced volume vital capacity. Seventy-nine articles (9,559 participants) were included in the systematic review, demonstrating different methodologies, measurements and CT airflow obstruction correlations. There were 15 high-quality articles (2,095 participants) in the meta-analysis. The absolute pooled correlation coefficients ranged from 0.48 (95 % CI, 0.40 to 0.54) to 0.65 (0.58 to 0.71) for inspiratory CT and 0.64 (0.53 to 0.72) to 0.73 (0.63 to 0.80) for expiratory CT. CT measurements of emphysema or peripheral airways are significantly related to airflow obstruction in COPD patients. CT provides a morphological method to investigate airway obstruction in COPD. (orig.)

Imaging of obstructive azoospermia

Energy Technology Data Exchange (ETDEWEB)

Cornud, F. [Clinique Radiologique, 15 Avenue Robert Schuman, F-75 007 Paris (France)]|[Service de Radiologie, Hopital Necker, 169 rue de Sevres, F-75 015 Paris (France); Belin, X. [Clinique Radiologique, 15 Avenue Robert Schuman, F-75 007 Paris (France)]|[Service de Radiologie, Hopital Necker, 169 rue de Sevres, F-75 015 Paris (France); Delafontaine, D. [Medicine de la Reproduction, 8 rue Jean Richepin, F-75 016 Paris (France); Amar, T. [Uro-Andrologist, 19 Avenue Victor Hugo, F-75016, Paris (France); Helenon, O. [Service de Radiologie, Hopital Necker, 169 rue de Sevres, F-75 015 Paris (France); Moreau, J.F. [Service de Radiologie, Hopital Necker, 169 rue de Sevres, F-75 015 Paris (France)

1997-09-01

Obstructive azoospermia represents approximately 10 % of cases of male hypofertility. It is classified according to the volume of ejaculate. When the latter is normal a proximal obstruction is suspected. Scrotal sonography can help to detect dilation of the epididymal head when clinical findings are equivocal. Ejaculatory duct obstruction (EDO) is suspected when the volume of ejaculate is low. The use of transrectal ultrasonography (TRUS) plays a major role in the investigation of these patients, and endorectal MRI is a very useful adjunct in selected cases. The most common cause of EDO is congenital bilateral absence of vas deferens, which is now thought to be a genital form of cystic fibrosis in 80 % of cases. Consequently, a definitive diagnosis must be made before any attempt at in vitro fertilization. TRUS accurately visualizes abnormalities of the caudal junction of the vas deferens and seminal vesicles, yielding a definitive diagnosis without scrototomy. Other causes of EDO are congenital cysts compressing the distal part of the ejaculatory ducts and inflammatory distal stenosis. The former are accurately identified by TRUS, but the latter give more or less marked signs of obstruction which are only of value in azoospermic patients with a low-volume ejaculate. More invasive imaging is required to diagnose partial obstruction of the ED. Surgical vasography is still the reference, but puncture of the seminal vesicles under TRUS guidance is an attractive alternative, as it permits aspiration of seminal fluid (to seek motile sperm) and vasography without scrototomy. Lastly, endorectal MRI well assesses the relationships between the proximal prostatic urethra and the posterior wall of the ejaculatory ducts, which need to be precisely known when endoscopic resection of the ejaculatory ducts is planned. (orig.). With 9 figs.

Imaging of obstructive azoospermia

International Nuclear Information System (INIS)

Cornud, F.; Belin, X.; Delafontaine, D.; Amar, T.; Helenon, O.; Moreau, J.F.

1997-01-01

Obstructive azoospermia represents approximately 10 % of cases of male hypofertility. It is classified according to the volume of ejaculate. When the latter is normal a proximal obstruction is suspected. Scrotal sonography can help to detect dilation of the epididymal head when clinical findings are equivocal. Ejaculatory duct obstruction (EDO) is suspected when the volume of ejaculate is low. The use of transrectal ultrasonography (TRUS) plays a major role in the investigation of these patients, and endorectal MRI is a very useful adjunct in selected cases. The most common cause of EDO is congenital bilateral absence of vas deferens, which is now thought to be a genital form of cystic fibrosis in 80 % of cases. Consequently, a definitive diagnosis must be made before any attempt at in vitro fertilization. TRUS accurately visualizes abnormalities of the caudal junction of the vas deferens and seminal vesicles, yielding a definitive diagnosis without scrototomy. Other causes of EDO are congenital cysts compressing the distal part of the ejaculatory ducts and inflammatory distal stenosis. The former are accurately identified by TRUS, but the latter give more or less marked signs of obstruction which are only of value in azoospermic patients with a low-volume ejaculate. More invasive imaging is required to diagnose partial obstruction of the ED. Surgical vasography is still the reference, but puncture of the seminal vesicles under TRUS guidance is an attractive alternative, as it permits aspiration of seminal fluid (to seek motile sperm) and vasography without scrototomy. Lastly, endorectal MRI well assesses the relationships between the proximal prostatic urethra and the posterior wall of the ejaculatory ducts, which need to be precisely known when endoscopic resection of the ejaculatory ducts is planned. (orig.). With 9 figs

Small Bowel Obstruction due to Intestinal Xanthomatosis

Directory of Open Access Journals (Sweden)

L. E. Barrera-Herrera

2015-01-01

Full Text Available Vast majority of bowel obstruction is due to postoperative adhesions, malignancy, intestinal inflammatory disease, and hernias; however, knowledge of other uncommon causes is critical to establish a prompt treatment and decrease mortality. Xanthomatosis is produced by accumulation of cholesterol-rich foamy macrophages. Intestinal xanthomatosis is an uncommon nonneoplastic lesion that may cause small bowel obstruction and several cases have been reported in the English literature as obstruction in the jejunum. We report a case of small intestinal xanthomatosis occurring in a 51-year-old female who presented with one day of copious vomiting and intermittent abdominal pain. Radiologic images revealed jejunal loop thickening and inflammatory changes suggestive of foreign body obstruction, diagnostic laparoscopy found two strictures at the jejunum, and a pathologic examination confirmed a segmental small bowel xanthomatosis. This case illustrates that obstruction even without predisposing factors such as hyperlipidemia or lymphoproliferative disorders.

Endoscopic third ventriculostomy for obstructive hydrocephalus

International Nuclear Information System (INIS)

Ali, M.; Usman, M.; Khan, Z.; Khan, K.M.; Hussain, R.; Khanzada, K.

2013-01-01

To determine the success rate of endoscopic third ventriculostomy (ETV) for treating obstructive hydrocephalus. Study Design: Cross-sectional observational study. Place and Duration of Study: The Neurosurgery Department of PGMI, Lady Reading Hospital, Peshawar, from May 2010 to November 2011. Methodology: Patients with obstructive hydrocephalus due to aqueductal stenosis, tectal and non-tectal tumour and already shunted patients for obstructive hydrocephalus presented with blocked shunt were included in the study. Patients with congenital hydrocephalus and secondary to meningitis were excluded. Endoscopic third ventriculostomy was performed. Success, complications and mortality was noted. Data was analyzed by descriptive statistics using SPSS software version 17. Results: There were 155 patients including 72 males and 83 females with ratio of 1: 1.33. Success rate was 71%. Indication of surgery was obstructive hydrocephalus due to aqueductal stenosis, posterior fossa tumour, brain stem and CP angle tumour. Complications were seen in 18 patients including mortality in 3 patients. Conclusion: ETV is effective, safe and successful procedure in patients with obstructive hydrocephalus. It may be used as replacement procedure of ventriculo-peritoneal shunt as initial line of management in selected patients. (author)

Intestinal Obstruction

Science.gov (United States)

... Colostomy ) is required to relieve an obstruction. Understanding Colostomy In a colostomy, the large intestine (colon) is cut. The part ... 1 What Causes Intestinal Strangulation? Figure 2 Understanding Colostomy Gastrointestinal Emergencies Overview of Gastrointestinal Emergencies Abdominal Abscesses ...

Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease: systematic review and meta-analysis

International Nuclear Information System (INIS)

Xie, XueQian; Oudkerk, Matthijs; Vliegenthart, Rozemarijn; Jong, Pim A. de; Wang, Ying; Hacken, Nick H.T. ten; Miao, Jingtao; Zhang, GuiXiang; Bock, Geertruida H. de

2012-01-01

To determine the correlation between CT measurements of emphysema or peripheral airways and airflow obstruction in chronic obstructive pulmonary disease (COPD). PubMed, Embase and Web of Knowledge were searched from 1976 to 2011. Two reviewers independently screened 1,763 citations to identify articles that correlated CT measurements to airflow obstruction parameters of the pulmonary function test in COPD patients, rated study quality and extracted information. Three CT measurements were accessed: lung attenuation area percentage 1 %pred) and FEV 1 divided by the forced volume vital capacity. Seventy-nine articles (9,559 participants) were included in the systematic review, demonstrating different methodologies, measurements and CT airflow obstruction correlations. There were 15 high-quality articles (2,095 participants) in the meta-analysis. The absolute pooled correlation coefficients ranged from 0.48 (95 % CI, 0.40 to 0.54) to 0.65 (0.58 to 0.71) for inspiratory CT and 0.64 (0.53 to 0.72) to 0.73 (0.63 to 0.80) for expiratory CT. CT measurements of emphysema or peripheral airways are significantly related to airflow obstruction in COPD patients. CT provides a morphological method to investigate airway obstruction in COPD. (orig.)

Drug-induced sleep endoscopy in the identification of obstruction sites in patients with obstructive sleep apnea: a systematic review.

Science.gov (United States)

Viana, Alonço da Cunha; Thuler, Luiz Claudio Santos; Araújo-Melo, Maria Helena de

2015-01-01

Obstructive sleep apnea syndrome has multifactorial causes. Although indications for surgery are evaluated by well-known diagnostic tests in the awake state, these do not always correlate with satisfactory surgical results. To undertake a systematic review on endoscopy during sleep, as one element of the diagnosis routine, aiming to identify upper airway obstruction sites in adult patients with OSAS. By means of electronic databases, a systematic review was performed of studies using drug-induced sleep endoscopy to identify obstruction sites in patients with OSAS. Ten articles were selected that demonstrated the importance of identifying multilevel obstruction, especially in relation to retrolingual and laryngeal collapse in OSAS. DISE is an additional method to reveal obstruction sites that have not been detected in awake patients. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Progress in surgical palliative treatment for malignant obstructive jaundice

Directory of Open Access Journals (Sweden)

LIANG Zhang

2013-06-01

Full Text Available Obstructive jaundice, also known as surgical jaundice, is divided into benign and malignant types. Most of the patients newly diagnosed with malignant obstructive jaundice have lost the opportunity of receiving radical surgery due to its insidious onset, so surgical palliative treatment is very important for patients with advanced malignant obstructive jaundice. This paper elaborates on various current modalities of surgical palliative treatment for malignant obstructive jaundice. Appropriate modality of surgical palliative treatment is of great significance for patients with advanced malignant obstructive jaundice.

Obstructive sleep apnoea and atopy among middle aged chronic obstructive pulmonary disease and bronchial asthma patients.

Science.gov (United States)

Kumar, Raj; Nagar, Devender; Mallick, Adeeb; Kumar, Manoj; Tarke, Chandrakant R; Goel, Nitin

2013-09-01

Obstructive sleep apnoea syndrome is associated with significant morbidity. A high prevalence of obstructive sleep apnoea (OSA) symptoms has been reported in patients with asthma and chronic obstructive pulmonary disease (COPD). There are limited studies regarding relationship between atopy and OSA. To study the risk of obstructive sleep apnoea among middle aged chronic obstructive pulmonary disease and asthma patients by a home based sleep study and its association with atopy. Patients with asthma and COPD were evaluated for OSA symptoms by Epworth sleepiness scale (ESS) and Berlin questionnaire (BQ). ESS score > or = 9 was considered as high risk for OSA. Patients having high risk for OSA by ESS and BQ were further evaluated for OSA by home based sleep study. Skin prick test against common allergens was done to diagnose atopy in these patients. Among 400 patients (229, 57.25% male and 171, 42.75% female) 328 were asthmatics and 72 were COPD patients. ESS and BQ was positive in 11.25% (45/400) and 18.25% (73/400) patients respectively. ESS was positive in 10.67% (35/328) of asthma and 13.88% (10/72) of COPD patients. BQ was positive in 18.29% (60/328) of asthmatic and 18.05% (13/72) of COPD patients. Skin prick test was positive in 74.16% patients. The maximum positivity was found in asthmatics (139/155, 89.68%) compared to COPD patients (16/155, 10.32%). Skin prick test was done for 40 patients out of 73 of Asthma and COPD patients who were found positive by ESS and BQ. 72.5% patients were found to be atopic. Out of 19 patients in whom home polysomnography was done, 13 patients consented for skin prick test with common aeroallergens and 9 (69.23%) patients were found to be atopic. There is an increased risk of obstructive sleep apnoea among middle aged chronic obstructive pulmonary disease and asthma patients. Atopy could be associated with OSA. The association needs to be proved in a larger study.

CT and ERCP diagnosis of obstructive jaundice

International Nuclear Information System (INIS)

Wang Dongfang; Cao Ran

2003-01-01

Objective: To evaluate some specific CT and ERCP findings for differentiating the nature of biliary obstructive diseases. Methods: In total 85 cases of obstructive jaundice verified by pathology were selected. The CT findings in 45 cases and ERCP features in 68 cases were retrospectively analyzed. Results: Mild dilatation of intrahepatic bile ducts were usually found in benign diseases, while moderately or severely dilated intrahepatic bile ducts were revealed in malignancies. Dilatation of intrahepatic bile ducts in vine pattern was one of the characteristic signs of malignant lesions, while 'withered branches' dilatation was usually found in benign diseases. Dilated extra-hepatic bile duct abruptly narrowed or obstructed was a typical finding in malignancies, while gradual tapering of common bile duct at the obstructed level usually indicated benign nature of the disease. Conclusion: Both CT and ERCP are valuable modalities in locating and differential diagnosis of biliary obstruction. A combined evaluation improves the accuracy of diagnosis

Les infections urinaires chez les patients insuffisants rénaux chroniques hospitalisés au service de néphrologie: profil bactériologique et facteurs de risque

Science.gov (United States)

Chemlal, Abdeljalil; Ismaili, Fatiha Alaoui; Karimi, Ilham; Elharraqui, Ryme; Benabdellah, Nawal; Bekaoui, Samira; Haddiya, Intissar; Bentata, Yassamine

2015-01-01

L'infection urinaire chez l'insuffisant rénal est fréquente et particulière dans sa prise en charge diagnostique et thérapeutique. L'objectif de notre étude est de déterminer le profil bactériologique et d’étudier les facteurs de risque des infections urinaires chez le patient insuffisant rénal chronique en milieu de néphrologie. Etude prospective débutée en Septembre 2012 menée au service de néphrologie à l'hôpital régional d'Oujda de l'oriental Marocain. Ont été inclus tous les patients hospitalisés en néphrologie avec une infection urinaire documentée. Nous avons analysé les données démographiques, cliniques, biologiques, et thérapeutiques de nos patients à l'admission et au cours de leurs hospitalisations. 48 épisodes d'infections urinaires chez 43 patients ont été colligés dont 3 enfants. L'incidence de l'infection urinaire dans notre étude était de 4,65%. La médiane d’âge était de 53 (32-66) années. 60,4% étaient de sexe féminin. Le germe isolé était un Escheria Coli dans 58,3% et un Klebsiella dans 29,2%. Le germe isolé était résistant à l'amoxicilline-acide clavulanique dans 83% des cas. L'antibiotique prescris en premiére intention chez nos patients était une céphalosporine de 3 éme génération dans 50%. L’évolution chez nos patients était favorable dans 89,6% des cas. 33,3% avaient présenté un sepsis et on a noté le décès dans 10,4% des cas. Les infections urinaires chez l'insuffisant rénal chronique reste très grave vu leur lourde morbi-mortalié d'où l'intêrét d'un dépistage précoce chez cette population. Un usage raisonné des antibiotiques est nécessaire afin de prévenir l'extension des résistances bactériennes. PMID:26213601

Apple-peel atresia presenting as foetal intestinal obstruction

Directory of Open Access Journals (Sweden)

Ashok Yadavrao Kshirsagar

2011-01-01

Full Text Available Apple-peel atresia or Type 3 jejuno-ileal atresia (JIA is an uncommon cause of foetal intestinal obstruction. Bowel obstruction in the foetus is diagnosed on the prenatal ultrasonography only in 50% cases. We report a case in which foetal intestinal obstruction was diagnosed on prenatal ultrasonography. The child showed signs of intestinal obstruction on day one after birth, for which an exploratory laparotomy was performed. Type 3 JIA was found for which resection of atretic segments with jejuno-ascending colon anastomosis was preformed.

Evidence-Based Decompression in Malignant Biliary Obstruction

Energy Technology Data Exchange (ETDEWEB)

Ho, Chia Sing [University of Toronto, Toronto General Hospital, Toronto (Canada); Warkentin, Andrew E [University of Toronto, 1 King& #x27; s College Circle, Toronto (Canada)

2012-02-15

As recent advances in chemotherapy and surgical treatment have improved outcomes in patients with biliary cancers, the search for an optimal strategy for relief of their obstructive jaundice has become even more important. Without satisfactory relief of biliary obstruction, many patients would be ineligible for treatment. We review all prospective randomized trials and recent retrospective non-randomized studies for evidence that would support such a strategy. For distal malignant biliary obstruction, an optimal strategy would be insertion of metallic stents either endoscopically or percutaneously. Evidence shows that a metallic stent inserted percutaneously has better outcomes than plastic stents inserted endoscopically. For malignant hilar obstruction, percutaneous biliary drainage with or without metallic stents is preferred.

Apple-peel atresia presenting as foetal intestinal obstruction ...

African Journals Online (AJOL)

Apple-peel atresia or Type 3 jejuno-ileal atresia (JIA) is an uncommon cause of foetal intestinal obstruction. Bowel obstruction in the foetus is diagnosed on the prenatal ultrasonography only in 50% cases. We report a case in which foetal intestinal obstruction was diagnosed on prenatal ultrasonography. The child showed ...

Influence of obstructive jaundice on pharmacodynamics of rocuronium.

Science.gov (United States)

Wang, Zhen-Meng; Zhang, Peng; Lin, Mi-Jia; Tan, Bo; Qiu, Hai-Bo; Yu, Wei-Feng

2013-01-01

Anesthetics are variable in patients with obstructive jaundice. The minimum alveolar concentration awake of desflurane is reduced in patients with obstructive jaundice, while it has no effect on pharmacodynamics and pharmacokinetics of propofol. In this study, we investigated the influence of obstructive jaundice on the pharmacodynamics and blood concentration of rocuronium. Included in this study were 26 control patients and 27 patients with obstructive jaundice. Neuromuscular block of rocuronium was monitored by acceleromyography. Onset time, spontaneous recovery of the height of twitch first (T1) to 25% of the final T1 value (Duration 25%, Dur 25%), recovery index (RI), and spontaneous recovery of train-of-four (TOF) ratios to 70% were measured. The plasma rocuronium concentrations were determined by high performance liquid chromatography using berberine as an internal standard. There was no significant difference in onset time between the two groups. The Dur 25%, the recovery index and the time of recovery of the TOF ratios to 70% were all prolonged in the obstructive jaundice group compared with the control group. The plasma concentration of rocuronium at 60, 90 and 120 min after bolus administration was significantly higher in the obstructive jaundice group. The neuromuscular blockade by rocuronium is prolonged in obstructive jaundice patients, and therefore precautions should be taken in case of postoperative residual neuromuscular block. The possible reason is impedance of rocuronium excretion due to biliary obstruction and increased plasma unbound rocuronium because of free bilirubin competing with it for albumin binding.

Accuracy of abdominal auscultation for bowel obstruction.

Science.gov (United States)

Breum, Birger Michael; Rud, Bo; Kirkegaard, Thomas; Nordentoft, Tyge

2015-09-14

To investigate the accuracy and inter-observer variation of bowel sound assessment in patients with clinically suspected bowel obstruction. Bowel sounds were recorded in patients with suspected bowel obstruction using a Littmann(®) Electronic Stethoscope. The recordings were processed to yield 25-s sound sequences in random order on PCs. Observers, recruited from doctors within the department, classified the sound sequences as either normal or pathological. The reference tests for bowel obstruction were intraoperative and endoscopic findings and clinical follow up. Sensitivity and specificity were calculated for each observer and compared between junior and senior doctors. Interobserver variation was measured using the Kappa statistic. Bowel sound sequences from 98 patients were assessed by 53 (33 junior and 20 senior) doctors. Laparotomy was performed in 47 patients, 35 of whom had bowel obstruction. Two patients underwent colorectal stenting due to large bowel obstruction. The median sensitivity and specificity was 0.42 (range: 0.19-0.64) and 0.78 (range: 0.35-0.98), respectively. There was no significant difference in accuracy between junior and senior doctors. The median frequency with which doctors classified bowel sounds as abnormal did not differ significantly between patients with and without bowel obstruction (26% vs 23%, P = 0.08). The 53 doctors made up 1378 unique pairs and the median Kappa value was 0.29 (range: -0.15-0.66). Accuracy and inter-observer agreement was generally low. Clinical decisions in patients with possible bowel obstruction should not be based on auscultatory assessment of bowel sounds.

Adult large bowel obstruction: A review of clinical experience

African Journals Online (AJOL)

Background: Adult large bowel obstruction is an infrequent cause of acute obstruction in Africa ... of obstruction varies between regions of the world. .... were obtained for bacteriological culture. ... attachment, as observed in previous studies.

Chronic partial ureteral obstruction and the developing kidney

Energy Technology Data Exchange (ETDEWEB)

Chevalier, Robert L. [University of Virginia, Department of Pediatrics, Box 800386, Charlottesville, VA (United States)

2008-01-15

Although congenital urinary tract obstruction is a common disorder, its pathophysiology remains poorly understood and clinical practice is controversial. Animal models have been used to elucidate the mechanisms responsible for obstructive nephropathy, and the models reveal that renal growth and function are impaired in proportion to the severity and duration of obstruction. Ureteral obstruction in the neonatal rat or mouse leads to activation of the renin-angiotensin system, renal infiltration by macrophages, and tubular apoptosis. Nephrons are lost by glomerular sclerosis and the formation of atubular glomeruli, and progressive injury leads to tubular atrophy and interstitial fibrosis. Recovery following release of obstruction depends on the timing, severity, and duration of obstruction. Growth factors and cytokines are produced by the hydronephrotic kidney, including MCP-1 and TGF-{beta}1, which are excreted in urine and can serve as biomarkers of renal injury. Because MRI can be used to monitor renal morphology, blood flow, and filtration rate, its use might supplant current imaging modalities (ultrasonography and diuretic renography), which have significant drawbacks. Combined use of MRI and new urinary biomarkers should improve our understanding of human congenital obstructive nephropathy and should lead to new approaches to evaluation and management of this challenging group of patients. (orig.)

Analysis of the patterns of bronchial obstruction at bronchography

International Nuclear Information System (INIS)

Huh, Suk; Kim, Yong Chul; Han, Sang Don; Lee, Yong Chul

1981-01-01

Of the bronchographic findings of 408 patients, performed in our hospital for recent 5 years, 108 cases showed definite bronchial obstruction, and 61 cases of those were selected and obstructive findings were evaluated. All that not confirmed were abandoned. For evaluation of the reliability of 9 braonchographic obstruction signs on applying to diagnose malignant or benign pulmonary diseases, each sign was identified and applied to each of the 61 confirmed cases. In addition, obstructed bronchi, distance of obstruction from the bifurcation site, and the direction of meniscus, if present, were evaluated. The results were follows: 1. The most frequent cause of bronchial obstruction was lung cancer (59.0%), and that of the benign obstruction was pulmonary tuberculosis (13.1%). 2. Amputation, asymmetric narrowing, thumbprint indentation, rat-tail narrowing and encasement signs were the most accurate signs of malignancy and were practically diagnostic ones. 3. The most frequent sign in lung cancer was sharp cutoff one, but it could be seen in lung abscess and in unresolved pneumonia, too. 4. Circumferential symmetric narrowing and regular concavity with a small central projection signs were specific ones to benignancy. 5. The most frequent obstruction sign in benign lung disease was gradual tapering sign, but it also could be seen in bronchogenic epidermoid and alveolar cell carcinoma. 6. Of all bronchial obstructions, 55.4% occurred at lobar bronchus and 77.4% of those were caused by lung cancer. 7. 77.2% of those obstruction which located within 3 times distance of the bronchial diameter at the nearest proximal bifurcation site, were lung cancer, but 75.0% of those located at over 3 times distance were benign pulmonary diseases. 8. There were no correlation of the direction of the meniscus at the obstructing end in differential diagnosis between benign and malignant pulmonary diseases

Analysis of the patterns of bronchial obstruction at bronchography

Energy Technology Data Exchange (ETDEWEB)

Huh, Suk; Kim, Yong Chul; Han, Sang Don; Lee, Yong Chul [National Medical Center, Seoul (Korea, Republic of)

1981-12-15

Of the bronchographic findings of 408 patients, performed in our hospital for recent 5 years, 108 cases showed definite bronchial obstruction, and 61 cases of those were selected and obstructive findings were evaluated. All that not confirmed were abandoned. For evaluation of the reliability of 9 braonchographic obstruction signs on applying to diagnose malignant or benign pulmonary diseases, each sign was identified and applied to each of the 61 confirmed cases. In addition, obstructed bronchi, distance of obstruction from the bifurcation site, and the direction of meniscus, if present, were evaluated. The results were follows: 1. The most frequent cause of bronchial obstruction was lung cancer (59.0%), and that of the benign obstruction was pulmonary tuberculosis (13.1%). 2. Amputation, asymmetric narrowing, thumbprint indentation, rat-tail narrowing and encasement signs were the most accurate signs of malignancy and were practically diagnostic ones. 3. The most frequent sign in lung cancer was sharp cutoff one, but it could be seen in lung abscess and in unresolved pneumonia, too. 4. Circumferential symmetric narrowing and regular concavity with a small central projection signs were specific ones to benignancy. 5. The most frequent obstruction sign in benign lung disease was gradual tapering sign, but it also could be seen in bronchogenic epidermoid and alveolar cell carcinoma. 6. Of all bronchial obstructions, 55.4% occurred at lobar bronchus and 77.4% of those were caused by lung cancer. 7. 77.2% of those obstruction which located within 3 times distance of the bronchial diameter at the nearest proximal bifurcation site, were lung cancer, but 75.0% of those located at over 3 times distance were benign pulmonary diseases. 8. There were no correlation of the direction of the meniscus at the obstructing end in differential diagnosis between benign and malignant pulmonary diseases.

Bladder outlet obstruction

Science.gov (United States)

BOO; Lower urinary tract obstruction; Prostatism; Urinary retention - BOO ... these diseases increases greatly. Other common causes of BOO include: Pelvic tumors (cervix, prostate, uterus, rectum) Narrowing ...

Prevalence of exercise-induced left ventricular outflow tract obstruction in symptomatic patients with non-obstructive hypertrophic cardiomyopathy.

LENUS (Irish Health Repository)

Shah, J S

2008-10-01

Resting left ventricular outflow tract obstruction (LVOTO) occurs in 25% of patients with hypertrophic cardiomyopathy (HCM) and is an important cause of symptoms and disease progression. The prevalence and clinical significance of exercise induced LVOTO in patients with symptomatic non-obstructive HCM is uncertain.

Ultrasonographic Demonstration of Intestinal Obstruction

International Nuclear Information System (INIS)

Lee, Dong Hoo; Choi, Hyae Seoun; Kim, S. K.; Han, S.U.; Park, K. S.; Park, H. N.

1982-01-01

The cardinal feature of intestinal obstruction is the intraluminal fluid accumulation within the bowel segments. The presence of air simply makes it easier to find dilated fluid-filled bowel loop on plain radiographic films. Distended fluid-filed loop, however, may be obscure on X-ray film when gas is absent, secondary to vomiting, or to cessation of air swallowing. furthermore, in closed loop obstruction, air cannot enter the involved bowel, and thereby in this situation gray scale ultrasonography may be a useful device in making a rapid diagnosis. By sonographic confirmations of intestinal obstruction, a tonic, fluid-filled bowel loops usually were revealed as multiple, circular or cylindrical cystic structures with a finely irregular wall. Valvulae connivente sexhibit a characteristic key-board appearance when they project into the fluid-filled lumen

Pathophysiology of increased intestinal permeability in obstructive jaundice

Science.gov (United States)

Assimakopoulos, Stelios F; Scopa, Chrisoula D; Vagianos, Constantine E

2007-01-01

Despite advances in preoperative evaluation and postoperative care, intervention, especially surgery, for relief of obstructive jaundice still carries high morbidity and mortality rates, mainly due to sepsis and renal dysfunction. The key event in the pathophysiology of obstructive jaundice-associated complications is endotoxemia of gut origin because of intestinal barrier failure. This breakage of the gut barrier in obstructive jaundice is multi-factorial, involving disruption of the immunologic, biological and mechanical barrier. Experimental and clinical studies have shown that obstructive jaundice results in increased intestinal permeability. The mechanisms implicated in this phenomenon remain unresolved, but growing research interest during the last decade has shed light in our knowledge in the field. This review summarizes the current concepts in the pathophysiology of obstructive jaundice-induced gut barrier dysfunction, analyzing pivotal factors, such as altered intestinal tight junctions expression, oxidative stress and imbalance of enterocyte proliferation and apoptosis. Clinicians handling patients with obstructive jaundice should not neglect protecting the intestinal barrier function before, during and after intervention for the relief of this condition, which may improve their patients’ outcome. PMID:18161914

Increased renal adrenomedullin expression in rats with ureteral obstruction

DEFF Research Database (Denmark)

Nørregaard, Rikke; Bødker, Tina; Jensen, Boye L

2009-01-01

Ureteral obstruction is characterized by decreased renal blood flow that is associated with hypoxia within the kidney. Adrenomedullin (AM) is a peptide hormone with tissue-protective capacity that is stimulated through hypoxia. We tested the hypothesis that ureteral obstruction stimulates...... increases in response to ureteral obstruction in agreement with expected oxygen gradients. Hypoxia acting through HIF-1alpha accumulation may be an important pathway for the renal response to ureteral obstruction....

Wrecks and Obstructions

Data.gov (United States)

Department of Homeland Security — In 1981, NOAA�s National Ocean Service (NOS) implemented the Automated Wreck and Obstruction Information System (AWOIS) to assist in planning hydrographic survey...

Spectrum of diseases in acute intestinal obstruction

International Nuclear Information System (INIS)

Masud, M.; Khan, A.; Gondal, Z.I.; Adil, M.

2015-01-01

To determine the etiological spectrum of acute intestinal obstruction in our clinical setup Military Hospital Rawalpindi. Study Design: Descriptive study. Place and Duration of Study: Surgical department of Military Hospital, Rawalpindi from Jul 2012 to Jul 2013, over a period of about 1 year. Material and Methods: A total of 120 patients with acute mechanical intestinal obstruction who underwent laparotomy were included in our study while those with non-mechanical intestinal obstruction like history of trauma and paralytic ileus were excluded from the study. All the patients were selected by non-probability purposive sampling technique. Emergency laparotomy was done and operative findings were recorded. Results: A total of 120 patients with mechanical intestinal obstruction were included in this study out of which 93 (69.17%) were female and remaining 27 (30.83%) were males. Male to female ratio was 1:2.24. Age range of patients was 22-85 years. Out of 120 patients operated for acute intestinal obstruction post-op adhesions were found in 37 (30.83%) patients followed by intestinal tuberculosis in 23 (19.17%) patients, obstructed inguinal hernias in 13 (10.83%), gut malignancies in 15 (12.5%) , Meckel's diverticulum with bands in 7 (5.83%), volvulus in 7 (5.83%), perforated appendix in 6 (5%), intussusception in 2 (1.7%), inflammatory bands in 5 (4.17%), trichobezoar and faecal impaction in 2 (1.7%) while in 3 (2.5%) patients no definite cause was found. Conclusion: Post-op adhesions are the commonest cause of mechanical intestinal obstruction in our setup followed by intestinal tuberculosis as second most common clinical pattern of presentation. (author)

Clinical Outcomes of Self-Expandable Metal Stents for Malignant Rectal Obstruction.

Science.gov (United States)

Lee, Hyun Jung; Hong, Sung Pil; Cheon, Jae Hee; Kim, Tae Il; Kim, Won Ho; Park, Soo Jung

2018-01-01

Self-expandable metal stents are widely used to treat malignant colorectal obstruction. However, data on clinical outcomes of stent placement for rectal obstruction specifically are lacking. We aimed to investigate the clinical outcomes of self-expandable metal stents in malignant rectal obstruction in comparison with those in left colonic obstruction and to identify factors associated with clinical failure and complication. This was a retrospective study. The study was conducted at a tertiary care center. Between January 2005 and December 2013, medical charts of patients who underwent stent placement for malignant rectal or left colonic obstruction were reviewed retrospectively. Study intervention included self-expandable metal stent placement. Technical success, clinical success, and complications were measured. Technical success rates for the 2 study groups (rectum vs left colon, 93.5% vs 93.1%; p = 0.86) did not differ significantly; however, the clinical success rate was lower in patients with rectal obstruction (85.4% vs 92.1%; p = 0.02). In addition, the complication rate was higher in patients with rectal obstruction (37.4% vs 25.1%; p = 0.01). Patients with rectal obstruction showed higher rates of obstruction because of extracolonic malignancy (33.8% vs 15.8%; p stent use for palliation (78.6% vs 56.3%; p stent usage to be independent risk factors for clinical failure. Factors predictive of complications in the palliative group were total obstruction, obstruction because of extracolonic malignancy, and covered stent usage. This was a retrospective, single-center study. The efficacy and safety of stent placement for malignant rectal obstruction were comparable with those for left colonic obstruction. However, obstruction attributed to extracolonic malignancy, use of covered stents, and total obstruction negatively impacted clinical outcomes of self-expandable metal stent placement and must be considered by endoscopists. See Video Abstract at http

25 CFR 11.435 - Obstructing justice.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Obstructing justice. 11.435 Section 11.435 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Criminal Offenses § 11.435 Obstructing justice. A person commits a misdemeanor if, with...

Intrabilary obstruction by colorectal metastases

OpenAIRE

Traeger, Luke; Kiroff, George

2018-01-01

Abstract Intrabiliary colorectal metastases are rare. We present a case of an 84-year-old man who developed obstructive jaundice secondary to intrabiliary growth of colorectal metastases. The patient presented with three weeks of jaundice and significant weight loss in the preceding months. The patient’s background included metastatic colorectal carcinoma, with a previous right hemicolectomy and left hepatectomy for liver metastases. A MRCP showed an obstruction of the biliary tract transitio...

[Tomato peel: rare cause of biliary tract obstruction].

Science.gov (United States)

Hagymási, Krisztina; Péter, Zoltán; Csöregh, Eva; Szabó, Emese; Tulassay, Zsolt

2011-11-20

Foreign bodies in the biliary tree are rare causes of obstructive jaundice. Food bezoars are infrequent as well. They can cause biliary obstruction after biliary tract interventions, or in the presence of biliary-bowel fistula or duodenum diverticulum. Food bezoars usually pass the gastrointestinal tract without any symptoms, but they can cause abdominal pain and obstructive jaundice in the case of biliary tract obstruction. Endoscopic retrograde cholangio-pancreatography has the major role in the diagnosis and the treatment of the disease. Authors summarize the medical history of a 91-year-old female patient, who developed vomiting and right subcostal pain due to the presence of tomato peel within the ductus choledochus.

Obstructive jaundice and advanced gastric carcinoma

International Nuclear Information System (INIS)

Saida, Yukihisa; Tsunoda, Hiroko; Kurosaki, Yoshihisa

1989-01-01

One hundred twenty-nine patients with far advanced or recurrent gastric carcinoma underwent computed tomography (CT) of the abdomen. There were three histologic types: differentiated (n=41), undifferentiated (n=68), and unclassified (n=20). Eighteen patients who had developed obstructive jaundice were retrospectively studied to elucidate the nature of obstruction with histologic correlation. In differentiated carcinomas tumor tended to grow in an expansive fashion. A fairly large, well-defined lymph adenopathy was observed on CT. The extrahepatic bile duct surrounded by lymph nodes appeared as ''doughnot sign'' in six of eight patients. Undifferentiated gastric carcinoma had tendency to extend infiltratively. Bile duct obstruction was only a part of diffuse spreading. In spite of the presence of obstructive jaundice, no discrete mass was demonstrated around the extrahepatic bile duct on CT. In none of nine patients was present ''doughnot sign''. The significance of lymph node dissection along the extrahepatic bile duct in patients with differentiated gastric carcinoma was emphasized. The region of hepatoduodenal and pancreatico-duodenal lymph nodes should be carefully evaluated in interpretation of abdominal CT. (author)

The role of computed tomography in uncertain obstructive jaundice

International Nuclear Information System (INIS)

Saito, Yoshihiro; Yoshino, Toyoaki; Takayanagi, Ryuichi; Negishi, Ken; Tanaka, Teruhiko; Ito, Ichiro.

1985-01-01

42 patients with uncertain obstructive jaundice were examined by computed tomography (CT). CT correctly diagnosed obstructive jaundice in 97% of 37 proven cases and the accuracy of CT in determing the level of obstruction was also 97%. But the sensitivity of CT in determing the cause of obstructive jaundice was 62.5%, particularly poor in common bile duct stone (61.5%), inflammation of common bile duct (0%), and common bile duct carcinoma (50%). All cases of diagnosed malignant tumors were inoperable. (author)

Rendezvous endoscopic recanalization for complete esophageal obstruction.

Science.gov (United States)

Fusco, Stefano; Kratt, Thomas; Gani, Cihan; Stueker, Dietmar; Zips, Daniel; Malek, Nisar P; Goetz, Martin

2018-03-30

Complete esophageal obstruction after (chemo)radiation for head and neck cancers is rare. However, inability to swallow one's own saliva strongly inflicts upon quality of life. Techniques for endoscopic recanalization in complete obstruction are not well established. We assessed the efficacy and safety of rendezvous recanalization. We performed a retrospective review of all patients who underwent endoscopic recanalization of complete proximal esophageal obstruction after radiotherapy between January 2009 and June 2016. Technical success was defined as an ability to pass an endoscope across the recanalized lumen, clinical success by changes in the dysphagia score. Adverse events were recorded prospectively. 19 patients with complete obstruction (dysphagia IV°), all of whom had failed at least one trial of conventional dilatation, underwent recanalization by endoscopic rendezvous, a combined approach through a gastrostomy and perorally under fluoroscopic control. Conscious sedation was used in all patients. In 18/19 patients (94.7%), recanalization was technically successful. In 14/18 patients (77.8%), the post-intervention dysphagia score changed to ≤ II. Three patients had their PEG removed. Factors negatively associated with success were obstruction length of 50 mm; and tumor recurrence for long-term success. No severe complications were recorded. Rendezvous recanalization for complete esophageal obstruction is a reliable and safe method to re-establish luminal patency. Differences between technical and clinical success rates highlight the importance of additional functional factors associated with dysphagia. Given the lack of therapeutic alternatives, rendezvous recanalization is a valid option to improve dysphagia.

Prosthodontic Approach to Treat Obstructive Sleep Apnea ...

African Journals Online (AJOL)

Prosthodontic Approach to Treat Obstructive Sleep Apnea. ... Annals of Medical and Health Sciences Research ... disordered breathing represents a continuum, ranging from simple snoring sans sleepiness, upper‑airway resistance syndrome, obstructive sleep apnea (OSA) syndrome, to hypercapnic respiratory failure.

Small Bowel Obstruction Caused by Aloe vera Bezoars: A Case Report.

Science.gov (United States)

Hong, In Taik; Cha, Jae Myung; Ki, Hye Jin; Kwak, Min Seob; Yoon, Jin Young; Shin, Hyun Phil; Jeoun, Jung Won; Choi, Sung Il

2017-05-25

Small bowel obstruction is a clinical condition commonly caused by postoperative adhesion, volvulus, intussusceptions, and hernia. Small bowel obstruction due to bezoars is clinically uncommon, accounting for approximately 2-4% of all obstructions. Computed tomography (CT) is a useful method in diagnosing the cause of small bowel obstruction. However, small bowel obstruction caused by bezoars may not be detected by an abdominal CT examination. Herein, we report a rare case of small bowel obstruction by Aloe vera bezoars, which were undetected by an abdominal CT. Phytobezoars should be included in the differential diagnosis of small bowel obstruction in patients with predisposing factors, such as excessive consumption of high-fiber food and diabetes.

Spectral analysis of bowel sounds in intestinal obstruction using an electronic stethoscope.

Science.gov (United States)

Ching, Siok Siong; Tan, Yih Kai

2012-09-07

To determine the value of bowel sounds analysis using an electronic stethoscope to support a clinical diagnosis of intestinal obstruction. Subjects were patients who presented with a diagnosis of possible intestinal obstruction based on symptoms, signs, and radiological findings. A 3M™ Littmann(®) Model 4100 electronic stethoscope was used in this study. With the patients lying supine, six 8-second recordings of bowel sounds were taken from each patient from the lower abdomen. The recordings were analysed for sound duration, sound-to-sound interval, dominant frequency, and peak frequency. Clinical and radiological data were reviewed and the patients were classified as having either acute, subacute, or no bowel obstruction. Comparison of bowel sound characteristics was made between these subgroups of patients. In the presence of an obstruction, the site of obstruction was identified and bowel calibre was also measured to correlate with bowel sounds. A total of 71 patients were studied during the period July 2009 to January 2011. Forty patients had acute bowel obstruction (27 small bowel obstruction and 13 large bowel obstruction), 11 had subacute bowel obstruction (eight in the small bowel and three in large bowel) and 20 had no bowel obstruction (diagnoses of other conditions were made). Twenty-five patients received surgical intervention (35.2%) during the same admission for acute abdominal conditions. A total of 426 recordings were made and 420 recordings were used for analysis. There was no significant difference in sound-to-sound interval, dominant frequency, and peak frequency among patients with acute bowel obstruction, subacute bowel obstruction, and no bowel obstruction. In acute large bowel obstruction, the sound duration was significantly longer (median 0.81 s vs 0.55 s, P = 0.021) and the dominant frequency was significantly higher (median 440 Hz vs 288 Hz, P = 0.003) when compared to acute small bowel obstruction. No significant difference was seen

Accuracy of abdominal auscultation for bowel obstruction

DEFF Research Database (Denmark)

Breum, Birger Michael; Rud, Bo; Kirkegaard, Thomas

2015-01-01

AIM: To investigate the accuracy and inter-observer variation of bowel sound assessment in patients with clinically suspected bowel obstruction. METHODS: Bowel sounds were recorded in patients with suspected bowel obstruction using a Littmann(®) Electronic Stethoscope. The recordings were process...

MR urography evaluation of obstructive uropathy

International Nuclear Information System (INIS)

Grattan-Smith, J.D.; Jones, Richard A.; Little, Stephen B.

2008-01-01

Hydronephrosis and the evaluation of obstructive uropathy are the most common indications for MR urography in our practice. Typically our patients fall into one of two groups: infants with antenatal hydronephrosis and older children who present with abdominal pain, hematuria or urinary tract infection. Obstruction in children is usually chronic and partial. Intermittent episodes of increased pressure occur when the urine production exceeds the capacity for drainage. MR urography uses a fluid and diuretic challenge to assess the hydronephrotic kidney. High-quality anatomic images provide a morphologic assessment of the hydronephrotic system. Although it is relatively straightforward to determine if a system is not obstructed on the basis of the renal transit time (RTT), no single parameter is adequate to fully characterize obstruction. By evaluating the changes in signal intensity in the renal parenchyma following contrast administration, the hydronephrotic systems are classified as compensated or decompensated. Delayed RTT and the presence of urine-contrast levels indicate stasis. Calyceal transit time and the difference between the volumetric and the Patlak differential renal function (vDRF-pDRF) are measures of the physiologic changes within the kidney. Additionally, MR urography provides prognostic information by assessing the quality of the renal parenchyma and identifying uropathy preoperatively. MR urography combines both anatomic and functional information in a single test and is capable of providing a comprehensive evaluation of obstructive uropathy that could ultimately help select those patients most likely to benefit from surgical intervention. (orig.)

MR urography evaluation of obstructive uropathy

Energy Technology Data Exchange (ETDEWEB)

Grattan-Smith, J.D.; Jones, Richard A. [Emory University School of Medicine, Department of Radiology, Children' s Healthcare of Atlanta, Atlanta, GA (United States); Little, Stephen B. [Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States)

2008-01-15

Hydronephrosis and the evaluation of obstructive uropathy are the most common indications for MR urography in our practice. Typically our patients fall into one of two groups: infants with antenatal hydronephrosis and older children who present with abdominal pain, hematuria or urinary tract infection. Obstruction in children is usually chronic and partial. Intermittent episodes of increased pressure occur when the urine production exceeds the capacity for drainage. MR urography uses a fluid and diuretic challenge to assess the hydronephrotic kidney. High-quality anatomic images provide a morphologic assessment of the hydronephrotic system. Although it is relatively straightforward to determine if a system is not obstructed on the basis of the renal transit time (RTT), no single parameter is adequate to fully characterize obstruction. By evaluating the changes in signal intensity in the renal parenchyma following contrast administration, the hydronephrotic systems are classified as compensated or decompensated. Delayed RTT and the presence of urine-contrast levels indicate stasis. Calyceal transit time and the difference between the volumetric and the Patlak differential renal function (vDRF-pDRF) are measures of the physiologic changes within the kidney. Additionally, MR urography provides prognostic information by assessing the quality of the renal parenchyma and identifying uropathy preoperatively. MR urography combines both anatomic and functional information in a single test and is capable of providing a comprehensive evaluation of obstructive uropathy that could ultimately help select those patients most likely to benefit from surgical intervention. (orig.)

Body imaging diagnosis of obstructive jaundice

International Nuclear Information System (INIS)

Tanehiro, Kenji; Kuno, Nobuyoshi; Kurimoto, Kumiko; Yokota, Tetsuo; Kato, Tomoyuki

1983-01-01

We have evaluated the efficacy of ultrasonography (US) and computed tomography (CT) in comparison with endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC), and angiography (AG), and discussed a rational diagnostic approach for the evaluation of obstructive jaundice. The subjects were 70 patients with obstructive jaundice, finally confirmed by subsequent surgery or autopsy. In this study, US and CT achieved a diagnostic accuracy of 95% and 98%, respectively, in detection of the presence and level of an obstruction. Therefore, we consider that US is the best initial procedure for evaluation of obstructive jaundice; followed by CT only when the bilialy ducts should be poorly demonstrated by US because of body habitus or gaseous distension. US might be able to identify even the specific etiology of an obstructive lesion. In tumors of the bilialy tract and the pancreas including small and resectable ones, the diagnostic rate of US was high, 91% for bilialy tract tumor and 100% for pancreatic tumor, which was almost the same as that of ERCP, PTC or AG. This result suggests that US eliminates the need of invasive procedures in some cases before making decision of therapeutic approach, while CT was not so accurate diagnostic modality as US in small lesions. But in papillary tumors, small lesions of the distal common bile duct, and gallstone diseases, either ERCP or PTC yielding almost 100% diagnostic accuracy, is the most reliable procedure, while US or CT did not show a good diagnostic accuracy. (J.P.N.)

Systematic review: the influence of nasal obstruction on sleep apnea

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Debora Petrungaro Migueis

2016-04-01

Full Text Available ABSTRACT INTRODUCTION: Obstructive sleep apnea syndrome (OSAS is a common disorder that can lead to cardiovascular morbidity and mortality, as well as to metabolic, neurological, and behavioral consequences. It is currently believed that nasal obstruction compromises the quality of sleep when it results in breathing disorders and fragmentation of sleep. However, recent studies have failed to objectively associate sleep quality and nasal obstruction. OBJECTIVE: The aim of this systematic review is to evaluate the influence of nasal obstruction on OSAS and polysomnographic indices associated with respiratory events. METHODS: Eleven original articles published from 2003 to 2013 were selected, which addressed surgical and non-surgical treatment for nasal obstruction, performing polysomnography type 1 before and after the intervention. RESULTS/CONCLUSIONS: In most trials, nasal obstruction was not related to the apnea-hypopnea index (AHI, indicating no improvement in OSAS with reduction in nasal resistance. However, few researchers evaluated other polysomnography indices, such as the arousal index and rapid eye movement (REM sleep percentage. These could change with nasal obstruction, since it is possible that the nasal obstruction does not completely block the upper airways, but can increase negative intrathoracic pressure, leading to sleep fragmentation.

Effect of ipsilateral ureteric obstruction on contralateral kidney and role of renin angiotensin system blockade on renal recovery in experimentally induced unilateral ureteric obstruction

Directory of Open Access Journals (Sweden)

Shasanka S Panda

2013-01-01

Full Text Available Aims: To study, the effects of ipsilateral ureteric obstruction on contralateral kidney and the role of renin angiotensin system (RAS blockade on renal recovery in experimentally induced unilateral ureteric obstruction. Materials and Methods: Unilateral upper ureteric obstruction was created in 96 adult Wistar rats that were reversed after pre-determined intervals. Losartan and Enalapril were given to different subgroups of rats following relief of obstruction. Results: The severity of dilatation on the contralateral kidney varied with duration of ipsilateral obstruction longer the duration more severe the dilatation. There is direct correlation between renal parenchymal damage, pelvi-ureteric junction (PUJ fibrosis, inflammation and severity of pelvi-calyceal system dilatation of contralateral kidney with duration of ipsilateral PUJ obstruction. Conclusions: Considerable injury is also inflicted to the contralateral normal kidney while ipsilateral kidney remains obstructed. Use of RAS blocking drugs has been found to significantly improve renal recovery on the contralateral kidney. It can, thus, be postulated that contralateral renal parenchymal injury was mediated through activation of RAS.

Endometriosis: A Rare Cause of Large Bowel Obstruction

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Gonçalo Alexandrino

2017-10-01

Full Text Available Large bowel obstruction can result in significant morbidity and mortality, especially in cases of acute complete obstruction. There are many possible causes, the most common in adults being colorectal cancer. Endometriosis is a benign disease, and the most affected extragenital location is the bowel, especially the rectosigmoid junction. However, transmural involvement and acute occlusion are very rare events. We report an exceptional case of acute large bowel obstruction as the initial presentation of endometriosis. The differential diagnosis of colorectal carcinoma may be challenging, and this case emphasizes the need to consider intestinal endometriosis in females at a fertile age presenting with gastrointestinal symptoms and an intestinal mass causing complete large bowel obstruction.

Value and Accuracy of Multidetector Computed Tomography in Obstructive Jaundice

International Nuclear Information System (INIS)

Mathew, Rishi Philip; Moorkath, Abdunnisar; Basti, Ram Shenoy; Suresh, Hadihally B.

2016-01-01

Objective; To find out the role of MDCT in the evaluation of obstructive jaundice with respect to the cause and level of the obstruction, and its accuracy. To identify the advantages of MDCT with respect to other imaging modalities. To correlate MDCT findings with histopathology/surgical findings/Endoscopic Retrograde CholangioPancreatography (ERCP) findings as applicable. This was a prospective study conducted over a period of one year from August 2014 to August 2015. Data were collected from 50 patients with clinically suspected obstructive jaundice. CT findings were correlated with histopathology/surgical findings/ERCP findings as applicable. Among the 50 people studied, males and females were equal in number, and the majority belonged to the 41–60 year age group. The major cause for obstructive jaundice was choledocholithiasis. MDCT with reformatting techniques was very accurate in picking a mass as the cause for biliary obstruction and was able to differentiate a benign mass from a malignant one with high accuracy. There was 100% correlation between the CT diagnosis and the final diagnosis regarding the level and type of obstruction. MDCT was able to determine the cause of obstruction with an accuracy of 96%. MDCT with good reformatting techniques has excellent accuracy in the evaluation of obstructive jaundice with regards to the level and cause of obstruction

Obstructive Sleep Apnea

Medline Plus

Full Text Available ... Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ...

Biliary obstruction dissipates bioelectric sinusoidal-canalicular barrier without altering taurocholate uptake

International Nuclear Information System (INIS)

Cotting, J.; Zysset, T.; Reichen, J.

1989-01-01

To study immediate events during extrahepatic cholestasis, we investigated the effect of short-term biliary obstruction on the bioelectrical sinusoidal-canalicular barrier in the rat using molecular weight-matched uncharged and negatively charged inert solute pairs. The bioelectrical barrier averaged -22 +/- 5 and -18 +/- 4 mV (NS) using the pair carboxy-/methoxyinulin and ferrocyanide/sucrose, respectively. After a 20-min biliary obstruction both decreased by 61 and 11%, respectively, but only the large molecular weight pair (the inulins) returned to base line after release of the obstruction. Inert solute clearances were increased after short biliary obstruction depending on molecular size and negative charge (ferrocyanide greater than sucrose greater than carboxyinulin greater than inulin), suggesting that both permeability and bioelectrical barriers were affected by obstruction. The hepatic extraction in vivo of a passively transported drug not excreted into bile (D-propranolol) was not affected by obstruction, whereas that of an actively transported drug (glycocholate) decreased from 66 +/- 8 to 41 +/- 20% during biliary obstruction (P less than 0.01). Unidirectional transfer of glycocholate was not affected by short-term biliary obstruction in the situ perfused rat liver; however, 2 min after [14C]glycocholate administration, increased return was observed in hepatic venous effluent in obstructed animals. Our findings demonstrate a loss of the bioelectrical barrier immediately after short-term biliary obstruction. Decreased hepatic extraction in the view of unaltered sinusoidal uptake demonstrates regurgitation of bile into blood during short-term biliary obstruction

Danish Register of chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Lange, Peter; Tøttenborg, Sandra Søgaard; Sorknæs, Anne Dichmann

2016-01-01

AIM OF DATABASE: The Danish Register of Chronic Obstructive Pulmonary Disease (DrCOPD) is a nationwide database aiming to describe the quality of treatment of all patients with chronic obstructive pulmonary disease (COPD) in Denmark. STUDY POPULATION: DrCOPD comprises data on all patients...

Airflow obstruction in young adults in Canada

DEFF Research Database (Denmark)

Al-Hazmi, Manal; Wooldrage, Kate; Anthonisen, Nicholas R.

2007-01-01

OBJECTIVE: Airflow obstruction is relatively uncommon in young adults, and may indicate potential for the development of progressive disease. The objective of the present study was to enumerate and characterize airflow obstruction in a random sample of Canadians aged 20 to 44 years. SETTING: The ...

Is nonoperative management of adhesive intestinal obstruction ...

African Journals Online (AJOL)

Background: Nonoperative management of adhesive intestinal obstruction gives good results in adults but there are scant studies on its outcome in children. This study reports outcomes and experiences with nonoperative and operative management of adhesive intestinal obstruction in children in a resource-poor country.

Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease : systematic review and meta-analysis

NARCIS (Netherlands)

Xie, X.Q.; de Jong, P.A.; Oudkerk, M.; Wang, Y.; ten Hacken, N.H.T.; Miao, J.T.; Zhang, GuiXiang; de Bock, G.H.; Vliegenthart, R.

2012-01-01

To determine the correlation between CT measurements of emphysema or peripheral airways and airflow obstruction in chronic obstructive pulmonary disease (COPD). PubMed, Embase and Web of Knowledge were searched from 1976 to 2011. Two reviewers independently screened 1,763 citations to identify

Obstructive Sleep Apnea

Medline Plus

Full Text Available ... The National Sleep Foundation estimates that 18 million adults have obstructive sleep apnea and it is likely ... Maxillofacial Surgeon (OMS). An estimated 18-20 million adults in the US suffer from OSA. What Is ...

Obstructive Sleep Apnea

Medline Plus

Full Text Available ... Apnea (OSA) Download Download the ebook for further information Obstructive sleep apnea (OSA) is a serious and ... that can create the necessary air passageway. The information provided here is not intended as a substitute ...

Obstructive Sleep Apnea

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Full Text Available ... can also invite bacteria that lead to gum disease. Click here to find out more. Who We ... can also invite bacteria that lead to gum disease. Click here to find out more. Obstructive Sleep ...

Role of ureteric stents in relieving obstruction in patients with obstructive uropathy

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M Shehab

2013-01-01

Conclusion: The predictors of renal recoverability revealed that ureteral stents alone can help in regaining renal function and significant improvement of clinical condition in patients with obstructive uropathy.

Systematic review: the influence of nasal obstruction on sleep apnea.

Science.gov (United States)

Migueis, Debora Petrungaro; Thuler, Luiz Claudio Santos; Lemes, Lucas Neves de Andrade; Moreira, Chirlene Santos Souza; Joffily, Lucia; Araujo-Melo, Maria Helena de

2016-01-01

Obstructive sleep apnea syndrome (OSAS) is a common disorder that can lead to cardiovascular morbidity and mortality, as well as to metabolic, neurological, and behavioral consequences. It is currently believed that nasal obstruction compromises the quality of sleep when it results in breathing disorders and fragmentation of sleep. However, recent studies have failed to objectively associate sleep quality and nasal obstruction. The aim of this systematic review is to evaluate the influence of nasal obstruction on OSAS and polysomnographic indices associated with respiratory events. Eleven original articles published from 2003 to 2013 were selected, which addressed surgical and non-surgical treatment for nasal obstruction, performing polysomnography type 1 before and after the intervention. In most trials, nasal obstruction was not related to the apnea-hypopnea index (AHI), indicating no improvement in OSAS with reduction in nasal resistance. However, few researchers evaluated other polysomnography indices, such as the arousal index and rapid eye movement (REM) sleep percentage. These could change with nasal obstruction, since it is possible that the nasal obstruction does not completely block the upper airways, but can increase negative intrathoracic pressure, leading to sleep fragmentation. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Intestinal Obstruction Due to Rectal Endometriosis: A Surgical Enigma

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Razman Jarmin

2006-07-01

Full Text Available Obstructed rectal endometriosis is an uncommon presentation. The clinical and intraoperative presentation may present as malignant obstruction. The difficulty in making the diagnosis may delay the definitive management of the patient. We report a unique case of rectal endometriosis mimicking malignant rectal mass causing intestinal obstruction and discuss the management of the case.

On the obstructions to non-Cliffordian pin structures

Energy Technology Data Exchange (ETDEWEB)

Chamblin, A. (Dept. of Applied Maths and Theoretical Physics, Univ. of Cambridge (United Kingdom))

1994-07-01

We derive the topological obstructions to the existence of non-Cliffordian pin structures on four-dimensional spacetimes. We apply these obstructions to the study of non-Cliffordian pin-Lorentz cobordism. We note that our method of derivation applies equally well in any dimension and in any signature, and we present a general format for calculating obstructions in these situations. Finally, we interpret the breakdown of pin structure and discuss the relevance of this to aspects of physics. (orig.)

Volvulus as a complication of chronic intestinal pseudo-obstruction syndrome

NARCIS (Netherlands)

de Betue, Carlijn T.; Boersma, Doeke; Oomen, Matthijs W.; Benninga, Marc A.; de Jong, Justin R.

2011-01-01

Chronic intestinal pseudo-obstruction syndrome (CIPS) is a severe motility disorder of the gastrointestinal tract that presents with continuous or recurrent symptoms and signs of intestinal obstruction without evidence of a structural lesion occluding the intestinal lumen. Mechanical obstruction

Obstructive sleep apnea: role of intermittent hypoxia and inflammation.

Science.gov (United States)

May, Anna M; Mehra, Reena

2014-10-01

Obstructive sleep apnea results in intermittent hypoxia via repetitive upper airway obstruction leading to partial or complete upper airway closure, apneas and hypopneas, respectively. Intermittent hypoxia leads to sympathetic nervous system activation and oxidative stress with a resultant systemic inflammatory cascade. The putative mechanism by which obstructive sleep apnea has been linked to numerous pathologic conditions including stoke, cardiovascular disease, hypertension, and metabolic derangements is through these systemic effects. Treatment of obstructive sleep apnea appears to reduce systemic markers of inflammation and ameliorates the adverse sequelae of this disease. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Office of Coast Survey Wrecks and Obstructions Database

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Office of Coast Survey's Wrecks and Obstructions database contains information on the identified submerged wrecks and obstructions within the U.S. maritime...

Obstructive Sleep Apnea

Medline Plus

Full Text Available ... It can also invite bacteria that lead to gum disease. Click here to find out more. Who We ... It can also invite bacteria that lead to gum disease. Click here to find out more. Obstructive Sleep ...

Obstructive ventriculomegaly

International Nuclear Information System (INIS)

Amato, M.; Howald, H.; Muralt, G. von

1986-01-01

Intracranial Hemorrhage (ICH) occurs primarily in premature infants, and posthemorrhagic ventricular dilatation is a well-known complication in this age-group. Blood clots within the ventricle are diagnostic of ICH but not usually seen. In our case Real-Time Ultrasonography has proved to be very helpful to identify intraventricular hematomas and to control obstructive ventriculomegaly without therapeutic intervention. (Author)

[Correlation between obstructive apnea syndrome and difficult airway in ENT surgery].

Science.gov (United States)

Pera, Marcia Hiray; Tardelli, Maria Angela; Novo, Neil Ferreira; Juliano, Yara; Silva, Helga Cristina Almeida da

2017-12-21

ENT patients with obstructive sleep apnea syndrome have a tendency of collapsing the upper airways in addition to anatomical obstacles. Obstructive sleep apnea syndrome is related to the increased risk of difficult airway and also increased perioperative complications. In order to identify these patients in the preoperative period, the STOP Bang questionnaire has been highlighted because it is summarized and easy to apply. Evaluate through the STOP Bang questionnaire whether patients undergoing ENT surgery with a diagnosis of obstructive sleep apnea syndrome have a higher risk of complications, particularly the occurrence of difficult airway. Measurements of anatomical parameters for difficult airway and questionnaire application for clinical prediction of obstructive sleep apnea syndrome were performed in 48 patients with a previous polysomnographic study. The sample detected difficult airway in about 18.7% of patients, all of them with obstructive sleep apnea syndrome. This group had older age, cervical circumference > 40cm, ASA II and Cormack III/IV. Patients with obstructive sleep apnea syndrome had higher body mass index, cervical circumference, and frequent apnea. In subgroup analysis, the group with severe obstructive sleep apnea syndrome showed a significantly higher SB score compared to patients without this syndrome or with a mild/moderate obstructive sleep apnea syndrome. The STOP Bang questionnaire was not able to predict difficult airway and mild obstructive sleep apnea syndrome, but it identified marked obstructive sleep apnea syndrome. All patients with difficult airway had moderate and marked obstructive sleep apnea syndrome, although this syndrome did not involve difficult airway. The variables Cormack III/IV and BMI greater than 35 Kg.m -2 were able to predict difficult airway and obstructive sleep apnea syndrome, respectively. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Timing Matters: Circadian Rhythm in Sepsis, Obstructive Lung Disease, Obstructive Sleep Apnea, and Cancer.

Science.gov (United States)

Truong, Kimberly K; Lam, Michael T; Grandner, Michael A; Sassoon, Catherine S; Malhotra, Atul

2016-07-01

Physiological and cellular functions operate in a 24-hour cyclical pattern orchestrated by an endogenous process known as the circadian rhythm. Circadian rhythms represent intrinsic oscillations of biological functions that allow for adaptation to cyclic environmental changes. Key clock genes that affect the persistence and periodicity of circadian rhythms include BMAL1/CLOCK, Period 1, Period 2, and Cryptochrome. Remarkable progress has been made in our understanding of circadian rhythms and their role in common medical conditions. A critical review of the literature supports the association between circadian misalignment and adverse health consequences in sepsis, obstructive lung disease, obstructive sleep apnea, and malignancy. Circadian misalignment plays an important role in these disease processes and can affect disease severity, treatment response, and survivorship. Normal inflammatory response to acute infections, airway resistance, upper airway collapsibility, and mitosis regulation follows a robust circadian pattern. Disruption of normal circadian rhythm at the molecular level affects severity of inflammation in sepsis, contributes to inflammatory responses in obstructive lung diseases, affects apnea length in obstructive sleep apnea, and increases risk for cancer. Chronotherapy is an underused practice of delivering therapy at optimal times to maximize efficacy and minimize toxicity. This approach has been shown to be advantageous in asthma and cancer management. In asthma, appropriate timing of medication administration improves treatment effectiveness. Properly timed chemotherapy may reduce treatment toxicities and maximize efficacy. Future research should focus on circadian rhythm disorders, role of circadian rhythm in other diseases, and modalities to restore and prevent circadian disruption.

Gastroesophageal Reflux Symptoms in Patients with Chronic Obstructive Pulmonary Disease

Directory of Open Access Journals (Sweden)

Zlatica Goseva

2014-09-01

CONCLUSION: GER symptoms are more prevalent in patients with severe airways obstruction when compared to less airways obstructed group and controls. We could suggest an association between the degree of airways obstruction in patients with COPD and the increased rate of GER symptoms.

Malignant duodenal obstructions: palliative treatment with covered expandable nitinol stent

Energy Technology Data Exchange (ETDEWEB)

Kim, Hyun Chul; Jung, Gyoo Sik; Lee, Sang Hee; Kim, Sung Min; Oh, Kyung Seung; Huh, Jin Do; Cho, Young Duk [College of Medicine, Kosin Univ, Pusan (Korea, Republic of); Song, Ho Young [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)

2002-04-01

To evaluate the feasibility and clinical effectiveness of using a polyurethane-covered expandable nitinol stent in the palliative treatment of malignant duodenal obstruction. Under fluoroscopic guidance, a polyurethane-covered expandable nitinol stent was placed in 12 consecutive patients with malignant duodenal obstructions. All presented with severe nausea and recurrent vomiting. The underlying causes of obstruction were duodenal carcinoma (n=4), pancreatic carcinoma (n=4), gall bladder carcinoma (n=2), distal CBD carcinoma (n=1), and uterine cervical carcinoma (n=1). The sites of obstruction were part I (n=1), part II (n=8), and III (n=3). Due to pre-existing jaundice, eight patients with part II obstructions underwent biliary decompression prior to stent placement. An introducer sheath with a 6-mm outer diameter and stents 16 mm in diameter were employed, and to place the stent, and after-loading technique was used. Stent placement was technically successful in ten patients, and no procedural complications occuured. In one of two patients in whom there was technical failure, and in whom the obstructions were located in part III, the stent was placed transgastrically. Stent migration occurred in one patient four days after the procedure, and treatment involved the palcement of a second, uncovered, nitinol stent. After stent placement, symptoms improved in all patients. During follow-up, obstructive symptoms due to stent stenosis (n=1), colonic obstruction (n=1), and multiple small bowel obstruction (n=1) recurred in three patients. Two of these were treated by placing additional stents in the duodenum and colon, respectively. One of the eight patients in whom a stent was placed in the second portion of the duodenum developed jaundice. The patients died a mean 14 (median, 9) weeks after stent placement. The placement of a polyurethane-covered expandable nitinol stent seems to be technically feasible, safe and effective for the palliative treatment of malignant

Small bowel obstruction in children: usefulness of CT for diagnosis and localization

International Nuclear Information System (INIS)

Lee, Young Cheol; Kim, Young Tong; Bae, Won Kyung; Kim, Il Young

2007-01-01

To evaluate the usefulness of CT for the diagnosis of the cause and localization of small bowel obstruction. Out of a group of children who underwent a CT examination for a suspected small bowel obstruction, 19 patients with confirmed underlying disorders were identified and included in the study. Neonates and patients with duodenal obstruction were excluded from the study. The CT findings were analyzed for the location of obstruction site, abnormalities of the mesentery and mesenteric vessels, bowel wall thickening, closed loop obstruction, and strangulation. The obstruction site was divided into five parts. The preoperative CT diagnosis was compared with the final diagnosis. Causes of small bowel obstruction were intussusception (n = 6), appendiceal perforation (n = 4), transmesenteric internal hernia (n = 2), postoperative bands (n = 1), idiopathic multiple bands (n = 1), a foreign body (n = 1), a small bowel adenocarcinoma (n = 1), Meckel's diverticulitis (n = 1), tuberculous peritonitis (n = 1) and Salmonella enteritis with bowel perforation (n = 1). The CT findings showed mesenteric vascular prominence (n = 13), omental or mesenteric infiltration (n = 10), localized bowel wall thickening (n = 7) closed loops obstruction (n = 3) and strangulation (n = 1). The obstruction site was identified in all cases. The causes of obstruction could be diagnosed preoperatively in 14 cases, but a preoperative diagnosis was difficult in 5 cases. The causes of small bowel obstruction in children are variable, and CT is useful for evaluating the cause and localization of small bowel obstruction

Small bowel obstruction in children: usefulness of CT for diagnosis and localization

Energy Technology Data Exchange (ETDEWEB)

Lee, Young Cheol; Kim, Young Tong; Bae, Won Kyung; Kim, Il Young [Cheonan Hospital, Soonchunhyang University, Cheonan (Korea, Republic of)

2007-12-15

To evaluate the usefulness of CT for the diagnosis of the cause and localization of small bowel obstruction. Out of a group of children who underwent a CT examination for a suspected small bowel obstruction, 19 patients with confirmed underlying disorders were identified and included in the study. Neonates and patients with duodenal obstruction were excluded from the study. The CT findings were analyzed for the location of obstruction site, abnormalities of the mesentery and mesenteric vessels, bowel wall thickening, closed loop obstruction, and strangulation. The obstruction site was divided into five parts. The preoperative CT diagnosis was compared with the final diagnosis. Causes of small bowel obstruction were intussusception (n = 6), appendiceal perforation (n = 4), transmesenteric internal hernia (n = 2), postoperative bands (n = 1), idiopathic multiple bands (n = 1), a foreign body (n = 1), a small bowel adenocarcinoma (n = 1), Meckel's diverticulitis (n = 1), tuberculous peritonitis (n = 1) and Salmonella enteritis with bowel perforation (n = 1). The CT findings showed mesenteric vascular prominence (n = 13), omental or mesenteric infiltration (n = 10), localized bowel wall thickening (n = 7) closed loops obstruction (n = 3) and strangulation (n = 1). The obstruction site was identified in all cases. The causes of obstruction could be diagnosed preoperatively in 14 cases, but a preoperative diagnosis was difficult in 5 cases. The causes of small bowel obstruction in children are variable, and CT is useful for evaluating the cause and localization of small bowel obstruction.

Multidetector Computed Tomography (MDCT in Gastrointestinal Obstruction: One Symptom Myriad Differentials

Directory of Open Access Journals (Sweden)

Geetika Sindhwani

2017-10-01

Full Text Available Introduction: Computed Tomography (CT is a highly sensitive modality with its multi-planar capabilities, used in evaluation of acute cases of intestinal obstruction. It delineates the level and helps to identify various etiologies of obstruction, where plain radiographs can only suggest signs of obstruction. It has an added advantage of detecting further complications, thus framing appropriate surgical approach. Aim: Our study aims at delineating variable CT spectrum of intestinal obstruction with highlight on atypical presentation. Materials and Methods: Retrospective hospital data based study was conducted in the Radiology Department of Shree Krishna Hospital, Anand, Gujarat, India, between 2014-2017 including 40 patients with mechanical causes of obstruction and excluding patients with non-mechanical causes of obstruction. Statistical analysis was done using percentages and proportions using MedCalc software version 17.6. Results: The age range of patients was from 5 days to 83 years and the maximum number of patients i.e., 7 (17.5% were in the age group of 41-50 years. Radiographic signs related to obstruction like air fluid levels, dilated bowel loops was seen in 26 out of 40 cases (sensitivity 60%. Small bowel obstruction dominated the case list with obstructed hernia as major causative factor. Conclusion: Study highlights the contribution of MDCT in early identification of underlying etiology and complications of obstruction with additional contribution in road mapping and framing appropriate and individualized treatment strategy for patients.

A CLINICAL STUDY OF ADHESIVE INTESTINAL OBSTRUCTION

Directory of Open Access Journals (Sweden)

Haricharan

2015-09-01

Full Text Available INTRODUCTION: Adhesive intestinal obstruction is an inevitable complication of abdominal surgeries. It has high morbidity with associated poor quality of life and predisposition to repeated hospitalization. Commonest cause of bowel obstruction in developed countries is postoperative adhesions with extrinsic compression of the intestine. Most of them can be managed conservatively. METHODS: A retrospective study of 30 patients admitted with the diagnosis of post - operative adhesive partial bowel obstruction was conducted by analyzing their medical records. Demographic data, clinical presentation including duration, previous surgical procedures, treatments received for the condition and successful conservative approach versus requirement of operative intervention were assesse d. RESULTS: The median age was 31yrs, most in their third decade of life. Male predominance was noted. Pelvic surgeries and gynecological surgeries (26% were found to be the most common cause of adhesive bowel obstruction followed by appendectomy (16%. M ore than two third of the patients (76.7% developed symptoms within two years of the initial surgery. Successful conservative treatment was noted in 22 patients (73.3% and discharged on fourth day of admission. Eight patients (26.6% underwent surgery. T hey all underwent adhesiolysis and had good outcome. CONCLUSIONS: The time - honored practice of expectant management of adhesive partial bowel obstruction has equally good outcome, as compared to various interventions practiced

Percutaneous transhepatic cholangiographic evaluation of obstructive jaundice

International Nuclear Information System (INIS)

Kang, Hee Tae; Kim, Hong Soo; Kim, Jong Deok; Rhee, Hak Song

1983-01-01

PTC is the single most valuable diagnostic method available to evaluate the size, shape and site of the causes of obstructive jaundice among various radiological procedures. The authors reviewed and radiologically classified the PTC films of 203 cases of obstructive jaundice from July, 1977 to June, 1983 at Presbyterian Medical Center, Jeonju confirmed clinically, operatively and pathologically. The results are as follows; 1. The most common cause of obstructive jaundice was bile duct stone (64/203: 31.53%) and the other causes were bile duct cancer (43/203: 21.18%), pancreas cancer (41/203: 20.19%), biliary ascariasis and/or clonorchiasis (20/203: 9.8%), ampulla and duodenal cancer (7/203: 3.45%), fibrotic stenosis of sphincter of Oddi (6/203: 2.96%) etc. in the order. Of these primary involvement with cancer was more frequent (91/203: 44.33%) than stone. 3. The average maximal diameter of extrahepatic bile duct just proximal to the site of obstruction or stenosis by stones or by cancers was nearly equal (2.36 cm : 2.38 cm). 4. Cancers caused complete bile duct obstruction in about 75% (68/91) of cases and also were associated with intrahepatic duct dilatation about 92% (84/91) of cases. But in contrast biliary calculi showed good drainage of contrast medium in 75% (48/64) of cases and 92% (59/64) showed normal diameter

Transrectal Ultrasonographic Findings of Obstructive Male Infertility

International Nuclear Information System (INIS)

Kim, Chang Il; Kim, Yun Hyeon; Kang, Heoung Keun; Kim, Jae Kyu; Park, Jin Gyoon; Park, Heung Il; Park, Kwang Seong

1996-01-01

To evaluate the usefulness of the transrectal ultrasound in infertile men with suspected obstructive lesions of sperm transport system. We performed transrectal US in 26 infertile patients in whom obstructive lesions of sperm transport system were suspected in physical examination and laboratory data. 7.0 MHz transrectal transducer was used and the content of analysis of sonographic findings was the presence of vas deferens, seminal vesicle and ejaculatory duct. Also, we measured the width of seminal vesicle and diameter of ejaculatory duct. Transrectal US revealed an accurate diagnosis in 12 infertile men who had obstructive lesions and associated abnormalities in distal sperm transport system, two of congenital bilateral absence of the vasa deferentia and seminal vesicles, two of congenital unilateral absence of the vas deferens and seminal vesicle, three of dilatation of seminal vesicles, and five of dilatation of ejaculatory ducts and proximal ducts. The other 14 patients who had normal findings on transrectal US were revealed to have testicular failure (10 patients) and obstruction of proximal sperm transport system (4 patients) which were beyond the field-of-view of transrectal US. Transrectal US is the useful diagnostic method for the evaluation of infertile men with suspected obstructive lesions of sperm transport system. It can possibly decrease the need for the invasive vasography and may be helpful in the guidance of appropriate management of male infertility

Overlap syndrome: obstructive sleep apnea in patients with chronic obstructive pulmonary disease.

Science.gov (United States)

Weitzenblum, Emmanuel; Chaouat, Ari; Kessler, Romain; Canuet, Matthieu

2008-02-15

Chronic obstructive pulmonary disease (COPD) and sleep apnea-hypopnea syndrome (SAHS) are both common diseases affecting respectively 10 and 5% of the adult population over 40 years of age, and their coexistence, which is denominated overlap syndrome, can be expected to occur in about 0.5% of this population. A recent epidemiologic study has shown that the prevalence of SAHS is not higher in COPD than in the general population, and that the coexistence of the two conditions is due to chance and not through a pathophysiologic linkage between these two diseases. Patients with overlap have a more important sleep-related O(2) desaturation than do patients with COPD with the same degree of bronchial obstruction. They have an increased risk of developing hypercapnic respiratory insufficiency and pulmonary hypertension when compared with patients with SAHS alone and with patients with "usual" COPD. In patients with overlap, hypoxemia, hypercapnia, and pulmonary hypertension can be observed in the presence of mild to moderate bronchial obstruction, which is different from "usual" COPD. Therapy of the overlap syndrome consists of nasal continuous positive airway pressure or nocturnal noninvasive ventilation (NIV), with or without associated nocturnal O(2). Patients who are markedly hypoxemic during daytime (Pa(O(2)) < 55-60 mm Hg) should be given conventional long-term O(2) therapy in addition to nocturnal ventilation.

Extrinsic ureteropelvic junction obstruction from a crossing renal vessel: demography and imaging

Energy Technology Data Exchange (ETDEWEB)

Rooks, V.J.; Lebowitz, R.L. [Children' s Hospital and Harvard Medical School, Dept. of Radiology, Boston, MA (United States)

2001-02-01

Background. The increase in the use of prenatal ultrasound has revolutionized the detection of hydronephrosis and has had an unanticipated consequence. Objective. To describe the new demographics of symptomatic ureteropelvic junction (UPJ) obstruction and the characteristic imaging findings, when the obstruction is extrinsic, from a crossing renal vessel. Materials and methods. From a uroradiology database (1994 through 1999) we identified children with surgically corrected UPJ obstruction from intrinsic and extrinsic causes. Results. One hundred children had symptomatic UPJ obstruction treated by surgery. In 51 (49 %), obstruction was due to a crossing vessel. One hundred and one had UPJ obstruction detected by prenatal sonography. Only 11 (11 %) were due to a vessel. Two clinical and imaging findings were strongly suggestive of obstruction from a vessel: (1) in 5 of the 100 children the symptoms (pain, nausea, and vomiting) were intermittent. Only when symptoms were present were there hydronephrosis and obstruction; (2) in 51 of the 100 children a short segment of ureter, just below the UPJ, was filled with contrast or urine (on renal sonography, intravenous urography, or retrograde/antegrade ureterography). Conclusions. Extrinsic UPJ obstruction caused by a vessel is an uncommon cause of obstruction when all patients are considered. However, in symptomatic older patients whose hydronephrosis was not first identified on prenatal sonography, a vessel was the cause of obstruction in one-half. (orig.)

Obstructive sleep apnea

DEFF Research Database (Denmark)

Jennum, Poul; Tønnesen, Philip; Ibsen, Rikke

2017-01-01

OBJECTIVE: Most studies have used cardiovascular and cerebrovascular disease (CVD) end-points to measure the effect of continuous positive airway pressure (CPAP), but pre-diagnostic morbidities involve a range of comorbidities that may influence the consequences of obstructive sleep apnea (OSA). We...

Inducible laryngeal obstruction

DEFF Research Database (Denmark)

Halvorsen, Thomas; Walsted, Emil Schwarz; Bucca, Caterina

2017-01-01

Inducible laryngeal obstruction (ILO) describes an inappropriate, transient, reversible narrowing of the larynx in response to external triggers. ILO is an important cause of a variety of respiratory symptoms and can mimic asthma. Current understanding of ILO has been hampered by imprecise nomenc...

Obstructive jaundice due to hepatobiliary cystadenoma or cystadenocarcinoma

NARCIS (Netherlands)

Erdogan, Deha; Busch, Olivier R. C.; Rauws, Erik A. J.; van Delden, Otto M.; Gouma, Dirk J.; van-Gulik, Thomas M.

2006-01-01

Hepatobiliary cystadenomas (HBC) and cystadenocarcinomas are rare cystic lesions. Most patients with these lesions are asymptomatic, but presentation with obstructive jaundice may occur. The first patient presented with intermittent colicky pain and recurrent obstructive jaundice. Imaging studies

Drug-induced MR urography: the effects of furosemide and intravenous saline injection on MR urography of obstructed and non-obstructed urinary tract

Energy Technology Data Exchange (ETDEWEB)

Park, Jeong Ha; Lee, Myung Jun; Lee, Chang Joon [National Medical Center, Seoul (Korea, Republic of)

2001-10-01

To determine the usefulness of MR urography technique for the evaluation of urinary systems in patients with obstructed urinary tract and normal volunteers with non-obstructed urinary tract after intravenous normal saline and diuretic injection. Three normal volunteers and 12 patients with urinary tract obstruction [ureteral calculi (n=8), extraurinary mass (n=1), ureteral tumor invasion (n=3)] underwent MR urography using a 1.0T scanner and a 2D non-breath-hold heavily T2-weighted fast spin-cho sequence. These acquisition were post-processed with a maximum intensity projection (MIP) algorithm. Two acquisitions were performed, the first prior to saline solution infusion following standard MR urography procedures, and the second, within 2-3 minutes of the infusion of 250 ml saline solution followed by 20 mg of Lasix administered intravenously. For this latter, drug-induced MR urography procedures were followed. In healthy volunteer (n=3) and those experiencing partial obstruction (n=4) by a urinary stone, drug-induced MR urography provided better images of the urinary tract than did standard MR urography. In those in whom a urinary stone or tumor had caused complete obstruction (n=8), standard MR urography provided good images, as did drug-induced MR urography. In patients with a partially or non-obstructed urinary tract, drug-induced MR urography provided better anatomic and functional details of the kidney and urinary tract than did standard MR urography. In those experiencing complete obstruction of the urinary tract, however, standard or drug-induced MR urography permitted very adequate evaluation of the tract, and drug-induced MR urography was unnecessary.

Analysis of electrocardiogram in chronic obstructive pulmonary disease patients.

Science.gov (United States)

Lazović, Biljana; Svenda, Mirjana Zlatković; Mazić, Sanja; Stajić, Zoran; Delić, Marina

2013-01-01

Chronic obstructive pulmonary disease is the fourth leading cause of mortality worldwide. It is defined as a persistent airflow limitation usually progressive and not fully reversible to treatment. The diagnosis of chronic obstructive pulmonary disease and severity of disease is confirmed by spirometry. Chronic obstructive pulmonary disease produces electrical changes in the heart which shows characteristic electrocardiogram pattern. The aim of this study was to observe and evaluate diagnostic values of electrocardiogram changes in chronic obstructive pulmonary disease patients with no other comorbidity. We analyzed 110 electrocardiogram findings in clinically stable chronic obstructive pulmonary disease patients and evaluated the forced expiratory volume in the first second, ratio of forces expiratory volume in the first second to the fixed vital capacity, chest radiographs and electrocardiogram changes such as p wave height, QRS axis and voltage, right bundle branch block, left bundle branch block, right ventricular hypertrophy, T wave inversion in leads V1-V3, S1S2S3 syndrome, transition zone in praecordial lead and QT interval. We found electrocardiogram changes in 64% patients, while 36% had normal electrocardiogram. The most frequent electrocardiogram changes observed were transition zone (76.36%) low QRS (50%) and p pulmonale (14.54%). Left axis deviation was observed in 27.27% patients. Diagnostic values of electrocardiogram in patients with chronic obstructive pulmonary disease suggest that chronic obstructive pulmonary disease patients should be screened electrocardiographically in addition to other clinical investigations.

Hg uptake in ureteral obstructions

International Nuclear Information System (INIS)

Desgrez, J.P.; Bourguignon, M.; Raynaud, C.; CEA, 91 - Orsay

1976-01-01

In the presence of a total obstruction the results obtained with the Hg uptake test, as indeed with other functional tests, inform on the value of the kidney function at the time but have no prognostic value where repair possibilities are concerned. Some preliminary results seem to show however that very soon after the obstacle is removed, by the 10th or 15th day perhaps, quantitative functional tests may once more be used to evaluate the functional prognosis. This would mean that by waiting about two weeks after the disappearance of a total obstruction the Hg uptake test may again be used in all confidence. In order to check this deduction, which is based on slender evidence but which nevertheless has important practical implications, the measurement of the Hg uptake rate during the days following removal of the obstacle appears essential. In long-standing partial obstructions the Hg uptake rate gives an accurate assessment of the functional balance and helps considerably in the choice of therapy [fr

Obstructive Sleep Apnea in MPS

Directory of Open Access Journals (Sweden)

Abhijit Ricky Pal MBBChir, MA, MD, FRCS(ORL-HNS

2015-11-01

Full Text Available The mucopolysaccharidoses (MPSs are a group of inherited, metabolic disorders characterized by progressive multisystem accumulation of partially degraded glycosaminoglycans. This manifests with multilevel airway obstruction, presenting with obstructive sleep apnea (OSA. We systematically reviewed the literature to determine the severity and prevalence of OSA in MPS based on polysomnography analysis. Fifteen studies with 294 participants met the inclusion criteria for review. The pretreatment prevalence of OSA in MPS was 81% with a mean apnea–hypopnea index (AHI of 10.4. Patients with MPS I are most significantly affected, with 75% suffering with moderate to severe OSA (mean AHI, 16.6. Enzyme replacement therapy (ERT results in an almost significant reduction in OSA in MPS I ( P = .06, while adenotonsillar surgery significantly improves AHI ( P = .002. Obstructive sleep apnea least affects MPS III. There is a lack of long-term post-ERT and hematopoietic stem cell transplant data relating to OSA outcomes in this population, with further prospective studies required to determine the ongoing response to treatment.

The Effect of Slipstream Obstructions on Air Propellers

Science.gov (United States)

Lesley, E P; Woods, B M

1924-01-01

The screw propeller on airplanes is usually placed near other objects, and hence its performance may be modified by them. Results of tests on propellers free from slip stream obstructions, both fore and aft, are therefore subject to correction, for the effect of such obstructions and the purpose of the investigation was to determine the effect upon the thrust and torque coefficients and efficiency, for previously tested air propellers, of obstructions placed in the slip stream, it being realized that such previous tests had been conducted under somewhat ideal conditions that are impracticable of realization in flight. Simple geometrical forms were used for the initial investigation. Such forms offered the advantage of easy, exact reproduction at another time or in other laboratories, and it was believed that the effects of obstructions usually encountered might be deduced or surmise from those chosen.

Facteurs prédictifs de la réponse à la CERA chez les hémodialysés ...

African Journals Online (AJOL)

Facteurs prédictifs de la réponse à la CERA chez les hémodialysés chroniques naïfs de traitement par agent stimulant l'érythropoïèse. ... Il s'agit une étude prospective mono centrique faite au sein d'une population d' hémodialysés chroniques. ... L'anémie est une complication majeure chez les hémodialysés chroniques.

Obstructive sleep apnea - adults

Science.gov (United States)

... SM. Obstructive sleep apnea: clinical features, evaluation, and principles of management. In: Kryger M, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, ...

Obstructive jaundice promotes bacterial translocation in humans.

Science.gov (United States)

Kuzu, M A; Kale, I T; Cöl, C; Tekeli, A; Tanik, A; Köksoy, C

1999-01-01

Significant bacterial translocation was demonstrated following experimental biliary obstruction, however very little is known about the importance and the prevalence of gut-origin sepsis in obstructive jaundice patients. Therefore, the aim of this study was to investigate the concept of gut-origin sepsis in obstructive jaundiced patients and its clinical importance. Twenty-one patients requiring laparotomy for obstructive jaundice (group I) and thirty patients operated on electively mainly for chronic cholecystitis (group II) were studied. Peritoneal swab, mesenteric lymph node, portal venous blood, liver wedge biopsy and bile were sampled for culture immediately after opening the peritoneum. Additionally, peripheral blood samples were taken pre- and post-operatively from all patients. Post-operatively, patients were monitored for infectious complications. The mean serum bilirubin concentration, gamma glutamyl transferase and alkaline phosphatase levels in jaundiced patients before therapeutic intervention were significantly higher than in control patients. Five patients demonstrated bacterial translocation in group I (24%), whereas only one did so in group II (3.5%, p jaundice significantly promotes bacterial translocation in humans, however, its clinical importance has yet to be defined.

Overlap Syndrome in Respiratory Medicine: Asthma and Chronic Obstructive Pulmonary Disease

OpenAIRE

Alexandru Corlateanu; Valeria Pripa; Gloria Montanari; Victor Botnaru

2014-01-01

Asthma and chronic obstructive pulmonary disease (COPD) are highly prevalent chronic diseases in the general population. Both are characterized by similar mechanisms: airway inflammation, airway obstruction, and airway hyperresponsiveness. However, the distinction between the two obstructive diseases is not always clear. Multiple epidemiological studies demonstrate that in elderly people with obstructive airway disease, as many as half or more may have overlapping diagnoses of asthma and COPD...

Sharp metric obstructions for quasi-Einstein metrics

Science.gov (United States)

Case, Jeffrey S.

2013-02-01

Using the tractor calculus to study smooth metric measure spaces, we adapt results of Gover and Nurowski to give sharp metric obstructions to the existence of quasi-Einstein metrics on suitably generic manifolds. We do this by introducing an analogue of the Weyl tractor W to the setting of smooth metric measure spaces. The obstructions we obtain can be realized as tensorial invariants which are polynomial in the Riemann curvature tensor and its divergence. By taking suitable limits of their tensorial forms, we then find obstructions to the existence of static potentials, generalizing to higher dimensions a result of Bartnik and Tod, and to the existence of potentials for gradient Ricci solitons.

Osteoporosis in chronic obstructive pulmonary disease patients

DEFF Research Database (Denmark)

Jørgensen, Niklas Rye; Schwarz, Peter

2008-01-01

The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence.......The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence....

A CLINICAL STUDY OF ADHESIVE INTESTINAL OBSTRUCTION

OpenAIRE

Haricharan; Murali Krishna; Koti Reddy; Nara Hari

2015-01-01

INTRODUCTION: Adhesive intestinal obstruction is an inevitable complication of abdominal surgeries. It has high morbidity with associated poor quality of life and predisposition to repeated hospitalization. Commonest cause of bowel obstruction in developed countries is postoperative adhesions with extrinsic compression of the intestine. Most of them can be managed conservatively. METHODS: A retrospective study of 30 patients admit...

Obstructive sleep apnea syndrome and growth failure.

Science.gov (United States)

Esteller, E; Villatoro, J C; Agüero, A; Lopez, R; Matiñó, E; Argemi, J; Girabent-Farrés, M

2018-05-01

Obstructive sleep apnea syndrome is a common problem among children and is recognized as a cause of significant medical morbidity. Since the 1980s, it has been suggested that obstructive sleep apnea syndrome is a risk factor for growth failure in children. In many cases, it has been shown that growth failure is reversible once the obstructive sleep apnea syndrome is resolved. The objectives of this study were to analyze and compare growth failure prevalence in a Mediterranean population of children with obstructive sleep apnea syndrome and healthy children matched in age and sex, and to assess the effectiveness of tonsillectomy and adenoidectomy in resolving growth retardation. We compared 172 children with obstructive sleep apnea syndrome (apnea-hypopnea index ≥ 3) who had undergone tonsillectomy and adenoidectomy with 172 healthy controls in terms of key anthropometric parameters. Most of the criteria used for growth failure were higher to a statistically significant degree in the study group vs the control group: height-for-age ≤ 3rd percentile (7.56% vs 2.91%; p = 0.044), weight-for-age ≤ 5th percentile (9.30% vs 2.33%; p = 0.005), weight-for-age ≤ 3rd percentile (8.14% vs 2.33%; p = 0.013) and height and/or weight for-age ≤ 5th percentile (13.95% vs 5.81%; p = 0.009). The height-for-age ≤ 5th percentile was almost at the limit of statistical significance (8.72% for the study group vs 4.65% for the control group; p = 0.097). At one-year post-surgery follow-up, 10 of 15 children with height-for-age ≤ 5th percentile had achieved catch-up growth (66.6%), and 14 of 24 children with height- and/or weight-for-age ≤ 5th percentile had normalized growth (58.33%). For children with failure to thrive or who have growth failure, physicians should consider the possibility of obstructive sleep apnea. A significant number of children with obstructive sleep apnea concurrent with growth failure could benefit from

Simple Modification of the Bladder Outlet Obstruction Index for Better Prediction of Endoscopically-Proven Prostatic Obstruction: A Preliminary Study.

Directory of Open Access Journals (Sweden)

Jang Hee Han

Full Text Available The bladder outlet obstruction index (BOOI, also known as the Abrams-Griffiths (AG number, is the most widely used index for predicting BOO. However, the obstructed prostatic urethra determined by the BOOI is often inconsistent with endoscopically-proven obstruction. We assessed abdominal straining pattern as a novel parameter for improving the prediction of BOO.We retrospectively reviewed the pressure-flow studies (PFS and cystourethroscopy in 176 BPH/LUTS patients who were unresponsive to medical therapy. During PFS, some groups of patients tried to urinate with abdominal straining, which can increases intravesical pressure and underestimate BOOI theoretically. Accordingly, the modified BOOI was defined as (PdetQmax+ΔPabd-2Qmax.Ultimately, 130 patients were eligible for the analysis. In PFS, ΔPabd (PabdQmax-initial Pabd was 11.81±13.04 cmH2O, and it was 0-9 cmH2O in 75 (57.7%, 10-19 cmH2O in 23 (17.7% and ≥20 cmH2O in 32 (24.6% patients. An endoscopically obstructed prostatic urethra in 92 patients was correctly determined in 47 patients (51.1% by the original BOOI versus 72 patients (78.3% based on the modified BOOI. Meanwhile, an "unobstructed" urethra according to the original BOOI was present in 11 patients (12.0%, whereas according to the modified BOOI, only 2 (2.1% would be labeled as "unobstructed". In receiver operating characteristic curves, the area under the curve was 0.906 using the modified BOOI number versus 0.849 in the original BOOI (p<0.05.The change in abdominal pressure was correlated with endoscopically-proven obstruction. Our simple modification of the BOOI on the basis of this finding better predicted bladder outlet obstruction and, therefore, should be considered when evaluating BOO in patients with LUTS/BPH.

Arterial stiffness in people with Type 2 diabetes and obstructive sleep apnoea

DEFF Research Database (Denmark)

Hvelplund Kristiansen, M; Banghøj, A M; Laugesen, E

2018-01-01

AIMS: To examine whether people with Type 2 diabetes with concurrent obstructive sleep apnoea have increased arterial stiffness as compared with people with Type 2 diabetes without obstructive sleep apnoea. METHODS: In a study with a case-control design, 40 people with Type 2 diabetes and treatment......-naïve moderate to severe obstructive sleep apnoea (Apnoea-Hypopnoea Index ≥15) and a control group of 31 people with Type 2 diabetes without obstructive sleep apnoea (Apnoea-Hypopnoea Index ... was not significantly different between participants with Type 2 diabetes with obstructive sleep apnoea and those without obstructive sleep apnoea (10.7±2.2 m/s vs 10.3±2.1 m/s; P=0.513), whereas oscillometric pulse wave velocity was significantly higher in participants with Type 2 diabetes with obstructive sleep...

RADIOLOGICAL EVALUATION OF OBSTRUCTIVE JAUNDICE BY ULTRASOUND AND CT

Directory of Open Access Journals (Sweden)

Padmalatha

2015-10-01

Full Text Available INTRODUCTION: The goals of any radiologic procedure in obstructive Jaundice are to confirm the presence of bile duct obstruction, its location, its extent & the probable cause. It should also attempt to obtain a map of the biliary tree that will help the surgeon to det ermine the best approach to each individual case. OBJECTIVES: 1. To evaluate the role of Ultrasound and CT in patients presenting with clinical features of obstructive jaundice. 2. To evaluate the causes of obstructive jaundice by Ultrasound and CT. PATIENTS AND METHODS: The study was carried with 45 patients from January 2006 to September 2007 who were attending the surgical and Gastroenterology Departments, Govt. General Hospital, Kurnool, which is an attached hospital to Kurnool Medical College, Kurnool. O BSERVATIONS AND RESULTS: In our study, there is female predominance with male: female ratio 1: 1.6.Majority of patients are in age group of 41 - 50 years. Jaundice was the commonest presentation in all patients followed by pruritis in 72% and pain abdomen in 67% of patients. Ultrasound identified the benign cause of biliary obstruction in 79.1% cases and the malignant cause in 61.9% cases. CT identified the benign cause of biliary obstruction in 91.6% of patients and the malignant cause in 80.9% cases.

Positive predictive value of cholescintigraphy in common bile duct obstruction

International Nuclear Information System (INIS)

Lecklitner, M.L.; Austin, A.R.; Benedetto, A.R.; Growcock, G.W.

1986-01-01

Technetium-99m DISIDA imaging was employed in 400 patients to differentiate obstruction of the common bile duct from medical and other surgical causes of hyperbilirubinemia. Sequential anterior images demonstrated variable degrees of liver uptake, yet there was no evidence of intrabiliary or extrabiliary radioactivity for at least 4 hr after injection in 25 patients. Twenty-three patients were surgically documented to have complete obstruction of the common bile duct. One patient had hepatitis, and another had sickle cell crisis without bile duct obstruction. The remaining patients had either partial or no obstruction of the common bile duct. We conclude that the presence of liver uptake without evident biliary excretion by 4 hr on cholescintigraphy is highly sensitive and predictive of total obstruction of the common bile duct

Retroperitoneal fibrosis: A rare cause of both ureteral and small bowel obstruction

Institute of Scientific and Technical Information of China (English)

Faisal Aziz; Srinivasulu Conjeevaram; Than Phan

2006-01-01

Retroperitoneal fibrosis (RPF) is a rare condition of unclear etiology. It can cause ureteral obstruction. We present the unique case of a 54 years old female, who initially presented with spontaneous perforation of the cecum. Upon exploring the abdomen, the classical glistening white, unyielding retroperitoneal fibrosis was encountered. A right hemicolectomy was performed.Subsequently, the patient presented with bilateral ureteral obstruction, and later on with small bowel obstruction. Ureteral obstruction was treated with stents,and small bowel obstruction was treated with bypass.To our knowledge no case of idiopathic RPF presenting with features of both bilateral ureteral and small bowel obstruction has been reported in the literature.

Acute pseudo-obstruction of the colon

International Nuclear Information System (INIS)

Beese, M.; Heller, M.

1988-01-01

The radiological correlate to the pseudo-obstruction of the colon is not specific, but it does supply a pointer to the disease of it shows dilation of the caecum, colon ascendens and colon transversum with air-pockets and reflected imaging as well as a usually not dilated colon descendens with remarkably little air. To make the diagnosis quite sure we must exclude intestinal obstruction by using X-ray contrast media or by coloscopy. (orig./GDG) [de

Pediatric ureteropelvic junction obstruction: can magnetic resonance urography identify crossing vessels?

Energy Technology Data Exchange (ETDEWEB)

Parikh, Kushal R.; Kraft, Kate H.; Ivancic, Vesna; Smith, Ethan A.; Dillman, Jonathan R. [Section of Pediatric Radiology, Mott Children' s Hospital, Department of Radiology, University of Michigan Health System, Ann Arbor, MI (United States); Hammer, Matthew R. [University of Texas Southwestern, Department of Radiology, Dallas, TX (United States)

2015-11-15

MR Urography (MRU) is an increasingly used imaging modality for the evaluation of pediatric genitourinary obstruction. To determine whether pediatric MR urography (MRU) reliably detects crossing vessels in the setting of suspected ureteropelvic junction (UPJ) obstruction. The clinical significance of these vessels was also evaluated. We identified pediatric patients diagnosed with UPJ obstruction by MRU between May 2009 and June 2014. MRU studies were evaluated by two pediatric radiologists for the presence or absence of crossing vessels. Ancillary imaging findings such as laterality, parenchymal thinning/scarring, trapped fluid in the proximal ureter, and presence of renal parenchymal edema were also evaluated. Imaging findings were compared to surgical findings. We used the Mann-Whitney U test to compare continuous data and the Fisher exact test to compare proportions. Twenty-four of 25 (96%) UPJ obstructions identified by MRU were surgically confirmed. MRU identified crossing vessels in 10 of these cases, with 9 cases confirmed intraoperatively (κ = 0.92 [95% CI: 0.75, 1.0]). Crossing vessels were determined to be the primary cause of UPJ obstruction in 7/9 children intraoperatively, while in two children the vessels were deemed incidental and noncontributory to the urinary tract obstruction. There was no significant difference in age or the proportions of ancillary findings when comparing children without and with obstructing vessels. MRU allows detection of crossing vessels in pediatric UPJ obstruction. Although these vessels are the primary cause of obstruction in some children, they are incidental and non-contributory in others. Our study failed to convincingly identify any significant predictors (e.g., age or presence of renal parenchymal edema) that indicate when a crossing vessel is the primary cause of obstruction. (orig.)

Results of radiotherapy for ureteric obstruction in muscle-invasive bladder cancer

International Nuclear Information System (INIS)

Holm, M.; Miskowiak, J.; Rolff, H.

1996-01-01

Retrospective evaluation of the records of 574 patients with muscle-invasive bladder cancer revealed 90 patients (16%) with ureteric obstruction; the obstruction was bilateral in 24%. The effect of radiotherapy was assessed in 55 patients with 68 obstructed kidneys. Six patients with eight obstructed kidneys required percutaneous nephrostomy or ureteric catheters in addition to radiotherapy. Drainage improved in only 20% of kidneys and the diverting catheter could be withdrawn permanently in only one (17%) of the diverted patients. The median survival was 11 months. Irradiation was followed by significant complications in 37 patients (67%). This raises doubts about the assumed beneficial effect of irradiation on ureteric obstruction due to muscle invasive bladder cancer. The short median survival of 11 months confirms that ureteric obstruction is a poor prognostic factor in muscle invasive bladder cancer. (au) 10 refs

Quantitative Assessment of Obstructive Uropathy with Diuretic Renography in children

International Nuclear Information System (INIS)

Kim, Jong Ho; Lee, Dong Soo; Kwark, Cheol Eun; Lee, Kyung Han; Choi, Chang Woon; Chung, June Key; Lee, Myung Chul; Koh, Chang Soon; Choi, Yong; Choi, Hwang

1993-01-01

Differentiating the various causes of hydronephrosis from that of obstruction can be very difficult. The decision-marking process for those instances of urinary tract dilatation that require surgical correction and those that do not is based in part on the findings of diuresis renography. The methodology for performing this test has differed among nuclear medicine practitioners and the surgical findings are occasionally discrepant from the diuretic renogram interpretation. Consequently we made an automatic computer software program that calculates the slope of the response curve. The quantitative indices, such as the injection and response t1/2 by linear-fitting and monoexponential-fitting, were compared with the visual assessment of the diuretic cinerenography and clinical outcome in 50 children (62 kidneys) with ureteropelvic junction obstruction. Pooled diuresis renogram data indicated that: (1) Visual evaluation of the diuretic cinerenography is a sensitive (87%, 54/62) tool to differentiate obstruction in suspected ureteropelvic junction obstruction. (2) The cut-off value (maximum washout t1/2 with non-obstruction) of injection and response t1/2 by linear-fitting were 40 min. (3) The sensitivity and specificity using injection and response t1/2 by linear-fitting for obstruction were 89%(23/26) and 100%(30/30), respectively. (4) Response t1/2 as well as injection t1/2 by monoexponential-fitting do not stratify children with possible ureteropelivic junction obstruction. In conclusion, quantitative assessment of diuretic renography as well as visual assessment of diuretic cinerenography correlate well with surgical and clinical outcome of suspected ureteropelvic junction obstruction.

Mesenteric Cysts Presenting with Acute Intestinal Obstruction: A ...

African Journals Online (AJOL)

The 3 children needed bowel resection with primary anastomosis. All made uneventful recovery. A high index of suspicion is important when managing children with acute intestinal obstruction as mesenteric cyst may be an uncommon cause. (Key words: Mesenteric Cyst: Intestinal Obstruction). Sahel Medical Journal ...

The baby has not come: obstructed labour

African Journals Online (AJOL)

Introduction. This article is about how to recognize obstructed labour and deal with it in a way that preserves the life and health of mother and child. It is for midwives and others who work in maternity care and is based on our experiences in Yei, South Sudan. Obstructed labour means that the baby is too big to pass through ...

Deliberate Perspectival Obstructions

DEFF Research Database (Denmark)

Mikkelsen, Henrik Hvenegaard; Rasmussen, Anders Emil

2017-01-01

This article discusses the collaborative use of what the authors call ‘perspectival obstructions’. Taking its outset in the events revolving around a series of challenges given to each other, as well as to their interlocutors, in Papua New Guinea, the article unfolds how obstructions may be tied...

A Case of Polyarteritis Nodosa with Bilateral Ureteral Obstruction

Science.gov (United States)

Yoo, Bin; Kim, Hong Kyu; Choi, Seung Won; Moon, Hee Bom

1996-01-01

We report a case of bilateral ureteral obstruction most likely caused by polyarteritis nodosa. The diagnosis was based upon muscle biopsy which showed typical necrotizing vasculitis in medium size artery in conjunction with microaneurysms in renal angiography. Ureteral obstruction is a rare manifestation of polyarteritis nodosa. This condition is thought to result from vasculitis of periureteral vessels. The patient was managed with prednisolone alone, which resulted in complete resolution of ureteral obstruction on both sides. PMID:8854655

Airway Obstruction Among Latino Poultry Processing Workers in North Carolina

Science.gov (United States)

MIRABELLI, MARIA C.; CHATTERJEE, ARJUN B.; MORA, DANA C.; ARCURY, THOMAS A.; BLOCKER, JILL N.; CHEN, HAIYING; GRZYWACZ, JOSEPH G.; MARÍN, ANTONIO J.; SCHULZ, MARK R.; QUANDT, SARA A.

2015-01-01

This analysis was conducted to evaluate the prevalence of airway obstruction among Latino poultry processing workers. Data were collected from 279 poultry processing workers and 222 other manual laborers via spirometry and interviewer-administered questionnaires. Participants employed in poultry processing reported the activities they perform at work. Participants with forced expiratory volume in 1 second (FEV1) or FEV1/forced expiratory volume (FVC) below the lower limits of normal were categorized as having airway obstruction. Airway obstruction was identified in 13% of poultry processing workers and 12% of the comparison population. Among poultry processing workers, the highest prevalence of airway obstruction (21%) occurred among workers deboning chickens (prevalence ratio: 1.75; 95% confidence interval: 0.97, 3.15). These findings identify variations in the prevalence of airway obstruction across categories of work activities. PMID:24965321

Prevalence, awareness and reporting of symptoms of obstructive ...

African Journals Online (AJOL)

Background: Obstructive sleep apnoea is the most common form of sleep- disordered breathing in adults and children. It is associated with many adverse health consequences. The objectives this study were to determine the prevalence, awareness and reporting of symptoms of obstructive sleep apnoea among hospitalized ...

Obstructive sleep apnoea syndrome in children and anaesthesia

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A Rudra

2010-01-01

Full Text Available Obstructive sleep apnoea syndrome (OSAS is a common medical disorder among adults, which is increasingly being recognized in children too. It is a breathing disorder characterized by upper airway obstruction with or without intermittent complete obstruction that disrupts normal breathing during sleep. Anatomical and neuromuscular disorders are mainly responsible for this disorder. This disorder leads to a state of chronic hypoxemia, which has significant cardiac, pulmonary and central nervous system implications. Diagnosis of OSAS is based on thorough history and clinical examination along with appropriate sleep studies including polysomnography. The mainstay of treatment of paediatric OSAS is adenotonsillectomy. Good anaesthetic practice in Paediatric patients with OSAS revolves around good and ideal airway management. Early detection of airway obstruction, intense monitoring to warn of impending airway problems and appropriate and early intervention of airway compromise are good anaesthetic practices. Coexisting medical problems should be adequately addressed and safe analgesic techniques in the perioperative period go towards improving outcomes in patients with paediatric OSAS.

Diospyrobezoar as a Cause of Small Bowel Obstruction

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Andréia Padilha de Toledo

2012-09-01

Full Text Available Phytobezoar, a concretion of indigestible fibers derived from ingested vegetables and fruits, is the most common type of bezoar. Diospyrobezoar is a subtype of phytobezoar formed after excessive intake of persimmons (Diospyros kaki. We report the case of a diabetic man with a 5-day history of abdominal pain after massive ingestion of persimmons who developed signs of complicated small bowel obstruction. The patient had a previous history of Billroth II hemigastrectomy associated with truncal vagotomy to treat a chronic duodenal ulcer 14 years earlier. Since intestinal obstruction was suspected, he underwent emergency laparotomy that revealed an ileal obstruction with small bowel perforation and local peritonitis due to a phytobezoar that was impacted 15 cm above the ileocecal valve. After segmental intestinal resection, the patient had a good recovery and was discharged on the 6th postoperative day. This report provides evidence that diospyrobezoar should be considered as a possible cause of small bowel obstruction in patients who have previously undergone gastric surgery.

Caecal volvulus in a patient with chronic intestinal pseudo-obstruction

Science.gov (United States)

El-Khatib, C

2011-01-01

Chronic intestinal pseudo-obstruction (CIPO) is a rare disorder characterised by recurrent symptoms and signs of intestinal obstruction without an underlying mechanical cause. Caecal volvulus remains a rare cause of intestinal obstruction that often requires operative intervention. We describe the previously unreported case of caecal volvulus occurring in an adult patient with CIPO, together with his subsequent management. PMID:22004621

Murine model of long term obstructive jaundice

Science.gov (United States)

Aoki, Hiroaki; Aoki, Masayo; Yang, Jing; Katsuta, Eriko; Mukhopadhyay, Partha; Ramanathan, Rajesh; Woelfel, Ingrid A.; Wang, Xuan; Spiegel, Sarah; Zhou, Huiping; Takabe, Kazuaki

2016-01-01

Background With the recent emergence of conjugated bile acids as signaling molecules in cancer, a murine model of obstructive jaundice by cholestasis with long-term survival is in need. Here, we investigated the characteristics of 3 murine models of obstructive jaundice. Methods C57BL/6J mice were used for total ligation of the common bile duct (tCL), partial common bile duct ligation (pCL), and ligation of left and median hepatic bile duct with gallbladder removal (LMHL) models. Survival was assessed by Kaplan-Meier method. Fibrotic change was determined by Masson-Trichrome staining and Collagen expression. Results 70% (7/10) of tCL mice died by Day 7, whereas majority 67% (10/15) of pCL mice survived with loss of jaundice. 19% (3/16) of LMHL mice died; however, jaundice continued beyond Day 14, with survival of more than a month. Compensatory enlargement of the right lobe was observed in both pCL and LMHL models. The pCL model demonstrated acute inflammation due to obstructive jaundice 3 days after ligation but jaundice rapidly decreased by Day 7. The LHML group developed portal hypertension as well as severe fibrosis by Day 14 in addition to prolonged jaundice. Conclusion The standard tCL model is too unstable with high mortality for long-term studies. pCL may be an appropriate model for acute inflammation with obstructive jaundice but long term survivors are no longer jaundiced. The LHML model was identified to be the most feasible model to study the effect of long-term obstructive jaundice. PMID:27916350

Obstructive sleep apnea, inflammation, and cardiopulmonary disease.

Science.gov (United States)

Arter, Jim L; Chi, David S; M, Girish; Fitzgerald, S Matthew; Guha, Bhuvana; Krishnaswamy, Guha

2004-09-01

Obstructive sleep apnea (OSA) occurs commonly in the U.S. population and is seen in both obese as well as non-obese individuals. OSA is a disease characterized by periodic upper airway collapse during sleep, which then results in either apnea, hypopnea, or both. The disorder leads to a variety of medical complications. Neuropsychiatric complications include daytime somnolence, cognitive dysfunction, and depression. Increased incidence of motor vehicle accidents has been documented in these patients and probably reflects disordered reflex mechanisms or excessive somnolence. More importantly, vascular disorders such as hypertension, stroke, congestive cardiac failure, arrhythmias, and atherosclerosis occur frequently in these patients. The lungs may be affected by pulmonary hypertension and worsening of asthma. Recent data from several laboratories demonstrate that obstructive sleep apnea is characterized by an inflammatory response. Cytokines are elaborated during the hypoxemic episodes leading to inflammatory responses as marked clinically by elevated C-reactive protein (CRP). As elevated CRP levels are considered markers of the acute phase response and characterize progression of vascular injury in coronary artery disease, it is likely that obstructive sleep apnea could lead to worsening of vasculopathy. Moreover, as inflammatory mechanisms regulate bronchial asthma, it is also likely that cytokines and superoxide radicals generated during hypoxemic episodes could exacerbate reactive airway disease. Patients with Cough, Obstructive sleep apnea, Rhinosinusitis, and Esophageal reflux clustered together can be categorized by the acronym, "CORE", syndrome. The purpose of this manuscript is to review the inflammatory responses that occur in patients with obstructive sleep apnea and relate them to the occurrence of cardiopulmonary disease.

Hypertrophic cardiomyopathy with mid-ventricular obstruction and apical aneurysm

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N.D. Oryshchyn

2016-11-01

Full Text Available A case report of apical left ventricular aneurysm in patient with hypertrophic cardiomyopathy with mid-ventricular obstruction (diagnosis and surgical treatment is presented. We revealed apical aneurysm and mid-ventricular obstruction during echocardiography and specified anatomical characteristics of aneurysm during computer tomography. There was no evidence of obstructive coronary artery disease during coronary angiography. Taking into consideration multiple cerebral infarcts, aneurysm resection and left ventricular plastics was performed. Electronic microscopy of myocardium confirmed the diagnosis of hypertrophic cardiomyopathy.

Cushing's syndrome in pregnancy and neonatal hypertrophic obstructive cardiomyopathy.

Science.gov (United States)

Fayol, L; Masson, P; Millet, V; Simeoni, U

2004-10-01

Cushing's syndrome is rare in pregnancy but can cause spontaneous abortion, stillbirth or premature birth. We report a case of transient hypertrophic obstructive cardiomyopathy in a newborn whose mother had hypercortisolism due to a primary adrenal lesion. There was no family history of hypertrophic obstructive cardiomyopathy. Follow-up revealed complete resolution of the cardiac abnormalities in the infant. Cushing's syndrome in the mother resolved after delivery. Although maternal hypercortisolism seldom results in symptomatic hypercortisolism in the newborn, hypertrophic obstructive cardiomyopathy can occur.

Obstructive Sleep Apnea Due To Extrathoracic Tracheomalacia

OpenAIRE

Muzumdar, Hiren; Nandalike, K.; Bent, J.; Arens, Raanan

2013-01-01

We report obstructive sleep apnea in a 3-year-old boy with tracheomalacia secondary to tracheotomy that resolved after placement of a metallic stent in the region of tracheomalacia. The tracheal location of obstruction during sleep in this case contrasts with the usual location in the pharynx or, less often, the larynx. This case also demonstrates the utility of polysomnography in managing decannulation of tracheostomies.

Obstructive sleep apnea due to extrathoracic tracheomalacia.

Science.gov (United States)

Muzumdar, Hiren; Nandalike, K; Bent, J; Arens, Raanan

2013-02-01

We report obstructive sleep apnea in a 3-year-old boy with tracheomalacia secondary to tracheotomy that resolved after placement of a metallic stent in the region of tracheomalacia. The tracheal location of obstruction during sleep in this case contrasts with the usual location in the pharynx or, less often, the larynx. This case also demonstrates the utility of polysomnography in managing decannulation of tracheostomies.

A Surgical Treatment of Obstructive Sleep Apnoea (OSA)

African Journals Online (AJOL)

Snoring is now seen as one end of sleep-related breathing disorder resulting ultimately in obstructive sleep apnea. Uvulopalatopharyngoplasty (UPPP) is the first surgical procedure specifically designed to alleviate the abnormalities, although the use of laser appears to be the new trend. We present a case of Obstructive ...

Congenital ureteropelvic junction obstruction: physiopathology, decoupling of tout court pelvic dilatation-obstruction semantic connection, biomarkers to predict renal damage evolution.

Science.gov (United States)

Alberti, C

2012-02-01

The widespread use of fetal ultrasonography results in a frequent antenatally observation of hydronephrosis, ureteropelvic junction obstruction (UPJO) accounting for the greatest fraction of congenital obstructive nephropathy. UPJO may be considered, in most cases, as a functional obstructive condition, depending on defective fetal smooth muscle/nerve development at this level, with lack of peristaltic wave propagation--aperistaltic segment--and, therefore, poor urine ejection from the renal pelvis into the ureter. The UPJO-related physiopathologic events are, at first, the compliant dilatation of renal pelvis that, acting as hydraulic buffer, protects the renal parenchyma from the rising intrapelvic pressure-related potential damages, and, subsequently, beyond such phase of dynamic balance, the tubular cell stretch-stress induced by increased intratubular pressure and following parenchymal inflammatory lesions: inflammatory infiltrates, fibroblast proliferation, activation of myofibroblasts, tubulo-interstitial fibrosis. Reactive oxygen species (ROS), nitric oxide (NO), several chemo- and cytokines, growth factors, prostaglandins and eicosanoids, angiotensin-II are the main pathogenetic mediators of the obstructive nephropathy. Apoptosis of tubular cells is the major cause of the tubular atrophy, together with epithelial-mesenchymal transdifferentiation. Some criticisms on tout court semantic renal pelvis dilatation-obstruction connection have been raised considering that the renal pelvis expansion isn't, in any case, linked to an ostructive condition, as it may be verified by diuretic (furosemide) renogram together with scintiscan-based evaluation of differential renal function. In this regard, rather than repetitive invasive nuclear procedures that expose the children to ionizing radiations, an intriguing noninvasive strategy, based on the evaluation of urinary biomarkers and urinary proteome, can define the UPJO-related possible progress of parenchymal lesions

Subjects with Discordant Airways Obstruction: Lost between Spirometric Definitions of COPD

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Bernd Lamprecht

2011-01-01

Full Text Available Background. Since the FEV1/FVC ratio declines with age, using the fixed ratio of 0.70 leads to overdiagnosis of COPD in older populations and underdiagnosis among young adults. Objective. To evaluate whether discordant obstructive cases (FEV1/FVC < 0.70 but ≥LLN are a healthy population or have clinical features that would place them at increased risk. Methods. We used post-bronchodilator spirometry data from the population-based Austrian Burden of Obstructive Lung Disease (BOLD study. Those with post-bronchodilator FEV1/FVC ratio obstructive cases. Participants with post-bronchodilator FEV1/FVC ratio ≥LLN but <0.70 were defined as discordant obstructive cases. Results. Discordant obstructive cases were more likely to be older, male and never-smokers. Additionally they had less respiratory symptoms and less severe impairment of FEV1. However, discordant obstructive cases reported significantly more often a diagnosis of heart disease than subjects with normal lung function (27.2% vs 7.3%, P=.015. Conclusion. The clinical profile of discordant obstructive cases includes potentially important comorbid disease.

Balloon dacryocystoplasty: Incomplete versus complete obstruction of the nasolacrimal system

International Nuclear Information System (INIS)

Lee, Jeong Min; Lee, Sang Hoon; Han, Young Min; Chung, Gyung Ho; Kim, Chong Soo; Choi, Ki Chul; Song, Ho Young

1993-01-01

Balloon dilatation of nasolacrimal drainage apparatus was attempted for the treatment of stenoses or obstructures of the nasolacrimal system in 49 eyes of 41 consecutive patients with complete obstructions and 16 eyes of 14 patients with incomplete obstructions. These two groups were compared with regards to the effectiveness of balloon dacryocystoplasty. All patients suffered from severe epiphora had already undergone multiple probings. A 0.018 inch hair or ball guide wire was introduced through the superior punctum into the inferior meatus of the nasal cavity and pulled out through the nasal aperture using a hemostat under nasal endoscopy. A deflated angiography balloon catheter was then introduced in a retrograde direction and dilated under fluoroscopic control. No major complications occurred in any of the patients. At 7 days after balloon dilatation, 25 of 49 eyes with complete obstruction demonstrated improvement in epiphora (initial success rate: 51.0%) and among them 17 eyes showed complete resolution of symptoms. Reocclusion occurred in 12 of the 25 eyes with initial improvement at the 2 months follow up. For the 16 eyes with incomplete obstruction, and improvement of epiphora was attained in 11 eyes (initial success rate 68.8%): 5 of these eyes showed complete resolution of epiphora, and 3 was failed to maintain initial improvement at the 2 month follow up. Although this study demonstrate that results of balloon dacryocystoplasty are not encouraging because of the high failure and recurrence rate, balloon dacryocystoplasty is a simple and safe nonsurgical technique that can be used to treat for obstructions of the nasolacrimal system. In addition, balloon dacryocystoplasty shows better results in incomplete obstruction than in complete obstruction than complete obstruction of the nasolacrimal system

Airway distensibility in Chronic Obstructive Airway Disease

DEFF Research Database (Denmark)

Winkler Wille, Mathilde Marie; Pedersen, Jesper Holst; Dirksen, Asger

2013-01-01

Rationale – Chronic Obstructive Pulmonary Disease (COPD) is a combination of chronic bronchitis and emphysema, which both may lead to airway obstruction. Under normal circumstances, airway dimensions vary as a function of inspiration level. We aim to study the influence of COPD and emphysema......-20% (mild), 20%-30% (moderate) or >30% (severe). Spirometry was performed annually and participants were divided into severity groups according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Data were analysed in a mixed effects regression model with log(airway lumen diameter...... and emphysema, respectively. Conclusions – Airway distensibility decreases significantly with increasing severity of both GOLD status and emphysema, indicating that in COPD the dynamic change in airway calibre during respiration is compromised. Chronic bronchitis and emphysema appear to be interacting...

DIvERTICULE DE ZENKER

African Journals Online (AJOL)

origine de complications respiratoires aigues (détresse respiratoire aigue, pneumopathie d'inha- lation) ou chronique (bronchite chronique, asthme) qui surviennent dans 20 % des cas [8]. L'examen clinique est souvent normal. Cependant une.

Bolus obstruction by Ascaris lumbricoides | Wynne | South African ...

African Journals Online (AJOL)

Bolus obstruction by Ascaris lumbricoides. J.M. Wynne, B.A.H. Ellman. Abstract. Seventy-three cases of obstruction due to a bolus of Ascaris worms are reviewed, The diagnosis was made on the basis either of a characteristic palpable mass or a characteristic radiographic appearance. In 67 cases conservative treatment ...

Ultrasonographic and computed tomographic characterization and localization of suspected mechanical gastrointestinal obstruction in dogs.

Science.gov (United States)

Winter, Matthew D; Barry, Katie S; Johnson, Matthew D; Berry, Clifford R; Case, J Brad

2017-08-01

OBJECTIVE To evaluate the usefulness of noncontrast abdominal CT and abdominal ultrasonography for the detection of mechanical gastrointestinal obstruction in dogs and compare intestinal diameter ratios between dogs with and without obstruction. DESIGN Controlled trial. ANIMALS 16 client-owned dogs with physical and radiographic findings consistent with mechanical gastrointestinal obstruction. PROCEDURES Abdominal ultrasonography and CT were performed for all dogs, followed by laparoscopy and exploratory laparotomy. Time required for image acquisition and presence and location of gastrointestinal obstruction were assessed with both imaging modalities. Findings were compared with those of exploratory surgery. Maximum and minimum intestinal diameters were recorded on CT scans; values were converted to a ratio and compared between dogs with and without obstruction. RESULTS Results of abdominal CT and exploratory surgery for the diagnosis of mechanical obstruction agreed for all 16 dogs; 10 dogs had complete obstruction, 3 had partial obstruction, and 3 had no obstruction. In 1 dog with functional ileus, abdominal ultrasonography resulted in an incorrect diagnosis of mechanical obstruction. Median (interquartile range) image acquisition time for abdominal CT (2.5 minutes [2.0 to 3.8 minutes]) was markedly and significantly shorter than that for ultrasonography (26.0 minutes [22.0 to 35.8 minutes]). In both dorsal and transverse CT planes, dogs with gastrointestinal obstruction (partial or complete) had significantly larger intestinal diameter ratios than dogs without obstruction. CONCLUSIONS AND CLINICAL RELEVANCE Abdominal CT was feasible, rapid, and accurate for the diagnosis of mechanical obstruction in dogs with clinical signs and physical examination findings consistent with partial or complete gastrointestinal obstruction.

Hypertrophic Obstructive Cardiomyopathy Masked by Tako-Tsubo Syndrome: A Case Report

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Y. Daralammori

2012-01-01

Full Text Available Introduction. Left ventricular outflow obstruction might be part of the pathophysiological mechanism of Tako-tsubo cardiomyopathy. This obstruction can be masked by Tako-tsubo cardiomyopathy and diagnosed only by followup. Case Presentation. A 70-year-old female presented with Tako-tsubo cardiomyopathy and masked obstructive hypertrophic cardiomyopathy at presentation. Conclusion. Tako-tsubo cardiomyopathy typically presents like an acute MI and is characterized by severe, but transient, regional left ventricular systolic dysfunction. Prompt evaluation of the coronary status is, therefore, mandatory. The prognosis under medical treatment of heart failure symptoms and watchful waiting is favourable. Previous studies showed that LVOT obstruction might be part of the pathophysiological mechanism of TCM. This paper supports this theory. However, TCM may also mask any preexisting LVOT obstruction.

Chronic obstructive pulmonary disease and obstructive sleep apnea: overlaps in pathophysiology, systemic inflammation, and cardiovascular disease.

LENUS (Irish Health Repository)

McNicholas, Walter T

2012-02-01

Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome represent two of the most prevalent chronic respiratory disorders in clinical practice, and cardiovascular diseases represent a major comorbidity in each disorder. The two disorders coexist (overlap syndrome) in approximately 1% of adults but asymptomatic lower airway obstruction together with sleep-disordered breathing is more prevalent. Although obstructive sleep apnea syndrome has similar prevalence in COPD as the general population, and vice versa, factors such as body mass index and smoking influence relationships. Nocturnal oxygen desaturation develops in COPD, independent of apnea\\/hypopnea, and is more severe in the overlap syndrome, thus predisposing to pulmonary hypertension. Furthermore, upper airway flow limitation contributes to nocturnal desaturation in COPD without apnea\\/hypopnea. Evidence of systemic inflammation in COPD and sleep apnea, involving C-reactive protein and IL-6, in addition to nuclear factor-kappaB-dependent pathways involving tumor necrosis factor-alpha and IL-8, provides insight into potential basic interactions between both disorders. Furthermore, oxidative stress develops in each disorder, in addition to activation and\\/or dysfunction of circulating leukocytes. These findings are clinically relevant because systemic inflammation may contribute to the pathogenesis of cardiovascular diseases and the cell\\/molecular pathways involved are similar to those identified in COPD and sleep apnea. However, the pathophysiological and clinical significance of systemic inflammation in COPD and sleep apnea is not proven, and thus, studies of patients with the overlap syndrome should provide insight into the mechanisms of systemic inflammation in COPD and sleep apnea, in addition to potential relationships with cardiovascular disease.

The genetics of chronic obstructive pulmonary disease

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Silverman Edwin K

2001-01-01

Full Text Available Abstract Chronic obstructive pulmonary disease (COPD is a significant cause of global morbidity and mortality. Previous studies have shown that COPD aggregates in families, suggesting a genetic predisposition to airflow obstruction. Many candidate genes have been assessed, but the data are often conflicting. We review the genetic factors that predispose smokers to COPD and highlight the future role of genomic scans in identifying novel susceptibility genes.

Inflammatory biomarkers and exacerbations in chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Thomsen, Mette; Ingebrigtsen, Truls Sylvan; Marott, Jacob Louis

2013-01-01

Exacerbations of respiratory symptoms in chronic obstructive pulmonary disease (COPD) have profound and long-lasting adverse effects on patients.......Exacerbations of respiratory symptoms in chronic obstructive pulmonary disease (COPD) have profound and long-lasting adverse effects on patients....

Mild obstructive sleep apnoea: clinical relevance and approaches to management.

Science.gov (United States)

McNicholas, Walter T; Bonsignore, Maria R; Lévy, Patrick; Ryan, Silke

2016-10-01

Obstructive sleep apnoea is highly prevalent in the general population worldwide, especially in its mild form. Clinical manifestations correlate poorly with disease severity measured by the apnoea-hypopnoea index (AHI), which complicates diagnosis. Full polysomnography might be more appropriate to assess suspected mild cases because limited ambulatory diagnostic systems are least accurate in mild disease. Treatment options in mild obstructive sleep apnoea include continuous positive airway pressure (CPAP) and oral appliance therapy, in addition to positional therapy and weight reduction when appropriate. The superior efficacy of CPAP in reducing AHI is offset by greater tolerance of oral appliances, especially in mild disease. Although severe obstructive sleep apnoea is associated with adverse health consequences, including cardiometabolic comorbidities, the association with mild disease is unclear, and reports differ regarding the clinical relevance of mild obstructive sleep apnoea. Improved diagnostic techniques and evidence-based approaches to management in mild obstructive sleep apnoea require further research. Copyright © 2016 Elsevier Ltd. All rights reserved.

Fetal tracheolaryngeal airway obstruction: prenatal evaluation by sonography and MRI

Energy Technology Data Exchange (ETDEWEB)

Courtier, Jesse; Poder, Liina; Wang, Zhen J.; Westphalen, Antonio C.; Yeh, Benjamin M.; Coakley, Fergus V. [University of California San Francisco, Department of Radiology, San Francisco, CA (United States)

2010-11-15

We reviewed the sonographic and MRI findings of tracheolaryngeal obstruction in the fetus. Conditions that can cause tracheolaryngeal obstruction include extrinsic causes such as lymphatic malformation, cervical teratoma and vascular rings and intrinsic causes such as congenital high airway obstruction syndrome (CHAOS). Accurate distinction of these conditions by sonography or MRI can help facilitate parental counseling and management, including the decision to utilize the ex utero intrapartum treatment (EXIT) procedure. (orig.)

Surgical treatment of colorectal cancer complicated with acute intestinal obstruction

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S. N. Schaeva

2016-01-01

Full Text Available Background. The main reason for urgent complications of colon cancer is an acute intestinal obstruction (AIO. This is complex pathological condition in 90 % of cases caused by colorectal cancer (CRC.Objective – to evaluate radicality of the performed operations in complicated colorectal cancer in general surgical hospitals. Dependence of the severity of intestinal obstruction by tumor localization, its morphological characteristics, determine dependence of the type of the surgical operation performed on the severity of intestinal obstruction.Materials and methods. We have studied the data on 667 patients with colorectal cancer complicated by acute intestinal obstruction. These patients were treated in the period from 2001 to 2013 in general surgical hospital in the territory of Smolensk and Smolensk region. For the processing of the obtained results we have used software Statistica 6.1. Differences were considered statistically at p ≤ 0.05.Results. All the patients were divided into 3 groups by the expression of intestinal obstruction. Group 1 (n = 279 consisted of patients with the presence of decompensated intestinal obstruction (DIO, group 2 (n = 313 consisted of patients with subcompensated intestinal obstruction (SIO, group 3 (n = 75 included patients with compensated intestinal obstruction (CIO. In case of tumor localization in right halfof the colon we most commonly observed clinical picture of acute development of decompensated intestinal obstruction (p = 0.041. Subcompensated intestinal obstruction prevailed in case of tumor localization in left half of the colon and rectal localization. In general surgical hospitals it is not always possible to speak about radicality of surgical treatment, as in a large number of cases (62.5 % the number of examined lymph nodes was less than 4. When DIO patients are admitted in the clinic, the percentage of singlestage operations is equal to 7.5 % (n = 21. In case of DIO and SIO there was a high

Acute small bowel obstruction due to chicken bone bezoar

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Vetpillai P

2012-12-01

Full Text Available Preadeepan Vetpillai,1 Ayo Oshowo21CT2 Surgery in General, Charing Cross Hospital, 2Colorectal and Laparoscopic Surgery, Whittington Hospital, London, UKAbstract: Acute intestinal obstruction due to foreign bodies, or bezoar, is a rare occurrence in an adult with a normal intestinal tract. We report an unusual case of a 43-year-old black man with no previous abdominal surgery and no significant medical history who presented with an acute episode of small bowel obstruction due to an impacted undigested chicken bone.Keywords: small bowel obstruction, chicken bone, bezoar

Murine model of long-term obstructive jaundice.

Science.gov (United States)

Aoki, Hiroaki; Aoki, Masayo; Yang, Jing; Katsuta, Eriko; Mukhopadhyay, Partha; Ramanathan, Rajesh; Woelfel, Ingrid A; Wang, Xuan; Spiegel, Sarah; Zhou, Huiping; Takabe, Kazuaki

2016-11-01

With the recent emergence of conjugated bile acids as signaling molecules in cancer, a murine model of obstructive jaundice by cholestasis with long-term survival is in need. Here, we investigated the characteristics of three murine models of obstructive jaundice. C57BL/6J mice were used for total ligation of the common bile duct (tCL), partial common bile duct ligation (pCL), and ligation of left and median hepatic bile duct with gallbladder removal (LMHL) models. Survival was assessed by Kaplan-Meier method. Fibrotic change was determined by Masson-Trichrome staining and Collagen expression. Overall, 70% (7 of 10) of tCL mice died by day 7, whereas majority 67% (10 of 15) of pCL mice survived with loss of jaundice. A total of 19% (3 of 16) of LMHL mice died; however, jaundice continued beyond day 14, with survival of more than a month. Compensatory enlargement of the right lobe was observed in both pCL and LMHL models. The pCL model demonstrated acute inflammation due to obstructive jaundice 3 d after ligation but jaundice rapidly decreased by day 7. The LHML group developed portal hypertension and severe fibrosis by day 14 in addition to prolonged jaundice. The standard tCL model is too unstable with high mortality for long-term studies. pCL may be an appropriate model for acute inflammation with obstructive jaundice, but long-term survivors are no longer jaundiced. The LHML model was identified to be the most feasible model to study the effect of long-term obstructive jaundice. Copyright © 2016 Elsevier Inc. All rights reserved.

Double obstruction of ureter: A diagnostic challenge.

Science.gov (United States)

Halder, Pankaj; Shukla, Ram Mohan; Mandal, Kartik Chandra; Mukhopadhyay, Biswanath; Barman, Shibsankar

2014-07-01

Isolated obstruction of the ureteropelvic junction and the vesico-ureteric junction are the two most common causes of hydronephrosis in a pediatric population.[1] They do not pose diagnostic difficulties when are present alone but when together can be difficult to diagnose. Here, we discuss the problems we faced when we encountered these two anomalies in the same ureter and the way in which we managed them. To assess the difficulties in diagnosis of pediatric patients who present with both ureteropelvic junction obstruction (UPJO) and vesico-ureteric junction obstruction (VUJO) in the ipsilateral ureter and their management protocol. This is a retrospective study. The study period is from 1 January 2004 to 31 December 2011. Out of 254 children who were diagnosed to have hydronephrosis due to UPJO in our institute, 5 patients (in the age range of 5 to 10 years) had both UPJO and VUJO in the ipsilateral ureter. The problems we faced in diagnosing the two conditions are mentioned with a literature review. Operative intervention was used in four out of five patients; none of the patients had an accurate diagnosis before surgery. All patients were suspected of having double obstruction during pyeloplasty when appropriate size double J stent could not be negotiated through the vesicoureteric junction into the bladder. Postoperative nephrostogram confirmed the diagnosis in all patients. Children with double obstruction of the ipsilateral ureter present as a diagnostic dilemma. Because of the rarity of this condition it can escape the eye of even an astute clinician. Early diagnosis can be made if this condition is kept in mind while treating any hydronephrosis due to UPJO or UVJO.

Partial unilateral ureteropelvic junction obstruction induced in 2-week-old piglets

DEFF Research Database (Denmark)

Dissing, Thomas; Eskild-Jensen, Anni; Pagh, Christian

2001-01-01

of 4, 12 and 24 weeks. RESULTS: At age 4 weeks hydronephrosis was found in all obstructed kidneys included in the study. Four obstructed kidneys had renographic functional share 40% or greater and 1 deteriorated to less than 40% at 24 weeks. A total of 11 obstructed kidneys had a functional share less...

Clinical presentation and outcome of cats with circumcaval ureters associated with a ureteral obstruction.

Science.gov (United States)

Steinhaus, J; Berent, A C; Weisse, C; Eatroff, A; Donovan, T; Haddad, J; Bagley, D

2015-01-01

Circumcaval ureters (CU) are a rare embryological malformation resulting in ventral displacement of the caudal vena cava, which crosses the ureter, potentially causing a ureteral stricture. To evaluate cats with obstructed CU(s) and report the presenting signs, diagnostics, treatment(s), and outcomes. Cats with obstructed CU(s) were compared to ureterally obstructed cats without CU(s). 193 cats; 22 circumcaval obstructed (Group 1); 106 non-circumcaval obstructed (Group 2); 65 non-obstructed necropsy cases (Group 3). Retrospective study, review of medical records for cats treated for benign ureteral obstructions from AMC and University of Pennsylvania between 2009 and 2013. surgical treatment of benign ureteral obstruction, complete medical record including radiographic, ultrasonographic, biochemistry, and surgical findings. Seventeen percent (22/128) of obstructed cats had a CU (80% right-sided) compared to 14% (9/65) non-obstructed necropsy cats (89% right-sided). Clinical presentation, radiographic findings, and creatinine were not statistically different between Groups 1 and 2. Strictures were a statistically more common (40%) cause of ureteral obstruction in Group 1 compared to Group 2 (17%) (P = .01). The MST for Groups 1 and 2 after ureteral decompression was 923 and 762 days, respectively (P = .62), with the MST for death secondary to kidney disease in both groups being >1,442 days. Re-obstruction was the most common complication in Group 1 (24%) occurring more commonly in ureters of cats treated with a ureteral stent(s) (44%) compared to the subcutaneous ureteral bypass (SUB) device (8%) (P = .01). Ureteral obstructions in cats with a CU(s) have a similar outcome to those cats with a ureteral obstruction and normal ureteral anatomy. Long-term prognosis is good for benign ureteral obstructions treated with a double pigtail stent or a SUB device. The SUB device re-obstructed less commonly than the ureteral stent, especially when a ureteral stricture was

Neonatal Intestinal Obstruction-Four Year Experience

Directory of Open Access Journals (Sweden)

D. Rathore

2015-06-01

Full Text Available Aim of study: To study the aetiology and frequency, sex incidence, age of presentation, management and outcome of neonatal intestinal obstruction. Material and Methods: This prospective study of 316 neonates with intestinal obstruction was conducted over a period of 4 years from November 2009 to October 2013 at single institute. These cases were managed by various surgical procedures. Their epidemiology, day of presentation, associated anomalies and outcomes were studied. Results: A total of 316 neonates (277 males and 39 females were operated for intestinal obstruction. 268(84.81% neonates presented in the 1st week of life. Imperforate anus occurred in 206 (65.19%.Small bowel atresia accounted for23 (7.27% cases while duodenal atresia was seen in19 (6.01% patients. Infantile hypertrophic pyloric stenosis and Malrotation each occurred in 14 (4.43% patients; Hirschsprung’s disease in 18(5.69%, Necrotising Enterocolitis in 12(3.79%, Meconium disease of newborn in 9(2.85% while colonic atresia was seen in one (0.3% patient. Colostomy was performed in 145(45.88%, Pouchostomy in 15(4.74% and Cutback anoplasty in 56(17.72% patients. Ramsted’s Pyloromyotomy in 13(4.11%% neonates, Laparoscopic Pyloromyotomy in 1(0.3%,Kimura’s Duodenoduodenostomy in 19(6.01% ,End to Back anastomosis in 24(7.59% , End to End anastomosis in 7(2.21% , Multiple anastomosis in 2(0.6% , Enterotomy with irrigation in 7(2.21% , Ladd’s procedure in 14(4.43% , ,Single stage transanal pull through in 8(2.53% , Ileostomy in 2(0.6% , Single stage Abdominoperineal pull through in 2(0.6%, Levelling colostomy in 6(1.89% ,Peritoneal drain insertion under Local anaesthesia in 5(1.58% . Overall mortality was 13.60%. Conclusion: Intestinal Obstruction is the most common surgical emergency in neonatal period. Early and accurate diagnosis is paramount for proper patient management. The etiology, mode of presentation, morbidity and outcome of surgery of intestinal obstruction in

Cholescintigraphy in experimentally induced obstructive and parenchymatous jaundice

International Nuclear Information System (INIS)

Baehre, M.; Biersack, H.J.; Hofmann, S.; Winkler, C.

1979-01-01

Animal studies have been performed in 30 dogs in order to obtain information concerning typical patterns of cholescintigraphy in acute obstructive jaundice. In 14 the choledochus was ligated and in 16 galactosamine-hepatitis was induced as an experimental model for parenchymatous jaundice. The results suggest a number of diagnostic criteria in obstructive disease. (Auth.)

Evaluation of computed tomography for obstructive jaundice

International Nuclear Information System (INIS)

Matsuoka, Shoji; Toda, Hiroshi; Suzuki, Toshihiko

1980-01-01

Findings of computed tomography were reviewed in 54 cases where obstructive jaundice was suggested by liver function studies and computed tomography was done with the diagnosis subsequently confirmed by surgery. Dilatation of the intrahepatic bile duct was found in 49 (91%) of the cases and the site of obstruction was determined in 44 cases (82%). The cause was shown in 28 cases (52%). By disease, the cause was correctly diagnosed with gallbladder in 40%, bile duct cancer in 46%, pancreas cancer in 71%, and choledocal cyst in 100%, but cholelithiasis was diagnosed correctly in only 17%. Further, non-calcium cholelithiasis is very difficult to diagnose by computed tomography. Computed tomography is a useful tool for diagnosis of obstructive jaundice as a noninvasive means of evaluating the patient; however, concomitand use of other diagnostic studies is essential for greater accuracy of diagnosis. (author)

Old dilemma : asthma with irreversible airway obstruction or COPD

NARCIS (Netherlands)

Fattahi, Fatemeh; Vonk, Judith M.; Bulkmans, Nicole; Fleischeuer, Ruth; Gouw, Annette; Grunberg, Katrien; Mauad, Thais; Popper, Helmut; Felipe-Silva, Aloisio; Vrugt, Bart; Wright, Joanne L.; Yang, Hui-Min; Kocks, Janwillem W. H.; Hylkema, Machteld N.; Postma, Dirkje S.; Timens, Wim; ten Hacken, Nick H. T.

2015-01-01

Older asthmatic patients may develop fixed airway obstruction and clinical signs of chronic obstructive pulmonary disease (COPD). We investigated the added value of pathological evaluation of bronchial biopsies to help differentiate asthma from COPD, taking into account smoking, age, and inhaled

Prediction of renal functional recovery after relief of upper urinary tract obstruction

International Nuclear Information System (INIS)

Kalika, V.; Bard, R.H.; Iloreta, A.; Freeman, L.M.; Heller, S.; Blaufox, M.D.

1981-01-01

Renal cortical regions of interest were used prospectively to predict recoverability of renal function in 27 patients with unilateral or bilateral urinary tract obstruction. In these 27 patients 36 kidneys with short-term or long-term obstruction were studied. The 131iodine radiohippuran renogram curves were generated from areas of interest from the renal cortex and from the whole kidney. Curves generated during obstruction were evaluated qualitatively to determine if regional cortical renograms exhibited a more normal appearance than total kidney curves. After relief of obstruction renograms generated from the whole kidney were evaluated for evidence of renal functional recovery. Cortical curves obtained before relief obstruction were judged normal, with an abnormal whole kidney renogram in 20 of 36 kidneys. The whole kidney renogram improved after relief of obstruction in all 20 cases. Cortical curves for the remaining 16 kidneys before relief of obstruction had the same abnormal appearance as the whole kidney renogram. After relief of obstruction no evidence of kidney function improvement as measured by the renogram was evident in 14 kidneys. The over-all accuracy of this test of renal functional recoverability was 94 per cent. These data support the hypothesis that when cortical curves appear more normal than total kidney curves there is a strong likelihood of postoperative improvement in renal function when the obstruction is relieved. Abnormal cortical curves are associated with a poor prognosis for renal functional improvement

Laparoscopic gastropexy relieves symptoms of obstructed gastric volvulus in highoperative risk patients.

Science.gov (United States)

Yates, Robert B; Hinojosa, Marcelo W; Wright, Andrew S; Pellegrini, Carlos A; Oelschlager, Brant K

2015-05-01

Operative repair of obstructive gastric volvulus is challenging. In high-operative risk patients with obstructive gastric volvulus, we perform laparoscopic reduction of gastric volvulus and anterior abdominal wall sutured gastropexy. This case series reports our experience with this operation. We reviewed the charts of all patients who presented with obstructive gastric volvulus and underwent laparoscopic gastropexy between 2007 and 2013. Eleven patients underwent laparoscopic gastropexy. Median age was 83 years (50 to 92). Six patients presented with chronic obstruction; 5 presented with acute obstruction. Median postoperative hospitalization was 2 days (1 to 39). Two patients required reoperation for displaced gastrostomy tubes. At median follow-up of 3 months (2 weeks to 57 months), all patients remained free of gastric obstructive symptoms and recurrent episodes of volvulus. Only 1 patient received nutrition via gastrostomy tube. Laparoscopic gastropexy can treat obstructed gastric volvulus in highoperative risk patients. Because of associated morbidity, gastrostomy tubes should be placed selectively. Copyright © 2015 Elsevier Inc. All rights reserved.

Acute bilateral ureteral obstruction following Dextranomer/hyaluronic acid polymer injection: A case report

Directory of Open Access Journals (Sweden)

Arnon Lavi

2017-05-01

Full Text Available Ureteral obstruction following bulking agent injection for treatment of vesicoureteral reflux is rare. Herein we report a case of acute bilateral ureteral obstruction following bilateral Dextranomer/hyaluronic acid polymer injection. The obstruction which manifested hours following the injection, was treated with prompt insertion of bilateral ureteral stents. The stents were removed 4 weeks later with complete resolution of the obstruction. We believe that ureteral stenting is an excellent solution for acute ureteral obstruction following Dextranomer/hyaluronic acid polymer injection

Radiological findings in patients with obstructive sleep apnea

Energy Technology Data Exchange (ETDEWEB)

Mello Junior, Carlos Fernando de; Guimaraes Filho, Helio Antonio; Gomes, Camila Albuquerque de Brito; Paiva, Camila Caroline de Amorim, E-mail: carlosfmello@hotmail.com [Universidade Federal da Paraiba UFPB, Joao Pessoa (Brazil)

2013-01-15

Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction occurring at the level of the pharynx during sleep. Although cephalometric analysis is an important method in the diagnosis of craniofacial deformities, CT and magnetic resonance imaging have been highlighted as the major imaging methods to investigate the possible causes of OSA, which, in most cases, is multifactorial. Magnetic resonance and CT both allow an excellent evaluation of the various anatomical planes of the site of obstruction, which enables better clinical assessment and surgical approach. This pictorial essay aims to describe the aspects that must be evaluated in the diagnostic imaging of patients presenting with the major predisposing factors for OSA. (author)

Radiological findings in patients with obstructive sleep apnea

International Nuclear Information System (INIS)

Mello Junior, Carlos Fernando de; Guimaraes Filho, Helio Antonio; Gomes, Camila Albuquerque de Brito; Paiva, Camila Caroline de Amorim

2013-01-01

Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction occurring at the level of the pharynx during sleep. Although cephalometric analysis is an important method in the diagnosis of craniofacial deformities, CT and magnetic resonance imaging have been highlighted as the major imaging methods to investigate the possible causes of OSA, which, in most cases, is multifactorial. Magnetic resonance and CT both allow an excellent evaluation of the various anatomical planes of the site of obstruction, which enables better clinical assessment and surgical approach. This pictorial essay aims to describe the aspects that must be evaluated in the diagnostic imaging of patients presenting with the major predisposing factors for OSA. (author)

Examination of cholangiogram of obstructive jaundice using MRI

International Nuclear Information System (INIS)

Nakagawa, Hiroshi; Okamura, Shouzo; Ohashi, Shinji; Mitake, Masahiro; Fujii, Yasuaki; Miyata, Takahiro; Satake, Koji; Matsui, Masumi

1993-01-01

PTC and ERCP are most often used in diagnosis of obstructive jaundice. We studied the possibility of clinical diagnosis using MRI in 33 cases of obstructive jaundice. A clinical diagnosis of malignant tumors could be given in 17 cases out of 20 (85%) using MRI if respiratory sandstill was possible. An MRI cholangiogram was particularly effective in describing tearful parting bile ducts and was clearer than PTC in describing negative gallbladders. Choledochal stones could be diagnosed in 58% of cases, which was less than the rate for malignant tumors. MRI is not an invasive examination, can be used in diagnosis of obstructive jaundice, and helps in selecting treatment methods such as PTCD and ERBD. (author)

Evaluation of peripheral auditory pathways and brainstem in obstructive sleep apnea

Directory of Open Access Journals (Sweden)

Erika Matsumura

Full Text Available Abstract Introduction Obstructive sleep apnea causes changes in normal sleep architecture, fragmenting it chronically with intermittent hypoxia, leading to serious health consequences in the long term. It is believed that the occurrence of respiratory events during sleep, such as apnea and hypopnea, can impair the transmission of nerve impulses along the auditory pathway that are highly dependent on the supply of oxygen. However, this association is not well established in the literature. Objective To compare the evaluation of peripheral auditory pathway and brainstem among individuals with and without obstructive sleep apnea. Methods The sample consisted of 38 adult males, mean age of 35.8 (±7.2, divided into four groups matched for age and Body Mass Index. The groups were classified based on polysomnography in: control (n = 10, mild obstructive sleep apnea (n = 11 moderate obstructive sleep apnea (n = 8 and severe obstructive sleep apnea (n = 9. All study subjects denied a history of risk for hearing loss and underwent audiometry, tympanometry, acoustic reflex and Brainstem Auditory Evoked Response. Statistical analyses were performed using three-factor ANOVA, 2-factor ANOVA, chi-square test, and Fisher's exact test. The significance level for all tests was 5%. Results There was no difference between the groups for hearing thresholds, tympanometry and evaluated Brainstem Auditory Evoked Response parameters. An association was observed between the presence of obstructive sleep apnea and changes in absolute latency of wave V (p = 0.03. There was an association between moderate obstructive sleep apnea and change of the latency of wave V (p = 0.01. Conclusion The presence of obstructive sleep apnea is associated with changes in nerve conduction of acoustic stimuli in the auditory pathway in the brainstem. The increase in obstructive sleep apnea severity does not promote worsening of responses assessed by audiometry, tympanometry and Brainstem

Chronic obstructive pulmonary disease : a proteomics approach

OpenAIRE

Alexandre, Bruno Miguel Coelho, 1980-

2011-01-01

Tese de doutoramento, Biologia (Biologia Molecular), Universidade de Lisboa, Faculdade de Ciências, 2012 Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation that is not fully reversible even under bronchodilators effect, caused by a mixture of small airway disease – obstructive bronchiolitis – and parenchymal destruction – emphysema. At the present time, COPD is the fourth leading cause of death and its prevalence and mortality are expected to contin...

Diagnostic Accuracy of Obstructive Airway Adult Test for Diagnosis of Obstructive Sleep Apnea.

Science.gov (United States)

Gasparini, Giulio; Vicini, Claudio; De Benedetto, Michele; Salamanca, Fabrizio; Sorrenti, Giovanni; Romandini, Mario; Bosi, Marcello; Saponaro, Gianmarco; Foresta, Enrico; Laforì, Andreina; Meccariello, Giuseppe; Bianchi, Alessandro; Toraldo, Domenico Maurizio; Campanini, Aldo; Montevecchi, Filippo; Rizzotto, Grazia; Cervelli, Daniele; Moro, Alessandro; Arigliani, Michele; Gobbi, Riccardo; Pelo, Sandro

2015-01-01

The gold standard for the diagnosis of Obstructive Sleep Apnea (OSA) is polysomnography, whose access is however reduced by costs and limited availability, so that additional diagnostic tests are needed. To analyze the diagnostic accuracy of the Obstructive Airway Adult Test (OAAT) compared to polysomnography for the diagnosis of OSA in adult patients. Ninety patients affected by OSA verified with polysomnography (AHI ≥ 5) and ten healthy patients, randomly selected, were included and all were interviewed by one blind examiner with OAAT questions. The Spearman rho, evaluated to measure the correlation between OAAT and polysomnography, was 0.72 (p diagnostic accuracy for the diagnosis of OSA. It has also been shown to be able to discriminate among the different degrees of severity of OSA. Additional large studies aiming to validate this questionnaire as a screening or diagnostic test are needed.

Closed loop obstructions of the small bowel: role of Computed Tomography

International Nuclear Information System (INIS)

Barbiera, F.; Ciraulo, R.; Cusma', S.

1999-01-01

Small bowel obstructions can be distinguished into more simple and closed loop obstructions. The latter is a more severe condition which is often complicated by strangulation with vascular impairment, edema and intramural and mesenteric hemorrhage. Consequent arterial insufficiency rapidly leads to ischemia, infarction and necrosis. The radiologist plays a role in the early recognition of the closed loop obstruction and of any sign of strangulation. The role of CT in the diagnosis and workup of patients with suspected intestinal occlusion has been analyzed in the literature with reported 63% sensitivity, 78% specificity and 66% accuracy. CT is also capable of revealing the causes of occlusion in 73-95% of cases. The above CT signs allow to identify closed loop obstruction and also small bowel strangulation, thus supplying a valuable contribution to diagnosis and accurate preoperative evaluation. The conclusion is that CT can accurately demonstrate the presence of closed loop obstruction and can be the technique of choice in patients in whom obstruction is associated with clinical signs suggestive of strangulation [it

Renal Structural And Physiological Alterations Subsequent To Unilateral Ureteral Obstruction

OpenAIRE

El Gohary, Z. M. A. [زينب محمود احمد الجوهري

1992-01-01

Complete obstruction of the right ureter of male rabbits for eight weeks resulted in filling of the obstructed kidney with clear urine, no precipitation or stone formation. The calyces and pelvis were distinctly dilated with parenchymal atrophy, the medulla was almost completely destroyed and the cortex was reduced to a thin extensively sclerotic rim. When compared with the contralateral control kidney, the parenchymal weight and water content of the obstructed kidney were distinctly greater....

Fetal tracheolaryngeal airway obstruction: prenatal evaluation by sonography and MRI

Science.gov (United States)

Courtier, Jesse; Poder, Liina; Wang, Zhen J.; Westphalen, Antonio C.; Yeh, Benjamin M.

2010-01-01

We reviewed the sonographic and MRI findings of tracheolaryngeal obstruction in the fetus. Conditions that can cause tracheolaryngeal obstruction include extrinsic causes such as lymphatic malformation, cervical teratoma and vascular rings and intrinsic causes such as congenital high airway obstruction syndrome (CHAOS). Accurate distinction of these conditions by sonography or MRI can help facilitate parental counseling and management, including the decision to utilize the ex utero intrapartum treatment (EXIT) procedure. PMID:20737145

Pattern recognition of obstructive sleep apnoea and Cheyne–Stokes respiration

International Nuclear Information System (INIS)

Weinreich, Gerhard; Teschler, Helmut; Armitstead, Jeff

2008-01-01

The aim of this study was to assess the validity of an artificial neural network based on flow-related spectral entropy as a diagnostic test for obstructive sleep apnoea and Cheyne–Stokes respiration. A data set of 37 subjects was used for spectral analysis of the airflow by performing a fast Fourier transform. The examined intervals were divided into epochs of 3 min. Spectral entropy S was applied as a measure for the spread of the related power spectrum. The spectrum was divided into several frequency areas with various subsets of spectral entropy. We studied 11 subjects with obstructive apnoeas (n = 267 epochs), 10 subjects with obstructive hypopnoeas (n = 80 epochs), 11 subjects with Cheyne–Stokes respiration (n = 253 epochs) and 5 subjects with normal breathing in non-REM sleep (n = 174 epochs). Based on spectral entropy an artificial neural network was built, and we obtained a sensitivity of 90.2% and a specificity of 90.9% for distinguishing between obstructive apnoeas and Cheyne–Stokes respiration, and a sensitivity of 91.3% and a specificity of 94.6% for discriminating between obstructive hypopnoeas and normal breathing in non-REM sleep. This resulted in an accuracy of 91.5% for identifying flow patterns of obstructive sleep apnoea, Cheyne–Stokes respiration and normal breathing in non-REM sleep. It is concluded that the use of an artificial neural network relying on spectral analysis of the airflow could be a useful method as a diagnostic test for obstructive sleep apnoea and Cheyne–Stokes respiration

Biliary intervention for malignant obstructive jaundice

International Nuclear Information System (INIS)

Naoi, Yutaka; Suzuki, Fuminao.

1990-01-01

Currently, diagnosis of obstructive jaundice has become easier with CT and USEG, and percutaneous transhepatic cholangialdrainage (PTCD) for obstructive jaundice has also become much safer using USEG control. We have performed PTCD in 277 cases, from December 1976 to May 1989 at Saitama Cancer Center with specially designed thin needle. And using a PTCD fistula, we have been attempted radiotherapy for 7 cases of the bile duct cancer using Remoto After Loading System (RALS), and hyperthermia for 5 cases of bile duct cancer using antenna of microwaves. From autopsy cases, we evaluated treated lesion pathologically, and we obtained the following results. Dosage of biliary RALS need up to 50 Gy at the point of 1 cm from 60 Co sourse. Biliary hyperthermia using microwave seem to be unsuccessful, and further improvement to the antenna of microwave were necessary. Furthermore, we have attempted biliary endoprosthesis 27 cases, for better quality of life to the patients with malignant obstructive jaundice. These methods seem to be effective in prolonging patient's lives, comparing of cases in which PTCD of an external fistula has been performed. (author)

Inflammatory biomarkers and comorbidities in chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Thomsen, Mette; Dahl, Morten; Lange, Peter

2012-01-01

Patients with chronic obstructive pulmonary disease (COPD) have evidence of systemic inflammation that may be implicated in the development of comorbidities.......Patients with chronic obstructive pulmonary disease (COPD) have evidence of systemic inflammation that may be implicated in the development of comorbidities....

Predictors of outcome among patients with obstructive jaundice at ...

African Journals Online (AJOL)

Despite recent advances both in preoperative diagnosis and postoperative care, obstructive jaundice still contributes significantly to high morbidity and mortality. A prospective study was undertaken to identify predictors of outcome among patients with obstructive jaundice at Bugando Medical Centre in north-western ...

Endoscopic retrograde cholangiopancreatographic evaluation of patients with obstructive jaundice

International Nuclear Information System (INIS)

Khurram, M.; Durrani, A.A.; Butt, A.A.; Ashfaq, S.

2003-01-01

Objective: To evaluate the role of endoscopic retrograde cholangiopancreatography (ERCP) in patients with obstructive jaundice. Results: Of the 226 patients, 117 (51.8%) were males, and 109 (48.2%) females, their mean age being 51.8 plus minus 16.6 years. Common bile and pancreatic ducts were visualized in 81.8% and 68.1% patients respectively. Growth/masses and stones were commonest causes of obstructive jaundice. Choledocholithias was common in males, while biliary channel related growth/masses were common in females (p-value = 0.03). Common bile duct stone clearance rate was 88%, stenting was highly successful in patients with growth and strictures. ERCP related complications were noted in 11 (4.8%) patients. Conclusion: ERCP is an important diagnostic and therapeutic modality for evaluation of patients with obstructive jaundice. Growth/masses and stones are common causes of obstructive jaundice, which can be diagnosed and treated with ERCP. (author)

Multi-component assessment of chronic obstructive pulmonary disease : an evaluation of the ADO and DOSE indices and the global obstructive lung disease categories in international primary care data sets

NARCIS (Netherlands)

Jones, Rupert C.; Price, David; Chavannes, Niels H.; Lee, Amanda J.; Hyland, Michael E.; Stallberg, Bjorn; Lisspers, Karin; Sundh, Josefin; van der Molen, Thys; Tsiligianni, Ioanna

2016-01-01

Suitable tools for assessing the severity of chronic obstructive pulmonary disease (COPD) include multi-component indices and the global initiative for chronic obstructive lung disease (GOLD) categories. The aim of this study was to evaluate the dyspnoea, obstruction, smoking, exacerbation (DOSE)

Assessing Urinary Tract Junction Obstruction Defects by Methylene Blue Dye Injection.

Science.gov (United States)

Yun, Kangsun

2017-10-12

Urinary tract junction obstruction defects are congenital anomalies inducing hydronephrosis and hydroureter. Murine urinary tract junction obstruction defects can be assessed by tracking methylene blue dye flow within the urinary system. Methylene blue dye is injected into the renal pelvis of perinatal embryonic kidneys and dye flow is monitored from the renal pelvis of the kidney through the ureter and into the bladder lumen after applying hydrostatic pressure. Dye accumulation will be evident in the bladder lumen of the normal perinatal urinary tract, but will be constrained between the renal pelvis and the end point of an abnormal ureter, if urinary tract obstructions occur. This method facilitates the confirmation of urinary tract junction obstructions and visualization of hydronephrosis and hydroureter. This manuscript describes a protocol for methylene blue dye injection into the renal pelvis to confirm urinary tract junction obstructions.

Non-obstructive coronary artery disease assessed by coronary computed tomography angiography

DEFF Research Database (Denmark)

Nielsen, L.; Bøtker, H. E.; Sorensen, H.

2015-01-01

Introduction: Coronary CT angiography (CTA) detects non-obstructive coronary artery disease (CAD) that may not be recognized by functional testing, but the prognostic impact is not well understood. This study aimed to compare the risk of myocardial infarction (MI) and all-cause mortality...... in patients without or with non-obstructive and obstructive CAD assessed by coronary CTA. Methods: Consecutive patients without known coronary artery disease (CAD) and with chest pain who underwent coronary CTA (>64-detector row) between January 2007 and December 2012 in the 10 centers participating...... in the Western Denmark Cardiac Computed Tomography Registry were included. The endpoints were 3-year MI or all-cause mortality. The coronary CTA result was defined as normal (0% luminal stenosis), non-obstructive CAD (1%-49% luminal stenosis) or obstructive CAD (>50% luminal stenosis; 1-vessel, 2-vessel, or 3...

The influence of flow obstructions on flooding phenomena in vertical channels

International Nuclear Information System (INIS)

Celata, G.P.; Cumo, M.; Farello, G.E.; Setaro, T.

1988-01-01

Flooding phenomenon limits the stability of a liquid film falling downwards along the walls of a channel inside which an upwards gas flow takes place. As known, this entrainment effect can completely prevent the liquid fall from its natural flow. A local reduction of the flow channel cross section, due for instance to an obstruction, will affect the flooding parameters, depending on the position at which the obstruction is located and on the obstruction flow cross section. The present work deals with an air-water experiment carried out with a transparent circular duct test section, inside which it is possible to insert orifices having several diameters, to test the influence of the obstruction on flooding parameters. Predictions by the correlations available in literature are compared and a method to evaluate the influence of the obstruction is proposed

Identifying patients at high risk for obstructive sleep apnoea ...

African Journals Online (AJOL)

Background: Obstructive sleep apnoea is associated with significant health consequences. A significant proportion of hospitalized patients at risk for obstructive sleep apnoea were never identified and referred for polysomnography for diagnosis. The objective of this study was to determine the factors associated with high ...

Obstructive uropathy in childhood: A review | Eke | Port Harcourt ...

African Journals Online (AJOL)

Methods: Contemporary information on the management of obstructive uropathy was obtained by searching the Medline and adding information from the authors\\' experience. Results: Obstructive uropathy causes renal impairment in all age groups. The causes in children may be congenital or acquired. The congenital ...

Office of Coast Survey's Automated Wreck and Obstruction Information System

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Automated Wreck and Obstruction Information System (AWOIS) is an automated file that contains information on wrecks and obstructions, and other significant...

A study of diagnosis and manegement of mechanical small-bowel obstruction

International Nuclear Information System (INIS)

Kawasaki, Masayasu; Kurumi, Yoshimasa; Naitoh, Hiroyuki

2007-01-01

We tried to clarify the most appropriate management for simple bowel obstruction and effective methods for diagnosis of strangulated bowel obstruction. Consecutive 252 cases of mechanical small-bowel obstruction treated in the hospital from 2000 to 2005 were assessed retrospectively. There were 219 cases of simple obstructions and 33 cases of strangulated obstruction. Seventy-eight percent of simple obstruction cases were treated conservatively (fasting in 82, decompression tube treatment in 88 and operation in 49). The average duration for indwelling the decompression tube was 5.2 days and the amount of discharge from the tube decreased day by day. In the cases of operation, the operation was performed on the 4.5th day after admission on the average, and the average amount of tube discharge before the operation was more than 450 ml/day. On the other hand, strangulation was most frequently diagnosed by enhanced abdominal CT scan, followed by physical examination, and the properties of decompression tube discharge in this order, and the blood data were only used for reference. Simple small-bowel obstruction should be treated by surgical therapy if symptomatic remission could not be gained by five days after beginning of the treatment. Enhanced abdominal CT scan is the most useful method for diagnosis of strangulation in an early stage of ischemia. (author)

Association of Obstructive Sleep Apnea Syndrome and Buerger's Disease: a Pilot Study

Directory of Open Access Journals (Sweden)

Gholam Hosein Kazemzadeh

2015-10-01

Full Text Available In this study we evaluated the incidence and severity of obstructive sleep apnea and Obstructive sleep apnea syndrome in patients with thromboangiitis obliterans for reduction of crisis. In 40 patients with Buerger's disease daily sleepiness and risk of Obstructive sleep apnea were evaluated using the Epworth sleeping scale (ESS and the Stop-Bang score. An Apnea-link device was used for evaluation of chest motion, peripheral oxygenation, and nasal airflow during night-time sleep. The apnea/hypopnea index (AHI and respiratory tdisurbance index were used for Obstructive sleep apnea syndrome diagnosis. All subjects were cigarette smokers and 80% were opium addicted. The prevalence of Obstructive sleep apnea (AHI>5 was 80%, but incidence of Obstructive sleep apnea syndrome (AHI>5 + ESS≥10 was 5% (2/40. There was no association between duration or frequency of hospitalization and Obstructive sleep apnea syndrome (P=0.74 and 0.86, respectively. In addition, no correlation between ESS and Stop-Bang scores and AHI was observed (P=0.58 and 0.41, respectively. There was an inverse correlation between smoking rate and AHI (P=0.032, r = −0.48. We did not find an association between Buerger's disease and Obstructive sleep apnea syndrome. Although the AHI was high (80% and daily sleepiness was low. The negative correlation of smoking with AHI and on the other hand daily napping in addiction may be caused by the absence of a clear relationship between Obstructive sleep apnea syndrome and Buerger's disease.

[Production, absorption and excretion of phenols in intestinal obstruction].

Science.gov (United States)

Kawamoto, M

1986-11-01

In intestinal obstruction, phenols were produced in the distended loop proximal to obstruction by enteric bacteria. Clinically, in 17 cases of non-strangulated intestinal obstruction, phenols were detected in 15 cases and mean concentration of phenols was 4.2 +/- 9.7 micro g/ml(mean +/- 1 SD). In the fraction of phenols, p-cresol was detected in 15 cases and mean concentration was 3.8 +/- 7.7 and phenol was detected in 4 cases and mean concentration was 0.5 +/- 2.6. Phenols were decreased as clinical improvement of intestinal obstruction. Enteric bacteria in enteric juice ranged from 10(4) to 10(10)/ml and its change paralleled to phenols concentration. Mean urinary concentration of phenols in intestinal obstruction was increased to 297 +/- 415 mg/day compared to control (less than 50 mg/day). Its change also paralleled to phenols concentration in enteric juice. Closed ileal loop was made in dogs and phenols were infused in the loop. Phenols were increased in the portal vein 5 min after the infusion and in the femoral vein 60 min after the infusion. Phenols, which was thought to be toxic to the host, were proved to be produced in the distended intestine and excreted from the kidney.

Double obstruction of ureter: A diagnostic challenge

Directory of Open Access Journals (Sweden)

Pankaj Halder

2014-01-01

Full Text Available Introduction: Isolated obstruction of the ureteropelvic junction and the vesico-ureteric junction are the two most common causes of hydronephrosis in a pediatric population. [1] They do not pose diagnostic difficulties when are present alone but when together can be difficult to diagnose. Here, we discuss the problems we faced when we encountered these two anomalies in the same ureter and the way in which we managed them. Aim: To assess the difficulties in diagnosis of pediatric patients who present with both ureteropelvic junction obstruction (UPJO and vesico-ureteric junction obstruction (VUJO in the ipsilateral ureter and their management protocol. Materials and Methods: This is a retrospective study. The study period is from 1 January 2004 to 31 December 2011. Out of 254 children who were diagnosed to have hydronephrosis due to UPJO in our institute, 5 patients (in the age range of 5 to 10 years had both UPJO and VUJO in the ipsilateral ureter. The problems we faced in diagnosing the two conditions are mentioned with a literature review. Results: Operative intervention was used in four out of five patients; none of the patients had an accurate diagnosis before surgery. All patients were suspected of having double obstruction during pyeloplasty when appropriate size double J stent could not be negotiated through the vesicoureteric junction into the bladder. Postoperative nephrostogram confirmed the diagnosis in all patients. Conclusion: Children with double obstruction of the ipsilateral ureter present as a diagnostic dilemma. Because of the rarity of this condition it can escape the eye of even an astute clinician. Early diagnosis can be made if this condition is kept in mind while treating any hydronephrosis due to UPJO or UVJO.

Iliocaval Confluence Stenting for Chronic Venous Obstructions

Energy Technology Data Exchange (ETDEWEB)

Graaf, Rick de, E-mail: r.de.graaf@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Wolf, Mark de, E-mail: markthewolf@gmail.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Sailer, Anna M., E-mail: anni.sailer@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Laanen, Jorinde van, E-mail: jorinde.van.laanen@mumc.nl; Wittens, Cees, E-mail: c.wittens@me.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Jalaie, Houman, E-mail: hjalaie@ukaachen.de [University Hospital Aachen, Department of Surgery (Germany)

2015-10-15

PurposeDifferent techniques have been described for stenting of venous obstructions. We report our experience with two different confluence stenting techniques to treat chronic bi-iliocaval obstructions.Materials and MethodsBetween 11/2009 and 08/2014 we treated 40 patients for chronic total bi-iliocaval obstructions. Pre-operative magnetic resonance venography showed bilateral extensive post-thrombotic scarring in common and external iliac veins as well as obstruction of the inferior vena cava (IVC). Stenting of the IVC was performed with large self-expandable stents down to the level of the iliocaval confluence. To bridge the confluence, either self-expandable stents were placed inside the IVC stent (24 patients, SECS group) or high radial force balloon-expandable stents were placed at the same level (16 patients, BECS group). In both cases, bilateral iliac extensions were performed using nitinol stents.ResultsRecanalization was achieved for all patients. In 15 (38 %) patients, a hybrid procedure with endophlebectomy and arteriovenous fistula creation needed to be performed because of significant involvement of inflow vessels below the inguinal ligament. Mean follow-up was 443 ± 438 days (range 7–1683 days). For all patients, primary, assisted-primary, and secondary patency rate at 36 months were 70, 73, and 78 %, respectively. Twelve-month patency rates in the SECS group were 85, 85, and 95 % for primary, assisted-primary, and secondary patency. In the BECS group, primary patency was 100 % during a mean follow-up period of 134 ± 118 (range 29–337) days.ConclusionStenting of chronic bi-iliocaval obstruction shows relatively high patency rates at medium follow-up. Short-term patency seems to favor confluence stenting with balloon-expandable stents.

Does vasoactive intestinal polypeptide mediate the pathophysiology of bowel obstruction?

Science.gov (United States)

Basson, M D; Fielding, L P; Bilchik, A J; Zucker, K A; Ballantyne, G H; Sussman, J; Adrian, T E; Modlin, I M

1989-01-01

We hypothesized that bioactive peptides might be released into the portal circulation and mediate pathophysiologic alterations accompanying small bowel obstruction. We studied this question in a subacute canine small bowel obstruction model using 50 percent diameter occlusion. Control animals underwent sham laparotomy. Vasoactive intestinal peptide (VIP), peptide YY, and gastrin were measured in portal and systemic plasma by specific radioimmunoassays at 24-hour intervals as the obstruction progressed to completion over 5 days. All peptides in both groups demonstrated portal and peripheral gradients. In control dogs, peptide concentrations did not change postoperatively but VIP increased markedly in obstructed dogs, demonstrating a median portal level of 95 pmol/liter at 96 hours compared with 31.5 pmol/liter in control animals. These portal VIP levels are known to cause hypersecretion and splanchnic vasodilation in experimental models. The release of vasoactive compounds such as VIP may mediate local pathophysiology in human small bowel obstruction. A similar explanation of the systemic effects is consistent with the known cardiopulmonary bioactivity of VIP.

[The euthyroid sick syndrome. Its incidence and clinical significance in an internal medicine department].

Science.gov (United States)

Di Napoli, M; Reda, G; Zannoni, G; Russo, S; Morace, G; Vasselli, C

1994-04-01

In this paper the authors have evaluated the incidence and the clinical implications of sick euthyroid syndrome (SES) in a group of 144 patients in a department of internal medicine. SES is an alteration of thyroid hormone values in the absence of a thyroid disease, which is seen in patients suffering from serious diseases. Having classified SES into 3 subgroups according to the different alterations seen in the values of T3, T4, FT3, FT4, TSH, rT3 and TBG, they show the hypotheses that explain the biochemical mechanisms which are at the basis of these hormonal alterations. Fourteen of the 144 patients under observation were excluded as they were suffering from ascertained or subclinical thyroid disease. Thirty (23% of cases) of the remaining 130 patients had alterations of the thyroid hormones in accordance with SES diagnosis. Of these 30 patients, 19 had hormone values found in SES type I (63%), 2 in SES type II (6.5%) and 9 in SES type III (30.5%). In SES type I the diseases seen, in order of frequency, were: obstructive chronic bronchopneumopathy with acute respiratory failure, diabetic ketoacidosis, neoplasms, ischemic heart disease, cardiac failure, chronic renal failure, liver diseases, acute cerebral vasculopathies, sepsis and collagenopathies. The disease seen in the 2 cases of SES type II was obstructive chronic bronchopneumopathy with acute respiratory failure. In SES type III the diseases seen were, in order of frequency: diabetic ketoacidosis, lung diseases, ischemic heart disease, cardiac failure, peripheral arteriopathies, acute cerebral vasculopathies, neoplasms, liver diseases, acute renal failure. The incidence of SES in 23% of the admitted to hospital patients was found to be slightly higher than in other studies; this could be explained by a stricter selection of inpatients: in fact self-sufficient patients or those not needing urgent admission, were sent to an efficient out patient clinic where necessary examinations were quickly carried out

Gastric Outlet Obstruction from Duodenal Lipoma in an Adult ...

African Journals Online (AJOL)

Gastric Outlet Obstruction from Duodenal Lipoma in an Adult. ... Nigerian Journal of Surgery ... Although, peptic ulcer disease remains the most common benign cause of gastric outlet obstruction (GOO), duodenal lipomas remain a rare, but possible cause of GOO and could pose a diagnostic challenge, especially in ...

Operable severe obstructive jaundice: How should we use pre ...

African Journals Online (AJOL)

Obstructive jaundice is a common surgical problem, and surgery in jaundiced patients is associated with a higher risk of postoperative complications than surgery in non-jaundiced patients. However, the efficacy of pre-operative biliary drainage (PBD) for patients with obstructive jaundice remains controversial. Many studies ...

Obstructed Labour in Adigrat Zonal Hospital, Tigray Region, Ethiopia

African Journals Online (AJOL)

Background: Obstructed labour is a common cause of maternal and pernatal morbidity and mortality in developing countries. There are few data from Ethiopia, although the problem is believed to be common. Objective: To describe the frequency, causes, complications and treatment outcome of mothers with obstructed ...

Early release of neonatal ureteral obstruction preserves renal function

DEFF Research Database (Denmark)

Shi, Yimin; Pedersen, Michael; Li, Chunling

2004-01-01

was left in place or released after 1 or 4 wk. Renal blood flow (RBF) and kidney size were measured sequentially over 24 wk using MRI. In rats in which the obstruction was left in place, RBF of the obstructed kidney was progressively reduced to 0.92 ± 0.17 vs. 1.79 ± 0.12 ml·min−1·100 g body wt−1 (P ...The incidence of congenital hydronephrosis is ∼1% and is often associated with renal insufficiency. It is unknown whether early release is essential to prevent deterioration of renal function. Rats were subjected to partial unilateral ureteral obstruction (PUUO) on postnatal day 2. The obstruction...... downregulation of Na-K-ATPase to 62 ± 7%, aquaporin-1 to 53 ± 3%, and aquaporin-3 to 53 ± 7% of sham levels. Release after 1 wk completely prevented development of hydronephrosis, reduction in RBF and glomerular filtration rate, and downregulation of renal transport proteins, whereas release after 4 wk had...

Trichobezoar obstruction after stapled jejunal anastomosis in a dog.

Science.gov (United States)

Carobbi, Barbara; Foale, Robert D; White, Richard A S

2009-04-01

To describe an unusual long-term complication of circular end-to-end anastomosis (CEEA) stapling in a dog. Clinical case report. An 11-year-old, female neutered, Labrador Retriever. The dog was referred for clinical signs of bowel obstruction. An enterectomy was performed 2 years before presentation using a CEEA stapling device. Palpation, plain radiographs, and ultrasound of the abdomen confirmed the presence of a mass in the bowel, causing obstruction, and requiring surgical approach. An exploratory celiotomy revealed a 5 cm mass in the jejunum, involving the site of the previous surgery. The mass was removed by enterectomy. Dissection of the mass revealed the presence of many staples at the previous enterectomy site, and a trichobezoar entangled in the exposed parts of the staples. An enterectomy was required to treat an intestinal obstruction caused by a trichobezoar entangled in a CEEA-stapled anastomosis. Development of trichobezoar and subsequent bowel obstruction should be considered an unusual but potential long-term complication of CEEA-stapled anastomosis.

Emergency management of acute colonic cancer obstruction.

Science.gov (United States)

Gainant, A

2012-02-01

Emergency management of obstructing colonic cancer depends on both tumor location and stage, general condition of the patient and surgeon's experience. Right sided or transverse colon obstructing cancers are usually treated by right hemicolectomy-extended if necessary to the transverse colon-with primary anastomosis. For left-sided obstructing cancer, in patients with low surgical risk, primary resection and anastomosis associated with on-table irrigation or manual decompression can be performed. It prevents the confection of a loop colostomy but presents the risk of anastomotic leakage. Subtotal or total colectomy allows the surgeon to encompass distended and fecal-loaded colon, and to perform one-stage resection and anastomosis. Its disadvantage is an increased daily frequency of stools. It must be performed only in cases of diastatic colon perforation or synchronous right colonic cancer. In patients with high surgical risk, Hartmann procedure must be preferred. It allows the treatment of both obstruction and cancer, and prevents anastomotic leakage but needs a second operation to reverse the colostomy. Colonic stenting is clinically successful in up to 90% in specialized groups. It is used as palliation in patients with disseminated disease or bridge to surgery in the others. If stent insertion is not possible, loop colostomy is still indicated in patients at high surgical risk. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Acceptance and stress effects of aircraft obstruction markings of wind turbines

International Nuclear Information System (INIS)

Pohl, Johannes; Hübner, Gundula; Mohs, Anja

2012-01-01

A dominant resistance factor against wind power projects seems to be their visual impact on the landscape. In addition stress effects from aircraft obstruction markings are an emerging topic related to acceptance. As the height of wind turbines increases, so does the number of mandatory obstruction markings. Recently, obstruction markings have caused a growing number of complaints from residents. Whether obstruction markings indeed cause stress or even substantial annoyance remains an open question. To analyse the stress impact of obstruction markings, we used environmental and stress psychology methodologies. Residents (N=420) with direct sight of turbines at 13 wind farms participated in a questionnaire survey. Evidence of substantial annoyance caused by obstruction markings was not found. However, residents exposed to xenon lights reported more intense and multifaceted stress responses than exposed to LED or colour markings on blades. Moreover, xenon lights negatively affected the general acceptance of wind energy. Additionally, synchronised navigation lights were found to be less annoying than non-synchronised lights under certain weather conditions. Markings with light intensity adjustment proved to be advantageous. To reduce stress and increase social acceptance of wind power, xenon lights should be abandoned, navigation lights synchronised, and light intensity adjustment applied. - Research highlights: ► Wind turbine obstruction markings influence the social acceptance of wind energy. ► Residents exposed to xenon lights reported more intense stress responses than exposed to LED or colour markings. ► Synchronised lights were found to be less annoying under certain weather conditions. ► Markings with light intensity adjustment proved to be advantageous. ► Evidence of substantial annoyance caused by obstruction markings was not found.

Fatal Airway Obstruction in a Man With a Cystic Hygroma.

Science.gov (United States)

Wygant, Cassandra Maria; Cohle, Stephen D

2018-05-03

We describe a 24-year-old man with a cystic hygroma of the left side of the lower neck that led to sudden death. Cystic hygroma (cystic lymphangioma) is a congenital malformation of the lymphatic system. The patient, who had a tracheostomy because of airway obstruction from the cystic hygroma, was found dead with his tracheostomy tube on the floor next to him. Complications of cystic hygroma include infiltration of the neck causing airway obstruction, dysphagia, pain, and obstructive sleep apnea.

Palliation of Malignant Upper Gastrointestinal Obstruction with Self-Expandable Metal Stent

Energy Technology Data Exchange (ETDEWEB)

Morikawa, Soichiro; Suzuki, Azumi; Nakase, Kojiro; Yasuda, Kenjiro [Kyoto Second Red Cross Hospital, Kyoto (Japan)

2012-02-15

To assess the technical success, ability to eat, complications and clinical outcomes of patients with self-expandable metal stent (SEMS) placed for malignant upper gastrointestinal (GI) obstruction. Data was collected retrospectively on patients who underwent SEMS placement for palliation of malignant upper GI obstruction by reviewing hospital charts from June 1998 to May 2011. Main outcome measurements were technical success, gastric outlet obstruction scoring system (GOOSS) score before and after treatment, complications, and survival. A total of 82 patients underwent SEMS placement with malignant upper GI obstruction. The initial SEMS placement was successful in 77 patients (93.9%). The mean GOOSS score was 0.56 before stenting and 1.92 (p < 0.001) after treatment. Complications arose in 12 patients (14.6%): stent migration in 1 patient (1.2%), perforation in 1 (1.2%), and obstruction of stent due to tumor ingrowth in 10 (12.2%). The median survival time after stenting was 52 days (6-445). SEMS placement is an effective and safe treatment for palliation of malignant upper GI obstruction. It provides lasting relief in dysphagia and improves the QOL of patients.

Palliation of Malignant Upper Gastrointestinal Obstruction with Self-Expandable Metal Stent

International Nuclear Information System (INIS)

Morikawa, Soichiro; Suzuki, Azumi; Nakase, Kojiro; Yasuda, Kenjiro

2012-01-01

To assess the technical success, ability to eat, complications and clinical outcomes of patients with self-expandable metal stent (SEMS) placed for malignant upper gastrointestinal (GI) obstruction. Data was collected retrospectively on patients who underwent SEMS placement for palliation of malignant upper GI obstruction by reviewing hospital charts from June 1998 to May 2011. Main outcome measurements were technical success, gastric outlet obstruction scoring system (GOOSS) score before and after treatment, complications, and survival. A total of 82 patients underwent SEMS placement with malignant upper GI obstruction. The initial SEMS placement was successful in 77 patients (93.9%). The mean GOOSS score was 0.56 before stenting and 1.92 (p < 0.001) after treatment. Complications arose in 12 patients (14.6%): stent migration in 1 patient (1.2%), perforation in 1 (1.2%), and obstruction of stent due to tumor ingrowth in 10 (12.2%). The median survival time after stenting was 52 days (6-445). SEMS placement is an effective and safe treatment for palliation of malignant upper GI obstruction. It provides lasting relief in dysphagia and improves the QOL of patients.

Hepatobiliary scintigraphy in the assessment of biliary obstruction after hepatic resection with biliary-enteric anastomosis

Energy Technology Data Exchange (ETDEWEB)

Kim, J.S.; Moon, D.H.; Shin, J.W.; Ryu, J.S.; Lee, H.K. [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea); Lee, S.G.; Lee, Y.J.; Park, K.M. [Department of General Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea)

2000-02-01

We investigated the usefulness of hepatobiliary scintigraphy (HBS) for diagnosing biliary obstruction after curative hepatic resection with biliary-enteric anastomosis. The study population consisted of 54 patients who underwent surgery for benign (n=18) or malignant (n=36) biliary disease. We analysed 68 technetium-99m DISIDA scintigrams which were performed at least 1 month after the surgery (median: 9 months). Final diagnosis was made by operative exploration, other invasive radiological studies or clinical and radiological follow-up for at least 6 months after the surgery. Diagnostic accuracy was analysed according to the pretest likelihood of biliary obstruction. There were two total and 15 segmental biliary obstructions. In patients with symptoms of biliary obstruction and abnormal liver function, HBS always allowed correct diagnosis (two instances of total obstruction, seven of segmental obstruction and seven of non-obstruction). Among the patients with non-specific symptoms or isolated elevation of serum alkaline phosphatase, HBS diagnosed segmental biliary obstruction in seven of the eight instances, and non-obstruction in 22 of 23 instances. There were no cases of biliary obstruction and no false-positive results of HBS in 21 instances with no clinical signs or symptoms of biliary obstruction. The diagnostic sensitivity and specificity of HBS for biliary obstruction were 94% (16/17) and 97% (50/51), respectively. In conclusion, HBS is a highly accurate modality for the diagnosis of segmental biliary obstruction during long-term follow-up after hepatic resection with biliary-enteric anastomosis. (orig.)

Hepatobiliary scintigraphy in the assessment of biliary obstruction after hepatic resection with biliary-enteric anastomosis

International Nuclear Information System (INIS)

Kim, J.S.; Moon, D.H.; Shin, J.W.; Ryu, J.S.; Lee, H.K.; Lee, S.G.; Lee, Y.J.; Park, K.M.

2000-01-01

We investigated the usefulness of hepatobiliary scintigraphy (HBS) for diagnosing biliary obstruction after curative hepatic resection with biliary-enteric anastomosis. The study population consisted of 54 patients who underwent surgery for benign (n=18) or malignant (n=36) biliary disease. We analysed 68 technetium-99m DISIDA scintigrams which were performed at least 1 month after the surgery (median: 9 months). Final diagnosis was made by operative exploration, other invasive radiological studies or clinical and radiological follow-up for at least 6 months after the surgery. Diagnostic accuracy was analysed according to the pretest likelihood of biliary obstruction. There were two total and 15 segmental biliary obstructions. In patients with symptoms of biliary obstruction and abnormal liver function, HBS always allowed correct diagnosis (two instances of total obstruction, seven of segmental obstruction and seven of non-obstruction). Among the patients with non-specific symptoms or isolated elevation of serum alkaline phosphatase, HBS diagnosed segmental biliary obstruction in seven of the eight instances, and non-obstruction in 22 of 23 instances. There were no cases of biliary obstruction and no false-positive results of HBS in 21 instances with no clinical signs or symptoms of biliary obstruction. The diagnostic sensitivity and specificity of HBS for biliary obstruction were 94% (16/17) and 97% (50/51), respectively. In conclusion, HBS is a highly accurate modality for the diagnosis of segmental biliary obstruction during long-term follow-up after hepatic resection with biliary-enteric anastomosis. (orig.)

Hepatic Scintigraphic Findings of Budd-Chiari Syndrome due to Inferior Vena Caval Obstruction

Energy Technology Data Exchange (ETDEWEB)

Kim, Sung Hoon; Chung, Soo Kyo; Byun, Jae Young; Lee, Sung Yong; Shinn, Kyung Sub; Kim, Choon Yul; Bahk, Yong Whee [Catholic University College of Medicine, Seoul (Korea, Republic of)

1988-03-15

Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by post-sinusoidal portal hypertension caused by the obstruction to the hepatic vein outflow. The diagnosis is suggested by hepatic scintigraphy and is usually confirmed by hepatic venography, inferior vena cavography and biopsy. The scintigraphic finding of BCS caused by the obstruction of main hepatic vein has been reported to consist typically of hypertrophy of the caudate lobe with increased radionuclide accumulation. Such a typical finding has been accounted for by the fact that the venous outflow from the caudate lobe is preserved when the main hepatic vein is obstructed. But usually, the hepatic venous outflow from the caudate lobe is also obstructed in BCS due to inferior vena caval obstruction. So hepatic scintigraphic findings of BCS due to inferior vena caval obstruction show different findings as compared with the BCS due to hepatic vein obstruction. We evaluate the hepatic scintigrams of the 13 cases of BCS due to inferior vena caval obstruction and review the literatures. The results are as follows: 1) We cannot observe the caudate lobe hypertrophy with increased uptake, which is known as a classic finding in BCS due to hepatic vein obstruction. 2) The most prominent hepatic scintigraphic findings of BCS are nonhomogenous uptake in the liver with extrahepatic uptake in the all cases. 3) We can see cold areas at the superior aspect of right hepatic lobe in 7 cases (54%). This is a useful finding suggesting BCS due to inferior vena caval obstruction.

Hepatic Scintigraphic Findings of Budd-Chiari Syndrome due to Inferior Vena Caval Obstruction

International Nuclear Information System (INIS)

Kim, Sung Hoon; Chung, Soo Kyo; Byun, Jae Young; Lee, Sung Yong; Shinn, Kyung Sub; Kim, Choon Yul; Bahk, Yong Whee

1988-01-01

Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by post-sinusoidal portal hypertension caused by the obstruction to the hepatic vein outflow. The diagnosis is suggested by hepatic scintigraphy and is usually confirmed by hepatic venography, inferior vena cavography and biopsy. The scintigraphic finding of BCS caused by the obstruction of main hepatic vein has been reported to consist typically of hypertrophy of the caudate lobe with increased radionuclide accumulation. Such a typical finding has been accounted for by the fact that the venous outflow from the caudate lobe is preserved when the main hepatic vein is obstructed. But usually, the hepatic venous outflow from the caudate lobe is also obstructed in BCS due to inferior vena caval obstruction. So hepatic scintigraphic findings of BCS due to inferior vena caval obstruction show different findings as compared with the BCS due to hepatic vein obstruction. We evaluate the hepatic scintigrams of the 13 cases of BCS due to inferior vena caval obstruction and review the literatures. The results are as follows: 1) We cannot observe the caudate lobe hypertrophy with increased uptake, which is known as a classic finding in BCS due to hepatic vein obstruction. 2) The most prominent hepatic scintigraphic findings of BCS are nonhomogenous uptake in the liver with extrahepatic uptake in the all cases. 3) We can see cold areas at the superior aspect of right hepatic lobe in 7 cases (54%). This is a useful finding suggesting BCS due to inferior vena caval obstruction.

High‑risk of obstructive sleep apnea and excessive daytime ...

African Journals Online (AJOL)

Background: The burden of obstructive sleep apnea among commercial drivers in Nigeria is not known. Aim: To assess the prevalence of high risk of obstructive sleep apnea (OSA) and excessive daytime sleepiness (EDS) among intra‑city commercial drivers. Setting and Design: A descriptive cross‑sectional study in three ...

Original Research Identifying patients at high risk for obstructive ...

African Journals Online (AJOL)

determine the factors associated with high risk for obstructive sleep apnoea and use it to identify patients at risk for the condition in ... mainstay of management is CPAP in addition to behavioral ..... the present study has some potential limitations which ... consequences of obstructive sleep apnea and short sleep duration.

Rapid morphological changes and loss of collagen following experimental acute colonic obstruction

DEFF Research Database (Denmark)

Krarup, Peter-Martin; Rehn, Martin; Sand-Dejmek, Janna

2013-01-01

Anastomosis of an acutely obstructed colon is associated with an increased risk of dehiscence. In experimental models, acute obstruction decreases collagen in the colonic wall, but the time course and propagation along the colon of the biochemical changes are unknown. Furthermore, there is a pauc......Anastomosis of an acutely obstructed colon is associated with an increased risk of dehiscence. In experimental models, acute obstruction decreases collagen in the colonic wall, but the time course and propagation along the colon of the biochemical changes are unknown. Furthermore...

Gastric diverticulum causing gastric outlet obstruction in the setting of duodenal atresia

Directory of Open Access Journals (Sweden)

Devashis Mukherjee

2018-04-01

Full Text Available Duodenal obstruction due to duodenal atresia occurs in 1 in 10,000 live births and is the most common type of intestinal obstruction in neonates [1–3]. Gastric outlet obstruction in the newborn period from causes other than hypertrophic pyloric stenosis is very uncommon [3]. Potential etiologies include gastric volvulus, antral web, and duplication cysts. Gastric diverticula in the infant is even more rare, with only a few case reports published, and only one describes a gastric diverticulum in the presence of a duodenal atresia [4–8]. In this report, we describe the first case of a gastric outlet obstruction due to a gastric diverticulum in the presence of duodenal atresia. Keywords: Duodenal atresia, Gastric diverticulum, Gastric outlet obstruction

Ultrasound evaluation of obstructive uropathy and its hemodynamic responses in southwest Nigeria

Directory of Open Access Journals (Sweden)

I. N. Apoku

2015-06-01

Full Text Available ABSTRACTPurpose:To determine the renal arterial hemodynamic changes induced by obstructive uropathy using Doppler ultrasonography.Materials and Methods:60 adult subjects with suspected obstructive uropathy and 60 asymptomatic apparently healthy controls with normal renal ultrasound features were evaluated.B-mode sonography of the kidneys and spectral Doppler examination of the renal interlobar arteries of all the participants were performed. The mean resistive indices (mRI of both interlobar arteries were obtained and compared to that of the controls. The mRI of bilaterally obstructed kidneys were also compared with the mRI of unilaterally obstructed kidneys.Results:The mRI of the right and left kidneys of subjects were 0.72±0.04 and 0.69±0.06 while those of the controls were 0.64±0.04 and 0.63±0.03 respectively. The mRI for the grades of caliectasis increased from grade I (0.72±0.03 to grade II (0.73±0.03 and grade III (0.73±0.02 but fell within the most severe levels of obstruction (0.69±0.07. There was no statistically significant relationship between the grades of caliectasis and unilateral or bilateral obstruction for both kidneys. The results show a sensitivity and specificity of 86.7% and 90% respectively when mRI≥0.7 was used to determine presence of obstruction.Conclusion:Renal duplex sonography is highly sensitive and specific for diagnosis of obstructive uropathy. Increased resistive index of the obstructed kidney may be a useful diagnostic tool in situations where intravenous urography cannot be done or is contraindicated.

Evaluation of peripheral auditory pathways and brainstem in obstructive sleep apnea.

Science.gov (United States)

Matsumura, Erika; Matas, Carla Gentile; Magliaro, Fernanda Cristina Leite; Pedreño, Raquel Meirelles; Lorenzi-Filho, Geraldo; Sanches, Seisse Gabriela Gandolfi; Carvallo, Renata Mota Mamede

2016-11-25

Obstructive sleep apnea causes changes in normal sleep architecture, fragmenting it chronically with intermittent hypoxia, leading to serious health consequences in the long term. It is believed that the occurrence of respiratory events during sleep, such as apnea and hypopnea, can impair the transmission of nerve impulses along the auditory pathway that are highly dependent on the supply of oxygen. However, this association is not well established in the literature. To compare the evaluation of peripheral auditory pathway and brainstem among individuals with and without obstructive sleep apnea. The sample consisted of 38 adult males, mean age of 35.8 (±7.2), divided into four groups matched for age and Body Mass Index. The groups were classified based on polysomnography in: control (n=10), mild obstructive sleep apnea (n=11) moderate obstructive sleep apnea (n=8) and severe obstructive sleep apnea (n=9). All study subjects denied a history of risk for hearing loss and underwent audiometry, tympanometry, acoustic reflex and Brainstem Auditory Evoked Response. Statistical analyses were performed using three-factor ANOVA, 2-factor ANOVA, chi-square test, and Fisher's exact test. The significance level for all tests was 5%. There was no difference between the groups for hearing thresholds, tympanometry and evaluated Brainstem Auditory Evoked Response parameters. An association was observed between the presence of obstructive sleep apnea and changes in absolute latency of wave V (p=0.03). There was an association between moderate obstructive sleep apnea and change of the latency of wave V (p=0.01). The presence of obstructive sleep apnea is associated with changes in nerve conduction of acoustic stimuli in the auditory pathway in the brainstem. The increase in obstructive sleep apnea severity does not promote worsening of responses assessed by audiometry, tympanometry and Brainstem Auditory Evoked Response. Copyright © 2016 Associação Brasileira de

Magnetic resonance urography: application in urinary tract obstruction

International Nuclear Information System (INIS)

Martin, J.; Malet, A.; Rue, M.; Villajos, M.; Martin, C.; Garcia, D.; Prats, J.

1999-01-01

To compare magnetic resonance urography (MRU) and conventional intravenous urography (IVU) in the assessment of the upper urinary tract in patients with obstructive uropathy. Twenty-three patients suspected of having urinary tract obstruction were examined by IVU and MRU, MRU imaging was performed with a 1.0 Tesla multicoil unit. The images were obtained with two MR sequences: a) half-Fourier single shot turbo spin echo (HASTE), and b) highly T2-weighted turbo spin echo (TSE) based on fast acquisition with the relaxation and enhancement (RARE) method. The images were examined independently by four radiologists. Two radiologists reviewed the IVU images by consensus and two reviewed the MRU images by consensus. The incidencences of dilatation and of stricture were calculated and the McNemar test was used to compare the two techniques. The mean duration of MRU was 11 minutes (range: 7 to 25 minutes), while the mean duration of IVU was 363 minutes (range: 45 to 2,160 minutes). IVU took more than 150 minutes to complete in over 50% of the patients. Twenty.one patients presented dilatation of the pyelocaliceal system. MRU disclosed the urinary tract dilatation in all 21 cases, while IVU detected it in 15 (65%: p=0.03). The causes of obstruction were neoplasm (n=9), calculi (n=6) and extrinsic stricture (n=6). MRU is much more reliable and rapid in the detection of dilatation and the site of obstruction in patients with obstructive uropathy, and could be used as an alternative to IVU in certain cases. (Author) 13 refs

Intestinal sclerosis with pseudo-obstruction in three dogs.

Science.gov (United States)

Moore, R; Carpenter, J

1984-04-01

Intestinal sclerosis causing chronic intestinal pseudo-obstruction was diagnosed in 3 dogs. The pseudo-obstruction was characterized by vomiting and weight loss of 2 weeks' to 3 months' duration. A patent intestinal lumen was determined by contrast radiography and verified at surgery. Intestinal biopsy revealed diffuse atrophy, fibrosis, and mononuclear cell infiltration of the tunica muscularis. Each dog was euthanatized because of a progressive, deteriorating clinical course.

Chronic obstructive pulmonary disease

International Nuclear Information System (INIS)

Karabulut, N.

2012-01-01

Full text: Chronic obstructive pulmonary diseases (COPD) denote progressive lung diseases characterized by airway obstruction. COPD exhibits specific morphologic changes in the lung parenchyma, central and peripheral airways and pulmonary vasculature. A person with COPD may have either emphysema or chronic bronchitis, but most have both. Some people with COPD may also have an asthma-like or reactive component. Imaging modalities play important role in the detection or exclusion of COPD, distribution and extent of disease processes. Combined inspiratory and expiratory high resolution CT allows phenotyping of COPD (emphysema predominant, airway predominant, or mixed) and quantification of severity. Magnetic resonance imaging enables functional evaluation and demonstrates ventilation defects correlating closely with pulmonary function tests. Imaging techniques are also helpful in guiding the treatment, such as bullectomy in patients with bullous emphysema, lung volume reduction surgery or endoscopic interventions in those with severe emphysema, and smoking cessation and medical treatment designed to stop lung destruction in patients with mild or moderate emphysema or bronchiectasis.

Ectopic pancreas causing partial gastric outlet obstruction: a case ...

African Journals Online (AJOL)

Ectopic pancreas causing partial gastric outlet obstruction: a case report and review of literature. ... Nigerian Journal of Surgery ... Gastric outlet obstruction resulting from ectopic pancreas in an adult is the first of its kind in our center; we, therefore, present this case to describe the challenges faced with diagnosis, treatment, ...

Epidemiology of small-bowel obstruction beyond the neonatal period

African Journals Online (AJOL)

Background The aim of this study was to evaluate the etiologies causing intestinal obstruction beyond the neonatal period. Patients and methods An observational study was conducted on children between 1 month and 17 years of age who underwent surgery for small-bowel obstruction. (SBO) at this tertiary referral center ...

Ectopic Pancreas Causing Partial Gastric Outlet Obstruction: A Case ...

African Journals Online (AJOL)

Ectopic pancreas is a rare cause of gastric outlet obstruction, perhaps rarer still among Africans. Although the entity is known, the diagnostic challenges are enormous, especially in the poor‑resource environment. Gastric outlet obstruction resulting from ectopic pancreas in an adult is the first of its kind in our center;.

Differentiation between endobronchial tuberculosis and bronchogenic carcinoma associated with atelectasis or obstructive pneumonitis: CT evaluation

International Nuclear Information System (INIS)

Chung, Hwan Hoon; Oh, Yu Whan; Kim, Kyeong Ah; Kim, Jung Hyuk

1995-01-01

Endobronchial tuberculosis and bronchogenic cancer are common causes of atelectasis or obstructive pneumonitis in Korea. Differentiation between endobronchial tuberculosis and bronchogenic carcinoma is important for the treatment and prognosis but it is sometimes difficult to differentiate these two lesions with radiologic examinations. The purpose of this study was to find the differential points between endobronchial tuberculosis and bronchogenic carcinoma associated with atelectasis or obstructive pneumonitis. Forty patients in whom atelectasis or obstructive pneumonitis was detected on chest radiographs comprised the study. A definite mass opacity was not observed on chest radiographs in all patients. In these patients, the causes of obstruction were endobronchial tuberculosis (n = 20) and bronchogenic cancer (n = 20) which were microbiologically or pathologically confirmed. Double obstructive lesions were more frequently found in endobronchial tuberculosis (8/20) than in bronchogenic cancer (1/20). Multiple calcification along the bronchial wall and severe distortion of bronchi were observed only in endobronchial tuberculosis (4/20) and associated low density mass at obstruction site was only observed in bronchogenic cancer (6/20). Bronchial dilatation (11/20) and parenchymal calcifications (14/20) distal to obstruction site, air containing bronchogram at post obstructive bronchus (14/20) were more frequently found in endobronchial tuberculosis. Contour bulging at obstruction site (14/20), and only mucus bronchogram at post obstructive bronchus (14/20) were more frequently found in bronchogenic carcinoma. In patients with atelectasis or obstructive pneumonitis, endobronchial tuberculosis is characterized by double obstructive lesion, multiple calcifications at the bronchial wall, and severe distortion of the bronchi. Endobronchial carcinoma is characterized by a low density mass at the obstructive site

Pathophysiology of obstructive sleep apnea-hypopnea syndrome (OSAHS

Directory of Open Access Journals (Sweden)

Marco Venegas-Mariño

2017-08-01

Full Text Available Obstructive sleep apnea-hypopnea syndrome (OSAHS is a disease characterized by recurrent upper airway obstruction (UAO, with decreased airflow, intermittent hypoxemia, and awakening during sleep. Two essential factors are related to the pathophysiology of OSAHS: anatomical alterations and reduction or absence of neural control. While studying OSAHS, the site or sites of obstruction of the UA should be identified; they may extend from the nasal wings to the hypopharynx. Another important factor in this syndrome is the nervous influence on muscle tone of the hypopharynx, as well as the changes in blood pH, which are secondary to micro-arousals. Body position and sleep stage determine the severity. The pathophysiology of OSAHS should be understood to properly study a patient and provide the best treatment option.

Expiratory timing in obstructive sleep apnoeas.

Science.gov (United States)

Cibella, F; Marrone, O; Sanci, S; Bellia, V; Bonsignore, G

1990-03-01

Diaphragmatic electromyogram was recorded during NREM sleep in 4 patients affected by obstructive sleep apnoea (OSA) syndrome in order to evaluate the behaviour of expiratory time (TE) in the course of the obstructive apnoea-ventilation cycle. The two components of TE, i.e. time of post-inspiratory inspiratory activity (TPIIA) and time of expiratory phase 2 (TE2) were separately analysed. TPIIA showed a short duration, with only minor variations, within the apnoea, while its duration was more variable and longer in the interapnoeic periods: the longest TPIIA values were associated with the highest inspiratory volumes in the same breaths. This behaviour seemed regulated according to the need of a more or less effective expiratory flow braking, probably as a result of pulmonary stretch receptors discharge. Conversely TE2 showed a continuous gradual modulation, progressively increasing in the pre-apnoeic period, decreasing during the apnoea and increasing in the post-apnoeic period: these TE2 variations seemed related to oscillations in chemical drive. These data show that TE in the obstructive apnoea-ventilation cycle results from a different modulation in its two components and suggest that both mechanical and chemical influences play a role in its overall duration.

Intestinal obstruction in germ-free dogs.

Science.gov (United States)

Heneghan, J B; Robinson, J W; Menge, H; Winistörfer, B

1981-08-01

Mechanical occlusions were created in the intestines of four germ-free dogs. At the time of the operation, a control loop of mid-intestine was perfused in vivo and then excised for examinations in vitro, which included the determination of the equilibrium uptake of phenylalanine and of beta-methyl-glucoside, the influx kinetics of phenylalanine and morphometric analysis of the mucosa by microdissection and stereological techniques. Seven days after establishment of the occlusion the abdomen was reopened, and loops above and below the occlusion were perfused, and then excised for the same tests in vitro. Unlike occluded loops of conventional dogs, the intestine of the germ-free animal above the occlusion does not secrete water and electrolytes into the lumen. Its transport properties in vitro do not differ from those of the control loop, and the morphometric analyses reveal only slight changes in villus structure. The loop below the obstruction undergoes marked atrophy, as has been observed in conventional dogs. The results suggest that the copious secretion that occurs above an intestinal obstruction in normal animals is due to the presence of an abundant bacterial population in the obstruction fluid.

Airflow obstruction: is it asthma or is it COPD?

Directory of Open Access Journals (Sweden)

Rogliani P

2016-11-01

Full Text Available Paola Rogliani, Josuel Ora, Ermanno Puxeddu, Mario Cazzola Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy Abstract: Despite the availability of guideline recommendations, diagnostic confusion between COPD and asthma appears common, and often it is very difficult to decide whether the obstruction is caused by asthma or COPD in a patient with airway obstruction. However, there are well-defined features that help in differentiating asthma from COPD in the presence of fixed airflow obstruction. Nonetheless, the presentations of asthma and COPD can converge and mimic each other, making it difficult to give these patients a diagnosis of either condition. The association of asthma and COPD in the same patient has been designated mixed asthma–COPD phenotype or overlap syndrome. However, since the absence of a clear definition and the inclusion of patients with different characteristics under this umbrella term, it may not facilitate treatment decisions, especially in the absence of clinical trials addressing this heterogeneous population. We are realizing that neither asthma nor COPD are single diseases, but rather syndromes consisting of several endotypes and phenotypes, consequently comprising a spectrum of diseases that must be recognized and adequately treated with targeted therapy. Therefore, we must treat patients by personalizing therapy on the basis of those treatable traits present in each subject. Keywords: airway obstruction, asthma, ACOS, chronic obstructive pulmonary disease

Educational series in congenital heart disease:Congenital left-sided heart obstruction

OpenAIRE

Carr, Michelle; Curtis, Stephanie; Marek, Jan

2018-01-01

Congenital obstruction of the left ventricular outflow tract remains a significant problem and multilevel obstruction can often coexist. Obstruction can take several morphological forms and may involve the subvalvar, valvar or supravalvar portion of the aortic valve complex. Congenital valvar stenosis presenting in the neonatal period represents a spectrum of disorders ranging from the hypoplastic left heart syndrome to almost normal hearts. Treatment options vary dependent on the severity of...

Prognostic value of quantitative furosemide radionuclide renography in obstructive nephropathy

International Nuclear Information System (INIS)

Schuemichen, C.; Fischer, R.; Sierke, P.; Joseph, A.; Krause, T.

1988-01-01

Diuretic radionuclide renography is applied in patients with hydronephrosis in order to distinguish dilated, non-obstructed systems from those with significant mechanical obstruction. This is done after furosemide application by (semi) quantification of pelvic radioactivity outflow. In the dilated, non-obstructed pelvis, this outflow is increased, whereas in mechanical obstructed systems no response or even a decreased outflow is observed. It was expected that the latter outcome of the test is associated with an impaired renal function due to obstructive nephropathy. In the case that furosemide was given 30 min after 123 I hippuran application, this assumption could not be proved. When furosemide and 123 I hippuran were applied simultaneously, only a poor correlation was found between the response of pelvic outflow and the individual tubular clearance of the affected kidney. On the other hand, there was a clear correlation between the delay of pelvic outflow in the non-diuretic radionuclide renography and the individual tubular clearance. It can therefore be concluded that this test has little prognostic value and that other criteria in addition to the quantification of diuretic pelvic outflow are necessary for providing more reliable results. (orig.)

Chroniques (Chronicles).

Science.gov (United States)

Muller, Charles; And Others

1979-01-01

This section consists of six essays dealing with: (1) current trends in French linguistics; (2) French possessive pronouns; (3) contemporary French novelists; (4) "happiness" in France; (5) the Belgian playwright Michel Ghelderode; and (6) the pedagogical use of popular songs. (AM)

The interventional treatment with two stents in malignant hilar obstruction

International Nuclear Information System (INIS)

Gao Kun; Dai Dingke; Zhao Renyou; Qian Xiaojun

2006-01-01

Objective: To evaluate the methodology of interventional treatment with two stents in malignant hilar obstructions. Methods: Retrospectively analyzing the two stents, interventional management of unresectable malignant hilar obstruction in 22 patients included unilateral and bilateral puncture routes for placing 'T' shape stent set and 'Y' shape stent set, respectively; together with recording the related complications. Results: The overall technical success rate was 100%, without severe complication. The total serum bilirubin reduced from (337.9 + 81.7) μmol/L before procedure to (129.1 + 51.1) μmol/L after the stent placement. Stent obstruction was found in 8 cases at 6 months; 5 cases by the time of 6-12 months and only 2 cases after 1 year. Conclusion: The method of two stents interventional treatment is a safe and useful management for malignant hilar obstructions. (authors)

A multiparous woman with lately diagnosed multilevel left ventricular obstruction

International Nuclear Information System (INIS)

Rahman, M. N.; Gul, I.; Nabi, A.

2017-01-01

A 56-year hypertensive, multiparous woman presented to the cardiology unit with Canadian Cardiovascular Society (CCS) class-III angina and worsening dyspnea for the past few weeks. Her clinical examination showed high blood pressure and mid-systolic crescendo-decrescendo murmur radiating to carotids. However, there was no radio-femoral delay or significant blood pressure difference between her arms. Her transthoracic echocardiography (TTE) revealed moderate aortic stenosis (AS) and mid cavity left ventricular outflow (LVO) obstruction. Left heart catheterization (LHC) showed coarctation of aorta with extensive collaterals, mid cavity LVO obstruction, and moderate AS. Thus, she was diagnosed as a case of multi-level LVO obstruction including mid cavity LVO obstruction AS and coarctation of aorta. She underwent stenting of aortic coarctation as the initial step of graded approach to her disease, and is doing well. (author)

Chronic constipation causing obstructive nephropathy in a delayed toddler.

LENUS (Irish Health Repository)

Barrett, Michael Joseph

2012-01-01

Chronic constipation causing obstructive nephropathy is very rare in children. However, it can cause urinary tract obstruction with acute impairment of renal function with a need for emergent disimpaction. The authors discuss a 2 years 4 months old child who presented to our emergency department with acute renal failure due to faecal impaction.

Malignant biliary obstruction: percutaneous use of self-expandable stents

NARCIS (Netherlands)

Laméris, J. S.; Stoker, J.; Nijs, H. G.; Zonderland, H. M.; Terpstra, O. T.; van Blankenstein, M.; Schütte, H. E.

1991-01-01

A total of 83 self-expandable metallic stents were placed percutaneously in 69 patients for palliation of malignant biliary obstruction. Stent diameter was 1 cm; length, 3.5-10.5 cm. Of the 41 patients with common bile duct obstruction, 27 died 0.2-12 months (median, 3.2 months) after stent

Endotracheal tube connector defect causing airway obstruction in an ...

African Journals Online (AJOL)

detected during routine visual inspection before their use, while some go unnoticed during such inspection and can lead to partial or complete airway obstruction in intubated patients. We report one case of partial airway obstruction resulting from manufacturing defect in the ET connector. A 3-month-old infant girl weighing 5 ...

Requirements for accurately diagnosing chronic partial upper urinary tract obstruction in children with hydronephrosis

International Nuclear Information System (INIS)

Koff, Stephen A.

2008-01-01

Successful management of hydronephrosis in the newborn requires early accurate diagnosis to identify or exclude ureteropelvic junction obstruction. However, the presence of hydronephrosis does not define obstruction and displays unique behavior in the newborn. The hydronephrotic kidney usually has nearly normal differential renal function at birth, has not been subjected to progressive dilation and except for pelvocaliectasis does not often show signs of high-grade obstruction. Furthermore, severe hydronephrosis resolves spontaneously in more than 65% of newborns with differential renal function stable or improving. The diagnosis of obstruction in newborn hydronephrosis is challenging because the currently available diagnostic tests, ultrasonography and diuretic renography have demonstrated inaccuracy in diagnosing obstruction and predicting which hydronephrotic kidney will undergo deterioration if untreated. Accurate diagnosis of obstruction is possible but it requires an understanding of the uniqueness of both the pathophysiology of obstruction and the biology of the kidney and renal collecting system in this age group. We examine here the requirements for making an accurate diagnosis of obstruction in the young child with hydronephrosis. (orig.)

Requirements for accurately diagnosing chronic partial upper urinary tract obstruction in children with hydronephrosis

Energy Technology Data Exchange (ETDEWEB)

Koff, Stephen A. [Ohio State University College of Medicine, Section of Pediatric Urology, Columbus Children' s Hospital, Columbus, OH (United States)

2008-01-15

Successful management of hydronephrosis in the newborn requires early accurate diagnosis to identify or exclude ureteropelvic junction obstruction. However, the presence of hydronephrosis does not define obstruction and displays unique behavior in the newborn. The hydronephrotic kidney usually has nearly normal differential renal function at birth, has not been subjected to progressive dilation and except for pelvocaliectasis does not often show signs of high-grade obstruction. Furthermore, severe hydronephrosis resolves spontaneously in more than 65% of newborns with differential renal function stable or improving. The diagnosis of obstruction in newborn hydronephrosis is challenging because the currently available diagnostic tests, ultrasonography and diuretic renography have demonstrated inaccuracy in diagnosing obstruction and predicting which hydronephrotic kidney will undergo deterioration if untreated. Accurate diagnosis of obstruction is possible but it requires an understanding of the uniqueness of both the pathophysiology of obstruction and the biology of the kidney and renal collecting system in this age group. We examine here the requirements for making an accurate diagnosis of obstruction in the young child with hydronephrosis. (orig.)

Hormonal treatment of obstructed kidneys in patients with prostatic cancer

DEFF Research Database (Denmark)

Honnens de Lichtenberg, M; Miskowiak, J; Rolff, H

1993-01-01

A review of 1288 patients with previously untreated prostatic cancer revealed 209 patients (16%) with ureteric obstruction; the obstruction was bilateral in 36%. The effect of hormonal treatment was assessed in 88 patients with 120 obstructed kidneys: 77 patients had androgen deprivation...... or hormonal medication alone and 11 patients needed percutaneous nephrostomy or ureteric catheters in addition. Drainage improved in 58% of the kidneys. The diverting catheter was withdrawn in 9 of the 11 patients after a median of 4 weeks. In all, 95% of patients were discharged. The patients with hormonal...

Volvulus as a complication of chronic intestinal pseudo-obstruction syndrome

NARCIS (Netherlands)

C.T. de Betue (Carlijn); D. Boersma (Doeke); M.W. Oomen (Matthijs W.); M.A. Benninga (Marc); J.R. de Jong (Justin)

2011-01-01

textabstractChronic intestinal pseudo-obstruction syndrome (CIPS) is a severe motility disorder of the gastrointestinal tract that presents with continuous or recurrent symptoms and signs of intestinal obstruction without evidence of a structural lesion occluding the intestinal lumen. Mechanical

Pulmonary artery hypertension in chronic obstructive lung disease

International Nuclear Information System (INIS)

Dinkel, E.; Mundinger, A.; Reinbold, W.D.; Wuertemberger, G.

1989-01-01

Standard biplane chest X-rays were tested for the validity of morphometric criteria in the diagnosis of pulmonary artery hypertension. Twenty-seven patients suffering from chronic obstructive lung disease were examined and compared with a control group without cardiopulmonary disease. The diameter of the right and left pulmonary artery, pulmonary conus and the hilar-to-thoracic ratio were significantly increased in patients with chronic obstructive lung disease (p [de

Bolus obstruction by Ascaris lumbricoides

African Journals Online (AJOL)

In 67 cases conservative treatment was successful. ... bolus of worms, biliary ascariasis,3.6 pancreatitis and acute ... or chronic granulomatous peritonitis is rare.i These complica- ... obstruction admitted to the paediatric surgical wards of the.

Collagen levels are normalized after decompression of experimentally obstructed colon

DEFF Research Database (Denmark)

Rehn, Martin; Ågren, Sven Per Magnus; Syk, I

2011-01-01

Our aim was to define the dynamics in collagen concentrations in the large bowel wall following decompression of experimental obstruction.......Our aim was to define the dynamics in collagen concentrations in the large bowel wall following decompression of experimental obstruction....

Prenatal MRI Findings of Fetuses with Congenital High Airway Obstruction Sequence

Energy Technology Data Exchange (ETDEWEB)

Guimaraes, Carolina V. A.; Linam, Leann E.; Kline-Fath, Beth M. [Cincinnati Children' s Hospital Medical Center, Cincinnati (United States)] (and others)

2009-04-15

To define the MRI findings of congenital high airway obstruction sequence (CHAOS) in a series of fetuses. Prenatal fetal MR images were reviewed in seven fetuses with CHAOS at 21 to 27 weeks of gestation. The MRI findings were reviewed. The MRI parameters evaluated included the appearance of the lungs and diaphragm, presence or absence of hydrops, amount of amniotic fluid, airway appearance, predicted level of airway obstruction, and any additional findings or suspected genetic syndromes. All the fetuses viewed (7 of 7) demonstrated the following MRI findings: dilated airway below the level of obstruction, increased lung signal, markedly increased lung volumes with flattened or inverted hemidiaphragms, massive ascites, centrally positioned and compressed heart, as well as placentomegaly. Other frequent findings were anasarca (6 of 7) and polyhydramnios (3 of 7). MRI identified the level of obstruction as laryngeal in five cases and tracheal in two cases. In four of the patients, surgery or autopsy confirmed the MRI predicted level of obstruction. Associated abnormalities were found in 4 of 7 (genetic syndromes in 2). Postnatal radiography (n = 3) showed markedly hyperinflated lungs with inverted or flattened hemidiaphragms, strandy perihilar opacities, pneumothoraces and tracheotomy. Two fetuses were terminated and one fetus demised in utero. Four fetuses were delivered via ex utero intrapartum treatment procedure. MRI shows a consistent pattern of abnormalities in fetuses with CHAOS, accurately identifies the level of airway obstruction, and helps differentiate from other lung abnormalities such as bilateral congenital pulmonary airway malformation by demonstrating an abnormally dilated airway distal to the obstruction.

Pancreatic Calculus Causing Biliary Obstruction: Endoscopic Therapy for a Rare Initial Presentation of Chronic Pancreatitis.

Science.gov (United States)

Shetty, Anurag J; Pai, C Ganesh; Shetty, Shiran; Balaraju, Girisha

2015-09-01

Biliary obstruction in chronic calcific pancreatitis (CCP) is often caused by inflammatory or fibrotic strictures of the bile duct, carcinoma of head of pancreas or less commonly by compression from pseudocysts. Pancreatic calculi causing ampullary obstruction and leading to obstructive jaundice is extremely rare. The medical records of all patients with CCP or biliary obstruction who underwent endoscopic retrograde cholangiopancreatography (ERCP) over 4 years between 2010-2014 at Kasturba Medical College, Manipal were analyzed. Five patients of CCP with impacted pancreatic calculi at the ampulla demonstrated during ERCP were identified. All 5 presented with biliary obstruction and were incidentally detected to have CCP when evaluated for the same; 3 patients had features of cholangitis. All the patients were managed successfully by endoscopic papillotomy and extraction of pancreatic calculi from the ampulla with resolution of biliary obstruction. Pancreatic calculus causing ampullary obstruction, though very rare, should be considered as a possibility in patients with CCP complicated by biliary obstruction. Endoscopic therapy is affective in the resolution of biliary obstruction in such patients.

Radiologic evaluation of intestinal obstruction in the neonates

Energy Technology Data Exchange (ETDEWEB)

Kim, Jin Hee; Kim, Dong Woo; Lee, Eun Suk; Kwon, Sun Young [Eul Ji General Hospital, Daejeon (Korea, Republic of); Lee, Sang Young [Chonbuk National University College of Medicine, Jeonju (Korea, Republic of); Kang, Hye Jeong [Eul Ji General Hospital, Seoul (Korea, Republic of)

1995-10-15

The purpose of this study is to evaluate the radiologic findings of the intestinal obstruction in the neonate according to the causes and to determine the findings useful for the differential diagnosis. The materials consisted of 29 neonates with surgically proven gastrointestinal tract obstruction. We analyzed simple abdominal radiography and barium study comparing with the operative findings. The causes of intestinal obstruction were gastric atresia in 1 case, duodenal atresia in 3 cases, small bowel atresia in 11 cases (jejunal; 3 cases, ileal; 8 cases), colonic atresia in 2 cases, Hirschsprung's disease in 9 cases, ano-rectal anomaly in 6 cases, midgut volvulus in 2 cases, and Meckel's diverticulum in 1 case. Vomiting was noted in the all cases. The abdominal distension was not noted in the cases of gastric atresia, duodenal atresia, and proximal jejunal atresia. The meconium passage was noted in 2 cases of ileal atresia and 3 cases of Hirschsprung's disease. On barium study, site of obstruction was predicted accurately in gastric atresia, duodenal atresia, proximal jejunal atresia, and colonic atresia but it was not possible in distal jejunal atresia and ileal atresia. The microcolon was noted in 2 cases of jejunal atresia, 4 cases of ileal atresia, and 2 cases of colonic atresia. Out of 9 Hirschsprung's disease transition zones were seen on rectum or rectosigmoid junction in 7 cases and barium study was normal in 2 cases. In the diagnosis of neonatal intestinal obstruction, the basic radiologic studies such as simple abdominal radiography and gastrointestinal contrast study was useful for the differential diagnosis of the proximal bowel loop atresia colonic atresia, and midgut volvulus.

Radiologic evaluation of intestinal obstruction in the neonates

International Nuclear Information System (INIS)

Kim, Jin Hee; Kim, Dong Woo; Lee, Eun Suk; Kwon, Sun Young; Lee, Sang Young; Kang, Hye Jeong

1995-01-01

The purpose of this study is to evaluate the radiologic findings of the intestinal obstruction in the neonate according to the causes and to determine the findings useful for the differential diagnosis. The materials consisted of 29 neonates with surgically proven gastrointestinal tract obstruction. We analyzed simple abdominal radiography and barium study comparing with the operative findings. The causes of intestinal obstruction were gastric atresia in 1 case, duodenal atresia in 3 cases, small bowel atresia in 11 cases (jejunal; 3 cases, ileal; 8 cases), colonic atresia in 2 cases, Hirschsprung's disease in 9 cases, ano-rectal anomaly in 6 cases, midgut volvulus in 2 cases, and Meckel's diverticulum in 1 case. Vomiting was noted in the all cases. The abdominal distension was not noted in the cases of gastric atresia, duodenal atresia, and proximal jejunal atresia. The meconium passage was noted in 2 cases of ileal atresia and 3 cases of Hirschsprung's disease. On barium study, site of obstruction was predicted accurately in gastric atresia, duodenal atresia, proximal jejunal atresia, and colonic atresia but it was not possible in distal jejunal atresia and ileal atresia. The microcolon was noted in 2 cases of jejunal atresia, 4 cases of ileal atresia, and 2 cases of colonic atresia. Out of 9 Hirschsprung's disease transition zones were seen on rectum or rectosigmoid junction in 7 cases and barium study was normal in 2 cases. In the diagnosis of neonatal intestinal obstruction, the basic radiologic studies such as simple abdominal radiography and gastrointestinal contrast study was useful for the differential diagnosis of the proximal bowel loop atresia colonic atresia, and midgut volvulus

COMPARISON OF COMPUTED TOMOGRAPHY AND ABDOMINAL RADIOGRAPHY FOR DETECTION OF CANINE MECHANICAL INTESTINAL OBSTRUCTION.

Science.gov (United States)

Drost, Wm Tod; Green, Eric M; Zekas, Lisa J; Aarnes, Turi K; Su, Lillian; Habing, Gregory G

2016-07-01

Vomiting, often caused by mechanical intestinal obstruction, is common in dogs. Equivocal radiographic signs often necessitate repeat radiographs or additional imaging procedures. For our prospective, case-controlled, accuracy study, we hypothesized the following: (1) using computed tomography (CT), radiologists will be more sensitive and specific for detecting mechanical intestinal obstruction and recommending surgery compared to using radiographs; and (2) using measurements, radiologists will be more sensitive and specific using radiographs or CT for detecting mechanical intestinal obstruction and recommending surgery. Twenty dogs had abdominal radiographs and abdominal CT. Seventeen dogs had abdominal surgery and three dogs were not obstructed based on clinical follow-up. Confidence levels (five-point scale) of three experienced radiologists for mechanical intestinal obstruction and recommending surgery were recorded before and after making selected measurements. Eight dogs had surgically confirmed mechanical intestinal obstruction, and 12 dogs did not have obstruction. For detecting mechanical intestinal obstruction, CT was more sensitive (95.8% vs. 79.2%) and specific (80.6% vs. 69.4%) compared to radiographs, but the difference was not statistically significant. For recommending surgery, radiography was more sensitive (91.7% vs. 83.3%) and specific (83.3% vs. 72.2%) than using CT, but differences were not statistically significant. We reported objective CT measurements for predicting small mechanical intestinal obstruction. By incorporating these objective data, the diagnosis of mechanical intestinal obstruction changed in five of 120 instances (radiographs and CT). In no instance (0/120), did the objective data change the recommendation for surgery. Using CT or abdominal radiographs for the detection of canine mechanical intestinal obstruction is sensitive and specific when evaluated by experienced veterinary radiologists. © 2016 American College of

Value of the biological data in the sonographic diagnosis of neoplastic biliary obstruction

Energy Technology Data Exchange (ETDEWEB)

Ferrari, F; Fagioli Zucchi, A; Rappuoli, G; Guercia, M; Terrosi Vagnoli, P

1988-01-01

The authors' purpose is to demonstrate the possibility of improving US reliability in the diagnosis of neoplastic obstructions of the bile ducts, basing their study on the hematic alkaline phosphates level (AP), wich is an earlier sign of obstruction than bilirubine values. All 368 patients observed had AP levels above the threshold of 270 IU/l. The 34 patients with neoplastic obstruction (including 13 without jaundice) had more than twice the normal level of AP, and presented with at least one dilated bile duct in the biliary tree. Coronal scans of the main bile duct are fundamental in the diagnosis of the level of obstruction. It seems thus possible to affirm that US diagnosis of the biliary obstruction, together with high AP values (more than twice the normal), provides with reliable information as to the neoplastic nature of the biliary obstruction, even if jaundice is not present.

Value of the biological data in the sonographic diagnosis of neoplastic biliary obstruction

International Nuclear Information System (INIS)

Ferrari, F.; Fagioli Zucchi, A.; Rappuoli, G.; Guercia, M.; Terrosi Vagnoli, P.

1988-01-01

The authors' purpose is to demonstrate the possibility of improving US reliability in the diagnosis of neoplastic obstructions of the bile ducts, basing their study on the hematic alkaline phosphates level (AP), wich is an earlier sign of obstruction than bilirubine values. All 368 patients observed had AP levels above the threshold of 270 IU/l. The 34 patients with neoplastic obstruction (including 13 without jaundice) had more than twice the normal level of AP, and presented with at least one dilated bile duct in the biliary tree. Coronal scans of the main bile duct are fundamental in the diagnosis of the level of obstruction. It seems thus possible to affirm that US diagnosis of the biliary obstruction, together with high AP values (more than twice the normal), provides with reliable information as to the neoplastic nature of the biliary obstruction, even if jaundice is not present

Chronic idiopathic intestinal pseudo-obstruction in an English bulldog.

Science.gov (United States)

Dvir, E; Leisewitz, A L; Van der Lugt, J J

2001-05-01

A case of chronic idiopathic intestinal pseudo-obstruction in an English bulldog is described. The dog was presented with chronic weight loss and vomiting. An intestinal obstruction was suspected based on clinical and radiological findings. A diagnosis of chronic idiopathic intestinal pseudo-obstruction was made on the basis of full thickness intestinal biopsies. The dog was refractory to any antiemetic therapy. Necropsy revealed marked atrophy and fibrosis of the tunica muscularis, together with a mononuclear cell infiltrate extending from the duodenum to the colon. This case was presented with clinical findings consistent with visceral myopathy in humans--namely, atony and dilatation of the whole gut--but the histological findings resembled sclerosis limited to the gastrointestinal tract.

Does night-shift work induce apnea events in obstructive sleep apnea patients?

Science.gov (United States)

Laudencka, A; Klawe, J J; Tafil-Klawe, M; Złomańczuk, P

2007-11-01

The aim of the present study was to determine the direct effect of night-work on the occurrence of obstructive apneas during sleep after a night shift in fast-rotating shift workers with sleep-related breathing disorders. Eight obstructive sleep apnea patients were examined with the use of a polysomnograph during sleep under two conditions: after day-shift work and after night-shift work. Both sleep studies were conducted within 2 to 3 weeks of each other. In four of the 8 subjects, during sleep after a night-shift, an increase in apnea/hypopnea index was found. Night work significantly increased several breathing variables: total duration of obstructive apneas during REM sleep, mean duration of obstructive apneas during arousal, and apnea index during arousal. We conclude that in a subpopulation of sleep apnea patients, acute sleep deprivation may worsen obstructive sleep apnea index.

Results of radiotherapy on ureteric obstruction in muscle-invasive bladder cancer

DEFF Research Database (Denmark)

Honnens De Lichtenberg, Mette; Miskowiak, J; Rolff, H

1995-01-01

To evaluate the effect of radiotherapy on ureteric obstruction due to muscle-invasive bladder cancer.......To evaluate the effect of radiotherapy on ureteric obstruction due to muscle-invasive bladder cancer....

Non-traumatic abdominal emergencies: imaging of acute intestinal obstruction

Energy Technology Data Exchange (ETDEWEB)

Taourel, P.; Kessler, N.; Lesnik, A.; Blayac, P.M.; Morcos, L. [Departement d' Imagerie Medicale, Hopital Lapeyronie, 371, avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5 (France); Bruel, J.M. [Departement d' Imagerie Medicale, Hopital Saint-Eloi, 80 rue Augustin Fliche, 34295 Montpellier Cedex 5 (France)

2002-09-01

The purpose of this paper is to give an overview of the main clinical questions in bowel obstruction, to discuss the value of various imaging modalities, including conventional radiography, ultrasound, and CT, to underline the impact of imaging in the management of patients with suspect bowel obstruction, and then to suggest a diagnostic triage in such patients. (orig.)

C reactive protein and chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Dahl, Morten; Vestbo, Jørgen; Zacho, Jeppe

2011-01-01

It is unclear whether elevated plasma C reactive protein (CRP) is causally related to chronic obstructive pulmonary disease (COPD). The authors tested the hypothesis that genetically elevated plasma CRP causes COPD using a Mendelian randomisation design.......It is unclear whether elevated plasma C reactive protein (CRP) is causally related to chronic obstructive pulmonary disease (COPD). The authors tested the hypothesis that genetically elevated plasma CRP causes COPD using a Mendelian randomisation design....

Correlation between hepatobiliary scintigraphy and surgery or postmortem examination findings in dogs and cats with extrahepatic biliary obstruction, partial obstruction, or patency of the biliary system: 18 cases (1995-2004).

Science.gov (United States)

Head, Laurie L; Daniel, Gregory B

2005-11-15

To evaluate the usefulness of serum biochemical variables and scintigraphic study results for differentiating between dogs and cats with complete extrahepatic biliary obstruction (EHO) and those with partial EHO or patent bile ducts. Retrospective case series. 17 dogs and 1 cat. Animals that underwent hepatobiliary scintigraphy and had either surgical or postmortem confirmation of the degree of bile duct patency were included. Scintigraphic images were evaluated and biliary tracts were classified as patent, partially obstructed but patent, or obstructed. Surgery or postmortem examination was considered the gold standard for diagnosis, and compared with those findings, sensitivity and specificity of scintigraphy were calculated. With absence of radioactivity in the intestinal tract as the diagnostic criterion for EHO, the sensitivity and specificity of scintigraphic diagnosis were both 83% when final images were acquired at 19 to 24 hours, compared with 100% and 33%, respectively, when 180 minutes was used as the cutoff time. Animals with partial biliary obstruction had less intestinal radioactivity that arrived later than that observed in animals with patent biliary tracts. Animals in which intestinal radioactivity has not been observed after the standard 3 to 4 hours should undergo additional scintigraphic imaging. Findings in animals with partial biliary obstruction include delayed arrival of radioactivity and less radioactivity in the intestine. Distinguishing between complete and partial biliary tract obstruction is important because animals with partial obstruction may respond favorably to medical management and should not be given an erroneous diagnosis of complete obstruction.

Differential diagnosis of mechanical bowel obstruction and paralytic ileus on CT features

International Nuclear Information System (INIS)

Jeon, Yong Sun; Kim, Mi Young; Suh, Chang Hae; Chung, Won Kyun; Kim, Kyung Rae; Kim, Kyung Kook; Shin, Yong Woon

1997-01-01

To evaluate CT findings for the differential diagnosis of mechanical bowel obstruction and paralytic ileus. Without information relating to clinical or operative findings, we retrospectively analyzed the CT scans of 24 patients with mechanical bowel obstruction and 19 patients with paralytic ileus. Final diagnosis was confirmed by operation (n=26), or by clinical symptoms, radiologic findings and follow-up study CT findings were obtained:1) the diameter of the most dilated part of the small bowel, and the thickness and enhancing pattern of the dilated small bowel wall;2) the diameter of the most dilated part of the descending colon and the ratio of the diameter of the small bowel to that of the descending colon;3) the number of transitional zones, length and thickness and 4) associated ascites and its location. The mean diameters of the most dilated part of the small bowel in mechanical bowel obstruction and paralytic ileus were 3.6cm and 2.9cm, respectively. The diameter of the small bowel in mechanical bowel obstruction was significantly greater than in paralytic ileus(p<.05). The mean thickness of dilated small bowel wall was 4.0mm in mechanical bowel obstruction and 2.4mm in paralytic ileus, and target-like enhancement was prominent in mechanical bowel obstruction(46%)(p<.05). The mean diameter of the most dilated part of the descending colon was not significantly different to that of the most dilated part of the small bowel, but the ratio of the diameter of the small bowel to that of the colon was 2.9 in mechanical bowel obstruction and 1.9 in paralytic ileus, respectively, which was statistically significant(p<.05). A transitional zone was seen in 23 cases(96%) of mechanical bowel obstruction and in nine (47%) of paralytic ileus. In mechanical bowel obstruction, mean transitional zone length was 2cm, shorter than that of paralytic ileus(3.4cm)(p<.05) The thickness of transitional zone and the presence of ascites and its locations were not significantly

Interventional Radiological Management of Prehepatic Obstruction the Splanchnic Venous System

International Nuclear Information System (INIS)

Semiz-Oysu, Aslihan; Keussen, Inger; Cwikiel, Wojciech

2007-01-01

Purpose. The purpose of this study was to retrospectively evaluate interventional radiological management of patients with symptomatic portal hypertension secondary to obstruction of splanchnic veins. Material and Methods. Twenty-four patients, 15 males and 9 females, 0.75 to 79 years old (mean, 36.4 years), with symptomatic portal hypertension, secondary to splanchnic venous obstruction, were treated by percutaneous methods. Causes and extent of splanchnic venous obstruction and methods are summarized following a retrospective evaluation. Results. Obstructions were localized to the main portal vein (n = 22), intrahepatic portal veins (n = 8), splenic vein (n = 4), and/or mesenteric veins (n = 4). Interventional treatment of 22 (92%) patients included recanalization (n = 19), pharmacological thrombolysis (n = 1), and mechanical thrombectomy (n = 5). Partial embolization of the spleen was done in five patients, in two of them as the only possible treatment. TIPS placement was necessary in 10 patients, while an existing occluded TIPS was revised in two patients. Transhepatic embolization of varices was performed in one patient, and transfemoral embolization of splenorenal shunt was performed in another. Thirty-day mortality was 13.6% (n=3). During the follow-up, ranging between 2 days and 58 months, revision was necessary in five patients. An immediate improvement of presenting symptoms was achieved in 20 patients (83%). Conclusion. We conclude that interventional procedures can be successfully performed in the majority of patients with obstruction of splanchnic veins, with subsequent improvement of symptoms. Treatment should be customized according to the site and nature of obstruction

Quantitative estimation of intestinal dilation as a predictor of obstruction in the dog.

Science.gov (United States)

Graham, J P; Lord, P F; Harrison, J M

1998-11-01

Mechanical obstruction is a major differential diagnosis for dogs presented with gastrointestinal problems. Small intestinal dilation is a cardinal sign of obstruction but its recognition depends upon the observer's experience and anecdotally derived parameters for normal small intestinal diameter. The objective of this study was to formulate a quantitative index for normal intestinal diameter and evaluate its usefulness in predicting small intestinal obstruction. The material consisted of survey abdominal radiographs of 50 normal dogs, 44 cases of intestinal obstruction and 86 patients which subsequently had an upper gastrointestinal examination. A ratio of the maximum small intestinal diameter (SI) and the height of the body of the fifth lumbar vertebra at its narrowest point (L5) was used, and a logistic regression model employed to determine the probability of an obstruction existing with varying degrees of intestinal dilation. A value of 1.6 for SI/L5 is recommended as the upper limit of normal intestinal diameter for clinical use. The model showed that obstruction is very unlikely if the SI/L5 value is less than this. Higher values were significantly associated with obstruction.

Quantitative estimation of intestinal dilation as a predictor of obstruction in the dog

International Nuclear Information System (INIS)

Graham, J.P.; Lord, P.F.; Harrison, J.M.

1998-01-01

Mechanical obstruction is a major differential diagnosis for dogs presented with gastrointestinal problems. Small intestinal dilation is a cardinal sign of obstruction but its recognition depends upon the observer's experience and anecdotally derived parameters for normal small intestinal diameter. The objective of this study was to formulate a quantitative index for normal intestinal diameter and evaluate its usefulness in predicting small intestinal obstruction. The material consisted of survey abdominal radiographs of 50 normal dogs, 44 cases of intestinal obstruction and 86 patients which subsequently had an upper gastrointestinal examination. A ratio of the maximum small intestinal diameter (SI) and the height of the body of the fifth lumbar vertebra at its narrowest point (L5) was used, and a logistic regression model employed to determine the probability of an obstruction existing with varying degrees of intestinal dilation. A value of 1.6 for SI/L5 is recommended as the upper limit of normal intestinal diameter for clinical use. The model showed that obstruction is very unlikely if the SI/L5 value is less than this. Higher values were significantly associated with obstruction

Spirometry utilisation among Danish adults initiating medication targeting obstructive lung disease.

Science.gov (United States)

Koefoed, Mette Marie

2015-02-01

This PhD thesis was written during my employment at the Research Unit of General Practice in Odense, University of Southern Denmark. It comprises an overview and three papers, all published or submitted for publication in international peer-reviewed scientific journals.   Non-infectious dyspnoea, chronic cough and wheezing are common symptoms in the population. Patients often present with these symptoms in general practice and have a high probability of having obstructive lung diseases. However, there is an indication that the majority of these patients are treated empirically with pharmacotherapy targeting obstructive lung disease and only few have additional tests conducted, although the predictive value of respiratory symptoms for diagnosing obstructive lung disease has proven to be low. Spirometry is recommended as the gold standard for confirming obstructive lung disease, and testing can also rule out airway obstruction in patients with respiratory symptoms caused by other illnesses, such as heart failure or lung cancer. Initiating medication for obstructive lung disease without spirometry entails the risk of these patients experiencing unnecessary delay in the diagnostic process and being exposed to unnecessary economic costs and medication risks. The literature has indicated that many users of medication targeting obstructive lung medication have not had spirometry performed and do not actually have obstructive lung disease. This potential quality gap needs to be assessed. Also, in order to target interventions enhancing earlier spirometry utilisation among patients initiating medication targeting obstructive lung disease, improved knowledge on patient and practice factors associated with spirometry testing is needed.   Among first time users of obstructive lung medication we aimed: - To assess to what extent spirometry was performed within the first year of medication use (Study I) - To assess if patient characteristics like socioeconomic and demographic

Non-emergency small bowel obstruction: assessment of CT findings that predict need for surgery

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Deshmukh, Swati D.; Shin, David S.; Willmann, Juergen K.; Rosenberg, Jarrett; Shin, Lewis; Jeffrey, R.B. [Stanford University, School of Medicine, Department of Radiology, Stanford, CA (United States)

2011-05-15

To identify CT findings predictive of surgical management in non-emergency small bowel obstruction (SBO). Contrast-enhanced abdominal CT of 129 patients with non-emergency SBO were evaluated for small bowel luminal diameter, wall thickness, presence of the small bowel faeces sign (intraluminal particulate matter in a dilated small bowel) and length, transition point, submucosal oedema, mesenteric stranding, ascites and degree of obstruction (low grade partial, high grade partial and complete obstruction). Medical records were reviewed for age, gender, management and history of abdominal surgery, abdominal malignancy, or SBO. Statistical analyses were performed with Stata Release 9.2. Degree of obstruction was the only predictor of need for surgery. Whereas 18.0% of patients with low-grade partial obstruction (n = 50) underwent surgery, 32.5% of patients with high-grade partial obstruction (n = 77) and 100% of patients with complete obstruction (n = 2) required surgery (P = 0.004). The small bowel faeces sign was inversely predictive of surgery (P = 0.018). In non-emergency SBO patients with contrast-enhanced CT imaging, grade of obstruction predicts surgery, while the small bowel faeces sign inversely predicts need for surgery. (orig.)

Secondary obstructive jaundice to pancreatic calculus impacted in the papilla

International Nuclear Information System (INIS)

Rafael Angel, Luis M. Limas; Lazaro Arango

2004-01-01

Bile duct stones obstructing the papilla are a quite common finding. On the other hand a pancreatic stone obstructing the papilla is quite rare. There are few reports of this complication of chronic pancreatitis in the literature. Here we inform of another unique case

Prognostic value of weight change in chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Prescott, E; Almdal, T; Mikkelsen, K L

2002-01-01

An association between low body mass index (BMI) and poor prognosis in patients with chronic obstructive pulmonary disease (COPD) has been found in a number of studies. The prevalence and prognostic importance of weight change in unselected subjects with COPD was examined. Subjects with COPD...... change: in the normal-to-underweight (BMI or = 25), best survival was seen in stable weight. A high proportion of subjects with chronic obstructive pulmonary disease experienced a significant weight loss......, which was associated with increased mortality. The results support further intervention studies that aim at avoiding weight loss in normal-to-underweight chronic obstructive pulmonary disease patients....

Diagnostic value of high strength MRCP in the obstructive jaundice

International Nuclear Information System (INIS)

Yang Yang; Dong Yuhai; Yin Jie; Lv Guoyi

2007-01-01

Objective: To evaluate the diagnostic value of high strength MRCP in patients with obstructive jaundice. Methods: Routine MRI and MRCP examination on 161 patients with obstructive jaundice were carded out with 1.5T Siemens super-conductive magnetic resonance machine. Of them, 103 cases were benign lesions and 58 were malignant after surgical and ERCP pathological confirmation. Results: The diagnostic accuracy of MRCP was 100%, with the qualitative diagnostic accuracy at 90.2%. Conclusion: MRCP was the best method in diagnosing patients with obstructive jaundice, the concerned performances of MRCP could provide the dependable basis for surgical operation project. (authors)

T-configured Dual Stent Placement in Malignant Biliary Hilar Obstruction: Technique and Clinical Application

International Nuclear Information System (INIS)

Jeon, Yong Sik; Kim, Ji Hyung

2010-01-01

To evaluate implanting techniques of T-configured dual stents in malignant hilar obstruction and investigate the clinical factors related to stent obstruction. The study included 28 patients undergoing T-configured dual stent implantation to palliate malignant biliary hilar obstruction. The unilobar approach was first attempted in the procedure, which progressed to bilobar approach when it was found that the unilobar approach was not feasible. If the stent was again obstructed, clinical palliation was attempted using stent re-insertion or PTBD. Clinical factors associated with T-configured dual stenting were examined in the patients with stent re-obstruction, which was followed by a correlation between these clinical factors and stent obstruction. Eleven of 13 patients were successfully treated by the unilobar approach. The two unsuccessful cases sustained angulation of the central large mesh stent. For the bilobar approach, 14 of 15 patients were successfully treated. For the one unsuccessful patient, the stent failed to pass through the central large mesh. Stent obstruction was revealed in 13 patients during the follow-up period. Balloon-assisted stent re-canalization was successfully performed in 5 patients. The analysis suggests that no definite correlation was found between stent obstruction and the clinical factors associated with dual stent placement. Conversely, bile containing sludge or debris was significantly correlated to early stent obstruction. Technical adoption considering the bile duct anatomy and obstruction pattern is important for T-configured dual stent implantation. The prudent evaluation of bile juice characters and cholangiographic findings is required for the appropriate clinical application of the T-configured dual stenting

Comparison of radiography and ultrasonography for diagnosing small-intestinal mechanical obstruction in vomiting dogs.

Science.gov (United States)

Sharma, Ajay; Thompson, Margret S; Scrivani, Peter V; Dykes, Nathan L; Yeager, Amy E; Freer, Sean R; Erb, Hollis N

2011-01-01

A cross-sectional study was performed on acutely vomiting dogs to compare the accuracy of radiography and ultrasonography for the diagnosis of small-intestinal mechanical obstruction and to describe several radiographic and ultrasonographic signs to identify their contribution to the final diagnosis. The sample population consisted of 82 adult dogs and small-intestinal obstruction by foreign body was confirmed in 27/82 (33%) dogs by surgery or necropsy. Radiography produced a definitive result (obstructed or not obstructed) in 58/82 (70%) of dogs; ultrasonography produced a definitive result in 80/82 (97%) of dogs. On radiographs, a diagnosis of obstruction was based on detection of segmental small-intestinal dilatation, plication, or detection of a foreign body. Approximately 30% (8/27) of obstructed dogs did not have radiographic signs of segmental small-intestinal dilatation, of which 50% (4/8) were due to linear foreign bodies. The ultrasonographic diagnosis of small-intestinal obstruction was based on detection of an obstructive lesion, sonographic signs of plication or segmental, small-intestinal dilatation. The ultrasonographic presence or absence of moderate-to-severe intestinal diameter enlargement (due to lumen dilatation) of the jejunum (>1.5 cm) was a useful discriminatory finding and, when present, should prompt a thorough search for a cause of small-intestinal obstruction. In conclusion, both abdominal radiography and abdominal ultrasonography are accurate for diagnosing small-intestinal obstruction in vomiting dogs and either may be used depending on availability and examiner choice. Abdominal ultrasonography had greater accuracy, fewer equivocal results and provided greater diagnostic confidence compared with radiography. © 2010 Veterinary Radiology & Ultrasound.

Assessment of airway lesion in obstructive lung diseases by CT

International Nuclear Information System (INIS)

Niimi, Akio; Matsumoto, Hisako; Ueda, Tetsuya; Mishima, Michiaki

2002-01-01

Airway lesion in obstructive pulmonary diseases, such as asthma or chronic obstructive pulmonary disease (COPD), has recently been assessed quantitatively. Especially in asthma, wall thickening of central airways, and its relation to the severity of disease or airflow obstruction has been clarified. Pathophysiologic importance of peripheral airway lesion has also been highlighted by pathologic or physiologic studies. However, direct evaluation of peripheral airway lesion is beyond resolutional limitation of CT. To assess airway trapping, an indirect CT finding of peripheral airway disease, by quantitative and semiquantitative measures and compare them with clinical indices such as pulmonary function, airway responsiveness, or airway inflammation. Patients with stable asthma (n=20) were studied. HRCT at 3 levels of both lungs were scanned. Low attenuation area (LAA)% and mean lung density were quantitatively assessed by an automatic method. Distribution of mosaic pattern was visually scored semiquantitatively. LAA% and mean lung density at full expiratory phase correlated with the degree of airflow obstruction. Mosaic score at full inspiratory phase correlated with the severity of disease and airflow obstruction. Expiratory/inspiratory ratio of mean lung density was also associated with airway responsiveness or residual volume/total lung capacity (RV/TLC). These CT findings may be useful as markers of asthma pathophysiology. (author)

Prevalence, causes and management outcome of intestinal obstruction in Adama Hospital, Ethiopia.

Science.gov (United States)

Soressa, Urgessa; Mamo, Abebe; Hiko, Desta; Fentahun, Netsanet

2016-06-04

In Africa, acute intestinal obstruction accounts for a great proportion of morbidity and mortality. Ethiopia is one of the countries where intestinal obstruction is a major cause of morbidity and mortality. This study aims to determine prevalence, causes and management outcome of intestinal obstruction in Adama Hospital in Oromia region, Ethiopia. A hospital based cross-sectional study design was used. Data covering the past three years were collected from hospital medical records of sampled patients. The collected data were checked for any inconsistency, coded and entered into SPSS version 16.0 for data processing and analysis. Descriptive and logistic regression analyses were used. Statistical significance was based on confidence interval (CI) of 95 % at a p-value of acute abdomen surgery and total surgical admissions, respectively. The mortality rate was 2.5 % (6 of 262). The most common cause of small bowel obstruction was intussusceptions in 48 patients (30.9 %), followed by small bowel volvulus in 47 patients (30.3 %). Large bowel obstruction was caused by sigmoid volvulus in 60 patients (69.0 %) followed by colonic tumor in 12 patients (13.8 %). After controlling for possible confounding factors, the major predictors of management outcome of intestinal obstruction were: duration of illness before surgical intervention (adjusted odds ratio (AOR) = 0.49, 95 % CI: 0.25-0.97); intra-operative findings [Viable small bowel volvulus (SBV) (AOR = 0.08, 95 % CI: 0.01-0.95) and viable (AOR = 0.17, 95 % CI: 0.03-0.88)]; completion of intra-operative procedures (bowel resection & anastomosis (AOR = 3.05, 95 % CI: 1.04-8.94); and length of hospital stay (AOR = 0.05, 95 % CI: 0.01-0.16). Small bowel obstruction was more prevalent than large bowel obstruction. Intussusceptions and sigmoid volvulus were the leading causes of small and large bowel obstruction. Laparotomy was the most common methods of intestinal obstruction management. Bowel

Overlap Syndrome in Respiratory Medicine: Asthma and Chronic Obstructive Pulmonary Disease

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Alexandru Corlateanu

2014-02-01

Full Text Available Asthma and chronic obstructive pulmonary disease (COPD are highly prevalent chronic diseases in the general population. Both are characterized by similar mechanisms: airway inflammation, airway obstruction, and airway hyperresponsiveness. However, the distinction between the two obstructive diseases is not always clear. Multiple epidemiological studies demonstrate that in elderly people with obstructive airway disease, as many as half or more may have overlapping diagnoses of asthma and COPD. A COPD-Asthma overlap syndrome is defined as an airflow obstruction that is not completely reversible, accompanied by symptoms and signs of increased obstruction reversibility. For the clinical identification of overlap syndrome COPD-Asthma Spanish guidelines proposed six diagnostic criteria. The major criteria include very positive bronchodilator test [increase in forced expiratory volume in one second (FEV1 ≥15% and ≥400 ml], eosinophilia in sputum, and personal history of asthma. The minor criteria include high total IgE, personal history of atopy and positive bronchodilator test (increase in FEV1 ≥12% and ≥200 ml on two or more occasions. The overlap syndrome COPD-Asthma is associated with enhanced response to inhaled corticosteroids due to the predominance of eosinophilic bronchial inflammation.The future clinical studies and multicenter clinical trials should lead to the investigation of disease mechanisms and simultaneous development of the novel treatment.

The outcome of surgical treatment in patients with obstructive colorectal cancer

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Abdullah Kısaoğlu

2013-01-01

Full Text Available orectal cancer obstructions are responsible for about 85% of colonic emergencies. The aim of this study was to investigate the results of urgent surgical intervention that applied in acute colonic obstructions related to cancer. Methods: In this study, 86 cases presenting with acute colonic obstruction who were operated with the diagnosis of colonic tumor between January 2010 and December 2010 were assessed retrospectively. Age, gender, symptoms on presentation, presence of concomitant disease, surgical methods applied, complication and mortality rates were recorded.Results: Fifty of the cases were male, 36 were female. The mean age was 63.6 years. Twenty cases had undergone emergency colonoscopic examination at diagnosis and an obstructive lesion had been observed. The surgical operations performed were right hemicolectomy in 18, sigmoid resection in 34, left hemicolectomy in 10, abdomino-perineal resection in 2, subtotal colectomy in 4, transverse colectomy in two. Primary anastomosis was performed in thirty-four cases. Mortality was observed in 12 cases. Conclusions: In selected cases of left colon cancers with obstruction, resection and primary anastomosis is generally possible. Those over 70, presence of co-morbidities, albumin level under 3 g/dl, ASA score 3 and higher, blood loss of more than 500 ml, and preoperative blood transfusion were related to the high postoperative morbidity.Key words: Colorectal cancer, obstruction, surgical treatment, outcome.

Hydrocephalus secondary to obstruction of the lateral apertures in two dogs.

Science.gov (United States)

Kent, M; Glass, E N; Haley, A C; Shaikh, L S; Sequel, M; Blas-Machado, U; Bishop, T M; Holmes, S P; Platt, S R

2016-11-01

Traditionally, hydrocephalus is divided into communicating or non-communicating (obstructive) based on the identification of a blockage of cerebrospinal fluid (CSF) flow through the ventricular system. Hydrocephalus ex vacuo refers to ventricular enlargement as a consequence of neuroparenchymal loss. Hydrocephalus related to obstruction of the lateral apertures of the fourth ventricles has rarely been described. The clinicopathologic findings in two dogs with hydrocephalus secondary to obstruction of the lateral apertures of the fourth ventricle are reported. Signs were associated with a caudal cervical spinal cord lesion in one dog and a caudal brain stem lesion in the other dog. Magnetic resonance imaging (MRI) disclosed dilation of the ventricular system, including the lateral recesses of the fourth ventricle. In one dog, postmortem ventriculography confirmed obstruction of the lateral apertures. Microscopic changes were identified in the choroid plexus in both dogs, yet a definitive cause of the obstructions was not identified. The MRI findings in both dogs are similar to membranous occlusion of the lateral and median apertures in human patients. MRI detection of dilation of the entire ventricular system in the absence of an identifiable cause should prompt consideration of an obstruction of the lateral apertures. In future cases, therapeutic interventions aimed at re-establishing CSF flow or ventriculoperitoneal catheterisation should be considered. © 2016 Australian Veterinary Association.

[Anaesthesia for patients with obstructive airway diseases].

Science.gov (United States)

Groeben, H; Keller, V; Silvanus, M T

2014-01-01

Obstructive lung diseases like asthma or chronic obstructive lung diseases have a high prevalence and are one of the four most frequent causes of death. Obstructive lung diseases can be significantly influenced by the choice of anesthetic techniques and anesthetic agents. Basically, the severity of the COPD and the degree of bronchial hyperreactivity will determine the perioperative anesthetic risk. This risk has to be assessed by a thorough preoperative evaluation and will give the rationale on which to decide for the adequate anaesthetic technique. In particular, airway instrumentation can cause severe reflex bronchoconstriction. The use of regional anaesthesia alone or in combination with general anaesthesia can help to avoid airway irritation and leads to reduced postoperative complications. Prophylactic antiobstructive treatment, volatile anesthetics, propofol, opioids, and an adequate choice of muscle relaxants minimize the anesthetic risk, when general anesthesia is required In case, despite all precautions intra-operative bronchospasm occurs, deepening of anaesthesia, repeated administration of beta2-adrenergic agents and parasympatholytics, and a single systemic dose of corticosteroids represent the main treatment options.

An unusual cause of intestinal obstruction in an adolescent: a case report

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Victor Hip Wo Yeung

2009-11-01

Full Text Available A 15-year-old boy presented with intestinal obstruction two weeks following a blunt abdominal trauma. He had progressive bilious vomiting without abdominal distension or peritonitis. The contrast computed tomography (CT scan of the abdomen provided the definitive diagnosis: there was an obstructing duodenal hematoma, which might have been slowly progressing or have arisen from secondary hemorrhage after the initial injury. The boy remained stable over a ten-day period of conservative treatment, and his obstructive symptoms and signs were resolved completely. A follow-up CT scan of the abdomen (16 days after admission showed an almost complete resolution of the hematoma. Delayed duodenal hematoma causing intestinal obstruction has been reported rarely in previous literature. Occasionally a significant secondary hemorrhage resulting in intestinal obstruction can become life threatening. Clinical follow-up is paramount after initial recovery. Although conservative treatment suffices in most cases, the surgeon should be wary of the need for definitive surgical intervention if there is evidence of ongoing acute hemorrhage or of the obstructing hematoma failing to resolve. Laparoscopic drainage of the hematoma provides optimistic results for patients failing conservative management.

Post-extubation airway obstruction. Literature review

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Álvaro SÁNCHEZ-TABERNERO

2017-03-01

Full Text Available Introduction and objective: airway obstruction after extubation in any surgery is a critical event with low incidence, which may require reintubation or tracheostomy, which often otolaryngologist is required. Objective: To determine the prevalence of BVA and its causes through systematic literature review. Method: Literature review in PubMed, Scopus and Cochrane clinical trials, meta-analysis, reviews and case series and control over airway obstruction after extubation that requires reintubation in adults. Results: 6 studies and one clinical practice guidelines were selected. The most common cause of extubation failure is blocking the airway for various reasons (pharyngeal muscle weakness residual effect -often farmacologycal-, laryngospasm, vocal cord paralysis, edema of upper respiratory tract, cervical postoperative hematoma, foreign bodies or secretions. Most cases of re-intubation occurred within 2 hours after extubation. Conclusions: The most common cause of failure after general anesthesia extubation is blocking the airway generally caused by residual neuromuscular blocking effect. Airway obstruction risk increases in airway and head and neck surgery. Difficult intubation guidlines have improved performance and reduced adverse events and similar strategies must be implemented in extubation. The procedure extubation and reintubation should be documented. Working groups airway must be multidisciplinary and include specialists in otolaryngology.

Large Intraluminal Ileal Hematoma Presenting as Small Bowel Obstruction in a Child

International Nuclear Information System (INIS)

Lim, Yun Jung; Nam, So Hyun; Kim, Seon Jeong

2015-01-01

Intraluminal small bowel hematoma has been rarely reported in children, as a rare cause of small bowel obstruction. We present a case of an intraluminal ileal hematoma presenting as small bowel obstruction in a child. Computed Tomography (CT) indicated a large intraluminal hyperdense lesion in the distal ileum as the cause of small bowel obstruction. Abdominal ultrasonography (US) showed an echogenic mass-like lesion with multiple septa in the distal ileum. Small bowel obstruction due to a complicated cystic mass was provisionally diagnosed. Histopathologic examination of the resected mass suggested a submucosal ileal hematoma. Although intraluminal small bowel hematoma is rare in children, it can present as an intraluminal cystic mass and should be considered as a rare cause of small bowel obstruction. The US and CT findings of submucosal ileal hematoma could be useful for the diagnosis of such cases in the future

Obstructive acute abdomen: reviewing important points; Abdome agudo obstrutivo: revisando pontos fundamentais

Energy Technology Data Exchange (ETDEWEB)

Francisco, Marina Celli; Abud, Thiago Giansante; Reibscheid, Samuel; Szejnfeld, Jacob; Lederman, Henrique Manoel [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: nana_celli@hotmail.com; Neves, Felipe Trentin [Hospital Ipiranga, Sao Paulo, SP (Brazil); Colleone Neto, Ramiro [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil)

2008-07-01

The obstructive acute abdomen is a common presentation, for which safe and effective management depends on a fast and accurate diagnosis. Conventional radiograph remains the first choice among the imaging exams because of its availability, low cost and the possibility to be done serially to follow the patient's clinical progression. The ultrasonography does not require ionizing radiation. It is a dynamic and in realtime exam. Computed tomography is used increasingly due to the provision of essential diagnostic information not apparent from radiographs, such as the confirmation of the obstruction, degree and place of the occlusion, presence of ischemia as well as the causes of the obstruction. Magnetic resonance imaging has presented great technological advances and it may play a role in the future of obstructive acute abdomen diagnosis. The objective of this pictorial essay is to review the different imaging techniques used on diagnosing obstructive acute abdomen. (author)

Premenarchal, recurrent vaginal discharge associated with an incomplete obstructing longitudinal vaginal septum.

Science.gov (United States)

Hansen, Keith A; DeWitt, Jason

2005-12-01

To describe an unusual, premenarchal presentation of an obstructive vaginal anomaly. Case Report. University Medical Center. Premenarchal subject Vaginogram, vaginal septum resection. Vaginal septum resection with resolution of vaginal discharge. This case demonstrates some of the typical features of uterus didelphys bicollis with incomplete obstructing hemivagina, but had a unique presentation with premenarchal, recurrent vaginal discharge. Typically, patients with an obstructing mullerian anomaly present after menarche with pelvic pain and a mass. The vaginogram assists in the preoperative definition of abnormal anatomy which allows the surgeon to develop the most appropriate surgical approach. Resection of this incompletely obstructing vaginal septum resulted in resolution of the recurrent vaginal discharge.

MALIGNANT OBSTRUCTIVE JAUNDICE: A STUDY OF INVESTIGATIVE PARAMETERS AND ITS OUTCOME

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Tilakdas S. Shetty

2016-08-01

Full Text Available BACKGROUND Obstructive jaundice is a surgical condition that occurs when there is an obstruction to the passage of conjugated bilirubin from the liver cells to the intestine. This study has studied five clinical and nine laboratory parameters in patients presenting with malignant obstructive jaundice along with their radiological findings. By studying these parameters, the prognosis of patients with malignant obstructive jaundice and the best possible intervention could be predicted. AIM To study the various aetiopathological aspects associated with obstructive jaundice and investigative parameters of these patients thereby evaluating the prognosis. MATERIALS AND METHODS This observational study has been conducted in a tertiary institute by collecting data of 50 cases of malignant obstructive jaundice admitted to the surgical wards of BYL Nair Hospital from August 2011 to August 2014 with followup of 3 months to obtain mortality data. Male and female patients above 18 years and below 80 years of age with histologically proven malignant obstructive jaundice were included as part of this study. Data of retrospective cases were obtained from Medical Record section without disclosing the address or identification of the patient. RESULTS In this study, a total of 50 cases of histologically proven malignant obstructive jaundice were evaluated. 50 patients were studied out of which 33 were male and 17 were female. Majority of the patients were in the age group of 61-70 years i.e. 21 of them. 11 patients were between 41-50 years of age, 10 were less than 40 years of age and 8 were between 51-60 years. The most common presentation of the patients was with yellowish discolouration of sclera and urine (YDS/YDU seen in 44 patients followed by pruritus seen in 38 patients. Dilated Common Bile Duct with/without pancreatic duct dilatation was the most common finding on sonography followed by a mass seen in the head of the pancreas. Moderately differentiated

Wedge and subselective pulmonary angiography in pulmonary hypertension secondary to venous obstruction

International Nuclear Information System (INIS)

Bowen, J.S.; Bookstein, J.J.; Johnson, A.D.; Peterson, K.L.; Moser, K.M.

1985-01-01

Pulmonary wedge or subselective angiography provided key diagnostic information in two cases of pulmonary hypertension secondary to pulmonary venous obstruction. Whereas conventional pulmonary angiograms and ventilation-perfusion lung scans were interpreted as showing embolism, plain radiographs demonstrated Kerley B lines, suggesting venous obstruction. Subselective or wedge angiography of nonopacified arteries verified their anatomical patency and also revealed venous stenoses, collaterals, and atrophy indicative of obstruction

Nano-based theranostics for chronic obstructive lung diseases: challenges and therapeutic potential

OpenAIRE

Vij, Neeraj

2011-01-01

The major challenges in the delivery and therapeutic efficacy of nano-delivery systems in chronic obstructive airway conditions is airway defense, severe inflammation and mucous hypersecretion. Chronic airway inflammation and mucous hypersecretion are hallmarks of chronic obstructive airway diseases, including asthma, COPD (chronic obstructive pulmonary disease) and CF (cystic fibrosis). Distinct etiologies drive inflammation and mucous hyper secretion in these diseases, that is further induc...

Ventricular dysfunction in children with obstructive sleep apnea: radionuclide assessment

International Nuclear Information System (INIS)

Tal, A.; Leiberman, A.; Margulis, G.; Sofer, S.

1988-01-01

Ventricular function was evaluated using radionuclide ventriculography in 27 children with oropharyngeal obstruction and clinical features of obstructive sleep apnea. Their mean age was 3.5 years (9 months to 7.5 years). Conventional clinical assessment did not detect cardiac involvement in 25 of 27 children; however, reduced right ventricular ejection fraction (less than 35%) was found in 10 (37%) patients (mean: 19.5 +/- 2.3% SE, range: 8-28%). In 18 patients wall motion abnormality was detected. In 11 children in whom radionuclide ventriculography was performed before and after adenotonsillectomy, right ventricular ejection fraction rose from 24.4 +/- 3.6% to 46.7 +/- 3.4% (P less than 0.005), and in all cases wall motion showed a definite improvement. In five children, left ventricular ejection fraction rose greater than 10% after removal of oropharyngeal obstruction. It is concluded that right ventricular function may be compromised in children with obstructive sleep apnea secondary to adenotonsillar hypertrophy, even before clinical signs of cardiac involvement are present

Extrahepatic biliary obstruction; postoperative morbidity and mortality

International Nuclear Information System (INIS)

Hussain, Z.; Khan, K.I.; Vaseem, M.; Rana, S.H.

2010-01-01

The objectives of this study are to evaluate the surgical management, both definitive and palliative, in selected patients with biliary obstruction and to find out the postoperative morbidity and mortality in these patients. Duration of the study is two years conducted from June 2002 to May 2004. The study was carried out at. the surgical. unit 4 of the Combined Military Hospital and surgical department of the Military Hospital. Thirty eight cases of biliary obstruction were included. A convenient sampling technique was followed. Data analyzed by using SPSS version 10.0 for windows on computer. Descriptive statistics like frequency, percentage, average etc were computed for data presentation. Any inferential test-was not found to be applicable for this descriptive type case series. We selected 38 patients with features of extrahepatic biliary obstruction. Out of these (n 38) 15 patients (39.5%) suffered from benign diseases while those having malignant diseases were 23 (60.5%). 19 (50%) patients died within two years of follow up while 19 (50%) were the survivors. Mortality was maximum for the malignant cases. In benign cases only one patient died. Maximum deaths 6 (31.6%) occurred in the period of up to one month of operation. 20 patients had one or another complication of operation and hence the morbidity came out to be 52%. According to our results the mortality and morbidity related to extrahepatic biliary obstruction in our patients was higher compared to other studies which can only be reduced by early detection and treatment. (author)

Upregulation of Interleukin-33 in obstructive renal injury

Energy Technology Data Exchange (ETDEWEB)

Chen, Wei-Yu, E-mail: wychen624@cgmh.org.tw [Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (China); Chang, Ya-Jen [Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan (China); Su, Chia-Hao [Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (China); Tsai, Tzu-Hsien [Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (China); Chen, Shang-Der [Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (China); Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan (China); Hsing, Chung-Hsi [Department of Anesthesiology, Chi-Mei Medical Center, Tainan, Taiwan (China); Yang, Jenq-Lin, E-mail: jyang@adm.cgmh.org.tw [Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (China)

2016-05-13

Interstitial fibrosis and loss of parenchymal tubular cells are the common outcomes of progressive renal diseases. Pro-inflammatory cytokines have been known contributing to the damage of tubular cells and fibrosis responses after renal injury. Interleukin (IL)-33 is a tissue-derived nucleus alarmin that drives inflammatory responses. The regulation and function of IL-33 in renal injury, however, is not well understood. To investigate the involvement of cytokines in the pathogenesis of renal injury and fibrosis, we performed the mouse renal injury model induced by unilateral urinary obstruction (UUO) and analyze the differentially upregulated genes between the obstructed and the contralateral unobstructed kidneys using RNA sequencing (RNAseq). Our RNAseq data identified IL33 and its receptor ST2 were upregulated in the UUO kidney. Quantitative analysis confirmed that transcripts of IL33 and ST2 were upregulated in the obstructed kidneys. Immunofluorescent staining revealed that IL-33 was upregulated in Vimentin- and alpha-SMA-positive interstitial cells. By using genetically knockout mice, deletion of IL33 reduced UUO-induced renal fibrosis. Moreover, in combination with BrdU labeling technique, we observed that the numbers of proliferating tubular epithelial cells were increased in the UUO kidneys from IL33-or ST2-deficient mice compared to wild type mice. Collectively, our study demonstrated the upregulation of IL-33/ST2 signaling in the obstructed kidney may promote tubular cell injury and interstitial fibrosis. IL-33 may serve as a biomarker to detect renal injury and that IL-33/ST2 signaling may represent a novel target for treating renal diseases. -- Highlights: •Interleukin (IL)-33 was upregulated in obstructed kidneys. •Interstitial myofibroblasts expressed IL-33 after UUO-induced renal injury. •Deficiency of IL33 reduced interstitial fibrosis and promoted tubular cell proliferation.

Prevalence of airflow obstruction in patients with stable systolic heart failure

DEFF Research Database (Denmark)

Dalsgaard, Morten; Plesner, Louis Lind; Schou, Morten

2017-01-01

Background: Chronic obstructive pulmonary disease (COPD) is an important differential diagnosis in heart failure (HF). However, routine use of spirometry in outpatient HF clinics is not implemented. The aim of the present study was to determine the prevalence of both airflow obstruction and non...... failure clinics were examined with spirometry at their first visit and after optimal medical treatment for HF was achieved. airflow obstruction was classified and graded according to the GOLD 2011 revision. Results: Baseline spirometry was performed in 593 included patients and 71 (12%) had a clinical......%) had mild disease (GOLD I) and 180 (30%) patients had moderate to very severe disease (GOLD II-IV). No difference in spirometric variables was observed following up titration of medication. Conclusion: In stable patients with HF airflow obstruction is frequent and severely underdiagnosed. Spirometry...

Diagnostic Instability and Reversals of Chronic Obstructive Pulmonary Disease Diagnosis in Individuals with Mild to Moderate Airflow Obstruction.

Science.gov (United States)

Aaron, Shawn D; Tan, Wan C; Bourbeau, Jean; Sin, Don D; Loves, Robyn H; MacNeil, Jenna; Whitmore, George A

2017-08-01

Chronic obstructive pulmonary disease (COPD) is a chronic, progressive disease, and reversal of COPD diagnosis is thought to be uncommon. To determine whether a spirometric diagnosis of mild or moderate COPD is subject to variability and potential error. We examined two prospective cohort studies that enrolled subjects with mild to moderate post-bronchodilator airflow obstruction. The Lung Health Study (n = 5,861 subjects; study duration, 5 yr) and the Canadian Cohort of Obstructive Lung Disease (CanCOLD) study (n = 1,551 subjects; study duration, 4 yr) were examined to determine frequencies of (1) diagnostic instability, represented by how often patients initially met criteria for a spirometric diagnosis of COPD but then crossed the diagnostic threshold to normal and then crossed back to COPD over a series of annual visits, or vice versa; and (2) diagnostic reversals, defined as how often an individual's COPD diagnosis at the study outset reversed to normal by the end of the study. Diagnostic instability was common and occurred in 19.5% of the Lung Health Study subjects and 6.4% of the CanCOLD subjects. Diagnostic reversals of COPD from the beginning to the end of the study period occurred in 12.6% and 27.2% of subjects in the Lung Health Study and CanCOLD study, respectively. The risk of diagnostic instability was greatest for subjects whose baseline FEV 1 /FVC value was closest to the diagnostic threshold, and the risk of diagnostic reversal was greatest for subjects who quit smoking during the study. A single post-bronchodilator spirometric assessment may not be reliable for diagnosing COPD in patients with mild to moderate airflow obstruction at baseline.

Fibroepithelial ureteral polyps presenting as ureteropelvic obstruction

Science.gov (United States)

Cusano, Antonio; Abarzua-Cabezas, Fernando; Kesler, Stuart

2014-01-01

A 57-year-old woman presented with bilateral abdominal pain and flank discomfort. Imaging studies, consisting of CT scan, diethylene triamine pentaacetic acid renal scan with Lasix and a retrograde pyelogram, indicated an obstruction at the uteropelvic junction (UPJ), possibly due to fibroepithelial polyps within the ureter. A robotic pyeloplasty revealed a ureteral diverticulum and a thin, still-attached fibroepithelial polyp of approximately 2 cm in length. The patient tolerated the procedure well and was discharged one day postpyeloplasty with no reported complications. This rare clinical scenario should be considered when formulating a diagnosis for a UPJ obstruction. PMID:24759168

Bronchial or Laryngeal Obstruction Induced by Exercise?

Directory of Open Access Journals (Sweden)

Ayoub Bey

2017-06-01

Full Text Available A child suspected of exercise-induced laryngeal obstruction and asthma is examined by laryngoscopy and respiratory resistance (Rrs after exercise challenge. Immediately at exercise cessation, the visualized adduction of the larynx in inspiration is reflected in a paroxystic increase in Rrs. While normal breathing has apparently resumed later on during recovery from exercise, the pattern of Rrs in inspiration is observed to reoccur following a deep breath or swallowing. The procedure may thus help diagnosing the site of exercise-induced obstruction when laryngoscopy is not available and identify re-inducers of laryngeal dysfunction.

[Obstructive renal insufficiency caused by amoxicillin crystalluria].

Science.gov (United States)

Boursas, M; Benhassine, L; Kempf, J; Petit, B; Vuillemin, F

1997-01-01

A 76-year-old woman was admitted to the ICU for a meningitis with rhombencephalitis due to Listeria monocytogenes. The treatment included amoxicillin (250 mg.kg-1.day-1) and gentamicin (3 mg.kg-1.day-1 over 6 days). Neurological outcome was favourable. However at the 14th day, an acute renal failure occurred, following macroscopic haematuria and milkiness urine. CT scan and sonography confirmed the diagnosis of obstructive renal failure with bilateral ureteral obstruction. Crystalluria caused by amoxicillin was suspected. Endoscopic ureteral insertion of double-J catheters permitted the recovery of a normal renal function.

Clinical and fiberoptic endoscopic assessment of swallowing in patients with chronic obstructive pulmonary disease

Directory of Open Access Journals (Sweden)

Macri, Marina Rodrigues Bueno

2014-01-01

Full Text Available Introduction: Chronic obstructive pulmonary disease is characterized by progressive and partially reversible obstruction of pulmonary airflow. Aim: To characterize swallowing in patients with chronic obstructive pulmonary disease and correlate the findings with the degree chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, and smoking. Method: We conducted a prospective cohort study of 19 patients (12 men and 7 women; age range, 50–85 years with confirmed medical diagnosis of chronic obstructive pulmonary disease. This study was performed in 2 stages (clinical evaluation and functional assessment using nasolaryngofibroscopy on the same day. During both stages, vital signs were checked by medical personnel. Results: Clinical evaluation of swallowing in all patients showed the clinical signs of cough. The findings of nasolaryngofibroscopy highlighted subsequent intraoral escape in 5 patients (26.5%. No patient had tracheal aspiration. There was no association of subsequent intraoral escape with degree of chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, or smoking. Conclusion: In patients with chronic obstructive pulmonary disease, there was a prevalence of oral dysphagia upon swallowing and nasolaryngofibroscopy highlighted the finding of subsequent intraoral escape. There was no correlation between intraoral escape and the degree of chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, or smoking.

Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea

Directory of Open Access Journals (Sweden)

Luciana Almeida Moreira da Paz Oliveira

2015-06-01

Full Text Available INTRODUCTION: Upper airway nerve and muscle damage associated with obstructive sleep apnea may impair the strength and dynamics of pharyngeal and esophageal contractions during swallowing. OBJECTIVE: To evaluate the presence of alterations in pharyngoesophageal manometry in patients with obstructive sleep apnea with and without oropharyngeal dysphagia. METHODS: This study prospectively evaluated 22 patients with obstructive sleep apnea without spontaneous complaints of dysphagia, using a questionnaire, fiberoptic endoscopic evaluation of swallowing, and pharyngoesophageal manometry, including measurement of the upper and lower esophageal sphincter pressures and mean pharyngeal pressures at three levels during swallowing. RESULTS: The dysphagia group consisted of 17 patients (77.3% in whom swallowing abnormalities were detected on fiberoptic endoscopic evaluation of swallowing (n = 15; 68.2% and/or in the questionnaire (n = 7; 31.8%. The five remaining cases comprised a control group without oropharyngeal dysphagia. In all cases of abnormalities on fiberoptic endoscopic evaluation of swallowing, there was premature bolus leakage into the pharynx. There was no statistically significant difference between the groups regarding any of the pharyngoesophageal manometry measurements, age, or severity of obstructive sleep apnea. CONCLUSION: Pharyngoesophageal manometry detected no statistically significant difference between the groups with and without oropharyngeal dysphagia.

Pharmacological treatment of bowel obstruction in cancer patients.

LENUS (Irish Health Repository)

O'Connor, Brenda

2012-02-01

INTRODUCTION: Malignant bowel obstruction (MBO) is a common complication of advanced cancer, occurring most frequently in gynaecological and colorectal cancer. Its management remains complex and variable. This is in part due to the lack of evidence-based guidelines for the clinicians involved. Although surgery should be considered the primary treatment, this may not be feasible in patients with a poor performance status or advanced disease. Advances have been made in the medical management of MBO which can lead to a considerable improvement in symptom management and overall quality of life. AREAS COVERED: This review emphasizes the importance of a prompt diagnosis of MBO with early introduction of pharmacological agents to optimize symptom control. The authors summarize the treatment options available for bowel obstruction in those patients for whom surgical intervention is not a feasible option. The authors also explore the complexities involved in the introduction of parenteral hydration and total parenteral nutrition in this group of patients. EXPERT OPINION: It is not always easy to distinguish reversible from irreversible bowel obstruction. Early and aggressive management with the introduction of pharmacological agents including corticosteroids, octreotide and anti-cholinergic agents have the potential to maintain bowel patency, and allow for more rapid recovery of bowel transit. A combination of analgesics, anti-emetics and anti-cholinergics with or without anti-secretory agents can successfully improve symptom control in patients with irreversible bowel obstruction.

Thallium myocardial tomoscintigraphy: detection of ischemia during weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease. Tomoscintigraphie myocardique au thallium: detection de l'ischemie provoquee par le sevrage de la ventilation assistee chez le bronchiteux chronique

Energy Technology Data Exchange (ETDEWEB)

Andre, L; Valette, H; Obama, S; Archambaud, F; Richard, C; Teboul, J L; Hebert, J L; Auzepy, P; Desgrez, A [Hopital de Bicetre, 94 - Le Kremlin-Bicetre (FR)

1990-01-01

In order to evidence myocardial ischemia-leading to ventricular dysfunction-during weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease, thallium myocardial tomography and gated blood pool studies were performed in 9 patients during mechanical ventilation and during weaning from mechanical ventilation. During the latter, results of gated blood pool studies showed a diffuse homogeneous left ventricular dysfunction. A fixed lower thallium uptake in the septum than in the lateral wall was found with the quantitative analysis of myocardial tomograms. Partial volume effect is likely the cause of this septal defect. The hypothesis of a diffuse ischemia cannot be excluded; but, without the absolute quantification of tomographic data, it cannot be proven.

Flextube reflectometry and pressure recordings for level diagnosis in obstructive sleep apnoea

DEFF Research Database (Denmark)

Faber, C E; Grymer, L; Hilberg, O

2002-01-01

The objective of this study was to compare sound reflections in a flexible tube (flextube reflectometry) with pressure-catheter recordings (ApneaGraph) for identifying the predominant obstructive level of the upper airway during sleep. Seventeen males with suspected obstructive sleep apnoea...... results were found in flextube reflectometry studies and pressure-recordings performed on different nights regarding the level distribution of obstructions during sleep. Possible explanations of this discrepancy are discussed....

 Papillary Cystadenocarcinoma of Ovary Presenting as Obstructive Jaundice: A Rare Presentation

Directory of Open Access Journals (Sweden)

Sunil Kumar

2012-03-01

Full Text Available  Obstructive jaundice resulting from malignancy of gastrointestinal tract and hepatobiliary tract has been reported in various studies. Ovarian malignancy leading to obstructive jaundice due to portal lymphadenopathy is of rare occurrence. We report a case presented with obstructive jaundice and on further evaluation, found to have ovarian papillary cyst adenocarcinoma with secondaries at porta hepatis which was managed successfully by neoadjuvant chemotherapy followed by cytoreductive surgery.

Two cases of airway obstruction after radiation therapies

International Nuclear Information System (INIS)

Matsumoto, Yuki; Hashimoto, Kazuyoshi; Yoshida, Ryu; Shimazu, Yuzou; Hattori, Hisashi; Kan, Keiichi

2016-01-01

We report two cases of airway obstruction due to several radiotherapies. In the first case, although a “cannot ventilate, cannot intubate” (CVCI) situation arose, we performed cricothyrotomy, thus saving the patient. In the second case, we were able to perform bronchoscopy early to assess her laryngeal edema before nasal intubation and tracheotomy were performed. As a result, a potentially distressing situation for the patient was prevented. We must be careful of airway obstructions that can occur in patients after several radiotherapies. (author)

Intestinal obstruction in children due to Ascariasis: A tertiary health ...

African Journals Online (AJOL)

of worms per mouth or rectum and on x-ray and ultrasonography fi ndings. Only the patients of intestinal obstruction with documented evidence of roundworm infestation were included in the study and were followed for one year. Results: One hundred and three children with intestinal obstruction due to Ascaris lumbricoides

Randomised trial of endoscopic endoprosthesis versus operative bypass in malignant obstructive jaundice

DEFF Research Database (Denmark)

Andersen, J R; Sørensen, S M; Kruse, A

1989-01-01

In patients with obstructive jaundice caused by malignant stricture of the extrahepatic bile duct we compared survival time, complication rates, hospitalisation requirements, and quality of life after palliation by endoscopic endoprosthesis or bypass surgery. During diagnostic endoscopic cholangi......In patients with obstructive jaundice caused by malignant stricture of the extrahepatic bile duct we compared survival time, complication rates, hospitalisation requirements, and quality of life after palliation by endoscopic endoprosthesis or bypass surgery. During diagnostic endoscopic...... in survival between treatment groups or randomisation groups. No differences were found when other variables were compared. We conclude, that palliation of obstructive jaundice in malignant bile duct obstruction with endoscopically introduced endoprosthesis is as effective as operative bypass....

[The problem of osteoporosis in patients with cardiovascular and broncho-obstructive disease].

Science.gov (United States)

Platitsyna, N G; Bolotnova, T V; Okonechnikova, N S; Kuimova, J V

2016-01-01

The article deals with the problem of osteoporosis in patients with cardiovascular and broncho-obstructive disease. The risk factors and clinical functional features of osteoporosis are analyzed in patients with coronary heart disease, hypertension, chronic obstructive pulmonary disease, bronchial asthma. Indicators of bone mineral density in patients with cardiovascular and broncho-obstructive disease on average meet the criteria for osteopenia. Most examinees had a high risk of osteoporotic fractures as a result of significant reduction in bone mineral density. The presence of osteoporosis in patients with cardiovascular and broncho-obstructive pathology from the point of co-morbidity results in a syndrome of mutual aggravation that determines the need for a comprehensive diagnosis, treatment and prevention.

Usefulness of flexible covered stent in malignant colorectal obstruction

Energy Technology Data Exchange (ETDEWEB)

Kang, Jee Hee; Kang, Sung Gwon; Kim, Hyung Jin; Noh, Hong Gi; Woo, Jae Hong; Suh, Chang Hae [Inha Univ. Hospital, Inchon (Korea, Republic of)

1998-07-01

To evaluate the usefulness of flexible covered stent in the treatment of acute colorectal obstruction secondary to colorectal carcinoma. Materials and Methods : Flexible covered stents were placed in 11 patients with clinical and radiologic signs of acute colonic obstruction secondary to colorectal carcinoma. The purposes of stent insertion were pre-operative bowel preparation in seven patients and palliative treatment in four. A fistula was present in two;in one this was between the proximal jejunum and colon, and the other was rectovaginal. The usefulness of stent insertion for the purpose of preoperative bowel preparation was evaluated according to the feasibility and status of bowel preparation, as decided by the operator. Palliative treatment for the relief of symptoms of acute bowel obstruction was evaluated according to the number and amount of defecation,bowel dilatation in simple abdomen radiography, and the presence of complications. Results : Bowel preparation for the purpose of preoperative bowel cleansing was easy in seven patients;the fecal materials remaining in the colon presented no problems during surgery. In one of four patients palliative treatment involved a colostomy;this was due to recurrent stent obstruction by fecal materials after three months, and in two other patients there was stent obstruction after two and five months, respectively. The stent in one of four patients who underwent palliative treatment was removed because of stent migration three days after insertion;the stents in two patients with fistulas covered the fistulas successfully. Complications after stent insertion were anal pain in three patients, anal bleeding in three and stent migration in one. Conclusion : The flexible covered stent was an effective device for the relief of acute colonic obstruction secondary to malignant rectosigmoid neoplasia. It allowed for single-stage operation and covered the fistula. We believe however that for further evaluation of the

Diagnostic value of diuretic-enhanced excretory MR urography in patients with obstructive uropathy

Energy Technology Data Exchange (ETDEWEB)

Karabacakoglu, Aydin E-mail: radaydin@hotmail.com; Karakose, Serdar; Ince, Ozlem; Cobankara, Osman Ege; Karalezli, Giray

2004-12-01

Purpose: Ultrasonography and conventional intravenous urography are most common methods in diagnosis of obstructive uropathies. The disadvantage of ultrasonography is inability of visualizing middle and lower one thirds of ureter, while intravenous urography is using radiation, also functionally extra loading effect on kidneys. In this study, the diagnostic value of MR urography on obstructive uropathy were investigated. Materials and methods: Forty five patients who were suffered from obstructive uropathy examined by ultrasonography, intravenous urography and diuretic-enhanced excretory MR urography by using MR-contrast-agent. Results: MR urography established accuracy rate of 92.8% for stone diseases which formed the largest group in this study, however, in other causes of obstructive uropathy, MR urography provide 100% correct diagnosis. Conclusion: MR urography provide high quality images for diagnosing and determining causes of urinary obstruction defining position and severity of dilatations as well as showing localization of the pathology. We think that MR urography should be a primary investigation in patients with obstructive uropathy who have contrast agent and X-ray contrindication.

Diagnostic value of diuretic-enhanced excretory MR urography in patients with obstructive uropathy

International Nuclear Information System (INIS)

Karabacakoglu, Aydin; Karakose, Serdar; Ince, Ozlem; Cobankara, Osman Ege; Karalezli, Giray

2004-01-01

Purpose: Ultrasonography and conventional intravenous urography are most common methods in diagnosis of obstructive uropathies. The disadvantage of ultrasonography is inability of visualizing middle and lower one thirds of ureter, while intravenous urography is using radiation, also functionally extra loading effect on kidneys. In this study, the diagnostic value of MR urography on obstructive uropathy were investigated. Materials and methods: Forty five patients who were suffered from obstructive uropathy examined by ultrasonography, intravenous urography and diuretic-enhanced excretory MR urography by using MR-contrast-agent. Results: MR urography established accuracy rate of 92.8% for stone diseases which formed the largest group in this study, however, in other causes of obstructive uropathy, MR urography provide 100% correct diagnosis. Conclusion: MR urography provide high quality images for diagnosing and determining causes of urinary obstruction defining position and severity of dilatations as well as showing localization of the pathology. We think that MR urography should be a primary investigation in patients with obstructive uropathy who have contrast agent and X-ray contrindication

Artificial intelligence in diagnosis of obstructive lung disease: current status and future potential.

Science.gov (United States)

Das, Nilakash; Topalovic, Marko; Janssens, Wim

2018-03-01

The application of artificial intelligence in the diagnosis of obstructive lung diseases is an exciting phenomenon. Artificial intelligence algorithms work by finding patterns in data obtained from diagnostic tests, which can be used to predict clinical outcomes or to detect obstructive phenotypes. The purpose of this review is to describe the latest trends and to discuss the future potential of artificial intelligence in the diagnosis of obstructive lung diseases. Machine learning has been successfully used in automated interpretation of pulmonary function tests for differential diagnosis of obstructive lung diseases. Deep learning models such as convolutional neural network are state-of-the art for obstructive pattern recognition in computed tomography. Machine learning has also been applied in other diagnostic approaches such as forced oscillation test, breath analysis, lung sound analysis and telemedicine with promising results in small-scale studies. Overall, the application of artificial intelligence has produced encouraging results in the diagnosis of obstructive lung diseases. However, large-scale studies are still required to validate current findings and to boost its adoption by the medical community.

Disease and drug-induced arrhythmias : the example of obstructive pulmonary disease

NARCIS (Netherlands)

Warnier, M.J.

2014-01-01

Notwithstanding the clinical importance of cardiac arrhythmias, relevant information about the background risk and the exact underlying mechanisms of cardiac arrhythmias in patients with obstructive pulmonary disease (asthma and chronic obstructive pulmonary disease [COPD]) is still lacking. The

Quantitative analysis of infantile ureteropelvic junction obstruction by diuretic renography

Energy Technology Data Exchange (ETDEWEB)

Ueno, Shigeru; Suzuki, Yutaka; Murakami, Takeshi; Yokoyama, Seishichi; Hirakawa, Hitoshi; Tajima, Tomoo; Makuuchi, Hiroyasu [Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine

2001-04-01

Infantile hydronephrosis detected by ultrasonography poses a clinical dilemma on how to treat the condition. This article reports a retrospective study to evaluate infantile hydronephrosis due to suspected ureteropelvic junction (UPJ) obstruction by means of standardized diuretic renography and to speculate its usefulness for quantitative assessment and management of this condition. Between November 1992 and July 1999, 43 patients who had the disease detected in their fetal or infantile period were submitted to this study. Standardized diuretic renograms were obtained with {sup 99m}Tc-labeled diethylene-triaminepenta-acetate (Tc-99m-DTPA) or {sup 99m}Tc-labeled mercaptoacetyl triglycine (Tc-99m-MAG3) as radiopharmaceuticals. Drainage half-time clearance (T 1/2) of the activity at each region of interest set to encompass the entire kidney and the dilated pelvis was used as an index of quantitative analysis of UPJ obstruction. Initial T 1/2s of 32 kidneys with suspected UPJ obstruction were significantly longer than those of 37 without obstruction. T 1/2s of kidneys which had undergone pyeloplasty decreased promptly after surgery whereas those of units followed up without surgery decreased more sluggishly. These findings demonstrate that a standardized diuretic renographic analysis with T 1/2 can reliably assess infantile hydronephrosis with UPJ obstruction and be helpful in making a decision on surgical intervention. (author)

Quantitative analysis of infantile ureteropelvic junction obstruction by diuretic renography

International Nuclear Information System (INIS)

Ueno, Shigeru; Suzuki, Yutaka; Murakami, Takeshi; Yokoyama, Seishichi; Hirakawa, Hitoshi; Tajima, Tomoo; Makuuchi, Hiroyasu

2001-01-01

Infantile hydronephrosis detected by ultrasonography poses a clinical dilemma on how to treat the condition. This article reports a retrospective study to evaluate infantile hydronephrosis due to suspected ureteropelvic junction (UPJ) obstruction by means of standardized diuretic renography and to speculate its usefulness for quantitative assessment and management of this condition. Between November 1992 and July 1999, 43 patients who had the disease detected in their fetal or infantile period were submitted to this study. Standardized diuretic renograms were obtained with 99m Tc-labeled diethylene-triaminepenta-acetate (Tc-99m-DTPA) or 99m Tc-labeled mercaptoacetyl triglycine (Tc-99m-MAG3) as radiopharmaceuticals. Drainage half-time clearance (T 1/2) of the activity at each region of interest set to encompass the entire kidney and the dilated pelvis was used as an index of quantitative analysis of UPJ obstruction. Initial T 1/2s of 32 kidneys with suspected UPJ obstruction were significantly longer than those of 37 without obstruction. T 1/2s of kidneys which had undergone pyeloplasty decreased promptly after surgery whereas those of units followed up without surgery decreased more sluggishly. These findings demonstrate that a standardized diuretic renographic analysis with T 1/2 can reliably assess infantile hydronephrosis with UPJ obstruction and be helpful in making a decision on surgical intervention. (author)

Depression and obstructive sleep apnea.

Science.gov (United States)

Hobzova, Milada; Prasko, Jan; Vanek, Jakub; Ociskova, Marie; Genzor, Samuel; Holubova, Michaela; Grambal, Ales; Latalova, Klara

2017-10-01

Obstructive sleep apnea (OSA), is described as intermittent interruptions or reductions in airflow which are initiated by an incomplete or complete collapse of the upper airways despite respiratory effort. When left untreated, OSA is connected with comorbid conditions, such as cardiovascular and metabolic illnesses. The PubMed database was used to examine papers published until April 2017 using the subsequent terms: "obstructive sleep apnea" or "obstructive sleep apnoea" and "depression" in successive combination with "CPAP (continuous positive airway pressure)", "therapy", "pharmacotherapy", "psychotherapy", "cognitive behavioral therapy" or "quality of life". After assessment for the suitability, 126 articles were chosen. The numerous evidence of a connection between OSA and depressive symptoms, as well as depressive disorder, were found. This connection may be directly or indirectly linked due to the participation of some OSA mediators consequences such as obesity, hypertension, and the decreased quality of life. Patients with the comorbid major depression and OSA reported more severe and longer episodes of depression. Nevertheless, the information on the effect of the treatment of OSA using CPAP on the depressive symptoms was limited. Still, the current state of the art suggests that this treatment decreases the severity of the comorbid depressive symptoms. It is important to evaluate the symptoms of depression in the patients with OSA. On the other side, a psychiatrist should not just treat the depression, as it is also important to screen individuals at high risk of OSA when assessing patients for depressive disorder, especially those with depression resistant to treatment.

Spirometry utilisation among Danish adults initiating medication targeting obstructive lung disease

DEFF Research Database (Denmark)

Koefoed, Mette

2015-01-01

performed. RESULTS: A total of 40,969 adults initiated medication targeting obstructive lung medication in 2008 in Denmark. The mean age of the cohort was 55.6 years (SD18.7) and approximately half of the mediations users had spirometry test performed. Initiating several types of medication targeting......UNLABELLED: This PhD thesis was written during my employment at the Research Unit of General Practice in Odense, University of Southern Denmark. It comprises an overview and three papers, all published or submitted for publication in international peer-reviewed scientific journals. BACKGROUND: Non...... with pharmacotherapy targeting obstructive lung disease and only few have additional tests conducted, although the predictive value of respiratory symptoms for diagnosing obstructive lung disease has proven to be low. Spirometry is recommended as the gold standard for confirming obstructive lung disease, and testing...

Usefulness of FDG PET/CT in determining benign from malignant endobronchial obstruction

International Nuclear Information System (INIS)

Cho, Arthur; Kang, Won Jun; Cho, Ho Jin; Lee, Jae-hoon; Yun, Mijin; Lee, Jong Doo; Hur, Jin

2011-01-01

To evaluate the usefulness of FDG PET/CT to differentiate malignant endobronchial lesions with distal atelectasis from benign bronchial stenosis. This retrospective study reviewed 84 patients who underwent contrast-enhanced chest CT and then PET/CT and had histological (n = 81) or follow-up imaging (n = 3) confirmation. Two chest radiologists reviewed initial chest CT and determined endobronchial lesions to be malignant or benign. Two nuclear medicine physicians reviewed PET/CT for FDG uptake at the obstruction site and measured SUV. Malignancy was considered when increased FDG uptake was seen in the obstruction site, regardless of FDG within the atelectatic lung. The sensitivity, specificity and accuracy of chest CT was 95%, 48% and 84%, compared with 95%, 91% and 94% for PET/CT. Benign obstructive lesions showed statistically lower FDG uptake than malignant obstructions (benign SUV 2.5 ± 0.84; malignant SUV 11.8 ± 5.95, p < 0.001). ROC analysis showed an SUV cut-off value of 3.4 with highest sensitivity of 94% and specificity of 91%. Increased FDG PET/CT uptake at the obstruction site indicates a high probability of malignancy, while benign lesions show low FDG uptake. Careful evaluation of FDG uptake pattern at the obstruction site is helpful in the differentiation between benign and malignant endobronchial lesions. (orig.)

Usefulness of FDG PET/CT in determining benign from malignant endobronchial obstruction

Energy Technology Data Exchange (ETDEWEB)

Cho, Arthur; Kang, Won Jun; Cho, Ho Jin; Lee, Jae-hoon; Yun, Mijin; Lee, Jong Doo [Yonsei University Health System, Division of Nuclear Medicine, Department of Radiology, Seoul (Korea, Republic of); Hur, Jin [Yonsei University Health System, Department of Radiology, Seoul (Korea, Republic of)

2011-05-15

To evaluate the usefulness of FDG PET/CT to differentiate malignant endobronchial lesions with distal atelectasis from benign bronchial stenosis. This retrospective study reviewed 84 patients who underwent contrast-enhanced chest CT and then PET/CT and had histological (n = 81) or follow-up imaging (n = 3) confirmation. Two chest radiologists reviewed initial chest CT and determined endobronchial lesions to be malignant or benign. Two nuclear medicine physicians reviewed PET/CT for FDG uptake at the obstruction site and measured SUV. Malignancy was considered when increased FDG uptake was seen in the obstruction site, regardless of FDG within the atelectatic lung. The sensitivity, specificity and accuracy of chest CT was 95%, 48% and 84%, compared with 95%, 91% and 94% for PET/CT. Benign obstructive lesions showed statistically lower FDG uptake than malignant obstructions (benign SUV 2.5 {+-} 0.84; malignant SUV 11.8 {+-} 5.95, p < 0.001). ROC analysis showed an SUV cut-off value of 3.4 with highest sensitivity of 94% and specificity of 91%. Increased FDG PET/CT uptake at the obstruction site indicates a high probability of malignancy, while benign lesions show low FDG uptake. Careful evaluation of FDG uptake pattern at the obstruction site is helpful in the differentiation between benign and malignant endobronchial lesions. (orig.)

Analysis of a urinary biomarker panel for obstructive nephropathy and clinical outcomes.

Directory of Open Access Journals (Sweden)

Yuanyuan Xie

Full Text Available To follow up renal function changes in patients with obstructive nephropathy and to evaluate the predictive value of biomarker panel in renal prognosis.A total of 108 patients with obstructive nephropathy were enrolled in the study; 90 patients completed the follow-up. At multiple time points before and after obstruction resolution, urinary samples were prospectively collected in patients with obstructive nephropathy; the levels of urinary kidney injury molecule-1 (uKIM-1, liver-type fatty acid-binding protein (uL-FABP, and neutrophil gelatinase associated lipocalin (uNGAL were determined by enzyme-linked immunosorbent assay (ELISA. After 1 year of follow-up, the predictive values of biomarker panel for determining the prognosis of obstructive nephropathy were evaluated.uKIM-1 (r = 0.823, uL-FABP (r = 0.670, and uNGAL (r = 0.720 levels were positively correlated with the serum creatinine level (all P96.69 pg/mg creatinine (Cr, a preoperative uL-FABP>154.62 ng/mg Cr, and a 72-h postoperative uL-FABP>99.86 ng/mg Cr were all positively correlated with poor prognosis (all P<0.01.Biomarker panel may be used as a marker for early screening of patients with obstructive nephropathy and for determining poor prognosis.

X-ray diagnosis of bronchial obstruction in chronic pneumonia

International Nuclear Information System (INIS)

Mamilyaev, R.M.

1981-01-01

Combined radiobronchological examination of patients with chronic pneumonia in the phase of reverse development of the disease has been performed. Severity, localization and extent of bronchial obstruction have been studied, depending on the phase of chronic pneumonia and aspects of lung tissue alterations. Bronchial lesions characteristic of chronic pneumonia were defined, as well as importance of x-ray examination methods for bronchial obstruction diagnosis. Three types of bronchial obstruction were distinguished: bronchoconstriction, bronchodilatation and their combination. With regard to the character and severity of bronchial and pulmonary tissue lesions 3 variants of chronic pneumonia are offered to be differentiated: bronchitic, bronchoectatic, and abscess-forming. The main significance in diagnosis of chronic pneumonia is attributed to combined x-ray examination, which also includes radiobronchological investigation in the first two variants of the disease [ru

Ventilation inhomogeneity in obstructive lung diseases measured by electrical impedance tomography: a simulation study.

Science.gov (United States)

Schullcke, B; Krueger-Ziolek, S; Gong, B; Jörres, R A; Mueller-Lisse, U; Moeller, K

2017-10-10

Electrical impedance tomography (EIT) has mostly been used in the Intensive Care Unit (ICU) to monitor ventilation distribution but is also promising for the diagnosis in spontaneously breathing patients with obstructive lung diseases. Beside tomographic images, several numerical measures have been proposed to quantitatively assess the lung state. In this study two common measures, the 'Global Inhomogeneity Index' and the 'Coefficient of Variation' were compared regarding their capability to reflect the severity of lung obstruction. A three-dimensional simulation model was used to simulate obstructed lungs, whereby images were reconstructed on a two-dimensional domain. Simulations revealed that minor obstructions are not adequately recognized in the reconstructed images and that obstruction above and below the electrode plane may result in misleading values of inhomogeneity measures. EIT measurements on several electrode planes are necessary to apply these measures in patients with obstructive lung diseases in a promising manner.

Clinical strategies for the management of intestinal obstruction and pseudo-obstruction. A Delphi Consensus study of SICUT (Società Italiana di Chirurgia d'Urgenza e del Trauma).

Science.gov (United States)

Costa, Gianluca; Ruscelli, Paolo; Balducci, Genoveffa; Buccoliero, Francesco; Lorenzon, Laura; Frezza, Barbara; Chirletti, Piero; Stagnitti, Franco; Miniello, Stefano; Stella, Francesco

2016-01-01

Intestinal obstructions/pseudo-obstruction of the small/large bowel are frequent conditions but their management could be challenging. Moreover, a general agreement in this field is currently lacking, thus SICUT Society designed a consensus study aimed to define their optimal workout. The Delphi methodology was used to reach consensus among 47 Italian surgical experts in two study rounds. Consensus was defined as an agreement of 75.0% or greater. Four main topic areas included nosology, diagnosis, management and treatment. A bowel obstruction was defined as an obstacle to the progression of intestinal contents and fluids generally beginning with a sudden onset. The panel identified four major criteria of diagnosis including absence of flatus, presence of >3.5 cm ileal levels or >6 cm colon dilatation and abdominal distension. Panel also recommended a surgical admission, a multidisciplinary approach, and a gastrografin swallow for patients presenting occlusions. Criteria for immediate surgery included: presence of strangulated hernia, a >10 cm cecal dilatation, signs of vascular pedicles obstructions and persistence of metabolic acidosis. Moreover, rules for non-operative management (to be conducted for maximum 72 hours) included a naso-gastric drainage placement and clinical and laboratory controls each 12 hours. Non-operative treatment should be suspended if any suspects of intra-abdominal complications, high level of lactates, leukocytosis (>18.000/mm3 or Neutrophils >85%) or a doubling of creatinine level comparing admission. Conversely, consensus was not reached regarding the exact timing of CT scan and the appropriateness of colonic stenting. This consensus is in line with current international strategies and guidelines, and it could be a useful tool in the safe basic daily management of these common and peculiar diseases. Delphi study, Intestinal obstruction, Large bowel obstruction, Pseudo-obstruction, Small bowel.

Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin ...

African Journals Online (AJOL)

Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin. AAG Jimoh, OR Balogun, Abubakar Danladi. Abstract. During a five-year period between 1st January 1995 to 31st December 1999, three hundred and twenty eight cases of obstructed labour were encountered out of a total of 12,614 deliveries managed ...

Wallstents for metastatic biliary obstruction

NARCIS (Netherlands)

van Berkel, A. M.; Bergman, J. J.; Waxman, I.; Andres, P.; Huibregtse, K.

1996-01-01

In patients with obstruction of the common bile duct caused by primary pancreaticoblliary tumors, Wallstents have been shown to remain patent for a median duration of 273 days (range: 14-363). However, in one study that included both patients with primary pancreaticobillary malignancies and patients

Effects of herbal medicine Sijunzi decoction on rabbits after relieving intestinal obstruction

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L. Li

2017-09-01

Full Text Available Intestinal obstruction leads to blockage of the movement of intestinal contents. After relieving the obstruction, patients might still suffer with compromised immune function and nutritional deficiency. This study aimed to evaluate the effects of Sijunzi decoction on restoring the immune function and nutritional status after relieving the obstruction. Experimental rabbits (2.5±0.2 kg were randomly divided into normal control group, 2-day intestinal obstruction group, 2-day natural recovery group, 4-day natural recovery group, 2-day treated group, and 4-day treated group. Sijunzi decoction was given twice a day to the treated groups. The concentration of markers was analyzed to evaluate the immune function and nutritional status. The concentration of interleukin-2, immunoglobulins and complement components of the treated groups were significantly higher than the natural recovery group (P<0.05. The levels of CD4+ and CD4+/CD8+ increased then decreased in the treated groups. The levels of tumor necrosis factor-α and CD8+ were significantly lower than the natural recovery group. The level of total protein in the treated groups also increased then decreased after relieving the obstruction. The levels of albumin, prealbumin and insulin-like growth factor-1 were significantly higher in the treated groups than in the natural recovery group (P<0.05. Transferrin level in the treated groups was significantly higher than the obstruction group (P<0.05. Sijunzi decoction can lessen the inflammatory response and improve the nutrition absorption after relieving the obstruction.

Validity of peak expiratory flow measurement in assessing reversibility of airflow obstruction.

Science.gov (United States)

Dekker, F W; Schrier, A C; Sterk, P J; Dijkman, J H

1992-01-01

BACKGROUND: Assessing the reversibility of airflow obstruction by peak expiratory (PEF) measurements would be practicable in general practice, but its usefulness has not been investigated. METHODS: PEF measurements were performed (miniWright peak flow meter) in 73 general practice patients (aged 40 to 84) with a history of asthma or chronic obstructive lung disease before and after 400 micrograms inhaled sulbutamol. The change in PEF was compared with the change in forced expiratory volume in one second (FEV1). Reversible airflow obstruction was analysed in two ways according to previous criteria. When defined as a 9% or greater increase in FEV1 expressed as a percentage of predicted values reversibility was observed in 42% of patients. Relative operating characteristic analysis showed that an absolute improvement in PEF of 60 l/min or more gave optimal discrimination between patients with reversible and irreversible airflow obstruction (the sensitivity and specificity of an increase of 60 l/min in detecting a 9% or more increase in FEV1 as a percentage of predicted values were 68% and 93% respectively, with a positive predictive value of 87%). When defined as an increase of 190 ml or more in FEV1, reversible airflow obstruction was observed in 53% of patients. Again an absolute improvement in PEF of 60 l/min or more gave optimal discrimination between patients with reversible and irreversible airflow obstruction (sensitivity 56%, specificity 94%, and positive predictive value 92%). CONCLUSION: Absolute changes in PEF can be used as a simple technique to diagnose reversible airflow obstruction in patients from general practice. PMID:1519192

Tonsillectomy or adenotonsillectomy versus non-surgical management for obstructive sleep-disordered breathing in children

NARCIS (Netherlands)

Venekamp, Roderick P; Hearne, Benjamin J; Chandrasekharan, Deepak; Blackshaw, Helen; Lim, Jerome; Schilder, Anne G M

2015-01-01

BACKGROUND: Obstructive sleep-disordered breathing (oSDB) is a condition that encompasses breathing problems when asleep, due to an obstruction of the upper airways, ranging in severity from simple snoring to obstructive sleep apnoea syndrome (OSAS). It affects both children and adults. In children,

Detection of high-grade small bowel obstruction on conventional radiography with convolutional neural networks.

Science.gov (United States)

Cheng, Phillip M; Tejura, Tapas K; Tran, Khoa N; Whang, Gilbert

2018-05-01

The purpose of this pilot study is to determine whether a deep convolutional neural network can be trained with limited image data to detect high-grade small bowel obstruction patterns on supine abdominal radiographs. Grayscale images from 3663 clinical supine abdominal radiographs were categorized into obstructive and non-obstructive categories independently by three abdominal radiologists, and the majority classification was used as ground truth; 74 images were found to be consistent with small bowel obstruction. Images were rescaled and randomized, with 2210 images constituting the training set (39 with small bowel obstruction) and 1453 images constituting the test set (35 with small bowel obstruction). Weight parameters for the final classification layer of the Inception v3 convolutional neural network, previously trained on the 2014 Large Scale Visual Recognition Challenge dataset, were retrained on the training set. After training, the neural network achieved an AUC of 0.84 on the test set (95% CI 0.78-0.89). At the maximum Youden index (sensitivity + specificity-1), the sensitivity of the system for small bowel obstruction is 83.8%, with a specificity of 68.1%. The results demonstrate that transfer learning with convolutional neural networks, even with limited training data, may be used to train a detector for high-grade small bowel obstruction gas patterns on supine radiographs.

Percutaneous intervention in obstructive

International Nuclear Information System (INIS)

Souftas, V.

2012-01-01

Percutaneous intervention procedures in obstructive uropathy include percutaneous nephrostomy tube placements, nephroureteral stents, percutaneous nephrostomy combined with ureteral embolization, percutaneous management of stone disease, suprapubic tube placements into the bladder, and perinephric/retroperitoneal urinomas/abscesses drainages. Percutaneous nephrostomy is performed to relieve urinary obstruction or divert the urinary stream away from the ureter or bladder. Patients are given preprocedure antibiotics. Percutaneous nephrostomies can be emergent cases because of risk of pyuria and sepsis from a stagnant urine collection. The procedure is performed using both ultrasound and fluoroscopy (or fluoroscopy alone using anatomic landmarks, or an internal radiopaque calculus, or delayed phase excretion of the contrast into the renal collecting system) under local anesthesia or conscious sedation. Ureteral stents are placed to bypass an obstructing stone or to stent across of an area of stricture or ureteral laceration. Stents may be placed by the urologist via a transurethral approach or by the interventional radiologist via a percutaneous approach. The decision as to method of stent placement is based upon the location and accessibility of the ureteral pathology. Ureteral embolization is performed in patients with unresectable tumors of the pelvis with long-standing nephrostomy tubes and distal urine leaks refractory to other treatments. Coils, gelfoam and liquid embolic materials can be used. Ureteral embolization for ureteral fistulas and incontinence is technically successful in 100% of the patients. Complications include bleeding, infection, ureteral or renal injury, and deployment (or movement) of the coils within the renal pelvis. Percutaneous management of stone disease, including renal, ureteral, and bladder stones requires close cooperation between the urologist and interventional radiologist, because of availability of sonographic lithotripsy

Acute colonic obstruction due to benign prostatic hypertrophy.

LENUS (Irish Health Repository)

Mac Giobuin, S

2012-02-01

A seventy two year old man presented to the Emergency Department with clinical features of colonic obstruction. Subsequent radiological investigations confirmed this impression and revealed the aetiology to be compression of the sigmoid colon against the sacrum by a massively distended urinary bladder. Chronic urinary retention due to benign prostatic hypertrophy is an extremely unusual cause of large bowel obstruction. Little in this patient\\'s clinical findings suggested this aetiology. We reviewed the literature in this area and highlight the benefits of CT scanning over contrast studies.

The Danish National Database for Obstructive Sleep Apnea

DEFF Research Database (Denmark)

Jennum, Poul Jørgen; Larsen, Preben; Cerqueira, Charlotte

2016-01-01

AIM: The aim of the Danish National Database for Obstructive Sleep Apnea (NDOSA) was to evaluate the clinical quality (diagnostic, treatment, and management) for obstructive sleep apnea and obesity hypoventilation syndrome in Denmark using a real-time national database reporting to the Danish...... departments was involved in the management of sleep apnea in Denmark for the purpose of quality improvement. CONCLUSION: The NDOSA has proven to be a real-time national database using diagnostic and treatment procedures reported to the Danish National Patient Registry....

Lifestyle modification for obstructive sleep apnoea.

Science.gov (United States)

Shneerson, J; Wright, J

2001-01-01

Obstructive sleep apnoeas are due to transient closure of the upper airway during sleep and merge into hypopnoeas in which the airway narrows, but some airflow continues. They are due to the forces compressing the airway overcoming those which stabilise its patency. The commonest association is obesity in which fatty tissue is deposited around the airway. Exercise has been recommended as a method of losing weight, but other techniques which achieve this are also thought to improve symptoms due to sleep apnoeas. Sleep hygiene may alter the sleep structure and the control of the upper airway during sleep and thus promote its patency. The objectives of this review are to determine whether weight loss, sleep hygiene and exercise are effective in the treatment of obstructive sleep apnoeas. The Cochrane Airways Group Trials Register, MEDLINE, EMBASE, CINAHL and reference lists of review articles have been searched. Randomised, single or double blind placebo controlled, either parallel group or crossover design studies of any of these interventions were to have been included. No completed trials have been identified. No randomised trial data were available for analysis. There is a need for randomised controlled trials of these commonly used treatments in obstructive sleep apnoeas. These should identify which sub groups of patients with sleep apnoeas benefit most from each type of treatment and they should have clear and standardised outcome measures.

ANESTHETIC CONSIDERATION S IN CHRONIC OBSTRUCTIVE PULMON ARY DISEASE

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Awati

2015-03-01

Full Text Available Chronic obstructive pulmonary disease (COPD is a spectrum of diseases that includes emphysema, chronic bronchitis, and small airway disease. It i s characterized by progressive increased resistance to breathing. Patients with marked obstructive pulmonary disease are at increased risk for both intraoperative and Postoperative pulmonary complications. These patients require thorough preoperative prepa ration, meticulous intraoperative management & postoperative care. This article describes anesthetic considerations in a patient with COPD.

Subtotal obstruction of the male reproductive tract.

Science.gov (United States)

Dohle, G R; van Roijen, J H; Pierik, F H; Vreeburg, J T M; Weber, R F A

2003-03-01

Bilateral obstruction of the male reproductive tract is suspected in men with azoospermia, normal testicular volume and normal FSH. A testicular biopsy is required to differentiate between an obstruction and a testicular insufficiency. Unilateral or subtotal bilateral obstructions and epididymal dysfunction may cause severe oligozoospermia in men with a normal spermatogenesis. However, information on spermatogenesis in oligozoospermic men is lacking, since testicular biopsy is not routinely performed. Men with a sperm concentration of scoring method. A testicular biopsy was performed in 78 men with severe oligozoospermia. The medical history showed male accessory gland infection in 12.8%, previous hernia repair in 14.1% and a history of cryptorchidism in 12.8%. A normal or slightly disturbed spermatogenesis (Johnsen score >8) was present in 39/78 (50%) of the men. Hernia repair occurred more often in men with normal spermatogenesis. A varicocele was predominantly seen in men with a disturbed spermatogenesis. FSH was significantly lower ( Preproductive tract is a frequent cause of severe oligozoospermia in men with a normal testicular volume and a normal FSH. In other cases, an epididymal dysfunction might explain the oligozoospermia in men with a normal testicular biopsy score.

Laparoscopic jejunostomy for obstructing upper gastrointestinal malignancies

Science.gov (United States)

TSUJIMOTO, HIRONORI; HIRAKI, SHUICHI; TAKAHATA, RISA; NOMURA, SHINSUKE; ITO, NOZOMI; KANEMATSU, KYOHEI; HORIGUCHI, HIROYUKI; AOSASA, SUEFUMI; YAMAMOTO, JUNJI; HASE, KAZUO

2015-01-01

The aim of this study was to describe a minimally invasive laparoscopic jejunostomy (Lap-J) technique for obstruction due to upper gastrointestinal malignancies and evaluate the nutritional benefit of Lap-J during neoadjuvant chemotherapy (NAC) in cases with obstructing esophageal cancer. Under general anesthesia, the jejunum 20–30 cm distant from the Treitz ligament was pulled out through an extended umbilical laparoscopic incision and a jejunal tube was inserted to 30 cm. The loop of bowel was gently returned to the abdomen and the feeding tube was drawn through the abdominal wall via the left lower incision. The jejunum was then laparoscopically sutured to the anterior abdominal wall. Lap-J was performed in 26 cases. The median operative time was 82 min. The postoperative course was uneventful. Lap-J prior to NAC was not associated with a decrease in body weight or serum total protein during NAC, compared with patients who received NAC without Lap-J. This minimally invasive jejunostomy technique may be particularly useful in patients in whom endoscopic therapy is not feasible due to obstruction from upper gastrointestinal malignancies. PMID:26807238

Managing obstructive gastric volvulus: challenges and solutions

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Rodriguez-Garcia HA

2017-03-01

Full Text Available Hector Alejandro Rodriguez-Garcia,1 Andrew S Wright,2–4 Robert B Yates1–3 1Department of Surgery, Center for Esophageal and Gastric Surgery, 2Center for Videoendoscopic Surgery, 3Hernia Center, 4Institute for Simulation and Interprofessional Studies, UWMC, University of Washington, Seattle, USA Abstract: Gastric volvulus is the abnormal torsion of the stomach along its short or long axis. Most patients who experience gastric volvulus present with mild or intermittent gastric obstructive symptoms. However, severe acute gastric volvulus can result in complete gastric outlet obstruction and ischemia. Consequently, acute gastric volvulus warrants immediate evaluation and management. The goals of management are to relieve the obstruction and prevent recurrent volvulus. Techniques to manage gastric volvulus depend on patient characteristics and the presence of gastric ischemia. In the absence of gastric ischemia, gastric volvulus can be managed with anterior abdominal wall gastropexy or paraesophageal hernia repair. If gastric ischemia is present, operative resection of the affected portion of the stomach is indicated. When operative management is indicated, many patients with gastric volvulus can be managed with minimally invasive (laparoscopic, endoscopic, or laparoendoscopic techniques. Keywords: gastric volvulus, paraesophageal hernia, hiatal hernia

Endoscopic stenting versus operative gastrojejunostomy for malignant gastric outlet obstruction.

Science.gov (United States)

Chandrasegaram, Manju D; Eslick, Guy D; Mansfield, Clare O; Liem, Han; Richardson, Mark; Ahmed, Sulman; Cox, Michael R

2012-02-01

Malignant gastric outlet obstruction represents a terminal stage in pancreatic cancer. Between 5% and 25% of patients with pancreatic cancer ultimately experience malignant gastric outlet obstruction. The aim in palliating patients with malignant gastric outlet obstruction is to reestablish an oral intake by restoring gastrointestinal continuity. This ultimately improves their quality of life in the advanced stages of cancer. The main drawback to operative bypass is the high incidence of delayed gastric emptying, particularly in this group of patients with symptomatic obstruction. This study aimed to compare surgical gastrojejunostomy and endoscopic stenting in palliation of malignant gastric outlet obstruction, acknowledging the diversity and heterogeneity of patients with this presentation. This retrospective study investigated patients treated for malignant gastric outlet obstruction from December 1998 to November 2008 at Nepean Hospital, Sydney, Australia. Endoscopic duodenal stenting was performed under fluoroscopic guidance for placement of the stent. The operative patients underwent open surgical gastrojejunostomy. The outcomes assessed included time to diet, hospital length of stay (LOS), biliary drainage procedures, morbidity, and mortality. Of the 45 participants in this study, 26 underwent duodenal stenting and 19 had operative bypass. Comparing the stenting and operative patients, the median time to fluid intake was respectively 0 vs. 7 days (P < 0.001), and the time to intake of solids was 2 vs. 9 days (P = 0.004). The median total LOS was shorter in the stenting group (11 vs. 25 days; P < 0.001), as was the median postprocedure LOS (5 vs. 10 days; P = 0.07). Endoscopic stenting is preferable to operative gastrojejunostomy in terms of shorter LOS, faster return to fluids and solids, and reduced morbidity and in-hospital mortality for patients with a limited life span.

Predictors of objective cough frequency in chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Sumner, Helen; Woodcock, Ashley; Kolsum, Umme

2013-01-01

Cough is one of the principal symptoms of chronic obstructive pulmonary disease (COPD) but the potential drivers of cough are likely to be multifactorial and poorly understood.......Cough is one of the principal symptoms of chronic obstructive pulmonary disease (COPD) but the potential drivers of cough are likely to be multifactorial and poorly understood....

Oxidative stress in obstructive nephropathy

NARCIS (Netherlands)

Dendooven, Amelie; Ishola, David A.; Nguyen, Tri Q.; Van der Giezen, Dionne M.; Kok, Robbert Jan; Goldschmeding, Roel; Joles, Jaap A.

P>Unilateral ureteric obstruction (UUO) is one of the most commonly applied rodent models to study the pathophysiology of renal fibrosis. This model reflects important aspects of inflammation and fibrosis that are prominent in human kidney diseases. In this review, we present an overview of the

Obstruction theory on 8-manifolds

Czech Academy of Sciences Publication Activity Database

Čadek, M.; Crabb, M.; Vanžura, Jiří

2008-01-01

Roč. 127, č. 2 (2008), s. 167-186 ISSN 0025-2611 R&D Projects: GA ČR GA201/05/2117 Institutional research plan: CEZ:AV0Z10190503 Keywords : 8-manifolds * obstruction theory Subject RIV: BA - General Mathematics Impact factor: 0.509, year: 2008

Palliative management of malignant bowel obstruction in terminally Ill patient

Directory of Open Access Journals (Sweden)

Darshit A Thaker

2010-01-01

Full Text Available Mr. P was a 57-year-old man who presented with symptoms of bowel obstruction in the setting of a known metastatic pancreatic cancer. Diagnosis of malignant bowel obstruction was made clinically and radiologically and he was treated conservatively (non-operativelywith octreotide, metoclopromide and dexamethasone, which provided good control over symptoms and allowed him to have quality time with family until he died few weeks later with liver failure. Bowel obstruction in patients with abdominal malignancy requires careful assessment. The patient and family should always be involved in decision making. The ultimate goals of palliative care (symptom management, quality of life and dignity of death should never be forgotten during decision making for any patient.

Ventilation therapy for patients suffering from obstructive lung diseases.

Science.gov (United States)

Jungblut, Sven A; Heidelmann, Lena M; Westerfeld, Andreas; Frickmann, Hagen; Körber, Mareike K; Zautner, Andreas E

2014-01-01

Severe bronchial obstruction due to one of the major pulmonary diseases: asthma, COPD, or emphysema often requires mechanical ventilation support. Otherwise, patients are at risk of severe hypooxygenation with consecutive overloading and dilatation of the right cardiac ventricle with subsequent failure. This review focuses on how to manage a calculated ventilation therapy of patients suffering from bronchial obstruction and relevant patents. Options and pitfalls of invasive and non-invasive ventilation in the intensive care setting regarding clinical improvement and final outcome are discussed. The non-invasive ventilation is very efficient in treating acute or chronic respiratory failure in COPD patients and is capable of shortening the duration of hospitalization. Further non-invasive ventilation can successfully support the weaning after a long-lasting ventilation therapy and improve the prognosis of COPD patients. "Permissive hypercapnia" is unequivocally established in invasive ventilation therapy of severe bronchial obstruction in situations of limited ventilation. When intrinsic positive end-expiratory pressure (PEEP) and elevated airways resistance are present PEEP may be useful although external-PEEP application relieves over-inflation only in selected patients with airway obstruction during controlled mechanical ventilation. Upper limit of airways peak pressure used in "protective ventilation" of adult respiratory distress syndrome (ARDS) patients can be exceeded under certain circumstances.

Crisis management during anaesthesia: obstruction of the natural airway.

Science.gov (United States)

Visvanathan, T; Kluger, M T; Webb, R K; Westhorpe, R N

2005-06-01

Obstruction of the natural airway, while usually easily recognised and managed, may present simply as desaturation, have an unexpected cause, be very difficult to manage, and have serious consequences for the patient. To examine the role of a previously described core algorithm "COVER ABCD-A SWIFT CHECK", supplemented by a specific sub-algorithm for obstruction of the natural airway, in the management of acute airway obstruction occurring in association with anaesthesia. The potential performance for this structured approach for each of the relevant incidents among the first 4000 reported to the Australian Incident Monitoring Study (AIMS) was compared with the actual management as reported by the anaesthetists involved. There were 62 relevant incidents among the first 4000 reports to the AIMS. It was considered that the correct use of the structured approach would have led to earlier recognition of the problem and/or better management in 11% of cases. Airway management is a fundamental anaesthetic responsibility and skill. Airway obstruction demands a rapid and organised approach to its diagnosis and management and undue delay usually results in desaturation and a potential threat to life. An uncomplicated pre-learned sequence of airway rescue instructions is an essential part of every anaesthetist's clinical practice requirements.

Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea.

Science.gov (United States)

Oliveira, Luciana Almeida Moreira da Paz; Fontes, Luiz Henrique de Souza; Cahali, Michel Burihan

2015-01-01

Upper airway nerve and muscle damage associated with obstructive sleep apnea may impair the strength and dynamics of pharyngeal and esophageal contractions during swallowing. To evaluate the presence of alterations in pharyngoesophageal manometry in patients with obstructive sleep apnea with and without oropharyngeal dysphagia. This study prospectively evaluated 22 patients with obstructive sleep apnea without spontaneous complaints of dysphagia, using a questionnaire, fiberoptic endoscopic evaluation of swallowing, and pharyngoesophageal manometry, including measurement of the upper and lower esophageal sphincter pressures and mean pharyngeal pressures at three levels during swallowing. The dysphagia group consisted of 17 patients (77.3%) in whom swallowing abnormalities were detected on fiberoptic endoscopic evaluation of swallowing (n=15; 68.2%) and/or in the questionnaire (n=7; 31.8%). The five remaining cases comprised a control group without oropharyngeal dysphagia. In all cases of abnormalities on fiberoptic endoscopic evaluation of swallowing, there was premature bolus leakage into the pharynx. There was no statistically significant difference between the groups regarding any of the pharyngoesophageal manometry measurements, age, or severity of obstructive sleep apnea. Pharyngoesophageal manometry detected no statistically significant difference between the groups with and without oropharyngeal dysphagia. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Long-acting beta 2-agonists in chronic obstructive pulmonary disease.

Science.gov (United States)

Llewellyn-Jones, Carol

2002-01-01

Until recently, the use of long-acting beta 2-agonists in chronic obstructive pulmonary disease has been understated. There is now evidence that they may offer benefits beyond bronchodilation. This article reviews the management of chronic obstructive pulmonary disease and looks at the place of long-acting beta 2-agonists as a first-line treatment option.

Tonsil volume, tonsil grade and obstructive sleep apnea: is there any meaningful correlation?

Directory of Open Access Journals (Sweden)

Michel Burihan Cahali

2011-01-01

Full Text Available OBJECTIVES: The aims of this study were to evaluate the correlation between oropharyngeal examination and objective palatine tonsil volume in snoring adults and verify the influence of the oropharyngeal anatomy, body mass index, age, and severity of obstructive sleep apnea on actual tonsil volume. In addition, we aimed to assess the influence of tonsil size on obstructive sleep apnea in adults. INTRODUCTION: Pharyngeal wall geometry is often altered in adults who have obstructive sleep apnea, and this might influence the findings of the oropharyngeal examination that, in turn, are the key factors when considering surgical management for this condition. Furthermore, the correlation between the actual tonsil volume and the severity of obstructive sleep apnea in adults is currently unknown. METHODS: We prospectively studied 130 patients with obstructive sleep apnea or primary snoring who underwent pharyngeal surgery with intraoperative measurement of tonsil volume. We compared tonsil volume with preoperative polysomnography, oropharyngeal examination, and anthropometric data. RESULTS: We found a significant correlation between actual tonsil volume and subjective tonsil grade. We also found a significant correlation between tonsil volume and the apnea-hypopnea index. Using a multivariate linear regression model, tonsil volume was found to be significantly correlated with age, body mass index, and oropharyngeal examination, but not with polysomnography. Clinically, only the rare tonsil grade IV was indicative of more severe obstructive sleep apnea. CONCLUSIONS: There is a strong correlation between clinical tonsil grade and objective tonsil volume in snoring adults, and this correlation exists regardless of the presence or severity of obstructive sleep apnea. Pharyngeal tissue volume likely reflects the body mass index rather than obstructive sleep apnea severity.

Annular pancreas causing extrahepatic biliary obstruction

International Nuclear Information System (INIS)

Ogulin, M.; Jamar, B.

2004-01-01

Background. Annular pancreas is an uncommon congenital abnormality, consisting of a flat band of pancreatic tissue, which encircles duodenum or extrahepatic biliary duct. We present a case of obstructive jaundice, caused by annular pancreas. Case report. A 46 years old female was admitted because of a sudden onset of abdominal pain, vomiting and jaundice. For the last six years she occasionally noticed her skin was light yellow, in the last year she felt distension in the upper abdomen, especially after fatty meals. Conclusions. Two US examinations, the first one six months before the admission, showed dilated hepatic ducts. The reason of dilatation was unclear, even after the endoscopic US examination. At operation an almost complete obstruction of the common hepatic duct was found, caused by a narrow band of pancreatic tissue. (author)

Effects of experimentally induced intestinal obstruction on the electrolyte profile in dogs

International Nuclear Information System (INIS)

Dar, E.M.; Khan, M.A.; Mehmood, A.K.

2004-01-01

This study was conducted to quantitatively asses the changes in serum electrolyte profile after experimentally induced upper and lower intestinal obstruction in dogs. Ten dogs of either sex ranging in weight from 20-25 Kg were selected. After thorough physical examination, de-worming and vaccination they were randomly divided into 3 groups. Groups A and B comprised of four animals each while group C had two animals. After preparing the operation site, upper intestinal obstruction was induced in animals of group A and lower intestinal obstruction was induced in all animals of group B through mid line laparotomy under general anesthesia. Animals of group C were kept as control without induction of any obstruction. Proper post-operative care was given to the operated animals. Blood samples were collected from all animals at an interval of 24 hours and evaluated to observe changes in serum sodium, potassium and chloride levels. The results of this study showed marked decline in electrolyte levels in animals of both groups A and B, however this decline was more severe and rapid in group A than group B, while group c acted normally. It can be concluded that upper intestinal obstruction is more fatal in its consequences than lower intestinal obstruction, which is relatively less dangerous in producing its ill effects. (author)

Tracheal obstructions in two horses and a donkey

International Nuclear Information System (INIS)

Mair, T.S.; Lane, J.G.

1990-01-01

The clinical signs associated with intramural tracheal obstructions in two horses and a donkey were respiratory distress and coughing, which were aggravated by exercise and excitement. The obstructions were at the level of the thoracic inlet and consisted either of flattening of the cartilage rings in the dorsoventral plane or of cartilage rings having a scroll-like conformation. They appeared to be developmental in origin and to have been present for a considerable time before the onset of clinical signs. Endoscopy and radiography were helpful in the diagnosis of the condition

Prediction of the clinical course of chronic obstructive pulmonary disease, using the new GOLD classification

DEFF Research Database (Denmark)

Lange, Peter; Marott, Jacob Louis; Vestbo, Jørgen

2012-01-01

The new Global Initiative for Obstructive Lung Disease (GOLD) stratification of chronic obstructive pulmonary disease (COPD) into categories A, B, C, and D is based on symptoms, level of lung function, and history of exacerbations.......The new Global Initiative for Obstructive Lung Disease (GOLD) stratification of chronic obstructive pulmonary disease (COPD) into categories A, B, C, and D is based on symptoms, level of lung function, and history of exacerbations....

[Surgical treatment of congenital obstruction of the left ventricular outflow tract].

Science.gov (United States)

Biocina, B; Sutlić, Z; Husedinović, I; Letica, D; Sokolić, J

1993-01-01

This report presents the classification and all types of left ventricular outflow tract obstructions. The possibilities of operative therapies are surveyed as well. Results of surgical treatment in 34 patients with obstruction to left ventricular outflow are shown. The majority of patients underwent operation under extracorporeal circulation (84.4%), while the rest were operated by means of the inflow occlusion technique (14.7%). The obtained results were compared with those from the literature. The importance of echocardiographic evaluation of location of the left ventricular outflow tract obstruction and the appropriate choice of a surgical technique according to the patient's age are emphasized.

Pre-operative biliary drainage for obstructive jaundice

Science.gov (United States)

Fang, Yuan; Gurusamy, Kurinchi Selvan; Wang, Qin; Davidson, Brian R; Lin, He; Xie, Xiaodong; Wang, Chaohua

2014-01-01

Background Patients with obstructive jaundice have various pathophysiological changes that affect the liver, kidney, heart, and the immune system. There is considerable controversy as to whether temporary relief of biliary obstruction prior to major definitive surgery (pre-operative biliary drainage) is of any benefit to the patient. Objectives To assess the benefits and harms of pre-operative biliary drainage versus no pre-operative biliary drainage (direct surgery) in patients with obstructive jaundice (irrespective of a benign or malignant cause). Search methods We searched the Cochrane Hepato-Biliary Group Controlled Trials Register, Cochrane Central Register of Controlled Clinical Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until February 2012. Selection criteria We included all randomised clinical trials comparing biliary drainage followed by surgery versus direct surgery, performed for obstructive jaundice, irrespective of the sample size, language, and publication status. Data collection and analysis Two authors independently assessed trials for inclusion and extracted data. We calculated the risk ratio (RR), rate ratio (RaR), or mean difference (MD) with 95% confidence intervals (CI) based on the available patient analyses. We assessed the risk of bias (systematic overestimation of benefit or systematic underestimation of harm) with components of the Cochrane risk of bias tool. We assessed the risk of play of chance (random errors) with trial sequential analysis. Main results We included six trials with 520 patients comparing pre-operative biliary drainage (265 patients) versus no pre-operative biliary drainage (255 patients). Four trials used percutaneous transhepatic biliary drainage and two trials used endoscopic sphincterotomy and stenting as the method of pre-operative biliary drainage. The risk of bias was high in all trials. The proportion of patients with malignant obstruction varied between 60

Clinical consequences and economic costs of untreated obstructive sleep apnea syndrome

Directory of Open Access Journals (Sweden)

Melissa Knauert

2015-09-01

Full Text Available Objective: To provide an overview of the healthcare and societal consequences and costs of untreated obstructive sleep apnea syndrome. Data sources: PubMed database for English-language studies with no start date restrictions and with an end date of September 2014. Methods: A comprehensive literature review was performed to identify all studies that discussed the physiologic, clinical and societal consequences of obstructive sleep apnea syndrome as well as the costs associated with these consequences. There were 106 studies that formed the basis of this analysis. Conclusions: Undiagnosed and untreated obstructive sleep apnea syndrome can lead to abnormal physiology that can have serious implications including increased cardiovascular disease, stroke, metabolic disease, excessive daytime sleepiness, work-place errors, traffic accidents and death. These consequences result in significant economic burden. Both, the health and societal consequences and their costs can be decreased with identification and treatment of sleep apnea. Implications for practice: Treatment of obstructive sleep apnea syndrome, despite its consequences, is limited by lack of diagnosis, poor patient acceptance, lack of access to effective therapies, and lack of a variety of effective therapies. Newer modes of therapy that are effective, cost efficient and more accepted by patients need to be developed. Keywords: Obstructive sleep apnea syndrome, Cost, Continuous positive airway pressure, Mandibular advancement device

Factors influencing self-management in chronic obstructive pulmonary disease: an integrative review.

Science.gov (United States)

Disler, R T; Gallagher, R D; Davidson, P M

2012-02-01

Chronic obstructive pulmonary disease is a common, chronic and burdensome condition requiring the individual to engage in a range of self-management strategies. The capacity to engage in self-management is dependent on a range of internal (e.g., personal) and external (e.g., health service) factors. This paper seeks to define self-management, identify the determinants which influence the individual's ability to cope and adjust to living with chronic obstructive pulmonary disease in the community, and identify implications for clinical practice and research. Integrative review. Medline, Embase, PubMed, CINAHL, Google Scholar. Integrative review using prospective research questions. Papers were included in the review if they were published in peer reviewed journals and written in English between 2000 and 2010. Articles were accepted for inclusion if they discussed the determinants that influenced self-management of chronic obstructive pulmonary disease in the community. Confirmation of results and discussion themes was validated by specialists in chronic obstructive pulmonary disease and complex care. Self-management is less well characterised in chronic obstructive pulmonary disease compared with other chronic conditions. Functional limitation and the need to balance disease management with everyday life are the two key elements that patients face in managing their condition. Provider characteristics, socioeconomic status and health literacy are sparsely discussed yet are known to influence chronic obstructive pulmonary disease self-management. Chronic obstructive pulmonary disease self-management must be a key focus internationally as the disease incidence increases. Collaborative care is required between patients and health providers in order facilitate patients in confident management of their condition. Copyright © 2011 Elsevier Ltd. All rights reserved.

Anaesthesia and subglottic airway obstruction

African Journals Online (AJOL)

2009-07-14

Jul 14, 2009 ... Introduction. Surgery on the upper airway remains challenging for both surgeon and ... from her upper airway obstruction rather than asthma.1 She had made a long ... patient was well oxygenated with oxygen saturation above. 95%. .... Difficulties relate to tidal volume measurement, CO2 detection and the.

CLINICAL CASES OF INTESTINAL OBSTRUCTION WITH FOREIGN BODIES AND INTUSSUSCEPTION IN DOGS

OpenAIRE

KOIKE, Toshio; OTOMO, Kanjuro; KUDO, Tadaaki; SAKAI, Tamotsu

1981-01-01

The medical records of dogs treated in our veterinary hospital during a period of 15 years until 1978 were reviewed. Intestinal obstruction was diagnosed in 47 dogs, among which 51.06% were under 12 months of age and 80.85% were under 3 years. The period which elasped from the appearance of clinical signs to the operation of the obstructed intestines averaged about 5 days (ranging from 1 to 24 days). The presurgical hematological findings of 5 dogs with intestinal obstruction suggested hemoco...

Occupational exposure to pesticides are associated with fixed airflow obstruction in middle-age.

Science.gov (United States)

Alif, Sheikh M; Dharmage, Shyamali C; Benke, Geza; Dennekamp, Martine; Burgess, John A; Perret, Jennifer L; Lodge, Caroline J; Morrison, Stephen; Johns, David Peter; Giles, Graham G; Gurrin, Lyle C; Thomas, Paul S; Hopper, John Llewelyn; Wood-Baker, Richard; Thompson, Bruce R; Feather, Iain H; Vermeulen, Roel; Kromhout, Hans; Walters, E Haydn; Abramson, Michael J; Matheson, Melanie Claire

2017-11-01

Population-based studies have found evidence of a relationship between occupational exposures and Chronic Obstructive Pulmonary Disease (COPD), but these studies are limited by the use of prebronchodilator spirometry. Establishing this link using postbronchodilator is critical, because occupational exposures are a modifiable risk factor for COPD. To investigate the associations between occupational exposures and fixed airflow obstruction using postbronchodilator spirometry. One thousand three hundred and thirty-five participants were included from 2002 to 2008 follow-up of the Tasmanian Longitudinal Health Study (TAHS). Spirometry was performed and lifetime work history calendars were used to collect occupational history. ALOHA plus Job Exposure Matrix was used to assign occupational exposure, and defined as ever exposed and cumulative exposure unit (EU)-years. Fixed airflow obstruction was defined by postbronchodilator FEV 1 /FVC biological dust (relative risk (RR)=1.58, 95% CI 1.01 to 2.48), pesticides (RR=1.74,95% CI 1.00 to 3.07) and herbicides (RR=2.09,95% CI 1.18 to 3.70) were associated with fixed airflow obstruction. Cumulative EU-years to all pesticides (RR=1.11,95% CI 1.00 to 1.25) and herbicides (RR=1.15,95% CI 1.00 to 1.32) were also associated with fixed airflow obstruction. In addition, all pesticides exposure was consistently associated with chronic bronchitis and symptoms that are consistent with airflow obstruction. Ever exposure to mineral dust, gases/fumes and vapours, gases, dust or fumes were only associated with fixed airflow obstruction in non-asthmatics only. Pesticides and herbicides exposures were associated with fixed airflow obstruction and chronic bronchitis. Biological dust exposure was also associated with fixed airflow obstruction in non-asthmatics. Minimising occupational exposure to these agents may help to reduce the burden of COPD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

Defaecography and obstructed defaecation

International Nuclear Information System (INIS)

Schmelzer, H.; Schweiberer, L.; Muenchen Univ.; Mangel, E.; Muenchen Univ.

1988-01-01

Severe constipation or unexplained anorectal symptoms may be caused by obstructed defaecation due to functional pelvic floor disorders that can be identified or verified by defaecography. Based upon own experiences this paper deals with the methodology and the parameters of this late radiological technique as well as the clinical picture of the disorders encountered. The possibilities of management and operative therapy are discussed in short. (orig.) [de

[The research progress of relationship between the obstructive sleep apnea hypopnea syndrome and asthma].

Science.gov (United States)

Wang, Jinfeng; Xie, Yuping; Ma, Wei

2015-02-01

Obstructive sleep apnea hypopnea syndrome (OSAHS) is characterized by repeated episodes of upper airway obstruction that results in brief periods of breathing cessation (apnea) or a marked reduction in airflow (hypopnea) during sleep. Asthma is a chronic inflammatory disease of the airways characterized by revesible air-flow obstruction and bronchial hyperresponsiveness. This article reviewed related reseaches progress of relationship between the obstructive sleep apnea hypopnea syndrom and asthma in the vascular endothelial growth factor, systemic inflammation, leptin, obesity, gastroesophageal reflux disease and upper airway diseases, excessive daytime sleepiness and asthma control.

Clinico-Pathological Profile and Management of Acute Mechanical Small Bowel Obstruction: A Prospective Study

Directory of Open Access Journals (Sweden)

Tahir Saleem Khan

2013-06-01

Conclusion: Abdominal pain and distention of the abdomen are the most common symptoms and physical findings in patients presenting with acute mechanical small bowel obstruction (SBO. Worm (ascaridial obstruction is the most common cause of obstruction followed by postoperative adhesions. Although all patients were managed conservatively to start with, the operative rate in our series remained very high because it is very difficult to distinguish simple from strangulation obstruction on clinical, biochemical and/or radiological grounds with certainty. [Arch Clin Exp Surg 2013; 2(3.000: 154-160

The CT diagnostic value of emergency intestinal obstruction caused by colon carcinoma

International Nuclear Information System (INIS)

Li Zhuohong

2008-01-01

Objective: To analyze the value of CT in the diagnosis of emergency intestinal obstruction (EIOB) caused by colon carcinoma. Methods: 17 cases with EIOB caused by colon carcinoma were submitted to CT scanning. Contrast enhanced scans were performed in 11 cases. The locations and characters of EIOB in CT imaging were recorded and compared with operation results. Results: The locations of the obstructions were 3 cases in cecum, 1 in ascending colon, 1 in transverse colon, 2 in descending colon, and 10 in sigmoid colon. Compared with operation results, the accuracy of CT in locating obstruction was 94%, and in qualitative diagnosis of colon carcinomas was 70%. Conclusion: CT can display very well the obstruction location of EIOB, and It has certain value in character izing colon carcinoma with EIOB. (authors)

Surgical treatment by otorhinolaryngology in obstructive sleep apnea-hypopnea syndrome (OSAHS

Directory of Open Access Journals (Sweden)

Andrés Vallejo-Balen

2017-08-01

Full Text Available Obstructive sleep apnea-hypopnea syndrome (OSAHS is characterized by the partial obstruction or total collapse of the upper airway in an intermittent and repetitive manner; in this scenario, surgical management was initially regarded as an alternative for treating this pathology. Nowadays, surgery is highly recognized because it improves tolerance and adaptation to positive pressure therapy; it remains as the first line of treatment, although high rates of effectiveness are not achieved. The first step before considering any surgical procedure is an adequate topographic diagnosis; therefore, a nasofibrolaryngoscopy should always be performed to identify the obstruction site(s. It is known that 75% of patients have obstructions at multiple levels, so correcting OSAHS by up to 95% is possible when the approach considers all the levels. Current procedures include nasal surgery, soft palate, tonsils, tongue base, hypoglossal nerve stimulator and facial skeletal procedures, as well as adjuvant procedures that include radiofrequency and palate implants.

Effects of the Airway Obstruction on the Skin Microcirculation in Patients with Bronchial Asthma.

Science.gov (United States)

Tikhonova, I V; Kosyakova, N I; Tankanag, A V; Chemeris, N K

Pulmonary hemodynamic disorders depend on the inflammatory phases and severity of the obstructive syndrome. However, the effect of asthma bronchial obstruction on the state of peripheral hemodynamics remains insufficiently known. To study the effects of airway obstruction on skin blood flow parameters and its regulatory systems in patients with persistent atopic bronchial asthma in the remission state. A comparative study of the skin peripheral blood flow in patients with bronchial asthma with severe airway obstruction (1st group) and without obstruction (2nd group) was conducted. 20 patients with confirmed diagnosis of atopic asthma of 50–74 years old participated in the study. All patients received basic therapy in a constant dosing of high doses of inhaled glucocorticosteroids/long-acting beta-2-agonists. The control group included 20 healthy volunteers without evidence of bronchial obstruction. The study lasted for 3 months. The forced expiratory volume in 1 s (FEV1) was used to evaluate the bronchial obstruction by spirometry technique. Skin blood perfusion changes were recorded by laser Doppler flowmetry at rest and in response to short-term local ischemia. Registered peripheral blood flow signals were examined using the amplitude temporal filtering in five frequency intervals to identify the functional features of the peripheral blood flow regulation systems. Consistent two-fold decrease of the oscillation amplitudes was found in the neurogenic interval at rest (p=0.031), as well as in the myogenic (p=0.043; p=0.031) and endothelial intervals (p=0.037; p≤0.001) both at rest and during the postocclusive reactive hyperemia respectively in the 1st group of patients with bronchial obstruction (FEV1 obstruction, FEV1 >80%) in comparison to control subjects. The presence of bronchial obstruction has a significant impact on the changes of the amplitudes of skin blood flow oscillations in patients with bronchial asthma in the myogenic, neurogenic and endothelial

Outpatient Chronic Obstructive Pulmonary Disease Management: Going for the GOLD.

Science.gov (United States)

Bellinger, Christina R; Peters, Stephen P

2015-01-01

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States with a burden of $50 billion in direct health care costs. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) defines airflow obstruction as spirometry where the ratio of forced expiratory volume in the first second to forced vital capacity after bronchodilation is less than 0.70. The guidelines also provided graded recommendations on current therapy for COPD. Treatment can be guided based on severity of disease and severity of symptoms. We review the GOLD guidelines to provide an overview of treatment modalities aimed at improving lung function, reducing hospitalization, and reducing mortality. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Obstructive renal injury: from fluid mechanics to molecular cell biology.

Science.gov (United States)

Ucero, Alvaro C; Gonçalves, Sara; Benito-Martin, Alberto; Santamaría, Beatriz; Ramos, Adrian M; Berzal, Sergio; Ruiz-Ortega, Marta; Egido, Jesus; Ortiz, Alberto

2010-04-22

Urinary tract obstruction is a frequent cause of renal impairment. The physiopathology of obstructive nephropathy has long been viewed as a mere mechanical problem. However, recent advances in cell and systems biology have disclosed a complex physiopathology involving a high number of molecular mediators of injury that lead to cellular processes of apoptotic cell death, cell injury leading to inflammation and resultant fibrosis. Functional studies in animal models of ureteral obstruction using a variety of techniques that include genetically modified animals have disclosed an important role for the renin-angiotensin system, transforming growth factor-β1 (TGF-β1) and other mediators of inflammation in this process. In addition, high throughput techniques such as proteomics and transcriptomics have identified potential biomarkers that may guide clinical decision-making.

Self-expandable metal stents for obstructing colonic and extracolonic cancer

DEFF Research Database (Denmark)

van Hooft, Jeanin E; van Halsema, Emo E; Vanbiervliet, Geoffroy

2014-01-01

as a bridge to elective surgery is not recommended as a standard treatment of symptomatic left-sided malignant colonic obstruction (strong recommendation, high quality evidence). 3 For patients with potentially curable but obstructing left-sided colonic cancer, stent placement may be considered......, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations The following recommendations should only be applied after a thorough diagnostic evaluation including a contrast-enhanced computed tomography (CT) scan. 1 Prophylactic colonic...... stent placement is not recommended. Colonic stenting should be reserved for patients with clinical symptoms and imaging evidence of malignant large-bowel obstruction, without signs of perforation (strong recommendation, low quality evidence). 2 Colonic self-expandable metal stent (SEMS) placement...

Genetics Home Reference: obstructive sleep apnea

Science.gov (United States)

... eCollection 2014. Review. Citation on PubMed or Free article on PubMed Central de Lima FF, Mazzotti DR, Tufik S, Bittencourt L. The role inflammatory response genes in obstructive sleep apnea syndrome: a review. Sleep ...

Percutaneous management of tumoral biliary obstruction in children

Energy Technology Data Exchange (ETDEWEB)

Akinci, Devrim; Gumus, Burcak; Ozkan, Orhan S.; Ozmen, Mustafa N.; Akhan, Okan [Hacettepe School of Medicine, Department of Radiology, Sihhiye, Ankara (Turkey); Ekinci, Saniye [Hacettepe School of Medicine, Department of Paediatric Surgery, Sihhiye, Ankara (Turkey); Akcoren, Zuhal [Hacettepe School of Medicine, Department of Paediatric Pathology, Sihhiye, Ankara (Turkey); Kutluk, Tezer [Hacettepe School of Medicine, Department of Paediatric Oncology, Sihhiye, Ankara (Turkey)

2007-10-15

There is limited experience of percutaneous biliary interventions in children although they are safe and effective procedures. To evaluate the efficacy and safety of percutaneous management of tumoral biliary obstruction in children. Percutaneous biliary interventions were performed in eight children (six boys, two girls) with a mean age of 10.5 years (range 4-17 years). The interventions included percutaneous biliary drainage (five patients), percutaneous biliary drainage and placement of a self-expanding metallic stent (two patients), and percutaneous cholecystostomy (one patient). All patients had signs of obstructive jaundice and two had cholangitis. All procedures were successful. No procedure-related mortality was observed. Bilirubin levels returned to normal in four of the eight patients. Findings of cholangitis resolved in the two affected patients after the procedure and antibiotic treatment. Two patients underwent surgery after percutaneous biliary drainage procedures. A self-expanding metallic stent was placed in two patients with malignancy and the stents remained patent until death. Percutaneous biliary interventions can be performed safely for the management of tumoral biliary obstruction in children. (orig.)

Female outlet obstruction constipation: assessment with MR defecography

International Nuclear Information System (INIS)

Li Min; Jiang Tao; Yang Xinqing; Peng Peng; Wang Wenchuan

2010-01-01

Objective: Using MR defecography to assess the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and evaluate the joint disease of' anterior and mid pelvic. Methods: One hundred and seven female patients, aged 20 to 84 years (average, 55 years), were diagnosed as outlet obstruction constipation based on clinical symptoms and signs. They all received MR defecography in our institution. The high compliance homemade balloon was inserted into rectum to simulate stool. Then relevant measurements were obtained during rest, squeezing and straining, respectively. Results: In all the 107 cases, 70 (65.4%) presented rectocele on dynamic MRI; 28 (26.2%) presented anismus; 60 (56.1%) presented cystocele; 59 presented vaginal or cervical prolapse(55.1%); and, 54 (50.5%) presented descending perineum. In 85 females (79.4%) multiple disorders were detected, involving more than one pelvic compartment. Conclusion: MR defecography allowed to accurately evaluate the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and the joint disease of anterior and mid pelvic. (authors)

Cholangiopathy in extrahepatic portal venous obstruction: radiological appearances

International Nuclear Information System (INIS)

Nagi, B.; Kochhar, R.; Bhasin, D.; Singh, K.

2000-01-01

To evaluate cholangiographic abnormalities resulting from extrahepatic portal venous obstruction (EHPVO) by sonography and endoscopic retrograde cholangiopancreaticography (ERCP). Material and Methods: Forty-three patients with an established diagnosis of EHPVO were subjected to duplex Doppler sonography and ERCP. Of these, 8 patients had obstructive jaundice. Results: Dilated common bile duct with pericholedochal varices showing a continuous type of flow pattern was seen in 5 EHPVO patients with obstructive jaundice. ERCP revealed cholangiographic abnormalities in 40 patients (93%). Extrahepatic bile ducts were involved in 100% of cases compared to intrahepatic bile ducts (57%). Abnormalities noted were contour irregularity with indentations, displacement and angulation, strictures and filling defects in the extrahepatic ductal system. Intrahepatic bile ducts showed dilatation with areas of narrowing and filling defects. Conclusion: Cholangiographic abnormalities are very common in patients with EHPVO, even without clinical manifestations of biliary disease. Extrahepatic bile ducts are far more often involved compared to intrahepatic bile ducts. Extrinsic compression with contour irregularity is the most common cholangiographic finding. Sonographic findings are not diagnostic. Dilated common bile duct with pericholedochal varices was seen in only 5 patients

Percutaneous management of tumoral biliary obstruction in children

International Nuclear Information System (INIS)

Akinci, Devrim; Gumus, Burcak; Ozkan, Orhan S.; Ozmen, Mustafa N.; Akhan, Okan; Ekinci, Saniye; Akcoren, Zuhal; Kutluk, Tezer

2007-01-01

There is limited experience of percutaneous biliary interventions in children although they are safe and effective procedures. To evaluate the efficacy and safety of percutaneous management of tumoral biliary obstruction in children. Percutaneous biliary interventions were performed in eight children (six boys, two girls) with a mean age of 10.5 years (range 4-17 years). The interventions included percutaneous biliary drainage (five patients), percutaneous biliary drainage and placement of a self-expanding metallic stent (two patients), and percutaneous cholecystostomy (one patient). All patients had signs of obstructive jaundice and two had cholangitis. All procedures were successful. No procedure-related mortality was observed. Bilirubin levels returned to normal in four of the eight patients. Findings of cholangitis resolved in the two affected patients after the procedure and antibiotic treatment. Two patients underwent surgery after percutaneous biliary drainage procedures. A self-expanding metallic stent was placed in two patients with malignancy and the stents remained patent until death. Percutaneous biliary interventions can be performed safely for the management of tumoral biliary obstruction in children. (orig.)

Application of transabdominal ultrasonography in diagnosis of bladder outlet obstruction in patients with benign prostatic hyperplasia

International Nuclear Information System (INIS)

Zhou Yanfeng; Wang Jian; Tang Qi; Yu Jiashun; Liu Dingyi; Jiang Yi; Wang Ying

2012-01-01

Objective: To analyze the correlation between the bladder weight (BW) and intravesical prostatic protrusion (IPP) and the degree of bladder outlet obstruction (BOO) in the patients with benign prostatic hyperplasia (BPH) and to explore the clinical value of transabdominal ultrasonography in judgement of BOO in the patients with BPH. Methods: Urodynamic examination was performed in 124 BPH patients from March 2009 to January 2011. 124 patients were divided into 2 groups (non-obstruction and obstruction). The BW and IPP were measured by transabdominal ultrasonography, the correlation between BW, IPP and the parameters reflecting BOO was analyzed. Results: The BW values in obstruction group and non-obstruction group were (77.47±44.34) g and (57.47±23.10) g. There was significant difference in BW between obstruction group and non-obstruction group (P<0.05). The IPP values in obstruction group and non-obstruction group were (11.05±9.65) mm and (7.67±7.99) mm. There was significant difference in IPP between obstruction group and non-obstruction group (P<0.05). The BW value of all the patients with BPH was negatively correlated with Q max (r=-0.177, P<0.05) and positively correlated with PdetQ max (P<0.05, r=-0.201). The IPP value was negatively correlated with Q max (r=-0.403, P<0.01) and positively correlated with PedQ max (r=0.192, P<0.01). Conclusion: The BW and IPP are highly correlated with BOO, and evaluating BW and IPP with ultrasound is a reliable method to determine the degree of BOO. (authors)

Renal vein doppler sonography in rabbits with acute ureteral obstruction: usefulness of impedance index of renal vein

International Nuclear Information System (INIS)

Sohn, Kyung Myung; Chung, Su Kyo; Lee, Sung Yong

2004-01-01

To evaluate the usefulness of the impedance index of the renal vein for the diagnosis of acute obstructive uropathy in rabbits. Ligation of the left ureter was done in 12 rabbits. Doppler sonography of the interlobar veins in both kidneys was checked before and 30 minutes, 1, 3, 6, 9 and 24 hours after ureteral ligation. The venous impedance index [(peak flow signal-least flow signal)/peak flow signal] was compared between the obstructed and non-obstructed kidneys for all periods. The change in the impedance index after ureteral ligation was also compared between the obstructed and non-obstructed kidneys. A decrease in the impedance index of the intrarenal vein was observed starting from 30 mins atter ureteral ligation, and the index remained low up to 24 hours after ureteral ligation. The obstructed kidneys had a significantly lower impedance index than the contralateral kidneys for all six of the postligation measurements (p< 0.05). There were significant differences in the change of impedance index after ureteral ligation between the obstructed and non-obstructed kidneys (p< 0.05). The impedance index of the intrarenal vein was significantly decreased in the obstructed kidneys. The measurement of the impedance index of the intrarenal vein using Doppler sonography could provide a useful method of diagnosing obstructive uropathy

[Qilin Pills for obstructive azoospermia after ejaculatory duct reconstruction].

Science.gov (United States)

Zhang, Lei; Gao, Ping; Ren, Fei-Qiang; Chang, De-Gui; Yu, Xu-Jun; Zhang, Pei-Hai

2016-09-01

To observe the clinical effect of Qilin Pills in the treatment of severe oligozoospermia after microsurgical ejaculatory duct reconstruction for obstructive azoospermia. We retrospectively analyzed 75 cases of obstructive azoospermia treated by ejaculatory duct reconstruction followed by administration of Qilin Pills. The patients were divided into a Qilin group (n=42) and a control group (n=33) postoperatively, treated with Qilin Pills and placebo, respectively. After 3 months of medication, we compared the sperm quality between the two groups of patients. After 3 months' treatment, all the patients experienced remarkable improvement in sperm quality (P0.05). The total effectiveness rate was higher in the Qilin group than in the controls (88.1% vs 72.7%), but with no significant difference between the two groups (P>0.05). Qilin Pills are fairly effective in improving the quantity of sperm in obstructive azoospermia patients after ejaculatory duct reconstruction.

Bullet Ultrasonic Obstruction Detection & Distance Measurement Using AVR Microcontroller

Directory of Open Access Journals (Sweden)

Satish Pandey

2008-08-01

Full Text Available This paper describes the practical implementation of a short range ultrasonic obstruction detection and distance measurement device. By employing an ultrasonic transducer pair for producing ultrasonic sounds and sensing the reflected sound waves, the obstructions are detected. The hardware interface uses an Atmel ATmega8 AVR microcontroller to facilitate the generation of 40 kHz signal burst which is used in the transmitter circuit, and also to process the received signal for measuring the time of flight of reflected waves and exact distance of the obstruction. The program for this device is developed in WinAVR, and the code generated is dumped into microcontroller using AVR Studio. Educational aspects of this project include the mastery of a programming language and corresponding tools, the design of a functional and intuitive embedded application, and the development of appropriate hardware to build the device.

Floating tumor debris. A cause of intermittent biliary obstruction.

Science.gov (United States)

Roslyn, J J; Kuchenbecker, S; Longmire, W P; Tompkins, R K

1984-11-01

Tumor debris, free-floating in the major biliary ductal system, is a cause of intermittent biliary obstruction that has previously not been recognized. Six patients had hepatic neoplasms with episodic jaundice and/or cholangitis due to floating tumor debris. Diagnosis included metastatic adenocarcinoma of the colon (n = 3), cholangiocarcinoma (n = 1), hepatocellular carcinoma (n = 1), and cavernous hemangioma (n = 1). All patients underwent biliary exploration, with hepatic resection and transhepatic intubation in two and T-tube placement in four. One patient died in the early postoperative period, and the major complication rate in the five survivors was 0%. Four of the five survivors had no further episodes suggestive of major bile duct obstruction. Our experience emphasizes the importance of distinguishing extrahepatic obstruction secondary to tumor debris from the more common causes of jaundice in patients with tumors and suggests that safe and effective palliation can be achieved in these patients.

Prediction of differential creatinine clearance in chronically obstructed kidneys by non-contrast helical computerized tomography

International Nuclear Information System (INIS)

Ng, Cheuk Fan; Chan, L.W.; Cheng, C.W.; Yu, S.C.H.; Wong, W.S.; Wong, K.T.

2004-01-01

Purpose: We investigate the use of non-contrast helical computerized tomography (NCHCT) in the measurement of differential renal parenchymal volume as a surrogate for differential creatinine clearance (Cr Cl) for unilateral chronically obstructed kidney. Materials And Methods: Patients with unilateral chronically obstructed kidneys with normal contralateral kidneys were enrolled. Ultrasonography (USG) of the kidneys was first done with the cortical thickness of the site with the most renal substance in the upper pole, mid-kidney, and lower pole of both kidneys were measured, and the mean cortical thickness of each kidney was calculated. NCHCT was subsequently performed for each patient. The CT images were individually reviewed with the area of renal parenchyma measured for each kidney. Then the volume of the slices was summated to give the renal parenchymal volume of both the obstructed and normal kidneys. Finally, a percutaneous nephrostomy (PCN) was inserted to the obstructed kidney, and Cr Cl of both the obstructed kidney (PCN urine) and the normal side (voided urine) were measured two 2 after the relief of obstruction. Results: From March 1999 to February 2001, thirty patients were enrolled into the study. Ninety percent of them had ureteral calculi. The differential Cr Cl of the obstructed kidney (%CrCl) was defined as the percentage of Cr Cl of the obstructed kidney as of the total Cr Cl, measured 2 weeks after relief of obstruction. The differential renal parenchymal volume of the obstructed kidney (%CTvol) was the percentage of renal parenchymal volume as of the total parenchymal volume. The differential USG cortical thickness of the obstructed kidney (%USGcort) was the percentage of mean cortical thickness as of the total mean cortical thickness. The Pearson's correlation coefficient (r) between %CTvol and %CrCl and that between %USGcort and %CrCl were 0.756 and 0.543 respectively. The regression line was %CrCl = (1.00) x %CTvol - 14.27. The %CTvol

Prediction of differential creatinine clearance in chronically obstructed kidneys by non-contrast helical computerized tomography

Directory of Open Access Journals (Sweden)

Ng C.F.

2004-01-01

Full Text Available PURPOSE: We investigate the use of non-contrast helical computerized tomography (NCHCT in the measurement of differential renal parenchymal volume as a surrogate for differential creatinine clearance (CrCl for unilateral chronically obstructed kidney. MATERIALS AND METHODS: Patients with unilateral chronically obstructed kidneys with normal contralateral kidneys were enrolled. Ultrasonography (USG of the kidneys was first done with the cortical thickness of the site with the most renal substance in the upper pole, mid-kidney, and lower pole of both kidneys were measured, and the mean cortical thickness of each kidney was calculated. NCHCT was subsequently performed for each patient. The CT images were individually reviewed with the area of renal parenchyma measured for each kidney. Then the volume of the slices was summated to give the renal parenchymal volume of both the obstructed and normal kidneys. Finally, a percutaneous nephrostomy (PCN was inserted to the obstructed kidney, and CrCl of both the obstructed kidney (PCN urine and the normal side (voided urine were measured two 2 after the relief of obstruction. RESULTS: From March 1999 to February 2001, thirty patients were enrolled into the study. Ninety percent of them had ureteral calculi. The differential CrCl of the obstructed kidney (%CrCl was defined as the percentage of CrCl of the obstructed kidney as of the total CrCl, measured 2 weeks after relief of obstruction. The differential renal parenchymal volume of the obstructed kidney (%CTvol was the percentage of renal parenchymal volume as of the total parenchymal volume. The differential USG cortical thickness of the obstructed kidney (%USGcort was the percentage of mean cortical thickness as of the total mean cortical thickness. The Pearson's correlation coefficient (r between %CTvol and %CrCl and that between %USGcort and %CrCl were 0.756 and 0.543 respectively. The regression line was %CrCl = (1.00 x %CTvol - 14.27. The %CTvol

Models of chronic obstructive pulmonary disease

Directory of Open Access Journals (Sweden)

Chung K Fan

2004-11-01

Full Text Available Abstract Chronic obstructive pulmonary disease (COPD is a major global health problem and is predicted to become the third most common cause of death by 2020. Apart from the important preventive steps of smoking cessation, there are no other specific treatments for COPD that are as effective in reversing the condition, and therefore there is a need to understand the pathophysiological mechanisms that could lead to new therapeutic strategies. The development of experimental models will help to dissect these mechanisms at the cellular and molecular level. COPD is a disease characterized by progressive airflow obstruction of the peripheral airways, associated with lung inflammation, emphysema and mucus hypersecretion. Different approaches to mimic COPD have been developed but are limited in comparison to models of allergic asthma. COPD models usually do not mimic the major features of human COPD and are commonly based on the induction of COPD-like lesions in the lungs and airways using noxious inhalants such as tobacco smoke, nitrogen dioxide, or sulfur dioxide. Depending on the duration and intensity of exposure, these noxious stimuli induce signs of chronic inflammation and airway remodelling. Emphysema can be achieved by combining such exposure with instillation of tissue-degrading enzymes. Other approaches are based on genetically-targeted mice which develop COPD-like lesions with emphysema, and such mice provide deep insights into pathophysiological mechanisms. Future approaches should aim to mimic irreversible airflow obstruction, associated with cough and sputum production, with the possibility of inducing exacerbations.

Renal functional recovery of the hydronephrotic kidney predicted before relief of the obstruction

International Nuclear Information System (INIS)

McDougal, W.S.; Flanigan, R.C.

1981-01-01

Employing technetium labeled dimercaptosuccinic acid, we predicted the inulin and p-aminohippuric acid (PAH) clearances after recovery of an obstructed kidney before relief of the obstruction. Sixteen rabbits had one renal unit obstructed for varying period of time. The animals were scanned immediately before relief of the obstruction. After 4 to 6 months recovery, inulin and PAH clearances were measured in all animals. The scans were mathematically analyzed, and accurately predicted the inulin and PAH clearances obtained after complete recovery (P less than 0.001 and P less than 0.001, respectively). Six rabbits were scanned at the time of the clearance measurements. By a different mathematical analysis, inulin and PAH clearance measured concurrently correlated with the scan

Temporary metal internal stent dilation for colorectal obstruction and effect on operation methods

International Nuclear Information System (INIS)

Chen Niwei; Cheng Yingsheng; Fan Youben; Jin Huimin; Xu Huimin

2005-01-01

Objective: To explore the methods and clinical value of temporary internal metal stent through endoscopy under X ray control for treating patients with malignant colorectal obstruction. Methods: 27 patients with malignant colorectal obstruction were treated by temporary metallic internal stent placement via endoscopy under the X ray guidance. Results: 27 patients with colorectal obstruction symptoms were all got rid of the trouble within 48 hours after the stent placement. Selective stage I colorectal cancer resection and anastomosis were performed after bowel preparation. Conclusions: Metallic internal stent placement can loosen the colorectal obstructive symptoms with higher successful rate via endoscopy under X ray control and furthermore for promotion of stage I colorectal cancer resection and anastomosis. (authors)

Treatment of obstructive sleep apnea in primary care.

Science.gov (United States)

Victor, Lyle D

2004-02-01

Obstructive sleep apnea should be suspected in patients who are overweight snore loudly, and have chronic daytime sleepiness. The diagnosis of sleep apnea may be confirmed by sleep laboratory studies. Patients' symptoms and the frequency of respiratory events on laboratory testing are important factors in determining the severity of disease. In patients with mild sleep apnea, conservative treatment measures include getting sufficient sleep, abstaining from the use of alcohol and sedatives, losing weight, and avoiding the supine position during sleep. Continuous positive airway pressure (CPAP) is the most consistently effective treatment for clinically significant obstructive sleep apnea. In general, heavier patients with thicker necks require higher pressure settings. As patients age or gain weight, additional pressure may be necessary. Bilevel pressure machines or machines that slowly ramp up the pressure may increase patient acceptance of CPAP therapy. Complications of CPAP use include nasal dryness and congestion, claustrophobia, facial skin abrasions, air leaks, and conjunctivitis. Strategies to improve patient compliance include allowing patients to try a number of masks to find the most comfortable fit, adding humidification, treating nasal disease and, most importantly, providing close follow-up and encouragement. Oral appliances are inconsistently effective in the management of obstructive sleep apnea but may be an option in patients with mild disease who cannot tolerate CPAP. Palatal surgery often decreases snoring but may not reduce the occurrence of sleep apnea. Patients with severe disease and intolerance of CPAP may be candidates for more invasive surgical procedures. Supplemental oxygen and drug therapy may have limited, adjunctive roles in the treatment of obstructive sleep apnea.

Le conseil féminin dans les chroniques du règne de Ferdinand III

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Estelle MAINTIER-VERMOREL

2011-11-01

Full Text Available Dans le cadre d’une réflexion sur le conseil et les conseillers du roi, comment ne pas s’interroger sur le conseil féminin et les conseillères. En effet ce conseil existe bel et bien, et c’est ce que l’on s’attachera à prouver à la lumière de la lecture des chroniques de Luc de Tuy, Rodrigue de Tolède et Jean d’Osma, rédigées sous le règne de Ferdinand III. Le conseil féminin est bien présent, sous divers aspects, que ce soit celui d’une mère à son fils ou d’une femme à son époux ; ses domaines d’application sont étonnamment vastes, allant jusqu’à s’étendre aux affaires du royaume et au champ militaire. Toutefois, ces constatations ne doivent pas faire oublier les limites de ce conseil, qui est bien souvent un substitut à l’action et dont la légitimité reste contestée. Seules les reines réunissant certaines conditions, certaines vertus, peuvent prétendre au titre de conseillères, et encore y a-t-il un prix à payer pour que leurs conseils soient entendus, et ce prix est celui du dévouement à l’homme, dans l’oubli de leurs intérêts personnels.En el marco de una reflexión sobre el consejo y los consejeros del rey, cómo no interrogarse sobre el consejo femenino y las consejeras. Pues este consejo existe de verdad, y eso es lo que trataremos de mostrar a la luz de la lectura de las crónicas de Lucas de Túy, Rodrigo de Toledo y Juan de Osma, redactadas bajo el reinado de Fernando III. El consejo femenino está muy presente, bajo varios aspectos, con el consejo de una madre a su hijo, o el de una mujer a su esposo ; sus dominios de aplicación resultan sorprendentemente amplios y cubren hasta los asuntos del reino y el campo militar. Sin embargo, estas constataciones no deben hacer olvidar los límites de este consejo que sigue siendo a menudo un sustituto para la acción, y cuya legitimidad sigue discutida. Sólo las reinas capaces de reunir ciertas condiciones, ciertas virtudes

PTC used for diagnosing the causes of obstructive jaundice in elders

International Nuclear Information System (INIS)

Yang Shunchun; Gu Haiyan; Xu Xiao; Chen Kemin

2000-01-01

Objective: To assess the value of PTC in diagnosing the causes of obstructive jaundice in elders. Methods: The signs of PTC in 45 obstructive jaundice cases were reviewed and analysed. 37 cases of them were proven by surgical and pathological diagnosis. Results: PTC had a high successful rate in puncture (97.3%, 36/37) and was safe considerably. The diagnostic accuracies of PTC in distinguishing the causes of non-tumorous from tumorous lesions were 93.3% and 86.4%, respectively. Conclusions: PTC is superior to US and CT, as a valuable method at present in diagnosing the causes of obstructive jaundice in the elders

Chronic intestinal pseudo-obstruction in adult patients: multidetector row helical CT features

International Nuclear Information System (INIS)

Merlin, Aurelie; Soyer, Philippe; Boudiaf, Mourad; Hamzi, Lounis; Rymer, Roland

2008-01-01

Chronic intestinal pseudo-obstruction (CIPO) is a rare condition due to severe gastrointestinal motility disorder. Adult patients with CIPO experience symptoms of mechanical obstruction, but reliable clinical signs that may help distinguish between actual mechanical obstruction and CIPO are lacking. Additionally, abdominal plain films that commonly show bowel dilatation with air-fluid levels do not reach acceptable degrees of specificity to exclude actual obstruction. Therefore, most adult patients with CIPO usually undergo multiple and often fruitless surgery, often leading to repeated bowel resections before diagnosis is made. In these patients who present with abdominal signs mimicking symptoms that would warrant surgical exploration, multidetector-row helical CT (MDCT) is helpful to resolve this diagnostic dilemma. MDCT shows a diffusely distended bowel and helps to rule out a mechanical cause of obstruction, thus suggesting CIPO and obviating the need for unnecessary laparotomy. In adult patients with CIPO, MDCT may show pneumatosis intestinalis, pneumoperitoneum or intussusception. However, these conditions generally do not require surgery in patients with CIPO. This pictorial essay presents the more and less common MDCT features of CIPO in adult patients, to make the reader more familiar with this disease. (orig.)

Reversible obstructive sleep apnea caused by occupational exposure to guar gum dust.

Science.gov (United States)

Leznoff, A; Haight, J S; Hoffstein, V

1986-05-01

This report describes a case of reversible obstructive sleep apnea caused by occupational exposure to an inhaled allergen, guar gum powder. The patient, a pet food plant employee, also experienced severe cough, rhinitis, and conjunctivitis. Skin tests confirmed the specific guar allergy. Pharyngeal cross-sectional area was smaller than normal. Pulmonary function studies, histamine challenge tests, nasal air-flow resistance measurements, and nocturnal polysomnography were performed on 3 separate occasions: while the patient was working at his usual occupation, at the end of a 3-wk holiday, and after a guar dust challenge in an inhalation chamber. Pulmonary function and histamine challenge tests were consistently normal. At the time of the initial tests, nasal resistance was elevated, and nocturnal polysomnography revealed obstructive sleep apnea. After absence from work, obstructive sleep apnea resolved, and the nasal resistance returned to normal. After challenge with guar gum dust, the patient developed increased resistance to nasal air flow, and obstructive sleep apnea reappeared. This case demonstrates that allergy can cause reversible obstructive sleep apnea and that occupational exposure should be considered in the assessment of patients with this disease.

Airways obstruction in survivors of thoracoplasty: reversibility is greater in non-smokers.

LENUS (Irish Health Repository)

O'Connor, Terence M

2012-02-03

OBJECTIVE: Before the advent of antituberculous chemotherapy, thoracoplasty (TPL) was the definitive form of therapy for cavitary pulmonary tuberculosis. This study aimed to characterize the late functional sequelae of TPL, and to establish the degree of reversibility of any consequent airway obstruction. METHODOLOGY: Pulmonary function was studied in 21 long-term (mean 35 years) survivors of TPL between the years 1990-2001. RESULTS: A mixed obstructive\\/restrictive defect was found in this patient cohort. After inhalation of bronchodilator, marginal increases in FEV(1) and FVC and marginal decreases in FRC, RV and TLC were observed. Maximum mid-expiratory flow rate was severely reduced (28.8% of predicted), but reversibility after inhaled beta(2)-agonist was highest for this parameter of pulmonary function (mean 11%). Smokers had a higher RV (P = 0.04), suggesting hyperinflation, while non-smokers had a larger increase in FEV(1)\\/FVC ratio postbronchodilator (P = 0.004), suggesting more marked reversibility of airways obstruction in this group. CONCLUSIONS: Long-term survivors of TPL have an obstructive as well as a restrictive ventilatory defect. These patients have partial reversibility of the obstructive defect. The degree of reversibility found suggests that bronchodilator therapy may help these patients.

Obstructive Sleep Apnea Hypopnea Syndrome

African Journals Online (AJOL)

hanumantp

Obstructive sleep apnea hypopnea syndrome (OSAHS) is an important medical condition brought to limelight in the last five decades.[1] It is a major cause of morbidity and significant cause of mortality worldwide, including developed and developing nations. A survey done in Abuja, Nigeria,[2] showed that OSAHS may be a ...

The interventional treatment for biliary recurrent obstruction after palliative T tube drainage in patients with obstruction due to cholangiocarcinoma

International Nuclear Information System (INIS)

Han Xinwei; Li Yongdong; Guan Sheng; Wu Gang; Xing Gusheng; Ma Bo

2002-01-01

Objective: To explore the interventional method to treat biliary recurrent jaundice after T tube drainage in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods: 7 biliary metallic stents were placed in 7 patients with recurrent jaundice after T-tube drainage in cholangiocarcinoma cases. Results: Stent placement was once successful in all 7 cases with successful rate of 100%. For all cases, TBIL, ALT, GTP and AKP values 7 days postoperatively were significantly lower than that of preoperation together with subsidence of jaundice satisfactorily for 100% after the treatment. Conclusions: Percutaneous placement of biliary metallic stents was effective economic, minimal invasive and safe for palliation of biliary recurrent jaundice after T tube drainage in cholangiocarcinoma-induced obstructive jaundice

[Symptoms of obstructive sleep apnea-hypopnea syndrome in children].

Science.gov (United States)

Gregório, Paloma Baiardi; Athanazio, Rodrigo Abensur; Bitencourt, Almir Galvão Vieira; Neves, Flávia Branco Cerqueira Serra; Terse, Regina; Hora, Francisco

2008-06-01

To investigate the symptoms most frequently found in children with a polysomnographic diagnosis of obstructive sleep apnea-hypopnea syndrome (OSAHS). We evaluated 38 children consecutively referred to the sleep laboratory with suspicion of OSAHS between June of 2003 and December of 2004. The patients were submitted to a pre-sleep questionnaire and to polysomnography. The mean age was 7.8 +/- 4 years (range, 2-15 years), and 50% of the children were male. Children without apnea accounted for 7.9% of the sample. The obstructive sleep apnea observed in the remainder was mild in 42.1%, moderate in 28.9% and severe in 22.1%. Severe cases of apnea were most common among children under the age of six (pre-school age). In children with OSAHS, the most common symptoms were snoring and nasal obstruction, which were observed in 74.3 and 72.7% of the children, respectively. Excessive sleepiness and bruxism were seen in 29.4 and 34.3%, respectively, and reflux disease was seen in only 3.1%. Restless legs and difficulty in falling asleep were identified in 65 and 33%, respectively. All of the children diagnosed with severe OSAHS also presented snoring and bruxism. Snoring and nasal obstruction were the most common symptoms found in our sample of children and adolescents with OSAHS. In addition, OSAHS severity was associated with being in the lower age bracket.

Metallic stents for management of malignant biliary obstruction

International Nuclear Information System (INIS)

Lee, Byung Hee; Do, Young Soo; Byun, Hong Sik; Kim, Kie Hwan; Chin, Soo Yil

1992-01-01

In patients with inoperable malignant biliary obstruction, percutaneous transhepatic biliary drainage (PTBD) has been the method of choice for palliative treatment. All patients except three had undergone PTBD, and the stents were placed 5-7 days after the initial drainage procedure. Three patients underwent stent placement on the same day of PTBD. External drainage catheter is converted to various types of tube endoprostheses with associated physiologic and psychologic benefits. Tube stents, however, have some problems such as migration, occlusion, and traumatic implantation procedure. We report our experiences and clinical results of percutaneous placement of metallic stents in 40 patients with malignant biliary obstruction

Metallic stents for management of malignant biliary obstruction

Energy Technology Data Exchange (ETDEWEB)

Lee, Byung Hee; Do, Young Soo; Byun, Hong Sik; Kim, Kie Hwan; Chin, Soo Yil [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

1992-11-15

In patients with inoperable malignant biliary obstruction, percutaneous transhepatic biliary drainage (PTBD) has been the method of choice for palliative treatment. All patients except three had undergone PTBD, and the stents were placed 5-7 days after the initial drainage procedure. Three patients underwent stent placement on the same day of PTBD. External drainage catheter is converted to various types of tube endoprostheses with associated physiologic and psychologic benefits. Tube stents, however, have some problems such as migration, occlusion, and traumatic implantation procedure. We report our experiences and clinical results of percutaneous placement of metallic stents in 40 patients with malignant biliary obstruction.

Cephalometric and anthropometric data of obstructive apnea in different age groups

Directory of Open Access Journals (Sweden)

Paulo de Tarso Moura Borges

2015-02-01

Full Text Available Introduction: Patients with obstructive sleep apnea syndrome usually present with changes in upper airway morphology and/or body fat distribution, which may occur throughout life and increase the severity of obstructive sleep apnea syndrome with age. Objective: To correlate cephalometric and anthropometric measures with obstructive sleep apnea syndrome severity in different age groups. Methods: A retrospective study of cephalometric and anthropometric measures of 102 patients with obstructive sleep apnea syndrome was analyzed. Patients were divided into three age groups (≥20 and <40 years, ≥40 and <60 years, and ≥60 years. Pearson's correlation was performed for these measures with the apnea-hypopnea index in the full sample, and subsequently by age group. Results: The cephalometric measures MP-H (distance between the mandibular plane and the hyoid bone and PNS-P (distance between the posterior nasal spine and the tip of the soft palate and the neck and waist circumferences showed a statistically significant correlation with apnea-hypopnea index in both the full sample and in the ≥40 and <60 years age group. These variables did not show any significant correlation with the other two age groups (<40 and ≥60 years. Conclusion: Cephalometric measurements MP-H and PNS-P and cervical and waist circumfer- ences correlated with obstructive sleep apnea syndrome severity in patients in the ≥40 and <60 age group.

Predicting hemorrhage and obstruction in the elderly population using thromboelastographic indices

Directory of Open Access Journals (Sweden)

Zheng Q

2013-10-01

Full Text Available Qiwen Zheng,1,* Shuhong Fu,2,* Dafang Chen,1 Xiaoxia Li,2 Yuru Li,2 Yanyan Li,2 Jihong Yu,2 Meiliang Gong,2 Jie Bai2 1Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China; 2Nanlou Clinical Lab, Chinese PLA General Hospital, Beijing, People's Republic of China *These authors contributed equally to this work Objective: To estimate the value of the different thromboelastogram indices for predicting hemorrhage and vascular obstruction in an elderly population. Methods: This was a prospective cohort study of patients 65 years and older without hematologic disorders who received thromboelastography (TEG examination at the Chinese People's Liberation Army General Hospital from January 2007 to December 2010. Detailed information was collected at recruitment including their TEG test results. Subjects were then followed during outpatient visits and hospitalization. The primary outcome measures were hemorrhage and vascular obstruction. Receiver-operating characteristics (ROC curves were used to compare the predictive value of the four TEG indices, reaction time (R, clot formation time (K, maximal amplitude (MA, alpha angle (ANGLE and their combination for predicting hemorrhage and vascular obstruction. The maximal Youden's index was used to estimate optimal cut-off values for the indices. Areas under the ROC curves were used to estimate overall predictive accuracies. Results: A total of 403 elderly patients met inclusion criteria and were included: 373 male and 30 females with mean age 83.0 ± 7.3 years and range of 65–103 years. Hemorrhage occurred in 25 (6.2% patients and vascular obstruction in 78 (19.4% patients during the 2-year follow up. The currently recommended TEG cut-off values were poorly predictive of vascular obstruction and modestly predictive of hemorrhage. Based on maximal Youden's, the optimal cutoffs of the TEG indices for predicting vascular

Obstruction of hepatic vein or inferior vena cava after liver transplantation: the diagnosis and interventional treatment

International Nuclear Information System (INIS)

Zhu Kangshun; Qian Jiesheng; Meng Xiaochun; Yi Shuhong; Pang Pengfei; He Keke; Jiang Zaibo; Lu Minqiang; Shan Hong

2010-01-01

Objective: To investigate the diagnosis and interventional therapeutic technology for the obstruction of hepatic vein (HV) or inferior vena cava (IVC) after liver transplantation. Methods: In the 831 patients who received orthotopic liver transplantation (OLT) and 26 patients who received living donor liver transplantation (LDLT), 11 cases were confirmed with HV or IVC obstruction by venography and received interventional treatment from 2 to 111 days after liver transplantation. Of the 11 patients, five had the obstruction of HV anastomosis, five had the obstruction of IVC anastomosis, and one had the obstruction of HV and IVC anastomosis. In the eleven patients, five patients underwent OLT, four patients underwent LDLT, and two pediatric patients underwent reduced-size OLT. Before interventional treatment, 9 patients function tests, clinical sympatom, and monitoring of HV or IVC flow. Pressure gradients before and after therapeutic technology of 11 cases were retrospectively analyzed. Results: In all 11 patients, CT or MRI could clearly show congested areas of the liver, and the location and degree of HV or IVC obstruction. Of the 11 patients, four with HV obstruction and five with IVC obstruction were treated with stent placement, one with HV obstruction was treated with percutaneous transluminal angioplasty (PTA), one with HV and IVC obstruction was treated with HV PTA and IVC stent placement. Interventional technical success was achieved in all patients. The venous pressure gradient across obstruction was significantly reduced from (16.5 ± 4.1) mm Hg (1 mm Hg =0.133 kPa) before the procedure to (2.9 ± 1.7) mm Hg after the procedure (t=11.5, P<0.01). Clinical improvement was noted in 10 patients except one pediatric patient who died of multiple-organs failure at the 9 th day after the treatment. During the follow-up period of 9 to 672 days, two patients with PTA treatment had recurrent HV stenosis within one month after treatment, no patient with stent

Genetics Home Reference: intestinal pseudo-obstruction

Science.gov (United States)

... A characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons. Intestinal pseudo-obstruction caused by ACTG2 gene mutations is inherited in an autosomal dominant pattern , which means one copy of the altered ...

Cognitive complaints in obstructive sleep apnea

NARCIS (Netherlands)

Vaessen, T.J.A.; Overeem, S.; Sitskoorn, M.M.

2015-01-01

Obstructive sleep apnea (OSA) is associated with impairments in cognitive functioning. Although cognitive complaints are related to quality of life, work productivity and health care expenditures, most research and all reviews have focused exclusively on objective cognitive functioning so far. In

An obstructing endobronchial lipoma simulating COPD

DEFF Research Database (Denmark)

Sivapalan, Pradeesh; Gottlieb, Magnus; Christensen, Merete

2014-01-01

Endobronchial lipomas are rare benign tumors of the respiratory tract. Bronchial occlusion may cause parenchymal damage and lead to a misdiagnosis of chronic obstructive pulmonary disease or malignancy. Therefore, both accurate diagnosis and radical treatment of endobronchial lipomas are essentia...

The role of impulse oscillometry in assessment of airway obstruction in smokers and ex-smokers

Directory of Open Access Journals (Sweden)

Taher El-Naggar

2012-10-01

Conclusion: IOS is an effective, easy to perform, and a non invasive method for the assessment of airway obstruction in obstructive pulmonary disorders. Although, there is no significant difference between impulse oscillometry and spirometry parameters in early detection of airway obstruction in smokers and ex-smokers groups.

Fluoroscopically-guided transnasal insertion of ileus tube intestinal decompression in patients with inoperable malignant bowel obstruction

International Nuclear Information System (INIS)

Fang Shiming; Li Haili; Lin Qing; Mao Aiwu; Wu Shaoqiu; Jiang Haosheng; Cao Yan; Wang Zhenlei

2011-01-01

Objective: To assess the technical feasibility and effectiveness of fluoroscopically-guided transnasal insertion of ileus tube for intestinal decompression in the treatment of inoperable malignant bowel obstruction. Methods: A total of 211 patients with inoperable malignant bowel obstruction were enrolled in this study. The median KPS scale was 40 (ranged from 20 to 60). Under fluoroscopic guidance, transnasal insertion of ileus tube by using conventional technique or guidewire-catheter exchange technique was performed in all patients. The technical success rate, the clinical effective rate, the curative rate and adverse reactions as well as complications were documented. The correlation among the obstructive sites, obstruction causes and therapeutic effectiveness was analyzed. The ileus tube used in this study was a four-cavity and double-balloon catheter with a diameter of 16 F/18 f, which is produced by Cliny Company. Results: Transnasal drainage tube was successfully inserted into the proximal jejunum in all 211 patients with malignant bowel obstruction, and the total technical success rate was 100%. The initial technical success rate of the traditional technique and the catheter-guidewire exchange method was 85.5% (65/76) and 100% (135/135) respectively, the difference between the two was significant (P<0.05). After 24 hours, the clinical remission rate in the patients with high-level intestinal obstruction, lower-level intestinal obstruction and colorectal obstruction was 95.8% (46/48), 92.9% (117/126) and 83.8% (31/37), respectively. A follow-up of 4-245 days (mean 138 days) was conducted, and the total clinical cure rate was 27.5% (58/211). The clinical cure rate in small intestine obstruction and colorectal obstruction caused by primary tumor or recurrence was 12.7% (20/157) and 59.5% (22/37), respectively (P<0.05). The adverse reactions and complications included uncomfortable pharynx feeling or pain (99.1%, 199/221), the tube obstruction (23.2%, 49

Intestinal Obstruction in Early Neonatal Period: A 3-Year Review Of ...

African Journals Online (AJOL)

BACKGROUND: Failure to pass meconium by a full-term neonate within the first 24 hours should raise a suspicion of bowel obstruction. The objective of this study was to determine pattern of presentation, diagnosis and outcome of management of intestinal obstruction in the early neonatal period in the Neonatal Care Unit ...

Patient-Centered Medical Home in chronic obstructive pulmonary disease

Directory of Open Access Journals (Sweden)

Ortiz G

2011-10-01

Full Text Available Gabriel Ortiz1, Len Fromer21Pediatric Pulmonary Services, El Paso, TX; 2Department of Family Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USAAbstract: Chronic obstructive pulmonary disease (COPD is a progressive and debilitating but preventable and treatable disease characterized by cough, phlegm, dyspnea, and fixed or incompletely reversible airway obstruction. Most patients with COPD rely on primary care practices for COPD management. Unfortunately, only about 55% of US outpatients with COPD receive all guideline-recommended care. Proactive and consistent primary care for COPD, as for many other chronic diseases, can reduce hospitalizations. Optimal chronic disease management requires focusing on maintenance rather than merely acute rescue. The Patient-Centered Medical Home (PCMH, which implements the chronic care model, is a promising framework for primary care transformation. This review presents core PCMH concepts and proposes multidisciplinary team-based PCMH care strategies for COPD.Keywords: Patient-Centered Medical Home, chronic care model, chronic obstructive pulmonary disease, patient education, physician assistants, nurse practitioners

An analysis of 'obstructive type' renography cases in 99mTc-DTPA renal dynamic imaging

International Nuclear Information System (INIS)

Wang Xinhui

1991-01-01

99m Tc-DTPA renal dynamic imaging and computed renography were performed in 61 cases. Renal blood perfusion imaging was also performed in some cases. Renography curves, which did not decrease in 20 min on all 61 cases (90 kidneys), are analysed in combination with renal dynamic imaging and renal perfusion imaging. 11 cases (12 kidneys) are only obstructive. 24 cases (32 kidneys) are obstructive and renal function impaired. Other 26 cases (46 kidneys) are renal function impaired or blood perfusion insufficient, but are not obstructive. The result demonstrated that the obstructive type renography may be obstructive or may be renal function impaired or blood supply insufficient. An analysis of renography in combination with renal dynamic imaging and blood perfusion imaging is more accurate than renography alone

Evaluation of UPJ obstruction before and after pyeloplasty using MR urography

International Nuclear Information System (INIS)

Little, Stephen B.; Jones, Richard A.; Grattan-Smith, J.D.

2008-01-01

This article builds on the previous article in this symposium and shows how MR urography contributes to the postoperative evaluation of children with UPJ obstruction. By analyzing the postoperative results, we derived new insights into their preoperative evaluation. With MR urography we combine simultaneous physiological and anatomic evaluation that enables us to identify changes in renal pathophysiology that occur in association with impaired drainage and obstruction. We studied 35 children before and after pyeloplasty. The pyeloplasty was considered successful in 30 and unsuccessful in 5. Both anatomic and functional criteria were used. The anatomic parameters included the degree of hydronephrosis, the appearance of the renal parenchyma, the quality of the nephrogram and the presence of crossing vessels. The functional criteria included the renal transit time, the calyceal transit time, the volumetric differential function, the Patlak differential function, the difference between the volumetric and Patlak differential function and the Patlak number per milliliter of renal tissue. No single parameter was sufficient to fully characterize UPJ obstruction, but by synthesizing all the information we were able to subdivide UPJ obstruction into compensated, decompensated and uropathic kidneys. Decompensated systems had the most significant improvement following successful pyeloplasty. Compensated systems showed little improvement in renal function, and uropathic kidneys were associated with a poor prognosis. It is clear that not all UPJ obstructions are the same, and it seems logical that treatment should be individually tailored rather than using a standard approach for all cases. Because MR urography can identify pathophysiological differences in children with UPJ obstruction that are occult to renal scintigraphy, it has an important potential role in identifying those who will benefit most from pyeloplasty and those who are probably best observed. (orig.)

The Efficacy of Endoscopic Palliation of Obstructive Jaundice in Hepatocellular Carcinoma

Science.gov (United States)

Park, Semi; Park, Jeong Youp; Chung, Moon Jae; Chung, Jae Bock; Park, Seung Woo; Han, Kwang-Hyub; Song, Si Young

2014-01-01

Purpose Obstructive jaundice in patients with hepatocellular carcinoma (HCC) is uncommon (0.5-13%). Unlike other causes of obstructive jaundice, the role of endoscopic intervention in obstructive jaundice complicated by HCC has not been clearly defined. The aim of this study was to evaluate the clinical characteristics of obstructive jaundice caused by HCC and predictive factors for successful endoscopic intervention. Materials and Methods From 1999 to 2009, 54 patients with HCC who underwent endoscopic intervention to relieve obstructive jaundice were included. We defined endoscopic intervention as a clinical success when the obstructive jaundice was relieved within 4 weeks. Results Clinical success was achieved in 23 patients (42.6%). Patients in the clinical success group showed better Child-Pugh liver function (C-P grade A or B/C; 17/6 vs. 8/20), lower total bilirubin levels (8.1±5.3 mg/dL vs. 23.1±10.4 mg/dL) prior to the treatment, and no history of alcohol consumption. The only factor predictive of clinical success by multivariate analysis was low total bilirubin level at the time of endoscopic intervention, regardless of history of alcohol consumption [odds ratio 1.223 (95% confidence interval, 1.071-1.396), p=0.003]. The cut-off value of pre-endoscopic treatment total bilirubin level was 12.8 mg/dL for predicting the clinical prognosis. Median survival after endoscopic intervention in the clinical success group was notably longer than that in the clinical failure group (5.6 months vs. 1.5 months, p≤0.001). Conclusion Before endoscopic intervention, liver function, especially total bilirubin level, should be checked to achieve the best clinical outcome. Endoscopic intervention can be helpful to relieve jaundice in well selected patients with HCC. PMID:25048484

Evaluation of UPJ obstruction before and after pyeloplasty using MR urography

Energy Technology Data Exchange (ETDEWEB)

Little, Stephen B. [Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States); Jones, Richard A. [Emory University School of Medicine, Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States); Grattan-Smith, J.D. [Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States); Emory University School of Medicine, Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States)

2008-01-15

This article builds on the previous article in this symposium and shows how MR urography contributes to the postoperative evaluation of children with UPJ obstruction. By analyzing the postoperative results, we derived new insights into their preoperative evaluation. With MR urography we combine simultaneous physiological and anatomic evaluation that enables us to identify changes in renal pathophysiology that occur in association with impaired drainage and obstruction. We studied 35 children before and after pyeloplasty. The pyeloplasty was considered successful in 30 and unsuccessful in 5. Both anatomic and functional criteria were used. The anatomic parameters included the degree of hydronephrosis, the appearance of the renal parenchyma, the quality of the nephrogram and the presence of crossing vessels. The functional criteria included the renal transit time, the calyceal transit time, the volumetric differential function, the Patlak differential function, the difference between the volumetric and Patlak differential function and the Patlak number per milliliter of renal tissue. No single parameter was sufficient to fully characterize UPJ obstruction, but by synthesizing all the information we were able to subdivide UPJ obstruction into compensated, decompensated and uropathic kidneys. Decompensated systems had the most significant improvement following successful pyeloplasty. Compensated systems showed little improvement in renal function, and uropathic kidneys were associated with a poor prognosis. It is clear that not all UPJ obstructions are the same, and it seems logical that treatment should be individually tailored rather than using a standard approach for all cases. Because MR urography can identify pathophysiological differences in children with UPJ obstruction that are occult to renal scintigraphy, it has an important potential role in identifying those who will benefit most from pyeloplasty and those who are probably best observed. (orig.)

Cognitive Function Among Obstructive Sleep Apnea Patients in North East Malaysia.

Science.gov (United States)

Yusop, Che Yusfarina Che; Mohamad, Irfan; Mohammad, Wan Mohd Zahiruddin Wan; Abdullah, Baharudin

2017-01-01

Obstructive sleep apnea patients may develop deficits in the cognitive domains of attention, concentration, executive function, verbal and visuospatial memory, constructional abilities, and psychomotor functioning. As cognitive performance will improve with the treatment, early screening for cognitive dysfunction should be done to prevent further deterioration. We aim to evaluate the cognitive function of obstructive sleep apnea patients by using the 'Mini Mental State Examination'. This was a cross sectional study to evaluate the cognitive function of moderate and severe obstructive sleep apnea patients with age ranged from 18 to 60 old who attended our sleep clinic. These patients were confirmed to have moderate and severe obstructive sleep apnea by Type 1 polysomnography (attended full overnight study). The age, gender and ethnicity were noted and other relevant data such as weight, height, body mass index and apnea and hypopnoea index were recorded accordingly. The cognitive function was evaluated using validated Malay version of Mini Mental State Examination which measured 5 areas of cognitive functions comprising orientation, registration, attention and calculation, word recall and language abilities, and visuospatial. A total of 38 patients participated in this study. All 19 patients of moderate group and 14 patients of severe group had normal cognitive function while only 5 patients in severe group had mild cognitive function impairment. There was a statistically significant difference between the moderate group and severe group on cognitive performance (p value = 0.042). Severe obstructive sleep apnea patients may have impaired cognitive function. Mini Mental State Examination is useful in the screening of cognitive function of obstructive sleep apnea patients but in normal score, more sophisticated test batteries are required as it is unable to identify in 'very minimal' or 'extremely severe' cognitive dysfunction. Copyright © 2017 National Medical

Surgical indications for unilateral neonatal hydronephrosis in considering ureteropelvic junction obstruction

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Hong-Lin Cheng

2014-09-01

Full Text Available Prenatal hydronephrosis is one of the most common urological congenital abnormalities detected by ultrasound. The incidence ranges from 0.59% to 0.69%. Approximately 50% of these fetuses do not have hydronephrosis on postnatal examination, whereas 25–33% of the rest have persistent hydronephrosis leading to the diagnosis of ureteropelvic junction (UPJ obstruction. Renal ultrasonography and renal radionuclide scanning are the major modalities used for assessment and follow-up. Three main criteria used to determine the presence of obstruction are: (1 the magnitude of hydronephrosis present on ultrasound, (2 the relative renal function (RRF measured by renography, and (3 the response of radionuclide washout with furosemide. Unfortunately, it is not always easy to determine obstruction; different types of management have been developed. Without depending on the severity of renal pelvis dilation, percentage of RRF, and response of radionuclide washout in the initial presentation, early surgery to preserve renal function and aggressive observation to prevent unnecessary surgery are two extremes on the spectrum of management for neonatal UPJ obstruction. Relying on renal function in renography, <35–40% or 5–10% of a decrease in the percentage of RRF or on the enlarging of hydronephrosis, respectively, and parenchymal thinning on ultrasonography are the indications for the surgical management to recover renal function in time. In addition to renal function change and imaging progression, the follow-up protocol and family compliance are the other considerations in prevention of impaired renal function. Through more than 40 years of development in the field of UPJ obstruction in infants, there have been several advances in management but controversies remain to be resolved. In this review, we focus on the surgical indications for the UPJ obstruction in this cohort.

Impact of Carcinomatosis on Clinical Outcomes after Self-Expandable Metallic Stent Placement for Malignant Gastric Outlet Obstruction.

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Ji Eun Lee

Full Text Available It is still unclear whether the peritoneal carcinomatosis had a negative effect on the clinical outcomes of patients who underwent self-expandable metallic stent (SEMS placement for malignant gastric outlet obstruction (GOO. Although carcinomatosis may be associated with the development of multifocal gastrointestinal (GI tract obstruction or decreased bowel movement, previous studies investigated the occurrence of stent failure only and thus had limitation in evaluating clinical outcomes of patients with carcinomatosis.Between 2009 and 2013, 155 patients (88 patients without carcinomatosis and 67 patients with carcinomatosis underwent endoscopic SEMS placement for malignant GOO. Factors affecting clinical success and obstructive symptom-free survival (time period between SEMS placement and the recurrence of obstructive symptoms due to multifocal GI tract obstruction or decreased bowel movement as well as stent failure were assessed.Patients with carcinomatosis showed higher Eastern Cooperative Oncology Group (ECOG scale than those without carcinomatosis. Clinical success rates were 88.1% in patients with carcinomatosis and 97.7% in patients without carcinomatosis. In multivariate analysis, only ECOG scale was identified as an independent predictor of clinical success. During follow-up period, patients with carcinomatosis showed significantly shorter obstructive symptom-free survival than those without carcinomatosis. In multivariate analysis, the presence of carcinomatosis, chemotherapy or radiation therapy after SEMS placement, and obstruction site were identified as independent predictors of obstructive symptom-free survival. For patient without carcinomatosis, stent failure accounted for the recurrence of obstructive symptoms in 84.6% of cases. For patients with carcinomatosis, multifocal GI tract obstruction or decreased bowel movement accounted for 37.9% of cases with obstructive symptom recurrence and stent failure accounted for 44.8% of

Thin-section CT imaging that correlates with pulmonary function tests in obstructive airway disease

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Arakawa, Hiroaki, E-mail: arakawa@dokkyomed.ac.jp [Department of Radiology, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi 321-0293 (Japan); Fujimoto, Kiminori [Department of Radiology, Kurume University School of Medicine (Japan); Fukushima, Yasutugu [Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University (Japan); Kaji, Yasushi [Department of Radiology, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi 321-0293 (Japan)

2011-11-15

Purpose: The purpose of this study was to identify independent CT findings that correlated with pulmonary function tests (PFTs) in patients with obstructive airway diseases. Materials and methods: Sixty-eight patients with obstructive airway disease and 29 normal subjects (mean age, 52 years; 36 men and 61 women) underwent inspiratory and expiratory thin-section CT and PFTs. Patient with obvious emphysema was excluded. Two radiologists independently reviewed the images and semi-quantitatively evaluated lung attenuation (mosaic perfusion, air trapping) and airway abnormalities (extent and severity of bronchial wall thickening and bronchiectasis, bronchiolectasis or centrilobular nodules, mucous plugging). Univariate, multivariate and receiver operating characteristic (ROC) analyses were performed with CT findings and PFTs. Results: Forty-two patients showed obstructive PFTs, 26 symptomatic patients showed near-normal PFTs. On univariate analysis, air trapping and bronchial wall thickening showed highest correlation with obstructive PFTs such as FEV1.0/FVC, MMEF and FEF75 (r ranged from -0.712 to -0.782; p < 0.001), while mosaic perfusion and mucous plugging showed moderate correlation, and bronchiectasis, bronchiolectasis and nodules showed the least, but significant, correlation. Multiple logistic analyses revealed air trapping and bronchial wall thickening as the only significant independent determinants of obstructive PFTs. ROC analysis revealed the cut-off value of air trapping for obstructive PFTs to be one-third of whole lung (area under curve, 0.847). Conclusions: Our study confirmed air trapping and bronchial wall thickening are the most important observations when imaging obstructive PFTs. The cut-off value of air trapping for identifying obstructive PFTs was one-third of lung irrespective of inspiratory CT findings.

An evaluation of sodium hyaluronate in preventing recurrence of tubal obstruction after interventional recanalization

International Nuclear Information System (INIS)

Chen Hanwei; Cao Xiaoying; Hu Peiling; Liu Haiying; Tang Yukuan; Xiao Chengjiang

2004-01-01

Objective: To evaluate the efficacy and application of sodium hyaluronate in preventing the recurrence of tubal obstruction after interventional recanalization. Methods: In total 103 cases of the study group were injected sodium hyaluronate to prevent tubal adhering obstruction after successful recanalization, while in the control group 206 cases were injected desamethasone, alphacutanee, metronidazole and gentamycin for the same purpose. Both groups were followed up in 2-3 months after the initial intervention. The assessments included water insufflation, intrauterine pregnancy rate, ectopic pregnancy rate and the normal labor. Results: In the study group, 190 tubes in 103 cases were obstructed, 27 tubes missing, and 188 tubes were recanalized out of 190 (99%). In the control group 390 tubes were obstructed, 27 tubes missing, 385 tubes were successfully recanalized (99%). In the 2-3 month follow up water insufflation showed satisfying patency in 99 cases in the study group, and in 178 cases in the control group. Significant difference of recurrence rate of tubal obstruction was found between the two groups. Conclusion: Sodium hyaluronate is effective to prevent the recurrence of tubal obstruction after interventional recanalization

Sialendoscopy-assisted treatment for chronic obstructive parotitis related to Sjogren syndrome.

Science.gov (United States)

Guo, Yong-Feng; Sun, Ning-Ning; Wu, Chuan-Bin; Xue, Lei; Zhou, Qing

2017-03-01

Chronic obstructive parotitis related to Sjogren syndrome is not uncommon, but it is rarely reported in the literature. The aim of this study was to describe our experience in the treatment of chronic obstructive parotitis related to Sjogren syndrome. Seventeen cases of chronic obstructive parotitis related to Sjogren syndrome treated with sialendoscopy from June 2014 to June 2015 at the Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, were retrospectively reviewed. The cohort underwent ultrasonography, salivary gland scintigraphy, and sialography before sialendoscopy. All patients were asked to complete a visual analogue scale (VAS) evaluation before and 6 months after surgery. A paired t test was conducted, and P parotid glands) successfully underwent interventional sialendoscopy under local anesthesia. The mean preoperative VAS score was 6, and the mean VAS score 6 months after sialendoscopy was significantly lower at 4.5 (P < .05). Interventional sialendoscopy plays a significant role in the treatment of chronic obstructive parotitis related to Sjogren syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

Mitral Prosthetic Valve Obstruction and Its Complications

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Rajesh Rajan

2015-12-01

Full Text Available Prosthetic Valve Obstruction (PVO is a serious complication which is associated with increased morbidity and mortality. This could result from thrombus formation, development of pannus, or a combination of both. Patients with this complication often present with symptoms and signs of heart failure, systemic embolism, acute cardiovascular collapse, and sudden death. Transesophageal echocardiography and cine fluoroscopy play a vital role in diagnosis of this potentially lethal condition. Herein, we reported a 56-year-old male patient who presented with severe heart failure and was found to have obstructed ATS27 bileaflet mitral prosthetic valve. Thrombolysis and redo surgery are two important options for treating this condition although guidelines for choosing between the two are not very definite.

Brain Structural Changes in Obstructive Sleep Apnea

Science.gov (United States)

Macey, Paul M.; Kumar, Rajesh; Woo, Mary A.; Valladares, Edwin M.; Yan-Go, Frisca L.; Harper, Ronald M.

2008-01-01

Study Objectives: Determine whether obstructive sleep apnea (OSA) subjects show indications of axonal injury. Design: We assessed fiber integrity in OSA and control subjects with diffusion tensor imaging (DTI). We acquired four whole-brain DTI series from each subject. The four series were realigned, and the diffusion tensor calculated at each voxel. Fractional anisotropy (FA), a measure of fiber integrity, was derived from the diffusion tensor, resulting in a whole brain FA “map.” The FA maps were spatially normalized, smoothed, and compared using voxel-based statistics to determine differences between OSA and control groups, with age as a covariate (P Valladares EM; Yan-Go FL; Harper RM. Brain structural changes in obstructive sleep apnea. SLEEP 2008;31(7):967-977. PMID:18652092

Genetic influences on chronic obstructive pulmonary disease - a twin study

DEFF Research Database (Denmark)

Sylvan Ingebrigtsen, Truls; Thomsen, Simon Francis; Vestbo, Jørgen

2010-01-01

Genes that contribute to the risk of developing Chronic Obstructive Pulmonary Disease (COPD) have been identified, but an attempt to accurately quantify the total genetic contribution to COPD has to our knowledge never been conducted.......Genes that contribute to the risk of developing Chronic Obstructive Pulmonary Disease (COPD) have been identified, but an attempt to accurately quantify the total genetic contribution to COPD has to our knowledge never been conducted....

A New Contention Management Technique for Obstruction Free Transactional Memory

OpenAIRE

Ghosh, Ammlan; Sahin, Anubhab; Silsarma, Anirban; Chaki, Rituparna

2014-01-01

Part 2: Algorithms; International audience; Transactional Memory, one of the most viable alternatives to lock based concurrent systems, was explored by the researchers for practically implementing parallel processing. The goal was that threads will run parallel and improve system performance, but the effect of their execution will be linear. In STM, the non-blocking synchronization can be implemented by Wait-Freedom, Lock-Freedom or Obstruction-Freedom philosophy. Though Obstruction Free Tran...

The Hot Spot in Superior Vena Caval Obstruction Using 99m Technetium tin Colloid

International Nuclear Information System (INIS)

Kim, Byung Tae; Kwon, Kye Ik; Shin, Young Tae; Cho, Kyung Sam; Lee, Myung Chul; Cho, Bo Yeon; Koh, Chang Soon

1981-01-01

The hot spot on liver scan was demonstrated by many authors in various conditions such as SVC obstruction, Budd-Chiari syndrome, liver abscess, hemangioma of liver, hepatic venoocclusive diseases, IVC obstruction, and tricuspid insufficiency. And the appearance of hot spot in SVC obstruction is due to unusual collateral circulation. But there was no report of this hots pot on liver scan in our country. We have recently observed one patient with SVC obstruction who shows well-defined area of increased radioactivity between right and left lobe of liver on liver scan using 99m Tc-tin colloid, and demonstrated collateral circulations with RI venography using 99m Tc-O 4 . The injection site of radiocolloid was left antecubital vein. This hot spot did not appear when the radiocolloid was injected into right leg vein. We report here this hoe spot on liver scan in SVC obstruction with review of some literatures.

Comparison of different morphological parameters with duration of obstruction created experimentally in unilateral upper ureters: an animal model.

Science.gov (United States)

Panda, Shasanka Shekhar; Bajpai, Minu; Mallick, Saumyaranjan; Sharma, Mehar C

2014-01-01

The objective of the following study is to determine and to compare the different morphological parameters with duration of obstruction created experimentally in unilateral upper ureters of rats. Unilateral upper ureteric obstruction was created in 60 adult Wistar rats that were reversed after predetermined intervals. Rats were sacrificed and ipsilateral kidneys were subjected for analysis of morphological parameters such as renal height, cranio-caudal diameter, antero-posterior diameter, lateral diameter, volume of the pelvis and average cortical thickness: Renal height. Renal height and cranio-caudal diameter of renal pelvis after ipsilateral upper ureteric obstruction started rising as early as 7 days of creating obstruction and were affected earlier than antero-posterior and lateral diameter and also were reversed earlier than other parameters after reversal of obstruction. Renal cortical thickness and volume of the pelvis were affected after prolonged obstruction (> 3 weeks) and were the late parameters to be reversed after reversal of obstruction. Cranio-caudal diameter and renal height were the early morphological parameters to be affected and reversed after reversal of obstruction in experimentally created ipsilateral upper ureteric obstruction.

[Thrombosis and obstruction associated with central venous lines. Incidence and risk factors].

Science.gov (United States)

Vivanco Allende, A; Rey Galán, C; Rodríguez de la Rúa, M V; Alvarez García, F; Medina Villanueva, A; Concha Torre, A; Mayordomo Colunga, J; Martínez Camblor, P

2013-09-01

To analyse the incidence of thrombosis and obstruction associated with central venous lines (CVL) inserted in critically ill children, and to determine their risk factors. Prospective observational study in a Pediatric Intensive Care Unit in a University Hospital. An analysis was made of 825 CVL placed in 546 patients. Age, gender, weight, type of catheter (lines, size, and brand), final location of the catheter, mechanical ventilation, type of sedation and analgesia used, initial failure by the doctor to perform CVL catheterization, number of attempts, CVL indication, admission diagnosis, emergency or scheduled procedure, and delayed mechanical complications (DMC). Risk factors for these complications were determined by a multiple regression analysis. A total of 52 cases of DMC, 42 cases of obstruction, and 10 of thrombosis were registered. Obstruction and thrombosis rates were 4.96 and 1.18 per 100 CVL, respectively. The only risk factor independently linked to obstruction was the duration of the CVL (OR 1.05; 95% CI; 1.00-1.10). The number of lines with thrombosis (OR 4.88; 95% CI; 1.26-18.0), as well as parenteral nutrition (OR 4.17; 95% CI; 1.06-16.31) was statistically significant according to bivariate analysis. However, no risk factors for thrombosis were found in the multivariate analysis. Obstruction and thrombosis of CVL inserted in a Pediatric Intensive Care Unit are relatively common complications. CVL duration is an independent risk factor for any line obstruction. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Périhépatite de découverte percoelioscopique pour infertilité a l ...

African Journals Online (AJOL)

retrouvés étaient la pelvialgie chronique (50,8%), la notion d'infection sexuellement transmissible à chlamydia et/ ... C'est la maladie par excellence de la femme jeune, elle est exceptionnelle chez l'homme [9 ... subaiguë ou chronique, une péri hépatite peut se développer sans manifestation clinique dans 66% des cas [10 ...

Post appendectomy acalculus bilateral ureteric obstruction: A rare entity in children

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Vipul Gupta

2013-01-01

Full Text Available Bilateral acalculus ureteric obstruction is described as rare sequelae of acute appendicitis in two paediatric patients aged 6 and 11 years presented with features of anuria. Imaging and endoscopic evaluation confirmed bilateral ureteric obstruction secondary to bladder wall oedema as an inflammatory reaction to appendix. Both cases recovered following bilateral ureteric stenting and are doing well.

Static T2w MRU in Noncalcular Urinary Obstruction: Comparison of Its Two Techniques

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Mohamed Abou El-Ghar

2008-01-01

Full Text Available The purpose of this study was to compare the diagnostic accuracy of T2-weighted (T2w MR urography (MRU techniques — the standard MRU using fast spin echo (FSE and postprocessing maximum intensity projection (MIP and the single-shot MRU — in the diagnosis of ureteric obstruction in patients with noncalcular urinary obstruction. The study included 150 patients admitted to our center between January 2005 and December 2006. There were 203 renal units with noncalcular obstruction; 53 patients had bilateral obstruction. Patients with calcular obstruction were excluded. There were 85 males and 65 females with a mean age of 50 (range: 5–83 years. All patients were examined with static MRU using both single-shot (thick slab and multisection MRU. Using single-shot MRU, we obtained images at the direct coronal and oblique coronal, as well as sagittal, planes for each renal unit. Postprocessing MIP for the standard coronal heavy T2 source images to obtain coronal and oblique images was done. Among the obstructed 203 units, the intrinsic causes were present in 157 units (151 were stricture and six were ureteric tumors, while the extrinsic causes were present in 46 units (35 bladder tumor, four ureterocele, five retroperitoneal fibrosis, one prostatic tumor, and one local pelvic recurrence after radical cystectomy for bladder cancer. The overall accuracy of single-shot MRU was 89% and was 93% for the multisection MRU in cases of intrinsic ureteric obstruction, while in cases of extrinsic obstruction, it was 20% for single-shot MRU and 96% for multisection MRU. T2w static MRU is a very useful technique in diagnosing noncalcular ureteric obstruction. Multisection MRU has a high diagnostic accuracy and reliability over that of the single-shot technique. The single-section technique is very rapid and useful in diagnosing ureteric stricture so it could be used as a localizer, while multisection images with postprocessing MIP is mandatory, especially in cases

Malignant inferior vena cava obstruction involving right atrium. Palliative treatment with self expandable metallic stent

International Nuclear Information System (INIS)

Shao Guoliang; Wang Jianhua; Zhou Kangrong; Yan Zhiping

2001-01-01

Objective: To investigate the safety and efficacy of placement of self-expandable metallic stent within right atrium and inferior vena cava (ICV) in patients with malignant ICV obstruction involving right atrium. Methods: There were 5 male patients with advanced hepatocellular carcinoma, aged from 42 to 65 years (mean 56.3 years). The malignancies invaded right atrium and ICV simultaneously, and caused obstruction of ICV. These patients presented symptoms and signs of obstruction of ICV such as hepatomegaly, ascites, edema of lower extremities. 'Z' type stainless steel stents (7.5-10.0 cm in length and 2.5 cm in diameter) were selected for these patients. Part (1.0-3.0 cm in length) of stent was placed in right atrium and the rest was in ICV. Results: All of stents were placed successfully and obstructed ICV reopened. The symptoms of obstruction of ICV relieved or disappeared. There were no recurrence of symptoms of obstruction of ICV and any cardiac complication related to placement of stents in follow-up period (67-188 days). Conclusion: Placement of self-expandable metallic stent within right atrium and ICV in treatment of patients with malignant ICV obstruction involving right atrium is one of the safe and effective methods

Impact of residual pulmonary obstruction on the long-term outcome of patients with pulmonary embolism.

Science.gov (United States)

Pesavento, Raffaele; Filippi, Lucia; Palla, Antonio; Visonà, Adriana; Bova, Carlo; Marzolo, Marco; Porro, Fernando; Villalta, Sabina; Ciammaichella, Maurizio; Bucherini, Eugenio; Nante, Giovanni; Battistelli, Sandra; Muiesan, Maria Lorenza; Beltramello, Giampietro; Prisco, Domenico; Casazza, Franco; Ageno, Walter; Palareti, Gualtiero; Quintavalla, Roberto; Monti, Simonetta; Mumoli, Nicola; Zanatta, Nello; Cappelli, Roberto; Cattaneo, Marco; Moretti, Valentino; Corà, Francesco; Bazzan, Mario; Ghirarduzzi, Angelo; Frigo, Anna Chiara; Miniati, Massimo; Prandoni, Paolo

2017-05-01

The impact of residual pulmonary obstruction on the outcome of patients with pulmonary embolism is uncertain.We recruited 647 consecutive symptomatic patients with a first episode of pulmonary embolism, with or without concomitant deep venous thrombosis. They received conventional anticoagulation, were assessed for residual pulmonary obstruction through perfusion lung scanning after 6 months and then were followed up for up to 3 years. Recurrent venous thromboembolism and chronic thromboembolic pulmonary hypertension were assessed according to widely accepted criteria.Residual pulmonary obstruction was detected in 324 patients (50.1%, 95% CI 46.2-54.0%). Patients with residual pulmonary obstruction were more likely to be older and to have an unprovoked episode. After a 3-year follow-up, recurrent venous thromboembolism and/or chronic thromboembolic pulmonary hypertension developed in 34 out of the 324 patients (10.5%) with residual pulmonary obstruction and in 15 out of the 323 patients (4.6%) without residual pulmonary obstruction, leading to an adjusted hazard ratio of 2.26 (95% CI 1.23-4.16).Residual pulmonary obstruction, as detected with perfusion lung scanning at 6 months after a first episode of pulmonary embolism, is an independent predictor of recurrent venous thromboembolism and/or chronic thromboembolic pulmonary hypertension. Copyright ©ERS 2017.