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  1. Analysis of clinical features and risk factors for infective endocarditis

    International Nuclear Information System (INIS)

    Objective: To analyze the clinical features of infective endocarditis (IE) and explore the risk factors for it's prognosis. Methods: Clinical data of 65 patients with IE were acquired retrospectively, and its causes, clinical characteristics, pathogenic microorganism, clinical outcomes were analyzed. Results: The major occurring heart diseases for IE in all patients were rheumatic heart disease, congenital heart disease, and there was no any previously known heart disease. The major clinical manifestations included fever and anemia. The major pathogenic bacteria is streptococcus, but percentage of other bacteria increased gradually. Thirteen patients were refractory, in hospital. Haematoglobin and seralbumin were significantly lower, and leucocyte, hsCRP, erythrocyte sedimentation were significantly higher in refractory group. Anaemia, lower seralbumin, higher hsCRP were independent predictors for bad prognosis. Conclusion: The proportion of rheumatic heart disease is decreasing as one of the risk factors for IE in recent years. Streptococcus is major pathogen of IE, and the mortality of IE is still very high. Anaemia, lower seralbumin, higher hsCRP are independent predictors for bad prognosis. (authors)

  2. Perinatal stroke in Saudi children: clinical features and risk factors

    International Nuclear Information System (INIS)

    To describe the clinical features and presentations of perinatal stroke in a prospective and retrospective cohort of Saudi children and ascertain the risk factors. Patients with perinatal stroke were identified from within a cohort of 104 Saudi children who were evaluated at the Division of Pediatric Neurology at King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia from July 1992 to February 2001 (retrospective study) and February 2001 to March 2003 (prospective study). Neuroimaging for suspected cases of stroke consisted of cranial CT, MRI, or both. During the study period, 23 (22%) of 104 children (aged one months to 12 years) were diagnosed to have had perinatal stroke. The male: female ratio was 1.6:1. Ten (67%) of the 15 children who had unilateral ischemic involvement had their lesion in the left hemisphere. The presentation of the ischemic result was within 24-72 hours of life in 13 (57%) patients, and in 6 children (26%), motor impairment was recognized at or after the age of 4 months. Nine children (39%) had seizures at presentation. Pregnancy, labor, and delivery risk factors were ascertained in 18 (78%) cases. The most common of these included emergency cesarean section in 5 cases, and instrumental delivery in other 5. Screening for prothrombotic risk factors detected abnormalities in 6 (26%) patients on at least one test carried out between 2 months and 9 years of age. Four children (17%) had low protein C, which was associated low protein S and raised anticardiolipin antibodies (ACA) in one patient, and low antithrombin III in another. Low proteins S was detected in a 42-month-old boy. The abnormality in the sixth child was confined to raised ACA. The present study highlights the non-specific features by which stroke presents during the neonatal period. The data are in keeping with the potential role for inherited and acquired thrombophilia as being the underlying cause. However, the high prevalence of

  3. Clinical features and risk factor analysis for lower extremity deep venous thrombosis in Chinese neurosurgical patients

    Directory of Open Access Journals (Sweden)

    Fuyou Guo

    2015-01-01

    Full Text Available Background: Deep venous thrombosis (DVT contributes significantly to the morbidity and mortality of neurosurgical patients; however, no data regarding lower extremity DVT in postoperative Chinese neurosurgical patients have been reported. Materials and Methods: From January 2012 to December 2013, 196 patients without preoperative DVT who underwent neurosurgical operations were evaluated by color Doppler ultrasonography and D-dimer level measurements on the 3rd, 7th, and 14th days after surgery. Follow-up clinical data were recorded to determine the incidence of lower extremity DVT in postoperative neurosurgical patients and to analyze related clinical features. First, a single factor analysis, Chi-square test, was used to select statistically significant factors. Then, a multivariate analysis, binary logistic regression analysis, was used to determine risk factors for lower extremity DVT in postoperative neurosurgical patients. Results: Lower extremity DVT occurred in 61 patients, and the incidence of DVT was 31.1% in the enrolled Chinese neurosurgical patients. The common symptoms of DVT were limb swelling and lower extremity pain as well as increased soft tissue tension. The common sites of venous involvement were the calf muscle and peroneal and posterior tibial veins. The single factor analysis showed statistically significant differences in DVT risk factors, including age, hypertension, smoking status, operation time, a bedridden or paralyzed state, the presence of a tumor, postoperative dehydration, and glucocorticoid treatment, between the two groups (P < 0.05. The binary logistic regression analysis showed that an age greater than 50 years, hypertension, a bedridden or paralyzed state, the presence of a tumor, and postoperative dehydration were risk factors for lower extremity DVT in postoperative neurosurgical patients. Conclusions: Lower extremity DVT was a common complication following craniotomy in the enrolled Chinese neurosurgical

  4. Pregnancy-Related Systemic Lupus Erythematosus: Clinical Features, Outcome and Risk Factors of Disease Flares — A Case Control Study

    OpenAIRE

    Huaxia Yang; Hui Liu; Dong Xu; Lidan Zhao; Qian Wang; Xiaomei Leng; Wenjie Zheng; Fengchun Zhang; Fulin Tang; Xuan Zhang

    2014-01-01

    OBJECTIVE: To investigate the clinical features, outcome, and risk factors of disease flares in patients with pregnancy-related lupus (PRL). METHODS: Medical charts of 155 consecutive PRL inpatients were systematically reviewed, including demographic data, clinical features, laboratory findings, treatment, complications, and outcome. RESULTS: PRL cases were divided into active (a-PRL) (n = 82, 53.0%) and stable lupus (s-PRL) (n = 73, 47.0%). Compared with nonpregnant active female systemic lu...

  5. Clinical features, outcome and risk factors in cervical cancer patients after surgery for chronic radiation enteropathy

    International Nuclear Information System (INIS)

    Radical hysterectomy and radiotherapy have long been mainstays of cervical cancer treatment. Early stage cervical cancer (FIGO stage IB1–IIA) is traditionally treated using radical surgery combined with radiotherapy, while locally advanced cervical cancer is treated using radiotherapy alone or chemoradiotherapy. In this retrospective study, we describe and analyse the presenting clinical features and outcomes in our cohort and evaluate possible risk factors for postoperative morbidity in women who underwent surgery for chronic radiation enteropathy (CRE). One hundred sixty-six eligible cervical cancer patients who underwent surgery for CRE were retrospectively identified between September 2003 and July 2014 in a prospectively maintained database. Among them, 46 patients received radical radiotherapy (RRT) and 120 received radical surgery plus radiotherapy (RS + RT). Clinical features, postoperative morbidity and mortality, and risk factors for postoperative morbidity were analysed. RS + RT group patients were more likely to present with RTOG/EORTC grade III late morbidity (76.1 % vs 92.5 %; p = 0.004), while RRT group patients tended to show RTOG/EORTC grade IV late morbidity (23.9 % vs 7.5 %; p = 0.004). One hundred forty patients (84.3 %) were treated with aggressive resection (anastomosis 57.8 % and stoma 26.5 %). Overall and major morbidity, mortality and incidence of reoperation in the RRT and RS + RT groups did not differ significantly (63 % vs 64.2 % [p = 1.000], 21.7 % vs 11.7 % [p = 0.137], 6.5 % vs 0.8 % [p = 0.065] and 6.5 % vs 3.3 % [p = 0.360], respectively). However, incidence of permanent stoma and mortality during follow-up was higher in the RRT group than in the RS + RT group (44.2 % vs 12.6 % [p = 0.000] and 16.3 % vs 3.4 % [p = 0.004], respectively). In multivariate analysis, preoperative anaemia was significantly associated with overall morbidity (p = 0.015), while severe intra-abdominal adhesion (p = 0.017), ASA grades III–V (P = 0

  6. Familial and sporadic porphyria cutanea tarda: clinical and biochemical features and risk factors in 152 patients.

    Science.gov (United States)

    Muñoz-Santos, Carlos; Guilabert, Antonio; Moreno, Nemesio; To-Figueras, Jordi; Badenas, Celia; Darwich, Esteve; Herrero, Carmen

    2010-03-01

    Porphyria cutanea tarda is the most frequent porphyria and occurs in both sporadic and familial forms. We conducted the current study in a series of 152 consecutive patients with porphyria cutanea tarda attending the Porphyria Unit of the Hospital Clinic of Barcelona, Spain, to update the clinical manifestations of the disease and to study the sex differences, the proportion of familial forms, and the role of different risk factors in this population. Patients were classified as familial and sporadic cases according to erythrocyte uroporphyrinogen-decarboxylase activity and uroporphyrinogen-decarboxylase genotyping. In our cohort, skin fragility and blisters on the hands were the most frequent clinical manifestations. Women more frequently had facial hypertrichosis (84.8%; p = 0.004), affected areas other than the hands and face (33.3%; p = 0.008), and pruritus (27.3%; p = 0.041) compared with men. Of our patients, 11.8% did not present the typical clinical onset of the disease, with facial hypertrichosis and hyperpigmentation the more frequent complaints in these cases. Analysis of risk factors showed a high prevalence of hepatitis C virus infection (65.8%) and alcohol abuse (59.9%), both being more frequent in men (p < 0.001). Hepatitis C virus infection was the only risk factor that showed differences between the sporadic and familial forms in the logistic regression model (odds ratio, 0.05; 95% confidence interval, 0.006-0.46). In conclusion, atypical forms of presentation of porphyria cutanea tarda should be considered in order to prevent delayed diagnosis. We note the sustained role of hepatitis C virus infection in the precipitation of sporadic porphyria cutanea tarda. Therefore, in countries with a high prevalence of hepatitis C virus infection, the absence of such infection in a patient with porphyria cutanea tarda may suggest a possible familial case. PMID:20517178

  7. Clinical risk factors and bronchoscopic features of invasive aspergillosis in Intensive Care Unit patients

    OpenAIRE

    ALIYALI, M.; HEDAYATI, M.T.; HABIBI, M.R.; KHODAVAISY, S.

    2013-01-01

    Summary Introduction. Invasive aspergillosis (IA) is an important cause of morbidity and mortality in immunocompromised patients. During recent years, a rising incidence of IA in Intensive Care Unit (ICU) patients has been reported. The patterns of IA related infection may differ according to the type of underlying disease. Unfortunately little is known about the characteristics of IA in ICU patients. In the present study we assessed IA related clinical and bronchoscopy findings in ICU patien...

  8. Pregnancy-related systemic lupus erythematosus: clinical features, outcome and risk factors of disease flares--a case control study.

    Directory of Open Access Journals (Sweden)

    Huaxia Yang

    Full Text Available OBJECTIVE: To investigate the clinical features, outcome, and risk factors of disease flares in patients with pregnancy-related lupus (PRL. METHODS: Medical charts of 155 consecutive PRL inpatients were systematically reviewed, including demographic data, clinical features, laboratory findings, treatment, complications, and outcome. RESULTS: PRL cases were divided into active (a-PRL (n = 82, 53.0% and stable lupus (s-PRL (n = 73, 47.0%. Compared with nonpregnant active female systemic lupus erythematosus (SLE patients, a-PRL including new-onset lupus (n-PRL and flare lupus (f-PRL (n = 41 respectively, had a higher incidence of renal and hematological involvement but less mucocutaneous and musculoskeletal involvement (p<0.05. The incidence of preeclampsia/eclampsia, fetal loss, and preterm birth were significantly higher in a-PRL than in s-PRL (p<0.05. Despite receiving a more vigorous glucocorticoid treatment, a-PRL mothers had a poorer prognosis (p<0.001. Five (6.1% of them died and 13 (15.9% developed severe irreversible organ failure, whereas none of these events was observed in the s-PRL group. Multivariate logistic analysis indicated that a history of lupus flares and serological activity (hypocomplementemia and/or anti-dsDNA positivity at the time of conception were associated with lupus flares in PRL mothers. CONCLUSIONS: SLE patients with a flare history and serological activity at the time of conception were at an increased risk of disease flares during pregnancy and puerperium. a-PRL patients were more prone to renal and hematological involvement, pregnancy complications, and a poorer prognosis despite more vigorous glucocorticoid treatment.

  9. Prognostic impact of demographic factors and clinical features on the mode of death in high-risk patients after myocardial infarction--a combined analysis from multicenter trials

    DEFF Research Database (Denmark)

    Yap, Yee Guan; Duong, Trinh; Bland, J Martin;

    2005-01-01

    BACKGROUND: Contemporary information is lacking on the effect of demographic features and clinical features on the specific mode of mortality after myocardial infarction (MI) in the thrombolytic era. HYPOTHESIS: The aims of this study were (1) to examine the risk and trend of a different mode of ...

  10. Case Characterization, Clinical Features and Risk Factors in Drug-Induced Liver Injury

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    Aida Ortega-Alonso

    2016-05-01

    Full Text Available Idiosyncratic drug-induced liver injury (DILI caused by xenobiotics (drugs, herbals and dietary supplements presents with a range of both phenotypes and severity, from acute hepatitis indistinguishable of viral hepatitis to autoimmune syndromes, steatosis or rare chronic vascular syndromes, and from asymptomatic liver test abnormalities to acute liver failure. DILI pathogenesis is complex, depending on the interaction of drug physicochemical properties and host factors. The awareness of risk factors for DILI is arising from the analysis of large databases of DILI cases included in Registries and Consortia networks around the world. These networks are also enabling in-depth phenotyping with the identification of predictors for severe outcome, including acute liver failure and mortality/liver transplantation. Genome wide association studies taking advantage of these large cohorts have identified several alleles from the major histocompatibility complex system indicating a fundamental role of the adaptive immune system in DILI pathogenesis. Correct case definition and characterization is crucial for appropriate phenotyping, which in turn will strengthen sample collection for genotypic and future biomarkers studies.

  11. Risk factors and the clinical and surgical features of fungal prosthetic joint infections: A retrospective analysis of eight cases

    Science.gov (United States)

    Geng, Lei; Xu, Meng; Yu, Ligang; Li, Jie; Zhou, Yonggang; Wang, Yan; Chen, Jiying

    2016-01-01

    Fungal prosthetic joint infections (PJI) and reports of their clinical investigation are rare. In addition, there has been little evidence regarding the outcome of the two-stage exchange protocol for the treatment of fungal PJI. In order to investigate the risk factors and clinical, microbiological and pathological features of fungal PJIs, as well as the effects of the two-stage exchange protocol on their outcome, the present study analyzed eight retrospective fungal PJI cases, involving four cases affecting the hips and four affecting the knees, between May 2000 and March 2012. In all cases, a cemented spacer saturated with antimicrobials was used during the two-stage exchange protocol, and systematic antifungal agents were administrated during the interim period. The average follow-up duration was 4.4 years. Of the eight cases, six had undergone additional surgery on the infected joint prior to infection with the fungus. Following histological analyses, it was determined that the average number of polymorphonuclear cells in the three patients infected with a fungus was only 5/HPF. The average Harris Hip scores or Hospital for Special Surgery knee scores were 43.6 preoperatively and 86 at the last follow-up. The two-stage exchange protocol was performed eight times in seven cases, with a failure rate of 12.5%. The remaining case was successfully treated by resection arthroplasty. The average duration of antifungal agent administration during the interim period in five of the eight cases was 1.5 months. For three of the patients, the duration of antifungal agent administration was prolonged until the c-reactive protein levels were decreased to normal. The average duration of spacer implantation into the joint was 4.3 months. The results of the present study suggested that undergoing surgery on a prosthetic joint may be a potential risk factor for the development of fungal PJI. In addition, infiltration of polymorphonuclear leukocytes into the site of the infection

  12. Clinical and Imaging Features Associated with an Increased Risk of Early and Late Stroke in Patients with Symptomatic Carotid Disease

    DEFF Research Database (Denmark)

    Naylor, A R; Sillesen, H; Schroeder, T V

    2015-01-01

    OBJECTIVE: The aim of this review was to identify clinical and/or imaging parameters that are associated with an increased (decreased) risk of early/late stroke in patients with symptomatic carotid disease. IN THE FIRST 14 DAYS: Natural history studies suggest that 8-15% of patients with 50...... intracranial disease; (v) a failure to recruit intracranial collaterals; (vi) low GSM; (vii) MR diagnosis of intra-plaque haemorrhage; (vii) spontaneous embolisation on TCD; and (viii) increased FDG uptake in the carotid plaque on PET. Clinical/imaging parameters associated with a lower risk of stroke include...

  13. Clinical and Imaging Features Associated with an Increased Risk of Late Stroke in Patients with Asymptomatic Carotid Disease

    DEFF Research Database (Denmark)

    Naylor, A R; Schroeder, T V; Sillesen, H

    2014-01-01

    target CEA/CAS. METHODS: Review of clinical and/or imaging based scoring systems, predictive algorithms and imaging parameters that may be associated with an increased (or decreased) risk of stroke in patients with asymptomatic carotid disease. RESULTS: Parameters associated with an increased risk of......BACKGROUND: The 2011 American Heart Association Guidelines on the management of asymptomatic carotid disease recommends that carotid endarterectomy (CEA) (with carotid artery stenting (CAS) as an alternative) may be considered in highly selected patients with 70-99% stenoses. However, no guidance...... randomized trials in order to identify a "high risk for stroke" cohort in whom CEA/CAS could be prioritized....

  14. Three-tiered risk stratification model to predict progression in Barrett's esophagus using epigenetic and clinical features.

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    Fumiaki Sato

    Full Text Available Barrett's esophagus predisposes to esophageal adenocarcinoma. However, the value of endoscopic surveillance in Barrett's esophagus has been debated because of the low incidence of esophageal adenocarcinoma in Barrett's esophagus. Moreover, high inter-observer and sampling-dependent variation in the histologic staging of dysplasia make clinical risk assessment problematic. In this study, we developed a 3-tiered risk stratification strategy, based on systematically selected epigenetic and clinical parameters, to improve Barrett's esophagus surveillance efficiency.We defined high-grade dysplasia as endpoint of progression, and Barrett's esophagus progressor patients as Barrett's esophagus patients with either no dysplasia or low-grade dysplasia who later developed high-grade dysplasia or esophageal adenocarcinoma. We analyzed 4 epigenetic and 3 clinical parameters in 118 Barrett's esophagus tissues obtained from 35 progressor and 27 non-progressor Barrett's esophagus patients from Baltimore Veterans Affairs Maryland Health Care Systems and Mayo Clinic. Based on 2-year and 4-year prediction models using linear discriminant analysis (area under the receiver-operator characteristic (ROC curve: 0.8386 and 0.7910, respectively, Barrett's esophagus specimens were stratified into high-risk (HR, intermediate-risk (IR, or low-risk (LR groups. This 3-tiered stratification method retained both the high specificity of the 2-year model and the high sensitivity of the 4-year model. Progression-free survivals differed significantly among the 3 risk groups, with p = 0.0022 (HR vs. IR and p<0.0001 (HR or IR vs. LR. Incremental value analyses demonstrated that the number of methylated genes contributed most influentially to prediction accuracy.This 3-tiered risk stratification strategy has the potential to exert a profound impact on Barrett's esophagus surveillance accuracy and efficiency.

  15. Clinical and Imaging Features Associated with an Increased Risk of Late Stroke in Patients with Asymptomatic Carotid Disease

    DEFF Research Database (Denmark)

    Naylor, A R; Schroeder, T V; Sillesen, H

    2014-01-01

    target CEA/CAS. METHODS: Review of clinical and/or imaging based scoring systems, predictive algorithms and imaging parameters that may be associated with an increased (or decreased) risk of stroke in patients with asymptomatic carotid disease. RESULTS: Parameters associated with an increased risk of...... late stroke include: (a) silent infarction on CT/MRI; (b) stenosis progression; (c) hypoechoic plaques or GSM <15; (d) irregular plaques; (e) evidence of spontaneous embolization on TCD; (f) AHA plaque types IV-V, VI; (g) MR diagnosed IPH; (h) plaque area >80 mm(2); (i) juxta-luminal black area >10 mm......(2); and (j) tandem intracranial disease. CONCLUSIONS: A number of imaging parameters have been shown to be predictive of an increased risk of late stroke in previously asymptomatic patients. None have been independently validated, but many could easily be evaluated in natural history studies or...

  16. Clinical and radiographic maxillofacial features of pycnodysostosis.

    Science.gov (United States)

    Alves, Nilton; Cantín, Mario

    2014-01-01

    The aim of this study was to review of the literature to determine the radiographic and clinical maxillofacial features of pycnodysostosis emphasizing the main aspects of interest to the dentist in order to make them fit for the proper treatment of this population. It is important to make the diagnosis as early as possible in order to plan the treatment more suitable to provide a better life's quality to the patients. The most frequent clinical maxillofacial features were: grooved palate, midfacial hypoplasia, mandibular hypoplasia and enamel hypoplasia. The most common radiographic maxillofacial features were: obtuse mandibular angle, frontal/parietal/occiptal bossing, open fontanels and sutures, multiple impacted teeth. The earlier diagnostic of pycnodysostosis has a fundamental role in general health of the patients. We consider that is very important that the dentist know recognize the radiographic and clinical maxillofacial features of pycnodysostosis, which allows correct treatment planning avoiding risks and ensuring better life's quality to the patients. PMID:24753741

  17. Clinical Aspects, Imaging Features, and Considerations on Bisphosphonate-Related Osteonecrosis Risk in a Pediatric Patient with Osteogenesis Imperfecta

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    Fábio Wildson Gurgel Costa

    2014-01-01

    Full Text Available Osteogenesis imperfecta (OI is a rare hereditary condition caused by changes in collagen metabolism. It is classified into four types according to clinical, genetic, and radiological criteria. Clinically, bone fragility, short stature, blue sclerae, and locomotion difficulties may be observed in this disease. OI is often associated to severe dental problems, such as dentinogenesis imperfecta (DI and malocclusions. Radiographically, affected teeth may have crowns with bulbous appearance, accentuated constriction in the cementoenamel junction, narrowed roots, large root canals due to defective dentin formation, and taurodontism (enlarged pulp chambers. There is no definitive cure, but bisphosphonate therapy is reported to improve bone quality; however, there is a potential risk of bisphosphonate-related osteonecrosis of the jaw. In this study we report a case of OI in a male pediatric patient with no family history of OI who was receiving ongoing treatment with intravenous perfusion of bisphosphonate and who required dental surgery. In addition, we discussed the clinical and imaging findings and briefly reviewed the literature.

  18. Clinical features, laboratory data, management and the risk factors that affect the mortality in patients with postoperative meningitis

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    Erdem Ilknur

    2008-01-01

    Full Text Available Background: Nosocomial meningitis is a rare complication following neurosurgical procedures and is associated with high morbidity and mortality. Aim: The aim of this study was to describe the clinical characteristics and the risk factors associated with mortality in patients who developed nosocomial meningitis following neurosurgical operations. Setting and design: Tertiary care hospital and an observational study. Materials and Methods: The study subjects included 2265 patients who underwent various neurosurgical operations during 2003-05. The diagnosis of nosocomial meningitis was based on the Center for Disease Control criteria. Statistical analysis: It was performed by using Statistical Package for Social Sciences for Windows 10.0 program. Results: The incidence of postoperative nosocomial meningitis was 2.7% (62 episodes in 49 patients among 2265 patients operated. Staphylococcus aureus and Acinetobacter spp. were the most frequently isolated pathogens. Of the 49 with meningitis 20 (40.8% patients died. In the logistic regression analysis model, Glascow coma scale score less than 10 (Odds Ratio (OR: 19.419, 95% Confidence Interval (CI; 1.637-230.41, P = 0.001, and low cerebrospinal fluid glucose level (≤ 30 mg/ dL (OR: 10.272, 95% CI; 1.273-82.854, P = 0.002, and presence of concurrent nosocomial infection (OR: 28.744, 95% CI;1.647-501.73, P =0.001 were the independent risk factors associated with mortality. Conclusion: The mortality in patients who developed meningitis was high. The high percentage of concurrent nosocomial infections was associated with a high mortality rate which was a serious problem.

  19. Renal disease in adult Nigerians with sickle cell anemia: A report of prevalence, clinical features and risk factors

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    R A Bolarinwa

    2012-01-01

    Full Text Available Renal abnormalities in adult Nigerians with sickle cell anemia (SCA have not been extensively studied. To determine the prevalence, pattern and the associated risk factors of renal disease, 72 subjects with SCA from two centers in the southwestern Nigeria were investigated. Socio-demographic data, body mass index and clinical findings were documented. The urine analysis, serum bio-chemistry, hemogram and renal factors attributable to SCA were determined. Presence of albuminuria of at least 1+ or microalbuminuria in those negative with dipstick; and the estimated glomerular filtration rate (eGFR using the Cockcroft-Gault formula categorized subjects to various stages of chronic kidney disease (CKD. Subjects with and without albuminuria were compared to determine the relative risk associated with renal disease. Four (5.6% subjects had macro-albuminuria, while 32 (44.4% had micro-albuminuria and 30 (41.7% had hemoglobinuria. In the subjects with albuminuria, age, hematocrit, systolic blood pressure, serum creatinine, urea and creatinine clearance were numerically higher while the eGFR was numerically lower. There was no significant difference in the clinical parameters studied in the two groups of subjects. The diastolic blood pressure was significantly higher in the albuminuric group. Based on eGFR, 22 (30.6% subjects had hyperfiltration (GFR > 140 mL/min/1.73 m2, of whom 36.4% had albuminuria, 18 (25.0% had stage 1 CKD, 30 (41.7% had stage 2 CKD and two (2.7% subjects had stage 3 CKD with albuminuria. None had stage 4 and 5 CKD. We conclude that renal abnormalities, importantly albuminuria, is common in adult Nigerians with SCA and the pattern and incidence are similar to those reported from other parts of the world. Regular blood pressure monitoring, early diagnosis and active intervention are advocated to delay progression to end-stage kidney disease in view of poor outcomes of renal replacement therapy in SCA patients with nephropathy.

  20. Clinical features and risk assessment for cardiac surgery in adult congenital heart disease: Three years at a single Japanese center

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    Satoshi Kurokawa

    2014-04-01

    Conclusion: Cardiac surgery could be safely performed in most ACHD cases. Exercise tolerance testing can be useful in identifying patients at high risk of mortality or major complications. BNP can be valuable in predicting poor outcomes after cardiac surgery.

  1. Clinical features of Hispanic thyroid cancer cases and the role of known genetic variants on disease risk

    Science.gov (United States)

    Estrada-Florez, Ana P.; Bohórquez, Mabel E.; Sahasrabudhe, Ruta; Prieto, Rodrigo; Lott, Paul; Duque, Carlos S.; Donado, Jorge; Mateus, Gilbert; Bolaños, Fernando; Vélez, Alejandro; Echeverry, Magdalena; Carvajal-Carmona, Luis G.

    2016-01-01

    Abstract Thyroid cancer (TC) is the second most common cancer among Hispanic women. Recent genome-wide association (GWA) and candidate studies identified 6 single nucleotide polymorphisms (SNPs; rs966423, rs2439302, rs965513, rs6983267, rs944289, and rs116909374), associated with increased TC risk in Europeans but their effects on disease risk have not been comprehensively tested in Hispanics. In this study, we aimed to describe the main clinicopathological manifestations and to evaluate the effects of known SNPs on TC risk and on clinicopathological manifestations in a Hispanic population. We analyzed 281 nonmedullary TC cases and 1146 cancer-free controls recruited in a multicenter population-based study in Colombia. SNPs were genotyped by Kompetitive allele specific polymerase chain reaction (KASP) technique. Association between genetic variants and TC risk was assessed by computing odds ratios (OR) and confidence intervals (CIs). Consistent with published data in U.S. Hispanics, our cases had a high prevalence of large tumors (>2 cm, 43%) and a high female/male ratio (5:1). We detected significant associations between TC risk and rs965513A (OR = 1.41), rs944289T (OR = 1.26), rs116909374A (OR = 1.96), rs2439302G (OR = 1.19), and rs6983267G (OR = 1.18). Cases carried more risk alleles than controls (5.16 vs. 4.78, P = 4.8 × 10−6). Individuals with ≥6 risk alleles had >6-fold increased TC risk (OR = 6.33, P = 4.0 × 10−6) compared to individuals with ≤2 risk alleles. rs944289T and rs116909374A were strongly associated with follicular histology (ORs = 1.61 and 3.33, respectively); rs2439302G with large tumors (OR = 1.50); and rs965513A with regional disease (OR = 1.92). To our knowledge, this is the first study of known TC risk variants in South American Hispanics and suggests that they increase TC susceptibility in this population and can identify patients at higher risk of severe disease. PMID

  2. Clinical features of Hispanic thyroid cancer cases and the role of known genetic variants on disease risk.

    Science.gov (United States)

    Estrada-Florez, Ana P; Bohórquez, Mabel E; Sahasrabudhe, Ruta; Prieto, Rodrigo; Lott, Paul; Duque, Carlos S; Donado, Jorge; Mateus, Gilbert; Bolaños, Fernando; Vélez, Alejandro; Echeverry, Magdalena; Carvajal-Carmona, Luis G

    2016-08-01

    Thyroid cancer (TC) is the second most common cancer among Hispanic women. Recent genome-wide association (GWA) and candidate studies identified 6 single nucleotide polymorphisms (SNPs; rs966423, rs2439302, rs965513, rs6983267, rs944289, and rs116909374), associated with increased TC risk in Europeans but their effects on disease risk have not been comprehensively tested in Hispanics. In this study, we aimed to describe the main clinicopathological manifestations and to evaluate the effects of known SNPs on TC risk and on clinicopathological manifestations in a Hispanic population.We analyzed 281 nonmedullary TC cases and 1146 cancer-free controls recruited in a multicenter population-based study in Colombia. SNPs were genotyped by Kompetitive allele specific polymerase chain reaction (KASP) technique. Association between genetic variants and TC risk was assessed by computing odds ratios (OR) and confidence intervals (CIs).Consistent with published data in U.S. Hispanics, our cases had a high prevalence of large tumors (>2 cm, 43%) and a high female/male ratio (5:1). We detected significant associations between TC risk and rs965513A (OR = 1.41), rs944289T (OR = 1.26), rs116909374A (OR = 1.96), rs2439302G (OR = 1.19), and rs6983267G (OR = 1.18). Cases carried more risk alleles than controls (5.16 vs. 4.78, P = 4.8 × 10). Individuals with ≥6 risk alleles had >6-fold increased TC risk (OR = 6.33, P = 4.0 × 10) compared to individuals with ≤2 risk alleles. rs944289T and rs116909374A were strongly associated with follicular histology (ORs = 1.61 and 3.33, respectively); rs2439302G with large tumors (OR = 1.50); and rs965513A with regional disease (OR = 1.92).To our knowledge, this is the first study of known TC risk variants in South American Hispanics and suggests that they increase TC susceptibility in this population and can identify patients at higher risk of severe disease. PMID:27512836

  3. The Clinical Features and Predictive Risk Factors for Reoperation in Patients With Perianal Crohn Diseases; A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group

    Science.gov (United States)

    Lee, Jae Bum; Yoon, Seo-Gue; Park, Kyu Joo; Lee, Kang Young; Kim, Dae Dong; Yoon, Sang Nam

    2015-01-01

    Purpose Perianal lesions are common in Crohn disease, but their clinical course is unpredictable. Nevertheless, predicting the clinical course after surgery for perianal Crohn disease (PCD) is important because repeated operations may decrease patient's quality of life. The aim of this study was to predict the risk of reoperation in patients with PCD. Methods From September 1994 to February 2010, 377 patients with PCD were recruited in twelve major tertiary university-affiliated hospitals and two specialized colorectal hospitals in Korea. Data on the patient's demographics, clinical features, and surgical outcomes were analyzed. Results Among 377 patients, 227 patients were ultimately included in the study. Among the 227 patients, 64 patients underwent at least one reoperation. The median period of reoperation following the first perianal surgery was 94 months. Overall 3-year, 5-year, and 10-year cumulative rates of reoperation-free individuals were 68.8%, 61.2%, and 50.5%, respectively. In multivariate analysis (Cox-regression hazard model), reoperation was significantly correlated with an age of onset less than 20 years (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.07-3.48; P = 0.03), history of abdominal surgery (HR, 1.99; 95% CI, 1.08-3.64; P = 0.03), and the type of surgery. Among types of surgery, fistulotomy or fistulectomy was associated with a decreased incidence of reoperation in comparison with incision and drainage (HR, 0.19; 95% CI, 0.09-0.42; P < 0.001). Conclusion Young age of onset and a history of abdominal surgery were associated with a high risk of reoperation for PCD, and the risk of reoperation were relatively low in fistulotomy or fistulectomy procedures. PMID:26576395

  4. Clinical Features and Correlates of Outcomes for High-Risk, Marginalized Mothers and Newborn Infants Engaged with a Specialist Perinatal and Family Drug Health Service

    Science.gov (United States)

    Taylor, Lee; Hutchinson, Delyse; Rapee, Ron; Burns, Lucy; Stephens, Christine; Haber, Paul S.

    2012-01-01

    Background. There is a paucity of research in Australia on the characteristics of women in treatment for illicit substance use in pregnancy and the health outcomes of their neonates. Aims. To determine the clinical features and outcomes of high-risk, marginalized women seeking treatment for illicit substance use in pregnancy and their neonates. Methods. 139 women with a history of substance abuse/dependence engaged with a perinatal drug health service in Sydney, Australia. Maternal (demographic, drug use, psychological, physical, obstetric, and antenatal care) and neonatal characteristics (delivery, early health outcomes) were examined. Results. Compared to national figures, pregnant women attending a specialist perinatal and family drug health service were more likely to report being Australian born, Aboriginal or Torres Strait Islander, younger, unemployed, and multiparous. Opiates were the primary drug of concern (81.3%). Pregnancy complications were common (61.9%). Neonates were more likely to be preterm, have low birth weight, and be admitted to special care nursery. NAS was the most prevalent birth complication (69.8%) and almost half required pharmacotherapy. Conclusion. Mother-infant dyads affected by substance use in pregnancy are at significant risk. There is a need to review clinical models of care and examine the longer-term impacts on infant development. PMID:23227054

  5. Association of polymorphisms in genes encoding hormone receptors ESR1, ESR2 and LHCGR with the risk and clinical features of testicular germ cell cancer

    DEFF Research Database (Denmark)

    Brokken, Leon J S; Lundberg-Giwercman, Yvonne; Rajpert-De Meyts, Ewa; Eberhard, Jakob; Ståhl, Olof; Cohn-Cedermark, Gabriella; Daugaard, Gedske; Arver, Stefan; Giwercman, Aleksander

    2012-01-01

    Testicular germ cell cancer (TGCC) is the most common malignancy in young men. Genetic variants known to be associated with risk of TGCC only partially account for the observed familial risks. We aimed to identify additional polymorphisms associated with risk as well as histological and clinical ...

  6. Etiology and Risk Factors of Acute Gastroenteritis in a Taipei Emergency Department: Clinical Features for Bacterial Gastroenteritis

    Directory of Open Access Journals (Sweden)

    Chao-Chih Lai

    2016-04-01

    Full Text Available Background: The causative pathogen is rarely identified in the emergency department (ED, since the results of cultures are usually unavailable. As a result, antimicrobial treatment may be overused. The aim of our study was to investigate the pathogens, risk factors of acute gastroenteritis, and predictors of acute bacterial gastroenteritis in the ED. Methods: We conducted a matched case-control study of 627 stool samples and 612 matched pairs. Results: Viruses (41.3% were the leading cause of gastroenteritis, with noroviruses (32.2% being the most prevalent, followed by bacteria (26.8% and Giardia lamblia (12.4%. Taking antacids (adjusted odds ratio [aOR] 4.10; 95% confidence interval [CI], 2.57–6.53, household members/classmates with gastroenteritis (aOR 4.69; 95% CI, 2.76–7.96, attending a banquet (aOR 2.29; 95% CI, 1.64–3.20, dining out (aOR 1.70; 95% CI, 1.13–2.54, and eating raw oysters (aOR 3.10; 95% CI, 1.61–5.94 were highly associated with gastroenteritis. Elders (aOR 1.04; 05% CI, 1.02–1.05, those with CRP >10 mg/L (aOR 2.04; 95% CI, 1.15–3.62, or those who were positive for fecal leukocytes (aOR 2.04; 95% CI, 1.15–3.62 or fecal occult blood (aOR 1.97; 95% CI, 1.03–3.77 were more likely to be hospitalized in ED. In addition, presence of fecal leukocytes (time ratio [TR] 1.22; 95% CI, 1.06–1.41, abdominal pain (TR 1.20; 95% CI, 1.07–1.41, and frequency of vomiting (TR 0.79; 95% CI, 0.64–0.98 were significantly associated with the duration of acute gastroenteritis. Presence of fecal leukocytes (aOR 2.08; 95% CI, 1.42–3.05, winter season (aOR 0.45; 95% CI, 0.28–0.74, frequency of diarrhea (aOR 1.69; 95% CI, 1.01–2.83, and eating shrimp or crab (aOR 1.53; 95% CI, 1.05–2.23 were highly associated with bacterial gastroenteritis. The area under the receiver operating characteristic curve of the final model was 0.68 (95% CI, 0.55–0.63. Conclusions: Acute bacterial gastroenteritis was highly associated with

  7. Demographic and clinical features of neuromyelitis optica

    DEFF Research Database (Denmark)

    Pandit, L.; Asgari, Nasrin; Apiwattanakul, M.;

    2015-01-01

    The comparative clinical and demographic features of neuromyelitis optica (NMO) are not well known. In this review we analyzed peer-reviewed publications for incidence and prevalence, clinical phenotypes, and demographic features of NMO. Population-based studies from Europe, South East and Southern...

  8. Clinical features in meniscus lesions

    OpenAIRE

    Karli, Mahmut

    2004-01-01

    In some circumstances the diagnosis of meniscus tears can be difficult. In addition to a detalied history and clinical examination standard radiographic, arthrographic and arthroscopic examinations can reduce the errors in diagnosis to less than 5%. General featues are pain, less of function, swelling, giving way. Quadriceps, atrophy and locking. Special test are also very important in the diagnosis of meniscus tears.

  9. Rosacea: clinical features and treatment.

    Science.gov (United States)

    Lavers, Isabel

    2016-03-30

    Rosacea is a chronic inflammatory skin condition that predominantly affects the central face. It is characterised by a variable range of symptoms, including erythema, telangiectasia, papules, pustules and changes in skin texture. Rosacea may be transient, recurrent or persistent. Because it affects the most visible part of the body, the psychosocial effects of this condition can be significant. This article describes the features and management of the condition. PMID:27027198

  10. Clinical and radiographic maxillofacial features of pycnodysostosis

    OpenAIRE

    Alves, Nilton; Cantín, Mario

    2014-01-01

    The aim of this study was to review of the literature to determine the radiographic and clinical maxillofacial features of pycnodysostosis emphasizing the main aspects of interest to the dentist in order to make them fit for the proper treatment of this population. It is important to make the diagnosis as early as possible in order to plan the treatment more suitable to provide a better life’s quality to the patients. The most frequent clinical maxillofacial features were: grooved palate, mid...

  11. Diagnostic clinical features of atopic dermatitis

    Directory of Open Access Journals (Sweden)

    Sharma Lata

    2001-01-01

    Full Text Available Atopic dermatitis is a common disease which varies widely in clinical presentation at different ages and places. Although authors working in western countries on white races have suggested many criteria, there is no uniform set which can be used in large population studies in this part of the world. Hence keeping in mind differences in environment and ethnicity of population, the present study was carried out. Seventy- three patients of atopic dermatitis and 71 age matched controls were studied. All the subjects were examined using a set of 34 potentially useful clinical features selected from different studies, including features for evaluation of photosensitivity. Multiple regression technique was used for analysing the data. It was found that 6 clinical features were diagnostic, 1. presence of itch, 2. history of flexural involvement, 3. history of dry skin, 4. family history of atopy, 5. personal history of diagnosed asthma and 6, visible flexural dermatitis. Photosensitivity was not a significant feature.

  12. Essential features for proactive risk management

    Science.gov (United States)

    Murashov, Vladimir; Howard, John

    2009-08-01

    We propose a proactive approach to the management of occupational health risks in emerging technologies based on six features: qualitative risk assessment; the ability to adapt strategies and refine requirements; an appropriate level of precaution; global applicability; the ability to elicit voluntary cooperation by companies; and stakeholder involvement.

  13. Infusion thrombophlebitis: the histological and clinical features.

    OpenAIRE

    Woodhouse, C R

    1980-01-01

    Thrombophlebitis was induced in 8 greyhounds by intravenous infusion of naftidrofuryl (Praxilene), dextrose saline being used as a control. The histological features were the same in the treated and the control veins: circulating polymorphonuclear leucocytes became attached to and later infiltrated the vein endothelium. In more severe cases the deeper layers of the vein wall were affected. The clinical features in 97 patients receiving intravenous infusions of physiological saline, dextrose s...

  14. Ectopic thyroid glands : clinical and radiological features

    International Nuclear Information System (INIS)

    To understand the various clinical and radiological features of ectopic thyroid. This study involved nine ectopic thyroid cases (M:F=2:7; age range, 2-57 years) confirmed by RI thyroid scan between 1993 and 1997. We analyzed one neck ultrasonogram, five CT scans, three MR images, nine Tc-99m thyroid scans, and classified the ectopic thyroid by the basis of these findings. Hormonal abnormalities and symptoms were evaluated on the basis of medical records. Understanding the various clinical and radiologic features of ectopic thyroid can help accurate diagnosis and prevent unnecessary surgery or other procedure. (author). 10 refs., 4 figs

  15. Ectopic thyroid glands : clinical and radiological features

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Nariya; Yoon, Choon Sik; Oh, Sei Jung; Chung, Tae Sub; Kim, Myung Joon; Kim, Dong Ik; Lee, Jong Doo; Park, Mi Suk [Yonsei Univ., Seoul (Korea, Republic of). Coll. of Medicine

    1998-03-01

    To understand the various clinical and radiological features of ectopic thyroid. This study involved nine ectopic thyroid cases (M:F=2:7; age range, 2-57 years) confirmed by RI thyroid scan between 1993 and 1997. We analyzed one neck ultrasonogram, five CT scans, three MR images, nine Tc-99m thyroid scans, and classified the ectopic thyroid by the basis of these findings. Hormonal abnormalities and symptoms were evaluated on the basis of medical records. Understanding the various clinical and radiologic features of ectopic thyroid can help accurate diagnosis and prevent unnecessary surgery or other procedure. (author). 10 refs., 4 figs.

  16. Juvenile myoclonic epilepsy: clinical and EEG features

    DEFF Research Database (Denmark)

    Pedersen, S B; Petersen, K A

    1998-01-01

    We aimed to characterize the clinical profile and EEG features of 43 patients with juvenile myoclonic epilepsy. In a retrospective design we studied the records of, and re-interviewed, 43 patients diagnosed with JME from the epilepsy clinic data base. Furthermore, available EEGs were re...... were sleep deprivation (84%), stress (70%), and alcohol consumption (51%). EEG findings included rapid spike-wave and polyspike-wave....

  17. Clinical and Morphological Features of Focal Adenomyosis

    Directory of Open Access Journals (Sweden)

    Yuliya B. Kurashvili

    2013-09-01

    Full Text Available Background: Adenomyosis is a very real problem encountered in modern gynecology due to the increase in the incidence, severity of the disease, and absence of effective methods of conservative treatment. The aim of the study was to investigate the clinical and morphological features of the focal and diffuse forms of adenomyosis. Methods and Results: The study involved 70 women who applied to the Center with the diagnosis of ‘adenomyosis’. Examination included transvaginal sonography (TVS, magnetic resonance spectroscopy (MRS, and morphological study of the adenomyotic foci. With a probability of 99%, one can argue that focal adenomyosis (FA in its clinical features is different from diffuse adenomyosis (DA in all its major manifestations. Conclusion: FA has unique morphological characteristics and clinical features. The diagnosis of FA should be based on a complex of clinical and instrumental data in conjunction with morphological process verification. Besides, there are difficulties in the diagnosis of FA, which is a major reason for the incorrect determination of the treatment tactic for patients. However, the application of MRS allows the preoperative identification of the biochemical structure of the focus and determination of its borders, and in the postoperative period, selection of optimal treatment tactics based on the identified morphological features of the removed adenomyotic foci.

  18. Barrett's esophagus: clinical features, obesity, and imaging.

    LENUS (Irish Health Repository)

    Quigley, Eamonn M M

    2011-09-01

    The following includes commentaries on clinical features and imaging of Barrett\\'s esophagus (BE); the clinical factors that influence the development of BE; the influence of body fat distribution and central obesity; the role of adipocytokines and proinflammatory markers in carcinogenesis; the role of body mass index (BMI) in healing of Barrett\\'s epithelium; the role of surgery in prevention of carcinogenesis in BE; the importance of double-contrast esophagography and cross-sectional images of the esophagus; and the value of positron emission tomography\\/computed tomography.

  19. Clinical and Morphological Features of Focal Adenomyosis

    OpenAIRE

    Yuliya B. Kurashvili; Alexander I. Guus; Evgeniya A. Kogan; Nina B. Paramonova; Aleksey A. Shklyar; Leila V. Adamyan

    2013-01-01

    Background: Adenomyosis is a very real problem encountered in modern gynecology due to the increase in the incidence, severity of the disease, and absence of effective methods of conservative treatment. The aim of the study was to investigate the clinical and morphological features of the focal and diffuse forms of adenomyosis. Methods and Results: The study involved 70 women who applied to the Center with the diagnosis of ‘adenomyosis’. Examination included transvaginal sonography (...

  20. Main clinical epidemiological features of lung cancer

    International Nuclear Information System (INIS)

    A descriptive and cross-sectional study of 95 patients with lung cancer, discharged from Neumology Service at 'Dr Juan Bruno Zayas Alfonso' General Hospital in Santiago de Cuba, was carried out from January, 2008 to December, 2008 in order to identify the main clinical epidemiological features of the aforementioned disease. A malignancy predominance among men aged between 56 and 65 years old, belonging to urban areas and being heavy smoker (out of 30 cigarettes per day over 30 years ), was found. Those affected without a confirmed histological type and IV clinical stage epidermoid carcinoma were predominant. Most of them had the opportunity to be treated. Increasing and intensifying health promotion and disease prevention campaigns were recommended so as to achieve the population to avoid or quit the smoking habit. (author)

  1. Clinical features of measles pneumonia in adults

    International Nuclear Information System (INIS)

    The clinical features, chest radiographs and computed tomographic (CT) images were evaluated in 11 cases of serologically proved adult measles complicated with pneumonia (10 were previously healthy and one had sarcoidosis). Pneumonia appeared during the rash period in all cases. Respiratory symptoms were cough (9/11), dyspnea (3/11), and hypoxemia (10/11). Pneumonia manifestations were detected in only 4 cases by chest radiograph; on the other hand, they were seen in all cases by CT scan and consisted of ground-glass opacities (73%), nodular opacities (64%) and consolidation (27%). CT seems to be useful method to detect measles pneumonia if it is suspected. Measles pneumonia in previously healthy patients had a good prognosis, as the hypoxemia disappeared within 6 days in all cases. The sarcoidosis patient showed prolonged pneumonic shadows and period of hypoxemia. Measles pneumonia occurring in a host with cellular immunodeficiency may have a severe clinical course. (author)

  2. Clinical Features of Endophthalmitis after Vitreoretinal Surgery

    Institute of Scientific and Technical Information of China (English)

    Shaochong Zhang; Xiaoyan Ding; Jie Hu; Rulong Gao

    2003-01-01

    Purpose: To investigate the rate, clinical features, treatment outcomes and prognosis ofpostvitrectomy endophthalmitis.Methods: Patients undergoing pars plana vitrectomy for vitreous opacity or complicatedretinal detachment during 1988 to 2000 were collected. Vitrectomies for recentpenetrating trauma or endophthalmitis were excluded. Patients suffered from clinical orculture-proven postvitrectomy endophthalmitis were selected.Results: Postvitrectomy endophthalmitis happened to 3 of 7 000 patients, resulting in anoverall frequency of 0. 04%. Enhanced systemic and local antibiotics were used assoon as diagnosis was made. Endophthamitis were controlled within 6 days, 8 days and10 days, respectively. Final visual acuities were light perception in 2 patients and0.02 in 1 patient.Conclusion: Postvitrectomy endophthalmitis was rare, but it deteriorate the visualacuity. Both ophthalmologist and patients should pay high attention to it.

  3. Prognostic value of stromal and epithelial periostin expression in human prostate cancer: correlation with clinical pathological features and the risk of biochemical relapse or death

    International Nuclear Information System (INIS)

    The purpose of the present study was to evaluate the prognostic value of POSTN expression following prostatectomy. Periostin (POSTN) expression in prostate cancer (PCa) and in normal specimens was evaluated in 90 patients by an immuno-reactive score(IRS) based on the intensity of immunostaining and on the quantity of stained cells. The t-test was applied to compare IRS values in cancer specimens to values in normal specimens. Pearson’s test was used to correlate POSTN expression to clinical pathologic features. PSA progression-free and survival curves were constructed by the Kaplan–Meier method and compared using the log-rank test. Multi-parametric models were constructed according to the Cox technique adding all the covariates predicting for either PSA progression or death into the models after univariate analysis. Both stromal and epithelial POSTN expression were significantly increased in tumor tissues. In particular, we found stromal expression to be significantly higher than epithelial expression as compared to normal tissues (p<0.000 and p=0.001).A significant correlation between POSTN epithelial expression and extra-prostatic extension was found (p=0.03). While high stromal expression was significantly associated with shorter survival (p=0.008), a low epithelial score significantly correlated with shorter PSA-free survival (p=0.04), suggesting that POSTN plays an apparently opposing biological role depending on its compartmentalization.Regardless of the mechanism that is involved, patients showing both high stromal and low epithelial expression made up a subgroup with a very bleak prognosis. Although requiring further validation through larger studies, our findings show that POSTN might represent a novel prognostic marker for PCa

  4. Clinical features of influenza disease in admitted children during the first postpandemic season and risk factors for hospitalization: a multicentre Spanish experience.

    Science.gov (United States)

    Launes, C; García-García, J J; Martínez-Planas, A; Moraga, F; Soldevila, N; Astigarraga, I; Arístegui, J; Korta, J; Quintana, J M; Torner, N; Domínguez, A

    2013-03-01

    The main objectives of this study were to describe the characteristics of children with influenza infection during the postpandemic outbreak, and to compare sociodemographic and clinical data between patients who required hospitalization and those managed on an outpatient basis with a matched case-control study design. This is a multicentre paediatric study in Spain that included patients aged 6 month to 18 years in whom influenza infection was confirmed by real-time reverse transcription-polymerase chain reaction between December 2010 and March 2011. Among the 143 admitted patients, the main reason for admission was respiratory failure (123/143). In 55 there was some previously known disease. The median age was lower in patients without comorbidity (1.8 years: interquartile range 1.0-3.0 versus 5.3 years: interquartile range 1.3-10.7); p lag time from onset of symptoms to starting antiviral treatment was correlated with the length of hospital stay (Rho Spearman = + 0.32; p 0.01). Twenty patients required admission to the paediatric intensive care units, all due to respiratory failure. Children with chest X-ray opacities in more than one quadrant more frequently required admission to intensive care. Having a neurological disease conferred the highest risk of requiring hospitalization (OR 17.18) in a multivariate analysis. This study concludes that influenza in the paediatric population requiring hospitalization during the postpandemic season affected mainly children with neurological or pulmonary comorbidities and children of parents with a lower educational level. Most of the influenza infections caused respiratory symptoms, although neurological manifestations were also observed. Early initiation of oseltamivir was associated with a shorter length of hospital stay. PMID:23305123

  5. Clinical and laboratory features of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Andrés Cárdenas

    2007-02-01

    have electrolyte disturbances like hyponatremia, hypokalemia, and metabolic alkalosis, associated with defective water handling or with diuretic use. Serum aminotransferases, alkaline phosphatase and gammaglutamyl transpeptidase are often abnormal in a nonspecific pattern. Some serum markers are useful in diagnosis of HCC. The most commonly used is alpha-fetoprotein (AFP. AFP is a glycoprotein that is normally produced during gestation by the fetal liver and the yolk sac.

    In adults, normal values are less than 20 ng/ml and AFP is often elevated in patients with HCC. Serum concentrations of AFP do not correlate with clinical features of HCC, such as size, stage and prognosis but is generally accepted that serum levels greater than 500 ng/ml in a high risk patient is diagnosis of HCC.

    Other serum markers - Because of the limitations of serum AFP measurements, other serum markers of HCC used alone or in combination with the serum AFP have been evaluated for diagnosis or determining prognosis in patients with HCC. These include lens culinaris agglutinin-reactive AFP and des-gamma carboxyprothrombin, glypican-3, human hepatocyte growth factor, and insulin-like growth factor.

     

  6. Clinical mastitis in ewes; bacteriology, epidemiology and clinical features

    Directory of Open Access Journals (Sweden)

    Kvitle Bjørg

    2007-09-01

    Full Text Available Abstract Background Clinical mastitis is an important disease in sheep. The objective of this work was to identify causal bacteria and study certain epidemiological and clinical features of clinical mastitis in ewes kept for meat and wool production. Methods The study included 509 ewes with clinical mastitis from 353 flocks located in 14 of the 19 counties in Norway. Clinical examination and collection of udder secretions were carried out by veterinarians. Pulsed-field gel electrophoresis (PFGE was performed on 92 Staphylococcus aureus isolates from 64 ewes. Results and conclusion S. aureus was recovered from 65.3% of 547 clinically affected mammary glands, coagulase-negative staphylococci from 2.9%, enterobacteria, mainly Escherichia coli, from 7.3%, Streptococcus spp. from 4.6%, Mannheimia haemolytica from 1.8% and various other bacteria from 4.9%, while no bacteria were cultured from 13.2% of the samples. Forty percent of the ewes with unilateral clinical S. aureus mastitis also had a subclinical S. aureus infection in the other mammary gland. Twenty-four of 28 (86% pairs of S. aureus isolates obtained from clinically and subclinically affected mammary glands of the same ewe were indistinguishable by PFGE. The number of identical pairs was significantly greater than expected, based on the distribution of different S. aureus types within the flocks. One-third of the cases occurred during the first week after lambing, while a second peak was observed in the third week of lactation. Gangrene was present in 8.8% of the clinically affected glands; S. aureus was recovered from 72.9%, Clostridium perfringens from 6.3% and E. coli from 6.3% of the secretions from such glands. This study shows that S. aureus predominates as a cause of clinical ovine mastitis in Norway, also in very severe cases. Results also indicate that S. aureus is frequently spread between udder halves of infected ewes.

  7. Clinical and laboratory features of preleukemia patients

    Institute of Scientific and Technical Information of China (English)

    施均; 邵宗鸿; 陈桂彬; 李克; 刘鸿; 张益枝; 和虹; 赵明峰; 何广胜; 张泓; 储榆林; 郝玉书

    2002-01-01

    Objective To explore prospective diagnostic criteria for preleukemia.Methods A case control study was done comparing the discrepancies on clinical and laboratory features between patients with preleukemia and those with chronic aplastic anemia (CAA) or atypical paroxysmal nocturnal hemoglubinuria (a-PNH).Results There were eight variables of significance: (1) lymphocytoid micromegakaryocytes in the bone marrow; (2) immature granulocytes in the peripheral blood; (3) ≥2.0% myeloblasts in the bone marrow; (4) positive periodic acid schiff (PAS) stained nucleated erythrocytes; (5) myeloid differentiation index ≥1.8; (6) typical colonal karyotypic abnormalities; (7) negative sister chromatid differentiation; (8) cluster/colony ratio of granulocyte-macrophage colony-forming units (CFU-GM)>4.0. The following criteria were assigned: A: to meet variable one and at least two of the other seven variables and B: to meet at least four of the eight variables. All of the patients with preleukemia met either A or B and none of the patients with CAA or a-PNH did. Conclusions Preleukemia is different from CAA or a-PNH. It has its own clinical and laboratory features, which may be useful for its prospective diagnosis.

  8. Autoimmune uveitis: clinical, pathogenetic, and therapeutic features.

    Science.gov (United States)

    Prete, Marcella; Dammacco, Rosanna; Fatone, Maria Celeste; Racanelli, Vito

    2016-05-01

    Autoimmune uveitis (AU), an inflammatory non-infectious process of the vascular layer of the eye, can lead to visual impairment and, in the absence of a timely diagnosis and suitable therapy, can even result in total blindness. The majority of AU cases are idiopathic, whereas fewer than 20 % are associated with systemic diseases. The clinical severity of AU depends on whether the anterior, intermediate, or posterior part of the uvea is involved and may range from almost asymptomatic to rapidly sight-threatening forms. Race, genetic background, and environmental factors can also influence the clinical picture. The pathogenetic mechanism of AU is still poorly defined, given its remarkable heterogeneity and the many discrepancies between experimental and human uveitis. Even so, the onset of AU is thought to be related to an aberrant T cell-mediated immune response, triggered by inflammation and directed against retinal or cross-reactive antigens. B cells may also play a role in uveal antigen presentation and in the subsequent activation of T cells. The management of AU remains a challenge for clinicians, especially because of the paucity of randomized clinical trials that have systematically evaluated the effectiveness of different drugs. In addition to topical treatment, several different therapeutic options are available, although a standardized regimen is thus far lacking. Current guidelines recommend corticosteroids as the first-line therapy for patients with active AU. Immunosuppressive drugs may be subsequently required to treat steroid-resistant AU and for steroid-sparing purposes. The recent introduction of biological agents, such as those targeting tumor necrosis factor-α, is expected to remarkably increase the percentages of responders and to prevent irreversible sight impairment. This paper reviews the clinical features of AU and its crucial pathogenetic targets in relation to the current therapeutic perspectives. Also, the largest clinical trials

  9. Clinical features and applications of thallium-201

    International Nuclear Information System (INIS)

    Thallium-201 is not only used widely in myocardial imaging but also has a great potential in other various nuclear medicine imaging studies. This paper presents clinical features and applications of thallium-201, focusing on clinical trials with thallium-201 at the Shinshu University School of Medicine. Thallium-201 myocardial scintigraphy offers information on 1) ventricular position and morphology, 2) hypertrophy or dilatation of the left ventricle, 3) hypertrophy or dilatation of the right ventricle, 4) site and extent of myocardial ischemia and infarct, 5) myocardial blood flow, 6) pulmonary congestion or interstitial pulmonary edema, and 7) pericardial effusion. It can be used in the following evaluation or diagnosis: 1) acute or old myocardial infarction, 2) angina pectoris, 3) treatment strategy or prognosis of ischemic heart disease, 4) treatment strategy or observation of bypass graft or drug therapy, 5) hypertrophic or dilated idiopathic cardiomyopathy, 6) myocardial lesions induced by sarcoidosis, collagen disease, and neuro-muscular disease, 7) ventricular hypertrophy and pulmonary edema, and 9) pericarditis, pericardial effusion, and systolic pericarditis associated with underlying disease. The significance of tumor, liver, bone marrow scintigraphies is also referred to. (Namekawa, K) 69 refs

  10. Clinical features of multiple spontaneous intracerebral hemorrhages

    Directory of Open Access Journals (Sweden)

    Tao CHANG

    2016-01-01

    Full Text Available Objective To analyze the clinical features of multiple spontaneous intracerebral hemorrhages (MICH. Methods Conservative therapy, puncture and drainage, hematoma removal and/or decompressive craniectomy were used in the treatment of 630 intracerebral hemorrhage (ICH patients, who were divided into 2 groups: 30 cases with MICH and another 600 cases with solitary intracerebral hemorrhage (SICH. Three months after onset, modified Rankin Scale (mRS was used to evaluate the prognosis of all cases. Results Compared with patients in SICH group, the occurrence rate of hypertension > 5 years (P = 0.008, diabetes mellitus (P = 0.024, hypercholesterolemia (P = 0.050 and previous ischemic stroke (P = 0.026 were all significantly higher in MICH group. The mean arterial pressure (MAP level (P = 0.002 and the incidence of limb movement disorder (P = 0.000 were significantly higher in patients with MICH than those with SICH. Basal ganglia and thalamus were the predilection sites of hematoma (P = 0.001. Patients with MICH had worse prognosis compared to those with SICH 3 months after onset (P = 0.006. Conclusions Hypertension > 5 years, diabetes mellitus, hypercholesterolemia and ischemic stroke were identified to be the pathophysiological basis of MICH in this study. All patients with MICH had more serious clinical manifestations after onset and worse prognosis. DOI: 10.3969/j.issn.1672-6731.2016.01.008

  11. Clinical and microbiological features of cryptococcal meningitis

    Directory of Open Access Journals (Sweden)

    Lucia Kioko Hasimoto e Souza

    2013-06-01

    Full Text Available Introduction In this study, the clinical features, underlying diseases and clinical outcomes of patients with cryptococcosis were investigated. In addition, a molecular analysis of the Cryptococcus neoformans species complex isolated from these patients was performed. Methods A prospective study of 62 cases of patients with cryptococcal infection was conducted at the Hospital de Doenças Tropicais de Goiás Dr. Anuar Auad from 2009-2010. Cryptococcal meningitis cases were diagnosed by direct examination and cerebrospinal fluid (CSF sample culture. The profiling of these patients was assessed. The CSF samples were submitted to India ink preparation and cultured on Sabouraud dextrose agar, and C. neoformans was identified by the production of urease, a positive phenoloxidase test and assimilation of carbohydrates. C. neoformans and C. gattii isolates were distinguished by growth on L-canavanine-glycine-bromothymol blue medium, and molecular analysis was conducted via PCR fingerprinting reactions using M13 and (GACA4 primers. Results From the 62 patients with cryptococcosis, 71 isolates of CSF were obtained; 67 (94.4% isolates were identified as C. neoformans var. grubii/VNI, and 4 (5.6% were identified as C. gattii/VGII. Of these patients, 53 had an HIV diagnosis. The incidence of cryptococcosis was higher among patients 20-40 years of age, with 74.2% of the cases reported in males. Cryptococcus-related mortality was noted in 48.4% of the patients, and the symptoms were altered sensorium, headache, fever and stiff neck. Conclusions The high morbidity and mortality observed among patients with cryptococcosis demonstrate the importance of obtaining information regarding the epidemiological profile and clinical course of the disease in the State of Goiás, Brazil.

  12. Clinical and neurophysiological features of tick paralysis.

    Science.gov (United States)

    Grattan-Smith, P J; Morris, J G; Johnston, H M; Yiannikas, C; Malik, R; Russell, R; Ouvrier, R A

    1997-11-01

    The clinical and neurophysiological findings in six Australian children with generalized tick paralysis are described. Paralysis is usually caused by the mature female of the species Ixodes holocyclus. It most frequently occurs in the spring and summer months but can be seen at any time of year. Children aged 1-5 years are most commonly affected. The tick is usually found in the scalp, often behind the ear. The typical presentation is a prodrome followed by the development of an unsteady gait, and then ascending, symmetrical, flaccid paralysis. Early cranial nerve involvement is a feature, particularly the presence of both internal and external ophthalmoplegia. In contrast to the experience with North American ticks, worsening of paralysis in the 24-48 h following tick removal is common and the child must be carefully observed over this period. Death from respiratory failure was relatively common in the first half of the century and tick paralysis remains a potentially fatal condition. Respiratory support may be required for > 1 week but full recovery occurs. This is slow with several weeks passing before the child can walk unaided. Anti-toxin has a role in the treatment of seriously ill children but there is a high incidence of acute allergy and serum sickness. Neurophysiological studies reveal low-amplitude compound muscle action potentials with normal motor conduction velocities, normal sensory studies and normal response to repetitive stimulation. The biochemical structure of the toxin of I. holocyclus has not been fully characterized but there are many clinical, neurophysiological and experimental similarities to botulinum toxin. PMID:9397015

  13. Clinical features and risk factors for severe and critical pregnant women with 2009 pandemic H1N1 influenza infection in China

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    Zhang Peng-jun

    2012-02-01

    Full Text Available Abstract Background 2009 pandemic H1N1 (pH1N1 influenza posed an increased risk of severe illness among pregnant women. Data on risk factors associated with death of pregnant women and neonates with pH1N1 infections are limited outside of developed countries. Methods Retrospective observational study in 394 severe or critical pregnant women admitted to a hospital with pH1N1 influenza from Sep. 1, 2009 to Dec. 31, 2009. rRT-PCR testing was used to confirm infection. In-hospital mortality was the primary endpoint of this study. Univariable logistic analysis and multivariate logistic regression analysis were used to investigate the potential factors on admission that might be associated with the maternal and neonatal mortality. Results 394 pregnant women were included, 286 were infected with pH1N1 in the third trimester. 351 had pneumonia, and 77 died. A PaO2/FiO2 ≤ 200 (odds ratio (OR, 27.16; 95% confidence interval (CI, 2.64-279.70 and higher BMI (i.e. ≥ 30 on admission (OR, 1.26; 95% CI, 1.09 to 1.47 were independent risk factors for maternal death. Of 211 deliveries, 146 neonates survived. Premature delivery (OR, 4.17; 95% CI, 1.19-14.56 was associated neonatal mortality. Among 186 patients who received mechanical ventilation, 83 patients were treated with non-invasive ventilation (NIV and 38 were successful with NIV. The death rate was lower among patients who initially received NIV than those who were initially intubated (24/83, 28.9% vs 43/87, 49.4%; p = 0.006. Septic shock was an independent risk factor for failure of NIV. Conclusions Severe hypoxemia and higher BMI on admission were associated with adverse outcomes for pregnant women. Preterm delivery was a risk factor for neonatal death among pregnant women with pH1N1 influenza infection. NIV may be useful in selected pregnant women without septic shock.

  14. Infantile hemangiomas: from pathogenesis to clinical features

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    Rosenblatt A

    2012-06-01

    Full Text Available Adena Rosenblatt,1 Erin F Mathes,2 Kristina W Rosbe31Department of Pediatrics, University of California, San Francisco, 2Division of Pediatric Dermatology, Departments of Dermatology and Pediatrics, University of California, San Francisco, 3Division of Pediatric Otolaryngology, Department of Otolaryngology – Head and Neck Surgery, University of California, San Francisco, CA, USAAbstract: Infantile hemangiomas (IH are benign vascular tumors consisting of a collection of immature cells, including progenitor stem cells and disorganized blood vessels. They are the most common benign tumors in childhood. Recently, there have been significant, exciting advancements in the understanding of the pathogenesis and treatment of infantile hemangiomas, which are discussed in this review. The decision to initiate treatment for IH is based on many factors, including size and location, functional compromise, psychosocial implications, and risks and benefits of the proposed therapy. For most families of children with hemangiomas, education about the natural history of IH and reassurance are often the only "treatment" required. A minority of patients with large, complex lesions or lesions that cause functional compromise require early intervention. These patients and families benefit from a multidisciplinary approach to care in vascular birthmark centers. Ongoing multi-institutional clinical trials will provide further important data on the efficacy and safety of hemangioma treatments.Keywords: progenitor stem cell, glucose transporter 1, PHACES, LUMBAR, infantile hemangioma

  15. Childhood Pars Planitis; Clinical Features and Outcomes

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    Homayoon Nikkhah

    2011-01-01

    Full Text Available Purpose: To evaluate the demographic and clinical features of childhood pars planitis, and to determine the therapeutic and visual outcomes of the disease. Methods: Medical records of pediatric patients (less than 16 years of age at diagnosis with pars planitis and at least 6 months of follow-up who were referred to Labbafinejad Medical Center, Tehran, Iran over a 22 year period were reviewed. Results: Overall, 117 eyes of 61 patients including 51 (83.6% male subjects were included. Mean age at the time of diagnosis was 7.8΁3.2 (range, 3-16 years. Mean best corrected visual acuity (BCVA was 0.88΁0.76 logMAR at presentation which improved to 0.39΁0.51 logMAR at final visit (P<0.001. Endotheliitis was present in 23 (19.6% eyes and was significantly more prevalent in subjects younger than 9 years (P=0.025. Cataract formation (41.9% and cystoid macular edema (19.7% were the most prevalent complications. Univariate regression analysis showed that better baseline visual acuity (OR=0.38, 95%CI 0.21-0.70, P=0.002, age older than 5 years at disease onset (OR=0.36, 95%CI 0.14-0.9, P=0.029, absence of endotheliitis (OR=0.39, 95%CI 0.15-0.99, P=0.047 and female gender (OR=3.77, 95%CI 1.03-13.93, P=0.046 were significantly associated with final BCVA of 20/40 or better. Conclusion: Childhood pars planitis was much more common among male subjects. Endotheliitis may be a sign of inflammation spillover and is more prevalent in younger patients. Visual prognosis is favorable in most patients with appropriate treatment.

  16. 75例术后瞻妄临床特征及危险因素分析%Clinical features and risk factors in 75 postoperative delirium patients

    Institute of Scientific and Technical Information of China (English)

    穆雪侠; 王建武; 刘晓敏; 邓大丽

    2012-01-01

    目的 探讨术后谵妄患者的临床特征,并分析谵妄发生的相关因素.方法 收集术后谵妄患者75例的临床资料,抽取同期住院的术后不发生谵妄患者为对照组进行比较.结果 结果分析表明年龄>60岁(P=0.000)、术中输血(P=0.032)与谵妄发生有关,术后并发症(P=0.113)、睡眠障碍(P=0.086)、应激(P=0.058)与术后谵妄发生无相关性;分析表明术后谵妄的发生与年龄>60岁(P=0.037)、术中输血(P=0.041)有关.术后非立即苏醒者较立即苏醒者的谵妄潜伏期显著缩短(P 0. 05 ). Anesthesia waking time and delirium incubation period had no relation with it. The prognosis was good. Conclusion Elderly patient and blood transfusions are the risk factors of delirium. The postoperative complications, sleep disorders, stress promote the delirium.

  17. Clinical Features of Liver Cancer with Cerebral Hemorrhage.

    Science.gov (United States)

    Lu, Qiuhong; Chen, Li; Zeng, Jinsheng; Huang, Gelun; Qin, Chao; Cheng, Daobin; Yu, Lixia; Liang, Zhijian

    2016-01-01

    BACKGROUND Cerebral hemorrhage is common in patients with cancer, but the clinical features and pathogenesis of liver cancer patients with cerebral hemorrhage are not well known. MATERIAL AND METHODS Liver cancer patients who developed cerebral hemorrhage were recruited from the First Affiliated Hospital of Guangxi Medical University between January 2003 and December 2014. We retrospectively analyzed clinical presentations, results of laboratory tests, and imaging examinations. The clinical features and pathogenesis were summarized. RESULTS Among 11133 patients with liver cancer, 9 patients (0.08%), including 3 females and 6 males met the inclusion criteria. The age range was 48-73 years and the average age was 61.67±8.97 years. Five patients did not have traditional hemorrhage risk factors and 4s had the risk factors; however, all had developed hepatocellular carcinoma, and 3 had developed metastasis. All 9 patients showed elevated tumor markers: an increased AFP level was detected in 6 patients, coagulation dysfunctions in 8 patients, and abnormal liver functions in 6 patients. Five patients had developed cerebral hemorrhagic lesions in the lobes of their brains, while hemorrhagic lesions in the basal ganglia occurred in 3 patients and in the brainstem in only 1 patient. Four patients had clear consciousness, while 5 patients were in coma and showed poor prognosis. CONCLUSIONS Patients who have liver cancer complicated with cerebral hemorrhage usually lack traditional risk factors of cerebral hemorrhage. The site of cerebral hemorrhage is often detected in the lobes of the brain. Coagulation dysfunctions might be the main pathogenesis of liver cancer complicated with cerebral hemorrhage. PMID:27209058

  18. Clinical features and multidisciplinary approaches to dementia care

    Directory of Open Access Journals (Sweden)

    Gr

    2011-05-01

    Full Text Available Jacob HG Grand¹, Sienna Caspar², Stuart WS MacDonald11Department of Psychology, University of Victoria, Victoria, BC, Canada; 2Interdisciplinary Graduate Studies, University of British Columbia, Vancouver, BC, CanadaAbstract: Dementia is a clinical syndrome of widespread progressive deterioration of cognitive abilities and normal daily functioning. These cognitive and behavioral impairments pose considerable challenges to individuals with dementia, along with their family members and caregivers. Four primary dementia classifications have been defined according to clinical and research criteria: 1 Alzheimer’s disease; 2 vascular dementias; 3 frontotemporal dementias; and 4 dementia with Lewy bodies/Parkinson’s disease dementia. The cumulative efforts of multidisciplinary healthcare teams have advanced our understanding of dementia beyond basic descriptions, towards a more complete elucidation of risk factors, clinical symptoms, and neuropathological correlates. The characterization of disease subtypes has facilitated targeted management strategies, advanced treatments, and symptomatic care for individuals affected by dementia. This review briefly summarizes the current state of knowledge and directions of dementia research and clinical practice. We provide a description of the risk factors, clinical presentation, and differential diagnosis of dementia. A summary of multidisciplinary team approaches to dementia care is outlined, including management strategies for the treatment of cognitive impairments, functional deficits, and behavioral and psychological symptoms of dementia. The needs of individuals with dementia are extensive, often requiring care beyond traditional bounds of medical practice, including pharmacologic and non-pharmacologic management interventions. Finally, advanced research on the early prodromal phase of dementia is reviewed, with a focus on change-point models, trajectories of cognitive change, and threshold models of

  19. Clinical Features of Interstitial Lung Diseases

    OpenAIRE

    Lim, Gune-Il; Lee, Kwang Hee; Jeong, Seong Whan; Uh, Soo-taek; Jin, So Young; Lee, Dong Hwa; Park, Jai Soung; Choi, Deuk Lin; Kang, Chang Hee; Park, Choon Sik

    1996-01-01

    Objectives Interstitial lung diseases (ILD) are heterogenous groups of disorders that involve the interstitium of the lung. Lung biopsy is mandatory in most cases of ILD for diagnosis. In Korea, a few clinical data about ILD were analyzed on the basis of pathologic proof. Thus, we analysed the clinical profiles of patients with ILD who had lung biopsy in a tertiary university hospital. Methods Clinical and pathologic data concerning 100 patients who had open lung biopsy (OLB) and/or transbron...

  20. Clinical pharmacology and vascular risk.

    Science.gov (United States)

    Silvestrelli, G; Corea, F; Micheli, S; Lanari, A

    2010-01-01

    Pharmacological treatment and several drugs of abuse have been associated with ischemic heart disease (IHD) and cerebrovascular diseases (CVD). However, there is a paucity of data on the independent risk of vascular disease (VD) associated with pharmacological treatment and no controlled trials demonstrating a reduction in risk with abstinence. Information about IHD and CVD-related drug abuse is mainly limited to epidemiological studies focused on urban populations. The potential link between some pharmacological treatments (estrogen, some oncologic drugs and some atypical antipsychotics) and cerebrovascular adverse events was analyzed, but disagreement about an association persists. Drugs of abuse, including cocaine, amphetamines and heroin, have been associated with an increased vascular risk. These drugs can cause abrupt changes in blood pressure, vasculitic-type changes, lead to embolization caused by infective endocarditis, and hemostatic and hematologic abnormalities that can result in increased blood viscosity and platelet aggregation. Long-term treatment strategies based on medication, psychological support, and outreach programs play an important role in treatment of drug dependency. In these last years public interest in risk factors for VD has been constantly increasing and the successful identification and management of pharmacological treatment and drug abuse can be challenging. One of the major public health issues for the future will be to focus more on new vascular risk factor recognition and management. The objective of this chapter is to review the relevance of IHD and CVD associated with various pharmacological treatments and drug abuse with focusing on ischemic disease. This chapter reports the clinical evidence of this association and analyzes the experimental role of new drugs as a growing risk factor of VD with the hypothetical new association. In conclusion, in this chapter great attention is paid to evaluating the scientific and real

  1. Clinical Features of Infection in Older Adults.

    Science.gov (United States)

    Norman, Dean C

    2016-08-01

    The impact of infectious diseases on older adults is far greater than on younger adults because of significantly higher morbidity and mortality caused by infection. The reasons for this greater impact include factors such as lower physiologic reserve due to age and chronic disease, age-related changes in host defenses, loss of mobility, higher risk for polypharmacy and adverse drug reactions, and being on drugs that increase the risk for infection (e.g., anticholinergic and other sedating medications increase the risk for pneumonia). PMID:27394015

  2. Ebola outbreak in Conakry, Guinea: Epidemiological, clinical, and outcome features

    OpenAIRE

    Barry, M; Traoré, F A; Sako, F B; Kpamy, D O; Bah, E I; Poncin, M; S. Keita; Cisse, M; Touré, A.

    2014-01-01

    The authors studied the epidemiological, clinical, and outcome features of the Ebola virus disease in patients hospitalized at the Ebola treatment center (ETC) in Conakry to identify clinical factors associated with death.

  3. Clinical features and management of autoimmune hepatitis

    OpenAIRE

    2008-01-01

    Autoimmune hepatitis (AIH) is a chronic hepatitis of unknown etiology which can progress to cirrhosis. Its clinical manifestations are highly variable and sometimes follow a fluctuating course. Diagnosis is based on characteristic histologic, clinical, biochemical and serological findings. Anti-inflammatory/immunosuppressive treatment frequently induces remission but long-term maintenance therapy is often required. Liver transplantation is generally successful in patients with decompensated c...

  4. Clinical features and management of autoimmune hepatitis

    Institute of Scientific and Technical Information of China (English)

    Edward L Krawitt

    2008-01-01

    Autoimmune hepatitis (AIH) is a chronic hepatitis of unknown etiology which can progress to cirrhosis.Its clinical manifestations are highly variable and sometimes follow a fluctuating course.Diagnosis is based on characteristic histologic,clinical,biochemical and serological findings. Anti-inflammatory/immunosuppressive treatment frequently induces remission but long-term maintenance therapy is often required. Liver transplantation is generally successful in patients with decompensated cirrhosis unresponsive to or intolerant of medical therapy.

  5. Clinical and epidemiological features of AIDS/tuberculosis comorbidity

    Directory of Open Access Journals (Sweden)

    Song Alice Tung Wan

    2003-01-01

    Full Text Available Considering the relevance of AIDS/tuberculosis comorbidity worldwide, especially in Brazil, this study was developed to describe the clinical and epidemiological features of the comorbid cases identified from 1989 to 1997 by the epidemiology service of the Hospital das Clínicas of the Universidade de São Paulo. METHODS: Databases containing information on all identified AIDS/tuberculosis cases cared for at the hospital were used to gather information on comorbid cases. RESULTS: During the period, 559 patients were identified as presenting with AIDS/tuberculosis comorbidity. Risk behavior for AIDS was primarily heterosexual contact (38.9%, followed by intravenous drug use (29.3% and homosexual/bisexual contact (23.2%. Regarding clinical features, there were higher rates of extrapulmonary tuberculosis when compared to tuberculosis without comorbidity. There was an increase in reporting of AIDS by ambulatory units during the period. Epidemiologically, there was a decrease in the male/female ratio, a predominance in the 20 to 39 year-old age group, and a majority of individuals who had less than 8 years of schooling and had low professional qualifications. CONCLUSIONS: High rates of AIDS/tuberculosis cases at our hospital indicate the need for better attention towards early detection of tuberculosis, especially in its extrapulmonary form. Since the population that attends this hospital tends to be of a lower socioeconomic status, better management of AIDS and tuberculosis is required to increase the rates of treatment adherence and thus lower the social costs.

  6. Diagnostic clinical features of atopic dermatitis

    OpenAIRE

    Sharma Lata

    2001-01-01

    Atopic dermatitis is a common disease which varies widely in clinical presentation at different ages and places. Although authors working in western countries on white races have suggested many criteria, there is no uniform set which can be used in large population studies in this part of the world. Hence keeping in mind differences in environment and ethnicity of population, the present study was carried out. Seventy- three patients of atopic dermatitis and 71 age matched controls were studi...

  7. Dermoscopic and clinical features of trunk melanomas

    OpenAIRE

    Emiroglu, Nazan; Pelin Cengiz, Fatma; Hofmann-Wellenhof, Rainer

    2014-01-01

    Introduction Malignant melanomas account for 5% of all skin cancers and usually have a fatal clinical course. Additionally, the incidence of melanoma increases more rapidly than in any other cancer, and this has been attributed to the development of highly sensitive diagnostic techniques, mainly dermoscopy, which allows for early diagnosis. The phenotypic manifestations of gene/environment interactions, environmental factor and genetic factors may determine subtypes and anatomic localization ...

  8. Schnitzler syndrome: clinical features and histopathology

    OpenAIRE

    Dingli, David

    2015-01-01

    David Dingli,1,2 Michael J Camilleri3 1Division of Hematology, Department of Internal Medicine, 2Department of Molecular Medicine, 3Department of Dermatology, Mayo Clinic, Rochester, MN, USA Abstract: Schnitzler syndrome is a rare and underrecognized syndrome characterized by chronic urticaria, a monoclonal protein, and a variety of other symptoms, including fever, bone pain, organomegaly, and evidence of an acute phase response. Biopsy of an involved area of the skin shows a neutrophilic in...

  9. Clinical Features and Outcome of Mucormycosis

    OpenAIRE

    Carlos Rodrigo Camara-Lemarroy; Emmanuel Irineo González-Moreno; René Rodríguez-Gutiérrez; Erick Joel Rendón-Ramírez; Ana Sofía Ayala-Cortés; Martha Lizeth Fraga-Hernández; Laura García-Labastida; Dionicio Ángel Galarza-Delgado

    2014-01-01

    Mucormycosis (MCM) is a life-threatening infection that carries high mortality rates despite recent advances in its diagnosis and treatment. The objective was to report 14 cases of mucormycosis infection and review the relevant literature. We retrospectively analyzed the demographic and clinical data of 14 consecutive patients that presented with MCM in a tertiary-care teaching hospital in northern Mexico. The mean age of the patients was 39.9 (range 5–65). Nine of the patients were male. Ten...

  10. Neurofibromatosis: Evaluation of Clinical Features of 11 Cases

    OpenAIRE

    Gülşen Akoğlu; Ali Serhan Gazyağcı; İbrahim Kutluer

    2013-01-01

    Objective: Neurofibromatosis (NF) is one of the most commonly seen autosomal dominantly inherited neurocutaneous syndromes. The most common subtypes are NF1 and NF2. The clinical course of NF may be heterogeneous.In this study, clinical features of patients with NF and its rare manifestations were described. Methods: Records of 11 patients with NF diagnosed between May 2008 and August 2011 were retrospectively reviewed. Demographic and clinical features of patients were detailed. Result...

  11. Clinic Pathological Features of Angiomyofibroblastoma in Vulva

    Institute of Scientific and Technical Information of China (English)

    CHEN Wei-xiang; TONG Shu-lan; FEI Shao-hua; CAO Zhi-xing; CAO Xiao-zhe

    2008-01-01

    Objective:To analyze the clinicopathological features and differential diagnosis of angiomyofibroblastoma(AMFB) of the vulva. Methods:Two cases of AMFB were examined by light microscopy and immunohistochemical study and to discuss the clinicopatholoical features and differential diagnosis of AMFB with the reference to the literature. Results:Tumors were all circumscribed,and<5 cm in diameter.Microscopically,the tumors were composed of spindle or polygonal cells that were cellularly or hypocellularly arranged with perivascular accentuation in a mucoid or fibrocollagenous background.The tumors contained numerous small-to medium-sized blood vessels,which were characteristically thin walled.Immunohistochemically,two cases of tumor cells were positive for vimentin,SMA,CD34(+)and FⅧ(+). Desmin and MSA were positive in one case:Cytokeratin,S-100,CD31 were negative in both. Conclusion:AMFB is a rare,benign soft tissue tumor that occurs in the genital tract of adult women.The origin remains unclear,but it is suggested that an origin from a perivascular pluripotent stem cell that is capable of myofibroblastoma differentiation.Angiomyofibroblastoma should be differentiated from other neoplasms of the vulva such as aggressive angiomyxoma, superficial angiomyxoma and cellular angiofibroma.

  12. [Smoking and schizophrenia: epidemiological and clinical features].

    Science.gov (United States)

    Dervaux, A; Laqueille, X

    2008-06-01

    FREQUENCY: The prevalence of cigarette smoking is significantly higher among patients with schizophrenia (60-90%) than in the general population (23-30%). While tobacco smoking decreases in the general population (from 45% in the 1960's to 23-30% in the 2000's), smoking in patients with schizophrenia remains high. Patients with schizophrenia smoke more cigarettes than control subjects. Patients smoke more deeply, thereby increasing their exposure to the harmful elements in tobacco smoke. IMPACT OF SMOKING IN SCHIZOPHRENIC PATIENTS: As in the general population, smoking contributes to the reduced life expectancy in patients with schizophrenia. Patients with schizophrenia are at increased risk for cardiovascular disease due to high rates of cigarette smoking. In the Department of Mental Health of the commonwealth of Massachusetts, cardiovascular disease was the factor the most strongly associated with excess mortality. Cardiac deaths were elevated more than six-fold. Weight gain, insulin resistance, metabolic syndrome and diabetes mellitus are frequent in patients with schizophrenia, and may worsen the risk of cardiovascular diseases. It has been reported that the risk for lung cancer in patients with schizophrenia is lower than that of the general population, despite increased smoking. However, in a study conducted in Finland, a slightly increased cancer risk was found in patients with schizophrenia. Half of the excess cases were attributable to lung cancer. IMPROVEMENT OF COGNITIVE DEFICITS: Patients with schizophrenia may use nicotine to reduce cognitive deficits and negative symptoms or neuroleptic side effects. Smoking may transiently alleviate negative symptoms in schizophrenic patients by increasing dopaminergic and glutamatergic neurotransmission in the prefrontal cortex. In patients with schizophrenia, nicotine improves some cognitive deficits: (1) sensory gating deficits and abnormalities in smooth pursuit eye movements associated with schizophrenia are

  13. Familial dementia lacking specific pathological features presenting with clinical features of corticobasal degeneration

    OpenAIRE

    Brown, J.; Lantos, P.; Rossor, M

    1998-01-01

    A family is described in which one member presented with symptoms and signs suggestive of corticobasal degeneration and a sibling presented with features of a frontal lobe dementia. Their mother developed a presenile dementia and movement disorder. At postmortem examination the member with clinical corticobasal degeneration had non-specific pathological features. Therefore, the clinical features of corticobasal degeneration can occur with non-specific pathological changes. Within ...

  14. Mycoplasma pneumonia: Clinical features and management

    Directory of Open Access Journals (Sweden)

    Kashyap Surender

    2010-01-01

    Full Text Available Mycoplasma pneumonia is a common respiratory pathogen that produces diseases of varied severity ranging from mild upper respiratory tract infection to severe atypical pneumonia. Apart from respiratory tract infections, this organism is also responsible for producing a wide spectrum of non-pulmonary manifestations including neurological, hepatic, cardiac diseases, hemolytic anemia, polyarthritis and erythema multiforme. This review focuses on molecular taxonomy, biological characteristics, epidemiology, clinical presentation, radiology and various laboratory tools in diagnosis, differential diagnosis, treatment and prevention of mycoplasma pneumonia.

  15. Risk factors of hand foot and mouth disease with different clinical features%不同临床类别手足口病危险因素分析

    Institute of Scientific and Technical Information of China (English)

    蔡剑; 吕华坤; 林君芬; 缪梓萍; 秦淑文; 陈直平

    2011-01-01

    目的 了解不同临床类别手足口病危险因素,为手足口病防控提供科学依据.方法 收集2009年3月至2010年4月浙江省手足口病疫情资料,轻症、重症与死亡病例个案资料,以及手足口病实验室检测结果,使用SPSS13.0 软件进行分析.结果 散居儿童、流动人口、居住在农村或城乡结合部、病前7天去过接种门诊,以及患者家14岁以下儿童数多是重症病例的危险因素.死亡病例的危险因素是初诊医院级别低、误诊率高和由祖父母照顾.重症、死亡病例的实验室检测结果以EV71为主.结论 重症手足口病主要发生在散居儿童、流动人口、居住在农村和城乡结合部的人群,病前去过接种门诊和家庭儿童数多是危险因素,而死亡病例的初诊医院级别较低、误诊率高,祖父母照顾比例高.EV71是重症、死亡病例的主要病原体.%Objective To understand the risk factors of hand foot and mouth disease with different clinical features,and provide scientific evidence for the disease control. Methods The epidemic data of HFMD, the data of mild, severe and death cases of HFMD in Zhejiang from March, 2009 to April, 2010 were collected to conduct analysis by using SPSS 13.0 software. Results The risk factors of severe cases of HFMD included children being outside child care settings, being floating population, living in rural area or outskirt, going to vaccination clinic 7 days prior to the onset and family with multichildren aged ≤ 14 years. The risk factors of death cases included the first medical care seeking in low grade hospital, high misdiagnosis rate and children being reared by grandparents. Most severe and death cases were detected to be EV71 positive. Conclusion Severe cases mainly occurred among children outside child care settings, in floating population and living in rural area or outskirt with the risk factors of going to vaccination clinic before the onset and family with muhichildren

  16. Clinical Features and Outcome of Mucormycosis

    Directory of Open Access Journals (Sweden)

    Carlos Rodrigo Camara-Lemarroy

    2014-01-01

    Full Text Available Mucormycosis (MCM is a life-threatening infection that carries high mortality rates despite recent advances in its diagnosis and treatment. The objective was to report 14 cases of mucormycosis infection and review the relevant literature. We retrospectively analyzed the demographic and clinical data of 14 consecutive patients that presented with MCM in a tertiary-care teaching hospital in northern Mexico. The mean age of the patients was 39.9 (range 5–65. Nine of the patients were male. Ten patients had diabetes mellitus as the underlying disease, and 6 patients had a hematological malignancy (acute leukemia. Of the diabetic patients, 3 had chronic renal failure and 4 presented with diabetic ketoacidosis. All patients had rhinocerebral involvement. In-hospital mortality was 50%. All patients received medical therapy with polyene antifungals and 11 patients underwent surgical therapy. Survivors were significantly younger and less likely to have diabetes than nonsurvivors, and had higher levels of serum albumin on admission. The clinical outcome of patients with MCM is poor. Uncontrolled diabetes and age are negative prognostic factors.

  17. Idiopathic spontaneous pneumomediastinum: radiologic and clinical features

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young; Kim, Su Young; Kim, Yong Hoon; Hwang, Yoon Joon; Seo, Jung Wook; Han, Yoon Hee; Cha, Soon Joo; Hur, Gham [College of Medicine, Inje Univ., Goyang (Korea, Republic of)

    2004-07-01

    To evaluate the clinical presentations, radiological characteristics, and natural history of healthy adolescents presenting with idiopathic spontaneous pneumomediastinum. We retrospectively reviewed the simple radiographs of 14 consecutive patients (11 males) with spontaneous pneumomediastinum, who were examined over a period of 8 years, and analyzed their clinical history, radiographic findings including distribution, combined subcutaneous emphysema, mediastinal widening, pneumothorax, pleural effusion, and resolving period on follow up chest radiographs. We also obtained CT images of 7 patients for the assessment of additional information. The most common complaint at the time of presentation was chest pain and chest discomfort (8/14), followed by neck discomfort (6/14). The chest radiograph was of diagnostic value in alI cases. The main distribution of the pneumomediastinum was cervical (14/14), upper lung (13/14) and lower lung (6/14). Combined subcutaneous emphysema was observed in 6 patients. However, there were no cases of mediastinal widening, pneumothorax or pleural effusion. Complete resolution of the pneumomediastinum on the radiograph was observed after 10 days (mean 5.6), following purely conservative treatment. There was no additional information on the CT images, as compared with that on the radiographs. Idiopathic spontaneous pneumomediastinum is a benign entity that usually goes undiagnosed, but which responds very weIl to conservative treatment.

  18. Idiopathic spontaneous pneumomediastinum: radiologic and clinical features

    International Nuclear Information System (INIS)

    To evaluate the clinical presentations, radiological characteristics, and natural history of healthy adolescents presenting with idiopathic spontaneous pneumomediastinum. We retrospectively reviewed the simple radiographs of 14 consecutive patients (11 males) with spontaneous pneumomediastinum, who were examined over a period of 8 years, and analyzed their clinical history, radiographic findings including distribution, combined subcutaneous emphysema, mediastinal widening, pneumothorax, pleural effusion, and resolving period on follow up chest radiographs. We also obtained CT images of 7 patients for the assessment of additional information. The most common complaint at the time of presentation was chest pain and chest discomfort (8/14), followed by neck discomfort (6/14). The chest radiograph was of diagnostic value in alI cases. The main distribution of the pneumomediastinum was cervical (14/14), upper lung (13/14) and lower lung (6/14). Combined subcutaneous emphysema was observed in 6 patients. However, there were no cases of mediastinal widening, pneumothorax or pleural effusion. Complete resolution of the pneumomediastinum on the radiograph was observed after 10 days (mean 5.6), following purely conservative treatment. There was no additional information on the CT images, as compared with that on the radiographs. Idiopathic spontaneous pneumomediastinum is a benign entity that usually goes undiagnosed, but which responds very weIl to conservative treatment

  19. An autopsy study of combined pulmonary fibrosis and emphysema: correlations among clinical, radiological, and pathological features

    OpenAIRE

    Inomata, Minoru; Ikushima, Soichiro; Awano, Nobuyasu; Kondoh, Keisuke; Satake, Kohta; Masuo, Masahiro; Kusunoki, Yuji; Moriya, Atsuko; Kamiya, Hiroyuki; Ando, Tsunehiro; Yanagawa, Noriyo; Kumasaka, Toshio; Ogura, Takashi; Sakai, Fumikazu; Azuma, Arata

    2014-01-01

    Background Clinical evaluation to differentiate the characteristic features of pulmonary fibrosis and emphysema is often difficult in patients with combined pulmonary fibrosis and emphysema (CPFE), but diagnosis of pulmonary fibrosis is important for evaluating treatment options and the risk of acute exacerbation of interstitial pneumonia of such patients. As far as we know, it is the first report describing a correlation among clinical, radiological, and whole-lung pathological features in a...

  20. Clinical features of diffuse axonal injury

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To analyze the mechanism of diffuse axonal injury (DAI) and study the relationship between DAI and brain concussion, brain contusion, and primary brain stem injury.Methods: The clinical data and iconographic characteristics of 56 patients with DAI were analyzed retrospectively.Results: Traffic accidents were the main cause of DAI. Among the 56 cases, 34 were injured for at least twice, and 71.43% of the patients were complicated with contusion.Conclusions: It is considered that DAI is a common pattern of primary brain injury, which is often underestimated. And DAI includes cerebral concussion and primary brain injury, and is often complicated by cerebral cortex contusion. Therefore, it is very simple and practical to divide primary brain injuries into local and diffuse injuries.

  1. Hepatobiliary Fascioliasis: Clinical and Radiological Features

    Directory of Open Access Journals (Sweden)

    K Aghazade

    2007-08-01

    Full Text Available Fascioliasis is a worldwide but unevenly distributed zoonosis caused by the trematode Fasciola hepatica that infects do­mesti­cated herbivores. Fasciolosis also occurs accidentally in humans by ingestion of metacercaria-laden freshwater or water plants. Human infections are common in developing countries and are not rare in Europe. The clinical course has been con­ventionally described in two phases: an acute phase of hepatic parenchymal invasion of an immature worm larva (parenchy­mal phase and a stationary phase after residence in the bile duct and production of eggs (ductal phase. We report a 34 years old woman from Ilam, western Iran with hepatic disorder, RUQ pain, and jaundice. The diagnosis was made by sonography, CT scan and serologic studies. Serologic exam (ELISA was positive & CT findings were compatible with fascioliasis.

  2. Schnitzler syndrome: clinical features and histopathology

    Directory of Open Access Journals (Sweden)

    Dingli D

    2015-06-01

    Full Text Available David Dingli,1,2 Michael J Camilleri3 1Division of Hematology, Department of Internal Medicine, 2Department of Molecular Medicine, 3Department of Dermatology, Mayo Clinic, Rochester, MN, USA Abstract: Schnitzler syndrome is a rare and underrecognized syndrome characterized by chronic urticaria, a monoclonal protein, and a variety of other symptoms, including fever, bone pain, organomegaly, and evidence of an acute phase response. Biopsy of an involved area of the skin shows a neutrophilic infiltrate without evidence of vasculitis or hemorrhage. Although the etiology of the syndrome is unknown, current evidence suggests this is an autoinflammatory syndrome. Recognition of this syndrome is critical since it is highly responsive to anakinra. Keywords: neutrophilic urticarial dermatosis, autoinflammatory syndrome, monoclonal gammopathy, neutrophilic dermatosis, anakinra 

  3. The Analysis of Clinical Features and Risk Factors of Children's Nutritional Iron Deficiency Anemia%儿童营养性缺铁性贫血的临床特征及相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    徐丽琼

    2015-01-01

    目的:观察儿童营养性缺铁性贫血的临床表现症状并分析患病的相关危险因素。方法搜集2012年10月至2014年10月经我院确诊的288例营养性缺铁性贫血患儿资料,回顾性总结他们的临床表现特征,并分析造成儿童营养性缺铁性贫血的危险因素。结果288例营养性缺铁性贫血患儿,轻度贫血146例(50.69%),中度贫血113例(39.24%),重度贫血29例(10.07%),结果显示,年龄、孕周、是否接受育儿教育、是否为儿童添加辅食、儿童生活环境是否良好或稳定,是儿童患营养性缺铁性贫血的危险因素,结果具有统计学意义(P<0.05)。结论加强育儿知识教育和对小儿进行科学、合理的喂养,确保小儿良好、稳定的生活环境,是预防小儿营养性缺铁性贫血的有力措施。%Objective To observe the clinical features of children's nutritional iron deficiency anemia, and to analyze the risk factors.Methods The information of 288 cases confirmed nutritional deficiency anemia from October 2012 to October 2014 in our hospital were collected, and their clinical features were retrospectively summarized, and the risk factors of children's nutritional iron deficiency anemia were analyzed.Results Among the 288 children with nutritional iron deficiency anemia, mild anemia happened in 146 cases (50.69%), moderate anemia in 113 cases (39.24%) and severe anemia in 29 cases (10.07%).The results showed:Age, gestational weeks, whether to accept the parenting education, whether to add a side dish for children, and children's living en-vironment were the risk factors for children to suffer from nutritional iron deficiency anemia, and the results had statistical significance (P<0.05).Conclusion Strengthening the child rearing knowledge education, the scientific and rational feeding of children, and ensuring children to have good and stable living environment are effective measures for the

  4. Narcolepsy: etiology, clinical features, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Jolanta B. Zawilska

    2012-10-01

    Full Text Available [u][/u] Narcolepsy is a chronic hypersomnia characterized by excessive daytime sleepiness (EDS and manifestations of disrupted rapid eye movement sleep stage (cataplexy, sleep paralysis, and hypnagogic/hypnopompic hallucinations. Mechanisms underlying narcolepsy are not fully understood. Experimental data indicate that the disease is caused by a loss of hypocretin neurons in the hypothalamus, likely due to an autoimmune process triggered by environmental factors in susceptible individuals. Most patients with narcolepsy and cataplexy have very low hypocretin-1 levels in the cerebrospinal fluid. An appropriate clinical history, polysomnogram, and multiple sleep latency test are necessary for diagnosis of the disease. Additionally, two biological markers, i.e., cerebrospinal fluid hypocretin-1 levels and expression of the DQB1*0602 gene, are used. The treatment of narcolepsy is aimed at the different symptoms that the patient manifests. Excessive daytime sleepiness is treated with psychostimulants (amphetamine-like, modafinil and armodafinil. Cataplexy is treated with sodium oxybate (GHB, tricyclic antidepressants, or selective serotonin and noradrenaline reuptake inhibitors. Sleep paralysis, hallucinations, and fragmented sleep may be treated with sodium oxybate. Patients with narcolepsy should follow proper sleep hygiene and avoid strong emotions.

  5. Transsexualism: Clinical Features and Legal Issues

    Directory of Open Access Journals (Sweden)

    Necla Keskin

    2015-12-01

    Full Text Available Although the epidemiological data is generally obtained from the patients that applied for gender reassignment surgery, it is known that transsexualism is not seen as rarely as it was estimated in the past and should be evaluated in detail because of its psychological and social consequences. Etiology remains to be unclear and biological and psychosocial factors are thought to be responsible for its development. Gender identity stabilizes approximately in 3-4 ages and it is impossible to change it after these ages. For this reason the aim of treatment approaches is to improve the conformity of individuals to their identity and life, but not to change the gender identity. The World Professional Association for Transgender Health [WPATH] published a guideline including standards of care [SOC] and SOC provide clinical guidance in follow-up and treatment of transsexual individuals. There is a detailed code in civil law about gender reassignment but when this code implemented strictly, the use of it is very limited and it is clear that a new arrangement is needed in this issue.

  6. Clinical features and patient management of Lujo hemorrhagic fever.

    Directory of Open Access Journals (Sweden)

    Nivesh H Sewlall

    Full Text Available In 2008 a nosocomial outbreak of five cases of viral hemorrhagic fever due to a novel arenavirus, Lujo virus, occurred in Johannesburg, South Africa. Lujo virus is only the second pathogenic arenavirus, after Lassa virus, to be recognized in Africa and the first in over 40 years. Because of the remote, resource-poor, and often politically unstable regions where Lassa fever and other viral hemorrhagic fevers typically occur, there have been few opportunities to undertake in-depth study of their clinical manifestations, transmission dynamics, pathogenesis, or response to treatment options typically available in industrialized countries.We describe the clinical features of five cases of Lujo hemorrhagic fever and summarize their clinical management, as well as providing additional epidemiologic detail regarding the 2008 outbreak. Illness typically began with the abrupt onset of fever, malaise, headache, and myalgias followed successively by sore throat, chest pain, gastrointestinal symptoms, rash, minor hemorrhage, subconjunctival injection, and neck and facial swelling over the first week of illness. No major hemorrhage was noted. Neurological signs were sometimes seen in the late stages. Shock and multi-organ system failure, often with evidence of disseminated intravascular coagulopathy, ensued in the second week, with death in four of the five cases. Distinctive treatment components of the one surviving patient included rapid commencement of the antiviral drug ribavirin and administration of HMG-CoA reductase inhibitors (statins, N-acetylcysteine, and recombinant factor VIIa.Lujo virus causes a clinical syndrome remarkably similar to Lassa fever. Considering the high case-fatality and significant logistical impediments to controlled treatment efficacy trials for viral hemorrhagic fever, it is both logical and ethical to explore the use of the various compounds used in the treatment of the surviving case reported here in future outbreaks

  7. [Clinical features of accessory parotid gland tumors].

    Science.gov (United States)

    Iguchi, Hiroyoshi; Wada, Tadashi; Yamamoto, Hidefumi; Yamada, Kei; Matsushita, Naoki; Okamoto, Sachimi; Teranishi, Yuichi; Koda, Yuki; Kosugi, Yuki; Yamane, Hideo

    2013-12-01

    Accessory parotid gland tumors are relatively rare; hence, adequately detailed clinical analyses of these tumors are difficult to perform at a single institution. In this report, we describe the findings for 65 patients [29 men, 36 women; median age, 51 (9-81) years] with accessory parotid gland tumors, consisting of 4 cases documented by us and 61 cases previously reported by other Japanese authors. Approximately 50% of the patients were treated in an otolaryngology department, while the remaining patients were treated in plastic surgery, oral surgery, or dermatology departments. In 4 patients, the results of preoperative fine-needle aspiration cytology indicated that the tumor was benign; however, the postoperative histopathology results revealed malignant tumors. The frequencies of malignant and benign tumors were 44.6% (n = 29) and 55.4% (n = 36), respectively. Mucoepidermoid carcinoma and pleomorphic adenoma were the most frequent types of malignant and benign accessory parotid gland tumors, respectively. Among the various surgical methods that were used, such as direct cheek and intraoral incisions, a standard parotidectomy incision was the most preferred treatment approach for these tumors. Recently, an endoscopic approach has also been found to yield satisfactory results. An optimal approach should be selected after evaluating the advantages and disadvantages of these methods. No definite guidelines are available regarding the choice of elective neck dissection and postoperative radiation therapy for malignant accessory parotid gland tumors. Although tumor resection (plus elective neck dissection) and postoperative radiation therapy have been frequently performed for various kinds of malignant accessory parotid gland tumors to date, additional studies are needed regarding the criteria for selecting elective neck dissection and postoperative radiation therapy. Since the malignancy rate for accessory parotid gland tumors is higher than that for parotid gland

  8. Parasomnias: Diagnosis, Classification and Clinical Features

    Directory of Open Access Journals (Sweden)

    Fatma Ozlem Orhan

    2009-10-01

    Full Text Available Parasomnias, as described in the recent second edition of the International Classification of Sleep Disorders, are “undesirable physical events or experiences” occurring during sleep transition, during arousal from sleep, or within the sleep period. These events encompass abnormal sleep related movements, behaviors, emotions, perceptions, dreaming, and autonomic nervous system functioning. Parasomnias are classified as: 1 disorders of arousal (from non-rapid eye movement, or NREM, sleep; 2 parasomnias usually associated with REM (rapid eye movement sleep; and 3 other parasomnias. This sleep disorders in childhood are common, and often more frequent than in adults. Clinicians should be aware that many pediatric parasomnias have benign and self-limited nature. Most of the parasomnias may not persist into late childhood or adolescence. Parasomnias in adults often differ in type from childhood parasomnias and may portend significant psychiatric disturbances or neurodegenerative disorders. A reliable diagnosis can often be made from a detailed history from the patient and, if possible, the parents or bed partner. Detailed overnight investigations of parasomnias are usually not required. The non-REM parasomnias are more common in community although REM parasomnias are more likely to be seen in general neurological practice. Sleep related eating disorder, sleep related dissociative disorders and sleep related sexual behavior and sleep related violence are novel and rarely reported sleep disorders. REM sleep behavior disorder is common and should be sought in all neurodegenerative diseases. They are included among clinical disorders due to the resulting injuries, and adverse health and psychosocial effects, which may affect the bed partner as well as the patient. Finally, parasomnias are common disturbances of sleep that may significantly affect the patient’s quality of life and that of the bed partner. Therefore, appropriate diagnostic and

  9. Clinical and histological features of nonalcoholic steatohepatitis in Iranian patients

    Directory of Open Access Journals (Sweden)

    Haghpanah Babak

    2003-10-01

    Full Text Available Abstract Background Although several studies have been performed on risk factors and natural course of NASH, it seems that NASH tends to be more than a disease confined to strict boundaries. The objective of this study was to assess the clinical and paraclinical features and risk factors for non-alcoholic steatohepatitis (NASH patients in an Iranian population Methods Patients with histologically confirmed NASH who had elevated liver aminotransaminases, negative serologic markers of viral or autoimmune hepatitis and no findings in favor of metabolic liver disease were enrolled. A careful history was taken regarding alcohol intake. Results 53 patients consisting of 32 male and 21 female entered the study. The mean age was 37.8 ± 11.3 years. Twenty-six patients (55.3% were overweight, 15 (31.9% obese, 40 (75.5% dyslipidemic, and three patients (5.7% were diabetic. Liver biopsy showed mild steatosis in 35.7%, moderate steatosis in 53.6%, and severe forms in 10.7%. In 80.2% of patients, portal inflammation was present, and 9.4% had cirrhosis. The amount of increase in liver enzymes bore no relationship with fibrosis, portal inflammation, and degree of steatosis. Conclusions The patients in our study showed a male predominancy and were somewhat younger than other studies.

  10. Clinical features of endemic community-acquired psittacosis

    Directory of Open Access Journals (Sweden)

    J.M. Branley

    2014-01-01

    Full Text Available Following a large outbreak of community-acquired psittacosis in 2002 in residents of the Blue Mountains, New South Wales, Australia, we reviewed new cases in this area over a 7-year period from 2003 to 2009. Using the 2010 criteria from the Centers for Disease Control National Notifiable Diseases Surveillance System, 85 patients with possible psittacosis were identified, of which 48 were identified as definite or probable infection. Clinical features of these cases are summarized. In addition to Chlamydia-specific serology, specimens, where available, underwent nucleic acid testing for chlamydial DNA using real-time PCR. Chlamydophila psittaci DNA was detected in samples from 23 patients. Four of 18 specimens were culture positive. This is the first description of endemic psittacosis, and is characterized in this location by community-acquired psittacosis resulting from inadvertent exposure to birds. The disease is likely to be under-diagnosed, and may often be mistaken for gastroenteritis or meningitis given the frequency of non-respiratory symptoms, particularly without a history of contact with birds. Clinical characteristics of endemic and outbreak-associated cases were similar. The nature of exposure, risk factors and reasons for the occurrence of outbreaks of psittacosis require further investigation.

  11. Pedophilia: Clinical Features, Etiology and Treatment

    Directory of Open Access Journals (Sweden)

    Ayten Erdogan

    2010-08-01

    alter the pedophile’s sexual orientation toward children, much of the focus of pedophilic treatment is on stopping further offenses against children. The combination of pharmacologic and behavioral treatment coupled with close legal supervision appears to help reduce the risk of repeated offense. Currently chemical castration; testosterone suppression by antiandrogenic therapy is a popular treatment option. Effective prevention is most effective means to manage the sexual abusement of children. For primary prevention and treatment, it is necessary to know the characteristics of pedophilia and understand the factors that lead to the development of the pedophilic tendencies.

  12. School Refusal: Clinical Features, Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Kayhan Bahali

    2010-12-01

    Full Text Available Children regularly and voluntarily go to school in order to fulfill the expectations of society from them to continue their education or schooling. School continuation has been made compulsory by laws. Nonetheless, contrary to popular belief, for some children it is distressing to go to school. These children have difficulty continuing school and/or refuse to go to school. Today school refusal is defined as a child’s inability to continue school for reasons, such as anxiety and depression. The prevalence of school refusal has been reported to be approximately 1% in school-age children and 5% in child psychiatry samples. The prevalence of school refusal is similar among boys and girls. School refusal can occur at any time throughout the child’s academic life and at all socio-economic levels. School refusal is considered a symptom rather than a clinical diagnosis and can manifest itself as a sign of many psychiatric disorders, with anxiety disorders predominant. Separation anxiety disorder, generalized anxiety disorder, social phobia, specific phobia, and adjustment disorder with anxiety symptoms are the most common disorders co-occurring with school refusal. While separation anxiety disorder is associated with school refusal in younger children, other anxiety disorders, especially phobias, are associated with school refusal in adolescents. Children who have parents with psychiatric disorders have a higher incidence of school refusal, and psychiatric disorders are more frequently seen in adult relatives of children with school refusal, which supports a significant role of genetic and environmental factors in th etiology of school refusal. School refusal is a emergency state for child mental health. As it leads to detrimental effects in the short term and the long term, it should be regarded as a serious problem. The long-lasting follow-up studies of school refusing children have revealed that these children have a higher incidence of

  13. Clinical features of 58 Japanese patients with mosaic neurofibromatosis 1.

    Science.gov (United States)

    Tanito, Katsumi; Ota, Arihito; Kamide, Ryoichi; Nakagawa, Hidemi; Niimura, Michihito

    2014-08-01

    Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder caused by mutation in the NF1 tumor-suppressor gene, and may sometimes manifest in a mosaic form. "Segmental NF1" is generally assumed to be the result of somatic mosaicism for a NF1 mutation, and patients with mosaic NF1 have typical features of NF1 limited to specific body segments. The clinical features of 58 patients (42 females and 16 males; aged 1-69 years; mean age, 23.4 years) with mosaic NF1 seen at the Jikei University Hospital during 2004-2007 and at the Jikei University Daisan Hospital during 2007-2011, were retrospectively studied. Somatic or gonosomal mosaicism was not investigated. Patients were classified into four groups: (i) pigmentary changes (café-au-lait spots and freckling) only (n = 32); (ii) neurofibromas only (n = 5); (iii) neurofibromas and pigmentary changes (n = 13); and (iv) solitary plexiform neurofibromas (n = 8). The area of involvement was variable. The majority of patients were asymptomatic, except patients with plexiform neurofibromas who presented most commonly with pain or tenderness. Lisch nodules were rarely seen. Only four of our 58 patients (6.9%) had specific NF1 complications, including language delay (n = 1) and bone deformity (n = 3). Two patients were ascertained through their children with generalized NF1. Patients with mosaic NF1 are at low risk of developing disease-associated complications, except patients with plexiform neurofibromas. However, they need to be aware of the small risk of having a child with generalized NF1. PMID:25041723

  14. Age-Related Differences in Clinical Features of Neurocysticercosis

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-11-01

    Full Text Available Clinical, radiologic, and inflammatory features of neurocysticercosis (NC in 92 pediatric (<15 years and 114 adult Mexican patients were compared in a study at three hospitals in Mexico City.

  15. Clinical features of schizophrenia in a woman with hyperandrogenism.

    OpenAIRE

    Kopala, L C; Lewine, R; Good, K P; Fluker, M; Martzke, J S; Lapointe, J S; HONER, W. G.

    1997-01-01

    Ample evidence supports sex differences in the clinical features of schizophrenia. In this regard, estrogen may contribute to later onset and less severe course of illness in women. Direct investigation of hormonal status in schizophrenia is extremely difficult. The present report documents the clinical features of schizophrenia in a young woman with long-standing hyperandrogenism related to polycystic ovarian disease. We postulate that hyperandrogenism contributed to a relatively early onset...

  16. Variability of clinical features in attacks of migraine with aura

    DEFF Research Database (Denmark)

    Hansen, Jakob M; Goadsby, Peter J; Charles, Andrew C

    2016-01-01

    BACKGROUND: There is significant variability in the clinical presentation of migraine, both among patients, and between attacks in an individual patient. We examined clinical features of migraine with aura in a large group of patients enrolled in a clinical trial, and compared retrospective...... detailed retrospective description of the clinical features of their attacks of migraine. During the trial, clinical symptoms in migraine attacks starting with aura were recorded prospectively in 861 attacks. RESULTS: Retrospectively reported visual aura symptoms were variable and often overlapping; the...... recalling or speaking words. A significant percentage of patients also reported a change in olfaction. There were several inconsistencies between the features of prospectively recorded and retrospectively reported attacks. Headache, nausea, photophobia, and phonophobia were all less common in prospectively...

  17. Clinical and biological features of familial nonmedullary thyroid carcinoma

    Institute of Scientific and Technical Information of China (English)

    高健

    2014-01-01

    Objective To analyze the clinical and biological features of familial nonmedullary thyroid carcinoma(FNMTC).Methods Clinical data of 66 FNMTC cases of 32pedigrees was retrospectively analyzed,compared with that of 182 control cases taken randomly from the patients with sporadic papillary thyroid carcinoma(SPTC),who

  18. The clinical and dermoscopic features of extremity melanomas

    OpenAIRE

    Fatma Pelin Cengiz; Nazan Emiroğlu; Rainer Hofmann-wellenhof

    2015-01-01

    Objectives: Dermoscopy is a noninvasive tool that helps to differentiate structures which can not be seen by naked eye. Dermoscopic and clinical features of malignant melanomas on the extremities are not well described in the literature. Therefore, in this study we aim to determine dermoscopic and clinical characteristics of melanoma on the extremities. Materials and Methods: 40 patients with melanoma on the extremities were included in this study. Their dermoscopic and clinical images, hi...

  19. The clinical profile and pathophysiology of atrial fibrillation: relationships among clinical features, epidemiology, and mechanisms.

    Science.gov (United States)

    Andrade, Jason; Khairy, Paul; Dobrev, Dobromir; Nattel, Stanley

    2014-04-25

    Atrial fibrillation (AF) is the most common arrhythmia (estimated lifetime risk, 22%-26%). The aim of this article is to review the clinical epidemiological features of AF and to relate them to underlying mechanisms. Long-established risk factors for AF include aging, male sex, hypertension, valve disease, left ventricular dysfunction, obesity, and alcohol consumption. Emerging risk factors include prehypertension, increased pulse pressure, obstructive sleep apnea, high-level physical training, diastolic dysfunction, predisposing gene variants, hypertrophic cardiomyopathy, and congenital heart disease. Potential risk factors are coronary artery disease, kidney disease, systemic inflammation, pericardial fat, and tobacco use. AF has substantial population health consequences, including impaired quality of life, increased hospitalization rates, stroke occurrence, and increased medical costs. The pathophysiology of AF centers around 4 general types of disturbances that promote ectopic firing and reentrant mechanisms, and include the following: (1) ion channel dysfunction, (2) Ca(2+)-handling abnormalities, (3) structural remodeling, and (4) autonomic neural dysregulation. Aging, hypertension, valve disease, heart failure, myocardial infarction, obesity, smoking, diabetes mellitus, thyroid dysfunction, and endurance exercise training all cause structural remodeling. Heart failure and prior atrial infarction also cause Ca(2+)-handling abnormalities that lead to focal ectopic firing via delayed afterdepolarizations/triggered activity. Neural dysregulation is central to atrial arrhythmogenesis associated with endurance exercise training and occlusive coronary artery disease. Monogenic causes of AF typically promote the arrhythmia via ion channel dysfunction, but the mechanisms of the more common polygenic risk factors are still poorly understood and under intense investigation. Better recognition of the clinical epidemiology of AF, as well as an improved appreciation of

  20. Clinical features of hepatopulmonary syndrome in cirrhotic patients

    Institute of Scientific and Technical Information of China (English)

    Amir Houshang Mohammad Alizadeh; Mohammad Reza Zali; Seyed Reza Fatemi; Vahid Mirzaee; Manoochehr Khoshbaten; Bahman Talebipour; Afsaneh Sharifian; Ziba Khoram; Farhad Haj-sheikh-oleslami; Masoomeh Gholamreza-shirazi

    2006-01-01

    AIM: To evaluate the frequency, clinical and paraclinical features of hepatopulmonary syndrome (HPS) and to determine their predictive values in diagnosis of this syndrome in patients in Iran.METHODS: Fifty four cirrhotic patients underwent contrast enhanced echocardiography to detect intrapulmonary and intracardiac shunts by two cardiologists. Arterial blood oxygen, O2 gradient (A-a) and orthodoxy were measured by arterial blood gas (ABG) test. The patients positive for diagnostic criteria of HPS were defined as clinical HPS cases and those manifesting the intrapulmonary arterial dilation but no other criteria (arterial blood hypoxemia) were defined as IHPS cases. HPS frequency, sensitivity, positive and negative predictive values of clinical and paraclinical features were studied.RESULTS: Ten (18.5%) and seven (13%) cases had clinical and subclinical HPS, respectively. The most common etiology was hepatitis B. Dyspnea (100%) and cyanosis (90%) were the most prevalent clinical features. Dyspnea and clubbing were the most sensitive and specific clinical features respectively. No significant relationship was found between HPS and splenomegaly, ascites, edema, jaundice, oliguria, and collateral veins. HPS was more prevalent in hepatitis B. PaO2 30 and their sum, are the most valuable negative and positive predictive values in HPS patients.

  1. Analysis of clinical features and risk factors for delayed encephalopathy after carbon monoxide poisoning%一氧化碳中毒迟发性脑病临床特征及危险因素分析

    Institute of Scientific and Technical Information of China (English)

    潘锐; 唐亚梅; 容小明; 沈庆煜; 谢海琴; 李鹏亮; 游春林; 彭英

    2012-01-01

    Objective To summarize the clinical features and potential risk factors of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods We surveyed the profiles of 58 patients with carbon monoxide-poisoning encephalopathy admitted to three affiliated hospitals of Sun Yat-sen University between 1998 and 2011 and divided patients to DEACMP group ( n = 17) and non-DEACMP group ( re =41 ) , based on the presence of DEACMP. This was followed by univariate analysis on the age, gender, past history of smoking or alcohol drinking, history of hypertension or diabetes or stroke,duration of coma,COHb saturation and acute-phase hyperbaric oxygenation therapy. Further processing on the correlation between duration of coma and incidence rate of DEACMP was conducted via Logistic regression analysis regarding the indices with statistical difference or clinical value. Results The most common symptom of DEACMP was dementia, followed by agitans paralysis and psychiatric symptom, while chorea and focal neurological dysfunction was less clinically manifested. Electroencephalogram (EEG) was featured by extensive slow waves,and abnormal signals could be observed bilaterally in white matter and basal ganglia region. Lower incidence rate of DEACMP was associated with prolonged observation period more than 30 days after acute poisoning. Both prolonged duration of coma( OR = 1. 197 ,95% CI 1. 067 ~ 1. 343 ) and failure of initiating hyperbaric oxygen therapy at acute phase(OR =0. 160,95%CI 0.033 -0.776) were regarded as risk factors of DEACMP. Prolonged duration of coma for > 11 hours may result in markedly increased incidence rate of DEACMP. Conclusion Physicians should be alert to the incidence of DEACMP in patients with acute carbon monoxide poisoning who had prolonged duration of coma for > 11 hours, suggesting that early initiation of hyperbaric oxygen therapy may effectively reduce the incidence rate of DEACMP.%目的 总结急性一氧化碳中毒迟发性脑

  2. Clinical features of adolescents with deliberate self-harm: A case control study in Lisbon, Portugal

    OpenAIRE

    Diogo F Guerreiro; Neves, Ema L; Navarro, Rita; Mendes, Raquel; Prioste, Ana; Ribeiro, Diana; Lila, Tiago; Neves, António; Salgado, Mónica; Santos, Nazaré; Sampaio, Daniel

    2009-01-01

    Deliberate self-harm (DSH) among adolescents is a high-risk condition for suicide. The aim of the present study is to describe the characteristic clinical features of adolescents with DSH according to our local context (Lisbon, Portugal), using easily available information from clinical settings. A case control study was constructed from a sample of 100 adolescents (aged 12 to 21 years). The sample was divided into two groups: adolescents with and without DSH. Case files were examined and dat...

  3. Different morphologic aspects and clinical features in massive hepatic amyloidosis.

    Science.gov (United States)

    Melato, M; Manconi, R; Magris, D; Morassi, P; Benussi, D G; Tiribelli, C

    1984-01-01

    4 cases of massive hepatic amyloidosis are reported with special reference to their clinical profiles and histologic features. On the basis of these data, two different clinical and histologic courses of the disease can be distinguished. 2 patients showed marked hepatomegaly without cholestasis, whereas in the other 2 the clinical picture was characterized by much less pronounced hepatomegaly, but by severe and progressive intrahepatic cholestasis. The time course of the disease seems to be different in the two forms, the cholestatic form being more rapidly fatal than the other. PMID:6745505

  4. Colonic duplications: Clinical presentation and radiologic features of five cases

    Energy Technology Data Exchange (ETDEWEB)

    Blickman, J.G. [Department of Radiology, University Medical Centre St Radboud, Route 667, P.O. Box 9101, 6500 HB Nijmegen (Netherlands) and Department of Pediatric Surgery, University Medical Centre St Radboud, Route 816, P.O. Box 9101, 6500 HB Nijmegen (Netherlands) and Department of Radiology, Children' s Hospital, 300 Longwood Ave., Boston, MA 02114 (United States)]. E-mail: J.Blickman@rad.umcn.nl; Rieu, P.H.M. [Department of Radiology, University Medical Centre St Radboud, Route 667, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); Department of Pediatric Surgery, University Medical Centre St Radboud, Route 816, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); Buonomo, C. [Department of Pediatric Surgery, University Medical Centre St Radboud, Route 816, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); Department of Radiology, Children' s Hospital, 300 Longwood Ave., Boston, MA 02114 (United States); Hoogeveen, Y.L. [Department of Radiology, University Medical Centre St Radboud, Route 667, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); Department of Pediatric Surgery, University Medical Centre St Radboud, Route 816, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); Department of Radiology, Children' s Hospital, 300 Longwood Ave., Boston, MA 02114 (United States); Boetes, C. [Department of Radiology, University Medical Centre St Radboud, Route 667, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); Department of Pediatric Surgery, University Medical Centre St Radboud, Route 816, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); Department of Radiology, Children' s Hospital, 300 Longwood Ave., Boston, MA 02114 (United States)

    2006-07-15

    Diagnosis of colonic duplication can pose a potential problem even for those familiar with gastro-intestinal tract duplications in general but unaware of the condition due to its rarity and its apparently bimodal clinical presentation. In this report of five cases of surgically proven pediatric colonic duplication, we illustrate how the condition manifests clinically and describe the imaging features in an attempt to illustrate this bimodal presentation of the condition. The possible etiology, associated congenital anomalies and modes of clinical presentation are reviewed based on literature review as well as on our own experience.

  5. Risk Management in the NHS: Governance, Finance and Clinical Risk

    OpenAIRE

    Fenn, Paul; Egan, Tom

    2012-01-01

    This paper explores this theme – the inter-relationship between good governance, financial incentives and clinical risk management – and presents evidence gleaned from views expressed by key decision takers within the NHS.

  6. Chronic Fatigue Syndrome in Adolescents: treatment, clinical features and epidemiology

    NARCIS (Netherlands)

    Nijhof, S.L.

    2013-01-01

    This thesis describes the treatment, epidemiology and clinical features of the adolescent chronic fatigue syndrome (CFS). Fatigue is a common complaint among adolescents, with a reported incidence of up to 20% in girls. This fatigue however is not chronic, does not debilitate and has an identifiable

  7. Chronic actinic dermatitis - A study of clinical features

    Directory of Open Access Journals (Sweden)

    Somani Vijay

    2005-01-01

    Full Text Available Background: Chronic actinic dermatitis (CAD, one of the immune mediated photo-dermatoses, comprises a spectrum of conditions including persistent light reactivity, photosensitive eczema and actinic reticuloid. Diagnostic criteria were laid down about 20 years back, but clinical features are the mainstay in diagnosis. In addition to extreme sensitivity to UVB, UVA and/or visible light, about three quarters of patients exhibit contact sensitivity to several allergens, which may contribute to the etiopathogenesis of CAD. This study was undertaken to examine the clinical features of CAD in India and to evaluate the relevance of patch testing and photo-aggravation testing in the diagnosis of CAD. Methods: The clinical data of nine patients with CAD were analyzed. Histopathology, patch testing and photo-aggravation testing were also performed. Results: All the patients were males. The average age of onset was 57 years. The first episode was usually noticed in the beginning of summer. Later the disease gradually tended to be perennial, without any seasonal variations. The areas affected were mainly the photo-exposed areas in all patients, and the back in three patients. Erythroderma was the presenting feature in two patients. The palms and soles were involved in five patients. Patch testing was positive in seven of nine patients. Conclusions: The diagnosis of CAD mainly depended upon the history and clinical features. The incidence of erythroderma and palmoplantar eczema was high in our series. Occupation seems to play a role in the etiopathogenesis of CAD.

  8. Biomolecular features of clinical relevance in breast cancer

    NARCIS (Netherlands)

    Daidone, M.G.; Paradiso, A.; Gion, M.; Harbeck, N.; Sweep, C.G.J.; Schmitt, M.

    2004-01-01

    Breast cancer is a heterogeneous disease and its consequent complexity is a major challenge for physicians and biologists. Notwithstanding its potential curability due to the availability of treatment modalities which are effective in the presence of favourable clinical or pathobiological features,

  9. Multiple sclerosis with clinical and radiological features of cerebral tumour

    OpenAIRE

    Sagar, HJ; Warlow, CP; Sheldon, PWE; Esiri, MM

    1982-01-01

    Three cases of multiple sclerosis, all confirmed pathologically, are described in whom both the unusual clinical features and the CT scan appearances suggested cerebral tumours. The failure of mass effect reliably to differentiate plaques and tumours on a CT scan is stressed and the literature relating to CT scanning in multiple sclerosis is reviewed.

  10. The early clinical features of dengue in adults: challenges for early clinical diagnosis.

    Directory of Open Access Journals (Sweden)

    Jenny G H Low

    Full Text Available BACKGROUND: The emergence of dengue throughout the tropical world is affecting an increasing proportion of adult cases. The clinical features of dengue in different age groups have not been well examined, especially in the context of early clinical diagnosis. METHODOLOGY/PRINCIPAL FINDINGS: We structured a prospective study of adults (≥ 18 years of age presenting with acute febrile illness within 72 hours from illness onset upon informed consent. Patients were followed up over a 3-4 week period to determine the clinical outcome. A total of 2,129 adults were enrolled in the study, of which 250 (11.7% had dengue. Differences in the rates of dengue-associated symptoms resulted in high sensitivities when the WHO 1997 or 2009 classification schemes for probable dengue fever were applied to the cohort. However, when the cases were stratified into age groups, fewer older adults reported symptoms such as myalgia, arthralgia, retro-orbital pain and mucosal bleeding, resulting in reduced sensitivity of the WHO classification schemes. On the other hand, the risks of severe dengue and hospitalization were not diminished in older adults, indicating that this group of patients can benefit from early diagnosis, especially when an antiviral drug becomes available. Our data also suggests that older adults who present with fever and leukopenia should be tested for dengue, even in the absence of other symptoms. CONCLUSION: Early clinical diagnosis based on previously defined symptoms that are associated with dengue, even when used in the schematics of both the WHO 1997 and 2009 classifications, is difficult in older adults.

  11. Risk Management in the Clinical Laboratory

    Science.gov (United States)

    Njoroge, Sarah W

    2014-01-01

    Clinical laboratory tests play an integral role in medical decision-making and as such must be reliable and accurate. Unfortunately, no laboratory tests or devices are foolproof and errors can occur at pre-analytical, analytical and post-analytical phases of testing. Evaluating possible conditions that could lead to errors and outlining the necessary steps to detect and prevent errors before they cause patient harm is therefore an important part of laboratory testing. This can be achieved through the practice of risk management. EP23-A is a new guideline from the CLSI that introduces risk management principles to the clinical laboratory. This guideline borrows concepts from the manufacturing industry and encourages laboratories to develop risk management plans that address the specific risks inherent to each lab. Once the risks have been identified, the laboratory must implement control processes and continuously monitor and modify them to make certain that risk is maintained at a clinically acceptable level. This review summarizes the principles of risk management in the clinical laboratory and describes various quality control activities employed by the laboratory to achieve the goal of reporting valid, accurate and reliable test results. PMID:24982831

  12. Confetti-like Sparing: A Diagnostic Clinical Feature of Melasma.

    Science.gov (United States)

    Wu, Douglas C; Fitzpatrick, Richard E; Goldman, Mitchel P

    2016-02-01

    Diagnostic uncertainty when a patient presents with melasma-like Undings can lead to suboptimal treatment and inaccurate prognostic expectations. In this study, the authors present a unique clinical feature of melasma that they term the "Fitzpatrick macule" and test its Utility in establishing diagnostic certainty. The "Fitzpatrick macule" is a confetti-like macule of regularly pigmented skin located within a larger patch of melasma hyperpigmentation. To test its diagnostic Utility, the authors compared clinical photography of known cases of melasma with common mimickers, such as poikiloderma of Civatte and solar lentiginosis, and determined the positivity rate of the Fitzpatrick macule in each scenario. Their results show that 89.1 percent of clinical photographs of melasma were positive for the presence of Fitzpatrick macules compared to 1.1 percent that were negative. In contrast, 37.5 and 56.3 percent of clinical photographs of poikiloderma of Civatte were positive and negative for Fitzpatrick macules, respectively. Solar lentiginosis showed a 5.6 percent positivity and a 77.8 percent negativity for Fitzpatrick macules. The sensitivity and specificity of Fitzpatrick macules for melasma was 99 and 83 percent, respectively. In summary, the authors report a highly sensitive and specific clinical feature of melasma. In cases of diagnostic uncertainty, the presence of Fitzpatrick macules may aid in establishing a diagnosis of melasma. PMID:27047632

  13. Neurofibromatosis: Evaluation of Clinical Features of 11 Cases

    Directory of Open Access Journals (Sweden)

    Gülşen Akoğlu

    2013-12-01

    Full Text Available Objective: Neurofibromatosis (NF is one of the most commonly seen autosomal dominantly inherited neurocutaneous syndromes. The most common subtypes are NF1 and NF2. The clinical course of NF may be heterogeneous.In this study, clinical features of patients with NF and its rare manifestations were described. Methods: Records of 11 patients with NF diagnosed between May 2008 and August 2011 were retrospectively reviewed. Demographic and clinical features of patients were detailed. Results: Six female and 5 male patients were enrolled. Patients' ages ranged between 1.5 and 58 years. Seven of them had positive family history for NF. A 1.5-year-old baby presented early appearance of Lisch nodules. One female patient had unilateral segmentally distributed pigmentary macules with bilateral Lisch nodules. Severe scoliosis and multiple painful neurofibromas were observed in a male patient. An asymptomatic arachnoid cyst was detected incidentally in a female patient. A male patient with NF1 had diffuse large B cell lymphoma and glioblastoma multiforme. Conclusion: Patients with NF may present with diverse clinical manifestations. Since patients may first apply to a dermatology outpatient clinic with only cutaneous complaints, early diagnosis of NF both in the patients and in their first degree relatives by careful dermatological and ophthalmological examinations and radiological evaluations can be possible.

  14. Idiopathic granulomatous mastitis; Clinical presentation, radiological features and treatmant

    International Nuclear Information System (INIS)

    To determine the clinical characteristic, clinical presentations and radiological features of diopathic granulomatous mastitis, and the best treatment approaches of this clinical entity. Between 1996 and 2003 the files and histopathology reports of 25 patients with granulomatous mastitis at King Abdul-Aziz University Hospital Jeddah, Kindom of Saudi Arabia were reviewed. The data were analyzed and a Medline search was carried out from 1970 to 2003 to review relevant cases. The age of patients ranged from 24-66 years and the mean age was 36.6+-9.43 years. All patients were females. The most common clinical presentation was palpable tender mass. The most common mammographic finding was ill-defined mass. However, mixed hypo- and hyper-echogenic lesions with tubular connections were the common ultrasonic findings. Treatment approaches were conservative or surgical excision or steroid. Conservative treatment associated with the higher rate of complications, while treatment with steroid showed complete remission of disease. Idiopathic granulomatous mastitis is a rare, benign breast disease that is usually underestimated or misdiagnosed. The clinical and radiological features resemble those of infectious mastitis or breast carcinoma. Early recognition and initiation of steroid treatment will result in complete remission of the disease and prevent complications. (author)

  15. Clinical features of depressive disorders in patients with brain tumors

    Directory of Open Access Journals (Sweden)

    Ogorenko V.V.

    2014-03-01

    Full Text Available The aim of the study was to examine the structure of psychopathology and clinical features of depressive disorders in patients with brain oncopathology. Polymorphic mental disorders of various clinical content and severity in most cases not only are comorbid to oncological pathology of the brain, but most often are the first clinical signs of early tumors. The study was conducted using the following methods: clinical psychiatric, questionnaire Simptom Check List- 90 -Revised-SCL- 90 -R, Luscher test and mathematical processing methods. Sample included 175 patients with brain tumors with non-psychotic level of mental disorders. The peculiarities of mental disorders and psychopathological structure of nonpsychotic depressive disorders have been a clinical option of cancer debut in patients with brain tumors. We found that nonpsychotic depression is characterized by polymorphism and syndromal incompletion; this causes ambiguity of diagnoses interpretation on stages of diagnostic period. Features of depressive symptoms depending on the signs of malignancy / nonmalignancy of brain tumor were defined.

  16. Eosinophilic Esophagitis: Clinical Features, Endoscopic Findings and Response to Treatment

    OpenAIRE

    Enns, Robert; Kazemi, Pooya; Chung, Wiley; Lee, Mitchell

    2010-01-01

    Eosinophilic esophagitis (EE) is a motility disorder of the esophagus that typically presents with dysphagia. The objective of the present study was to explore patient characteristics, clinical and endoscopic features, and response to treatment of patients with EE. Patients were selected retrospectively based on a review of biopsy results from previous endoscopies performed between 2004 and 2008. A total of 54 patients (41 men and 13 women) with biopsy-proven EE were included in the study. Fu...

  17. Clinical Detection and Feature Analysis on Neuro Signals

    Institute of Scientific and Technical Information of China (English)

    张晓文; 杨煜普; 许晓鸣; 胡天培; 高忠华; 张键; 陈中伟; 陈统一

    2004-01-01

    Research on neuro signals is challenging and significative in modern natural science. By clinical experiment, signals from three main nerves (median nerve, radial nerve and ulnar nerve) are successfully detected and recorded without any infection. Further analysis on their features under different movements, their mechanics and correlations in dominating actions are also performed. The original discovery and first-hand materials make it possible for developing practical neuro-prosthesis.

  18. Clinical and epidemiological features of AIDS/tuberculosis comorbidity

    OpenAIRE

    Song Alice Tung Wan; Schout Denise; Novaes Hillegonda Maria Dutilh; Goldbaum Moisés

    2003-01-01

    Considering the relevance of AIDS/tuberculosis comorbidity worldwide, especially in Brazil, this study was developed to describe the clinical and epidemiological features of the comorbid cases identified from 1989 to 1997 by the epidemiology service of the Hospital das Clínicas of the Universidade de São Paulo. METHODS: Databases containing information on all identified AIDS/tuberculosis cases cared for at the hospital were used to gather information on comorbid cases. RESULTS: During the per...

  19. Clinical features of subacute course of radiation disease

    OpenAIRE

    Krasnyuk V.I.; Konchalovsky M.V.; Ustyugova A.A.

    2014-01-01

    Aim: to show the clinical features of subacute course of subacute course of radiation disease and how they differ from the typical manifestations of acute and chronic radiation syndrome. Material and methods. Materials of the Burnasyan Federal Medical and Biophysical Center Register of acute radiation disease (ARS) in the Former USSR and Russia and Materials of a Burnasyan Federal Medical and Biophysical Center database of workers "Mayak" with chronic radiation syndrome (CRS) were analyzed. T...

  20. Confetti-like Sparing: A Diagnostic Clinical Feature of Melasma

    OpenAIRE

    Wu, Douglas C.; Fitzpatrick, Richard E.; Goldman, Mitchel P.

    2016-01-01

    Diagnostic uncertainty when a patient presents with melasma-like Undings can lead to suboptimal treatment and inaccurate prognostic expectations. In this study, the authors present a unique clinical feature of melasma that they term the “Fitzpatrick macule” and test its Utility in establishing diagnostic certainty. The “Fitzpatrick macule” is a confetti-like macule of regularly pigmented skin located within a larger patch of melasma hyperpigmentation. To test its diagnostic Utility, the autho...

  1. The clinical features of late onset anorexia nervosa.

    OpenAIRE

    Joughin, N. A.; Crisp, A H; Gowers, S. G.; Bhat, A V

    1991-01-01

    This study examines clinical features of late onset anorexia nervosa. This involved the scrutiny of a large database of patients with anorexia nervosa comprising data gathered at standardized initial assessments over the period 1960-1990. Patients with a late onset were compared to other selected patient samples. The population comprised 12 patients with a first onset of anorexia nervosa at or after the age of 30, 415 patients with an onset after 15 but before 20 and 9 patients with an onset ...

  2. The clinical and polysomnographic features in complex sleep apnea syndrome

    OpenAIRE

    İNÖNÜ, Handan; ÇİFTÇİ, Tansu Ulukavak; KÖKTÜRK, Oğuz

    2010-01-01

    Complex sleep apnea syndrome (CompSAS) is characterized by the onset of central apneas or a Cheyne-Stokes breathing pattern in some patients with obstructive sleep apnea syndrome (OSAS) who were treated with continuous positive airway pressure (CPAP). The etiology of CompSAS is unclear, but derangement of respiratory control has been proposed. We sought to compare clinical and polysomnography (PSG) features of patients with CompSAS and OSAS. Materials and methods: Records of PSG were evaluat...

  3. Clinical features of endemic community-acquired psittacosis

    OpenAIRE

    J.M. Branley; Weston, K M; England, J; Dwyer, D E; Sorrell, T C

    2014-01-01

    Following a large outbreak of community-acquired psittacosis in 2002 in residents of the Blue Mountains, New South Wales, Australia, we reviewed new cases in this area over a 7-year period from 2003 to 2009. Using the 2010 criteria from the Centers for Disease Control National Notifiable Diseases Surveillance System, 85 patients with possible psittacosis were identified, of which 48 were identified as definite or probable infection. Clinical features of these cases are summarized. In addition...

  4. Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy

    OpenAIRE

    Templin, Christian; Ghadri, J R; Diekmann, J.; Napp, L C; Seifert, Burkhardt; et al

    2015-01-01

    BACKGROUND The natural history, management, and outcome of takotsubo (stress) cardiomyopathy are incompletely understood. METHODS The International Takotsubo Registry, a consortium of 26 centers in Europe and the United States, was established to investigate clinical features, prognostic predictors, and outcome of takotsubo cardiomyopathy. Patients were compared with age- and sex-matched patients who had an acute coronary syndrome. RESULTS Of 1750 patients with takotsubo cardiomyopathy, ...

  5. Clinical, Epidemiologic, Histopathologic and Molecular Features of an Unexplained Dermopathy

    OpenAIRE

    Pearson, Michele L.; Selby, Joseph V.; Katz, Kenneth A; Cantrell, Virginia; Braden, Christopher R.; Parise, Monica E.; Paddock, Christopher D.; Michael R Lewin-Smith; Kalasinsky, Victor F.; Goldstein, Felicia C.; Hightower, Allen W.; Papier, Arthur; Lewis, Brian; Motipara, Sarita; Eberhard, Mark L.

    2012-01-01

    Background Morgellons is a poorly characterized constellation of symptoms, with the primary manifestations involving the skin. We conducted an investigation of this unexplained dermopathy to characterize the clinical and epidemiologic features and explore potential etiologies. Methods A descriptive study was conducted among persons at least 13 years of age and enrolled in Kaiser Permanente Northern California (KPNC) during 2006–2008. A case was defined as the self-reported emergence of fibers...

  6. Cryptogenic fibrosing alveolitis: clinical features and their influence on survival

    OpenAIRE

    Turner-Warwick, M.; Burrows, B; Johnson, A

    1980-01-01

    A retrospective analysis of 220 cases fulfilling criteria for cryptogenic fibrosing alveolitis (CFA) attending the Brompton Hospital between 1955 and 1973 has been carried out and patients have been followed for between four and 21 years. The frequency of various clinical features confirms previous reports. The 2: 1 male preponderance was similar in all age groups. The mean age at presentation was 54 years ± 12 SD; 202 (92%) of the patients presented with dyspnoea, the severity of which was r...

  7. Clinical and morphological features of hypertrophic cardiomyopathy in Korean patients.

    OpenAIRE

    Park, Y. B.; Lee, W S; Kim, D. K.; Choi, Y. S.; Seo, J. D.; Lee, Y. W.

    1989-01-01

    Thirty three cases of hypertrophic cardiomyopathy (HCMP) were reviewed to estimate the relative frequencies of the subtypes of HCMP and to clarify whether there is any racial difference in clinical and morphological features of HCMP. The diagnosis was made by echocardiography, cardiac catheterization and left ventriculography. Twenty four patients underwent coronary angiogram. Numbers of cases by the types of HCMP were 20 (61%) with asymmetrical septal hypertrophy (ASH), 11 (33%) with apical ...

  8. Macroprolactin as a Cause of Hyperprolactinemia: Clinical and Radiological Features

    OpenAIRE

    Assim Alfadda

    2008-01-01

    Objective: The aim of this study was to determine the prevalence of macroprolactin in patients with hyperprolactinemia in our region, and to determine the clinical and neuroradiological features of the affected individuals. Materials and Methods: We used the Roche Elecsys Prolactin assay (Prolactin II) with polyethylene glycol precipitation to identify macroprolactin; recovery of ≤40% was considered to represent significant macroprolactinemia. Of 156 consecutive patients with hyperprolactinem...

  9. Characteristic clinical and pathologic features for preoperative diagnosed groove pancreatitis

    OpenAIRE

    Kim, Joo Dong; Han, Young Seok; Choi, Dong Lak

    2011-01-01

    Purpose Groove pancreatitis is a rare specific form of chronic pancreatitis that extends into the anatomical area between the pancreatic head, the duodenum, and the common bile duct, which are referred to as the groove areas. We present the diagnostic modalities, pathological features and clinical outcomes of a series of symptomatic patients with groove pancreatitis who underwent pancreaticoduodenectomy. Methods Six patients undergoing pancreaticoduodenectomy between May 2006 and May 2009 due...

  10. Update on Human Herpesvirus 6 Biology, Clinical Features, and Therapy

    OpenAIRE

    de Bolle, Leen; Naesens, Lieve; De Clercq, Erik

    2005-01-01

    Human herpesvirus 6 (HHV-6) is a betaherpesvirus that is closely related to human cytomegalovirus. It was discovered in 1986, and HHV-6 literature has expanded considerably in the past 10 years. We here present an up-to-date and complete overview of the recent developments concerning HHV-6 biological features, clinical associations, and therapeutic approaches. HHV-6 gene expression regulation and gene products have been systematically characterized, and the multiple interactions between HHV-6...

  11. Spinal cord ischemia: aetiology, clinical syndromes and imaging features

    International Nuclear Information System (INIS)

    The purpose of this study was to analyse MR imaging features and lesion patterns as defined by compromised vascular territories, correlating them to different clinical syndromes and aetiological aspects. In a 19.8-year period, clinical records and magnetic resonance imaging (MRI) features of 55 consecutive patients suffering from spinal cord ischemia were evaluated. Aetiologies of infarcts were arteriosclerosis of the aorta and vertebral arteries (23.6 %), aortic surgery or interventional aneurysm repair (11 %) and aortic and vertebral artery dissection (11 %), and in 23.6 %, aetiology remained unclear. Infarcts occurred in 38.2 % at the cervical and thoracic level, respectively, and 49 % of patients suffered from centromedullar syndrome caused by anterior spinal artery ischemia. MRI disclosed hyperintense pencil-like lesion pattern on T2WI in 98.2 %, cord swelling in 40 %, enhancement on post-contrast T1WI in 42.9 % and always hyperintense signal on diffusion-weighted imaging (DWI) when acquired. The most common clinical feature in spinal cord ischemia is a centromedullar syndrome, and in contrast to anterior spinal artery ischemia, infarcts in the posterior spinal artery territory are rare. The exclusively cervical location of the spinal sulcal artery syndrome seems to be a likely consequence of anterior spinal artery duplication which is observed preferentially here. (orig.)

  12. The clinical and dermoscopic features of extremity melanomas

    Directory of Open Access Journals (Sweden)

    Fatma Pelin Cengiz

    2015-03-01

    Full Text Available Objectives: Dermoscopy is a noninvasive tool that helps to differentiate structures which can not be seen by naked eye. Dermoscopic and clinical features of malignant melanomas on the extremities are not well described in the literature. Therefore, in this study we aim to determine dermoscopic and clinical characteristics of melanoma on the extremities. Materials and Methods: 40 patients with melanoma on the extremities were included in this study. Their dermoscopic and clinical images, histopathological and clinical data were assessed. The relations between Breslow thickness and dermoscopic characteristics were evaluated. Results: The most frequent localization for women was lower extremities, whereas it was upper extremities for men. The most common subtype of melanoma was superficial spreading melanoma on the extremities. The mean age of patients with extremity melanoma was 56,21 ± 15,20 in men, as well as the mean age of patients with extremity melanoma was 53,09 ± 13,96 in women. The most common dermoscopic feature for extremity melanoma was irregular dots (85%. There were positive correlations between Breslow thickness and diameter, 3 or more colors in lesion, blue-white veil and lineer white streaks, respectively (p< 0.005, r= +0.462 (p< 0.001, r= +0.550 (p< 0.001, r= +0.606 (p< 0.001, r= +0.662. Conclusions: To our knowledge, this is the first study investigating dermoscopic and clinical features in patients with extremity melanomas. We should suggest that melanomas on the lower extremities are more common in women than men and the patients with lower extremity melanomas were younger than the patients with upper extremity melanomas and there are associations between Breslow thickness and some dermoscopic characteristics.

  13. CT diagnosis of appendicitis with atypical clinical features

    International Nuclear Information System (INIS)

    Objective: To investigate the value of CT in diagnosis of appendicitis with atypical clinical features. Methods: CT manifestations of 20 cases of appendicitis, which were not initially considered on clinical presentation, confirmed surgically and pathologically were retrospectively analyzed. Results: The CT findings of appendicitis included: (1) The appendix enlarged in diameter, with wall thickening and enhancement after administration of IV contrast material (7 cases), presence of appendicolith in 4 cases. (2) pericecal inflammation (14 cases). (3) Localized abscess of right lower quadrant (11 cases), calcified appendicolith seen in 2 cases. CT misdiagnosed 2 cases as tumour of ascending colon, and another 2 cases as pelvic inflammatory disease. Conclusions: The clinical diagnosis of appendicitis is very difficult when patients present with atypical signs and symptoms, but in most cases, the correct diagnosis of appendicitis could be made on the basis of CT findings

  14. Modelling the Clinical Risk: RFID vs Barcode

    OpenAIRE

    Lecce, Vincenzo Di; Calabrese, Marco; Quarto, Alessandro; Dario, Rita

    2010-01-01

    In this chapter the improvement resulted by RFID-based modelling for the clinical risk management has been discussed. The comparison between barcode-based healthcare systems and RFID technologies has shown the possibilities for a significant process reengineering which would represent an essential key to efficacy and efficiency increase in personalized healthcare services. In this view, the new model is centred around the idea of patient as an active element in the clinical process, thus over...

  15. Clinical and immunopathological features of patients with lupus hepatitis

    Institute of Scientific and Technical Information of China (English)

    ZHENG Ru-hua; WANG Jin-hui; WANG Shu-bing; CHEN Jie; GUAN Wei-ming; CHEN Min-hu

    2013-01-01

    Background Lupus hepatitis is yet to be characterized based on its clinical features and is often difficult to differentially diagnose from other liver diseases.We aimed to elucidate clinical,histopathological and immunopathological features of lupus hepatitis and to evaluate primarily the effectiveness of liver immunopathological manifestations on differential diagnosis of lupus hepatitis from other liver diseases.Methods A retrospective study was performed to analyze clinical features of lupus hepatitis in 47 patients out of 504 inpatients with systemic lupus erythematosus (SLE) in First Affiliated Hospital of Sun Yat-sen University,China from May 2006 to July 2009,and to evaluate the association between lupus hepatitis and SLE activity.Additionally,liver histopathological changes by hematoxylin and eosin (HE) staining and immunopathological changes by direct immunofluorescence test in 10 lupus hepatitis cases were analyzed and compared to those in 16 patients with other liver diseases in a prospective study.Results Of 504 SLE patients,47 patients (9.3%) were diagnosed to have lupus hepatitis.The prevalence of lupus hepatitis in patients with active SLE was higher than that in those with inactive SLE (11.8% vs.3.2%,P <0.05).The incidence of hematological abnormalities in patients with lupus hepatitis was higher than that in those without lupus hepatitis (40.4% vs.21.7%,P <0.05),such as leucocytes count (2.92×109/L vs.5.48×109/L),platelets count (151×109/L vs.190×109/L),serum C3 and C4 (0.34 g/L vs.0.53 g/L; 0.06 g/L vs.0.09 g/L) (P <0.05); 45 of 47 (95.7%) lupus hepatitis patients showed 1 upper limit of normal (ULN) <serum ALT level <5 ULN.The liver histopathological features in patients with lupus hepatitis were miscellaneous and non-specific,similar to those in other liver diseases,but liver immunopathological features showed positive intense deposits of complement 1q in 7/10 patients with lupus hepatitis and negative complement 1q

  16. Hepatic angiomyolipoma: Dynamic computed tomography features and clinical correlation

    Institute of Scientific and Technical Information of China (English)

    Bin Yang; Wen-Hui Chen; Qiao-Yun Li; Jing-Jing Xiang; Ru-Jun Xu

    2009-01-01

    AIM: To study the dynamic computed tomography (CT) features of hepatic angiomyolipoma (AML) in patients with or without tuberous sclerosis complex (TSC). METHODS: The clinical information, CT findings and histopathological results of hepatic AML were analyzed retrospectively in 10 patients. RESULTS: Hepatic AML was prone to occur in female patients (7/10), and most of the patients (8/10) had no specific symptoms. All tumors presented as welldefined, unenveloped nodules in the liver. Six patients with sporadic hepatic AML had a solitary hepatic nodule with a definite fat component. Non-fat components of the hepatic lesions were enhanced earlier and persistently. Prominent central vessels were noted in the portal venous phase in three patients. In four patients with hepatic AML and TSC, most of the nodules were within the peripheral liver. Seven fatdeficient nodules were found with earlier contrast enhancement and rapid contrast material washout in two patients. Lymphangioleiomyomatosis was found in one patient.CONCLUSION: Imaging features of hepatic AML are characteristic. Correct diagnosis preoperatively can be made in combination with clinical features.

  17. Clinical features of adolescents with deliberate self-harm: A case control study in Lisbon, Portugal

    OpenAIRE

    Diogo F Guerreiro; Neves, Ema L; Rita Navarro; et al, ...

    2009-01-01

    Diogo F Guerreiro, Ema L Neves, Rita Navarro, Raquel Mendes, Ana Prioste, Diana Ribeiro, Tiago Lila, António Neves, Mónica Salgado, Nazaré Santos, Daniel SampaioYouth Suicide Study Group (NES), The Hospital Santa Maria, Psychiatry Department, Lisbon Faculty of Medicine, PortugalAbstract: Deliberate self-harm (DSH) among adolescents is a high-risk condition for suicide. The aim of the present study is to describe the characteristic clinical features of adolesce...

  18. Clinical Characteristics and Features of Frequent Idiopathic Ventricular Premature Complexes in the Korean Population

    OpenAIRE

    Hwang, Jin Kyung; Park, Seung-Jung; On, Young Keun; Kim, June Soo; Park, Kyoung-Min

    2015-01-01

    Background and Objectives Frequent ventricular premature complexes (VPCs) increase the risk of cardiomyopathy (CMP). However, most data regarding VPCs have been obtained from Western population and in-hospital patient-based studies. The objective of this study was to define the clinical characteristics and features of idiopathic VPCs in the Korean population. Subjects and Methods We investigated subjects undergoing transthoracic echocardiography and documented VPC burdens >1% by Holter monito...

  19. Idiopathic Pulmonary Fibrosis: Epidemiology, Clinical Features, Prognosis, and Management.

    Science.gov (United States)

    Lynch, Joseph P; Huynh, Richard H; Fishbein, Michael C; Saggar, Rajan; Belperio, John A; Weigt, S Sam

    2016-06-01

    Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic interstitial lung pneumonia associated with the histologic pattern of usual interstitial pneumonia (UIP). Although UIP is a distinct histologic lesion, this histologic pattern is not specific for IPF and can also be found in other diseases (e.g., connective tissue disease and asbestosis). Clinical features of IPF include progressive cough, dyspnea, restrictive ventilatory defect, and progressive fibrosis and destruction of the lung parenchyma. IPF is rare (13-42 cases/100,000), and primarily affects older adults (>50 years of age). The diagnosis of IPF often requires surgical lung biopsy, but the diagnosis can be affirmed with confidence in some patients provided the results of computed tomographic (CT) scans and clinical features are consistent. The clinical course is variable, but inexorable progression (typically over months to years) is typical. Mean survival from the onset of symptoms approximates 3 to 5 years. Medical treatment is only modestly effective, primarily by slowing the rate of disease progression. Lung transplantation is the best therapeutic option. PMID:27231859

  20. The clinical and mammographic features of plasma cell mastitis

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical and mammographic features of plasma cell mastitis. Methods: Twenty-five patients (28 lesions) with histologically confirmed plasma cell mastitis, aged from 26 to 70 years (mean age 41 years), were examined with X-ray mammography. The clinical manifestations and imaging features were retrospectively reviewed. Results: No case was in lactation. The painful irregular masses, ranged from 1.3 to 8cm in size, were found in 22 patients, while 3 patients with acute episode. Recurrent episodes of breast masses were noted in 4 patients. Based on the mammographic appearances, the plasma cell mastitis were classified as the following four types: inflammation-like type (2/28), ductal ectasia type (3/28), focal infiltration type (10/28) and nodular type (13/28). The valuable radiographic signs: (1) An asymmetrically increased density along the lactiferous duct with a flame-like appearance, inhomogeneous low density tubular structures and scattered stick-shape calcifications. (2) Architectural distortion and oil cysts formation in adjacent area, (3) Subareolar ductal ectasia. Conclusions: The clinical and mammographic characteristics of plasma cell mastitis are critical to avoiding unnecessary surgery. Histopathological result is needed for the diagnosis in patients highly suspected of malignancy. (authors)

  1. Clinical features, comorbidity, and cognitive impairment in elderly bipolar patients

    Science.gov (United States)

    Rise, Ida Vikan; Haro, Josep Maria; Gjervan, Bjørn

    2016-01-01

    Introduction Data specific to late-life bipolar disorder (BD) are limited. Current research is sparse and present guidelines are not adapted to this group of patients. Objectives We present a literature review on clinical characteristics, comorbidities, and cognitive impairment in patients with late-life BD. This review discusses common comorbidities that affect BD elders and how aging might affect cognition and treatment. Methods Eligible studies were identified in MedLine by the Medical Subject Headings terms “bipolar disorder” and “aged”. We only included original research reports published in English between 2012 and 2015. Results From 414 articles extracted, 16 studies were included in the review. Cardiovascular and respiratory conditions, type II diabetes, and endocrinological abnormalities were observed as highly prevalent. BD is associated with a high suicide risk. Bipolar elderly had an increased risk of dementia and performed worse on cognitive screening tests compared to age-matched controls across different levels of cognition. Despite high rates of medical comorbidity among bipolar elderly, a systematic under-recognition and undertreatment of cardiovascular disease have been suggested. Conclusion There was a high burden of physical comorbidities and cognitive impairment in late-life BD. Bipolar elderly might be under-recorded and undertreated in primary medical care, indicating that this group needs an adapted clinical assessment and specific clinical guidelines need to be established.

  2. Clinical and microbiologic features of dacryocystitis-related orbital cellulitis.

    Science.gov (United States)

    Wladis, Edward J; Shinder, Roman; LeFebvre, Daniel R; Sokol, Jason A; Boyce, Michelle

    2016-10-01

    Dacryocystitis-related orbital cellulitis is a relatively rare condition, and large case series of this clinical entity have been reported. This study was undertaken to identify a larger cohort of patients with this ailment, with the intent of defining its clinical and microbiologic features. Case logs from four institutions were reviewed to identify patients that suffered from dacryocystitis-related orbital cellulitis. A retrospective chart review was then performed to identify clinical features, management strategies, microbiologic features, and outcomes. A dedicated statistical software package was utilized to identify correlations between these variables. 13 patients (7 females, 6 males; mean age = 57.2 years, range = 7-89 years) were identified. One patient carried a diagnosis of immunosuppressive disease. All patients underwent emergent surgical drainage and received intravenous antibiotics. Primary acquired nasolacrimal duct obstruction was found to be the underlying etiology in nine cases (69.2%), whereas four patients suffered from specific causes of their obstructions. An average of 1.07 organisms/patient (standard deviation = 0.49 organisms/patient) were recovered from microbiologic cultures, and Gram-positive bacteria represented the majority of cultured organisms. All patients experienced either stable or improved vision upon discharge. The relationships between a specific etiology and the possibility of vision loss or the number of organisms cultured, between the number of organisms cultured and vision loss, and immunosuppression and vision loss or the number of organisms cultured were all not statistically significant (p > 0.05). Dacryocystitis-related orbital cellulitis most commonly occurs in adult patients who do not carry immunosuppressive diagnoses and suffer from primary obstructions. Multiple microbiologic species may cause this problem, although Gram-positive organisms are most common. With appropriate management, stable or improved vision

  3. Clinical features of allergic rhinitis in children of Shanghai, China.

    Science.gov (United States)

    He, S; Li, Y J; Chen, J

    2016-01-01

    The aims of the current study were to assess the clinical features of allergic rhinitis (AR) in children in Shanghai. Serum-specific IgE (sIgE) tests were performed on samples from patients with AR symptoms from January 2011 to December 2014. A disease-related questionnaire was completed after AR diagnosis. The allergen profile and clinical features of AR were analyzed. In total, 2713 AR patients were enrolled in this study. Dermatophagoides pteronyssinus was found to be the most common offending allergen in the study population. With increasing age, the prevalence of sIgE against inhalant allergens was significantly increased; however, the opposite trend was observed for food allergens. Additionally, the proportion of children with high levels of sIgE against D. pteronyssinus increased with age. Of the AR cases, 8.6% were classified as intermittent mild, 4.2% as persistent mild, 40.5% as intermittent moderate-severe, and 46.7% as persistent moderate-severe. A family history of allergies and a patient history of allergies within 6 months of birth were significantly associated with the duration and severity of AR symptoms. The occurrence of co-morbidities, such as allergic conjunctivitis, cough, and asthma, gradually increased from intermittent mild, persistent mild, and intermittent moderate-severe to persistent moderate-severe. The most frequently used drugs were topical corticosteroids and oral antihistamines, which were used by 86.7 and 79.0% of patients, respectively. These results confirm the adequacy of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines for classifying AR patients, and advance the understanding of clinical features of AR in children in Shanghai, China. PMID:27173334

  4. Clinical risk assessment in intensive care unit

    Directory of Open Access Journals (Sweden)

    Saeed Asefzadeh

    2013-01-01

    Full Text Available Background: Clinical risk management focuses on improving the quality and safety of health care services by identifying the circumstances and opportunities that put patients at risk of harm and acting to prevent or control those risks. The goal of this study is to identify and assess the failure modes in the ICU of Qazvin′s Social Security Hospital (Razi Hospital through Failure Mode and Effect Analysis (FMEA. Methods: This was a qualitative-quantitative research by Focus Discussion Group (FDG performed in Qazvin Province, Iran during 2011. The study population included all individuals and owners who are familiar with the process in ICU. Sampling method was purposeful and the FDG group members were selected by the researcher. The research instrument was standard worksheet that has been used by several researchers. Data was analyzed by FMEA technique. Results: Forty eight clinical errors and failure modes identified, results showed that the highest risk probability number (RPN was in respiratory care "Ventilator′s alarm malfunction (no alarm" with the score 288, and the lowest was in gastrointestinal "not washing the NG-Tube" with the score 8. Conclusions: Many of the identified errors can be prevented by group members. Clinical risk assessment and management is the key to delivery of effective health care.

  5. Skeletal Muscle Laminopathies: A Review of Clinical and Molecular Features.

    Science.gov (United States)

    Maggi, Lorenzo; Carboni, Nicola; Bernasconi, Pia

    2016-01-01

    LMNA-related disorders are caused by mutations in the LMNA gene, which encodes for the nuclear envelope proteins, lamin A and C, via alternative splicing. Laminopathies are associated with a wide range of disease phenotypes, including neuromuscular, cardiac, metabolic disorders and premature aging syndromes. The most frequent diseases associated with mutations in the LMNA gene are characterized by skeletal and cardiac muscle involvement. This review will focus on genetics and clinical features of laminopathies affecting primarily skeletal muscle. Although only symptomatic treatment is available for these patients, many achievements have been made in clarifying the pathogenesis and improving the management of these diseases. PMID:27529282

  6. Relationship Between Clinical and Pathologic Features of Ductal Carcinoma in Situ and Patient Age: An Analysis of 657 Patients

    OpenAIRE

    Collins, Laura C.; Achacoso, Ninah; Nekhlyudov, Larissa; Fletcher, Suzanne W; Haque, Reina; Quesenberry, Charles P; Puligandla, Balaram; Alshak, Najeeb S.; Goldstein, Lynne C.; Gown, Allen M.; Schnitt, Stuart J.; Habel, Laurel A

    2009-01-01

    Prior studies have shown that young patient age at diagnosis is associated with an increased risk of local recurrence (LR) among women with DCIS treated with breast-conserving therapy. Whether this can be explained by differences in clinical or pathologic features of DCIS according to age is an unresolved issue. We compared clinical and pathologic features of DCIS among 657 women in four age groups:

  7. Clinical and radiological features of bronchiolitis obliterans in children

    International Nuclear Information System (INIS)

    Objective: To study the value of chest radiograph and thin-section computed tomography (CT) in diagnosis bronchiolitis obliterans in children, and to determine clinical view of obliterative bronchiolitis in children. Methods: We identified 12 infants, 10 boys, and 2 girls (age range, 5 month to 11 years) with clinical confirmation of bronchiolitis obliterans. Three cases were after Steven-Johnson syndrome, 8 were post-infection (2 adenovirus, 2 measles and 1 Pseudomonas aeruginosa infection, 3 cases were unknown etiology infection); The symptoms lasted for at least 6 weeks. One case had lung ventilation nuclear scan. We evaluated individual bronchoscopy, pulmonary function test, chest radiograph and thin- section CT features and their characteristic appearance. Results: All cases had typical clinical characteristics and pulmonary function testing results that were consistent with nonreversible small airways obstruction. One case had lung ventilation nuclear scan illustrated absent and reduced ventilation of the right lower lobe. Nine cases who underwent bronchoscopy were chronic endobronchial inflammation. Three children had transbronchial biopsy and 1 patient who underwent open pulmonary biopsies were uncertain of histological diagnosis. Chest radiography showed hyperinflation in 8 cases; peribronchial thickening in 6 cases; consolidation/atelectasia in 6 cases; unilateral hyperlucency of a small/normal-sized lung in 4 cases. Thin-section CT/HRCT features included: mosaic perfusion pattern, decreased lung attenuation in 11 cases, pulmonary vascular attenuation in 10 cases; bronchial dilatation in 7 cases; bronchial wall thickening in 9 cases; unilateral hyperlucency of a small/normal-sized lung in 5 cases; consolidation in 6 cases; nodular in 3 cases; mucoid impaction in 5 cases. Conclusions: In our study, correct diagnoses of bronchiolitis obliterans in children were made more special with thin-section CT than with chest radiographs. The diagnosis of BO in

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

    International Nuclear Information System (INIS)

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

  9. Gender effect on clinical features of achalasia: a prospective study

    Directory of Open Access Journals (Sweden)

    Mahdavinia Mahboobeh

    2006-04-01

    Full Text Available Abstract Background Achalasia is a well-characterized esophageal motor disorder but the rarity of the disease limits performing large studies on its demographic and clinical features. Methods Prospectively, 213 achalasia patients (110 men and 103 women were enrolled in the study. The diagnosis established by clinical, radiographic, and endoscopic as well as manometry criteria. All patients underwent a pre-designed clinical evaluation before and within 6 months after the treatment. Results Solid dysphagia was the most common clinical symptom in men and women. Chest pain was the only symptom which was significantly different between two groups and was more complained by women than men (70.9% vs. 54.5% P value= 0.03. Although the occurrence of chest pain significantly reduced after treatment in both groups (P Conclusion It seems that chest pain is the distinct symptom of achalasia which is affected by sex as well as age and does not relate to the duration of illness, LESP and the type of treatment achalasia patients receive.

  10. Clinical Features of Right-sided Infective Endocarditis

    Institute of Scientific and Technical Information of China (English)

    杨莉; 伍卫; 王景峰; 张燕; 张小玲

    2002-01-01

    Objective To discuss thepathogenesis, etiology, clinical manifestations, diagnosis, treatment and prognosis of right-sided infective endocarditis (RIE) . Methods To investigate retrospectively the clinical data of patients with RIE admitted in our hospital from Jan 1985 to Dec 2000.Results There were 17 cases of RIE (12 male, 5female, mean age 22 years), among which 7 with congenital heart disease, 1 with pacemaker implantation and 9 with a history of intravenous drug abuse but without underlying heart disease. Fever and multiple pulmonary emboli were the major clinical manifestations. Blood cultures were positive in 8 cases with Staphylococcus aureus as the predominant microorganism. Echocardiography detected right heart vegetations in all cases, with tricuspid valve as the structure most frequently affected. Most patients were successfully treated with antimicrobials. The outcome was favourable, with a mortality of 11.8 % . Conclusions The clinical features of RIE are different from that of left-sided infective endocarditis (LIE) . Echocardiography plays an important role in the diagnosis of RIE.

  11. Clinical Features of 294 Turkish Patients with Chronic Myeloproliferative Neoplasms

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    Neslihan Andıç

    2016-08-01

    Full Text Available Objective: Myeloproliferative neoplasms (MPNs share common clonal stem cells but show significant differences in their clinical courses. The aim of this retrospective study was to evaluate thrombotic and hemorrhagic complications, JAK2 status, gastrointestinal and cardiac changes, treatment modalities, and survival in MPNs in Turkish patients. Materials and Methods: Medical files of 294 patients [112 essential thrombocythemia (ET, 117 polycythemia vera (PV, 46 primary myelofibrosis, and 19 unclassified MPN cases] from 2 different universities in Turkey were examined. Results: Older age, higher leukocyte count at diagnosis, and JAK2 mutation positivity were risk factors for thrombosis. Platelet count over 1000x109/L was a risk factor for hemorrhagic episodes. Hydroxyurea treatment was not related to leukemic transformation. Median follow-up time was 50 months (quartiles: 22.2-81.75 in these patients. Patients with primary myelofibrosis had the shortest survival of 137 months when compared with 179 months for ET and 231 months for PV. Leukemic transformation, thromboembolic events, age over 60 years, and anemia were found to be the factors affecting survival. Conclusion: Thromboembolic complications are the most important preventable risk factors for morbidity and mortality in MPNs. Drug management in MPNs is done according to hemoglobin and platelet counts. Based on the current study population our results support the idea that leukocytosis and JAK2 positivity are more important risk factors for thrombosis than hemoglobin and platelet values.

  12. Gluteal Tendinopathy: Integrating Pathomechanics and Clinical Features in Its Management.

    Science.gov (United States)

    Grimaldi, Alison; Fearon, Angela

    2015-11-01

    Synopsis Gluteal tendinopathy is now believed to be the primary local source of lateral hip pain, or greater trochanteric pain syndrome, previously referred to as trochanteric bursitis. This condition is prevalent, particularly among postmenopausal women, and has a considerable negative influence on quality of life. Improved prognosis and outcomes in the future for those with gluteal tendinopathy will be underpinned by advances in diagnostic testing, a clearer understanding of risk factors and comorbidities, and evidence-based management programs. High-quality studies that meet these requirements are still lacking. This clinical commentary provides direction to assist the clinician with assessment and management of the patient with gluteal tendinopathy, based on currently limited available evidence on this condition and the wider tendon literature and on the combined clinical experience of the authors. J Orthop Sports Phys Ther 2015;45(11):910-922. Epub 17 Sep 2015. doi:10.2519/jospt.2015.5829. PMID:26381486

  13. Clinical feature and imaging findings of juvenile ankylosing spondylitis

    International Nuclear Information System (INIS)

    Objective: To analyze the clinical features and imaging findings of juvenile ankylosing spondylitis (JAS) in order to improve the diagnosis and the prognosis of JAS. Methods: Twelve cases were analyzed retrospectively and 14 cases, who were followed-up averagely for 2.3 years, were analyzed prospectively. Initially 10 were diagnosed as Still's disease and four were diagnosed as rheumatoid arthritis. Photography was performed in all cases, CT scan was done in 18 cases, and MRI in 8 cases. Lower extremity big joint disorders were observed in all cases and the small joints were reserved. The abnormalities of the sacroiliac joint were revealed in the early stage in 12 cases. The results were analyzed statistically. Results: The age of preliminary diagnosis was 9.3 years in average. There were statistical correlation between the age of the first episode and severity of the disease. And there were statistical correlation between the course of the illness and severity of the disease. The large joints of the lower extremities were most commonly involved. Conclusion: There were characteristic clinical features and imaging findings in the JAS. Early diagnosis and treatment improve the prognosis

  14. Clinical Features and Management of a Median Cleft Lip

    Science.gov (United States)

    Kim, Do Yeon; Oh, Tae Suk

    2016-01-01

    Background Median cleft lip is a rare anomaly consisting of a midline vertical cleft through the upper lip. It can also involve the premaxillary bone, the nasal septum, and the central nervous system. In our current report, we present the clinical features of 6 patients with a median cleft lip and their surgical management according to the accompanying anomalies. Methods From December 2010 to January 2014, 6 patients with a median cleft lip were reviewed. Five of these cases underwent surgical correction; alveolar bone grafting was performed in a patient with a median alveolar cleft. The surgical technique included inverted-U excision of the upper lip and repair of the orbicularis oris muscle. The mean follow-up period was 20.4 months (range, 7.4–44.0 months). Results The study patients presented various anomalous features. Five patients received surgical correction, 4 with repair of the median cleft lip, and one with iliac bone grafting for median alveolar cleft. A patient with basal sphenoethmoidal meningocele was managed with transoral endoscopic surgery for repair of the meningocele. Successful surgical repair was achieved in all cases with no postoperative complications. Conclusions Relatively mild forms of median cleft lip can be corrected with inverted-U excision with good aesthetic outcomes. In addition, there is a broad spectrum of clinical features and various anomalies, such as nasal deformity, alveolar cleft, and short upper frenulum, which require close evaluation. The timing of the operation should be decided considering the presence of other anomalies that can threaten patient survival. PMID:27218021

  15. Clinical and imaging features of neonatal chlamydial pneumonia

    International Nuclear Information System (INIS)

    Objective: To study the clinical and imaging features of chlamydial pneumonia in newborns. Methods: Medical records,chest X-Ray and CT findings of 17 neonates with chlamydia pneumonia were reviewed. The age was ranged from 9.0 to 28.0 days with mean of (16.8 ± 5.8) days. There were 11 males and 6 females. Sixteen were full term infants and one was born post term. All babies were examined with chest X-ray film, and 13 patients also underwent chest CT scan. Serologic test using immunofluorescence method for Chlamydia IgG and IgM antibodies were performed in all patients. Results: All newborns presented with cough but without fever. Positive results of the serologic tests were demonstrated. Chest films showed bilateral hyperventilation in 10 patients, diffuse reticular nodules in 10 patients including nodules mimicking military tuberculosis in 7 patients, and accompanying consolidation in 9 patients. CT features included interstitial reticular nodules in 13 patients with size, density, and distribution varied. Subpleural nodules (11 patients) and fusion of nodules (10 patients) predominated. Bilateral hyperinflation was found in 10 patients, which combined with infiltration in 12 patients, thickening of bronchovascular bundles in 10 patients, and ground glass sign in 5 patients. No pleural effusion and lymphadenopathy was detected in any patient. Conclusions: Bilateral hyperinflation and diffuse interstitial reticular nodules were the most common imaging features of neonatal chlamydial pneumonia. The main clinical characteristic of neonatal chlamydial pneumonia is respiratory symptoms without fever, which is helpful to its diagnosis. (authors)

  16. Features of clinical and radiographic appearances of SARS in children

    International Nuclear Information System (INIS)

    Objective: To evaluate the features of clinical and radiographic appearances of SARS in children. Methods: The chest films obtained at clinical presentation and during treatment in 18 children with confirmed SARS were retrospectively evaluated. Results: The main X-ray manifestations included: (1) air-space opacity in 13/18; (2) round lesion with clear margin in 3/18; (3) ground-glass lesions in 2/18; (4) unilateral and single focal involvement was more common in children than in adults (5) no reticular shadow, lymphanopathy or pleural effusion was demonstrated; (6) radiographic changes of foci was not as rapid in children as in adults. The lesions migrated in 1 case. The average absorption time of the lesions was 19 days, and most of them had no remnant. Conclusion: Compare with that in adults , the clinical manifestation was not so severe in children with SARS, and most of the infected children had clear contact history. Chest X-ray appearance in affected children mainly showed unilateral involvement of the lungs with chiefly air-space infiltrates. Remnant lesion of lung is rare in children. Differential diagnosis of SARS in children includes mycoplasma pneumonia or adenovirus pneumonia

  17. The clinical features of the overlap between COPD and asthma

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    Schroeder Joyce D

    2011-09-01

    Full Text Available Abstract Background The coexistence of COPD and asthma is widely recognized but has not been well described. This study characterizes clinical features, spirometry, and chest CT scans of smoking subjects with both COPD and asthma. Methods We performed a cross-sectional study comparing subjects with COPD and asthma to subjects with COPD alone in the COPDGene Study. Results 119 (13% of 915 subjects with COPD reported a history of physician-diagnosed asthma. These subjects were younger (61.3 vs 64.7 years old, p = 0.0001 with lower lifetime smoking intensity (43.7 vs 55.1 pack years, p = 0.0001. More African-Americans reported a history of asthma (33.6% vs 15.6%, p Conclusion Subjects with COPD and asthma represent a relevant clinical population, with worse health-related quality of life. They experience more frequent and severe respiratory exacerbations despite younger age and reduced lifetime smoking history. Trial registration ClinicalTrials.gov: NCT00608764

  18. Clinical features of reversed halo sign in cryptogenic organizing pneumonia

    International Nuclear Information System (INIS)

    Reversed halo sign (RHS) is often seen in computed tomography (CT) scans of cryptogenic organizing pneumonia (COP). To investigate its clinical features, we retrospectively reviewed 30 cases of COP in 13 men and 17 women, whose age range 28 to 73, with a mean of 58.4 years. All diagnoses were made with transbronchial lung biopsy (TBLB), but it took an average of 24.8 days from the first visit until the diagnosis of COP. RHS was seen in 7 cases (23%) and multiple RHSs were seen in 3 cases. We treated 5 cases (71%) with steroids. Their CT images showed parenchymal abnormalities which started as nodular lesions, then enlarged, and then the central lesion changed into ground-glass opacities, until finally, RHS was formed. The presence of RHS does not necessarily indicate a marked difference in the clinical course of COP. In conclusion, in the present series RHS was a phase of the clinical course of COP, and was useful to diagnose COP. (author)

  19. Clinical features and etiology of retinal vasculitis in Northern Thailand

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    Supanut Apinyawasisuk

    2013-01-01

    Full Text Available Purpose: To report on the clinical features and etiology of patients with retinal vasculitis (RV. Materials and Methods: We reviewed medical records of 47 patients (75 affected eyes diagnosed with RV. Clinical presentations, ocular complications, associated systemic diseases, and treatment regimens were registered. Results: Etiology of RV included infectious causes in 10/47, (21% while an association with systemic and/or ocular non-infectious disorders was noted in 22/47 (47%. Eales′ disease and Behcet′s disease represented the most common clinical entities in non-infectious group while tuberculosis-associated RV was diagnosed in 6/10 (60% among those with infectious disorders. RV was bilateral in 28/47 (60% patients. Retinal veins were most commonly affected (72%, 34/47. Involvement of arteries was present in 12/47 (25% and was associated with viral infections and Behcet′s disease. Ocular complications developed in 60/75 (80% eyes. The most common complications were elevated intraocular pressure and/or glaucoma (33/75, 44%. Retinal detachment, vitreous hemorrhage, and cystoid macular edema developed in similar percentages (15%. Conclusions: RV in Thailand manifested mostly in male patients, was typically bilateral and involved mostly veins. Involvement of arteries was observed in patients with viral infections and Behcet′s disease. Tuberculosis was the most common infectious cause.

  20. Rheumatoid arthritis combined with bronchiectasis:analysis of clinical features and associated risk factors%类风湿关节炎合并支气管扩张临床及危险因素分析

    Institute of Scientific and Technical Information of China (English)

    刘涌; 孙永昌; 刘晓芳

    2013-01-01

    Objective To investigate the clinical characteristics and risk factors of rheumatoid arthritis combined with bronchiectasis (RA-BR) by retrospective analysis of cases.Methods The clinical data of cases diagnosed as RA-BR were compared with those of cases with RA only in Beiing Tongren Hospital from May 2008 to May 2013.A logistic regression analysis was performed to investigate the independent risk factors.Results Sixty-six cases diagnosed as RA were analyzed including 19 cases of RA-BR and 47 cases of RA only.Respiratory manifestation was found in eight cases (8/19,42.1%) of RA-BR patients with RA duration (16.6±9.1) years and respiratory duration (4.6± 11.7) years.RA proceeding BR was found in 14 cases (14/19,73.7 %) and the mean duration was about 12 years.BR was mostly located in the right middle lobe and right lower lobe (52.6% and 36.8%).Compared with RA group,RA duration (P =0.045),PEF (P =0.000),FEV1.0 (P =0.032),FEF25-75 (P =0.002) and DLCO (P =0.008) were found significant difference in RA-BR group.There was no difference in lab tests between RA-BR and RA group,such as RF,APF,CCP,ANA,SSA,SSB,ESR,and CRP.No difference was found in disease-modifying treatment and corticosteroid usage between these two groups,too.Multivariate analysis showed that RA duration (P =0.018) and using leflunomide (P =0.026) were independent risk factors.Conclusions Bronchiectasis is not unusual in RA patients.The predominant BR distribution is right middle lobe and right lower lobe.The abnormal PFT results are usually found in RA-BR cases including obstructive respiratory dysfunction,small airway dysfunction,and diffusion dysfunction.RA duration and using leflunomide are the independent risk factors.%目的 回顾性分析类风湿关节炎(RA)合并支气管扩张病例资料,探讨其临床特点及相关危险因素.方法 分析自2008年5月至2013年5月入住.北京同仁医院RA合并支气管扩张病例的一般临床特征、肺功能、高分辨率CT等,与

  1. Stable feature selection for clinical prediction: exploiting ICD tree structure using Tree-Lasso.

    Science.gov (United States)

    Kamkar, Iman; Gupta, Sunil Kumar; Phung, Dinh; Venkatesh, Svetha

    2015-02-01

    Modern healthcare is getting reshaped by growing Electronic Medical Records (EMR). Recently, these records have been shown of great value towards building clinical prediction models. In EMR data, patients' diseases and hospital interventions are captured through a set of diagnoses and procedures codes. These codes are usually represented in a tree form (e.g. ICD-10 tree) and the codes within a tree branch may be highly correlated. These codes can be used as features to build a prediction model and an appropriate feature selection can inform a clinician about important risk factors for a disease. Traditional feature selection methods (e.g. Information Gain, T-test, etc.) consider each variable independently and usually end up having a long feature list. Recently, Lasso and related l1-penalty based feature selection methods have become popular due to their joint feature selection property. However, Lasso is known to have problems of selecting one feature of many correlated features randomly. This hinders the clinicians to arrive at a stable feature set, which is crucial for clinical decision making process. In this paper, we solve this problem by using a recently proposed Tree-Lasso model. Since, the stability behavior of Tree-Lasso is not well understood, we study the stability behavior of Tree-Lasso and compare it with other feature selection methods. Using a synthetic and two real-world datasets (Cancer and Acute Myocardial Infarction), we show that Tree-Lasso based feature selection is significantly more stable than Lasso and comparable to other methods e.g. Information Gain, ReliefF and T-test. We further show that, using different types of classifiers such as logistic regression, naive Bayes, support vector machines, decision trees and Random Forest, the classification performance of Tree-Lasso is comparable to Lasso and better than other methods. Our result has implications in identifying stable risk factors for many healthcare problems and therefore can

  2. Genetic analysis and clinical features of familial hypokalemic periodic paralysis

    Directory of Open Access Journals (Sweden)

    Hui-li ZHANG

    2014-06-01

    Full Text Available Background To investigate the gene mutation and clinical features of hypokalemic periodic paralysis (HypoPP in a Han family. Methods Mutation analyses of CACNA1S, SCN4A and KCNE3 gene were screened by DNA direct sequencing in the proband (Ⅲ3. Then, other patients and one asymptomatic relative were tested for the mutation detected in the proband before. Besides, clinical information was collected and analyzed carefully so as to detect whether the mutations were responsible for HypoPP.  Results KCNE3 gene was not detected in the propositus (Ⅲ 3. Mutations of IVS25-194C/T in CACNA1S gene were detected in the propositus (Ⅲ 3 and other patients (Ⅱ 1, Ⅲ 4, Ⅳ 3, while it was not detected in the asymptomatic relative (Ⅲ1. Given that it was an intron mutation, we presumed that it was not responsible for HypoPP in this family. In addition, mutations of IVS18-130G/A in SCN4A gene were detected in all patients (except for Ⅰ1 and asymptomatic relative (Ⅲ 1. Since it was an intron mutation and it was detected in symptomatic or asymptomatic members simultaneously, we also presumed that it was not responsible for HypoPP in this family. Interestingly, a missense mutation (V662I of c.1984G > A in exon 12 of SCN4A gene was detected in the proband (Ⅲ 3 and asymptomatic relative (Ⅲ 1. However, it was not detected in other symptomatic members ( Ⅱ 1, Ⅲ 4, Ⅳ 3. Based on clinical information and bioinformatics, we presumed that it was not causative mutation for the disease in this pedigree.  Conclusions This pedigree research enriched the data of gene mutation and clinical features of HypoPP in China. Besides for gene KCNE3, CACNA1S and SCN4A, other gene mutations accounted for HypoPP in the Han family should be further studied. doi: 10.3969/j.issn.1672-6731.2014.06.006

  3. Clinical and MRI features in pediatric multiple sclerosis

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical and MRI features of multiple sclerosis in children, including the clinically isolated syndrome (CIS) and relapse. Methods: In total, 16 cases of pediatric multiple sclerosis were included in this study. Of them, 11 patients were female and 5 were male, with the mean onset age of 10.1 years. They were followed up for 4 months to 7 years and found to have 1- 5 relapses. The clinical manifestations of CIS and relapse were analyzed by a pediatric neurologist. An experienced neuroradiologist reviewed the MRI images of CIS and relapse. Information on the location, size, and pattern of the lesions was gathered. The location of lesions included subcortical, central, and periventricular white matter, cortex, deep gray matter, brain stem, and cerebellum. Results: CIS episode presented acute onsets in 13/16 cases, with symptoms of cortices in 10 cases and visual impairment in 6 cases. Relapse occurred in 14/16 cases within one year. The incidence of symptoms of cortices was less frequent and severe in the second episode of MS, whereas the visual impairment had a high incidence. All patients had full recovery after the last episode. MRI of CIS showed confluent subcortical white matter lesions in 13/16 cases, abutting on central white matter lesions. The most frequently involved brain part was the frontal lobe, followed by the parietal lobe. Cortical involvement was observed in 9/16 cases. In 6 cases, periventricular white matter lesions were detected. Bilateral deep gray matter was abnormal in 4 cases. Other abnormalities included brain stem lesions in 5 cases, cerebellum lesions in 3 cases, optic nerve involvement in 3 cases, and pyramidal tract lesions in 2 cases. MRI of relapse revealed more small lesions in the subcortical and periventricular white matter in the patients. In the second episode, only 2 cases presented cortical involvement. Lesions were found in the brain stem in 4 cases and in the cerebellum in 5 cases. Pyramidal tract

  4. Clinical Features Of Acute Febrile Thrombocytopaenia Among Patients Attending Primary Care Clinics

    OpenAIRE

    Fah, Tong Seng; MMed, Noorazah Abdul Aziz; Liew, Chin Gek; Omar, Khairani

    2006-01-01

    Introduction: Identifying clinical features that differentiate acute febrile thrombocytopaenia from acute febrile illness without thrombocytopaenia can help primary care physician to decide whether to order a full blood count (FBC). This is important because thrombocytopaenia in viral fever may signify more serious underlying aetiology like dengue infection.

  5. Clinical Features of Choroidal Metastases from Carcinoid Tumour

    Institute of Scientific and Technical Information of China (English)

    Huaning She; Yuping Zheng; Xiaohua Wang; Yanlong Quan; Naixue Sun

    2004-01-01

    Purpose :To report ophthalmologic and angiographic features of choroidal metastases from carcinoid tumor and analyze their common clinical manifestation.Methods:Ophthalmologic examinations and fundus fluorescein angiography (FFA) were performed in 30 patients suffered from carcinoid tumor, and four patients diagnosed of breast cancer (2 cases), lung cancer (1 case) and maxillary sinus cancer (1 case) were confirmed with choroidal metastases.Results:Choroidal metastases were found as the initial manifestations of the malignant tumors on 2 patients whose initial and chief complaints were decreasing vision, their fundus lesions were mainly presented in the posterior pole and FFA showed high density of fluorescence of the lesions.Conclusions:This study indicated choroidal metastasis might be the first sign of metastases for patients with cancer. For patients with unknown metastastic cancers, examinations of the choroids may be useful for diagnosis and prognosis. Eye Science 2004;20:15-18.

  6. Hyperprolactinemia in children: clinical features and long-term results.

    Science.gov (United States)

    Catli, Gonul; Abaci, Ayhan; Altincik, Ayca; Demir, Korcan; Can, Sule; Buyukgebiz, Atilla; Bober, Ece

    2012-01-01

    Hyperprolactinemia is a rare endocrine disorder in childhood, which may result from hypophyseal adenoma. We aimed to review the etiologic reasons and clinical features in hyperprolactinemia patients retrospectively. The mean age of 11 female patients at diagnosis was 14.2 ± 1.3 years. Five patients had microadenoma, four patients had macroadenoma, and two patients were diagnosed with idiopathic hyperprolactinemia. The most frequent symptoms were menstrual disorders, headache, and galactorrhea, and one-third of the patients had obesity at diagnosis. There was no anterior pituitary hormone deficiency. All patients received bromocriptine as initial therapy; only two patients with macroadenoma and one patient with microadenoma were switched to cabergoline. Transsphenoidal surgery was performed for a patient with macroadenoma, who had cavernous sinus invasion and visual field defect. Medical treatment should be the first-line treatment option in both microadenoma and macroadenoma cases without any neurological signs. Surgery should be employed with limited indications. PMID:23329759

  7. Update on Mastocytosis (Part 1): Pathophysiology, Clinical Features, and Diagnosis.

    Science.gov (United States)

    Azaña, J M; Torrelo, A; Matito, A

    2016-01-01

    Mastocytosis is a term used to describe a heterogeneous group of disorders characterized by clonal proliferation of mast cells in various organs. The organ most often affected is the skin. Mastocytosis is a relatively rare disorder that affects both sexes equally. It can occur at any age, although it tends to appear in the first decade of life, or later, between the second and fifth decades. Our understanding of the pathophysiology of mastocytosis has improved greatly in recent years, with the discovery that somatic c-kit mutations and aberrant immunophenotypic features have an important role. The clinical manifestations of mastocytosis are diverse, and skin lesions are the key to diagnosis in most patients. PMID:26546030

  8. Clinical and echocardiographic features of aorto-atrial fistulas

    Directory of Open Access Journals (Sweden)

    Ananthasubramaniam Karthik

    2005-01-01

    Full Text Available Abstract Aorto-atrial fistulas (AAF are rare but important pathophysiologic conditions of the aorta and have varied presentations such as acute pulmonary edema, chronic heart failure and incidental detection of the fistula. A variety of mechanisms such as aortic dissection, endocarditis with pseudoaneurysm formation, post surgical scenarios or trauma may precipitate the fistula formation. With increasing survival of patients, particularly following complex aortic reconstructive surgeries and redo valve surgeries, recognition of this complication, its clinical features and echocardiographic diagnosis is important. Since physical exam in this condition may be misleading, echocardiography serves as the cornerstone for diagnosis. The case below illustrates aorto-left atrial fistula formation following redo aortic valve surgery with slowly progressive symptoms of heart failure. A brief review of the existing literature of this entity is presented including emphasis on echocardiographic diagnosis and treatment.

  9. Clinical Investigation of Radiation Retinopathy Fundus and Fluorescein Angiographic Features

    Institute of Scientific and Technical Information of China (English)

    LiMei; QiuGT

    1999-01-01

    Purpose:To investigate the fundus and fluorescein angiographic features in the patients with radiation retinopathy.Clinical Materials:Color fundus photography and/or fluorescein angiography from 13 patients with nasopharyngeal carcinomas received external beam radiation were retrospectively analyzed.Reslts:In this study,26 damaged eyes of 13 patients eveloped some degree of radiation retinopathy.The earliest and most common finding was macular microvascular changes (microaneurysms and/or telangiectasia),which was observed in 100%(26/26)of the eyes.Intraretinal hemorrhages,macular capillary nonperfusion,and macular edema were noted in 84%,50%,and 42% of the eyes,respectively.Conclusions:Radiation retinopathy is common after external beam radiation of nasopharyngeal carcinomas.The prominent changes include maular microvascular changes,intraretinal hemorrhages and macular capillary nonperfusion.

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

    Science.gov (United States)

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

    2015-12-01

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

  11. HYPERPHAGIA REACTIONS WITHIN EATING DISORDERS. CLINICAL FEATURES AND THERAPY

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    O. A. Gladyshev

    2015-09-01

    Full Text Available Aim. To evaluate clinical features of hyperphagia reactions, their significance in attraction abnormities within eating disorders and treatment options for these conditions with escitalopram.Material and methods. Mental state of 39 women (age 19-50 years with psychogenic overeating and obesity (body mass index of 30 to 53 kg/m2 was studied. Patients were admitted to the Institute of Nutrition of the Russian Academy of Medical Sciences. Diagnostic criteria for International Classification of Diseases, 10th edition, as well as Eating Disorder Inventory (EDI, Hospital Anxiety and Depression Scale (HADS and Ferreri Anxiety Rating Diagram (FARD were used for syndrome qualifications. Patient Global Impression of Change was also studied using a 4-point scale of results (excellent, good, fair, and negative.Results. Clinical features of hyperphagic reactions were found. Escitalopram treatment course was completed with excellent and good results in 80% of patients. 50%-reduction in HADS score for anxiety was found in 74% of patients, for depression – in 63%, and for Ferreri scale – in 68% of patients. Escitalopram promoted more intensive body weight loss: 11% vs 8% of baseline weight in active and control groups, respectively. Adverse events occurred only in 7 (36% patients; they were transient and did not require therapy discontinuation.Conclusion: Significant differences of premanifest disorders were often observed in patients history. Escitalopram in these patients showed efficacy in improvement of both mental and somatic symptoms of anxiety. It decreased dependence on food as a factor mitigating affect and stress, thus provided better results in body weight reduction.

  12. Factors Associated with Clinical and Topographical Features of Laryngeal Tuberculosis

    Science.gov (United States)

    Reis, João Gustavo Corrêa; Reis, Clarissa Souza Mota; da Costa, Daniel César Silva; Lucena, Márcia Mendonça; Schubach, Armando de Oliveira; Oliveira, Raquel de Vasconcellos Carvalhaes; Rolla, Valéria Cavalcanti; Conceição-Silva, Fátima; Valete-Rosalino, Cláudia Maria

    2016-01-01

    Introduction Laryngeal tuberculosis (LTB) is the most frequent granulomatous disease of the larynx and represents less than 2% of extrapulmonary TB cases. There are no pathognomonic clinical and endoscopic features of this disease and studies on LTB that can assist in its diagnostic characterization are lacking. Objective To identify factors associated with clinical and topographical features of LTB. Method a retrospective cross-sectional study was conducted from the medical records of 36 patients with confirmed LTB diagnosis. Results Dysphonia and cough were the main symptoms presented by patients and the true vocal folds the most frequently affected site. The average of the duration of the disease evolution was significantly higher in patients with dysphonia than in patients without this symptom. We observed association between dysphonia and true vocal fold lesions and between odynophagia and lesions in the epiglottis, arytenoids and aryepiglottic folds. Odynophagia was more frequent in individuals with lesions in four or more laryngeal sites. Weight loss equal or above 10% of the body weight was more frequent in patients with odynophagia as first symptom and in patients with ulcerated lesion. Dyspnea on exertion was more frequent in individuals with more extensive laryngeal lesions. The percentage of smokers with lesions in four or more laryngeal sites was greater than that found in non-smokers. Laryngeal tissue fragment bacilloscopy and culture examinations were less positive than sputum ones. Conclusions Smoking appears to be associated with the development of more extensive LTB lesions, and LTB with dyspnea on exertion and odynophagia with consequent impairment of nutritional status. We emphasize the need for histopathologic confirmation, once positive sputum bacteriological examinations seem not to necessarily reflect laryngeal involvement. PMID:27077734

  13. Clinical features of pedophilia and implications for treatment.

    Science.gov (United States)

    Cohen, Lisa J; Galynker, Igor I

    2002-09-01

    The authors discuss the diagnostic criteria for pedophilia and review the literature on its clinical features, including data on prevalence, gender, age of onset, number of victims, frequency and type of acts, violence, impulsivity, and insight. Findings concerning the characteristics of victims (e.g., sex, age, relationship to the pedophile) and research on pedophilic subtypes-exclusive versus nonexclusive; incestuous versus nonincestuous; heterosexual, homosexual, or bisexual-are reviewed. Studies have shown that pedophiles may share many psychiatric features beyond deviant sexual desire, including high rates of comorbid axis I disorders (affective disorders, substance use disorders, impulse control disorders, other paraphilias) as well as severe axis II psychopathology (especially antisocial and Cluster C personality disorders). The authors present several possible etiological models for pedophilia and conclude that further research is needed concerning the etiological role of a childhood history of sexual abuse as well as the underlying neurobiology of deviant sexual arousal and decreased erotic differentiation. Finally, findings concerning pharmacological and cognitive-behavioral treatments for pedophilia are briefly reviewed. Recidivism, drop-out, and noncompliance are significant problems in the treatment of pedophilia. The authors review predictors of treatment outcome and conclude that pedophilia is extremely difficult to treat and that effective treatment needs to be intensive, long-term, and comprehensive, possibly with lifetime follow-up. PMID:15985890

  14. Clinical and genetic features of ataxia-telangiectasia

    International Nuclear Information System (INIS)

    There are several variants of ataxia-telangiectasia (A-T): classical A-T with marked radiation sensitivity; classical A-T with intermediate levels of radiation sensitivity; mild A-T with intermediate levels of radiation sensitivity; A-T without telangiectasia; A-T without oculomoto apraxia; and A-T with microcephaly. These disorders are probably caused by different allelic mutations, because affected sibs resemble the index patients, and because there is an association of certain haplo-types of 11q22-23 with specific phenotypes. The Nijmegen Breakage Syndrome, with its lack of ataxia, seems on clinical grounds to be a different disorder. Although A-T is almost always inherited as an autosomal recessive, there are some unusual features; an unexpectedly low parental consanguinity rate, an incidence in sibs that is < 0.25, and occurrence of disease in many different races and in the offspring of mixed race unions. Moreover, looking at haplotypes from 63 UK patients, there is a remarkably low incidence of homozygosity. An autosomal recessive condition that is deficient in parental consanguinity, and in homozygosity for the region around the gene, can be explained by J.H. Edwards' hypothesis that homozygosity for alleles at a neighbouring locus are lethal early in embryogenesis. Other possible mechanisms to explain the unusual genetic features are discussed. (author)

  15. Clinical features in patients with long-lasting macrophagic myofasciitis

    Directory of Open Access Journals (Sweden)

    Muriel eRIGOLET

    2014-11-01

    Full Text Available Macrophagic myofasciitis (MMF is an emerging condition characterized by specific muscle lesions assessing abnormal long-term persistence of aluminium hydroxide within macrophages at the site of previous immunization. Affected patients usually are middle-aged adults, mainly presenting with diffuse arthromyalgias, chronic fatigue, and marked cognitive deficits, not related to pain, fatigue or depression. Clinical features usually correspond to that observed in chronic fatigue syndrome/myalgic encephalomyelitis. Representative features of MMF-associated cognitive dysfunction include dysexecutive syndrome, visual memory impairment and left ear extinction at dichotic listening test. Most patients fulfil criteria for non-amnestic/dysexecutive mild cognitive impairment, even if some cognitive deficits appear unusually severe. Cognitive dysfunction seems stable over time despite marked fluctuations. Evoked potentials may show abnormalities in keeping with central nervous system involvement, with a neurophysiological pattern suggestive of demyelination. Brain perfusion SPECT shows a pattern of diffuse cortical and subcortical abnormalities, with hypoperfusions correlating with cognitive deficiencies. The combination of musculoskeletal pain, chronic fatigue and cognitive disturbance generates chronic disability with possible social exclusion. Classical therapeutic approaches are usually unsatisfactory making patient care difficult.

  16. Clinical and genetic features of ataxia-telangiectasia

    Energy Technology Data Exchange (ETDEWEB)

    Bundey, S. [Birmingham Maternity Hospital (United Kingdom). Clinical Genetics Unit

    1994-12-01

    There are several variants of ataxia-telangiectasia (A-T): classical A-T with marked radiation sensitivity; classical A-T with intermediate levels of radiation sensitivity; mild A-T with intermediate levels of radiation sensitivity; A-T without telangiectasia; A-T without oculomoto apraxia; and A-T with microcephaly. These disorders are probably caused by different allelic mutations, because affected sibs resemble the index patients, and because there is an association of certain haplo-types of 11q22-23 with specific phenotypes. The Nijmegen Breakage Syndrome, with its lack of ataxia, seems on clinical grounds to be a different disorder. Although A-T is almost always inherited as an autosomal recessive, there are some unusual features; an unexpectedly low parental consanguinity rate, an incidence in sibs that is < 0.25, and occurrence of disease in many different races and in the offspring of mixed race unions. Moreover, looking at haplotypes from 63 UK patients, there is a remarkably low incidence of homozygosity. An autosomal recessive condition that is deficient in parental consanguinity, and in homozygosity for the region around the gene, can be explained by J.H. Edwards` hypothesis that homozygosity for alleles at a neighbouring locus are lethal early in embryogenesis. Other possible mechanisms to explain the unusual genetic features are discussed. (author).

  17. Clinical features of schizophrenia with enhanced carbonyl stress.

    Science.gov (United States)

    Miyashita, Mitsuhiro; Arai, Makoto; Kobori, Akiko; Ichikawa, Tomoe; Toriumi, Kazuya; Niizato, Kazuhiro; Oshima, Kenichi; Okazaki, Yuji; Yoshikawa, Takeo; Amano, Naoji; Miyata, Toshio; Itokawa, Masanari

    2014-09-01

    Accumulating evidence suggests that advanced glycation end products, generated as a consequence of facilitated carbonyl stress, are implicated in the development of a variety of diseases. These diseases include neurodegenerative illnesses, such as Alzheimer disease. Pyridoxamine is one of the 3 forms of vitamin B6, and it acts by combating carbonyl stress and inhibiting the formation of AGEs. Depletion of pyridoxamine due to enhanced carbonyl stress eventually leads to a decrease in the other forms of vitamin B6, namely pyridoxal and pyridoxine. We previously reported that higher levels of plasma pentosidine, a well-known biomarker for advanced glycation end products, and decreased serum pyridoxal levels were found in a subpopulation of schizophrenic patients. However, there is as yet no clinical characterization of this subset of schizophrenia. In this study, we found that these patients shared many clinical features with treatment-resistant schizophrenia. These include a higher proportion of inpatients, low educational status, longer durations of hospitalization, and higher doses of antipsychotic medication, compared with patients without carbonyl stress. Interestingly, psychopathological symptoms showed a tendency towards negative association with serum vitamin B6 levels. Our results support the idea that treatment regimes reducing carbonyl stress, such as supplementation of pyridoxamine, could provide novel therapeutic benefits for this subgroup of patients. PMID:24062594

  18. Acute hematogenous osteomyelitis in young children - clinical and radiological features

    International Nuclear Information System (INIS)

    Acute hematogenous osteomyelitis is a bacterial infectious disease which mainly affects the paediatrics age group. The incidence seems to decline through the last decade. The authors analyzed the clinical, bacteriological and radiological features of acute hematogenous osteomyelitis in 49 young children. Their age ranged from 12 days to 2.9 years (19 new-born and 30 babies). The most affected locus was the femur (46.9 %), followed by the humerus (40.9 %) and tibia (6.2 %). The adjacent joint was involved in 38.8 %. Up to the third day after onset of symptoms were admitted 32 children (65.3 %). A bacteriological diagnosis has been achieved in only 19 cases (38.8 %) which underwent different surgical procedures. Staphylococcus aureus (9 children; 64.3 %) was the most common causative microbe. Radiological characteristic showed mainly widening of joints, destruction of cartilage, bone destruction and osteoporosis. The median duration of antibiotic therapy was 31 days. Nine children underwent needle aspiration while another 10 required locus incision or open surgery with debridement or sequestrectomy. Definitive clinical restoration was observed in 42 cases (85.7%). (authors)

  19. Clinical-Diagnostic Features of Duchenne Muscular Dystrophy in Children

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    Umida T. Omonova

    2013-12-01

    Full Text Available Duchenne Muscular Dystrophy (DMD is a severe, progressive disease that affects about 1 out of every 5,000 male infants; this is the most destructive of all muscular dystrophies, which worsens rapidly. In this study, we performed a clinical analysis of 37 children with DMD. They ranged in age from 3 to 15 years, mean age being 7.8±0.48 years. The mean age at onset was 4.3±0.36 years and ranged from birth to 8 years. The biochemical examination included the determination of the serum levels of the following enzymes, AST, ALT, CPK-MM, and LDH. A genealogical analysis was conducted among 240 first-degree relatives of children with DMD. Electroneuromyography examination included registration of the biopotentials of the hand and foot muscles, measurement of the muscle response (M-wave and the late-evoked responses. The clinical-diagnostic features of DMD in children were characterized.

  20. Clinical features of primary cicatricial alopecia in Chinese patients

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    Shiling Qi

    2014-01-01

    Full Text Available Background: There have been few reports on primary cicatricial alopecias (PCR especially from Asia (PCA. Aims: To study the clinical, pathological and dermoscopic characteristics of PCA among Chinese patients. Methods: A retrospective analysis of the clinical data of 59 patients with PCA was conducted and the dermoscopic, pathological, treatment and prognosis characteristics analyzed. Fisher′s Chi-square exact test, Kruskal-Wallis and Spearman rank correlation test were performed. Results: The ratio of neutrophilic to lymphocytic cicatricial alopecias was about 1.3:1 in this group. The most frequent disorder was folliculitis decalvans. Follicular openings were absent on dermoscopy in all cases except alopecia mucinosa. Patulous follicular openings were characterisitc of alopecia mucinosa. After treatment, an increase in short vellus hairs was the earliest feature, while telangiectasia, epidermal scale, follicular hyperkeratosis, pustules and hair diameter diversity gradually decreased or even disappeared. Improvement in the areas of hair loss after treatment was seen more often in discoid lupus erythematosus, folliculitis decalvans and dissecting cellulitis than in patients with classic pseudopelade of Brocq. Nine patients (13.6% relapsed after cessation of therapy. Female patients needed longer treatment times. Long duration, large areas of hair loss and shorter treatment courses were the major factors in relapses. Conclusions: Dermatoscopy provides a rapid, practical and useful aid for the diagnosis of PCA and also to assess disease activity. Patulous follicular openings are a specific dermoscopic sign of alopecia mucinosa. Lichen planopilaris is less common in China than in the West.

  1. Ebola in children: epidemiology, clinical features, diagnosis and outcomes.

    Science.gov (United States)

    Olupot-Olupot, Peter

    2015-03-01

    Ebola virus disease is caused by a highly contagious and pathogenic threadlike RNA virus of the Filoviridae family. The index human case is usually a zoonosis that launches human-to-human transmission interface with varying levels of sustainability of the epidemic depending on the level of public health preparedness of the affected country and the Ebola virus strain. The disease affects all age groups in the population. Clinical diagnosis is challenging in index cases especially in the early stages of the disease when the presenting features are usually nonspecific and only similar to a flu-like illness. However, in the agonal stages, hemorrhage frequently occurs in a high proportion of cases. The diagnostic gold standard is by detecting the antigen using reverse transcription-polymerase chain reaction. Mortality rates in the past 28 outbreaks since 1976 have ranged from 30% to 100% in different settings among adults, but lower mortality rates have been documented in children. This review aims to describe Ebola virus infection, clinical presentation, diagnosis and outcomes in children. PMID:25522340

  2. Clinical features and treatment of endophthalmitis after cataract surgery.

    Science.gov (United States)

    Zhu, J; Li, Z H

    2015-01-01

    The aim of this study was to investigate the clinical features and treatment results of endophthalmitis after cataract surgery. Five patients with endophthalmitis after phacoemulsification with intraocular lens implantation were enrolled in this study. The pathogenesis, clinical manifestation, and surgical outcomes of 5 patients were compared. Three patients were surgically treated with anterior chamber irrigation and vitrectomy with intravitreal injection. The remaining two patients were medically treated with an intravitreal injection of vancomycin and ceftazidime. Treatment results of the five patients were analyzed. Four patients had positive cultures for bacteria (two cases Staphylococcus epidermidis, one case Enterococcus faecalis, and one case head-like Staphylococcus). The culture of the fifth patient did not have bacterial growth. One year following treatment, four patients had restored visual acuity and a clear vitreous cavity. Retinal detachment and other complications were not observed. The remaining patient had a visual acuity of index at 30 cm one year following treatment. For patients with endophthalmitis after cataract surgery, a biochemical laboratory examination should be promptly performed and should include a bacterial culture and drug sensitivity test. When necessary, vitrectomy combined with an intravitreal injection of vancomycin should be performed to treat the infection early and to help retain useful vision. PMID:26125869

  3. Macroprolactin as a Cause of Hyperprolactinemia: Clinical and Radiological Features

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    Assim Alfadda

    2008-08-01

    Full Text Available Objective: The aim of this study was to determine the prevalence of macroprolactin in patients with hyperprolactinemia in our region, and to determine the clinical and neuroradiological features of the affected individuals. Materials and Methods: We used the Roche Elecsys Prolactin assay (Prolactin II with polyethylene glycol precipitation to identify macroprolactin; recovery of ≤40% was considered to represent significant macroprolactinemia. Of 156 consecutive patients with hyperprolactinemia, macroprolactin was found in ten (6.4%. Clinical records of these patients were reviewed. Results: Of ten patients with macroprolactinemia, two males presented with infertility and two with decreased libido and erectile dysfunction. Females presented with menstrual dysfunction, with or without infertility. Pituitary adenomas were identified in two of seven patients who underwent neuroimaging. Dopamine agonists were prescribed to seven patients; their symptoms were not affected by this therapy. Conclusions: Macroprolactin is a cause of misdiagnosis and inappropriate treatment in patients with hyperprolactinemia. It is important to be aware of the extent to which the assay system used in the measurement of prolactin may detect macroprolactin, and to have a available validated method to confirm its presence. This will ensure appropriate management for patients with this benign condition. Turk Jem 2008; 12: 46-9

  4. Fat necrosis of the breast: clinical, mammographic and sonographic features

    International Nuclear Information System (INIS)

    Objective: the purpose of this study was to describe and quantitate the clinical, mammographic and sonographic (US) features and to evaluate the evolution of fat necrosis in the breast. Materials and methods: a retrospective review of the clinical, mammographic and US findings of 126 fat necrosis lesions in 94 patients, diagnosed between 1989 and 1999, was done. All the cases included in the study had at least 3 years follow-up mammograms. In addition, 48 patients with a total of 62 fat necrosis lesions, also had an US follow-up. Fat necrosis was diagnosed on the basis of histologic (n=25) and initial or follow-up imaging (n=69) findings. Results: the predominant mammographic features of the 114 lesions apparent on mammograms were radiolucent oil cyst (n=34, 26.9%), round opacity (n=16, 12.6%), asymmetrical opacity or heterogenicity of the subcutaneous tissues (n=20, 15.8%), dystrophic calcifications (n=34, 26.9%), clustered pleomorphic microcalcifications (n=5, 3.9%), and suspicious speculated mass (n=5, 3.9%). In five patients with 12 (9.5%) palpable masses, mammograms were normal. The predominant US features of the 112 lesions apparent on sonograms were solid (n=18, 14.2%), anechoic with posterior acoustic enhancement (n=21, 16.6%), anechoic with posterior acoustic shadowing (n=20, 15.8%), cystic with internal echoes (n=14, 11.1%), cystic with mural nodule (n=5, 3.9%) and increased echogenicity of the subcutaneous tissues (n=34, 26.9%). In five patients with 14 (11.1%) lesions, sonographic examination was normal. Mammographic follow-up showed that five of the radiolucent oil cysts developed curvilinear calcifications, six of the round opacities decreased in size and density, and another two disappeared. Eleven of the dystrophic calcifications became even more coarse. Six of the asymmetrical opacities became vague and one developed an oil cyst and coarse calcifications. The only nonoperated speculated mass developed a typical small radiolucent oil cyst in the

  5. Clinical features of subacute course of radiation disease

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    Krasnyuk V.I.

    2014-12-01

    Full Text Available Aim: to show the clinical features of subacute course of subacute course of radiation disease and how they differ from the typical manifestations of acute and chronic radiation syndrome. Material and methods. Materials of the Burnasyan Federal Medical and Biophysical Center Register of acute radiation disease (ARS in the Former USSR and Russia and Materials of a Burnasyan Federal Medical and Biophysical Center database of workers "Mayak" with chronic radiation syndrome (CRS were analyzed. There were selected 22 patients with radiation syndrome due to fractionated or prolonged accidental exposure (the main group of patients. There were formed two subgroups for comparison: patients with a typical marrowy syndrome of acute radiation disease and with chronic radiation syndrome. Statistical analysis of results was made by means of statistical software package Statistica v. 6.1 for Windows (StatSoft Inc., USA and Microsoft Excel 2010. Results. It was found that subacute course of radiation syndrome is possible under radiation exposure with medium dose rate in the range of 0.1-0.3 Gy/day Early symptoms of the disease as a primary reaction symptoms are completely absent. First complaints appeared in the earliest one month after the start of work in adverse conditions, on the average 6 months. In the period of formation there is a pancytopenia in the peripheral blood. Duration of the formation period was also determined. In this case radiation cataracts in patients are not observed. After the termination of radiation exposure hematopoietic recovery is slow, possibly incomplete with a high probability of hemoblastosis development. Conclusions. There has been described the subacute course of radiation disease by analyzing the clinical material of patients with radiation syndrome, there has been analyzed the clinical criteria that distinguish subacute radiation syndrome from acute and chronic.

  6. Clinical features of probable severe acute respiratory syndrome in Beijing

    Institute of Scientific and Technical Information of China (English)

    Hai-Ying Lu; Xiao-Yuan Xu; Yu Lei; Yang-Feng Wu; Bo-Wen Chen; Feng Xiao; Gao-Qiang Xie; De-Min Han

    2005-01-01

    AIM: To summarize clinical features of probable severe acute respiratory syndrome (SARS) in Beijing.METHODS: Retrospective cases involving 801 patients admitted to hospitals in Beijing between March and June 2003, with a diagnosis of probable SARS, moderate type.The series of clinical manifestation, laboratory and radiograph data obtained from 801 cases were analyzed. RESULTS: One to three days after the onset of SARS, the major clinical symptoms were fever (in 88.14% of patients), fatigue, headache, myalgia, arthralgia (25-36%), etc. The counts of WBC (in 22.56% of patients) lymphocyte (70.25%)and CD3, CD4, CD8 positive T cells (70%) decreased. From 4-7 d, the unspecific symptoms became weak; however, the rates of low respiratory tract symptoms, such as cough (24.18%), sputum production (14.26%), chest distress (21.04%) and shortness of breath (9.23%) increased, so did the abnormal rates on chest radiograph or CT. The low counts of WBC, lymphocyte and CD3, CD4, CD8 positiveT cells touched bottom. From 8 to 16 d, the patients presented progressive cough (29.96%), sputum production (13.09%), chest distress (29.96%) and shortness of breath (35.34%). All patients had infiltrates on chest radiograph or CT, some even with multi-infiltrates. Two weeks later, patients' respiratory symptoms started to alleviate, the infiltrates on the lung began to absorb gradually, the counts of WBC, lymphocyte and CD3, CD4, CD8 positive T cells were restored to normality.CONCLUSION: The data reported here provide evidence that the course of SARS could be divided into four stages, namely the initial stage, progressive stage, fastigium and convalescent stage.

  7. Clinical features of Crohn disease concomitant with ankylosing spondylitis

    Science.gov (United States)

    Liu, Song; Ding, Jie; Wang, Meng; Zhou, Wanqing; Feng, Min; Guan, Wenxian

    2016-01-01

    Abstract Extraintestinal manifestations (EIMs) cause increased morbidity and decreased quality of life in Crohn disease (CD). Ankylosing spondylitis (AS) belongs to EIMs. Very little is known on the clinical features of CD concomitant with AS. This study is to investigate the clinical features of CD patients with AS. We retrospectively collected all CD patients with AS in our hospital, and established a comparison group (CD without AS) with age, sex, and duration of Crohn disease matched. Clinical information was retrieved for comparison. Eight CD + AS patients were identified from 195 CD patients. Sixteen CD patients were randomly selected into comparison group. All CD + AS patients were male, HLA-B27 (+), and rheumatoid factor (−) with an average age of 40.8 ± 4.52 years. Significant correlation between disease activity of CD and AS was revealed (r = 0.857, P = 0.011). Significant correlation between disease activity of CD and functional limitation associated with AS was identified (r = 0.881, P < 0.01). C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and globulin were positively correlated to Crohn disease activity index (CDAI), Bath AS disease activity index, and Bath AS functional index(BASFI) scores (r = 0.73–0.93, P < 0.05). Albumin was negatively associated with CDAI and BASFI (r = −0.73 to −0.91, P < 0.05). The ratio of albumin to globulin (Alb/Glo) was significantly related to all 3 scores (r = −0.81 to −0.91, P < 0.05). Male predominance with a 4.12% concomitant incidence of AS is observed in CD patients. Disease activity of CD correlates with disease activity of AS and functional limitation caused by AS. CRP, ESR, and Alb/Glo may serve as biomarkers for disease activity and functional limitation in CD patients concomitant with AS, although future studies are expected. PMID:27428240

  8. Analysis of the risk factors of gastrointesital esophageal reflux disease and its clinical features.%胃食管反流病相关危险因素及诊疗特点分析

    Institute of Scientific and Technical Information of China (English)

    蒋绚; 王淑杰; 张素巧; 李萌; 李加宁; 吕宗昌; 刘玉兰

    2011-01-01

    目的 探讨胃食管反流病(GERD)发病的危险因素及诊疗特点.方法 利用2004年3月至5月在北京大学人民医院消化内科门诊就诊患者填写的反流性疾病问卷(RDQ)表及其他相关信息进行分析,并在2011年5月对部分调查者进行电话回访.结果 1052例患者填写RDQ表,可利用资料为1045例(占99.3%).GERD在消化门诊就诊患者中占16.3%;其发病无季节规律,平均病程6.45年.老年(OR= 1.02,95%CI∶1.01~1.04)、体力劳动(OR= 1.79,95% CI∶ 1.13~2.86)及经常饮酒(OR =2.63,95%CI∶1.17~5.92)增加GERD危险性.而性别、吸烟、体重指数(BMI)及ABO血型与GERD发病无相关性.GERD患者中29.6%合并咽部及呼吸系统症状,相比非GERD组为高(X2=37.6,P<0.01);26.3%的GERD患者服用抗酸药物治疗,其中9.3%患者服用质子泵抑制剂治疗;40%的患者对治疗效果不满意.7年后对307例调查者回访,以往存在GERD者中44.0%病例症状仍明显.结论 GERD为综合医院消化科就诊患者的常见病症.老年、体力劳动及经常饮酒是GERD的高危因素.GERD合并食管外表现多见,症状不易控制.半数患者症状持续多年.%Objective To explore the risk factors of gastrointestinal esophageal reflux disease (GERD) and its clinical characteristics. Methods We analyzed the Reflux Disease Questionnaire (RDQ) and other related data from GI out-patient department,People's hospital,Peking University during March 2004 to May 2004,with follow-up call made in May of 2011. Results 1045 (99. 3% ) out of 1052 RDQ questionnaires were available. GERD, noted in 16. 3% patients, was not seasonal. The mean course of disease took for 6. 45 years. Old age [odds ratio (OR) =1.02;95% confidence interval (CI) =1.01~1.04] .physical work (OR = 1.79,95% CI:1. 13 ~ 2.86) and drinking (OR =2.63,95% CI:1. 17 ~5.92) increased the risk of GERD. Gender, smoking, body mass index,as well as blood type were not associated with GERD. Among

  9. Clinical features, comorbidity, and cognitive impairment in elderly bipolar patients

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    Rise IV

    2016-05-01

    Full Text Available Ida Vikan Rise,1 Josep Maria Haro,2–4 Bjørn Gjervan,5,61Department of Psychiatry, Sorlandet Hospital, Arendal, Norway; 2Research Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; 3Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain; 4CIBERSAM (Centro de Investigación Biomédica En Red de Salud Mental, Madrid, Spain; 5Department of Psychiatry, North-Trondelag Hospital Trust, Levanger, Norway; 6Department of Medicine, Institute of Neuromedicine, Norwegian University of Science and Technology, Trondheim, NorwayIntroduction: Data specific to late-life bipolar disorder (BD are limited. Current research is sparse and present guidelines are not adapted to this group of patients.Objectives: We present a literature review on clinical characteristics, comorbidities, and cognitive impairment in patients with late-life BD. This review discusses common comorbidities that affect BD elders and how aging might affect cognition and treatment.Methods: Eligible studies were identified in MedLine by the Medical Subject Headings terms “bipolar disorder” and “aged”. We only included original research reports published in English between 2012 and 2015.Results: From 414 articles extracted, 16 studies were included in the review. Cardiovascular and respiratory conditions, type II diabetes, and endocrinological abnormalities were observed as highly prevalent. BD is associated with a high suicide risk. Bipolar elderly had an increased risk of dementia and performed worse on cognitive screening tests compared to age-matched controls across different levels of cognition. Despite high rates of medical comorbidity among bipolar elderly, a systematic under-recognition and undertreatment of cardiovascular disease have been suggested.Conclusion: There was a high burden of physical comorbidities and cognitive impairment in late-life BD. Bipolar elderly might be under-recorded and undertreated in primary medical care, indicating that

  10. Clinical and epidemiological features of patients with clonorchiasis

    Institute of Scientific and Technical Information of China (English)

    Ke-Xia Wang; Rong-Bo Zhang; Yu-Bao Cui; Ye Tian; Ru Cai; Chao-Pin Li

    2004-01-01

    AIM: To study the clinical and epidemiological features of patients with clonorchiasis so as to provide scientific evidences for the diagnosis and prevention of clonorchiasis.METHODS: Stools from 282 subjects suspected of having clonorchiasis were examined for helminth eggs with modified Kato's thick smear and sedimentation methods, and their Sera Were tested for HAV-DNA, HBV-DNA, HCV-RNA, HDV-RNA and HEV-RNA with polymerase chain reaction (PCR).Clinical symptoms of patients with clonorchiasis only were analyzed, and their blood samples were tested for cireulating antigen (CAg) with Dot-ELISA, esoinophilic granulocyte count,and alanine aminotransferase (ALT). Meanwhile, they were asked to provide data of occupation, eating habit, hygienic habit and knowledge of clonorchiasis. In addition, the ecosystem of the environment in epidemic areas was surveyed.RESULTS: Among the 282 patients, 61 (21.43%) were infected with clonorchis sinensis only, 97 (34.64%) were co-infected with clonorchis sinensis and other pathogens,92 (32.86%) were infected with hepatitis virus only and 31 (11.07%) neither with clonorchis sinensis nor hepatitis virus.Among the 61 patients with clonorchiasis only, there were 14 (22.95%) subjects with discomfort over hepatic region or epigasfrium, 12 (19.67%) with general malaise or discomfort and inertia in total body, 6 (9.84%) with anorexia, indigestion and nausea, 4 (6.56%) with fever, dizziness and headache (6.56%), and 25 (40.98%) without any symptoms; sixty one (100%) with CAg (+), 98.33% (59/60) with eosinophilic granulocytes increased and 65.00% (39/60) with ALT increased. B-mode ultrasonography revealed 61 cases with dilated and thickened walls of intrahepatic bile duct, and blurred patchy echo acoustic image in liver. Twenty-six cases had stones in the bile duct, 39 cases had slightly enlarged liver with diffuse coarse spots in liver parenchyma. Twenty cases had enlarged gallbladder with thickened coarse wall and image of floating plagues, 9

  11. Clinical features of progressive supranuclear palsy in 105 Chinese patients

    Institute of Scientific and Technical Information of China (English)

    Jing Hou; Ruibiao Guo; Tong Chen; Xiaohong Zhang; Weiping Wu; Zhenfu Wang

    2011-01-01

    OBJECTIVE: To thoroughly investigate clinical characteristics of progressive supranuclear palsy (PSP) in a Chinese population.METHODS: Computer-based online searches through China National Knowledge Infrastructure and Weipu Periodical Database were performed to collect case reports of PSP published between 1980 and 2009. Clinical characteristics were analyzed.RESULTS: A total of 58 studies comprising 105 patients (76 males and 29 females) were included. All cases were sporadic and free of family history. The mean age at onset was 60.6 ± 9.1 years, and the mean course from onset of symptoms to diagnosis was 3.4 ± 2.4 years. The male-to-female ratio was approximately 3: 1. Onset was characterized by akinetic-rigid features and accounted for 34.3% of all cases, followed by early postural instability (25.5%), pseudobulbar palsy (9.8%), cognitive impairment (9.8%), and vertical supranuclear ophthalmoplegia (7.8%). With disease progression, vertical supranuclear ophthalmoplegia was reported in 95.1% of cases, followed by akinetic-rigid features (83.3%), pseudobulbar palsy (82.4%), axial dystonia (75.5%), cognitive impairment (72.5%), and early postural instability (69.6%). A total of 70.5% of patients exhibited abnormal electroencephalograms, and 21.4% exhibited mild abnormalities in cerebrospinal fluid. Brain CT scanning results of 37 patients showed 37.8% with midbrain and concurrent cerebral hemisphere atrophy, and 5.4% and 24.3% with midbrain and cerebral hemisphere atrophy, respectively. Brain MRI scanning results of 55 patients revealed a total of 16.4% patients with midbrain atrophy, 23.6% with midbrain and concurrent cerebral hemisphere atrophy, 32.7% with cerebral hemisphere atrophy, and 11% with brainstem atrophy. The percentage of midbrain atrophy revealed by MRI was greater than by CT. All 11 patients subjected to Mini-Mental State Examination scored < 23. A total of 10 patients underwent brain electrophysiological examination, and 80% presented with

  12. Clinical and Treatment Features of Orbital Neurogenic Tumors

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    Pınar Bingöl Kızıltunç

    2013-10-01

    Full Text Available Purpose: To evaluate the clinical and treatment features of orbital neurogenic tumors. Material and Method: The records of 35 patients with orbital neurogenic tumors who were diagnosed and treated at Ankara University Faculty of Medicine, Department of Ophthalmology, between 1998 and 2011 were evaluated retrospectively. Results: Orbitotomy via a cutaneous approach was performed in 21 (60% cases and orbitotomy via a transconjunctival approach was performed in 7 (20% cases. Three (8% cases had been operated at different centers. Four (12% cases were diagnosed clinically. Total excisional biopsy was performed in 11 (31.4% cases, subtotal excisional biopsy was performed in 7 (20%, and incisional biopsy was performed in 10 (28.6% cases. 14 (40% 35 cases were diagnosed as meningioma, 12 (34% as peripheral nerve sheath tumor, and 9 (26% cases were diagnosed as optic nerve glioma. Six (43% meningioma cases were optic nerve sheath meningioma, 5 (36% were sphenoid wing meningioma, 2 (14% were ectopic meningioma, and 1 (7% was perisellar meningioma. Six (50% of peripheral nerve sheath tumors were schwannoma, 2 (16% were solitary neurofibroma, 4 (34% were plexiform neurofibroma. External beam radiotherapy was performed in 15 (42.8% cases, cyberknife radiosurgery in 1 (2.8% , chemotherapy in 1 (2.8%, and enucleation ( because of neovascular glaucoma and vitreous hemorrhage was performed in 1 (2.8% case. Discussion: The most common orbital neurogenic tumors are meningioma, peripheral nerve sheath tumor, and optic nerve glioma. For meningioma and glioma, external beam radiotherapy is required; for schwannoma and solitary neurofibroma, total excisional biopsy is the preferred treatment. The success of visual and anatomic results are high after treatment. (Turk J Ophthalmol 2013; 43: 335-9

  13. Clinical features and management of Crohn's disease in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    郑家驹; 史晓华; 褚行琦; 贾黎明; 王风鸣

    2004-01-01

    Background An increasing incidence of Crohn' s disease has been found in China in recent years.Our study has been focused on evaluating the diversity of the clinical manifestations of Crohn' s disease in order to improve early diagnostic accuracy and therapeutic efficacy.Methods Thirty patients with active Crohn's disease were enrolled and their clinical data, including diagnostic and therapeutic results, were analyzed. Endoscopy combined with histological examination of biopsy specimens provided characteristic features of the disease. Transabdominal bowel sonography (TABS) was used for detecting intestinal complications. Nutritional supportive therapy was given to 20 subjects with active cases of the disease.Results Most patients were young adults with a higher proportion of females to males (ratio: 1.14:1). The disease affects any segment or a combination of segments along with the alimentary tract(from the mouth to the anus). In this study, the colon and small bowel were the major sites involved.Recurrent episodes of abdominal pain in the right lower quadrant and watery diarrhea were the most common symptoms. Granulomas were identifiable in nearly one-third (30.8%) of all biopsy specimens. In moderate cases of the disease, remission was achieved more quickly through the use of oral prednisone therapy than with SASP or 5-ASA. Beneficial effects on the host' s nutritional status were observed. Immunosuppressives were used on an individual basis and showed variable therapeutic effects. Sixteen patients had surgery due to intestinal obstruction or failure to respond to drug therapies. Rapid improvement after surgery was reported. Conclusion Endoscopy (with biopsy) and TABS were both crucial procedures for diagnosis. SASP(or 5-ASA) and prednisone were effective as inductive therapies. Azathioprine has demonstrable benefits after induction therapy with prednisone. Surgery, as an alternative treatment, provided another effective choice in selected patients.

  14. Clinical Features and Echocardiographic Findings in Children with Hypertrophic Cardiomyopathy

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    Cristina Blesneac

    2013-12-01

    Full Text Available Background: Hypertrophic cardiomyopathy, one of the most common inherited cardiomyopathies, is a heterogeneous disease resulting from sarcomeric protein mutations, with an incidence in the adult population of 1:500. Current information on the epidemiology and outcomes of this disease in children is limited. Methods: Thirty-four children diagnosed with hypertrophic cardiomyopathy in the Pediatric Cardiology Department from Tîrgu Mureș were evaluated concerning familial and personal history, clinical, paraclinical and therapeutic aspects. Hypertrophic cardiomyopathy was defined by the presence of a hypertrophied, non-dilated ventricle, in the absence of a cardiac or systemic disease that could produce ventricular hypertrophy. Results: The youngest diagnosed child was a neonate, a total of 10 patients being diagnosed until 1 year of age. In 6 cases a positive familial history was found. Noonan syndrome was found in 2 cases. Only 21 patients were symptomatic, the predominant symptoms being shortness of breath on exertion with exercise limitations. Left ventricular outflow tract obstruction was present in 21 cases (61.7%. Twenty-four patients were on β-blocking therapy, while 4 patients underwent septal myectomy. Conclusions: Hypertrophic cardiomyopathy is a heterogeneous disorder in terms of evolution, age of onset, type and extent of hypertrophy, and the risk of sudden death. It can affect children of any age. There is a need for a complex evaluation, including familial and personal anamnesis, clinical examination, electrocardiogram and echocardiography of all patients. It is highly important to develop screening strategies, including genetic testing, for an early diagnosis, especially in asymptomatic patients with a positive familial background

  15. Clinical, epidemiologic, histopathologic and molecular features of an unexplained dermopathy.

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    Michele L Pearson

    Full Text Available BACKGROUND: Morgellons is a poorly characterized constellation of symptoms, with the primary manifestations involving the skin. We conducted an investigation of this unexplained dermopathy to characterize the clinical and epidemiologic features and explore potential etiologies. METHODS: A descriptive study was conducted among persons at least 13 years of age and enrolled in Kaiser Permanente Northern California (KPNC during 2006-2008. A case was defined as the self-reported emergence of fibers or materials from the skin accompanied by skin lesions and/or disturbing skin sensations. We collected detailed epidemiologic data, performed clinical evaluations and geospatial analyses and analyzed materials collected from participants' skin. RESULTS: We identified 115 case-patients. The prevalence was 3.65 (95% CI = 2.98, 4.40 cases per 100,000 enrollees. There was no clustering of cases within the 13-county KPNC catchment area (p = .113. Case-patients had a median age of 52 years (range: 17-93 and were primarily female (77% and Caucasian (77%. Multi-system complaints were common; 70% reported chronic fatigue and 54% rated their overall health as fair or poor with mean Physical Component Scores and Mental Component Scores of 36.63 (SD = 12.9 and 35.45 (SD = 12.89, respectively. Cognitive deficits were detected in 59% of case-patients and 63% had evidence of clinically significant somatic complaints; 50% had drugs detected in hair samples and 78% reported exposure to solvents. Solar elastosis was the most common histopathologic abnormality (51% of biopsies; skin lesions were most consistent with arthropod bites or chronic excoriations. No parasites or mycobacteria were detected. Most materials collected from participants' skin were composed of cellulose, likely of cotton origin. CONCLUSIONS: This unexplained dermopathy was rare among this population of Northern California residents, but associated with significantly reduced health

  16. Epilepsy in hypothalamic hamartoma: clinical and EEG features.

    Science.gov (United States)

    Harvey, A Simon; Freeman, Jeremy L

    2007-06-01

    Hypothalamic hamartoma (HH) is a congenital malformation of the hypothalamus that may be asymptomatic or manifest with precocious puberty or seizures. Gelastic seizures often begin early in life, even in the newborn period, being manifest by frequent attacks of inappropriate laughter resulting from seizure activity in the HH. The scalp electroencephalogram (EEG) is often normal in children with gelastic seizures, such that the diagnosis of epilepsy and the finding of a HH are often delayed. In a proportion of children with HH, there is an epileptic progression, in which complex partial seizures with frontal, temporal, and lateralized clinical features appear, usually with the appearance of focal slowing and epileptiform activity on the interictal EEG. Further progression may ensue with the appearance of tonic or atonic drop attacks, generalized tonic-clonic seizures, and epileptic spasms; rarely, infantile spasms may be the presenting seizure type. With the appearance of generalized seizures, the interictal EEG shows bilaterally synchronous and generalized epileptiform activity, often in abundance. The mechanism of this evolution is incompletely understood but neocortical seizure propagation and secondary epileptogenesis are believed to be important. Paralleling the development of the focal and generalized electroclinical manifestations in children with HH is usually slowing of development and the appearance of behavioral problems. Fortunately, many of these neurologic manifestations can be arrested, or reversed, with effective surgical treatment directed at the HH. PMID:17544948

  17. Brain metastases from esophageal cancers. Clinical features and treatment results

    International Nuclear Information System (INIS)

    Metastatic brain tumors from esophageal cancer are relatively rare. We analyzed the clinical features and results of treatment in 14 cases of brain metastases from esophageal carcinoma. The average time to diagnosis of brain metastases in the 11 patients with metachronous lesions was 13 months. The average age of patients at the diagnosis of brain metastasis was 65 years. Most patients had T4 or N1 disease at the time of diagnosis of esophageal cancer. Performance status of grade 3 was most frequent at the time of diagnosis of brain metastasis. Treatment for brain metastases was surgery followed by radiation in five cases, radiotherapy alone in seven cases, and conservative treatment in two cases. The median survival time of all patients from the treatment of brain metastases was 2 months, with only one patient alive after more than one year. Improvement in neurological symptoms was demonstrated in 42% of cases. These extremely poor treatment results reflect the fact that most patients at the time of diagnosis of brain metastasis had poor performance status and the presence of extracerebral metastases. Therefore, a short-course, high-dose-per-fraction treatment for brain metastases from esophageal cancer should be selected from the viewpoint of quality of life. (author)

  18. Clinical features and MRI characteristics in patients with cardiac amyloidosis

    International Nuclear Information System (INIS)

    Objective: To observe the clinical features and cardiac magnetic resonance (CMR) imaging characteristics in patients with cardiac amyloidosis. Methods: A total of 5 patients (4 males and 1 female) with the diagnosis of cardiac amyloidosis (3 were proven by heart transplantation, 2 by endomyocardial biopsy) were evaluated by electrocardiogram, echocardiogram, chest X-ray and CMR with delayed Gadolinium enhancement. Results: Echocardiograms were abnormal in all five patients; chest X- ray showed pulmonary hemorrhage (3), cardiomegaly (5), pleural effusion (3); echocardiogram showed atrial enlargement, left ventricular wall thickening, limited ventricular wall motion, etc. CMR exhibited increased thickness of the left ventricular wall, mild to moderate depression of systolic function (mean ejection fraction: 32.5%±15.0%) and bilateral atrial enlargement with restriction of diastolic ventricular filling. In all patients, there were widespread enhancement of the thickened myocardium on delayed post- contrast studies. In 4 patients, global subendocardial delayed gadolinium enhancement was found, in papillary muscles, and interventricular septa with 'zebra-like' sign in 3 patients. Left ventricular transmural delayed gadolinium enhancement was found in 1 patient. Conclusions: CMR shows a characteristic pattern of global subendocardial delayed gadolinium enhancement in cardiac amyloidosis. The findings may be valuable in the diagnosis of cardiac amyloidosis. (authors)

  19. Mucocele and fibroma: treatment and clinical features for differential diagnosis.

    Science.gov (United States)

    Valério, Rodrigo Alexandre; de Queiroz, Alexandra Mussolino; Romualdo, Priscila Coutinho; Brentegani, Luiz Guilherme; de Paula-Silva, Francisco Wanderley Garcia

    2013-01-01

    Mucocele is a benign lesion occurring in the buccal mucosa as a result of the rupture of a salivary gland duct and consequent outpouring of mucin into soft tissue. It is usually caused by a local trauma, although in many cases the etiology is uncertain. Mucocele is more commonly found in children and young adults, and the most frequent site is the lower inner portion of the lips. Fibroma, on the other hand, is a benign tumor of fibrous connective tissue that can be considered a reactionary connective tissue hyperplasia in response to trauma and irritation. They usually present hard consistency, are nodular and asymptomatic, with a similar color to the mucosa, sessile base, smooth surface, located in the buccal mucosa along the line of occlusion, tongue and lip mucosa. Conventional treatment for both lesions is conservative surgical excision. Recurrence rate is low for fibroma and high for oral mucoceles. This report presents a series of cases of mucocele and fibroma treated by surgical excision or enucleation and the respective follow-up routine in the dental clinic and discusses the features to be considered in order to distinguish these lesions from each other. PMID:24474300

  20. Clinical and epidemiological features of the genus Malassezia in Iran.

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    Elham Zeinali

    2014-10-01

    Full Text Available The genus Malassezia contains an expanding list of lipophilic yeasts involve in the etiology of various superficial fungal infections. Pityriasis versicolor (PV is the most prevalent Malassezia-related infection distributed worldwide. In the present study, clinical and epidemiological features of the genus Malassezia are discussed with special focus on PV in Iran.During June 2012 to April 2013, among 713 confirmed cases of fungal infections, 68 (9.5% were diagnosed as PV by positive direct microscopy results in 20% potassium hydroxide (KOH preparation of skin scrapings. All the specimens were cultured on modified Dixon agar and incubated at 32°C for 10 days. Identification of the isolated yeasts was carried out based on macro- and microscopic morphology, catalase test, utilization of Tweens, polyethoxylated castor oil (EL slant, and hydrolysis of esculin and utilization of Tween-60 (TE slant.Out of 68 skin scrapings, 55 (80.9% yielded yeast colonies on mDixon's agar which were finally identified as M. globosa (36.36%, M. pachydermatis (29.08%, M. furfur (23.65%, M. slooffiae (7.28% and M. obtusa (3.64%.Results of the present study further indicate clinico-epidemiological importance of the genus Malassezia with growing importance of M. pachydermatis as a major species involve in the etiology of pityriasis versicolor. These findings are of major concern in management of Malassezia-related diseases.

  1. Glutaric aciduria type 1: neuroimaging features with clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Mohammad, Shaimaa Abdelsattar; Ahmed, Khaled A. [Ain-Shams University, Department of Radiodiagnosis, Faculty of Medicine, Cairo (Egypt); Abdelkhalek, Heba Salah; Zaki, Osama K. [Ain-Shams University, Medical Genetics Unit, Pediatric Department, Faculty of Medicine, Cairo (Egypt)

    2015-10-15

    Glutaric aciduria type 1 is a rare neurometabolic disease with high morbidity. To describe the MR imaging abnormalities in glutaric aciduria type 1 and to identify any association between the clinical and imaging features. MRI scans of 29 children (mean age: 16.9 months) with confirmed diagnosis of glutaric aciduria type 1 were retrospectively reviewed. Gray matter and white matter scores were calculated based on a previously published pattern-recognition approach of assessing leukoencephalopathies. Hippocampal formation and opercular topography were assessed in relation to the known embryological basis. MRI scores were correlated with morbidity score. The most consistent MRI abnormality was widened operculum with dilatation of the subarachnoid spaces surrounding underdeveloped frontotemporal lobes. Incomplete hippocampal inversion was also seen. The globus pallidus was the most frequently involved gray matter structure (86%). In addition to the central tegmental tract, white matter abnormalities preferentially involved the central and periventricular regions. The morbidity score correlated with the gray matter abnormality score (P = 0.004). Patients with dystonia had higher gray matter and morbidity scores. Morbidity is significantly correlated with abnormality of gray matter, rather than white matter, whether secondary to acute encephalopathic crisis or insidious onset disease. (orig.)

  2. Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features

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    Daher Elizabeth De Francesco

    2003-01-01

    Full Text Available Hyperamylasemia has been reported in more than 65% of patients with severe leptospirosis, and the true diagnosis of acute pancreatitis is complicated by the fact that renal failure can increase serum amylase levels. Based on these data we retrospectively analyzed the clinical and histopathological features of pancreas involvement in 13 cases of fatal human leptospirosis. The most common signs and symptoms presented at admission were fever, chills, vomiting, myalgia, dehydratation, abdominal pain and diarrhea. Trombocytopenia was evident in 11 patients. Mild increased of AST and ALT levels was seen in 9 patients. Hyperamylasemia was recorded in every patient in whom it was measured, with values above 180 IU/L (3 cases. All patients presented acute renal failure and five have been submitted to dialytic treatment. The main cause of death was acute respiratory failure due to pulmonary hemorrhage. Pancreas fragments were collected for histological study and fat necrosis was the criterion used to classify acute pancreatitis. Histological pancreatic findings were edema, mild inflammatory infiltrate of lymphocytes, hemorrhage, congestion, fat necrosis and calcification. All the patients infected with severe form of leptospirosis who develop abdominal pain should raise the suspect of pancreatic involvement.

  3. Review of clinical and laboratory features of human Brucellosis

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    Mantur B

    2007-01-01

    Full Text Available Infection with Brucella spp. continues to pose a human health risk globally despite strides in eradicating the disease from domestic animals. Brucellosis has been an emerging disease since the discovery of Brucella melitensis by Sir David Bruce in 1887. Although many countries have eradicated B. abortus from cattle, in some areas B. melitensis and B. suis have emerged as causes of this infection in cattle, leading to human infections. Currently B. melitensis remains the principal cause of human brucellosis worldwide including India. The recent isolation of distinct strains of Brucella from marine mammals as well as humans is an indicator of an emerging zoonotic disease. Brucellosis in endemic and non-endemic regions remains a diagnostic puzzle due to misleading non-specific manifestations and increasing unusual presentations. Fewer than 10% of human cases of brucellosis may be clinically recognized and treated or reported. Routine serological surveillance is not practiced even in Brucella - endemic countries and we suggest that this should be a part of laboratory testing coupled with a high index of clinical suspicion to improve the level of case detection. The screening of family members of index cases of acute brucellosis in an endemic area should be undertaken to pick up additional unrecognised cases. Rapid and reliable, sensitive and specific, easy to perform and automated detection systems for Brucella spp. are urgently needed to allow early diagnosis and adequate antibiotic therapy in time to decrease morbidity / mortality. The history of travel to endemic countries along with exposure to animals and exotic foods are usually critical to making the clinical diagnosis. Laboratory testing is indispensable for diagnosis. Therefore alertness of clinician and close collaboration with microbiologist are essential even in endemic areas to correctly diagnose and treat this protean human infection. Existing treatment options, largely based on

  4. Features of risk-management in innovative activity: regional aspect

    OpenAIRE

    Darmilova Zhenni, D.; Kolesnikov Yuriy, S.

    2015-01-01

    The main problems of risk management in modern conditions, especially in risk management innovation, tools, exposure to risks, directions of state support in the management of risk in a public- private partnership are considered in the paper.

  5. Healthcare-associated Pneumonia: Clinical Features and Retrospective Analysis Over 10 Years

    Institute of Scientific and Technical Information of China (English)

    Fei Qi; Guo-Xin Zhang; Dan-Yang She; Zhi-Xin Liang; Ren-Tao Wang; Zhen Yang; Liang-An Chen

    2015-01-01

    Background:Healthcare-associated pneumonia (HCAP) is associated with drug-resistant pathogens and high mortality,and there is no clear evidence that this is due to inappropriate antibiotic therapy.This study was to elucidate the clinical features,pathogens,therapy,and outcomes of HCAP,and to clarify the risk factors for drug-resistant pathogens and prognosis.Methods:Retrospective observational study among hospitalized patients with HCAP over 10 years.The primary outcome was 30-day all-cause hospital mortality after admission.Demographics (age,gender,clinical features,and comorbidities),dates of admission,discharge and/or death,hospitalization costs,microbiological results,chest imaging studies,and CURB-65 were analyzed.Antibiotics,admission to Intensive Care Unit (ICU),mechanical ventilation,and pneumonia prognosis were recorded.Patients were dichotomized based on CURB-65 (low-vs.high-risk).Results:Among 612 patients (mean age of 70.7 years),88.4% had at least one comorbidity.Commonly detected pathogens were Acinetobacter baumannii,Pseudomonas aeruginosa,and coagulase-negative staphylococci.Initial monotherapy with β-lactam antibiotics was the most common initial therapy (50%).Mean age,length of stay,hospitalization expenses,ICU admission,mechanical ventilation use,malignancies,and detection rate for P.aeruginosa,and Staphylococcus aureus were higher in the high-risk group compared with the low-risk group.CURB-65 ≥3,malignancies,and mechanical ventilation were associated with an increased mortality.Logistic regression analysis showed that cerebrovascular diseases and being bedridden were independent risk factors for HCAR.Conclusion:Initial treatment of HCAP with broad-spectrum antibiotics could be an appropriate approach.CURB-65 ≥3,malignancies,and mechanical ventilation may result in an increased mortality.

  6. Clinical features of tuberous sclerosis complex in children with epilepsy

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    Dong LI

    2014-12-01

    Full Text Available Objective To explore the clinical features of tuberous sclerosis complex (TSC in children with epilepsy.  Methods The clinical data of 36 TSC children complicated with epilepsy were analyzed retrospectively.  Results All children had epilepsy as first symptom: 23 cases of seizures happened on age less than one year old (63.89%, 8 cases on age 1-3 years old (22.22%, and 5 cases on age more than 3 years old (13.89% . Main attack types were as follows: 12 cases with focal seizures (33.33% , 5 cases with generalized seizures (13.89% , 7 cases with spasms (19.44% and 12 cases (33.33% with mixed seizures. Mental retardation was found in 19 cases (67.86%. Among 30 cases who received brain MRI examination, all had subependymal nodules, 26 cases (86.67% were complicated with cortical and subcortical nodules, 2 cases (6.67% with subependymal giant cell astrocytoma (SEGA, one case (3.33% with pachygyria. EEG examination showed interictal epileptiform discharges in 34 cases (94.44% , including multifocal discharges in 12 patients (35.29% , generalized discharges in 8 patients (23.53% , focal discharges and hypsarrhythmia in 7 patients (20.59% respectively. Seizures were monitored in 8 patients, and the types included spasms in 4 cases, focal seizures in 3 cases, and myoclonic seizures in one case. Seventeen cases (47.22% took one single antiepileptic drug, 12 cases (33.33% took two drugs, and 7 cases (19.44% took three drugs, while one of them underwent surgical treatment. After 0.50-10 year follow-up, seizures free happened in 7 cases (19.44%, improved in 16 cases (44.44%, and invalid in 13 cases (36.11%.  Conclusions Epilepsy is the most common nervous system performance in children TSC, and most seizures begin to happen in infants. The main types of onset are partial seizures and spasms. Most of the patients get improved with antiepileptic drugs. doi: 10.3969/j.issn.1672-6731.2014.12.011

  7. Clinical and immunological features of retinal vasculitis in systemic diseases

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    Paović Jelena

    2009-01-01

    Full Text Available Background/Aim. Vasculitis is a clinical, pathologic process characterized by inflammation and necrosis of blood vessel occurring anywhere in the body. The aim of the study was to present some clinical and immunologic features of retinal vasculitis in systemic diseases: systemic lupus erythematosus, multiple sclerosis, sarcoidosis, Behcet's diseases, and others. Methods. A total of 1 254 patients with uveitis were included in the study. The immunochemical diagnostic methods were used to determine the pathogenesis of ocular manifestations. Ocular manifestations were examined using biomicroscope, direct or indirect ophtalmoscopy. Results. Primary retinal vasculitis was diagnosed in 85/1254 (6.8% of total uveitis. In more than half of the cases of vasculitis (58.8%, both arteries and veins were involved in inflammatory process. Periphlebitis was diagnosed far more commonly (36.5% than periarteritis (4.7%. Retinal vasculitis associated with systemic lupus erythematosus was characterized by microinfarctions and the consequent foci of inflammatory cells or diseases of large arteries manifesting in vasospasm and occlusions. Cotton wool spots occurred in 38.3% and retinal hemorrhages in 34% of the cases. In this study periphlebitis of the retina was one of the less frequent ocular manifestations of multiple sclerosis. Comparing with the other changes of the retinal blood vessels, venous sheating occurred in 25.1% and occlusion and vein trombosis in 43.75% of the cases. Retinal vasculitis associated with chronic sarcoidosis occured in 37.5% of patients with sarcoidosis. The most frequent manifestation of ocular sarcoidosis was intermediary uveitis (43.75%. Anterior granulomatous uveitis occured in 37.5% of patients with sarcoidoses. Immune complexes occurred in 13/20 (65% of the patients. Antiretinal anti-S antibody in the serum occurred in 73% of the patients with retinal detachment as a complication of primary disease and in 25% those with vasculitis

  8. Clinical features and related factors to anxiety disorders in adolescents

    Institute of Scientific and Technical Information of China (English)

    杨帆

    2013-01-01

    Objective To explore the social and psychological risk factors to anxiety disorders in adolescents,and to screen protective factors and risk factors and establish the prediction model.Methods The Screen for Child Anxiety

  9. Clinical and neuroradiological features of syringomyelia associated with Chiari malformation

    International Nuclear Information System (INIS)

    The clinical presentation and radiological features were analyzed in 30 cases of syringomyelia associated with Chiari malformation. None of the patients had spinal dysraphism. The age on admission ranged from 6 to 59 years with a mean of 27 years. Syringomyelia was diagnosed by CT myelography and or MRI from 1982 to 1988. The initial symptoms were skeletal abnormality (43%) such as scolisis (12 cases) or pescavus (one case), unilateral pain or numbness (40%) and unilateral motor weakness (17%). Frequently seen signs on admission were sensory deficit (100%), scoliosis (57%), muscle weakness (57%), muscle atrophy (37%) and lower cranial nerve palsy (40%). The neurological findings were asymmetrical in all patients. The characteristic neurological findings in the cases presenting under 20 years of age were unilateral sensory and motor deficits (61%) with decreased or absent deep tendon reflex on the same side. The localization of the syrinx in axial section varied according to the level even in the same case. In 15 cases with unilateral sensory disturbance or unilateral sensory and motor deficit, the syrinx was located in the region corresponding to the posterolateral portion on the same side as that of sensory disturbance in the cervical or thoracic level. On the other hand, in 15 cases with bilateral sensory and motor deficit, the syrinx was located in the central portion and extended into the posterolateral portion of the more affected side. The authors think that the syrinx which originates from the unilateral posterolateral portion, extends to involve the gray matter around the central canal and the posterolateral portion of the other side with progression of the syrinx to cause bilateral disturbance. As a result, unilateral neurological symptoms also become bilateral with progression of the syrinx. (author)

  10. Clinical and neuroradiological features of syringomyelia associated with Chiari malformation

    Energy Technology Data Exchange (ETDEWEB)

    Isu, Toyohiko; Iwasaki, Yoshinobu; Akino, Minoru; Abe, Hiroshi; Tashiro, Kunio; Sudo, Kazumasa; Miyasaka, Kazuo (Hokkaido Univ., Sapporo (Japan). School of Medicine); Saito, Hisatoshi

    1990-01-01

    The clinical presentation and radiological features were analyzed in 30 cases of syringomyelia associated with Chiari malformation. None of the patients had spinal dysraphism. The age on admission ranged from 6 to 59 years with a mean of 27 years. Syringomyelia was diagnosed by CT myelography and or MRI from 1982 to 1988. The initial symptoms were skeletal abnormality (43%) such as scolisis (12 cases) or pescavus (one case), unilateral pain or numbness (40%) and unilateral motor weakness (17%). Frequently seen signs on admission were sensory deficit (100%), scoliosis (57%), muscle weakness (57%), muscle atrophy (37%) and lower cranial nerve palsy (40%). The neurological findings were asymmetrical in all patients. The characteristic neurological findings in the cases presenting under 20 years of age were unilateral sensory and motor deficits (61%) with decreased or absent deep tendon reflex on the same side. The localization of the syrinx in axial section varied according to the level even in the same case. In 15 cases with unilateral sensory disturbance or unilateral sensory and motor deficit, the syrinx was located in the region corresponding to the posterolateral portion on the same side as that of sensory disturbance in the cervical or thoracic level. On the other hand, in 15 cases with bilateral sensory and motor deficit, the syrinx was located in the central portion and extended into the posterolateral portion of the more affected side. The authors think that the syrinx which originates from the unilateral posterolateral portion, extends to involve the gray matter around the central canal and the posterolateral portion of the other side with progression of the syrinx to cause bilateral disturbance. As a result, unilateral neurological symptoms also become bilateral with progression of the syrinx. (author).

  11. Clinical features and MRI findings of blow-out fracture

    International Nuclear Information System (INIS)

    Precise anatomical understanding of orbital blow-out fracture lesions is necessary for the treatment of patients. Retrospectively, MRI findings were compared with the clinical features of pure type blow-out fractures and the efficacy of MRI in influencing a decision for surgical intervention was evaluated. Eighteen child (15 boys, 3 girls) cases were evaluated and compared with adult cases. The patients were classified into three categories (Fig.1) and two types (Fig.2) in accordance with the degree of protrusion of fat tissue. The degree of muscle protrusion also was divided into three categories (Fig. 3). Both muscle and fat tissue were protruding from the fracture site in 14 cases. Fat tissue protrusion alone was found in 3 cases. In contrast, no protrusion was seen in one case. The incarcerated type of fat prolapse was found in 40% of cases, while muscle tissue prolapse was found in 75% of patients. Marginal irregularity or swelling of muscle was observed in 11 patients. There was good correlation of ocular motor disturbance and MRI findings. Disturbance of eyeball movement was observed in all patients with either incarcerated fat tissue or marginal irregularity or swelling of muscle. In contrast, restriction of eyeball movement was rare in cases of no incarceration, even if the fracture was wide. Deformity or marginal irregularity of the ocular muscle demonstrated in MRI may suggest damage an adhesion to the muscle wall. When MRI reveals incarceration or severe prolapse of fat tissue, or deformity and marginal irregularity of the ocular muscle, surgical intervention should be considered. (author)

  12. Pathogenesis, clinical features and pathology of chronic arsenicosis

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    Sengupta Sujit

    2008-01-01

    Full Text Available Arsenicosis is a multisystem disorder, with virtually no system spared from its vicious claw; though its predominant manifestations are linked to cutaneous involvement. Cutaneous effects take the form of pigmentary changes, hyperkeratosis, and skin cancers (Bowen′s disease, squamous cell carcinoma, and basal cell epithelioma. Peripheral vascular disease (blackfoot disease, hypertension, ischemic heart disease, noncirrhotic portal hypertension, hepatomegaly, peripheral neuropathy, respiratory and renal involvement, bad obstetrical outcome, hematological disturbances, and diabetes mellitus are among the other clinical features linked to arsenic toxicity. The effects are mediated principally by the trivalent form of arsenic (arsenite, which by its ability to bind with sulfhydryl groups present in various essential compounds leads to inactivation and derangement of body function. Though the toxicities are mostly linked to the trivalent state, arsenic is consumed mainly in its pentavalent form (arsenate, and reduction of arsenate to arsenite is mediated through glutathione. Body attempts to detoxify the agent via repeated oxidative methylation and reduction reaction, leading to the generation of methylated metabolites, which are excreted in the urine. Understandably the detoxification/bio-inactivation process is not a complete defense against the vicious metalloid, and it can cause chromosomal aberration, impairment of DNA repair process, alteration in the activity of tumor suppressor gene, etc., leading to genotoxicity and carcinogenicity. Arsenic causes apoptosis via free radical generation, and the cutaneous toxicity is linked to its effect on various cytokines (e.g., IL-8, TGF-β, TNF-α, GM-CSF, growth factors, and transcription factors. Increased expression of cytokeratins, keratin-16 (marker for hyperproliferation and keratin-8 and -18 (marker for less differentiated epithelial cells, can be related to the histopathological findings of

  13. Difference of clinical features in childhood Mycoplasma pneumoniae pneumonia

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    Kang Jin-Han

    2010-07-01

    Full Text Available Abstract Background M. pneumoniae pneumonia (MP has been reported in 10-40% of community-acquired pneumonia cases. We aimed to evaluate the difference of clinical features in children with MP, according to their age and chest radiographic patterns. Methods The diagnosis of MP was made by examinations at both admission and discharge and by two serologic tests: the indirect microparticle agglutinin assay (≥1:40 and the cold agglutinins titer (≥1:32. A total of 191 children with MP were grouped by age: ≤2 years of age (29 patients, 3-5 years of age (81 patients, and ≥6 years of age (81 patients. They were also grouped by pneumonia pattern: bronchopneumonia group (96 patients and segmental/lobar pneumonia group (95 patients. Results Eighty-six patients (45% were seroconverters, and the others showed increased antibody titers during hospitalization. Among the three age groups, the oldest children showed the longest duration of fever, highest C-reactive protein (CRP values, and the most severe pneumonia pattern. The patients with segmental/lobar pneumonia were older and had longer fever duration and lower white blood cell (WBC and lymphocyte counts, compared with those with bronchopneumonia. The patient group with the most severe pulmonary lesions had the most prolonged fever, highest CRP, highest rate of seroconverters, and lowest lymphocyte counts. Thrombocytosis was observed in 8% of patients at admission, but in 33% of patients at discharge. Conclusions In MP, older children had more prolonged fever and more severe pulmonary lesions. The severity of pulmonary lesions was associated with the absence of diagnostic IgM antibodies at presentation and lymphocyte count. Short-term paired IgM serologic test may be mandatory for early and definitive diagnosis of MP.

  14. Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance.

    Science.gov (United States)

    Kim, Chong Jai; Romero, Roberto; Chaemsaithong, Piya; Chaiyasit, Noppadol; Yoon, Bo Hyun; Kim, Yeon Mee

    2015-10-01

    Acute inflammatory lesions of the placenta consist of diffuse infiltration of neutrophils at different sites in the organ. These lesions include acute chorioamnionitis, funisitis, and chorionic vasculitis and represent a host response (maternal or fetal) to a chemotactic gradient in the amniotic cavity. While acute chorioamnionitis is evidence of a maternal host response, funisitis and chorionic vasculitis represent fetal inflammatory responses. Intraamniotic infection generally has been considered to be the cause of acute chorioamnionitis and funisitis; however, recent evidence indicates that "sterile" intraamniotic inflammation, which occurs in the absence of demonstrable microorganisms induced by "danger signals," is frequently associated with these lesions. In the context of intraamniotic infection, chemokines (such as interleukin-8 and granulocyte chemotactic protein) establish a gradient that favors the migration of neutrophils from the maternal or fetal circulation into the chorioamniotic membranes or umbilical cord, respectively. Danger signals that are released during the course of cellular stress or cell death can also induce the release of neutrophil chemokines. The prevalence of chorioamnionitis is a function of gestational age at birth, and present in 3-5% of term placentas and in 94% of placentas delivered at 21-24 weeks of gestation. The frequency is higher in patients with spontaneous labor, preterm labor, clinical chorioamnionitis (preterm or term), or ruptured membranes. Funisitis and chorionic vasculitis are the hallmarks of the fetal inflammatory response syndrome, a condition characterized by an elevation in the fetal plasma concentration of interleukin-6, and associated with the impending onset of preterm labor, a higher rate of neonatal morbidity (after adjustment for gestational age), and multiorgan fetal involvement. This syndrome is the counterpart of the systemic inflammatory response syndrome in adults: a risk factor for short- and long

  15. Clinical risk management of interactions between natural products and drugs.

    NARCIS (Netherlands)

    Smet, P.A.G.M. de; Floor-Schreudering, A.; Bouvy, M.L.; Wensing, M.J.P.

    2008-01-01

    Clinical risk management offers a systematic approach to minimize healthcare-related risks by paying attention to: (1) risk identification and assessment; (2) develop notment and execution of risk reduction strategies; (3) evaluation of risk reduction strategies. This paper reviews these key areas f

  16. Clinical Features of Acute Myocardial Infarction in Elderly Patients

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    Shiraki,Teruo

    2011-12-01

    Full Text Available The aim of this study was to clarify the prevalence of coronary risk factors in order to characterize the prognostic factors in elderly patients and to also identify any factors beneficial for the prevention of further cardiac events and death. We studied 888 patients with ST-elevation acute myocardial infarction who were admitted within 48h of symptom onset. The patients were divided into 3 groups according to age for comparison of variables:a younger group (n=99 aged<50, a middle-aged group (n=435>51 years but<70 years and an elderly group (n=354 aged>71 years. The elderly group had higher rates of female gender, pulmonary congestion, in-hospital mortality, and atrial fibrillation and a higher plasma concentration of high-sensitivity CRP (hs-CRP (p<0.05. Hypertension, diabetes mellitus, and dyslipidemia were more common in the middle-aged group (p<0.05. The prevalence of smokers and the plasma level of total cholesterol, LDL-cholesterol and triglycerides were lower in the elderly group (p<0.05. The grade of collateral circulation was highest in the elderly group, but the success rate of reperfusion therapy was lowest. Multiple regression analysis showed that age, pulmonary congestion, CKD and hs-CRP were predictors of in-hospital mortality.This investigation indicated that elderly patients with acute myocardial infarction have different clinical characteristics than younger patients. A specific algorithm might be needed in elderly patients, and could use hs-CRP, eGFR and atrial fibrillation as factors.

  17. Popliteal Cysts in Paediatric Patients: Clinical Characteristics and Imaging Features on Ultrasound and MRI

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    Henning Neubauer

    2011-01-01

    Full Text Available Popliteal cysts, or Baker cysts, are considered rare in children and may exhibit particular features, as compared with adults. We studied data from 80 paediatric patients with 55 Baker cysts, examined over a period of 7 years, and correlated clinical presentation with findings on ultrasonography and MRI. Prevalence of popliteal cysts was 57% in arthritic knees, 58% with hypermobility syndrome, and 28% without risk factors. Only one patient had a trauma history and showed an ipsilateral cyst. Mean cyst volume was 3.4 mL; cysts were larger in boys. Patients with arthritis had echogenic cysts in 53%. Cyst communication with the joint space was seen in 64% on ultrasonography and 86% on MRI. In conclusion, Baker cysts are a common finding in a clinically preselected paediatric population. Children with Baker cysts should be assessed for underlying arthritis and inherited joint hypermobility, while sporadic Baker cysts appear to be common, as well.

  18. Wilson's disease in children: clinical and diagnostic features

    International Nuclear Information System (INIS)

    Objective: To study the clinical and diagnostic laboratory features of Wilsons disease in children and adolescents. Design: A prospective cohort study. Place and Duration of study: The study included patients diagnosed as Wilson s disease at the Department of Pediatrics Allied Hospital, Punjab medical College, Faisalabad from May 1997 to June 2001. Patients and methods: Patients presenting with liver or suggestive neurological disease were investigated. Others were diagnosed as a result of family screening. Diagnosis of neurologic disease was made if two of the following were present: Typical neurological findings, Kayser Fleischer corneal rings and low serum ceruloplasmin (100 mu gm) free serum copper (>10 mu gm/dl). In other forms and for family screening, 24 hours. Urinary copper (> 100 mu gm), free serum copper (>10 mu gm/dl), and wherever possible liver biopsy for histopathology and cytochemical staining by rubeanic acid was also done. Results: Twenty-seven patients with a mean age of 10.2 years were diagnosed as suffering from Wilson disease. Mean age for hepatic and neurological disease was 9 years and 11.5 years respectively. Youngest patient (neurologic) was 6 years old. 48% cases presented with neurological, 41% with hepatic and 4% with skeletal manifestations while 7 % were asymptomatic. Mean duration of symptoms before diagnosis was 6.1 months. Dysarthria (84.6%), tremors (69.2%), rigidity and poor school performance and hand writing (61.5%), dysphagia (46.1%) and dystonia (38.5%), were the most common neurologic findings. Chronic liver disease was seen in 73 % while acute forms were seen in 27 % cases. Two cases presented with fulminant hepatic failure. Consanguineous marriage of the parents was found in 70 % and family history of disease was present in 65 % cases. K-F (Kayser Fleischer) rings and low serum ceruloplasmin(<20 mg/dl) was found in 85% of all patients. In non neurologic types other tests of copper metabolism were done. Elevated urinary

  19. The clinical and genetic features of the COPD asthma overlap syndrome

    Science.gov (United States)

    Hardin, Megan; Cho, Michael; McDonald, Merry-Lynn; Beaty, Terri; Ramsdell, Joe; Bhatt, Surya; van Beek, Edwin J. R.; Make, Barry J.; Crapo, James D.; Silverman, Edwin K.; Hersh, Craig P.

    2014-01-01

    Background Individuals with COPD and asthma are an important but poorly characterized group. The genetic determinants of COPD-asthma overlap have not been studied. Objective Identify clinical features and genetic risk factors for COPD-asthma overlap. Methods Subjects were current or former smoking non-Hispanic whites (NHW) or African-Americans (AA) with COPD. Overlap subjects reported a history of physician-diagnosed asthma before the age of 40. We compared clinical and radiographic features between COPD and overlap subjects. We performed genome-wide association studies (GWAS) in the NHW and AA populations, and combined these results in a meta-analysis. Results More women and African Americans reported a history of asthma. Overlap subjects had more severe and more frequent respiratory exacerbations, less emphysema, and greater airway wall thickness compared to subjects with COPD alone. The NHW GWAS identified SNPs in CSMD1 (rs11779254, P=1.57×10−6) and SOX5(rs59569785, P=1.61×10−6) and the meta-analysis identified SNPs in the gene GPR65 (rs6574978, P=1.18×10−7) associated with COPD-asthma overlap. Conclusions Overlap subjects have more exacerbations, less emphysema and more airway disease for any degree of lung function impairment compared to COPD alone. We identified novel genetic variants associated with this syndrome. COPD-asthma overlap is an important syndrome and may require distinct clinical management. PMID:24876173

  20. Female Breast Cancer: Epidemiological And Clinical Study Of Some Risk Factors Among Egyptian Females- Multi Clinics Study

    OpenAIRE

    E. A. El-Moselhy; M. A. S. Ahmed*; A. M. Abdel-Fattah

    2005-01-01

    This study was conducted on 390 female breast cancer patients and an equal number of females as controls. The patients were attending some University and Teaching Hospitals in Cairo and Assuit. Ninety of them were newly operated. A retrospective, case-control, clinic based study was chosen to carry out this research. The aim of the study was to describe the sociodemographic, characteristics and clinical features of female breast cancer and to determine its risk factors among Egyptian women. A...

  1. Brucellosis in Kosovo and Clinical Features of Brucellosis at University clinical center of Kosovo

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    Emine Qehaja Buçaj

    2015-12-01

    Full Text Available Objective: Brucellosis became a remarkable disease in Kosovo. But there is not a comprehensive epidemiological study about epidemiology and clinical course of this disease from Kosovo. The aim of our study is to present demographic and clinical data of patients with brucellosis at University Clinical Center of Kosovo. Methods: A retrospective study was performed for the patients with brucellosis treated in our clinic during years 2011- 2012. The data about demography, history of the disease, clinical presentations, serological test, serum biochemistry and reatment were collected from hospital medical records. The diagnosis of brucellosis based on clinical and laboratory findings. Results: This descriptive study included 47 patients, who 33 of them (70.2% were males. The mean age was 37.9 ± 19.3 years. The route of transmission of the disease was known in 28 59.5% of them. Direct contact with livestock in 22 (46.8% and ingestion of dairy products in six cases (12.7% were reported as the transmission route. The majority of patients (27 patients, 57.4% were from rural area. The main presenting symptoms were atigue, fever and arthralgia. Osteoarticular manifestations were the common forms of localized disease. Regarding to the therapy, 45 (95.7% of patients were treated with streptomycin and doxycycline for the first three weeks. Conclusion: Human brucellosis is not a common in Kosovo but there is a potential risk. Osteoarticular symptoms were the most common presentation reasons. The most effective and preferred treatment regimen was Streptomycin plus Doxycycline for the first three weeks, and Doxycycline plus Rifampicin thereafter. J Microbiol Infect Dis 2015;5(4: 147-150

  2. Clinical Features of Patients with Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

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    Hai Chen

    2016-01-01

    Conclusion: The different CSF features combined with clinical, magnetic resonance imaging, and serum characteristics between Chinese patients with MS and NMOSD could assist in the differential diagnosis.

  3. 30-Day Mortality in Acute Pulmonary Embolism: Prognostic Value of Clinical Scores and Anamnestic Features

    Science.gov (United States)

    Bach, Andreas Gunter; Taute, Bettina-Maria; Baasai, Nansalmaa; Wienke, Andreas; Meyer, Hans Jonas; Schramm, Dominik; Surov, Alexey

    2016-01-01

    Purpose Identification of high-risk patients with pulmonary embolism is vital. The aim of the present study was to examine clinical scores, their single items, and anamnestic features in their ability to predict 30-day mortality. Materials and Methods A retrospective, single-center study from 06/2005 to 01/2010 was performed. Inclusion criteria were presence of pulmonary embolism, availability of patient records and 30-day follow-up. The following clinical scores were calculated: Acute Physiology and Chronic Health Evaluation II, original and simplified pulmonary embolism severity index, Glasgow Coma Scale, and euroSCORE II. Results In the study group of 365 patients 39 patients (10.7%) died within 30 days due to pulmonary embolism. From all examined scores and parameters the best predictor of 30-day mortality were the Glasgow Coma scale (≤ 10) and parameters of the circulatory system including presence of mechanical ventilation, arterial pH (< 7.335), and systolic blood pressure (< 99 mm Hg). Conclusions Easy to ascertain circulatory parameters have the same or higher prognostic value than the clinical scores that were applied in this study. From all clinical scores studied the Glasgow Coma Scale was the most time- and cost-efficient one. PMID:26866472

  4. Argyrophilic Grain Disease: Demographics, Clinical, and Neuropathological Features From a Large Autopsy Study.

    Science.gov (United States)

    Rodriguez, Roberta Diehl; Suemoto, Claudia Kimie; Molina, Mariana; Nascimento, Camila Fernandes; Leite, Renata Elaine Paraizo; de Lucena Ferretti-Rebustini, Renata Eloah; Farfel, José Marcelo; Heinsen, Helmut; Nitrini, Ricardo; Ueda, Kenji; Pasqualucci, Carlos Augusto; Jacob-Filho, Wilson; Yaffe, Kristine; Grinberg, Lea Tenenholz

    2016-07-01

    Argyrophilic grain disease (AGD) is a frequent late-onset, 4-repeat tauopathy reported in Caucasians with high educational attainment. Little is known about AGD in non-Caucasians or in those with low educational attainment. We describe AGD demographics, clinical, and neuropathological features in a multiethnic cohort of 983 subjects ≥50 years of age from São Paulo, Brazil. Clinical data were collected through semistructured interviews with an informant and included in the Informant Questionnaire on Cognitive Decline in the Elderly, the Clinical Dementia Rating, and the Neuropsychiatric Inventory. Neuropathologic assessment relied on internationally accepted criteria. AGD was frequent (15.2%) and was the only neuropathological diagnosis in 8.9% of all cases (mean, 78.9 ± 9.4 years); it rarely occurred as an isolated neuropathological finding. AGD was associated with older age, lower socioeconomic status (SES), and appetite disorders. This is the first study of demographic, clinical, and neuropathological aspects of AGD in different ethnicities and subjects from all socioeconomic strata. The results suggest that prospective studies of AGD patients include levels of hormones related to appetite control as possible antemortem markers. Moreover, understanding the mechanisms behind higher susceptibility to AGD of low SES subjects may disclose novel environmental risk factors for AGD and other neurodegenerative diseases. PMID:27283329

  5. Clinical features of adult spinal muscular atrophy:46 cases

    Institute of Scientific and Technical Information of China (English)

    Xiaojun He; Ping Zhang; Guanghui Chen

    2006-01-01

    BACKGROUND: Spinal muscular atrophy (SMA) is a kind of degenerative disease of nervous system. There are 4 types in clinic, especially types Ⅰ, Ⅱ and Ⅲ are common, and the researches on those 3 types are relative mature. Type Ⅳ is a kind of adult spinal muscular atrophy (ASMA), which has low incidence rate and is often misdiagnosed as amyotrophic lateral sclerosis, muscular dystrophy, cervical syndrome, or others.OBJECTIVE: To observe the clinical features of 46 ASMA patients and analyze the relationship between course and activity of daily living.DESIGN: Case analysis.SETTING: Departments of Neurology of the 81 Hospital of Chinese PLA, the Second Affiliated Hospital of Nanjing Medical College and General Hospital of Nanjing Military Area Command of Chinese PLA.PARTICIPANTS: A total of 46 ASMA patients were selected from the Departments of Neurology of the 81Hospital of Chinese PLA, the Second Affiliated Hospital of Nanjing Medical College and General Hospital of Nanjing Military Area Command of Chinese PLA between April 1998 and January 2002. All patients were consentient. Among 46 cases, there were 37 males and 9 females with the mean age of 42 years. The patients' courses in all ranged from 6 months to 23 years, concretely, courses of 37 cases were less than or equal to 5 years, and those of 9 cases were more than or equal to 6 years.METHODS : ① All the 46 ASMA patients were asked to check blood sedimentation, anti O, serum creatinine,creatine, blood creatine phosphokinase (CPK) and muscular biopsy as early as possible. ② X-ray was used to measure plain film of cervical vertebra borderline film of cranium and neck at proximal end of upper limb of 25 cases and plain film of abdominal vertebra at proximal end of lower limb of 17 cases.③ Cerebrospinal fluid of lumbar puncture was checked on 42 cases, for routine examination, biochemical examination, and immunoglobulin examination. Electromyogram (EMG) was also examined to 42 cases. ④ Barthel index

  6. ANALYSIS OF INITIAL CLINICAL FEATURES OF PRIMARY IMMUNODEFICIENCIES IN ADULTS

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    I. A. Tuzankina

    2014-01-01

    Full Text Available At present, we are observing eighty-three adult patients with various primary immunodeficiencies (PID of different origin. The aim of our study was to identify the optimal ways for early detection of such disorders. In this work, we present an analysis of initial clinical manifestations of PID in adults. It was revealed that the type of clinical manifestations is quite unique for individual cases. And the patients exhibit quite diverse clinical findings and course of the disorder, even within a single nosological entity. However, infectious syndrome prevailed among others manifestations. Combinations of complex clinical syndromes were not typical to initial PID pattern. We observed polytopic lesions within each single immunopathological syndrome.

  7. Clinical features of severe malaria associated with death: a 13-year observational study in the Gambia.

    Directory of Open Access Journals (Sweden)

    Muminatou Jallow

    Full Text Available BACKGROUND: Severe malaria (SM is a major cause of death in sub-Saharan Africa. Identification of both specific and sensitive clinical features to predict death is needed to improve clinical management. METHODS: A 13-year observational study was conducted from 1997 through 2009 of 2,901 children with SM enrolled at the Royal Victoria Teaching Hospital in The Gambia to identify sensitive and specific predictors of poor outcome in Gambian children with severe malaria between the ages 4 months to 14 years. We have measured the sensitivity and specificity of clinical features that predict death or development of neurological sequelae. FINDINGS: Impaired consciousness (odds ratio {OR} 4.4 [95% confidence interval {CI}, 2.7-7.3], respiratory distress (OR 2.4 [95%CI, 1.7-3.2], hypoglycemia (OR 1.7 [95%CI, 1.2-2.3], jaundice (OR 1.9 [95%CI, 1.2-2.9] and renal failure (OR 11.1 [95%CI, 3.3-36.5] were independently associated with death in children with SM. The clinical features that showed the highest sensitivity and specificity to predict death were respiratory distress (area under the curve 0.63 [95%CI, 0.60-0.65] and impaired consciousness (AUC 0.61[95%CI, 0.59-0.63], which were comparable to the ability of hyperlactatemia (blood lactate>5 mM to predict death (AUC 0.64 [95%CI, 0.55-0.72]. A Blantyre coma score (BCS of 2 or less had a sensitivity of 74% and specificity of 67% to predict death (AUC 0.70 [95% C.I. 0.68-0.72], and sensitivity and specificity of 74% and 69%, respectively to predict development of neurological sequelae (AUC 0.72 [95% CI, 0.67-0.76].The specificity of this BCS threshold to identify children at risk of dying improved in children less than 3 years of age (AUC 0.74, [95% C.I 0.71-0.76]. CONCLUSION: The BCS is a quantitative predictor of death. A BCS of 2 or less is the most sensitive and specific clinical feature to predict death or development of neurological sequelae in children with SM.

  8. Suicide attempts and clinical features of bipolar patients

    OpenAIRE

    Berkol, Tonguç D.; İslam, Serkan; Kırlı, Ebru; Pınarbaşı, Rasim; Özyıldırım, İlker

    2016-01-01

    Objectives: To identify clinical predictors of suicide attempts in patients with bipolar disorder. Methods: This study included bipolar patients who were treated in the Psychiatry Department, Haseki Training and Research Hospital, Istanbul, Turkey, between 2013 and 2014; an informed consent was obtained from the participants. Two hundred and eighteen bipolar patients were assessed by using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition...

  9. Multiple, sclerosis: clinical feature, pathogenesis and current therapeutical approaches

    International Nuclear Information System (INIS)

    Multiple sclerosis (MS) is considered as a T-cell mediated autoimmune disease. Caused by central nervous system demyelination and axonal damage varying clinical signs do occur either with relapsing-remitting or with chronic progressive course. Based on pathogenetic considerations immunomodulative and immunosuppressive therapeutical approaches are used to limit the disease progression. Clinical symptoms, diagnostic criteria, pathogenetical considerations, and consecutive therapeutical interventions are summarized. (orig.)

  10. Vulvovaginitis: clinical features, aetiology, and microbiology of the genital tract

    OpenAIRE

    Jaquiery, A; Stylianopoulos, A; Hogg, G; Grover, S

    1999-01-01

    AIM—To clarify the contribution of clinical and environmental factors and infection to the aetiology of vulvovaginitis in premenarchal girls, and to determine clinical indicators of an infectious cause.
DESIGN—It was necessary first to define normal vaginal flora. Cases were 50 premenarchal girls > 2 years old with symptoms of vulvovaginitis; 50 controls were recruited from girls in the same age group undergoing minor or elective surgery.
RESULTS—Interview questionnaire show...

  11. Clinical features, assessment and treatment of essential tremor.

    OpenAIRE

    Panicker, J N; Pal, P K

    2003-01-01

    Essential tremor is the most common of the movement disorders, being 20 times more common than Parkinson's Disease. It is characterised by postural and kinetic tremor which maximally affects the hands. It can be assessed by physiological techniques, subjective clinical methods, objective clinical methods and handicap/disability scales. Accelerometry, spirography and handwriting assessment, volumetry and handicap/disability questionnaires are commonly used methods. Primidone and propranolol ar...

  12. Identification of risk factors and demographic features of patients with peri partum cardiomyopathy

    International Nuclear Information System (INIS)

    Objective: To describe and identify the demographic features and risk factors for peri partum cardiomyopathy (PPCM). Design: A prospective study: The study was conducted at the department of Adult Cardiology, National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan from December 1999 to August 2001. Subjects and Methods: A total of 35 consecutive patients diagnosed to have peri partum cardiomyopathy (PPCM) on echocardiogram were enrolled. Proforma containing demographic characteristics and established risk factors for PPCM was established and filled carefully. The data gathered was analyzed statistically. Results: The mean age at the time of diagnosis was 30.8-6.74 years. Urdu speaking (Mohajir) population was found to be more affected ethnic group (42.9%) Majority of the patients was from lower socio-economic group with poor nutritional status (77%) and multiparous (77.14%). 25.7% had past history of PPCM and 71.4% presented during postpartum period. Mortality at six months was 22.8% while 42.9% had persistent disease and only 34.3% recovered completely. Conclusion: Advanced age, lower economic group with poor nutritional status, multi parity and past history of peri partum cardiomyopathy were identified as risk factors for the development of PPCM, especially among Mohajir population. There was no statistically significant difference between the clinical features and outcome of patients presented first time or with recurrent PPCM. We identified advanced age (>30 years), high LVEDD, and low ejection fraction (EF) at initial presentation as poor prognostic factors. (author)

  13. Familial deletion of 18p associated with Turner like clinical features

    Energy Technology Data Exchange (ETDEWEB)

    Say, B.; Gopal Rao, V.V.N.; Harris, S. [H.A. Chapman Institute of Medical Genetics, Tulsa, OK (United States)] [and others

    1994-09-01

    The authors report the first occurrence to our knowledge of a familial deletion of the short arm of chromosome 18 in a mother and daughter. The proband is an 18-year-old female referred for chromosomal analysis because of mental retardation and short stature. She is the only offspring. Her birth weight was 3 pounds 10 ounces (below 5th percentile). As a child, she had delayed milestones. Her IQ is 69 and she is in classes for the educable mentally handicapped. Her height is 145.6 cm and weight 38.7 kg (both below 5th percentile). Physical examination revealed a low nuchal hairline. She has myopia. Chromosome analysis from peripheral blood lymphocytes revealed a 46,XX,del(18)(p11.21) karyotype. Since some of the same clinical features are also seen in the mother including short stature (157 cm), mental retardation, ocular problems like cataracts, exotropia and refractive error, chromosome analysis was performed which showed the same 46,XX,del(18)(p11.21) karyotype. A familial case like this has great implications in genetic counseling. Since the syndrome is not associated with sterility, the recurrence risk for the offspring is 50%. Patients with deletion (18p) syndrome are reported to have findings suggestive of Turner syndrome with varying degrees of mental retardation. We recommend that in patients with such clinical features associated with mental retardation, normal menstrual history and/or fertility, the possibility of deletion (18p) syndrome be considered.

  14. Clinical features of adolescents with deliberate self-harm: A case control study in Lisbon, Portugal

    Directory of Open Access Journals (Sweden)

    Diogo F Guerreiro

    2009-11-01

    Full Text Available Diogo F Guerreiro, Ema L Neves, Rita Navarro, Raquel Mendes, Ana Prioste, Diana Ribeiro, Tiago Lila, António Neves, Mónica Salgado, Nazaré Santos, Daniel SampaioYouth Suicide Study Group (NES, The Hospital Santa Maria, Psychiatry Department, Lisbon Faculty of Medicine, PortugalAbstract: Deliberate self-harm (DSH among adolescents is a high-risk condition for suicide. The aim of the present study is to describe the characteristic clinical features of adolescents with DSH according to our local context (Lisbon, Portugal, using easily available information from clinical settings. A case control study was constructed from a sample of 100 adolescents (aged 12 to 21 years. The sample was divided into two groups: adolescents with and without DSH. Case files were examined and data was completed by clinical interviews. Demographic, psychosocial, and psychopathological data were assessed and compared. Ninety-eight subjects completed the protocol. The DSH group was associated with the following: suicidal ideation or suicidal behavior as consultation motive, emergency room referral, previous follow-up attempts, suicidal ideation, psychosocial difficulties, or lack of therapeutic goals. There was a nonsignificant trend towards diagnosis of depression in the DSH group. These results reflect our clinical practice with adolescents and add data about teenagers who self-harm to the literature. Prevention and early recognition of DSH (and frequently associated depression in adolescents are essential and could be life-saving measures. An integrated approach, which takes into account psychosocial difficulties, family dysfunction, and negative expectations, seems to be of great importance.Keywords: deliberate self-harm, suicide, adolescents, suicide risk, case control

  15. CLINICAL AND FUNCTIONAL FEATURES OF PANCREAS STATE IN RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    O. O. Basieva

    2000-01-01

    Full Text Available Aim of study: complex pancreas study in rheumatoid arthritis (RA. Material and methods: 120 RA pts were examined clinically Pancreas US-and biochemical study (level of a-amylase and lipase of blood serum by kinetic-calorimetric method was performed in this grouh. Results: 50.8% of pts demonstrated increase of pancreas echo, in 23.3%- widened Wirsung s duct, in 45%- single small focal indurations, more often in the body and cauda pancreatis. Decrease of lipolitic and amylolytic pancreas activity is characteristic for RA, especially in systemic process and long-term disease. Clinical and functional disturbances are connected with morphological changes.

  16. Epidemiological and clinical features of patients with disseminated sclerosis in Perm region

    Directory of Open Access Journals (Sweden)

    Zhelnin A.V.

    2013-03-01

    Full Text Available The purpose of the article is to identify the epidemiological and clinical features of disseminated sclerosis (DS in Perm region. Material and methods: Data have been analyzed in 932 patients with DS. Among them there were 607 women (65% and 325 men (35%. The age of patients with DS varied from 17 to 68 years, in average 44,5±4,5years. All the patients have experienced comprehensive clinical and neurological study, MRI study of brain and spinal cord. Calculation of prevalence and incidence has been conducted among 100,000 people. Results: The prevalence of DS in Perm region on January 1, 2011 amounted to 35.1 cases perthe population of 100,000 people, which can be attributed to our region to the zone of medium risk of DS developing. The growth of incidence of DS in Perm region has been revealed. It has been determined that in 1997 the incidence of DS averaged 3.2. Risk factors have been identified. Conclusion: The data on the prevalence and incidence of disseminated sclerosis help improve the quality of treatment and preventive care for patients with disseminated sclerosis.

  17. Triploid pregnancies, genetic and clinical features of 158 cases

    DEFF Research Database (Denmark)

    Joergensen, Mette W; Niemann, Isa; Rasmussen, Anders A;

    2014-01-01

    OBJECTIVE: The purpose of this study was to analyze the correlation between the genetic constitution and the phenotype in triploid pregnancies. STUDY DESIGN: One hundred fifty-eight triploid pregnancies were identified in hospitals in Western Denmark from April 1986 to April 2010. Clinical data and...

  18. Primary and secondary syphilis, 20 years' experience. 2. Clinical features.

    OpenAIRE

    Mindel, A; Tovey, S J; Timmins, D J; Williams, P.

    1989-01-01

    The notes of 946 patients with primary and 854 with secondary syphilis were retrospectively reviewed. Of the 184 heterosexual men with primary syphilis, 182 (99%) had chancres affecting the penis, compared with 467 (64%) of the 728 homosexual men (p less than 0.0001). Anorectal chancres occurred in 249 (34%) of homosexual men. The commonest features of secondary syphilis included a rash, lymphadenopathy, and mucous patches of the mouth or genital area. Hepatitis, meningitis, other neurologica...

  19. The clinical and radiological features of Fanconi's anaemia pictorial review

    International Nuclear Information System (INIS)

    Fanconi's anaemia is a severe refractory anaemia, associated with congenital malformations in approximately two-thirds of cases. Although these malformations may involve every organ system, suggestive dysmorphic features include growth retardation, radial ray deformities and urinary malformations. These malformations are not specific for Fanconi's anaemia, but should be recognized during pregnancy, or later in childhood, and suggest the possibility of inherited haematopoiesis disorders. De Kerviler, E. (2000)

  20. Heterotopic ossification: Pathophysiology, clinical features, and the role of radiotherapy for prophylaxis

    International Nuclear Information System (INIS)

    Heterotopic ossification (HO) is a benign condition of abnormal formation of bone in soft tissue. HO is frequently asymptomatic, though when it is more severe it typically manifests as decreased range of motion at a nearby joint. HO has been recognized to occur in three distinct contexts-trauma, neurologic injury, and genetic abnormalities. The etiology of HO is incompletely understood. A posited theory is that HO results from the presence of osteoprogenitor cells pathologically induced by an imbalance in local or systemic factors. Individuals at high risk for HO development frequently undergo prophylaxis to prevent HO formation. The two most commonly employed modalities for prophylaxis are nonsteroidal anti-inflammatory drugs and radiation therapy. This review discusses HO pathophysiology, clinical features, and the role of radiotherapy for prophylaxis

  1. Clinical and demographic features of patients with dementia attended in a tertiary outpatient clinic

    Directory of Open Access Journals (Sweden)

    Vale Francisco A.C.

    2002-01-01

    Full Text Available We describe clinical and socio-demographic features of patients with dementia attended in a tertiary outpatient clinic during a three years period (56.9% of the total attendance. Most of them were men, white, from the local community, urban district. Nobody had a job at the moment, two thirds of them got social welfare benefit. They lived with their family, the caregiver being the spouse or a daughter. The education level was very low, a quarter of them being illiterate. They were referred mostly from the public health care service, by neurologists or psychiatrists due to cognitive disorders. Family history as well as individual history of previous neurological/psychiatric disorders were frequent, especially alcoholism, stroke, head trauma and dementia. The neurological exam showed abnormalities in two thirds of cases, chiefly extra-pyramidal and pyramidal signs. Alzheimer's disease was the most frequent cause, followed by cerebrovascular disorder; alcoholism and normal pressure hydrocephalus were also frequent causes. Most patients presented concomitant non-etiological neurological/psychiatric disorders, mainly alcoholism and depression, and non-neurological/psychiatric diseases, predominantly hypertension, cardiopathy and diabetes. Most patients had been referred under medication, frequently politherapy, including psychotropics.

  2. Cowden Syndrome Presenting as Breast Cancer: Imaging and Clinical Features

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Mirinae [Dept. of Radiology, Graduate School of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Cho, Nariya; Moon, Hyeong Gon [Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Ahn, Hye Shin [Dept. of Radiology, Chung-Ang University Hospital, Seoul (Korea, Republic of)

    2014-10-15

    Cowden syndrome is an uncommon, autosomal dominant disease which is characterized by multiple hamartomas of the skin, mucous membrane, brain, breast, thyroid, and gastrointestinal tract. The diagnosis of Cowden syndrome implicates an increased risk of developing breast cancer. We report a case of a 22-year-old woman with Cowden syndrome that presented as breast cancer with concomitant bilateral exuberant benign masses in both breasts.

  3. Lower back pain: clinical features and examination of patients

    Directory of Open Access Journals (Sweden)

    I.V. Damulin

    2014-05-01

    Full Text Available This article discusses the clinical and paraclinical aspects of pain syndromes of the lumbosacral localization. The past medical history (including the working conditions of the patient and the presence of constant stress, physical and paraclinical examination, and assessment of psychological condition are important for establishing the correct diagnosis. It should be noted that there is no strict parallelism between the presence of back pain and the results of paraclinical examination of the spine. Therefore, the comprehensive assessment of the patient's clinical status, including the state of the musculoskeletal system, has a leading value for correct diagnosis and selection of therapy. Increasing pain when coughing or sneezing is noted in patients with discogenic pain syndromes; the development of pain along the root innervation often occurs simultaneously with the reduction of localized pain in the lumbar region. The diagnostic value of the radiography and neuroimaging data is unquestioned; however, these methods allow one to evaluate mainly the anatomical rather than pathophysiological changes. The direct dependence between the anatomical changes and the clinical situation is not typical of back pain. Magnetic resonance imaging (MRI is when the injury level is unclear and the clinical examination data indicate pathology of the spinal cord or soft tissues. Moreover, MRI data help either to eliminate or confirm a tumor or the inflammatory nature of the pain syndrome. MRI is also an informative method in patients who have undergone surgery for vertebral pathology. Computed tomography is an effective diagnosis method only in those cases where the symptomatology clearly indicates the injury level and the bone changes are the pain cause with a high degree of probability. Electromyography (EMG is very informative in patients with radiculopathies; it allows one to evaluate the pathophysiological changes in such patients. However, there usually is

  4. LEPROSY NEPHROPATHY: A REVIEW OF CLINICAL AND HISTOPATHOLOGICAL FEATURES

    Directory of Open Access Journals (Sweden)

    Geraldo Bezerra da Silva Junior

    2015-02-01

    Full Text Available Leprosy is a chronic disease caused by Mycobacterium leprae, highly incapacitating, and with systemic involvement in some cases. Renal involvement has been reported in all forms of the disease, and it is more frequent in multibacillary forms. The clinical presentation is variable and is determined by the host immunologic system reaction to the bacilli. During the course of the disease there are the so called reactional states, in which the immune system reacts against the bacilli, exacerbating the clinical manifestations. Different renal lesions have been described in leprosy, including acute and chronic glomerulonephritis, interstitial nephritis, secondary amyloidosis and pyelonephritis. The exact mechanism that leads to glomerulonephritis in leprosy is not completely understood. Leprosy treatment includes rifampicin, dapsone and clofazimine. Prednisone and non-steroidal anti-inflammatory drugs may be used to control acute immunological episodes.

  5. Clinical and radiological features of brain neurotoxicity caused by antitumor and immunosuppressant treatments.

    Science.gov (United States)

    Erbetta, Alessandra; Salmaggi, Andrea; Sghirlanzoni, Angelo; Silvani, Antonio; Potepan, Paolo; Botturi, Andrea; Ciceri, Elisa; Bruzzone, Maria Grazia

    2008-06-01

    Antitumor and immunosuppressant treatment-related neurotoxicity can determine nonspecific clinical syndromes. Exclusion of other possible causes, among which tumor progression, appearance of paraneoplastic disease, renal or hepatic failure, diabetes or hypertension, is relevant. We report clinical and neuroradiological features in five patients with neurotoxic syndromes due to chemotherapy/radiotherapy or immunosuppression in the context of neoplastic disease/organ transplantation. Acute neurological syndrome developed in three patients after methotrexate (MTX), cyclosporine A, and L-asparaginase therapy, respectively. MRI showed posterior reversible encephalopathy in two cases and venous thrombosis with intraparenchymal hematoma in the third patient. Late onset clinical syndrome occurred in the last two patients, treated with MTX or radiation therapy for breast cancer metastasis and pituitary adenoma. Neuroimaging showed brain diffuse abnormalities. Patients affected by tumors suffer from increased risk for treatment-related toxicities. Appearance or worsening of neurological signs and symptoms challenge the clinician to discriminate between CNS involvement by the tumor, toxicity of drugs, parane-oplastic disease and infections. MRI has a key role in differential diagnosis. Close interaction between the neurologist, the oncologist and the neuroradiologist leads to the optimal management of patients. PMID:18612759

  6. Hereditary anaemias: genetic basis, clinical features, diagnosis, and treatment*

    OpenAIRE

    1982-01-01

    The hereditary anaemias present a major genetic health problem that contributes considerably to childhood mortality and morbidity in many developing countries. This article summarizes recent scientific and technical advances in knowledge concerning the genes involved and their interaction to produce major haemoglobinopathies, the clinical pictures of these conditions, and their diagnostic criteria. Though there is no definitive cure, supportive treatment for the haemoglobinopathies has improv...

  7. Traumatic optic neuropathy—Clinical features and management issues

    OpenAIRE

    Yu-Wai-Man, Patrick

    2015-01-01

    Traumatic optic neuropathy (TON) is an uncommon cause of visual loss following blunt or penetrating head trauma, but the consequences can be devastating, especially in cases with bilateral optic nerve involvement. Although the majority of patients are young adult males, about 20% of cases occur during childhood. A diagnosis of TON is usually straightforward based on the clinical history and examination findings indicative of an optic neuropathy. However, the assessment can be difficult when t...

  8. Demographics, clinical features and treatment of pediatric celiac disease

    OpenAIRE

    Tapsas, Dimitrios

    2015-01-01

    Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy triggered by ingestion of gluten-containing food in genetically predisposed subjects. The enteropathy is presented with a wide variety of clinical manifestations, which can occur even outside the gastrointestinal tract. In the majority of cases, the diagnosis of CD is based on a small intestinal biopsy showing mucosal alterations, i.e. intraepithelial lymphocytosis, crypt hyperplasia, and villous atrophy. The treatm...

  9. Whipple's disease. Report of five cases with different clinical features

    OpenAIRE

    Ferrari, Maria de Lourdes de Abreu; Vilela, Eduardo Garcia; FARIA Luciana Costa; Claudia Alves COUTO; SALGADO Célio Jefferson; LEITE Virgínia Rios; BRASILEIRO FILHO Geraldo; Bambirra, Eduardo Alves; MENDES Claudia Maria de Castro; CARVALHO Silas de Castro; Oliveira, Celso Affonso; CUNHA Aloísio Sales da

    2001-01-01

    Whipple's disease (WD) is a rare systemic disease of infectious etiology which involves the small intestine but can virtually affect any organ. We present here five cases (four males and one female) ranging in age from 20 to 59 years. All patients had intestinal involvement associated or not with clinical manifestations linked to this organ. Vegetation in the tricuspid valve was observed in one patient, suggesting endocarditis caused by Tropheryma whippelii, with disappearance of the echocard...

  10. Clinical and genetic features of anoctaminopathy in Saudi Arabia

    OpenAIRE

    Bohlega, Saeed; Monies, Dorothy M.; Abulaban, Ahmad A; Murad, Hatem N.; Alhindi, Hindi N.; Meyer, Brian F.

    2015-01-01

    Objectives: Characterization of the phenotypic, pathological, radiological, and genetic findings in 2 Saudi Arabian families with anoctaminopathies, and limb girdle muscular dystrophy type 2L (LGMD2L). Methods: Over a 2-year period from December 2010 to January 2013, the clinical presentations were analyzed and all genes responsible for limb girdle muscular dystrophy (LGMD) were screened in families seen at King Faisal Specialist Hospital and Research Centre, a tertiary care hospital in Riyad...

  11. Evaluation of Clinical Features of Female Patients with Macroprolactinemia

    OpenAIRE

    Göksun Ayvaz; Alev Eroğlu Altınova; Leyla Mollamahmutoğlu; Metin Arslan; Sevim Güllü; Müjde Aktürk

    2011-01-01

    Aim: Macroprolactin is a high-molecular-weight form of prolactin. It has been suggested that macroprolactin has no clinical importance because of its decreased or limited bioactivity. Although screening for macroprolactinemia is recommended especially in patients with idiopathic hyperprolactinemia; recent studies reported that patients with macroprolactinemia may have some hyperprolactinemia symptoms. Currently, the causes of the symptoms as well as the treatment and follow-up of this group o...

  12. Clinical features and computerized tomography in chronic schizophrenia

    International Nuclear Information System (INIS)

    Computed tomography (CT) scans and clinical manifestations were compared in severe (53) and mild (42) schizophrenic patients. Severe patients were defined as having been hospitalized during the previous 3 years or more, and mild patients as having lived at home. Regarding psychiatric symptoms, behavior, dosage of antipsychotic agents, and admission duration or disease duration, there were significant differences between the severe and mild groups. Both Hasegawa's and Moriya's dementia rating scales were significantly lower in the severe group than the mild group. Cranial CT scans were analyzed for the Sylvian fissure, third ventricle, body of the lateral ventricle, frontal lobe, and parietofrontal cortex. There were significant differences in CT scans for the Sylvian fissure, third ventricle, and body of the lateral ventricle between the severe and mild groups. For the other two sites, no significant differences were observed. The Sylvian fissure was significantly dilatated in the severe group. Dilatation of the Sylvian fissure was well correlated with clinical manifestations, such as language, feeling expression, decreased will, strange behavior, and disease recognition, reflecting clinical severity. (N.K.)

  13. Evaluation of Clinical Features of Female Patients with Macroprolactinemia

    Directory of Open Access Journals (Sweden)

    Göksun Ayvaz

    2011-09-01

    Full Text Available Aim: Macroprolactin is a high-molecular-weight form of prolactin. It has been suggested that macroprolactin has no clinical importance because of its decreased or limited bioactivity. Although screening for macroprolactinemia is recommended especially in patients with idiopathic hyperprolactinemia; recent studies reported that patients with macroprolactinemia may have some hyperprolactinemia symptoms. Currently, the causes of the symptoms as well as the treatment and follow-up of this group of patients are not clear. In our study, we aimed to retrospectively evaluate and compare the clinical characteristics and gonadal hormone levels of patients with macroprolactinemia and hyperprolactinemia.Materials and Methods: Forty patients with macroprolactinemia and 15 patients with hyperprolactinemia who referred to Obstetrics and Gynecology Hospital were examined.Results: We observed that the patients with macroprolactinemia had similar menstrual disturbances (oligomenorrhea/amenorrhea to the patients with hyperprolactinemia. There was no statistically significant difference between the two groups with respect to FSH, LH and estradiol levels. The frequencies of galactorrhea (p=0.002, headache (p=0.04 and positive radiological finding (p=0.001 were higher in patients with hyperprolactinemia. Infertility rate was found to be increased in women with macroprolactinemia (p=0.02.Conclusion: Patients with macroprolactinemia may have very similar clinic symptoms to those with hyperprolactinemia. Therefore, macroprolactin levels should be measured regardless of the symptoms of hyperprolactinemia in patients with elevated prolactin levels. Türk Jem 2011; 15: 62-5

  14. Whipple's disease. Report of five cases with different clinical features

    Directory of Open Access Journals (Sweden)

    FERRARI Maria de Lourdes de Abreu

    2001-01-01

    Full Text Available Whipple's disease (WD is a rare systemic disease of infectious etiology which involves the small intestine but can virtually affect any organ. We present here five cases (four males and one female ranging in age from 20 to 59 years. All patients had intestinal involvement associated or not with clinical manifestations linked to this organ. Vegetation in the tricuspid valve was observed in one patient, suggesting endocarditis caused by Tropheryma whippelii, with disappearance of the echocardiographic alterations after treatment. In one of the male patients the initial clinical manifestation was serologically negative spondylitis, with no diarrhea occurring at any time during follow-up. Ocular involvement associated with intestinal malabsorption and significant weight loss were observed in one case. In the other two cases, diarrhea was the major clinical manifestation. All patients were diagnosed by histological examination of the jejunal mucosa and, when indicated, of extraintestinal tissues by light and electron microscopy. After antibiotic treatment, full remission of symptoms occurred in all cases. A control examination of the intestinal mucosa performed after twelve months of treatment with sulfamethoxazole-trimethoprim revealed the disappearance of T. whippelii in four patients. The remaining patient was lost to follow-up.

  15. Ocular features in Alport syndrome: pathogenesis and clinical significance.

    Science.gov (United States)

    Savige, Judy; Sheth, Shivanand; Leys, Anita; Nicholson, Anjali; Mack, Heather G; Colville, Deb

    2015-04-01

    Alport syndrome is an inherited disease characterized by progressive renal failure, hearing loss, and ocular abnormalities. Mutations in the COL4A5 (X-linked), or COL4A3 and COL4A4 (autosomal recessive) genes result in absence of the collagen IV α3α4α5 network from the basement membranes of the cornea, lens capsule, and retina and are associated with corneal opacities, anterior lenticonus, fleck retinopathy, and temporal retinal thinning. Typically, these features do not affect vision or, in the case of lenticonus, are correctable. In contrast, the rarer ophthalmic complications of posterior polymorphous corneal dystrophy, giant macular hole, and maculopathy all produce visual loss. Many of the ocular features of Alport syndrome are common, easily recognizable, and thus, helpful diagnostically, and in identifying the likelihood of early-onset renal failure. Lenticonus and central fleck retinopathy strongly suggest the diagnosis of Alport syndrome and are associated with renal failure before the age of 30 years, in males with X-linked disease. Sometimes, ophthalmic features suggest the mode of inheritance. A peripheral retinopathy in the mother of a male with hematuria suggests X-linked inheritance, and central retinopathy or lenticonus in a female means that recessive disease is likely. Ocular examination, retinal photography, and optical coherence tomography are widely available, safe, fast, inexpensive, and acceptable to patients. Ocular examination is particularly helpful in the diagnosis of Alport syndrome when genetic testing is not readily available or the results are inconclusive. It also detects complications, such as macular hole, for which new treatments are emerging. PMID:25649157

  16. The clinical features of 17 patients with steroid-responsive encephalopathy associated with autoimmune thyroiditis

    OpenAIRE

    Chen, Hai; Jia, Jian-ping; XU Er-he; XUE Xiao-fan; DA Yu-wei

    2013-01-01

    Objective To investigate the onset pattern, clinical manifestations, laboratory findings and imaging features of 17 Chinese patients with steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT). Methods The clinical data of 17 SREAT patients were collected. Retrospective analysis of their clinical features, as well as their serum levels of anti-thyroid, cerebrospinal fluid (CSF) biochemical indicators, MRI and therapy was performed. Results The initial symptoms of th...

  17. Clinical Features of Acute Myocardial Infarction in Elderly Patients

    OpenAIRE

    Shiraki, Teruo; Saito, Daiji

    2011-01-01

    The aim of this study was to clarify the prevalence of coronary risk factors in order to characterize the prognostic factors in elderly patients and to also identify any factors beneficial for the prevention of further cardiac events and death. We studied 888 patients with ST-elevation acute myocardial infarction who were admitted within 48h of symptom onset. The patients were divided into 3 groups according to age for comparison of variables:a younger group (n=99) aged<50, a middle-aged grou...

  18. The Retrospective Evaluation of Childhood Psoriasis Clinically and Demographic Features

    Directory of Open Access Journals (Sweden)

    Ayşe Serap Karadağ

    2013-03-01

    Full Text Available Objective: This study was aimed to define the clinical and demographic findings of psoriasis in childhood. Methods: In this retrospective study, the data from 64 children with psoriasis admitted at the our dermatology clinic between January 2007 and January 2011 were included whose data were fully. Results: Of the patients, 37 (57.8% were boys and 27 (42.2% were girls. Mean age of the children was 10.08 ±3.98 years (3-16. In 10 (15% cases, a positive family history was detected. The most frequent localizations at onset were trunk (46.9%, scalp (28.1%, knee-elbow (10.9% and extremities (7.9%, respectively. The most commonly seen clinical types were plaque (68.8%, guttate (20.3%, palmoplantar (9.4%, pustular (1.6%, respectively. Nine children had nail involvement. Out of all patients, 21.9% had upper respiratory tract infections and 9.4% had emotional stres. Four cases were diagnosed with depression. Of the cases, two cases were on non-steroid anti-inflammatory medication, and 4 of them were on antibiotics. Systemic treatments were given to 21.9% of the cases besides topical treatments. Conclusion: The epidemiological studies of psoriasis during childhood period for different countries have been reported. In this study, the ratio shows differences when compared to those previous studies. There are few epidemiologic studies for Turkey. We believe that further epidemiological studies including large number of patients' groups will contribute the diagnosis and treatment of the disease.

  19. Clinical features of gout in a cohort of Italian patients

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    M.A. Cimmino

    2011-06-01

    Full Text Available Objective: To assess the clinical characteristics of gout and its diagnostic approach in a group of Italian patients. Methods: In a retrospective analysis, we evaluated 72 consecutive gouty patients examined in the years 2000-2007.We recorded demographic data, family history, comorbidities and disease characteristics (seasonality of the attacks, joints affected, serum uric acid concentration, and treatment. Result: 63/72 (87.5% patients were men and 9 women, with mean age 61.9±13.7 years. 8/72 (11.1% patients reported a familial history of gout. The first attack occurred mainly in the months of June, July and December. The first metatarsophalangeal joint was affected in 59.7% of patients and the hand in 25%. Treatment changed over the follow- up period, with a decreased use of NSAIDs (p<0.0001 and an increased use of colchicine (p=0.015 and allopurinol (p<0.0001. In 9 (12.5% patients, joint aspiration was performed and monosodium urate crystals were found in synovial fluid or tophi. 42/72 (58.3% patients fulfilled a minimum of 6 clinical criteria of the American College of Rheumatology, necessary for gout diagnosis. 47/72 (65.3% patients, met the EULAR recommendations and had an 82% probability of being affected by gout. Conclusions: The diagnosis of gout is not always easy because of its changing clinical spectrum. Identification of MSU crystals in joint aspirates was obtained only in a minority of patients. In this setting the diagnosis with gout was often based on the observation of an acute intermittent monoarthritis involving mainly the first metatarsophlangeal joint, associated with hyperuricaemia and responsive to colchicine.

  20. The clinical and genetic features of COPD-asthma overlap syndrome.

    Science.gov (United States)

    Hardin, Megan; Cho, Michael; McDonald, Merry-Lynn; Beaty, Terri; Ramsdell, Joe; Bhatt, Surya; van Beek, Edwin J R; Make, Barry J; Crapo, James D; Silverman, Edwin K; Hersh, Craig P

    2014-08-01

    Individuals with chronic obstructive pulmonary disease (COPD) and asthma are an important but poorly characterised group. The genetic determinants of COPD and asthma overlap have not been studied. The aim of this study was to identify clinical features and genetic risk factors for COPD and asthma overlap. Subjects were current or former smoking non-Hispanic whites or African-Americans with COPD. Overlap subjects reported a history of physician-diagnosed asthma before the age of 40 years. We compared clinical and radiographic features between COPD and overlap subjects. We performed genome-wide association studies (GWAS) in the non-Hispanic whites and African-American populations, and combined these results in a meta-analysis. More females and African-Americans reported a history of asthma. Overlap subjects had more severe and more frequent respiratory exacerbations, less emphysema and greater airway wall thickness compared to subjects with COPD alone. The non-Hispanic white GWAS identified single nucleotide polymorphisms in the genes CSMD1 (rs11779254, p=1.57 × 10(-6)) and SOX5 (rs59569785, p=1.61 × 10(-6)) and the meta-analysis identified single nucleotide polymorphisms in the gene GPR65 (rs6574978, p=1.18 × 10(-7)) associated with COPD and asthma overlap. Overlap subjects have more exacerbations, less emphysema and more airway disease for any degree of lung function impairment compared to COPD alone. We identified novel genetic variants associated with this syndrome. COPD and asthma overlap is an important syndrome and may require distinct clinical management. PMID:24876173

  1. Clinical and CT imaging features of abdominal fat necrosis

    International Nuclear Information System (INIS)

    Fat necrosis is a common pathological change at abdominal cross-sectional imaging, and it may cause abdominal pain, mimic pathological change of acute abdomen, or be asymptomatic and accompany other pathophysiologic processes. Fat necrosis is actually the result of steatosis by metabolism or mechanical injury. Common processes that are present in fat necrosis include epiploic appendagitis, infarction of the greater omentum, pancreatitis, and fat necrosis related to trauma or ischemia. As a common fat disease, fat necrosis should be known by clinicians and radiologists. Main content of this text is the clinical symptoms and CT findings of belly fat necrosis and related diseases. (authors)

  2. Sporadic Cerebral Amyloid Angiopathy: Pathophysiology, Neuroimaging Features, and Clinical Implications.

    Science.gov (United States)

    Boulouis, Gregoire; Charidimou, Andreas; Greenberg, Steven M

    2016-06-01

    Sporadic cerebral amyloid angiopathy is a small vessel disorder defined pathologically by progressive amyloid deposition in the walls of cortical and leptomeningeal vessels resulting from disruption of a complex balance between production, circulation, and clearance of amyloid-β peptide (Aβ) in the brain. Cerebral amyloid angiopathy is a major cause of lobar symptomatic intracerebral hemorrhage, transient focal neurologic episodes, and a key contributor to vascular cognitive impairment. The mechanisms and consequences of amyloid-β deposition at the pathological level and its neuroimaging manifestations, clinical consequences, and implications for patient care are addressed in this review. PMID:27214698

  3. Clinical features the diaphyseal refractures of the forearm in children

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    A. Kosimov

    2014-03-01

    Full Text Available Background: The forearm refractures are the most common and serious injuries in the childhood. In our practice the refractures in children occur from 1.3% up to 5.2% among all fractures in children. Clinical characteristics of the refractures were highlighted insufficiently. Purpose: To study clinical signs of forearm refractures and effect of osteoreparative process. Material and methods: In the department of children's trauma of Scientific Research Institute of Traumatology and Orthopedics during the period from 2002 to 2012 from the general number of the patients 136 children with refracture of the tubular bones were revealed. With regard to the number of fractures twice refractures were in 132 patients, three times refractures found in 4 patients. From these patients 102 were boys and 34 were girls. According to structure of refracture localization the forearm refractures were on the leading place, which were observed in 109 (80.1% of patients. The refractures of the middle third forearm were noted in 82 patients, the refracture of middle upper third forearm - in 2 patients, the refracture of the lower third forearm was in 25 patients. Results: In the refractures at the second stage of regeneration (time of occurrence more than 3 months, especially at the moment of active process of the callus ossification the close of medullar canal occur and hematoma volume became significantly less than in primary fracture. At refractures hematoma at the place of fracture was more localized. At the refracture the weak pain is defined, and sometimes pain can be absent (about the reasons is said above, and the main active and passive movements in the full volume. The cases of absence of crepitation are possible in refractures. It is important that in refractures the longitudinal and impacted displacement we did not observe. In cases with painless clinical course of the refracture in the patients the active and passive movements were saved in complete volume

  4. Clinical features of severe wasp sting patients with dominantly toxic reaction: analysis of 1091 cases.

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    Cuihong Xie

    Full Text Available BACKGROUND: Massive wasp stings have been greatly underestimated and have not been systematically studied. The aim of this study was to identify the clinical features and treatment strategies of severe wasp stings. METHODS AND FINDINGS: A multicenter retrospective study was undertaken in 35 hospitals and medical centers including 12 tertiary care hospitals and 23 secondary care hospitals in the Hubei Province, China. The detailed clinical data of 1091 hospitalized wasp sting patients were investigated. Over three-fourths (76.9% of the cases had 10 or more stings and the in-hospital mortality of patients was 5.1%. Forty-eight patients died of organ injury following toxic reactions to the stings, whereas six died from anaphylactic shock. The in-hospital mortality in patients with >10 stings was higher than that of ≤10 stings (5.2% vs. 1.0%, p = 0.02. Acute kidney injury (AKI was seen in 21.0% patients and most patients required blood purification therapy. Rhabdomyolysis was seen in 24.1% patients, hemolysis in 19.2% patients, liver injury in 30.1% patients, and coagulopathy in 22.5% patients. Regression analysis revealed that high creatinine level, shock, oliguria, and anemia were risk factors for death. Blood purification therapy was beneficial for patients with ≥20 stings and delayed hospital admission of patients (≥4 hours after sting. CONCLUSIONS: In China, most patients with multiple wasp stings presented with toxic reactions and multiple organ dysfunction caused by the venom rather than an anaphylactic reaction. AKI is the prominent clinical manifestation of wasp stings with toxic reaction. High creatinine levels, shock, oliguria, and anemia were risk factors for death.

  5. Clinical features and management of primary biliary cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Andrea Crosignani; Pier Maria Battezzati; Pietro Invernizzi; Carlo Selmi; Elena Prina; Mauro Podda

    2008-01-01

    Primary biliary cirrhosis (PBC),which is characterised by progressive destruction of intrahepatic bile ducts,is not a rare disease since both prevalence and incidence are increasing during the last years mainly due to the improvement of case finding strategies.The prognosis of the disease has improved due to both the recognition of earlier and indolent cases,and to the wide use of ursodeoxycholic acid (UDCA).New indicators of prognosis are available that will be useful especially for the growing number of patients with less severe disease.Most patients are asymptomatic at presentation.Pruritus may represent the most distressing symptom and,when UDCA is ineffective,cholestyramine represents the mainstay of treatment.Complications of long-standing cholestasis may be clinically relevant only in very advanced stages.Available data on the effects of UDCA on clinically relevant end points clearly indicate that the drug is able to slow but not to halt the progression of the disease while,in advanced stages,the only therapeutic option remains liver transplantation.

  6. Clinical Features and Surgical Treatment of A-pattern Exotropia

    Institute of Scientific and Technical Information of China (English)

    Jingchang Chen; Guanghuan Mai; Daming Deng; Xiaoming Lin; Yan Guo; Xiao Yang; Chunxiu Yuan

    2004-01-01

    Purpose: To investigate the clinical characteristics and determine the effective surgical managements of A-pattern exotropia.Methods: Thirty-two patients with A-pattern exotropia underwent superior oblique muscle weakening procedures, medial rectus resection or (and) lateral rectus recession. Preand post-operative eye position, deviation angle, superior oblique function and binocular vision were examined and analyzed in the cases.Results: Overaction of the superior oblique muscles (31/32) and underaction of the medial rectus muscle (20/32) were presented in the cases. Postoperatively, a satisfactory ocular alignment was obtained in 28 cases (87.5%), and the A-pattern was corrected in 31 cases (96.9%). Four cases got binocular vision after surgery.Conclusions: As one of the most common forms of A and V patterns, A-pattern exotropia showed clinical characteristics of superior oblique muscle overaction and medial rectus muscle underacion, which should be the primary factors in the etiology of A-pattern exotropia, and superior oblique weakening procedures combined with horizontal surgery should be an effective approach to A-pattern exotropia treatment.

  7. Stress fractures: pathophysiology, clinical presentation, imaging features, and treatment options.

    Science.gov (United States)

    Matcuk, George R; Mahanty, Scott R; Skalski, Matthew R; Patel, Dakshesh B; White, Eric A; Gottsegen, Christopher J

    2016-08-01

    Stress fracture, in its most inclusive description, includes both fatigue and insufficiency fracture. Fatigue fractures, sometimes equated with the term "stress fractures," are most common in runners and other athletes and typically occur in the lower extremities. These fractures are the result of abnormal, cyclical loading on normal bone leading to local cortical resorption and fracture. Insufficiency fractures are common in elderly populations, secondary to osteoporosis, and are typically located in and around the pelvis. They are a result of normal or traumatic loading on abnormal bone. Subchondral insufficiency fractures of the hip or knee may cause acute pain that may present in the emergency setting. Medial tibial stress syndrome is a type of stress injury of the tibia related to activity and is a clinical syndrome encompassing a range of injuries from stress edema to frank-displaced fracture. Atypical subtrochanteric femoral fracture associated with long-term bisphosphonate therapy is also a recently discovered entity that needs early recognition to prevent progression to a complete fracture. Imaging recommendations for evaluation of stress fractures include initial plain radiographs followed, if necessary, by magnetic resonance imaging (MRI), which is preferred over computed tomography (CT) and bone scintigraphy. Radiographs are the first-line modality and may reveal linear sclerosis and periosteal reaction prior to the development of a frank fracture. MRI is highly sensitive with findings ranging from periosteal edema to bone marrow and intracortical signal abnormality. Additionally, a brief description of relevant clinical management of stress fractures is included. PMID:27002328

  8. Classifying types of DIC: clinical features and animal models.

    Science.gov (United States)

    Asakura, Hidesaku

    2016-04-01

    Disseminated intravascular coagulation (DIC) is a pathological state in which varying degrees of fibrinolytic activation are seen simultaneously as systemic, persistent, and marked coagulation activation in the presence of an underlying disease. Suppressed-fibrinolytic-type DIC usually develops in patients with sepsis. Coagulation activation is severe, while fibrinolytic activation is mild. Enhanced-fibrinolytic-type DIC usually occurs with acute promyelocytic leukemia (APL). Both coagulation activation and fibrinolytic activation are severe in affected patients. Balanced-fibrinolytic-type DIC is usually seen in patients with solid tumors, and has a pathogenesis intermediate between those of the two aforementioned types. In animal DIC models, lipopolysaccharide (LPS)-induced forms of DIC are similar to suppressed-fibrinolytic-type DIC, whereas models of tissue factor (TF)-induced DIC have features similar to those of enhanced-fibrinolytic/balanced-fibrinolytic DIC. We are moving in the direction of more appropriate selection of treatment based on DIC type. PMID:27169441

  9. CLINICAL FEATURES AND CLINICAL OUTCOME OF ACUTE PROMYELOCYTIC LEUKEMIA PATIENTS TREATED AT CAIRO NATIONAL CANCER INSTITUTE IN EGYPT

    Directory of Open Access Journals (Sweden)

    Tamer M Fouad

    2011-01-01

    Full Text Available

    The current study reports the clinical features and treatment outcome of 67 patients with acute promyelocytic leukemia (APL presented to National Cancer Institute (NCI-Cairo, in Egypt from January 2007 to January 2011. The median follow-up time was 36 months. All patients were treated with the simultaneous administration of all-trans retinoic acid (ATRA and anthracyclin. The treatment protocol was modified due to resource limitations at the NCI-Cairo by replacing of idarubicin with doxorubicin in most of the cases and the inclusion of cytarbine during the consolidation phase only in pediatric patients. All patients who achieved molecular complete remission (CRm after consolidation received two-year maintenance treatment with low dose chemotherapy composed of 6 mercaptopurine, methotrexate and intermittent ATRA courses. The median age at presentation was 29 years. There was a slight male predominance (53%.  Bleeding was the most common presenting symptom (79%. Most patients had an intermediate risk Sanz score (49% and 34% had a high risk score.  All patients achieved molecular CR at end of consolidation therapy with a median duration of 100 days. The main therapeutic complications during the induction phase were febrile neutropenia (42%, bleeding (18% and differentiation syndrome (11%. Five patients died at diagnosis due to bleeding, three died during induction chemotherapy due to febrile neutropenia (n=2 and bleeding (n=1 and one patient died during consolidation therapy due to febrile neutropenia.  The 3-year OS was 89% and relapse rate was 3%. Adapting standard AIDA treatment protocols to limited resources by reducing dose-intensity during treatment consolidation, using ATRA in the consolidation phase and alternative anthracyclin (doxorubicin may be a valid treatment option in developing countries. In spite of the increased incidence of high and intermediate risk score APL in our sample, we reported an acceptable CR rate

  10. CLINICAL FEATURES AND CLINICAL OUTCOME OF ACUTE PROMYELOCYTIC LEUKEMIA PATIENTS TREATED AT CAIRO NATIONAL CANCER INSTITUTE IN EGYPT

    Directory of Open Access Journals (Sweden)

    Ola Khorshid

    2011-12-01

    Full Text Available The current study reports the clinical features and treatment outcome of 67 patients with acute promyelocytic leukemia (APL presented to National Cancer Institute (NCI-Cairo, in Egypt from January 2007 to January 2011. The median follow-up time was 36 months. All patients were treated with the simultaneous administration of all-trans retinoic acid (ATRA and anthracyclin. The treatment protocol was modified due to resource limitations at the NCI-Cairo by replacing of idarubicin with doxorubicin in most of the cases and the inclusion of cytarbine during the consolidation phase only in pediatric patients. All patients who achieved molecular complete remission (CRm after consolidation received two-year maintenance treatment with low dose chemotherapy composed of 6 mercaptopurine, methotrexate and intermittent ATRA courses. The median age at presentation was 29 years. There was a slight male predominance (53%.  Bleeding was the most common presenting symptom (79%. Most patients had an intermediate risk Sanz score (49% and 34% had a high risk score.  All patients achieved molecular CR at end of consolidation therapy with a median duration of 100 days. The main therapeutic complications during the induction phase were febrile neutropenia (42%, bleeding (18% and differentiation syndrome (11%. Five patients died at diagnosis due to bleeding, three died during induction chemotherapy due to febrile neutropenia (n=2 and bleeding (n=1 and one patient died during consolidation therapy due to febrile neutropenia.  The 3-year OS was 89% and relapse rate was 3%. Adapting standard AIDA treatment protocols to limited resources by reducing dose-intensity during treatment consolidation, using ATRA in the consolidation phase and alternative anthracyclin (doxorubicin may be a valid treatment option in developing countries. In spite of the increased incidence of high and intermediate risk score APL in our sample, we reported an acceptable CR rate, toxicity and OS.

  11. LIPODERMATOSCLEROSIS AS A VARIETY OF LOBULAR PANNICULITIS: CLINICAL FEATURES

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    O. N. Egorova

    2015-01-01

    Full Text Available Objective: to to study and reveal the diagnostic signs of lipodermatosclerosis (LDS as one of the types of panniculitis (PN.Materials and methods. A total of 550 patients were examined; LDS with its duration of 18.97 ± 7.4 months was verified in 53 (9.6 % patients (3 men and 50 women; whose age was 18–80 years, including 32 overweight ones. All the patients underwent comprehensive clinical examination and laboratory and instrumental studies involving biochemical and immunological parameters, as well as chest computed tomography and Doppler ultrasound (DUS of the lower limb vascular bed. While characterizing the skin lesion, the extent, skin color, number and intensity of pain were assessed using the visual analogue scale (VAS in the affected areas. Chronic venous insufficiency (CVI was evaluated in accordance with the international classification and the classification developed by V.S. Savel’ev et al. The skin and hypodermic tissue were biopsied from an area of the highest lesion and further pathomorphologically examined.Results. Thirty-seven (70 % of the 53 patients with LDS were noted to have predominantly inflammation of the subcutaneous adipose layer of the leg (88.6 % on its medial surface (54.7 % with the development of the glass symptom (79.2 % (p = 0.005. Main types of the disease course (acute, subacute, and chronic were identified, which differed in clinical symptoms. ROC analysis indicated that the VAS sensitivity (86 % and specificity (58 % in the patients with LDS corresponded to a separation point of 40 mm. In 46 % of the cases, skin lesion was associated with polyarthralgias (n = 15 or myalgias (n = 12 in the presence of insignificant inflammatory activity. Twenty-eight patients (including 19 with chronic LDS had CVI with a duration of 10.2 ± 1.3 years, which was verified by DUS of the lower limb vessels (p < 0.05. All the patients took venous tonics, nonsteroidal anti-inflammatory drugs, aminocholines, and antioxidants for

  12. Fluorescein angiographic findings and clinical features in Fuchs' uveitis.

    Science.gov (United States)

    Bouchenaki, Nadia; Herbort, Carl P

    2010-10-01

    Fuchs' uveitis is very often diagnosed with substantial delay, which is at the origin of deleterious effects such as unnecessary treatment and its consequences. The aim of this study was to analyse the type and frequency of posterior inflammatory and fluorescein angiographic signs in Fuchs' uveitis in conjunction with other clinical signs. Patients seen at the Centre for Ophthalmic Specialised Care (COS) in Lausanne and the Memorial A. de Rothschild, Clinique Générale-Beaulieu in Geneva between 1995 and 2008 with the diagnosis of Fuchs' uveitis and who had undergone a fundus fluorescein angiography (FFA) were analysed. In addition to FFA signs, the data collected included age, gender, initial and final visual acuities, clinical findings at presentation, mean diagnostic delay and ocular complications. Between 1995 and 2008, 105 patients seen in our centres in Lausanne and Geneva were diagnosed with Fuchs' uveitis. Forty of them (38.1%) had undergone at least one FFA. One patient was excluded because of a concomittant diagnosis of multiple sclerosis. In 28 of 39 patients (71.2%) diagnosis was not reached at presentation with a mean diagnosis delay of 3.67 ± 4.86 years (range: 1 month-24 years). The original erroneous diagnosis was intermediate uveitis in 16 patients (57.1%), posterior uveitis in two patients (7.1%), panuveitis in four patients (14.3%) and anterior granulomatous uveitis in six patients (21.4%). Fluorescein angiography demonstrated the presence of disc hyperfluorescence in 43/44 eyes (97.7%), sectorial peripheral retinal vascular leaking in 6/44 eyes (13.6%) and cystoid macular oedema in 4/44 eyes (9.1%), all of which were seen in eyes having undergone cataract surgery. Fuchs' uveitis was bilateral in 5/39 patients (12.8%). The most frequent clinical signs were vitritis in 42/44 eyes (95.5%), stellate keratic precipitates in 41 eyes (93.2%), posterior subcapsular opacities or cataract in 19 eyes (43.2%), and heterochromia in 19 eyes (43.2%). Fuchs

  13. A clinical and echocardiographic score for assigning risk of major events after dobutamine echocardiograms

    NARCIS (Netherlands)

    T. Marwick; L. Case (Laura); D. Poldermans (Don); H. Boersma (Eric); J.J. Bax (Jeroen); T. Sawada (Takahiro); J.D. Thomas (James)

    2004-01-01

    textabstractObjectives We sought to develop and validate a risk score combining both clinical and dobutamine echocardiographic (DbE) features in 4,890 patients who underwent DbE at three expert laboratories and were followed for death or myocardial infarction for up to five years. Background In cont

  14. Anatomical features and clinical relevance of a persistent trigeminal artery

    Science.gov (United States)

    Alcalá-Cerra, Gabriel; Tubbs, R S; Niño-Hernández, Lucía M

    2012-01-01

    Background: Although persistent trigeminal artery (PTA) is uncommonly identified, knowledge of this structure is essential for clinicians who interpret cranial imaging, perform invasive studies of the cerebral vasculature, and operate this region. Methods: A review of the medical literature using standard search engines was performed to locate articles regarding the PTA, with special attention with anatomical descriptions. Results: Although anatomical reports of PTA anatomy are very scarce, those were analyzed to describe in detail the current knowledge about its anatomical relationships and variants. Additionally, the embryology, classification, clinical implications, and imaging modalities of this vessel are extensively discussed. Conclusions: Through a comprehensive review of isolated reports of the PTA, the clinician can better understand and treat patients with such an anatomical derailment. PMID:23087827

  15. Severe scrub typhus infection: Clinical features, diagnostic challenges and management.

    Science.gov (United States)

    Peter, John Victor; Sudarsan, Thomas I; Prakash, John Anthony J; Varghese, George M

    2015-08-01

    Scrub typhus infection is an important cause of acute undifferentiated fever in South East Asia. The clinical picture is characterized by sudden onset fever with chills and non-specific symptoms that include headache, myalgia, sweating and vomiting. The presence of an eschar, in about half the patients with proven scrub typhus infection and usually seen in the axilla, groin or inguinal region, is characteristic of scrub typhus. Common laboratory findings are elevated liver transaminases, thrombocytopenia and leukocytosis. About a third of patients admitted to hospital with scrub typhus infection have evidence of organ dysfunction that may include respiratory failure, circulatory shock, mild renal or hepatic dysfunction, central nervous system involvement or hematological abnormalities. Since the symptoms and signs are non-specific and resemble other tropical infections like malaria, enteric fever, dengue or leptospirosis, appropriate laboratory tests are necessary to confirm diagnosis. Serological assays are the mainstay of diagnosis as they are easy to perform; the reference test is the indirect immunofluorescence assay (IFA) for the detection of IgM antibodies. However in clinical practice, the enzyme-linked immuno-sorbent assay is done due to the ease of performing this test and a good sensitivity and sensitivity when compared with the IFA. Paired samples, obtained at least two weeks apart, demonstrating a ≥ 4 fold rise in titre, is necessary for confirmation of serologic diagnosis. The mainstay of treatment is the tetracycline group of antibiotics or chloramphenicol although macrolides are used alternatively. In mild cases, recovery is complete. In severe cases with multi-organ failure, mortality may be as high as 24%. PMID:26261776

  16. Perigastric appendagitis: CT and clinical features in eight patients

    International Nuclear Information System (INIS)

    Aim: To describe perigastric appendagitis (PA) on CT as a new and distinct clinical entity to enable recognition and prevent additional unnecessary investigation or intervention. Materials and methods: Institutional review board approval was obtained and informed consent was waived. Retrospective review of the clinical data and CT findings in eight patients with PA encountered over 10 years at one institution was performed. The English literature was reviewed and summarized. Two experienced abdominal radiologists reviewed the CT images by consensus. Results: Seven of eight patients had moderate to severe epigastric pain for 1–7 days. All eight patients (four men, four women; mean age 44 years, range 33–81 years) had no fever or leukocytosis. All underwent abdominal CT which showed ovoid fat inflammation along the course of the perigastric ligaments (gastrohepatic, gastrosplenic, and falciform). Two had gastric wall thickening. Although the inflammation was correctly described, the specific diagnosis was not made on initial interpretation in five patients. Subsequently, they underwent further diagnostic testing [an upper gastrointestinal examination and hepatobiliary iminodiacetic acid (HIDA) cholescintigraphy, an upper endoscopy and MRI examination, HIDA cholescintigraphy, another CT, and an MRI examination, respectively]. The HIDA cholescintigraphy, upper GI examination, and upper endoscopy examinations were normal. No repeated examination was performed on the other three patients. Pain resolved spontaneously in all within two days. Conclusion: Perigastric appendagitis can present with an acute abdomen, which is safely managed conservatively if diagnosed correctly. Radiologists should be aware of the entity to avoid unnecessary intervention, and recognize the CT findings of ovoid fat inflammation in the distribution of the perigastric ligaments. - Highlights: • Normal perigastric ligaments can have fatty appendages. • Torsion of these appendages causes

  17. Dorsal Tear of Triangular Fibrocartilage Complex: Clinical Features and Treatment.

    Science.gov (United States)

    Abe, Yukio; Moriya, Atsushi; Tominaga, Yasuhiro; Yoshida, Koji

    2016-03-01

    Background Several different triangular fibrocartilage complex (TFCC) tear patterns have been classified through the use of wrist arthroscopy. A tear of the dorsal aspect of the TFCC has been previously reported, but it is not included in Palmer original classification. Our purpose was to describe this type of tear pattern along with the clinical presentation. Methods An isolated dorsal TFCC tear was encountered in seven wrists of six patients (three men and three women; average age was 31 years). All patients were evaluated by physical exam, X-ray, plain axial computed tomography with pronation, neutral and supination position, magnetic resonance imaging (MRI) with coronal, sagittal, and axial section and arthroscopy. Results The clinical findings varied and included the following: tenderness at the dorsoulnar aspect of the wrist was positive in all wrists, fovea sign was positive in five wrists, and tenderness at the dorsal aspect of the distal radioulnar joint was present in one wrist. Pain with forearm rotation was positive in all wrists. The ulnar head ballottement test induced pain in all wrists, whereas dorsal instability of the ulnar head was present in one wrist with this test. The ulnocarpal stress test was positive in five wrists. Axial and sagittal images on MRI revealed the dorsal tear in five wrists. All wrists were treated with an arthroscopic capsular repair. The final functional outcome at an average follow-up of 16.1 months was four excellent and one good wrist according to the modified Mayo wrist score. Conclusions The aim of this article is to describe our experiences with tears involving the dorsal aspect of the TFCC, which may be misdiagnosed if the surgeon is not cognizant of this injury. Type of study/level of evidence Diagnostic/level IV. PMID:26855835

  18. Brain metastases from hepatocellular carcinoma: clinical features and prognostic factors

    International Nuclear Information System (INIS)

    Brain metastases (BM) from hepatocellular carcinoma (HCC) are extremely rare and are associated with a poor prognosis. The aim of this study was to define clinical outcome and prognostic determinants in patients with BM from HCC. Between January 1994 and December 2009, all patients with HCC and BM treated in Sun Yat-sen University Cancer Center were retrospectively reviewed. Univariate and multivariate survival analyses were performed to identify possible prognostic factors. Forty-one patients were diagnosed with BM from HCC, an incidence of 0.47%. The median age at diagnosis of BM was 48.5 years. Thirty-three patients (80.5%) developed extracranial metastases at diagnosis of BM, and 30 patients (73.2%) had hepatitis B. Intracranial hemorrhage occurred in 19 patients (46.3%). BM were treated primarily either with whole brain radiation therapy (WBRT; 5 patients), stereotactic radiosurgery (SRS; 7 patients), or surgical resection (6 patients). The cause of death was systemic disease in 17 patients and neurological disease in 23. Patients in a high RPA (recursive partitioning analysis) class, treated with conservatively and without lung metastases, tended to die from neurological disease. Median survival after the diagnosis of BM was 3 months (95% confidence interval: 2.2-3.8 months). In multivariate analysis, the presence of extracranial metastases, a low RPA class and aggressive treatment, were positively associated with improved survival. BM from HCC is rare and associated with an extremely poor prognosis. However, patients with a low RPA class may benefit from aggressive treatment. The clinical implication of extracranial metastases in HCC patients with BM needs further assessment

  19. Diagnosis of Fanconi anemia in children with atypical clinical features: a primary study

    Institute of Scientific and Technical Information of China (English)

    LIU Rong; HU Tao; LI Jun-hui; LIANG Chao; GU Wei-yue; SHI Xiao-dong; WANG Hong-xing

    2013-01-01

    Background Fanconi anemia is a severe congenital disorder associated with mutations in a cluster of genes responsible for DNA repair.Arriving at an accurate and timely diagnosis can be difficult in cases of Fanconi anemia with atypical clinical features.It is very important to increase the rate of accurate diagnosis for such cases in a clinical setting.The purpose of this study is to explore the clinical diagnosis of Fanconi anemia in children with atypical clinical features.Methods Six cases of Fanconi anemia with atypical clinical features were enrolled in the study,and their clinical features were recorded,their FANCA gene transcription was assessed by RT-PCR,and FANCA mutations and the ubiquitination of FANCD2 protein were analyzed using DNA sequencing and western blotting respectively.Results All six cases showed atypical clinical features including no apparent deformities,lack of response to immune therapy,and progressively increasing bone marrow failure.They also have significantly increased fetal hemoglobin,negative mitomycin-induced fracture test results,and carry a FANCA gene missense mutation.Single protein ubiquitination of FANCD2 was not observed in those patients.Conclusion The combination of clinical features,FANCA pathogenic gene mutation genotype and the absence of FANCD2 protein ubiquitination are helpful in the accurate and timely diagnosis of Fanconi anemia in children.

  20. Cystic synovial sarcomas: imaging features with clinical and histopathologic correlation

    International Nuclear Information System (INIS)

    To characterize the radiological and clinicopathologic features of cystic synovial sarcoma. Seven patients with primary cystic synovial sarcoma were evaluated. Computed tomography (CT) and magnetic resonance (MR) imaging were undertaken at the first presentation. The diagnosis of synovial sarcoma was made on the basis of histological examinations followed by molecular analysis. Radiological and clinicopathologic findings were reviewed. CT showed well-defined soft tissue mass without cortical bone erosion and invasion. Calcification was seen at the periphery of the mass in three cases. T2-weighted MR images showed multilocular inhomogeneous intensity mass in all cases, five of which showed fluid-fluid levels. On gross appearance, old and/or fresh hematomas were detected in six cases. In the one remaining case, microscopic hemorrhage in the cystic lumen was proven. Four cases had poorly differentiated areas. In five cases prominent hemangiopericytomatous vasculature was observed. Histologic grade was intermediate in one tumor and high in six. One case had a history of misdiagnosis for tarsal tunnel syndrome, one for lymphadenopathy, two for sciatica and two for hematoma. All cystic synovial sarcomas demonstrated multilocularity with well-circumscribed walls and internal septae. Synovial sarcoma should be taken into consideration in patients with deeply situated multicystic mass with triple signal intensity on T2-weighted MR imaging. (orig.)

  1. Cystic synovial sarcomas: imaging features with clinical and histopathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, Hirofumi; Araki, Nobuhito [Department of Orthopedic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3, Nakamichi, Higashinari-Ku, 537-8511, Osaka (Japan); Sawai, Yuka [Department of Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Kudawara, Ikuo [Department of Orthopedic Surgery, Osaka National Hospital, Osaka (Japan); Mano, Masayuki; Ishiguro, Shingo [Department of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Ueda, Takafumi; Yoshikawa, Hideki [Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka (Japan)

    2003-12-01

    To characterize the radiological and clinicopathologic features of cystic synovial sarcoma. Seven patients with primary cystic synovial sarcoma were evaluated. Computed tomography (CT) and magnetic resonance (MR) imaging were undertaken at the first presentation. The diagnosis of synovial sarcoma was made on the basis of histological examinations followed by molecular analysis. Radiological and clinicopathologic findings were reviewed. CT showed well-defined soft tissue mass without cortical bone erosion and invasion. Calcification was seen at the periphery of the mass in three cases. T2-weighted MR images showed multilocular inhomogeneous intensity mass in all cases, five of which showed fluid-fluid levels. On gross appearance, old and/or fresh hematomas were detected in six cases. In the one remaining case, microscopic hemorrhage in the cystic lumen was proven. Four cases had poorly differentiated areas. In five cases prominent hemangiopericytomatous vasculature was observed. Histologic grade was intermediate in one tumor and high in six. One case had a history of misdiagnosis for tarsal tunnel syndrome, one for lymphadenopathy, two for sciatica and two for hematoma. All cystic synovial sarcomas demonstrated multilocularity with well-circumscribed walls and internal septae. Synovial sarcoma should be taken into consideration in patients with deeply situated multicystic mass with triple signal intensity on T2-weighted MR imaging. (orig.)

  2. [Denial of pregnancy and neonaticide: psychopathological and clinical features].

    Science.gov (United States)

    Seigneurie, A-S; Limosin, F

    2012-11-01

    Pregnancy denial and neonaticide have recently received media coverage following a series of French cases of neonatal killing. Although it has been known for a long time that some women deny their pregnancy and may kill their newborns, there is still no consensus on the etiopathogenic factors involved in the denial of pregnancy occurrence. Even though neonaticide is often committed by young, poor, unmarried women with little or no prenatal care, it appears that denial of pregnancy is a heterogeneous condition associated with different psychological features. Societies are ambivalent with regard to mothers who killed their children and tend to lay the entire blame on them. Furthermore, there is a widespread lack of understanding among the public on these affairs, when birth control techniques and methods are widely available. The purpose of this article is to describe the different types of pregnancy denial and neonaticide and to review the still debated etiopathogenic hypotheses. The absence of the physical changes of pregnancy at the time of the denial such as cessation of menstruation, abdominal swelling or perception of foetal movements is also discussed. PMID:22939654

  3. Clinical, psychophysiological and psychological aspects of risk factors of periodontal disease development in clinically healthy persons

    Directory of Open Access Journals (Sweden)

    I.N. Nikulina

    2009-12-01

    Full Text Available The research goal is to determine risk factors of periodontal disease development, psychophysiological personal types and their interrelations in clinically healthy persons. 47 first-year cadets of St.-Petersburg Military School of radio electronics have been examined. This group of respondents has been chosen by presence of such social stressor as change of place of living (97,9% cadets have arrived in St.-Petersburg from other cities and republics of the Russian Federation and strict disciplinary conditions. The research has revealed a low level of oral hygiene, cases of mild gingivitis in most respondents. The general mental state of group under study is characterized by raised level of personal anxiety and low indices of reactive anxiety. The examined group has demonstrated anxiety, tension, indecision and lowered stress stability. Clinically healthy persons are more liable to develop inflammatory and inflammatory-destructive periodontal diseases. It was possible to determine psychophysiological features correlated with physiological parameters of risk degree of periodontal diseases. It may have a great significance in defining of periodontal disease etiology and pathogenesis

  4. Clinical features, pathogenesis and management of drug-induced seizures.

    Science.gov (United States)

    Zaccara, G; Muscas, G C; Messori, A

    1990-01-01

    Many classes of pharmacological agents have been implicated in cases of drug-induced seizures. The list includes antidepressant drugs, lithium salts, neuroleptics, antihistamines (H1-receptor antagonists), anticonvulsants, central nervous system stimulants, general and local anaesthetics, antiarrhythmic drugs, narcotic and non-narcotic analgesics, non-steroidal anti-inflammatory drugs, antimicrobial agents, antifungal agents, antimalarial drugs, antineoplastic drugs, immunosuppressive drugs, radiological contrast agents and vaccines. For each of these classes of drugs, this article offers a revision of the literature and emphasises in particular the frequency of the adverse reaction, its clinical presentation, its presumed epileptogenic mechanism and the therapeutic strategy for the management of drug-induced seizures. An attempt is also made to distinguish seizures induced by standard dosages from those provoked by accidental or self-induced intoxication. For some classes of drugs such as antidepressants, neuroleptics, central nervous system stimulants (e.g. theophylline, cocaine, amphetamines) and beta-lactam antibiotics, seizures are a well recognised adverse reaction, and a large body of literature has been published discussing exhaustively the major aspects of the issue; sufficient data are available also for the other classes of pharmacological agents mentioned above. In contrast, several other drugs [e.g. allopurinol, digoxin, cimetidine, protirelin (thyrotrophin releasing hormone), bromocriptine, domperidone, insulin, fenformin, penicillamine, probenecid, verapamil, methyldopa] have not been studied thoroughly under this aspect, and the only source of information is the occasional case report. This review does not address the issue of seizures induced by drug withdrawal. PMID:2182049

  5. Clinical Features and Treatment of Penile Schwannoma: A Systematic Review.

    Science.gov (United States)

    Nguyen, Austin Huy; Smith, Megan L; Maranda, Eric L; Punnen, Sanoj

    2016-06-01

    Schwannomas, although common in the head and limbs, are an exceedingly rare tumor of the penis. We conducted a systematic review to include 33 patients with schwannoma of the penile shaft or glans penis. Most patients presented with a single painless nodule on the dorsal aspect of the penile shaft. These nodules were slow growing, with an average of 62 months from the onset to presentation. Several cases were accompanied by sexual dysfunction. Most histologic studies were consistent, with a benign schwannoma that showed a palisading Antoni A and Antoni B pattern without malignant changes in cell morphology. Of the 14 studies in which a history of genetic disease was investigated, only 2 reported a connection to neurofibromatosis. These tumors were treated with surgical excision, and 4 malignant cases received additional chemotherapy or radiotherapy. All the patients had achieved full remission by the final follow-up examination. Given the rarity of this tumor, the present review of available case studies serves to comprehensively describe the clinical presentation and treatment approaches to penile schwannoma. PMID:26797586

  6. [Vasculitic Peripheral Neuropathies: Clinical Features and Diagnostic Laboratory Tests].

    Science.gov (United States)

    Ogata, Katsuhisa

    2016-03-01

    Vasculitic peripheral neuropathy (VPN) occurs due to ischemic changes of peripheral nerves, resulting from a deficit of vascular blood supply due to damaged vasa nervorum leading to vasculitis. VPN usually manifests as sensorimotor or sensory disturbances accompanied by pain, presenting as a type of multiple mononeuropathy, with a scattered distribution in distal limbs. VPN may also present as a mononeuropathy, distal symmetric polyneuropathy, plexopathy, or radiculopathy. The rapidity of VPN is variable, ranging from days to months, with symptoms occasionally changing with the appearance of new lesions. Careful history taking and neurological examination provides an exact diagnosis. The most common cause of VPN is primary vasculitis predominantly affecting small vessels, including vasa nervorum, anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, and polyarteritis nodosa. Similar vasculitic processes can also result from a systemic collagen disorder or secondary vasculitis. Electrophysiological studies and pathological investigation of biopsied peripheral nerves and muscles are important for diagnosis of vasculitis. Serological tests, including ANCA, are useful for diagnosis of vasculitis. Accurate neurological examinations are essential for diagnosis and evaluation of clinical course. PMID:27001769

  7. Clinical Features and Causes of Endogenous Hyperinsulinemic Hypoglycemia in Korea

    Directory of Open Access Journals (Sweden)

    Chang-Yun Woo

    2015-04-01

    Full Text Available BackgroundEndogenous hyperinsulinemic hypoglycemia (EHH is characterized by an inappropriately high plasma insulin level, despite a low plasma glucose level. Most of the EHH cases are caused by insulinoma, whereas nesidioblastosis and insulin autoimmune syndrome (IAS are relatively rare.MethodsTo evaluate the relative frequencies of various causes of EHH in Korea, we retrospectively analyzed 84 patients who were diagnosed with EHH from 1998 to 2012 in a university hospital.ResultsAmong the 84 EHH patients, 74 patients (88%, five (6%, and five (6% were diagnosed with insulinoma, nesidioblastosis or IAS, respectively. The most common clinical manifestation of EHH was neuroglycopenic symptoms. Symptom duration before diagnosis was 14.5 months (range, 1 to 120 months for insulinoma, 1.0 months (range, 6 days to 7 months for nesidioblastosis, and 2.0 months (range, 1 to 12 months for IAS. One patient, who was diagnosed with nesidioblastosis in 2006, underwent distal pancreatectomy but was later determined to be positive for insulin autoantibodies. Except for one patient who was diagnosed in 2007, the remaining three patients with nesidioblastosis demonstrated severe hyperinsulinemia (157 to 2,719 µIU/mL, which suggests that these patients might have had IAS, rather than nesidioblastosis.ConclusionThe results of this study suggest that the prevalence of IAS may be higher in Korea than previously thought. Therefore, measurement of insulin autoantibody levels is warranted for EHH patients, especially in patients with very high plasma insulin levels.

  8. Clinical features of human intestinal capillariasis in Taiwan

    Institute of Scientific and Technical Information of China (English)

    Ming-Jong Bair; Kao-Pin Hwang; Tsang-En Wang; Tai-Cherng Liou; Shee-Chan Lin; Chin-Roa Kao; Tao-Yeuan Wang; Kwok-Kuen Pang

    2004-01-01

    Human intestinal capillariasis is a rare parasitosis that was first recognized in the Philippines in the 1960 s. Parasitosis is a life threatening disease and has been reported from Thailand, Japan, South of Taiwan (Kaoh-Siung), Korea,Tran, Egypt, Italy and Spain. Its clinical symptoms are characterized by chronic diarrhea, abdominal pain,borborygmus, marked weight loss, protein and electrolyte loss and cachexia. Capillariasis may be fatal if early treatment is not given. We reported 14 cases living in rural areas of Taiwan. Three cases had histories of travelling to Thailand. They might have been infected in Thailand while stayed there. Two cases had the diet of raw freshwater fish before. Three cases received emergency laparotomy due to peritonitis and two cases were found of enteritis cystica profunda. According to the route of transmission,freshwater and brackish-water fish may act as the intermediate host of the parasite. The most simple and convenient method of diagnosing capillariasis is stool examination. Two cases were diagnosed by histology.Mebendazole or albendezole 200 mg orally twice a day for 20-30 d is the treatment of choice. All the patients were cured, and relapses were not observed within 12 mo.

  9. Clinical and radiological features of nonfamilial cherubism: A case report

    International Nuclear Information System (INIS)

    Cherubism is an uncommon hereditary benign fibro-osseous disorder characterized by bilateral enlargement of the mandible and the maxilla that presents with varying degrees of involvement and a tendency toward spontaneous remission. On radiography cherubic lesions appear as cystic multilocular radiolucencies limited to the jaw bones. A 5-year-old boy was referred to the Department of Maxillo-Facial Surgery due to deformation of the lower and middle section of the face and displacement or absence of teeth. A panoramic radiograph and a computed tomography revealed extensive multilocular, bilateral radiolucent areas and marked bony expansion in the mandible and maxilla, with sparing of the mandibular condyles. Histopathological evaluation of an incisional biopsy of the left maxilla and genotypic characterization confirmed the diagnosis of cherubism. The radiologic characteristics of cherubism are not pathognomonic but the diagnosis is strongly suggested by bilateral relatively symmetric jaw involvement that is limited to the jaw bones and, together with clinical and histopathologic findings, enables the diagnosis of cherubism. Genotypic characterization confirms the diagnosis

  10. Migraine with Prolonged Aura: Correlation of Clinical and EEG Features

    Directory of Open Access Journals (Sweden)

    A. O. Ogunyemi

    1995-01-01

    Full Text Available Migraine with prolonged aura has rarely been examined with regard to the sequence of the neurological symptoms and the associated EEG changes. This report describes five patients who underwent clinical assessment and EEG recordings during attacks of migraine with prolonged aura. CT scan of the brain was obtained in four of them. Follow-up EEG was also obtained. The aura symptoms either preceded the headache or were coincident with it. The aura symptoms evolved in a manner consistent with posterior-to-anterior dysfunction of the cerebral cortex. The EEG abnormalities were non-epileptiform and consisted of focal delta slow waves or theta slow waves. The EEG abnormalities showed good correlation with the patients' aura symptoms and resolved when the patients became symptom free. The posterior-to-anterior sequence of the aura symptoms is in accord with the findings during cerebral blood flow studies in patients having migraine with aura. Also the symptoms and EEG changes in our patients indicate dysfunction of the cerebral cortex, consistent with the notion that spreading cortical depression may be the underlying pathophysiological event in migraine with aura.

  11. Radiologic and clinical features of vesicoureteral reflux in children

    International Nuclear Information System (INIS)

    This study represents the radiologic and clinical analysis of vesicoureteral reflux in 32 children which were confirmed with intravenous pyelography, voiding cystourethrography and Cystoscopy in Ewha Womans University Hospital, during June 1979 to April 1985. The result were as follows: 1. Age distribution was from 2 Mos. to 15 Yrs. 2. Chief complaints at admission were fever 14 cases (43.8%), flank pain 8 cases (25%), urinary frequency 5 cases (15.6%). 3. Urinary culture at admission revealed urinary tract infection in 26 patients (81.2%). 4. 22 of 32 patients showed normal findings in I.V.P. before treatment. 5. 26 of 46 ureters showed vesicoureteral reflux more than grade III in V.C.U.G. before treatment. 6. Unilateral involvement of vesicoureteral reflux was 18 cases (56%) and bilateral involvement was 14 cases (44%). 7. Cystoscopic findings of ureteral orifice were golf-hole type 20 cases (62.5%), cone type 6 cases (18.7%), stadium type 3 cases (9.4%), hore-shoe type 3 cases (9.4%). 8. 1) Medical treatment Reflex corrected: 83.3% Infection erradicated : 100% 2) Surgical treatment Reflux corrected: 85.8% Infection erradicated: 92.9%

  12. Radiologic and clinical features of vesicoureteral reflux in children

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Kyung Hee; Lee, Cho Hye; Rhee, Chung Sik; Kim, Hee Seup [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    1986-04-15

    This study represents the radiologic and clinical analysis of vesicoureteral reflux in 32 children which were confirmed with intravenous pyelography, voiding cystourethrography and Cystoscopy in Ewha Womans University Hospital, during June 1979 to April 1985. The result were as follows: 1. Age distribution was from 2 Mos. to 15 Yrs. 2. Chief complaints at admission were fever 14 cases (43.8%), flank pain 8 cases (25%), urinary frequency 5 cases (15.6%). 3. Urinary culture at admission revealed urinary tract infection in 26 patients (81.2%). 4. 22 of 32 patients showed normal findings in I.V.P. before treatment. 5. 26 of 46 ureters showed vesicoureteral reflux more than grade III in V.C.U.G. before treatment. 6. Unilateral involvement of vesicoureteral reflux was 18 cases (56%) and bilateral involvement was 14 cases (44%). 7. Cystoscopic findings of ureteral orifice were golf-hole type 20 cases (62.5%), cone type 6 cases (18.7%), stadium type 3 cases (9.4%), hore-shoe type 3 cases (9.4%). 8. 1) Medical treatment Reflex corrected: 83.3% Infection erradicated : 100% 2) Surgical treatment Reflux corrected: 85.8% Infection erradicated: 92.9%.

  13. Clinical and laboratory features of human herpesvirus 6 chromosomal integration.

    Science.gov (United States)

    Clark, D A

    2016-04-01

    Human herpesvirus 6 (HHV-6) comprises two separate viruses, HHV-6A and HHV-6B, although this distinction is not commonly made. HHV-6B is ubiquitous in the population with primary infection usually occurring in early childhood, and often resulting in febrile illness. HHV-6B is also recognized as a pathogen in the immunocompromised host, particularly in transplant recipients. HHV-6A is less well characterized and may have a more restricted prevalence. Both viruses are unique among the human herpesviruses in that the entire viral genome can be found integrated into the telomeric regions of host cell chromosomes. Approximately 1% of persons have inherited integrated viral sequences through the germline, and these individuals characteristically have very high viral loads in blood and other sample types. Emerging evidence suggests that HHV-6A and HHV-6B chromosomal integration may not just be an uncommon biological observation, but more likely a characteristic of the replication properties of these viruses. The integrated viral genome appears capable of excision from the chromosomal site and potentially allows viral replication. The clinical consequences of inherited chromosomally integrated HHV-6 have yet to be fully appreciated. PMID:26802216

  14. Male breast disease: clinical, mammographic, and ultrasonographic features

    Energy Technology Data Exchange (ETDEWEB)

    Guenhan-Bilgen, Isil E-mail: isilbilgen@hotmail.com; Bozkaya, Halil; Uestuen, Esin Emin; Memis, Aysenur

    2002-09-01

    Purpose: To describe and quantitate the radiological (mammographic and ultrasonographic) characteristics of male breast disease and to report the clinical and pathological findings. Materials and methods: Two-hundred-thirty-six male patients with different male breast diseases, diagnosed at our institution between January 1990 and July 2001, were retrospectively evaluated. The history, physical examination, mammographic and ultrasonographic findings were analyzed. Results: The spectrum of the disease in 236 male patients were gynecomastia (n=206), primary breast carcinoma (n=14), fat necrosis (n=5), lipoma (n=3), subareolar abscess (n=2), epidermal inclusion cyst (n=1), sebaceous cyst (n=1), hematoma (n=1), myeloma (n=1), and metastatic carcinoma (n=2). The distribution of patterns of gynecomastia were; 34% (n=71) nodular, 35% (n=73) dendritic and 31% (n=62) diffuse glandular. Gynecomastia was unilateral in 55% (n=113) and bilateral in 45% (n=93) of the patients. Male breast cancer presented as a mass without microcalcifications in 86% (n=12) and with microcalcifications in 7% (n=1) of patients. The mass was obscured by gynecomastia, partially in two, totally in one patient. The location of the mass was retroareolar in 46% (n=6) and eccentric to the nipple in 54% (n=7) of patients. On ultrasonography (US), the contours were well-circumscribed in 20% (n=3) and irregular in 80% (n=12) of the masses. Conclusion: Male breast has a wide spectrum of diseases, some of which have characteristic radiological appearances that can be correlated with their pathologic diagnosis. In the evaluation of the male breast, mammography and US are essential and should be performed along with physical examination.

  15. Clinical Features and Ultrasonographic Findings of Lactating Adenoma

    International Nuclear Information System (INIS)

    Purpose: This study was designed to evaluate the clinical manifestations and characteristic ultrasonographic findings of lactating adenoma in pregnant or lactating women. Ultrasonographic findings of nine lactating adenomas in nine patients (age range, 19-38 years; mean age, 30.4 years) were retrospectively reviewed. All of the lesions were histologically diagnosed with the use of an ultrasound (US) guided core needle biopsy. Ultrasonographic findings were categorized according to the ACR/BI-RADS classification. The size of the lesions varied from 13 to 43 mm (mean, 27.8 mm). The most common findings of the breast lesions were an oval-shape (n = 9, 100%), presence of circumscribed margins (n = 5, 55.6%), a location parallel to the chest wall (n = 9, 100%), the presence of complex or hypoechoic lesions (n = 7, 77.8%), posterior acoustic enhancement (n = 5, 55.6%) and no microcalcifications (n = 8, 88.9%). Six lesions (66.7%) were classified as category 3 (probably benign lesions) and three lesions (33.3%) were classified as category 4A (low-suspicion for malignancy). Followup ultrasonography was performed in six patients; four (66.7%) patients showed complete resolution and two (33.3%) patients showed a decreased size of the lesions. One patient developed a milk fistula as a complication of the core needle biopsy as seen on a follow-up evaluation. Conclusion: Ultrasonographic findings of lactating adenomas are generally benign, with some lesions displaying suspicious malignant findings. On follow-up US images after the use of an US-guided core needle biopsy, all lesions showed complete regression or a decreased size

  16. Clinical and pathological features in 49 elderly patients with meningiomas

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: As aging in elderly people, their brain tissue has degeneration and brain atrophy of different severity, and the volume of cranial cavity is relatively enlarged, it has greater compensatory ability to the space occupying lesion, and it is difficult to detect the meningioma because it grows to expand slowly, the tumor locates in non-functional region, and there are atypical symptoms and deficiency of localization signs.OBJECTIVE: To investigate the clinicopathologic features of senile meningiomas.DESIGN: A retrospective analysis.SETTING: Affiliated Hospital of Hebei University.PARTICIPANTS: Forty-nine elderly patients with meningioma were selected from the Department of Neurosurgery, Affiliated Hospital of Hebei University from May 1999 to March 2005, including 15 males and 34 females, 60 - 74 years of age, and they were all diagnosed by CT and MRI.METHODS: The sites of tumors were identified by CT and MRI examinations in all the patients. The tumors were partially or totally resected according to their own conditions. The types of the resected tumor were pathologically observed. The conditions of postoperative recovery were observed after 1, 3 and 6 months, and without new neurological dysfunction or complication was considered as good outcome.MAIN OUTCOME MEASURES: ① Sites and pathological types of the tumor; ② Postoperative outcomes and complications.RESULTS: All the 49 patients were involved in the analysis of results. ① The tumors had wide distributions with a main location in brain convexity. Among the 49 cases of meningioma, there were 25 cases of fibrocystic type, 12 cases of meningothelial type, 6 cases of psammomatous type, 4 cases of angiomatous type and 2 cases of microcystic type. ② Among the 49 patients, 35 had good outcome, 8 had self-care ability, 4 required care by others, 2 (4.1%) died postoperatively. No long-term complication related to the operation was observed during the follow-up postoperatively.CONCLUSION: Meningioma has

  17. Clinical features, current treatments and outcome of pregnant women with preeclampsaia/eclampsia in northern afghanistan.

    Science.gov (United States)

    Ahadi, Sayed Shir Mohammad; Yoshida, Yoshitoku; Rabi, Mirwais; Sarker, Mohammad Abul Bashar; Reyer, Joshua A; Hamajima, Nobuyuki

    2015-02-01

    In Afghanistan, preeclampsia/eclampsia is the second leading cause of maternal deaths following maternal hemorrhage. This study aimed to describe clinical features, current treatments, and outcome among preeclampsia and eclampsia patients in the north region of Afghanistan. This was a retrospective study based on medical records of four center hospitals (one regional hospital and three provincial hospitals) in the north region of Afghanistan. Subjects were 322 patients with preeclampsia/eclampsia, admitted from March 2012 to March 2013. Out of 322 cases, 72.7% were diagnosed as preeclampsia and the rest as eclampsia. Those aged 30-39 years were 41.0% among preeclampsia patients and 29 years and younger were 35.2% among eclampsia patients (p= 0.002). The first delivery was significantly higher (p=0.045) among eclampsia patients (51.1%) than among preeclampsia patients (36.8%). While none died among the preeclampsia patients, 12 out of 88 eclampsia patients died in the hospitals. The causes of the 12 deaths were pulmonary edema (6 patients), renal failure (3 patients), cerebrovascular attack (2 patients), and hemorrhage (1 patient). There were no clinical findings at admission significantly associated with the deaths within the eclampsia patient group. Although the sample size was not large enough, patients admitted to the regional/provincial hospitals at the stage of preeclampsia had a low risk of death. Access at the stage of preeclampsia and improvement in treatments for eclampsia would reduce maternal mortality in Afghanistan. PMID:25797975

  18. Actinomycosis: etiology, clinical features, diagnosis, treatment, and management

    Directory of Open Access Journals (Sweden)

    Valour F

    2014-07-01

    Full Text Available Florent Valour,1–3 Agathe Sénéchal,1,2 Céline Dupieux,2–4 Judith Karsenty,1,2 Sébastien Lustig,2,5 Pierre Breton,2,6 Arnaud Gleizal,2,7 Loïc Boussel,2,8,9 Frédéric Laurent,2–4 Evelyne Braun,1 Christian Chidiac,1–3 Florence Ader,1–3 Tristan Ferry1–3 1Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France; 2Université Claude Bernard Lyon 1, Lyon, France; 3Centre International de Recherche en Infectiologie, CIRI, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France; 4Laboratoire de Bactériologie, Centre de Biologie du Nord, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France; 5Chirurgie Orthopédique, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France; 6Stomatologie et Chirurgie Maxillo-faciale, Hospices Civils de Lyon, Groupement Hospitalier Sud, Lyon, France; 7Chirurgie Maxillo-faciale, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France; 8Radiologie, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France; 9Creatis, CNRS UMR 5220, INSERM U1044, Université Lyon 1, INSA Lyon, Lyon, France Abstract: Actinomycosis is a rare chronic disease caused by Actinomyces spp., anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and genital tracts. Physicians must be aware of typical clinical presentations (such as cervicofacial actinomycosis following dental focus of infection, pelvic actinomycosis in women with an intrauterine device, and pulmonary actinomycosis in smokers with poor dental hygiene, but also that actinomycosis may mimic the malignancy process in various anatomical sites. Bacterial cultures and pathology are the cornerstone of diagnosis, but particular conditions are required in order to get the correct diagnosis. Prolonged bacterial cultures in anaerobic conditions are necessary to identify the bacterium and typical microscopic findings include necrosis with

  19. The relationship between the angiographic findings and the clinical features of carotid artery plaque.

    Science.gov (United States)

    Kim, D I; Lee, S J; Lee, B B; Kim, Y I; Chung, C S; Seo, D W; Lee, K H; Ko, Y H; Kim, D K; Do, Y S; Byun, H S

    2000-01-01

    The purpose of this study was to investigate the histological characteristics of atheromatous carotid plaque, and to analyze the relationship between the angiographic findings and the clinical features. We retrospectively reviewed 55 cases of carotid endarterectomy for extracranial internal carotid artery stenosis, who were treated at our institute from January 1995 to December 1997. The histological examination included hematoxylin-eosin staining, Masson-trichrome staining, and immunostaining for antismooth muscle antibody and anti-CD68 antibody. The main compositions of the carotid plaque included synthetic type vascular smooth muscle cells and extracellular matrix. The histological findings showed ulceration in 49 (89.1%) cases, calcium deposits in 42 (76.4%) cases, and an inflammatory reaction in 44 (80.0%) cases. Neurological abnormalities were strongly associated with plaque ulceration (P = 0.045) and an inflammatory reaction (P = 0.013), whereas no correlation existed regarding calcium deposits (P = 0.173). The angiographic findings showed ulceration in 46 (83.6%) cases. Plaque ulceration in the angiography findings showed no statistically significant correlation with the histologic findings (P = 0.410) and preoperative neurologic abnormalities (P = 0.059). All of the atherosclerotic risk factors such as hypertension, smoking, diabetes mellitus, hyperlipidemia, and myocardial infarction had no statistically significant correlation with the histological features of the carotid plaque. In conclusion, the main compositions of carotid plaque were synthetic-type vascular smooth muscle cells and extracellular matrix. The histological ulceration and inflammatory reaction of the plaque showed a statistically significant correlation with the preoperative neurologic symptoms, whereas no correlation was seen in the calcium deposits. Angiographic ulceration showed no correlation with the histological findings or preoperative neurologic abnormalities. In addition, the

  20. Competing risk and heterogeneity of treatment effect in clinical trials

    Directory of Open Access Journals (Sweden)

    Alsheikh-Ali Alawi

    2008-05-01

    Full Text Available Abstract It has been demonstrated that patients enrolled in clinical trials frequently have a large degree of variation in their baseline risk for the outcome of interest. Thus, some have suggested that clinical trial results should routinely be stratified by outcome risk using risk models, since the summary results may otherwise be misleading. However, variation in competing risk is another dimension of risk heterogeneity that may also underlie treatment effect heterogeneity. Understanding the effects of competing risk heterogeneity may be especially important for pragmatic comparative effectiveness trials, which seek to include traditionally excluded patients, such as the elderly or complex patients with multiple comorbidities. Indeed, the observed effect of an intervention is dependent on the ratio of outcome risk to competing risk, and these risks – which may or may not be correlated – may vary considerably in patients enrolled in a trial. Further, the effects of competing risk on treatment effect heterogeneity can be amplified by even a small degree of treatment related harm. Stratification of trial results along both the competing and the outcome risk dimensions may be necessary if pragmatic comparative effectiveness trials are to provide the clinically useful information their advocates intend.

  1. Diagnosis of Hair Loss: Clinical features of common causes of hair loss

    OpenAIRE

    Coupe, Robert L.M.

    1992-01-01

    Common causes of hair loss include androgenic hair loss, alopecia areata, trichotillomania, tinea capitis, telogen effluvium, and traction alopecia. The author discusses their distinguishing clinical features and those of less common alopecias.

  2. Clinical features of adult patients with Eisenmenger syndrome associated with different types of congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    陈果

    2013-01-01

    Objective To explore the clinical features and hemodynamics of adult patients with Eisenmenger syndrome in different types of congenital heart diseases (CHD) .Methods Patients with Eisenmenger syndrome with different types of CHD diagnosed by right heart

  3. Distinct Clinic-Pathological Features of Early Differentiated-Type Gastric Cancers after Helicobacter pylori Eradication

    OpenAIRE

    Noriyuki Horiguchi; Tomomitsu Tahara; Tomohiko Kawamura; Masaaki Okubo; Takamitsu Ishizuka; Yoshihito Nakagawa; Mitsuo Nagasaka; Tomoyuki Shibata; Naoki Ohmiya

    2016-01-01

    Background. Gastric cancer is discovered even after successful eradication of H. pylori. We investigated clinic pathological features of early gastric cancers after H. pylori eradication. Methods. 51 early gastric cancers (EGCs) from 44 patients diagnosed after successful H. pylori eradication were included as eradication group. The clinic-pathological features were compared with that of 131 EGCs from 120 patients who did not have a history of H. pylori eradication (control group). Results. C...

  4. Clinical features, management and visual outcome of polypoidal choroidal vasculopathy in Indian patients

    OpenAIRE

    Anantharaman Giridhar; Ramkumar Gudapati; Gopalakrishnan Mahesh; Rajput Alpesh

    2010-01-01

    Aims: To present the clinical, indocyanine green angiography (ICGA) features and results of treatment for polypoidal choroidal vasculopathy (PCV) in Indian patients by a retrospective chart review.Materials and Methods: Forty five patients with PCV underwent complete ocular examination, fluorescein angiography (FFA) and ICGA. Treatment was advised for patients with macular involvement and progressive loss of visual acuity. Demographic data, clinical features and results of treatment were anal...

  5. Feature Selection for Bayesian Evaluation of Trauma Death Risk

    CERN Document Server

    Jakaite, L

    2008-01-01

    In the last year more than 70,000 people have been brought to the UK hospitals with serious injuries. Each time a clinician has to urgently take a patient through a screening procedure to make a reliable decision on the trauma treatment. Typically, such procedure comprises around 20 tests; however the condition of a trauma patient remains very difficult to be tested properly. What happens if these tests are ambiguously interpreted, and information about the severity of the injury will come misleading? The mistake in a decision can be fatal: using a mild treatment can put a patient at risk of dying from posttraumatic shock, while using an overtreatment can also cause death. How can we reduce the risk of the death caused by unreliable decisions? It has been shown that probabilistic reasoning, based on the Bayesian methodology of averaging over decision models, allows clinicians to evaluate the uncertainty in decision making. Based on this methodology, in this paper we aim at selecting the most important screeni...

  6. Brucellosis in Kosovo and Clinical Features of Brucellosis at University clinical center of Kosovo

    OpenAIRE

    Emine Qehaja Buçaj; Edmond Puca; Sadie Namani; Muharem Bajrami; Valbon Krasniqi; Lindita Ajazaj Berisha; Xhevat Jakupi; Bahrie Halili; Dhimiter Kraja

    2015-01-01

    Objective: Brucellosis became a remarkable disease in Kosovo. But there is not a comprehensive epidemiological study about epidemiology and clinical course of this disease from Kosovo. The aim of our study is to present demographic and clinical data of patients with brucellosis at University Clinical Center of Kosovo. Methods: A retrospective study was performed for the patients with brucellosis treated in our clinic during years 2011- 2012. The data about demography, history of the diseas...

  7. Predicting Relapse in Patients With Medulloblastoma by Integrating Evidence From Clinical and Genomic Features

    NARCIS (Netherlands)

    P. Tamayo; Y.J. Cho; A. Tsherniak; H. Greulich; L. Ambrogio; N. Schouten-van Meeteren; T. Zhou; A. Buxton; M. Kool; M. Meyerson; S.L. Pomeroy; J.P. Mesirov

    2011-01-01

    Purpose Despite significant progress in the molecular understanding of medulloblastoma, stratification of risk in patients remains a challenge. Focus has shifted from clinical parameters to molecular markers, such as expression of specific genes and selected genomic abnormalities, to improve accurac

  8. Risk perception and clinical decision making in primary care

    DEFF Research Database (Denmark)

    Barfoed, Benedicte Marie Lind

    2015-01-01

    Objectives We aim to present new knowledge about different perspectives of health care professionals’ risk perceptions and clinical decision making. Furthermore, we intend to discuss differences between professional and personal risk perceptions and the impact on decisions in terms of both short...... considerations and the specific context. Most research has been focused on understanding of the concepts of risk. However healthcare professionals’ risk perception and personal attitudes also affect their clinical decision-making and risk communication. The differences between health care professionals’ personal...... and professional risk perception and attitudes and the subsequent impact on patients’ decision making have not previously been discussed. Content 1. Peder Halvorsen, MD, Professor, General Practice, Department of Community Medicine, The Arctic University of Norway: Making good decisions: Intuition or...

  9. Syncope: risk stratification and clinical decision making.

    Science.gov (United States)

    Peeters, Suzanne Y G; Hoek, Amber E; Mollink, Susan M; Huff, J Stephen

    2014-04-01

    Syncope is a common occurrence in the emergency department, accounting for approximately 1% to 3% of presentations. Syncope is best defined as a brief loss of consciousness and postural tone followed by spontaneous and complete recovery. The spectrum of etiologies ranges from benign to life threatening, and a structured approach to evaluating these patients is key to providing care that is thorough, yet cost-effective. This issue reviews the most relevant evidence for managing and risk stratifying the syncope patient, beginning with a focused history, physical examination, electrocardiogram, and tailored diagnostic testing. Several risk stratification decision rules are compared for performance in various scenarios, including how age and associated comorbidities may predict short-term and long-term adverse events. An algorithm for structured, evidence-based care of the syncope patient is included to ensure that patients requiring hospitalization are managed appropriately and those with benign causes are discharged safely. PMID:25105200

  10. The prognostic impact of clinical and molecular features in hairy cell leukaemia variant and splenic marginal zone lymphoma.

    Science.gov (United States)

    Hockley, Sarah L; Else, Monica; Morilla, Alison; Wotherspoon, Andrew; Dearden, Claire; Catovsky, Daniel; Gonzalez, David; Matutes, Estella

    2012-08-01

    Hairy cell leukaemia variant (HCL-variant) and splenic marginal zone lymphoma (SMZL) are disorders with overlapping features. We investigated the prognostic impact in these disorders of clinical and molecular features including IGH VDJ rearrangements, IGHV gene usage and TP 53 mutations. Clinical and laboratory data were collected before therapy from 35 HCL-variant and 68 SMZL cases. End-points were the need for treatment and overall survival. 97% of HCL-variant and 77% of SMZL cases required treatment (P = 0·009). Survival at 5 years was significantly worse in HCL-variant [57% (95% confidence interval 38-73%)] compared with SMZL [84% (71-91%); Hazard Ratio 2·25 (1·20-4·25), P = 0·01]. In HCL-variant, adverse prognostic factors for survival were older age (P = 0·04), anaemia (P = 0·01) and TP 53 mutations (P = 0·02). In SMZL, splenomegaly, anaemia and IGHV genes with >98% homology to the germline predicted the need for treatment; older age, anaemia and IGHV unmutated genes (100% homology) predicted shorter survival. IGHV gene usage had no impact on clinical outcome in either disease. The combination of unfavourable factors allowed patients to be stratified into risk groups with significant differences in survival. Although HCL-variant and SMZL share some features, they have different outcomes, influenced by clinical and biological factors. PMID:22594855

  11. Hypernatremia in Children With Diarrhea: Presenting Features, Management, Outcome, and Risk Factors for Death.

    Science.gov (United States)

    Chisti, Mohammad Jobayer; Ahmed, Tahmeed; Ahmed, A M Shamshir; Sarker, Shafiqul Alam; Faruque, Abu Syed Golam; Islam, Md Munirul; Huq, Sayeeda; Shahrin, Lubaba; Bardhan, Pradip Kumar; Salam, Mohammed Abdus

    2016-06-01

    We sought to investigate the magnitude, clinical features, treatment, and outcome of children suffering from hypernatremic diarrhea and to identify risk factors for fatal outcome among them. We reviewed 2 data sets of children hypernatremia (serum sodium ≥150 mmol/L): (a) March 2001 to March 2002 (n = 371) and (b) March 2009 to August 2011 (n = 360). We reviewed their records and collected relevant information for analyses. The prevalence of hypernatremia was 5.1% (371/7212) and 2.4% (360/15 219), case fatality rate was 15% and 19%, respectively. In logistic regression analysis, the risk for death significantly increased in association with serum sodium ≥170 mmol/L, nutritional edema, hypoglycemia, respiratory distress, and absent peripheral pulses and reduced with the sole use of oral rehydration salts (ORS) or ORS following intravenous fluid, if indicated (for all, P hypernatremia using only ORS or ORS following intravenous fluid may help reduce the number of deaths. PMID:26810623

  12. Nocardiosis: Risk Factors, Clinical Characteristics and Outcome

    OpenAIRE

    Alavi Darazam, Ilad; Shamaei, Masoud; Mobarhan, Mandana; Ghasemi, Shahin; Tabarsi, Payam; Motavasseli, Masoud; Mansouri, Davood

    2013-01-01

    Nocardiosis has been reported increasingly in recent two decades, probably due to improvement in isolation of the organism and increased burden of immune compromised patients. Nocardia occasionally has been reported in healthy people. A case series of definitive Nocardiosis (2002 to 2010), clinical characteristics, underlying diseases, immune status and in-patient outcome were studied in a tertiary referral center. Twenty one patients with definite diagnosis of Nocardiosis were studied. 17 ca...

  13. Clinical, biochemical and ultrasonographic features of infertile women with polycystic ovarian syndrome

    International Nuclear Information System (INIS)

    To evaluate and compare the clinical, biochemical and ultrasonic features of infertile women with PCOS from the two infertility centers of Karachi, The Aga Khan University Hospital and Concept Fertility Centre. Patients attending the Infertility Clinics of Aga Khan University Hospital, Karachi and Concept Fertility Centre, Karachi, were evaluated for their clinical features. Complete biochemical evaluation was performed by day 2 FSH, LH, serum prolactin, serum testosterone and fasting serum insulin determination. These results were recorded on the data collection form. Ultrasonic evaluation was performed with transvaginal ultrasound to check the morphological appearance of ovaries. A total of 508 patients were evaluated for epidemiological features of PCOS. Frequency of PCOS in the infertility clinic was 17.6% with high rate of obesity (68.5%) and hyperinsulinemia (59%). The highest rate of abnormal clinical, biochemical features were seen above BMI of 30. High rates of obesity, hyperinsulinemia and impaired glycemic control were seen in this series. It was demonstrated that high BMI had an association and correlation with abnormal clinical and biochemical features. Obese women with PCOS need more attention for their appropriate management. (author)

  14. 川东北地区原发性痛风的临床特点及发病危险因素分析%Logistic regression analysis on clinical features and related risk factors of primary gout in the northeastern area of China

    Institute of Scientific and Technical Information of China (English)

    李玲琴; 青玉凤; 周畅; 周京国

    2014-01-01

    Objective To explore the clinical features and related risk factors of primary gout in the northeastern area of China .Methods A clinical investigation and related laboratory indicator detections of primary gout were made on 583 cases of patients with primary gout and 459 healthy persons by a unified questionnaire .Then, logistic regression analysis was applied in analyzing related risk factors .Results (1) Only a joint was involved in the first attack of 94.9% of pa-tients, while the first metatarsophalangeal joint accounted for 68.6%.(2) 37.6%of patients didn't have predisposing fac-tors, 62.4%of patients had predisposing factors , during which 88.2%of 364 patients was related with beer, sea food and other dietary factors.(3) The rates of patients complicated with tophus , hypertension and hyperlipidemia were 12.2%, 35.7%and 66.9%.(4) Tophus occurred in the 3-8 years after the gout, when we compared with patients without tophus , the course of disease was longer , and the level of serum uric acid ( SUA) was significantly higher than that of patients with tophus (all P<0.01).(5) Logistic regression analysis indicated the occurrence of primary gout was related to the follow-ing factors:hyperuricemia, drinking, BMI, hypertriglyceridemia, eating habits, hypertension and smoking (P<0.01 or P<0.05).Conclusion Primary gout is affected by many factors; hyperuricemia, drinking, BMI, high TG, high purine diet, hypertension and smoking may increase the onset risk .%目的:探讨川东北地区原发性痛风的临床特点及发病危险因素。方法采用统一调查表,对583例原发性痛风患者及459例健康体检者进行临床调查及相关实验室指标检测,采用Logistic回归分析痛风的发病危险因素。结果①94.9%的患者首次发作时累及一个关节,其中累及第一跖趾关节者占68.6%。②痛风发作无诱因者占37.6%;有诱因者占62.4%,其中88.2%与饮食因素有关。③痛风并发

  15. Introduction and Clinical Overview of the DVH Risk Map.

    Science.gov (United States)

    Asbell, Sucha O; Grimm, Jimm; Xue, Jinyu; Chew, Meng-Sang; LaCouture, Tamara A

    2016-04-01

    Radiation oncologists need reliable estimates of risk for various fractionation schemes for all critical anatomical structures throughout the body, in a clinically convenient format. Reliable estimation theory can become fairly complex, however, and estimates of risk continue to evolve as the literature matures. To navigate through this efficiently, a dose-volume histogram (DVH) Risk Map was created, which provides a comparison of radiation tolerance limits as a function of dose, fractionation, volume, and risk level. The graphical portion of the DVH Risk Map helps clinicians to easily visualize the trends, whereas the tabular portion provides quantitative precision for clinical implementation. The DVH Risk Map for rib tolerance from stereotactic ablative body radiotherapy (SABR) and stereotactic body radiation therapy (SBRT) is used as an example in this overview; the 5% and 50% risk levels for 1-5 fractions for 5 different volumes are given. Other articles throughout this issue of Seminars in Radiation Oncology present analysis of new clinical datasets including the DVH Risk Maps for other anatomical structures throughout the body. PMID:27000504

  16. Automated Risk Identification of Myocardial Infarction Using Relative Frequency Band Coefficient (RFBC) Features from ECG

    OpenAIRE

    Bakul, Gohel; Tiwary, U.S

    2010-01-01

    Various structural and functional changes associated with ischemic (myocardial infarcted) heart cause amplitude and spectral changes in signals obtained at different leads of ECG. In order to capture these changes, Relative Frequency Band Coefficient (RFBC) features from 12-lead ECG have been proposed and used for automated identification of myocardial infarction risk. RFBC features reduces the effect of subject variabilty in body composition on the amplitude dependent features. The proposed ...

  17. Clinical and pathological features and surgical treatment of Budd-Chiari syndrome-associated hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    WANG Ya-dong; XUE Huan-zhou; ZHANG Xiao; XU Zong-quan; JIANG Qing-feng; SHEN Quan; YU Miao

    2013-01-01

    Background Budd-Chiari syndrome (BCS) is characterized by liver sinusoidal congestion,ischemic liver cell damage,and liver portal hypertension caused by hepatic venous outflow constriction.The aim of this research was to investigate the clinicopathological features of BCS-associated hepatocellular carcinoma (HCC) and explore its surgical treatment and prognosis.Methods Clinical data from 38 patients with BCS-associated HCC who were surgically treated in our hospital from July 1998 to August 2010 were retrospectively analyzed.The clinicopathological features and prognosis of patients with BCS-associated HCC and surgical treatment for BCS-associated HCC were investigated.Results Compared to the patients with hepatitis B virus (HBV)-associated HCC,the patients with BCS-associated HCC showed a female predominance,and had significantly higher cirrhosis rate,higher incidence of solitary tumors,lower incidence of infiltrative growth,higher proportion of marginal or exogenous growth,lower rate of portal vein invasion,and higher degree of differentiation.Median survival was longer in patients with BCS-associated HCC (76 months) than in those with HBV associated HCC (38 months).Of 38 patients with BCS-associated HCC,22 patients who received combined surgery mainly by liver resection plus cavoatrial shunts exhibited hepatic venous outflow constriction relief,while the other 16 patients only underwent liver resection.The combined surgery group had significantly longer survival and lower incidences of post-operative lethal complications (P <0.05).Multivariate analysis showed that relief of hepatic venous outflow obstruction was a protective factor for survival of patients with BCS-associated HCC,whereas portal vein invasion was a risk factor.Conclusions BCS-associated HCC has a more favorable biological behavior and prognosis than HBV-associated HCC.For patients with BCS-associated HCC,tumor resection accompanied with relief of hepatic venous outflow obstruction can reduce

  18. An Educational System to Help Students Assess Website Features and Identify High-Risk Websites

    Science.gov (United States)

    Kajiyama, Tomoko; Echizen, Isao

    2015-01-01

    Purpose: The purpose of this paper is to propose an effective educational system to help students assess Web site risk by providing an environment in which students can better understand a Web site's features and determine the risks of accessing the Web site for themselves. Design/methodology/approach: The authors have enhanced a prototype…

  19. Clinical and imaging features of intracranial arterial aneurysms in the pediatric population

    International Nuclear Information System (INIS)

    Intracranial arterial aneurysms (IAAs) are rare in children. Nevertheless, IAAs account for at least 10 % - 15 % of hemorrhagic strokes during the first two decades of life. Traditional vascular risk factors, which are common in the adult population, are generally absent in the pediatric population, engendering distinct modes of IAA pathogenesis. Classification of pediatric IAAs according to the pathogenetic mechanism shows eight distinct categories: idiopathic, traumatic, those due to excessive hemodynamic stress, vasculopathic, infectious, noninfectious inflammatory, oncotic, and familial. Pathogenetic mechanism is the best predictor of the clinical course of the disease, response to treatment, and long-term prognosis. The pathogenetic subtypes of pediatric IAA show characteristic and variably overlapping features. In most cases, IAAs manifesting during the first two decades of life are idiopathic. IAAs that are idiopathic, traumatic (second most common type), or due to excessive hemodynamic stresses (third most common type) account for more than 80 % of IAAs in the pediatric age group. Most of the remaining pediatric IAAs are the result of congenital cerebral aneurysmal arteriopathies or infection. Multiple IAAs are unusual in young children except in those with acquired (secondary to immune deficiency states) or congenital cerebral aneurysmal arteriopathies or infectious IAAs. (orig.)

  20. Analysis on the childhood and adolescent differentiated thyroid cancer: clinical features and radioiodine treatment

    International Nuclear Information System (INIS)

    Objective: Children with differentiated thyroid cancer (DTC) frequently present with more extensive disease than adults. The aim of this study was to characterize the clinical features of child-hood and adolescent DTC and evaluate the outcome and safety of radioiodine treatment. Methods: The records of 38 childhood and adolescent DTC cases, with 28 females and 10 males (mean age: 16.4 years) were reviewed. At diagnosis, all had metastatic lesions with 38 at regional lymph nodes, 15 at lung, 2 at brain and bone. Twenty-three had a total thyroidectomy, 7 had subtotal thyroidectomy, 5 had lobectomy, and 3 had other treatment. All received post-operative radioiodine therapy. All had follow-up for at least one year. Results: At the time of follow-up, all were survive (with a median follow-up of 5.13 years). Four-teen patients had no evidence of disease, 16 had partial remission, and 8 were stable disease. Conclusions: DTC of the thyroid in childhood and adolescent has high risks of residual/recurrence and metastasis. Post-thyroidectomy oral administration of radioiodine was an effective and safety adjuvant therapy for outcomes. (authors)

  1. A clinical feature and therapeutic strategy in pituitary adenomas associated with intracranial aneurysms

    International Nuclear Information System (INIS)

    We studied the clinical feature and treatment strategy of pituitary adenomas associated with intracranial aneurysms. Among 102 pituitary adenoma patients (mean age: 54.8 years old) who received MR angiography and/or 3D-CT angiography,seven patients (6.9%) had intracranial aneurysms. The association of an aneurysm was more common in large size adenomas (p<0.05). According to the location of the aneurysms,five patients had these in the paraclinoid portion or cavernous portion of the internal carotid artery. Using MR images,we classified the aneurysms associated with pituitary adenomas as non-adjacent,adjacent,and intra-adenoma types. In non-adjacent types,an aneurysm is located apart from the adenoma,and has less chance of exposure during transsphenoidal surgery. In adjacent types,an aneurysm is located adjacent to the adenoma,and could be exposed during transsphenoidal surgery. In intra-adenoma types,an aneurysm is encased in the adenoma. In non-adjacent type aneurysms,a resection of the pituitary adenoma can be carried out before aneurysm treatment due to the low risk of rupture during surgery. In adjacent types,a tumor resection can precede aneurysm treatment in cases of low rupture risk aneurysms and untreatable aneurysms. In intra-adenoma types,adenoma resection should come after treatment of the aneurysms. Neurosurgeons should be careful about not only the presence of aneurysms in preoperative images during transsphenoidal surgery planning,but also their locations and proximity to adenomas. Such information may be crucial in deciding the order of treatment. (author)

  2. Spinal cord infarction: MR imaging and clinical features in 16 cases

    International Nuclear Information System (INIS)

    Spinal cord infarctions are rare and due to heterogeneous etiologies. The aim of the study was to analyze the MR imaging findings and evaluate their correlations with clinical symptoms in ischemic spinal cord lesions. MR images and clinical features of 16 patients (11 male, 5 female) with typical sudden onset of neurological deficits caused by spinal cord ischemia were evaluated. MR imaging was performed within 2 h to 14 days after the initial neurological symptoms. Eight patients had follow-up examinations including contrast-enhanced MR imaging. MR abnormalities were best demonstrated on sagittal T2-weighted images, with ''pencil-like'' hyperintensities (16/16) and cord enlargement (9/16). Axial T2-weighted images showed bilateral (13/16) and unilateral (3/16) hyperintensities according, in 15 patients, to anterior spinal artery (ASA) territory, with three of them located particularly in the spinal sulcal artery territory. In one patient only the posterior spinal artery (PSA) territory was involved. Spinal cord was affected at the cervical level (especially C2-C3) in seven patients, at the upper thoracic level (T3-T5) in two patients and at the thoracolumbar region including the conus medullaris (T10-L1) in seven patients. Presumed etiologies were vascular surgery (3 patients), infrarenal aortic aneurysm (1 patient), bilateral vertebral artery dissection (1 patient), hypotension (1 patient), spine operation (1 patient), excessive cocaine misuse (1 patient) and cardioembolic vertebral artery occlusion (1 patient); six of seven patients with unclear etiologies had vascular risk factors such as hypertension, diabetes and cigarette smoking. MR imaging is therefore useful in detecting spinal cord infarction, with axial T2-weighted images showing hyperintensities in the ASA territory in 15 of 16 patients. Contrary to the presumed spinal cord watershed at the lower cervical and upper thoracic level, and despite numerous central arteries in the cervical cord, our data

  3. Clinical features of diabetes mellitus in Japan as observed in a hospital outpatient clinic

    Energy Technology Data Exchange (ETDEWEB)

    Wada, Sunao; Toda, Shintaro; Omori, Yoshiaki; Yamakido, Michio; Blackard, W.G.

    1963-04-18

    A university diabetes clinic in Japan was characterized by age at examination, age at onset, sex ratio, microangiopathies, atherosclerotic complications, weight, heredity, and diet. The findings in this clinic, along with those from other diabetes clinics in Japan, were compared with studies on Western diabetics. The similarities between the 2 diabetic populations far outnumbered the dissimilarities. However, diabetes mellitus in Japan is distinguished by infrequent occurrence of juvenile diabetes and ketosis, relative lack of atherosclerotic complications, and reversal of the sex ratio. 39 references, 7 tables.

  4. CHRONIC URTICARIAL IN CHILDHOOD. CLINICAL FEATURES OF CHRONIC URTICARIA IN CHILDREN. DIFFERENTIAL DIAGNOSTICS (PART II

    Directory of Open Access Journals (Sweden)

    N. A. Sinelnikova

    2014-07-01

    Full Text Available Abstract. Clinical structure of urticaria has been changed over last decade, due to discovery of an autoimmune form of the disease. This clinical form of chronic idiopathic urticaria comprises 30 to 52% of total. Incidence of physical urticaria varies from 17 to 20%, whereas other forms, including allergic urticaria, are diagnosed for < 5% of the patients. Different types of chronic urticaria exhibit their typical immunological features and clinical characteristics. A joint study of European Expert Group for Allergology, Clinical Immunology and Dermatology (EAACI/GA2LEN/EDF/UNEV is going on. Appropriate recommendations are aimed for improvement of diagnosis and management of children with this disease.

  5. Clinical presentation and risk factors of osteoradionecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Chronopoulos, Aristeidis

    2015-03-26

    Introduction: Osteoradionecrosis (ORN) of the jaws is defined as exposed irradiated bone that fails to heal over a period of 3 months without the evidence of a persisting or recurrent tumor. In the previous decades, numerous factors were associated with the risk of ORN development and severity. Aims: The purposes of this study were to present the data of the patients that were treated for ORN in the Department of Oral and Maxillofacial Surgery in Munich (LMU), to detect factors that contributed to the onset of ORN, to identify risk factors associated with the severity of ORN and finally, to delineate and correlate these factors with the personal, health and treatment characteristics of the patients. Material and Methods: A retrospective study was conducted during the period from January 2003 until December 2012 that included all ORN cases having been treated in the Department of Oral and Maxillofacial Surgery in Munich (LMU). The total sample was categorized in three groups according to stage and several variables were evaluated in an attempt to identify possible correlations between them and the necrosis severity. Results: One hundred and fifty three cases of ORN were documented. Among them, 23 (15.1%) cases were stage I, 31 (20.2%) were stage II and 99 (64.7%) were stage III and all localised in the mandible. There was a predominance of the disease in the posterior region when compared to the anterior region. The majority of cases was addicted to alcohol and tobacco abuse and was suffering from Diabetes Mellitus (DM). All cases were treated with RT and 80.4% of them with concomitant chemotherapy. The initial tumor was predominantly located in the floor of the mouth, the tongue and the pharynx. Approximately two thirds of the cases occured either after dental treatment or due to a local pathological condition. Logistic regression analysis identified Diabetes Mellitus (OR: 4.955, 95% Cl: 1.965-12.495), active smoking (OR: 13.542, 95% Cl: 2.085-87.947), excessive

  6. Clinical presentation and risk factors of osteoradionecrosis

    International Nuclear Information System (INIS)

    Introduction: Osteoradionecrosis (ORN) of the jaws is defined as exposed irradiated bone that fails to heal over a period of 3 months without the evidence of a persisting or recurrent tumor. In the previous decades, numerous factors were associated with the risk of ORN development and severity. Aims: The purposes of this study were to present the data of the patients that were treated for ORN in the Department of Oral and Maxillofacial Surgery in Munich (LMU), to detect factors that contributed to the onset of ORN, to identify risk factors associated with the severity of ORN and finally, to delineate and correlate these factors with the personal, health and treatment characteristics of the patients. Material and Methods: A retrospective study was conducted during the period from January 2003 until December 2012 that included all ORN cases having been treated in the Department of Oral and Maxillofacial Surgery in Munich (LMU). The total sample was categorized in three groups according to stage and several variables were evaluated in an attempt to identify possible correlations between them and the necrosis severity. Results: One hundred and fifty three cases of ORN were documented. Among them, 23 (15.1%) cases were stage I, 31 (20.2%) were stage II and 99 (64.7%) were stage III and all localised in the mandible. There was a predominance of the disease in the posterior region when compared to the anterior region. The majority of cases was addicted to alcohol and tobacco abuse and was suffering from Diabetes Mellitus (DM). All cases were treated with RT and 80.4% of them with concomitant chemotherapy. The initial tumor was predominantly located in the floor of the mouth, the tongue and the pharynx. Approximately two thirds of the cases occured either after dental treatment or due to a local pathological condition. Logistic regression analysis identified Diabetes Mellitus (OR: 4.955, 95% Cl: 1.965-12.495), active smoking (OR: 13.542, 95% Cl: 2.085-87.947), excessive

  7. 儿童期急性白血病合并水痘的特点及其高危预后因素的临床分析%Clinical features of chickenpox and high risk factors of prognosis in childhood cases with acute lymphocytic leukemia

    Institute of Scientific and Technical Information of China (English)

    曾慧慧; 程澄; 陈志海; 李兴旺

    2015-01-01

    目的:分析儿童期急性淋巴细胞白血病(ALL)合并水痘的临床特点,探讨与预后相关的高危临床因素。方法对2008年1月1日~2014年12月31日首都医科大学附属北京地坛医院感染中心收治的儿童期ALL合并水痘的患儿及同期随机普通水痘患儿的临床资料进行回顾性对照分析。结果仅5例(31.25%)儿童期ALL患儿合并水痘有明确水痘接触史。13例(81.25%)儿童期ALL患儿合并水痘临床表现为高热,较普通水痘患儿热程长,为(7.38±3.32)d(t =5.575,P <0.05);皮疹结痂时间较长,为(10.92±2.50)d(t=4.928,P<0.05)。100%患儿出现骨髓抑制,其中10例(62.50%)患儿出现粒细胞缺乏,7例(43.75%)出现血小板减少;8例(50.00%)患儿肝功能异常。儿童期ALL患儿合并水痘经抗病毒、对症支持等治疗,临床治愈11例,自动出院4例,死亡1例。儿童期ALL患儿合并水痘临床表现危重和最终死亡者,具有应用静脉药物化疗方案治疗、化疗中或完成静脉化疗1周内罹患水痘、所有病例均出现骨髓抑制粒细胞缺乏且持续较长时间[(10.08±2.77) d]等特点。结论儿童期ALL患儿合并水痘具有临床症状持续时间长、并发骨髓抑制粒细胞减少等特点,经积极抗病毒及对症支持治疗后预后良好。应用静脉药物化疗中或完成化疗1周内罹患水痘、持续性粒细胞缺乏是与儿童期ALL患儿并发水痘预后不良的临床相关因素。%Objective To investigate the clinical features of chickenpox and the high risk factors of the prognosis in childhood patients with acute lymphocytic leukemia (ALL). Methods The clinical characteristics of chickenpox in childhood ALL patients hospitalized in Beijing Ditan Hospital, Capital Medical University, from January 1st, 2008 to December 31st, 2014 were studied, retrospectively, and the features of random ordinary children onset chickenpox

  8. Do pressure ulcer risk assessment scales improve clinical practice?

    Directory of Open Access Journals (Sweden)

    Jan Kottner

    2010-07-01

    Full Text Available Jan Kottner1, Katrin Balzer21Department of Nursing Science, Charité-Universitätsmedizin Berlin, Germany; 2Nursing Research Group, Institute for Social Medicine, Universitätsklinikum Schleswig-Holstein, Lübeck, GermanyAbstract: Standardized assessment instruments are deemed important for estimating pressure ulcer risk. Today, more than 40 so-called pressure ulcer risk assessment scales are available but still there is an ongoing debate about their usefulness. From a measurement point of view pressure ulcer (PU risk assessment scales have serious limitations. Empirical evidence supporting the validity of PU risk assessment scale scores is weak and obtained scores contain varying amounts of measurement error. The concept of pressure ulcer risk is strongly related to the general health status and severity of illness. A clinical impact due do the application of these scales could also not be demonstrated. It is questionable whether completion of standardized pressure ulcer risk scales in clinical practice is really needed.Keywords: Braden pressure ulcer, prevention, risk assessment, nursing assessment, predictive value, clinical effectiveness, review

  9. Distinct Clinic-Pathological Features of Early Differentiated-Type Gastric Cancers after Helicobacter pylori Eradication.

    Science.gov (United States)

    Horiguchi, Noriyuki; Tahara, Tomomitsu; Kawamura, Tomohiko; Okubo, Masaaki; Ishizuka, Takamitsu; Nakagawa, Yoshihito; Nagasaka, Mitsuo; Shibata, Tomoyuki; Ohmiya, Naoki

    2016-01-01

    Background. Gastric cancer is discovered even after successful eradication of H. pylori. We investigated clinic pathological features of early gastric cancers after H. pylori eradication. Methods. 51 early gastric cancers (EGCs) from 44 patients diagnosed after successful H. pylori eradication were included as eradication group. The clinic-pathological features were compared with that of 131 EGCs from 120 patients who did not have a history of H. pylori eradication (control group). Results. Compared with control group, clinic-pathological features of eradication group were characterized as depressed (p EGC after H. pylori eradication are depressed, reddish appearances, which should be treated as a caution because histological diagnosis of cancerous tissue is sometimes difficult by endoscopic biopsy. PMID:27212944

  10. Classification of spinocerebellar degeneration on the basis of clinical features and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Abe, Kazuo; Hirono, Nobutsugu; Udaka, Fukashi; Fujita, Masashi; Kameyama, Masakuni

    1989-04-01

    We measured diameters of pons, medulla, the fourth ventricle and culmen of vermis of 30 sporadic spinocerebellar degeneration patients on midsagittal plane of MR image. And we compared them with those of 30 age- and sex-matched controls, which were significantly different from the formers. Significant differences were also observed between patients with and without autonomic disturbances, however, not between patients with and without pyramidal signs. Traditionally spinocerebellar degeneration has been classified pathologically. But, time gap between pathological features and clinical ones makes its classification difficult. MR image is changing this situation and makes it possible to compare clinical features and atrophies of brainstem and cerebellum at the same time. This report shows the possibility of classifying this disease on the basis of clinical features and MR images. (author).

  11. The prognostic significance of clinical and pathological features in hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Lun-Xiu Qin; Zhao-You Tang

    2002-01-01

    The prognosis of patients with HCC still remains dismal. The life expectancy of HCC patients is hard to predict because of the high possibility of postoperative recurrence. Many factors, such as patient's general conditions, macroscopic tumor morphology, as well as tumor hictopathology features, have been proven of prognostic significance. Female HCC patient often has a better prognosis than male patient, which might be due to the receptor of sex hormones. Younger patients often have tumors with higher invasiveness and metastatic potentials, and their survival and prognosis are worse than the older ones. Co-existing hepatitis status and hepatic functional reserve have been confirmed as risk factors for recurrence. Serum alpha-fetoprotein (AFP) is useful not only for diagnosis, but also as a prognostic indicator for HCC patients. AFP mRNA has been proposed as a predictive marker of HCC cells disseminated into the circulation and for metastatic recurrence. Many pathologic features,such as tumor size, number, capsule state, cell differentiation, venous invasion, intrahepatic spreading, and advanced pTNM stage, are the best-established risk factors for recurrence and important aspects affecting the prognosis of patients with HCC. Marked inflammatory cell infiltration in the tumor could predict a better prognosis. Clinical stage is still the most important factor influencing on the prognosis. Extratumor spreading and lymph nodal metastasis are independent predictors for poor outcome. Soma new predictive systems have recently been proposed. Different strategies of treatment might have significant different effects on the patients'prognosis. To date, surgical resection is still the only potentially curative treatment for HCC,including localized postoperative recurrences.Extent of resection, blood transfusion, occlusion of porta hepatis, and blood loss affect the survival and prognosis of HCC patients. Regional therapies provide alternative ways to improve the prognosis of

  12. A comparison of clinical features among Japanese eating-disordered women with obsessive-compulsive disorder.

    Science.gov (United States)

    Matsunaga, H; Miyata, A; Iwasaki, Y; Matsui, T; Fujimoto, K; Kiriike, N

    1999-01-01

    Clinical features, such as obsessive-compulsive disorder (OCD) symptoms, were investigated in Japanese women with DSM-III-R eating disorders (EDs) and concurrent OCD in comparison to age-matched women with OCD. Sixteen women with restricting anorexia nervosa (AN), 16 with bulimia nervosa (BN), and 16 with both AN and BN (BAN) showed commonality in a more elevated prevalence of OCD symptoms of symmetry and order compared with 18 OCD women. Among the personality disorders (PDs), likewise, obsessive-compulsive PD (OCPD) was more prevalent in each ED group compared with the OCD group. However, aggressive obsessions were more common in both BN and BAN subjects compared with AN subjects. Subjects with bulimic symptoms were also distinguished from AN subjects by impulsive features in behavior and personality. Thus, an elevated prevalence of aggressive obsessions along with an admixture of impulsive and compulsive features specifically characterized the clinical features of bulimic subjects with OCD. PMID:10509614

  13. Evaluation of features to support safety and quality in general practice clinical software

    Directory of Open Access Journals (Sweden)

    Schattner Peter

    2011-05-01

    Full Text Available Abstract Background Electronic prescribing is now the norm in many countries. We wished to find out if clinical software systems used by general practitioners in Australia include features (functional capabilities and other characteristics that facilitate improved patient safety and care, with a focus on quality use of medicines. Methods Seven clinical software systems used in general practice were evaluated. Fifty software features that were previously rated as likely to have a high impact on safety and/or quality of care in general practice were tested and are reported here. Results The range of results for the implementation of 50 features across the 7 clinical software systems was as follows: 17-31 features (34-62% were fully implemented, 9-13 (18-26% partially implemented, and 9-20 (18-40% not implemented. Key findings included: Access to evidence based drug and therapeutic information was limited. Decision support for prescribing was available but varied markedly between systems. During prescribing there was potential for medicine mis-selection in some systems, and linking a medicine with its indication was optional. The definition of 'current medicines' versus 'past medicines' was not always clear. There were limited resources for patients, and some medicines lists for patients were suboptimal. Results were provided to the software vendors, who were keen to improve their systems. Conclusions The clinical systems tested lack some of the features expected to support patient safety and quality of care. Standards and certification for clinical software would ensure that safety features are present and that there is a minimum level of clinical functionality that clinicians could expect to find in any system.

  14. Evaluation of features to support safety and quality in general practice clinical software

    Science.gov (United States)

    2011-01-01

    Background Electronic prescribing is now the norm in many countries. We wished to find out if clinical software systems used by general practitioners in Australia include features (functional capabilities and other characteristics) that facilitate improved patient safety and care, with a focus on quality use of medicines. Methods Seven clinical software systems used in general practice were evaluated. Fifty software features that were previously rated as likely to have a high impact on safety and/or quality of care in general practice were tested and are reported here. Results The range of results for the implementation of 50 features across the 7 clinical software systems was as follows: 17-31 features (34-62%) were fully implemented, 9-13 (18-26%) partially implemented, and 9-20 (18-40%) not implemented. Key findings included: Access to evidence based drug and therapeutic information was limited. Decision support for prescribing was available but varied markedly between systems. During prescribing there was potential for medicine mis-selection in some systems, and linking a medicine with its indication was optional. The definition of 'current medicines' versus 'past medicines' was not always clear. There were limited resources for patients, and some medicines lists for patients were suboptimal. Results were provided to the software vendors, who were keen to improve their systems. Conclusions The clinical systems tested lack some of the features expected to support patient safety and quality of care. Standards and certification for clinical software would ensure that safety features are present and that there is a minimum level of clinical functionality that clinicians could expect to find in any system.

  15. [Does clinical risk management require a structured conflict management?].

    Science.gov (United States)

    Neumann, Stefan

    2015-01-01

    A key element of clinical risk management is the analysis of errors causing near misses or patient damage. After analyzing the causes and circumstances, measures for process improvement have to be taken. Process management, human resource development and other established methods are used. If an interpersonal conflict is a contributory factor to the error, there is usually no structured conflict management available which includes selection criteria for various methods of conflict processing. The European University Viadrina in Frankfurt (Oder) has created a process model for introducing a structured conflict management system which is suitable for hospitals and could fill the gap in the methodological spectrum of clinical risk management. There is initial evidence that a structured conflict management reduces staff fluctuation and hidden conflict costs. This article should be understood as an impulse for discussion on to what extent the range of methods of clinical risk management should be complemented by conflict management. PMID:25421136

  16. Suicide during Perinatal Period: Epidemiology, Risk Factors, and Clinical Correlates.

    Science.gov (United States)

    Orsolini, Laura; Valchera, Alessandro; Vecchiotti, Roberta; Tomasetti, Carmine; Iasevoli, Felice; Fornaro, Michele; De Berardis, Domenico; Perna, Giampaolo; Pompili, Maurizio; Bellantuono, Cesario

    2016-01-01

    Perinatal period may pose a great challenge for the clinical management and treatment of psychiatric disorders in women. In fact, several mental illnesses can arise during pregnancy and/or following childbirth. Suicide has been considered a relatively rare event during the perinatal period. However, in some mental disorders (i.e., postpartum depression, bipolar disorder, postpartum psychosis, etc.) have been reported a higher risk of suicidal ideation, suicide attempt, or suicide. Therefore, a complete screening of mothers' mental health should also take into account thoughts of suicide and thoughts about harming infants as well. Clinicians should carefully monitor and early identify related clinical manifestations, potential risk factors, and alarm symptoms related to suicide. The present paper aims at providing a focused review about epidemiological data, risk factors, and an overview about the main clinical correlates associated with the suicidal behavior during the pregnancy and postpartum period. Practical recommendations have been provided as well. PMID:27570512

  17. Rubinstein-Taybi syndrome: clinical features, genetic basis, diagnosis, and management

    OpenAIRE

    Milani, D.; F. Manzoni; Pezzani, L; P. Ajmone; C. Gervasini; F. Menni; ESPOSITO, S.

    2015-01-01

    Background Rubinstein-Taybi syndrome (RSTS) is an extremely rare autosomal dominant genetic disease, with an estimated prevalence of one case per 125,000 live births. RSTS is characterized by typical facial features, microcephaly, broad thumbs and first toes, intellectual disability, and postnatal growth retardation. However, no standard diagnostic criteria are available for RSTS. In this review, we summarized the clinical features and genetic basis of RSTS and highlighted areas for future st...

  18. Clinical Significance of Histological Features of Thrombi in Patients with Myocardial Infarction

    Energy Technology Data Exchange (ETDEWEB)

    Sebben, Juliana Canedo; Cambruzzi, Eduardo; Avena, Luisa Martins; Gazeta, Cristina do Amaral; Gottschall, Carlos Antonio Mascia; Quadros, Alexandre Schaan de, E-mail: quadros.pesquisa@gmail.com [Instituto de Cardiologia / Fundação Universitária de Cardiologia - IC/FUC, Porto Alegre, RS (Brazil)

    2013-12-15

    Percutaneous Coronary Intervention (PCI) is the most common strategy for the treatment of Acute ST segment elevation Myocardial Infarction (STEMI), and thromboaspiration has been increasingly utilized for removal of occlusive thrombi. To analyze the influence of histopathological features of coronary thrombi in clinical outcomes of patients with STEMI, and the association of these variables with clinical, angiographic, and laboratory features and medications used in hospitalization. Prospective cohort study. All patients were monitored during hospitalization and thirty days after the event. Aspirated thrombi were preserved in formalin and subsequently stained with hematoxylin-eosin and embedded in paraffin. Thrombi were classified as recent and old. The primary outcome was the occurrence of major cardiovascular events within thirty days. During the study period, 1,149 patients were evaluated with STEMI, and 331 patients underwent thrombi aspiration, leaving 199 patients available for analysis. It was identified recent thrombi in 116 patients (58%) and old thrombi in 83 patients (42%). Recent thrombi have greater infiltration of red blood cells than old thrombi (p = 0.02), but there were no statistically significant differences between other clinical, angiographic, laboratory, and histopathological features and medications in both group of patients. The rates of clinical outcomes were similar in both groups. Recent thrombi were identified in 58% of patients with STEMI and it was observed an association with infiltration of red blood cells. There was no association between histopathological features of thrombi and clinical variables and cardiovascular outcomes.

  19. Relational Network for Knowledge Discovery through Heterogeneous Biomedical and Clinical Features.

    Science.gov (United States)

    Chen, Huaidong; Chen, Wei; Liu, Chenglin; Zhang, Le; Su, Jing; Zhou, Xiaobo

    2016-01-01

    Biomedical big data, as a whole, covers numerous features, while each dataset specifically delineates part of them. "Full feature spectrum" knowledge discovery across heterogeneous data sources remains a major challenge. We developed a method called bootstrapping for unified feature association measurement (BUFAM) for pairwise association analysis, and relational dependency network (RDN) modeling for global module detection on features across breast cancer cohorts. Discovered knowledge was cross-validated using data from Wake Forest Baptist Medical Center's electronic medical records and annotated with BioCarta signaling signatures. The clinical potential of the discovered modules was exhibited by stratifying patients for drug responses. A series of discovered associations provided new insights into breast cancer, such as the effects of patient's cultural background on preferences for surgical procedure. We also discovered two groups of highly associated features, the HER2 and the ER modules, each of which described how phenotypes were associated with molecular signatures, diagnostic features, and clinical decisions. The discovered "ER module", which was dominated by cancer immunity, was used as an example for patient stratification and prediction of drug responses to tamoxifen and chemotherapy. BUFAM-derived RDN modeling demonstrated unique ability to discover clinically meaningful and actionable knowledge across highly heterogeneous biomedical big data sets. PMID:27427091

  20. Relational Network for Knowledge Discovery through Heterogeneous Biomedical and Clinical Features

    Science.gov (United States)

    Chen, Huaidong; Chen, Wei; Liu, Chenglin; Zhang, Le; Su, Jing; Zhou, Xiaobo

    2016-07-01

    Biomedical big data, as a whole, covers numerous features, while each dataset specifically delineates part of them. “Full feature spectrum” knowledge discovery across heterogeneous data sources remains a major challenge. We developed a method called bootstrapping for unified feature association measurement (BUFAM) for pairwise association analysis, and relational dependency network (RDN) modeling for global module detection on features across breast cancer cohorts. Discovered knowledge was cross-validated using data from Wake Forest Baptist Medical Center’s electronic medical records and annotated with BioCarta signaling signatures. The clinical potential of the discovered modules was exhibited by stratifying patients for drug responses. A series of discovered associations provided new insights into breast cancer, such as the effects of patient’s cultural background on preferences for surgical procedure. We also discovered two groups of highly associated features, the HER2 and the ER modules, each of which described how phenotypes were associated with molecular signatures, diagnostic features, and clinical decisions. The discovered “ER module”, which was dominated by cancer immunity, was used as an example for patient stratification and prediction of drug responses to tamoxifen and chemotherapy. BUFAM-derived RDN modeling demonstrated unique ability to discover clinically meaningful and actionable knowledge across highly heterogeneous biomedical big data sets.

  1. Estimating the re-identification risk of clinical data sets

    OpenAIRE

    Dankar Fida; El Emam Khaled; Neisa Angelica; Roffey Tyson

    2012-01-01

    Abstract Background De-identification is a common way to protect patient privacy when disclosing clinical data for secondary purposes, such as research. One type of attack that de-identification protects against is linking the disclosed patient data with public and semi-public registries. Uniqueness is a commonly used measure of re-identification risk under this attack. If uniqueness can be measured accurately then the risk from this kind of attack can be managed. In practice, it is often not...

  2. Risk Management in Clinical Laboratory: from Theory to Practice

    OpenAIRE

    Eliza David Remona; Minodora Dobreanu

    2015-01-01

    Clinical laboratory tests ensure approximately 70% of the medical decisions, so that the time until the release of the results and its accuracy are critical for the diagnosis and the efficiency of the treatment [1]. Risk management involves both the anticipation of what could happen erroneous and the assessment of errors’ frequency as well as the consequences or the severity of the effects caused by it, and finally to decide what can be done in order to reduce the risk to an acceptable clinic...

  3. Clinical Profile & Risk Factors in Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    P Yadav, D Joseph, P Joshi, P Sakhi, RK Jha, J Gupta

    2010-12-01

    Full Text Available Coronary Artery Disease (CAD is becoming a major cause of morbidity & mortality burden in the developing world. Indians have been associated with a more severe form of CAD that has its onset at a younger age group with a male predominance. A prospective study was carried out to identify the risk factors and to know the emerging clinical profile in acute coronary syndrome (ACS including S T elevation & Non S T elevation myocardial infarction. We enrolled 200 consecutive patients with typical ECG changes & clinical history, admitted in emergency department from January 2009 to December 2009. A predefined Performa was completed in every patient with a detailed clinical history, physical examinations, and investigation studies. The clinical history revealed information about age, gender, risk factors, and modes of presentation and duration of symptoms. The details of physical examination including anthropometric data, vital signs and complete systemic evaluation were recorded. The regions of infarction and rhythm disturbances were also documented. Our study showed a significant male predominance with mean age being 56 years. Tobacco was identified as major risk factors (65% & obesity (BMI more than 25 is least common risk factor (13%.Patients had typical chest pain (94% and ECG showed anterior wall changes in54%. Forty percent patients developed complications, majority being arrhythmias (60% and least common is mechanical complication (2.5% Thus we conclude that ACS is more common in adult male with tobacco being major risk factors in our population.

  4. Clinical features and therapeutic management of patients admitted to Italian acute hospital psychiatric units: the PERSEO (psychiatric emergency study and epidemiology) survey

    OpenAIRE

    Russo Federico; Righi Roberto; Minervini Lina; Margari Francesco; Casacchia Massimo; Boncompagni Giancarlo; Boccalon Roberto M; Ballerini Andrea; Salteri Andrea; Frediani Sonia; Rossi Andrea; Scatigna Marco

    2007-01-01

    Abstract Background The PERSEO study (psychiatric emergency study and epidemiology) is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management). The aims of this paper are: (i) to describe the epidemiological and clinical characteristics of patients, including sociodemographic features, risk factors, life habits and psychiatric diagnoses; and...

  5. Clinical feature and image analysis of 29 cases of meningeal carcinomatosis

    OpenAIRE

    Jia-cai LIN; Si-ting WU; Shi, Qiang

    2016-01-01

    Objective  To study the clinical features, laboratory results and image characteristics of meningeal carcinomatosis (MC). Methods  The clinical data, laboratory and image results, and cerebrospinal fluid (CSF) findings of 29 cases diagnosed as MC were retrospectively reviewed and analyzed. Results  Lung cancer is more common as the primary malignancy in MC patients [16(55.2%)]. The earliest neurological symptoms varied in MC patients, and headache was the most common symptom (58.6%), followed...

  6. Degeneration of Leiomyoma in Patients Referred for Uterine Fibroid Embolization: Incidence, Imaging Features and Clinical Characteristics

    OpenAIRE

    Han, Seung Chul; Kim, Man-Deuk; Jung, Dae Chul; Lee, Myungsu; Lee, Mu Sook; Park, Sung Il; Won, Jong Yun; Lee, Do Yun; Lee, Kwang Hun

    2012-01-01

    Purpose Imaging features and clinical characteristics of degenerated leiomyoma in patients referred for uterine fibroid embolization (UFE) were analyzed to assess the incidence of degenerated leiomyoma. Materials and Methods Patients referred for UFE between 2008 and 2009 were retrospectively analyzed (n=276). Patients ranged in age from 27 to 51 years (mean 38.0 years). All patients underwent screening MRI with contrast enhancement. Medical histories and clinical symptoms were evaluated. Res...

  7. Canavan disease - unusual imaging features in a child with mild clinical presentation

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Ho V.; Ishak, Gisele E. [University of Washington, Department of Radiology, Seattle Children' s Hospital, Seattle, WA (United States)

    2015-03-01

    Canavan disease is a rare hereditary leukodystrophy that manifests in early childhood. Associated with rapidly progressive clinical deterioration, it usually results in death by the third year of life. The predominant MRI appearance is diffuse and symmetrical white matter disease. We discuss an atypical, late presentation of Canavan disease with a benign clinical course and uncharacteristic imaging features. This case introduces a previously unreported pattern of diffuse cortical abnormality without significant white matter involvement. (orig.)

  8. Atypical ultrasound features of parathyroid tumours may bear a relationship to their clinical and biochemical presentation

    OpenAIRE

    Chandramohan, Anuradha; Sathyakumar, Kirthi; John, Reetu Amrita; Manipadam, Marie Therese; Abraham, Deepak; Thomas V Paul; Thomas, Nihal; Paul, M. J.

    2013-01-01

    Objectives To describe atypical ultrasound features of parathyroid lesions and correlate them with clinical presentation and histopathology. Materials and methods Retrospective review of 264 patients with primary hyperparathyroidism who underwent ultrasound imaging prior to parathyroidectomy was performed. Patients with atypical ultrasound findings (n = 26) were identified; imaging findings were correlated with clinical presentation and histopathology. Results Twenty-one (80 %) lesions were a...

  9. Fractographic features of glass-ceramic and zirconia-based dental restorations fractured during clinical function

    OpenAIRE

    Øilo, Marit; Hardang, Anne Dybdahl; Ulsund, Amanda Hembre; Gjerdet, Nils Roar

    2014-01-01

    Fractures during clinical function have been reported as the major concern associated with all-ceramic dental restorations. The aim of this study was to analyze the fracture features of glass-ceramic and zirconia-based restorations fractured during clinical use. Twenty-seven crowns and onlays were supplied by dentists and dental technicians with information about type of cement and time in function, if available. Fourteen lithium disilicate glass-ceramic restorations and 13 zirconia-based res...

  10. Recognizing clinical entities in hospital discharge summaries using Structural Support Vector Machines with word representation features

    OpenAIRE

    Tang, Buzhou; Cao, Hongxin; WU, YONGHUI; Jiang, Min; Xu, Hua

    2013-01-01

    Background Named entity recognition (NER) is an important task in clinical natural language processing (NLP) research. Machine learning (ML) based NER methods have shown good performance in recognizing entities in clinical text. Algorithms and features are two important factors that largely affect the performance of ML-based NER systems. Conditional Random Fields (CRFs), a sequential labelling algorithm, and Support Vector Machines (SVMs), which is based on large margin theory, are two typica...

  11. Canavan disease - unusual imaging features in a child with mild clinical presentation

    International Nuclear Information System (INIS)

    Canavan disease is a rare hereditary leukodystrophy that manifests in early childhood. Associated with rapidly progressive clinical deterioration, it usually results in death by the third year of life. The predominant MRI appearance is diffuse and symmetrical white matter disease. We discuss an atypical, late presentation of Canavan disease with a benign clinical course and uncharacteristic imaging features. This case introduces a previously unreported pattern of diffuse cortical abnormality without significant white matter involvement. (orig.)

  12. Aggressive posterior retinopathy of prematurity classification, based on clinical and morphometric disease features

    OpenAIRE

    A. V. Tereshchenko; Yu. A. Belyy; I. G. Trifanenkova; M. S. Tereshchenkova

    2014-01-01

    Based on dynamic monitoring of 133 premature infants (266 eyes) with aggressive posterior retinopathy of prematurity (ROP), digital retinoscopy and computer morphometry the disease clinical and morphometric features were revealed and systematized, and their consecutive replacement was fixed. As a result the separate classification of aggressive posterior disease was worked up. In ag- gressive posterior ROP course the next consecutive stages were marked out: subclinical, early clinical appeara...

  13. Clinical features and outcomes of autoimmune hemolytic anemia: a retrospective analysis of 32 cases

    OpenAIRE

    Baek, Seung-Woo; Lee, Myung-Won; Ryu, Hae-Won; Lee, Kyu-Seop; SONG, IK-CHAN; Lee, Hyo-Jin; Yun, Hwan-Jung; Kim, Samyong; Jo, Deog-Yeon

    2011-01-01

    Background There has been no report on the clinical features or natural history of autoimmune hemolytic anemia (AIHA) in the Korean adult population. This study retrospectively analyzed the clinical characteristics and long-term outcomes of AIHA in the Korean adults. Methods Patients newly diagnosed with AIHA between January 1994 and December 2010 at Chungnam National University Hospital were enrolled. Patient characteristics at diagnosis, response to treatment, and the natural course of the ...

  14. Histological, Immunohistological, and Clinical Features of Merkel Cell Carcinoma in Correlation to Merkel Cell Polyomavirus Status

    Directory of Open Access Journals (Sweden)

    T. Jaeger

    2012-01-01

    Full Text Available Merkel cell carcinoma is a rare, but highly malignant tumor of the skin with high rates of metastasis and poor survival. Its incidence rate rises and is currently about 0.6/100000/year. Clinical differential diagnoses include basal cell carcinoma, cyst, amelanotic melanoma, lymphoma and atypical fibroxanthoma. In this review article clinical, histopathological and immunhistochemical features of Merkel cell carcinoma are reported. In addition, the role of Merkel cell polyomavirus is discussed.

  15. Features of Clinical Thinking Formation during the lessons of Propaedeutics of Internal Medicine

    OpenAIRE

    Zozuliak, N. V.

    2014-01-01

    In the article the features of the formation of clinical thinking of third year students of Ivano-Frankivsk Medical University during the study of the subject “Propaedeutics of Internal Diseases” are described. The basic prerequisite for successful formation of clinical thinking in students is stated in the article. An important prerequisite for the successful studying of the students is performing of practical skills during each class. Propaedeutics of internal diseases acquaint students wit...

  16. Clinical Psychologists’ Firearm Risk Management Perceptions and Practices

    OpenAIRE

    Traylor, Andrea; Price, James H.; Telljohann, Susan K; King, Keith; Thompson, Amy

    2010-01-01

    The purpose of this study was to investigate the current perceptions and practices of discussing firearm risk management with patients diagnosed with selected mental health problems. A three-wave survey was mailed to a national random sample of clinical psychologists and 339 responded (62%). The majority (78.5%) believed firearm safety issues were greater among those with mental health problems. However, the majority of clinical psychologists did not have a routine system for identifying pati...

  17. Clinical features of early onset, familial Alzheimer`s disease linked to chromosome 14

    Energy Technology Data Exchange (ETDEWEB)

    Mullan, M.; Bennett, C.; Figueredo, C.; Crawford, F. [Univ. of South Florida, Tampa, FL (United States)] [and others

    1995-02-27

    Early onset familial Alzheimer`s disease (AD) has an autosomal dominant mode of inheritance. Two genes are responsible for the majority of cases of this subtype of AD. Mutations in the {beta}-amyloid precursor protein ({beta}APP) gene on chromosome 21 have been shown to completely cosegregate with the disease. We and others have previously described the clinical features of families with {beta}APP mutations at the codon 717 locus in an attempt to define the phenotype associated with a valine to isoleucine (Val {r_arrow} Ile) or a valine to glycine (Val {r_arrow} Gly) change. More recently, a second locus for very early onset disease has been localized to chromosome 14. The results of linkage studies in some families suggesting linkage to both chromosomes have been explained by the suggestion of a second (centromeric) locus on chromosome 21. Here we report the clinical features and genetic analysis of a British pedigree (F74) with early onset AD in which neither the {beta}APP locus nor any other chromosome 21 locus segregates with the disease, but in which good evidence is seen for linkage on the long arm of chromosome 14. In particular we report marker data suggesting that the chromosome 14 disease locus is close to D14S43 and D14S77. Given the likelihood that F74 represents a chromosome 14 linked family, we describe the clinical features and make a limited clinical comparison with the {beta}APP717 Val {r_arrow} Ile and {beta}APP717 Val {r_arrow} Gly encoded families that have been previously described. We conclude that although several previously reported clinical features occur to excess in early onset familial AD, no single clinical feature demarcates either the chromosome 14 or {beta}APP codon 717 mutated families except mean age of onset. 52 refs., 2 figs., 5 tabs.

  18. Clinical risk factors for gestational hypertensive disorders in pregnant women at high risk for developing preeclampsia

    NARCIS (Netherlands)

    Wong, Tsz Y.; Groen, Henk; Faas, Marijke M.; van Pampus, Maria G.

    2013-01-01

    Objectives: To evaluate clinical risk factors for the development of gestational hypertensive disorders in a group of pregnant women at high risk for developing preeclampsia. Secondly we evaluated the incidence and recurrence rate of preeclampsia and pregnancy-induced hypertension. Study design: A p

  19. The Ten Years Survey on Clinical and Epidemiologic Features of Guillain-Barre Syndrome in Sina Hospital, Hamadan, Iran

    Directory of Open Access Journals (Sweden)

    Sh. Mazaheri

    2007-07-01

    Full Text Available Introduction & Objective: Since the elimination of poliomyelitis from Iran, Guillain–Barre Syndrome (GBS has been the leading cause of acute flaccid paralysis. There are a few studies concerning clinical and epidemiologic features of Guillain-Barré syndrome in our country, therefore we evaluated ten years clinical and epidemiologic features of GBS in Sina hospital, Hamadan, Iran.Materials & Methods: In a retrospective descriptive study, we reviewed 80 records of patients with GBS who were hospitalized in Sina Hospital (Hamadan, Iran during 1993-2003. Because of incomplete data we excluded 29 patients from the study. We evaluated clinical and epidemiologic features, risk factors, lab data and management protocols. Complete remission defined as complete improved patient four weeks after the GBS treatment and partial remission as the continuation of the symptom after that time. All the data extracted manually and analyzed with SPSS software.Results: From 51 patients, 36 (70.59% were men and 15 (29.41% women, with a proportion of 2.4 men to 1 woman. The age ranged from 3 to 85 years. The highest frequency was observed in patients aged 11 to 20 (35.28%. 13 patients were student, 11 were house keeper, 11 were farmer, 7 were worker. 29 patients (56.84% had risk factors like respiratory and gastrointestinal track infection, surgery and fever before the disease onset. Complete and partial remission occurred in 17 and 28 patients respectively and 5 patients did not improve. Management failure occurred in 3 (8.83%, 2 (22.23% and 5 (62.5% patients who underwent IVIG, plasmapheresis and corticosteroids respectively.Conclusion: Our data was not similar to other studies in term of male to female proportion, age distribution and management protocols, therefore geographical pattern of the disease should be concerned for better patients’ management.

  20. Establishing a family risk assessment clinic for breast cancer.

    LENUS (Irish Health Repository)

    Mulsow, Jurgen

    2012-02-01

    Breast cancer is the most common cancer affecting European women and the leading cause of cancer-related death. A total of 15-20% of women who develop breast cancer have a family history and 5-10% a true genetic predisposition. The identification and screening of women at increased risk may allow early detection of breast cancer and improve prognosis. We established a family risk assessment clinic in May 2005 to assess and counsel women with a family history of breast cancer, to initiate surveillance, and to offer risk-reducing strategies for selected high-risk patients. Patients at medium or high risk of developing breast cancer according to NICE guidelines were accepted. Family history was determined by structured questionnaire and interview. Lifetime risk of developing breast cancer was calculated using Claus and Tyrer-Cuzick scoring. Risk of carrying a breast cancer-related gene mutation was calculated using the Manchester system. One thousand two hundred and forty-three patients have been referred. Ninety-two percent were at medium or high risk of developing breast cancer. Formal assessment of risk has been performed in 368 patients, 73% have a high lifetime risk of developing breast cancer, and 72% a Manchester score >or=16. BRCA1\\/2 mutations have been identified in 14 patients and breast cancer diagnosed in two. Our initial experience of family risk assessment has shown there to be a significant demand for this service. Identification of patients at increased risk of developing breast cancer allows us to provide individuals with accurate risk profiles, and enables patients to make informed choices regarding their follow-up and management.

  1. Aggressive posterior retinopathy of prematurity classification, based on clinical and morphometric disease features

    Directory of Open Access Journals (Sweden)

    A. V. Tereshchenko

    2014-07-01

    Full Text Available Based on dynamic monitoring of 133 premature infants (266 eyes with aggressive posterior retinopathy of prematurity (ROP, digital retinoscopy and computer morphometry the disease clinical and morphometric features were revealed and systematized, and their consecutive replacement was fixed. As a result the separate classification of aggressive posterior disease was worked up. In ag- gressive posterior ROP course the next consecutive stages were marked out: subclinical, early clinical appearances stage, manifesta- tion stage, developed, advanced and terminal stages. the peculiarity of early clinical appearances stage and manifestation stage is thepresence of types: favourable and unfavourable.

  2. Sex Differences in Clinical Features of Early, Treated Parkinson’s Disease

    OpenAIRE

    Augustine, Erika F.; Adriana Pérez; Rohit Dhall; Chizoba C Umeh; Aleksandar Videnovic; Franca Cambi; Anne-Marie A Wills; Elm, Jordan J; Zweig, Richard M.; Shulman, Lisa M.; Nance, Martha A.; Jacquelyn Bainbridge; Oksana Suchowersky

    2015-01-01

    Introduction: To improve our understanding of sex differences in the clinical characteristics of Parkinson’s Disease, we sought to examine differences in the clinical features and disease severity of men and women with early treated Parkinson’s Disease (PD) enrolled in a large-scale clinical trial. Methods: Analysis was performed of baseline data from the National Institutes of Health Exploratory Trials in Parkinson’s Disease (NET-PD) Long-term Study-1, a randomized, multi-center, double-blin...

  3. Mitochondrial diseases: an overview of genetics, pathogenesis, clinical features and an approach to diagnosis and treatment.

    Directory of Open Access Journals (Sweden)

    Singhal N

    2000-07-01

    Full Text Available Defects in structures or functions of mitochondria, mainly involving the oxidative phosphorylation, mitochondrial biogenesis and other metabolic pathways have been shown to be associated with a wide spectrum of clinical phenotypes. The ubiquitous nature of mitochondria and their unique genetic features contribute to the clinical, biochemical and genetic heterogenecity of mitochondrial diseases. This article focuses on the recent advances in the field of mitochondrial disorders with respect to the consequences for an advanced clinical and genetic diagnostics. In addition, an overview on recently identified genetic defects and their pathogenic molecular mechanisms are given.

  4. Neurobrucellosis: clinical, diagnostic, therapeutic features and outcome. Unusual clinical presentations in an endemic region

    Directory of Open Access Journals (Sweden)

    Nurgul Ceran

    2011-02-01

    Full Text Available Brucellosis is a zoonotic infection and has endemic characteristics. Neurobrucellosis is an uncommon complication of this infection. The aim of this study was to present unusual clinical manifestations and to discuss the management and outcome of a series of 18 neurobrucellosis cases. Initial clinical manifestations consist of pseudotumor cerebri in one case, white matter lesions and demyelinating syndrome in three cases, intracranial granuloma in one case, transverse myelitis in two cases, sagittal sinus thrombosis in one case, spinal arachnoiditis in one case, intracranial vasculitis in one case, in addition to meningitis in all cases. Eleven patients were male and seven were female. The most prevalent symptoms were headache (83% and fever (44%. All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Duration of treatment (varied 3-12 months was determined on basis of the CSF response. In four patients presented with left mild sequelae including aphasia, hearing loss, hemiparesis. In conclusion, although mortality is rare in neurobrucellosis, its sequelae are significant. In neurobrucellosis various clinical and neuroradiologic signs and symptoms can be confused with other neurologic diseases. In inhabitants or visitors of endemic areas, neurobrucellosis should be kept in mind in cases that have unusual neurological manifestations.

  5. Distinct Clinic-Pathological Features of Early Differentiated-Type Gastric Cancers after Helicobacter pylori Eradication

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    Noriyuki Horiguchi

    2016-01-01

    Full Text Available Background. Gastric cancer is discovered even after successful eradication of H. pylori. We investigated clinic pathological features of early gastric cancers after H. pylori eradication. Methods. 51 early gastric cancers (EGCs from 44 patients diagnosed after successful H. pylori eradication were included as eradication group. The clinic-pathological features were compared with that of 131 EGCs from 120 patients who did not have a history of H. pylori eradication (control group. Results. Compared with control group, clinic-pathological features of eradication group were characterized as depressed (p<0.0001, reddish (p=0.0001, and smaller (p=0.0095 lesions, which was also confirmed in the comparison of six metachronous lesions diagnosed after initial ESD and subsequent successful H. pylori eradication. Prevalence of both SM2 (submucosal invasion greater than 500 μm and unexpected SM2 cases tended to be higher in eradication group (p=0.077, 0.0867, resp.. Prevalence of inconclusive diagnosis of gastric cancer during pretreatment biopsy was also higher in the same group (26.0% versus 1.6%, p<0.0001. Conclusions. Informative clinic pathological features of EGC after H. pylori eradication are depressed, reddish appearances, which should be treated as a caution because histological diagnosis of cancerous tissue is sometimes difficult by endoscopic biopsy.

  6. Sciatica-like symptoms and the sacroiliac joint: clinical features and differential diagnosis

    NARCIS (Netherlands)

    Visser, L.H.; Nijssen, P.G.; Tijssen, C.C.; Middendorp, J.J. van; Schieving, J.H.

    2013-01-01

    PURPOSE: To compare the clinical features of patients with sacroiliac joint (SIJ)-related sciatica-like symptoms to those with sciatica from nerve root compression and to investigate the necessity to perform radiological imaging in patients with sciatica-like symptoms derived from the SIJ. METHODS:

  7. Correlation between clinical features and MECP2 gene mutations in patients with Rett syndrome

    Directory of Open Access Journals (Sweden)

    Hisham Megahed

    2015-03-01

    Conclusions: Mutation screening for MECP2 is a fast and reliable method to diagnose patients clinically suspected to suffer from Rett syndrome or female patients with atypical Rett syndrome features, mental retardation, developmental delay and other neurological abnormalities who do not fit any specific diagnosis. Also, patients with MECP2 mutation presented with a more severe phenotype.

  8. Feature Issue Introduction: Bio-Optics in Clinical Applications, Nanotechnology, and Drug Discovery

    OpenAIRE

    Nordstrom, Robert J; Almutairi, Adah; Hillman, Elizabeth M. C.

    2010-01-01

    The editors introduce the Biomedical Optics Express feature issue, “Bio-Optics in Clinical Applications, Nanotechnology, and Drug Discovery,” which combines three technical areas from the 2010 Optical Society of America (OSA), Biomedical Optics (BIOMED) Topical Meeting held on 11–14 April in Miami, FL and includes contributions from conference attendees.

  9. Distinct Clinic-Pathological Features of Early Differentiated-Type Gastric Cancers after Helicobacter pylori Eradication

    Science.gov (United States)

    Horiguchi, Noriyuki; Tahara, Tomomitsu; Kawamura, Tomohiko; Okubo, Masaaki; Ishizuka, Takamitsu; Nakagawa, Yoshihito; Nagasaka, Mitsuo; Shibata, Tomoyuki; Ohmiya, Naoki

    2016-01-01

    Background. Gastric cancer is discovered even after successful eradication of H. pylori. We investigated clinic pathological features of early gastric cancers after H. pylori eradication. Methods. 51 early gastric cancers (EGCs) from 44 patients diagnosed after successful H. pylori eradication were included as eradication group. The clinic-pathological features were compared with that of 131 EGCs from 120 patients who did not have a history of H. pylori eradication (control group). Results. Compared with control group, clinic-pathological features of eradication group were characterized as depressed (p < 0.0001), reddish (p = 0.0001), and smaller (p = 0.0095) lesions, which was also confirmed in the comparison of six metachronous lesions diagnosed after initial ESD and subsequent successful H. pylori eradication. Prevalence of both SM2 (submucosal invasion greater than 500 μm) and unexpected SM2 cases tended to be higher in eradication group (p = 0.077, 0.0867, resp.). Prevalence of inconclusive diagnosis of gastric cancer during pretreatment biopsy was also higher in the same group (26.0% versus 1.6%, p < 0.0001). Conclusions. Informative clinic pathological features of EGC after H. pylori eradication are depressed, reddish appearances, which should be treated as a caution because histological diagnosis of cancerous tissue is sometimes difficult by endoscopic biopsy. PMID:27212944

  10. Clinical features and outcomes of plasma cell leukemia: a single-institution experience in the era of novel agents

    Directory of Open Access Journals (Sweden)

    Giampaolo Talamo

    2012-06-01

    Full Text Available Plasma cell leukemia (PCL is a rare hematologic malignancy with aggressive clinical and biologic features. Data regarding its prognosis with the use of the novel agents, i.e., the immunomodulatory drugs thalidomide and lenalidomide, and the proteasome inhibitor bortezomib, are limited. We retrospectively reviewed clinical outcomes, response to therapy, and survival of 17 patients seen at the Penn State Hershey Cancer Institute since the availability of novel agents (2006-2011. Twelve patients had primary PCL (pPCL, and 5 second- ary PCL (sPCL. PCL was associated with aggressive clinicobiological features, such as high-risk cytogenetics, elevated serum beta-2-microglobulin and lactate dehydrogenase, International Staging System stage III, and rapid relapse after therapy. With the use of thalidomide, lenalidomide, and bortezomib in 53%, 53%, and 88% patients, respectively, median overall survival (OS was 18 months in the whole group (95% confidence interval, 11-21 months, and 21 and 4 months in pPCL and sPCL, respectively (P=0.015. OS was inferior to that of 313 consecutive patients with multiple myeloma (MM treated in the same period, even when compared with a subset of 47 MM with high-risk cytogenetics. Although our data are limited by the small sample size, we conclude that novel agents may modestly improve survival in patients with PCL, when compared to historical controls. Novel therapies do not seem to overcome the negative prognosis of PCL as compared with MM.

  11. Cauda equina syndrome as the initial presenting clinical feature of medulloblastoma: a case report

    Directory of Open Access Journals (Sweden)

    Al-Otaibi Faisal

    2012-05-01

    Full Text Available Abstract Introduction Medulloblastoma is one of the most common pediatric brain malignancies. The usual presenting clinical features are related to posterior fossa syndrome or/and hydrocephalus. Cauda equina syndrome is a very rare presentation for this disease. Case presentation We describe the case of a three-year-old boy with cauda equina syndrome as the initial presenting clinical feature for medulloblastoma. He was initially diagnosed as having a spinal tumor by magnetic resonance imaging scan. Subsequently, a cranial magnetic resonance imaging scan revealed a posterior fossa tumor with features of dissemination. He had substantial improvement after treatment. This case report is complemented by a literature review related to this unusual presentation. Conclusions Medulloblastoma primarily presenting with cauda equina syndrome is very rare. However, spinal drop metastasis should be considered in the pediatric age group to avoid suboptimal management.

  12. Clinical features of the head and neck mucosal melanoma. А review

    Directory of Open Access Journals (Sweden)

    A. V. Ignatova

    2016-01-01

    Full Text Available Melanoma is an aggressive and rare neoplasm of melanocytic origin. Mucosal melanomas of the head and neck account for 1 % of neoplasms, 0,2–8,0 4 % of all melanomas and over 50 % of all mucosal melanomas. To date, in Russian and foreign literature only few retrospective series and case reports have been reported on mucosal melanoma. Despite melanoma’s common histological origin, head and neck mucosal melanoma presentation has some specific features due to its anatomical localization and poor clinical outcomes compared with those of cutaneous melanomas. Mucosal melanoma has a high metastatic potential. Five-year overall survival does not exceed 30 %. Advances in understanding of the clinical presentation can be used for prediction of behaviour and prognosis of this disease. We considered and analised articles devoted to clinical features of head and neck mucosal melanoma according to its localization.

  13. Surgery planning and navigation by laser lithography plastic replica. Features, clinical applications, and advantages

    International Nuclear Information System (INIS)

    The use of three-dimensional replicas created using laserlithography has recently become popular for surgical planning and intraoperative navigation in plastic surgery and oral maxillofacial surgery. In this study, we investigated many clinical applications that we have been involved in regarding the production of three-dimensional replicas. We have also analyzed the features, application classes, and advantages of this method. As a result, clinical applications are categorized into three classes, which are 'three-dimensional shape recognition', 'simulated surgery', and 'template'. The distinct features of three-dimensional replicas are 'direct recognition', 'fast manipulation', and 'free availability'. Meeting the requirements of surgical planning and intraoperative navigation, they have produced satisfactory results in clinical applications. (author)

  14. Heterogeneity of the clinical manifestations and pathology features in C3 glomerulopathy

    Directory of Open Access Journals (Sweden)

    Jin-quan WANG

    2015-01-01

    Full Text Available C3 glomerulopathy is a kind of glomerular diseases mediated by abnormal activation of alternative complement pathway. As diversity and multiplicity of pathogenic mechanism, heterogeneity exists in the clinical manifestation and pathological features of C3 glomerulopathy. The clinical manifestation of the disease may be shown as abnormality in urine, hypertension, hematuria, nephrotic syndrome, nephritic syndrome, renal insufficiency, etc. Membranoproliferative glomerulonephritis, mesangial proliferation, crescent formation, focal segmental necrosis, diffuse hyperplasia and exudative lesions, etc may be found in renal biopsies. Also, the prognosis of C3 glomerulopathy is not uniform. The clinical manifestations and pathological features of C3 glomerulopathy were reviewed in the present paper. DOI: 10.11855/j.issn.0577-7402.2014.12.15

  15. Analysis of clinical features and risk factors of fungal infections of patients with liver failure after plasma exchange%血浆置换后肝功能衰竭患者真菌感染临床特点及其预后危险因素分析

    Institute of Scientific and Technical Information of China (English)

    于建武; 孙丽杰; 康鹏; 李树臣

    2008-01-01

    Objective To study clinical features and predisposing risk faetors of fungal infections after plasma exchange(PE)in patients with liver failure.Methods The clinical data and prognosis of 31 liver failure patients with fungal infections after PE were retrospectively analyzed.The risk factor of the fungal infections was studied by univariatc analysis.The risk factor of the prognosis of patients was studied by multivariate analysis.Results The rate of fungal infections in patients with liver failure after PE was 31.0%.Fungal infections presented in oral cavity(61.3%),lung(32.3%),intestinal tract(19.4%),uropoietic system(9.7%),abdominal cavity(6.5%),blood(6.5%)and dwell catheter(3.2%).The confirmed pathogens included Candida albicans(58.1%),Candida tropicalis (12.9%),classified budding fungus(6.5%),Aspergillus(12.9%)and mold fungus(9.7%).Univariate analysis showed that fungal infections was significantly related to glucocorticoid(X2=5.201,P=0.023),antibiotic(X2=7.979,P=0.005),hypo-neutrophil(X2=14.373,P<0.01),bacterial infection(X2=6.955,P=0.008).model for end-stage liver disease(MELD)score(X2=12.548,P<0.01),PE frequency(X2=9.878,P=0.002),but not associated with sex(P=0.795),age(P=0.959)or hypoproteinemia(P=0.482).The mortality of fungal infections in patients with liver failure after PE was 80.6%.According to multivariate analysis,plural pathogenic infection(P=0.012),MELD score(P=0.021)and multi-location of fungal infection(P=0.004)were independent predictors of patients mortality.Conclusions The rate of fungal infections increases in patients with liver failure after PE,which can result in higher mortality.Plural pathogenic infection,MELD score and multi-location of fungal infection are related with the prognosis of patients.%目的 了解血浆置换(PE)后肝功能衰竭患者真菌感染的临床特征、易感因素以及影响患者预后的危险因素.方法 对PE后肝功能衰竭合并真菌感染的31例患者的临床资料及转归进行回顾性分

  16. Clinical and genetic features of pediatric acute lymphoblastic leukemia in Down syndrome in the Nordic countries

    DEFF Research Database (Denmark)

    Lundin, Catarina; Forestier, Erik; Klarskov Andersen, Mette;

    2014-01-01

    BACKGROUND: Children with Down syndrome (DS) have an increased risk for acute lymphoblastic leukemia (ALL). Although previous studies have shown that DS-ALL differs clinically and genetically from non-DS-ALL, much remains to be elucidated as regards genetic and prognostic factors in DS-ALL. METHODS...

  17. Prevalence and clinical features associated with bipolar disorder polypharmacy: a systematic review

    Directory of Open Access Journals (Sweden)

    Fornaro M

    2016-03-01

    Full Text Available Michele Fornaro,1 Domenico De Berardis,2 Ann Sarah Koshy,3 Giampaolo Perna,4 Alessandro Valchera,5 Davy Vancampfort,6 Brendon Stubbs7,8 1New York Psychiatric Institute, Columbia University, New York, NY, USA; 2National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”, Teramo, Italy; 3St. John’s National Academy of Health Sciences, Bangalore, India; 4Department of Clinical Neurosciences, Hermanas Hospitalarias - Villa San Benedetto Menni Hospital, FoRiPsi, 5Hermanas Hospitalarias, FoRiPsi Villa S. Giuseppe Hospital, Ascoli Piceno, Italy; 6Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; 7Physiotherapy Department, South London and Maudsley NHS Foundation Trust, 8Health Service and Population Research Department, Institute of Psychiatry, King’s College London, London, UK Background: Uncertainty exists regarding the prevalence and clinical features associated with the practice of polypharmacy in bipolar disorder (BD, warranting a systematic review on the matter.Methods: Three authors independently searched major electronic databases from inception till September 2015. Articles were included that reported either qualitative or quantitative data about the prevalence and clinical features associated with polypharmacy in adult cases of BD.Results: The operative definitions of polypharmacy adopted across varying studies varied, with concomitant use of two or more psychotropic medications or use of four or more psychotropic medications at once being the most common and the most reliable, respectively. Regardless of type or current mood episode polarity of BD, prevalence rates up to 85% and 36% were found using the most permissive (two or more medications at once and the most conservative (four or more operative definitions for polypharmacy, respectively. Point prevalence prescription rates of one or more antidepressant or antipsychotic as part of a polypharmacy

  18. Relationship of child abuse with personality features and high risk behaviors in adolescents

    Directory of Open Access Journals (Sweden)

    Mehdi Ghezelseflo

    2015-05-01

    Full Text Available Background: Children are one of the most vulnerable groups of the society and are constantly threatened by different people in their family or society. The aim of this study was investigating the correlation of child abuse with personality features and high risk behavior in high school students of Islamshahr, Iran. Methods: This study cross-sectional analytical was conducted on the high school girls and boys of Islamshahr in spring 2014.528 students were selected by cluster random sampling among 4 high schools (two female and two male high schools. Childhood trauma questionnaire, NEO-Five Factor Inventory and Youth Risk-Taking Scale were used for data collection. Data were analyzed by independence t-test, Pearson's correlation coefficient and multiple linear regression. Results: The results of independence t-test indicated significant differences between girls and boys in terms of child abuse and high risk experience (t=-2.16,p=0.03 and t=-5.03, P=0.001, respectively. Also, the results demonstrated a significant relationship between child abuse and personality characteristics, high risk behavior and all its subscales (P<0.05. The findings of multiple linear regressionindicated that child abuse could explain 14% total risk-taking, 25% neurotic personality feature , 14% extroversion, 10% agreeableness, 1% flexibility and 13% conscientiousness (P<0.05. Conclusion: According to the research findings, appropriate behavior with children is of great importance. Therefore, child abuse would form inappropriate personality features and increase risk behaviors among children.

  19. Morphological features of the lumbosacral spinal lipomas with special reference to clinical symptoms and surgical outcome in children

    International Nuclear Information System (INIS)

    The shape and structures surrounding lumbosacral spinal lipoma have a variety of morphologies, including neural tissues and the dural sac. In determining how best to manage lumbosacral spinal lipomas, it is necessary to compare the natural course of the disease and the outcomes associated with surgery (e.g., incomplete untethering, the risk of surgical complications and the remaining risk of retethering). In this study, we compared the morphological implications associated with the natural course and operative results in patients with lipoma. Thirty-four consecutive patients with spinal lipomas (20 cases of conus lipomas and 14 cases of filum lipomas), aged 0 months to 13 years, were studied retrospectively. We analyzed the association of 3 morphological features-protrusion of the spinal cord from the spinal canal, widespread adhesion between the spinal cord and lipoma, and abnormal exit of the nerve root from the dural sac-with preoperative symptoms and surgical outcomes. Preoperative symptoms of conus lipomas were more significantly associated with the existence of any of the 3 morphological features (92%) than their absence (0%) (p<0.05). Surgical outcomes for conus lipomas, such as incomplete untethering, neurological complications, and remaining narrow subarachnoid space, were more significantly associated with the existence of any of the 3 morphological features (46%) than their absence (0%) (p<0.05). None of the 3 morphological features were observed in patients with filum lipomas. Preoperative MRI demonstrated spinal cord herniation and widespread adhesion of the lipoma in all of the patients with these morphologies but failed to demonstrate abnormal root exits in 50% of the patients. The morphological features of the spinal lipomas presented in this study may be important factors for predicting the difficulty of untethering surgery and the clinical course of conus lipomas. (author)

  20. Socio-demographic, Clinical and Laboratory Features of Rotavirus Gastroenteritis in Children Treated in Pediatric Clinic

    Science.gov (United States)

    Azemi, Mehmedali; Berisha, Majlinda; Ismaili-Jaha, Vlora; Kolgeci, Selim; Avdiu, Muharrem; Jakupi, Xhevat; Hoxha, Rina; Hoxha-Kamberi, Teuta

    2013-01-01

    Aim: The aim of work was presentation of several socio-demographic, clinical and laboratory characteristics of gastroenteritis caused by rotavirus. The examinees and methods: The examinees were children under the age of five years treated at the Pediatric Clinic due to acute gastroenteritis caused by rotavirus. Rotavirus is isolated by method chromatographic immunoassay by Cer Test Biotec. Results: From the total number of patients (850) suffering from acute gastroenteritis, feces test on bacteria, viruses. protozoa and fungi was positive in 425 (49.76%) cases. From this number the test on bacteria was positive in 248 (58.62%) cases, on viruses it was positive in 165 (39.0%), on protozoa in 9 (2.12%) cases and on fungi only one case. Rotavirus was the most frequent one in viral test, it was isolated in 142 (86.06%) cases, adenoviruses were found in 9 (5.45%) cases and noroviruses in only one case. The same feces sample that contained rotavirus and adenoviruses were isolated in five cases, whereas rotavirus with bacteria was isolated in the same feces sample in five cases. The biggest number of cases 62 (43.66%) were of the age 6-12 months, whereas the smallest number 10 (7.04%) cases were of the age 37-60 months. There were 76 (53.52%) of cases of male gender, from rural areas there were 81 (57.04%) cases and there were 58 (40.80%) cases during the summer period. Among the clinical symptoms the most prominent were diarrhea, vomiting, high temperature, whereas the different degree of dehydration were present in all cases (the most common one was moderate dehydration). The most frequent one was isonatremic dehydration in 91 (64.08%) cases, less frequent one was hypernatremic dehydration in 14 (9.85%) cases. The majority of cases (97.89%) had lower blood pH values, whereas 67 (47.17%) cases had pH values that varied from 7.16 -7.20 (curve peak), normal values were registered in only 3 (2.11%) cases. Urea values were increased in 45 (31.07%) cases (the maximum value

  1. Distinguishing clinical and imaging features of nodular regenerative hyperplasia and large regenerative nodules of the liver

    International Nuclear Information System (INIS)

    Aim: Nodular regenerative hyperplasia (NRH) and large regenerative nodules (LRN) are distinct types of hepatocellular nodules that have been confused in the radiology literature. However, distinction is critical because their clinical significance is quite different. Our purpose was to review the clinical and imaging findings in a series of patients with NRH and LRN in order to identify distinguishing clinical and imaging features. Materials and methods: This was a retrospective case series. The clinical and imaging features were compared in 36 patients with pathological proof of NRH and 23 patients with pathological evidence of LRN. Results: NRH and LRN have different predisposing factors and imaging findings. NRH is often associated with organ transplantation, myeloproliferative disease, or autoimmune processes. Livers with NRH typically do not have enhancing nodules; none of the present patients with NRH had enhancing liver masses. In contrast, LRN are often associated with Budd-Chiari syndrome. Enhancing liver masses were noted in 19 (83%) of the 23 patients with LRN. The p values for the comparisons were less than 0.001 for both enhancing liver masses and hepatic vein thrombosis. Conclusion: NRH and LRN can have distinct clinical presentations and imaging appearances. LRN often result in enhancing liver nodules, whereas NRH usually does not. Clinical and imaging information enables the distinction of LRN and NRH in many cases.

  2. Distinguishing clinical and imaging features of nodular regenerative hyperplasia and large regenerative nodules of the liver

    Energy Technology Data Exchange (ETDEWEB)

    Ames, J.T. [Departments of Radiology, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania (United States); Federle, M.P., E-mail: federle@stanford.ed [Departments of Radiology, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania (United States); Chopra, K. [Departments of Gastroenterology, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania (United States)

    2009-12-15

    Aim: Nodular regenerative hyperplasia (NRH) and large regenerative nodules (LRN) are distinct types of hepatocellular nodules that have been confused in the radiology literature. However, distinction is critical because their clinical significance is quite different. Our purpose was to review the clinical and imaging findings in a series of patients with NRH and LRN in order to identify distinguishing clinical and imaging features. Materials and methods: This was a retrospective case series. The clinical and imaging features were compared in 36 patients with pathological proof of NRH and 23 patients with pathological evidence of LRN. Results: NRH and LRN have different predisposing factors and imaging findings. NRH is often associated with organ transplantation, myeloproliferative disease, or autoimmune processes. Livers with NRH typically do not have enhancing nodules; none of the present patients with NRH had enhancing liver masses. In contrast, LRN are often associated with Budd-Chiari syndrome. Enhancing liver masses were noted in 19 (83%) of the 23 patients with LRN. The p values for the comparisons were less than 0.001 for both enhancing liver masses and hepatic vein thrombosis. Conclusion: NRH and LRN can have distinct clinical presentations and imaging appearances. LRN often result in enhancing liver nodules, whereas NRH usually does not. Clinical and imaging information enables the distinction of LRN and NRH in many cases.

  3. Clinical features and mortality in Chinese with lupus nephritis and neuropsychiatric lupus: A 124-patient study

    Directory of Open Access Journals (Sweden)

    Min Feng

    2014-01-01

    Full Text Available Background: Few investigation has focused on the patients with lupus nephritis (LN and neuropsychiatric systemic lupus erythematosus (NPSLE. This study was aimed to investigate the clinical features, mortality, and the predictors for mortality of this group of patients. Materials and Methods: Medical records were retrospectively reviewed in Sun Yat-sen Memorial Hospital from 1996 to 2012. Data of demographic information, clinical manifestations, laboratory tests, SLE disease activity index 2000 (SLEDAI-2K score, diagnosis, complications, treatment, and mortality was collected. Results: A total of 124 patients were included in our study. Thirty-five (29.1% patients had glomerular filtration rate <60 ml/min/1.73 m 2 , while 24 (19.4% experienced acute kidney injury (AKI. Thirteen of the 19 American College of Rheumatology defined NPSLE syndromes were identified. The most frequent manifestation was seizure disorder (56/124, 45.2%, followed by psychosis (37/124, 29.8% and cerebrovascular disease (35/124, 28.2%. One hundred and five (84.7% patients had SLEDAI-2K scores ≥15, the mean of which was 21.5 ± 6.2. The mortality during hospitalization was 12.9% (16/124 with NP involvement itself being the leading cause of death (7/16, 43.8%. Multivariate logistic regression confirmed that age <14 years at onset of NPSLE (odds ratios [OR]: 9.95, 95% confidence intervals [CI]: 1.43-69.36, P = 0.020, AKI (OR: 10.40, 95% CI: 2.33-46.48, P = 0.002 and pneumonia (OR: 4.52, 95% CI: 1.14-17.96, P = 0.032 were risk factors for mortality, while cyclophosphamide (CYC treatment (OR: 0.09, 95% CI: 0.02-0.54, P = 0.008 was a protective factor. Conclusion: Most of SLE patients with LN and new-onset NPSLE are in an active disease state. NP manifestation itself was the leading cause of death during hospitalization. Childhood-onset NPSLE, AKI and pneumonia might be predictors of mortality, whereas CYC treatment might improve the prognosis.

  4. Clinical Features and Outcome of Pheochromocytoma-Induced Takotsubo Syndrome: Analysis of 80 Published Cases.

    Science.gov (United States)

    Y-Hassan, Shams

    2016-06-01

    Myriads of physical stress factors including pheochromocytoma have been reported triggering takotsubo syndrome (TS). The aim of this study was to report on the clinical features and outcome of pheochromocytoma-induced TS (Pheo-TS) in a large cohort of patients. Eighty published cases of Pheo-TS were retrieved from the literature and compared with 1,750 cases of all patients with TS (All-TS) published recently by Templin et al. Patients with Pheo-TS were on average 19.87 years younger than those with All-TS (p <0.0001). The women were still predominating in Pheo-TS but significantly in a lower percentage (70% in Pheo-TS vs 89.8% in All-TS, p <0.00001). Almost 1/3 (30%) of Pheo-TS cases had basal TS pattern compared with 2.2% of cases in All-TS (p <0.00001) and 1/5 (20%) had global TS compared with no cases in All-TS. Two thirds of Pheo-TS cases (67.9%) developed complications, which was significantly higher than complication rates in All-TS (21.8%), but there was no difference in the inhospital mortality between the 2 studies. The most important risk factors for the development of complications in Pheo-TS were age <50 years and global and basal TS localization patterns. The recurrence rate of 17.7% in Pheo-TS was significantly higher than the 3.26% in All-TS (p <0.00001). In conclusion, Pheo-TS is characterized by a dramatic clinical presentation with high complication rates and relatively high recurrence rate. Patients with Pheo-TS are significantly younger than All-TS. The TS localization pattern in Pheo-TS differed significantly from All-TS with basal pattern in almost 1/3 of cases and global pattern in 1/5 of the cases. PMID:27103159

  5. Clinical features and surgical outcomes of complete transposition of the great arteries

    Directory of Open Access Journals (Sweden)

    Suk Jin Hong

    2012-10-01

    Full Text Available &lt;B&gt;Purpose:&lt;/B&gt; This single-center study aimed to assess the clinical features and surgical approaches and outcomes of complete transposition of the great arteries (TGA. &lt;B&gt;Methods:&lt;/B&gt; TGA patients who had undergone surgical correction at the Kyungpook National University Hospital from January 2000 to December 2010, were retrospectively evaluated for patient characteristics, clinical manifestation, preoperative management, intraoperative findings, postoperative progress, and follow-up status. &lt;B&gt;Results:&lt;/B&gt; Twenty-eight patients (17 boys and 11 girls, mean age= 10.6±21.5 days were included and were categorized as follows: group I, TGA with intact ventricular septum (n=13; group II, TGA with ventricular septal defect (VSD, n=12; and group III, TGA/VSD with pulmonary stenosis (n=3. Group I underwent the most intensive preoperative management (balloon atrial septostomy and prostaglandin E1 medication. Group II showed the highest incidence of heart failure (P&lt;0.05. Usual and unusual coronary anatomy patterns were observed in 20 (71% and 8 patients, respectively. Arterial and half-turned truncal switch operations were performed in 25 and 3 patients (Group III, respectively. Postoperative complications included cardiac arrhythmias (8 patients, central nervous system complications (3 patients, acute renal failure (1 patient, infections (3 patients, and cardiac tamponade (1 patient, and no statistically significant difference was observed between the groups. Group II showed the mildest aortic regurgitation on follow-up echocardiograms (P&lt;0.05. One patient underwent reoperation, and 1 died. The overall mortality rate was 4%. &lt;B&gt;Conclusion:&lt;/B&gt; Our study showed favorable results in all the groups and no significant difference in postoperative complication, reoperation, and mortality among the groups. However, our results were

  6. 视神经脊髓炎高危综合征患者血清尿酸水平与临床特征的相关性%Serum uric acid level and related clinical features in high risk syndrome of neuromyelitis optica

    Institute of Scientific and Technical Information of China (English)

    尤小凡; 秦伟; 郝咏刚; 赵文慧; 叶静; 胡文立

    2011-01-01

    目的 探讨视神经脊髓炎高危综合征患者血清尿酸水平与临床特征的关系.方法 尿酶法检测51例急性期视神经脊髓炎高危综合征(34例长节段脊髓炎,17例视神经炎),48例视神经脊髓炎,45例神经科其他疾病,65名健康对照的血清尿酸水平.采用扩展残疾状态量表(EDSS)评价病情严重程度,MRI评估受累病灶,细胞免疫荧光法检测水通道蛋白4抗体水平.结果 长节段脊髓炎组尿酸水平(189.84±85.65)μmol/L,视神经炎组(222.12±61.68)μmol/L,低于其他疾病组[(315.90±71.36)μmol/L]和健康对照组[(291.05±76.64)μmol/L,P<0.01],与视神经脊髓炎[(219.19±76.47)μmol/L]比较差异无统计学意义.各组女性患者尿酸水平[(158.24±55.92)、(187.00±47.52)、(198.21±62.62)、(274.51±70.66)和(243.26±60.65)μmol/L]均低于男性组[(262.09±101.63)、(262.45±62.13)、(298.90±74.14)、(355.37±50.30)和(340.34±58.23)μmol/L,t=3.183、2.578、4.356、4.365、6.579,P<0.05].高危综合征组患者不同病程组,水通道蛋白4抗体阳性、阴性组尿酸差异无统计学意义.长节段脊髓炎组尿酸水平与EDSS评分呈负相关(r=-0.714,P<0.01).结论 低尿酸可能与视神经脊髓炎高危综合征发病相关,且与长节段脊髓炎患者疾病严重程度有关.%Objective To investigate serum uric acid (UA) levels and related clinical features in patients with high risk syndrome of neuromyelitis optica. Methods UA levels were measured in 51 patients with high risk syndrome of neuromyelitis optica including 34 with longitudinally extensive transverse myelitis (LETM) and 17 with optic neuritis (ON), 48 with neuromyelitis optica (NMO), 45 with other neurological diseases (OND) and 65 with healthy controls (HC). The disability severity was assessed by the expanded disability status scale (EDSS). Spinal lesions were viewed by MRI. Serum aquaporin-4(AQP4) antibody was tested in cell based immunofluorescence assay. Results Serum UA

  7. Clinical Report of a 17q12 Microdeletion with Additionally Unreported Clinical Features

    Directory of Open Access Journals (Sweden)

    Jennifer L. Roberts

    2014-01-01

    Full Text Available Copy number variations involving the 17q12 region have been associated with developmental and speech delay, autism, aggression, self-injury, biting and hitting, oppositional defiance, inappropriate language, and auditory hallucinations. We present a tall-appearing 17-year-old boy with marfanoid habitus, hypermobile joints, mild scoliosis, pectus deformity, widely spaced nipples, pes cavus, autism spectrum disorder, intellectual disability, and psychiatric manifestations including physical and verbal aggression, obsessive-compulsive behaviors, and oppositional defiance. An echocardiogram showed borderline increased aortic root size. An abdominal ultrasound revealed a small pancreas, mild splenomegaly with a 1.3 cm accessory splenule, and normal kidneys and liver. A testing panel for Marfan, aneurysm, and related disorders was negative. Subsequently, a 400 K array-based comparative genomic hybridization (aCGH + SNP analysis was performed which identified a de novo suspected pathogenic deletion on chromosome 17q12 encompassing 28 genes. Despite the limited number of cases described in the literature with 17q12 rearrangements, our proband’s phenotypic features both overlap and expand on previously reported cases. Since syndrome-specific DNA sequencing studies failed to provide an explanation for this patient’s unusual habitus, we postulate that this case represents an expansion of the 17q12 microdeletion phenotype. Further analysis of the deleted interval is recommended for new genotype-phenotype correlations.

  8. Computational phenotype discovery using unsupervised feature learning over noisy, sparse, and irregular clinical data.

    Directory of Open Access Journals (Sweden)

    Thomas A Lasko

    Full Text Available Inferring precise phenotypic patterns from population-scale clinical data is a core computational task in the development of precision, personalized medicine. The traditional approach uses supervised learning, in which an expert designates which patterns to look for (by specifying the learning task and the class labels, and where to look for them (by specifying the input variables. While appropriate for individual tasks, this approach scales poorly and misses the patterns that we don't think to look for. Unsupervised feature learning overcomes these limitations by identifying patterns (or features that collectively form a compact and expressive representation of the source data, with no need for expert input or labeled examples. Its rising popularity is driven by new deep learning methods, which have produced high-profile successes on difficult standardized problems of object recognition in images. Here we introduce its use for phenotype discovery in clinical data. This use is challenging because the largest source of clinical data - Electronic Medical Records - typically contains noisy, sparse, and irregularly timed observations, rendering them poor substrates for deep learning methods. Our approach couples dirty clinical data to deep learning architecture via longitudinal probability densities inferred using Gaussian process regression. From episodic, longitudinal sequences of serum uric acid measurements in 4368 individuals we produced continuous phenotypic features that suggest multiple population subtypes, and that accurately distinguished (0.97 AUC the uric-acid signatures of gout vs. acute leukemia despite not being optimized for the task. The unsupervised features were as accurate as gold-standard features engineered by an expert with complete knowledge of the domain, the classification task, and the class labels. Our findings demonstrate the potential for achieving computational phenotype discovery at population scale. We expect such

  9. Angioimmunoblastic T-Cell lymphoma: A critical analysis of clinical, morphologic and immunophenotypic features

    Directory of Open Access Journals (Sweden)

    Bal Munita

    2010-10-01

    Full Text Available Background: Angioimmunoblastic T-cell lymphoma (AITL, a subtype of peripheral T-cell lymphoma (PTCL, is characterized by unique clinical and biological features. Its diagnosis remains a challenge as clinical presentation as well as pathologic findings are frequently misleading. Material and Methods: We retrospectively analyzed the clinical, morphological and immunophenotypic spectrum of 17 cases of histologically proven AITL. Result: The mean age was 54 years and male to female ratio was 2.4. Common clinical features included generalized lymphadenopathy (60%, hepatomegaly (70%, splenomegaly (50%, anemia (80% and polyclonal hypergammaglobulinemia (100%. Microscopically, three architectural patterns; pattern I (6%, pattern II (41% and pattern III (53% were observed. Bone marrow infiltration was seen in 60% cases and 30% cases revealed plasmacytosis. Absence of follicles, polymorphous infiltrate, extra-follicular follicular dendritic cell (FDC proliferation, high endothelial venules (HEV prominence and neoplastic T-cells were the diagnostic features of AITL. CD10 positivity (47%, clear cells in the background (59% admixture with large size CD20+ B-immunoblasts (35% and bone marrow plasmacytosis (50% were common observations. Conclusion: Awareness of various morphological and immunophenotypic complexities of AITL and distinction from reactive adenopathies and other types of lymphomas that mimic AITL is underscored in this study.

  10. Evaluation of haptoglobin phenotypes in association with clinical features of patients suffered from preterm labor disease.

    Directory of Open Access Journals (Sweden)

    Hossein Ali Khazaei

    2014-02-01

    Full Text Available Preterm birth means the birth before thirty seven week of pregnancy that causes a lot of complications for the baby. Variety factors are suggested to be involved in disease. In this study, we decided to evaluate haptoglobin (Hp phenotypes association with clinical features of patients suffered from premature delivery to understand better the possible correlation of genetic and clinical features in this disease. This cross-sectional analytic descriptive study has been carried out in two groups of 120 women, 60 with preterm and 60 with term labor. Patients were selected with previously diagnosed by gynecologist with preterm birth in the labor during the study period. After performing diagnostic tests, the frequency of each haptoglobin phenotype in the two groups was analyzed using the Chi-square test (X2 test and SPSS software. The maximum serum haptoglobin phenotype frequency in patients with Hp2-2, was 43 (71.7% whereas in healthy individuals, 35 (58.3%. No, statistically significant differences between the two groups were found (p=0.310. But based on some patients clinical features such as their history of preterm delivery, previous history of recurrent abortions and history of preterm delivery in their family, significant association was found with Hp2-2 compared with healthy control (p<0.003. This study showed that Hp2-2 phenotypes levels in the case group was higher than in control but the factors influencing the presence or absence of preterm labor is clinically various.

  11. Clinical Evaluation of a Novel and Mobile Autism Risk Assessment.

    Science.gov (United States)

    Duda, Marlena; Daniels, Jena; Wall, Dennis P

    2016-06-01

    The Mobile Autism Risk Assessment (MARA) is a new, electronically administered, 7-question autism spectrum disorder (ASD) screen to triage those at highest risk for ASD. Children 16 months-17 years (N = 222) were screened during their first visit in a developmental-behavioral pediatric clinic. MARA scores were compared to diagnosis from the clinical encounter. Participant median age was 5.8 years, 76.1 % were male, and most participants had an intelligence/developmental quotient score >85; 69 of the participants (31 %) received a clinical diagnosis of ASD. The sensitivity of the MARA in detecting ASD was 89.9 % [95 % CI = 82.7-97]; the specificity was 79.7 % [95 % CI = 73.4-86.1]. In a high-risk clinical setting, the MARA shows promise as a screen to distinguish ASD from other developmental/behavioral disorders. PMID:26873142

  12. Clinical and psychopatological features of organic depressive disorder in the individual abusing alcohol (case report

    Directory of Open Access Journals (Sweden)

    Spirina I.D.

    2015-03-01

    Full Text Available The article describes a clinical case of organic depressive disorder in the personality who sustained a traumatic brain injury and who abused alcohol, with distinguishing number of clinical and psychopathological features. Depressed mood, slowed thinking process, sleep disturbances, low self-esteem, hypochondriacal tendencies allowed to diagnose depressive disorder. Clinical history on sustained brain concussion, as well as inertness of nervous and mental processes revealed in psychodiagnostic study testified to organic genesis of the disease. Alcohol abuse by the person having an adverse organic background contributed to appearance of psychotic symptoms in clinical picture. Hallucinatory and delusional inclusions relatively quickly stopped on a background of antipsychotic treatment; this testified that they are secondary to the affective (depressive symptoms.

  13. Polyarteritis nodosa presenting with clinical and radiologic features suggestive of polymyositis.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2011-02-18

    We report a patient who presented with clinical and MRI findings suggestive of polymyositis but, in whom, muscle biopsy disclosed a strikingly different diagnosis. A 65-year-old woman presented with 3-week history of bilateral proximal muscle pain and weakness. Laboratory investigations showed markedly elevated inflammatory markers and mildly elevated muscle enzymes. MRI scans of lower limbs showed features suggestive of polymyositis. However, muscle biopsy showed features of a polyarteritis-type vasculitis affecting an intramuscular blood vessel. Our reports highlight the critical role of muscle biopsy in establishing the correct diagnosis in patients with suspected myositis.

  14. "Orbiting around" the orbital myositis: clinical features, differential diagnosis and therapy.

    Science.gov (United States)

    Montagnese, F; Wenninger, S; Schoser, B

    2016-04-01

    Orbital myositis (OM) is a rare disease whose clinical heterogeneity and different treatment options represent a diagnostic and therapeutic challenge. We aim to review the state of knowledge on OM, also describing a cohort of patients diagnosed in our centre, to highlight some remarkable clinical features. A literature review was conducted in PubMed and Medline databases. The herein described cohort is composed of seven OM patients, diagnosed according to clinical, laboratory and neuroradiological features, whose clinical data were retrospectively analysed. OM is a non-infectious, inflammatory process primarily involving extraocular eye-muscles. It typically presents as an acute to sub-acute, painful ophthalmoplegia with signs of ocular inflammation, but atypical cases without pain or with a chronic progression have been described. The wide range of OM mimicking diseases make a prompt diagnosis challenging but orbit MRI provides valuable clues for differential diagnosis. Timely treatment is greatly important as OM promptly responds to steroids; nevertheless, partial recovery or relapses often occur. In refractory, recurrent or steroid-intolerant cases other therapeutic options (radiotherapy, immunosuppressants, immunoglobulins) can be adopted, but the most effective therapeutic management is yet to be established. In this review, we provide a detailed clinical description of OM, considering the main differential diagnoses and suggesting the most useful investigations. In light of the currently available data on therapy efficacy, we propose a therapeutic algorithm that may guide neurologists in OM patients' management. PMID:26477021

  15. Clinical Efficacy of Various Diagnostic Tests for Small Bowel Tumors and Clinical Features of Tumors Missed by Capsule Endoscopy

    Directory of Open Access Journals (Sweden)

    Jung Wan Han

    2015-01-01

    Full Text Available Background. We aimed to evaluate the efficacy of various diagnostic tools such as computerized tomography (CT, small bowel follow-through (SBFT, and capsule endoscopy (CE in diagnosing small bowel tumors (SBTs. Additionally, we aimed to evaluate the clinical features of SBTs missed by CE. Methods. We retrospectively studied 79 patients with histologically proven SBT. Clinical data were analyzed with particular attention to the efficacy of CT, SBFT, and CE in detecting SBT preoperatively. We also analyzed the clinical features of SBTs missed by CE. Results. The most common symptoms of SBT were bleeding (43% and abdominal pain (13.9%. Diagnostic yields were as follows: CT detected 55.8% of proven SBTs; SBFT, 46.1%; and CE, 83.3%. The sensitivity for detecting SBTs was 40.4% for CT, 43.9% for SBFT, and 79.6% for CE. Two patients with nondiagnostic but suspicious findings on CE and seven patients with negative findings on CE were eventually found to have SBT. These nine patients were eventually diagnosed with gastrointestinal stromal tumor (4, small polyps (3, inflammatory fibroid polyp (1, and adenocarcinoma (1. These tumors were located in the proximal jejunum (5, middle jejunum (1, distal jejunum (1, and proximal ileum (1. Conclusion. CE is more efficacious than CT or SBFT for detecting SBTs. However, significant tumors may go undetected with CE, particularly when located in the proximal jejunum.

  16. MR imaging of pregnancy luteoma: a case report and correlation with the clinical features

    International Nuclear Information System (INIS)

    We report here on a 26-year-old pregnant female who developed hirsutism and virilization during her third trimester along with a significantly elevated serum testosterone level. Abdominal US and MR imaging studies were performed, and they showed unique imaging features that may suggest the diagnosis of pregnancy luteoma in the clinical context. After the delivery, the serum testosterone level continued to decrease, and it returned to normal three weeks postpartum. The follow-up imaging findings were closely correlated with the clinical presentation

  17. Clinical features of interstitial lung disease in primary Sjgren’s syndrome

    Institute of Scientific and Technical Information of China (English)

    李娅

    2013-01-01

    Objective To detect the clinical features of interstitial lung disease (ILD) in patients with primary Sjgren’s syndrome (pSS) .Methods From January 2009 to November 2011,368 patients with pSS from 16 clinical centers in China were collected.Patients were divided into the ILD group and the non ILD group according to their chest high resolution CT (HRCT) presentation.Ttest,nonparametric test and Chisquare test were applied to compare data in the subgroups.Logistic regression

  18. Clinical, biological, histological features and treatment of oral mucositis induced by radiation therapy: a literature review

    International Nuclear Information System (INIS)

    The oral mucositis is a main side effect of radiotherapy on head and neck, initiating two weeks after the beginning of the treatment. It is characterized by sensation of local burning to intense pain, leading in several cases, to the interruption of the treatment. The purpose of this work is to review the main published studies that discuss the clinical, biological and histopathological features of oral mucositis induced by radiation therapy and to describe the main approaches recommended to prevent or to treat it. Although the clinical features of mucositis are intensively described in the literature, few studies address the histopathological alterations in oral mucositis and only recently, its biological processes have been investigated. The biological mechanisms involved in the radiation tissue damage have been only recently discussed and there is no consensus among treatment modalities. Yet, the progressive knowledge in the histopathology and biological characteristics of oral mucositis probably will lead to more effective in prevention and control strategies. (author)

  19. Empathy in individuals clinically at risk for psychosis

    DEFF Research Database (Denmark)

    Derntl, B.; Michel, T. M.; Prempeh, P.;

    2015-01-01

    Background Empathy is a basic human ability, and patients with schizophrenia show dysfunctional empathic abilities on the behavioural and neural level. Aims These dysfunctions may precede the onset of illness; thus, it seems mandatory to examine the empathic abilities in individuals at clinical...... high risk for psychosis. Method Using functional magnetic resonance imaging, we measured 15 individuals at clinical high risk of psychosis (CHR group) and compared their empathy performance with 15 healthy volunteers and 15 patients with schizophrenia. Results Behavioural data analysis indicated no...... significant deficit in the CHR group. Functional data analysis revealed hyperactivation in a frontotemporoparietal network including the amygdala in the CHR group compared with the other two groups. Conclusions Despite normal behavioural performance, the CHR group activated the neural empathy network...

  20. Presumed Perinatal Stroke: Risk Factors, Clinical and Radiological Findings.

    Science.gov (United States)

    Ilves, Pilvi; Laugesaar, Rael; Loorits, Dagmar; Kolk, Anneli; Tomberg, Tiiu; Lõo, Silva; Talvik, Inga; Kahre, Tiina; Talvik, Tiina

    2016-04-01

    It is unknown why some infants with perinatal stroke present clinical symptoms late during infancy and will be identified as infants with presumed perinatal stroke. The risk factors and clinical and radiological data of 42 infants with presumed perinatal stroke (69% with periventricular venous infarction and 31% with arterial ischemic stroke) from the Estonian Pediatric Stroke Database were reviewed. Children with presumed perinatal stroke were born at term in 95% of the cases and had had no risk factors during pregnancy in 43% of the cases. Children with periventricular venous infarction were born significantly more often (82%) vaginally (P = .0213) compared to children with arterial stroke (42%); nor did they require resuscitation (P = .0212) or had any neurological symptoms after birth (P = .0249). Periventricular venous infarction is the most common type of lesion among infants with the presumed perinatal stroke. Data suggest that the disease is of prenatal origin. PMID:26446909

  1. Clinical and radiological features of idiopathic interstitial pneumonias (IIPs): a pictorial review

    OpenAIRE

    Palmucci, Stefano; Roccasalva, Federica; Puglisi, Silvia; Torrisi, Sebastiano Emanuele; Vindigni, Virginia; Mauro, Letizia Antonella; Ettorre, Giovanni Carlo; Piccoli, Marina; Vancheri, Carlo

    2014-01-01

    Objectives To illustrate the clinical and radiological features of idiopathic interstitial pneumonias (IIPs), according to the American Thoracic Society (ATS)/European Respiratory Society (ERS) classification updated in 2013. Methods IIPs include a subset of diffuse and restrictive lung diseases, resulting from damage to the parenchyma characterised by inflammation and fibrosis of the interstitium. Classification into major and rare IIPs is based on the 2013 ATS/ERS committee. Results The dia...

  2. MR Imaging of Pregnancy Luteoma: a Case Report and Correlation with the Clinical Features

    OpenAIRE

    Kao, Hung-Wen; Wu, Ching-Jiunn; Chung, Kuo-Teng; Wang, Sheng-Ru; Chen, Cheng-Yu

    2005-01-01

    We report here on a 26-year-old pregnant female who developed hirsutism and virilization during her third trimester along with a significantly elevated serum testosterone level. Abdominal US and MR imaging studies were performed, and they showed unique imaging features that may suggest the diagnosis of pregnancy luteoma in the clinical context. After the delivery, the serum testosterone level continued to decrease, and it returned to normal three weeks postpartum. The follow-up imaging findin...

  3. Clinical, Pathological, and Molecular Features of Lung Adenocarcinomas with AXL Expression

    OpenAIRE

    Sato, Katsuaki; Suda, Kenichi; Shimizu, Shigeki; Sakai, Kazuko; Mizuuchi, Hiroshi; Tomizawa, Kenji; Takemoto, Toshiki; Nishio, Kazuto; Mitsudomi, Tetsuya

    2016-01-01

    The receptor tyrosine kinase AXL is a member of the Tyro3-Axl-Mer receptor tyrosine kinase subfamily. AXL affects several cellular functions, including growth and migration. AXL aberration is reportedly a marker for poor prognosis and treatment resistance in various cancers. In this study, we analyzed clinical, pathological, and molecular features of AXL expression in lung adenocarcinomas (LADs). We examined 161 LAD specimens from patients who underwent pulmonary resections. When AXL protein ...

  4. Effective feature selection of clinical and genetic to predict warfarin dose using artificial neural network

    OpenAIRE

    Mohammad Karim Sohrabi; Alireza Tajik

    2016-01-01

    Background: Warfarin is one of the most common oral anticoagulant, which role is to prevent the clots. The dose of this medicine is very important because changes can be dangerous for patients. Diagnosis is difficult for physicians because increase and decrease in use of warfarin is so dangerous for patients. Identifying the clinical and genetic features involved in determining dose could be useful to predict using data mining techniques. The aim of this paper is to provide a convenient way t...

  5. DNA methylation Profiles in Primary Cutaneous Melanomas are Associated with Clinically Significant Pathologic Features

    OpenAIRE

    Thomas, Nancy E.; Slater, Nathaniel A.; Edmiston, Sharon N.; Zhou, Xin; Kuan, Pei-Fen; Groben, Pamela A; Carson, Craig C.; Hao, Honglin; Parrish, Eloise; Moschos, Stergios J; Berwick, Marianne; Ollila, David W.; Conway, Kathleen

    2014-01-01

    DNA methylation studies have elucidated a methylation signature distinguishing primary melanomas from benign nevi and provided new insights about genes that may be important in melanoma development. However, it is unclear whether methylation differences among primary melanomas are related to tumor pathologic features with known clinical significance. We utilized the Illumina Golden Gate Cancer Panel array to investigate the methylation profiles of 47 primary cutaneous melanomas...

  6. A case of asymptomatic pancytopenia with clinical features of hemolysis as a presentation of pernicious anemia.

    Science.gov (United States)

    Kollipara, Venkateswara K; Brine, Patrick L; Gemmel, David; Ingnam, Sisham

    2016-01-01

    Pernicious anemia is an autoimmune disease with a variety of clinical presentations. We describe a case of pernicious anemia presenting with pancytopenia with hemolytic features. Further workup revealed very low vitamin B12 levels and elevated methylmalonic acid. It is important for a general internist to identify pernicious anemia as one of the cause of pancytopenia and hemolytic anemia to avoid extensive workup. Pernicious anemia can present strictly with hematological abnormalities without neurological problems or vice versa as in our case. PMID:27609735

  7. Clinical Features of Obstructive Sleep Apnea That Determine Its High Prevalence in Resistant Hypertension

    OpenAIRE

    Min, Hyun Jin; Cho, Yang-Je; Kim, Chang-Hoon; Kim, Da Hee; Kim, Ha Yan; Choi, Ji In; Lee, Jeung-Gweon; Park, Sungha; Cho, Hyung-ju

    2015-01-01

    Purpose Resistant hypertension (HTN) occurs in 15-20% of treated hypertensive patients, and 70-80% of resistant hypertensive patients have obstructive sleep apnea (OSA). The characteristics of resistant HTN that predispose patients to OSA have not been reported. Therefore, we aimed to determine the clinical, laboratory, and polysomnographic features of resistant HTN that are significantly associated with OSA. Materials and Methods Hypertensive patients (n=475) who underwent portable polysomno...

  8. T cell transcriptional factors in allergic rhinitis and its association with clinical features

    OpenAIRE

    Mo, Ji-Hun; Chung, Young-Jun; Kim, Ji Hye

    2013-01-01

    Background Th2 cells are crucially important in allergic disease and the possible involvement of Treg and Th17 cells has not been clearly identified. Objective To identify the mRNA expression of T cell transcription factors in nasal mucosa in patients with allergic rhinitis (AR) and to reveal their correlations with clinical features. Methods Eighteen patients with AR and 12 controls with turbinate hypertrophy were included. mRNA expression of the following transcriptional factors in nasal mu...

  9. Animal model of PTSD based on clinically relevant features of trauma susceptibility and expression

    OpenAIRE

    David Diamond; Roth, Tania L.; Monika Fleshner; Zoladz, Phillip R

    2012-01-01

    Rationale/statement of the problem : There is an insufficient understanding of the neurobiology of post-traumatic stress disorder (PTSD). Therefore, the development of an animal model of PTSD that takes into account clinical features of the disorder is of value toward enhancing our understanding of the mechanisms, and in the development of novel treatments, of emotional trauma. Methods : Adult male rats were administered chronic psychosocial stress composed of two 1-hour periods of inescapabl...

  10. Clinical features and histological patterns of lupus nephritis in Eastern Nepal

    OpenAIRE

    Subodh Sagar Dhakal; Sanjib Kumar Sharma; Narendra Bhatta; Sabina Bhattarai; Smriti Karki; Shailendra Shrestha; Suman Rijal; Prahlad Karkil

    2011-01-01

    To determine the clinical profile and patterns of lupus nephritis patients in Eastern Nepal, we studied 38 patients fulfilling the 1982 revised criteria of American College of Rheu-matology for systemic lupus erythematous (SLE), followed up from January 2004 to January 2008. Arthritis was a common initial feature in addition to variable cutaneous, cardiac, pulmonary and neuropsychiatric manifestations. Renal biopsy showed grade 1 changes in 5 (13.5%) patients, grade 2 changes in 13 (35.1%) pa...

  11. Epidemiology and Clinical Features of Ciguatera Fish Poisoning in Hong Kong

    OpenAIRE

    Thomas Y. K. Chan

    2014-01-01

    In the present review, the main objective was to describe the epidemiology and clinical features of ciguatera fish poisoning in Hong Kong. From 1989 to 2008, the annual incidence of ciguatera varied between 3.3 and 64.9 (median 10.2) per million people. The groupers have replaced the snappers as the most important cause of ciguatera. Pacific-ciguatoxins (CTX) are most commonly present in reef fish samples implicated in ciguatera outbreaks. In affected subjects, the gastrointestinal symptoms...

  12. Epidemiology and clinical features of obsessive-compulsive disorder during pregnancy and postpartum period: a review

    OpenAIRE

    Uguz, Faruk; Ayhan, Medine Gıynas

    2011-01-01

    In this study we reviewed the current literature on the epidemiology and clinical features of obsessive-compulsive disorder (OCD) during pregnancy and postpartum period. The available reports on this topic have significant limitations and heterogenous methods. However, the prevalence and incidence rates of OCD reported during these two reproductive periods are higher than the rates estimated in the general population. The most common obsessions in pregnancy and puerperium were contamination a...

  13. Multidrug-Resistant Pseudomonas aeruginosa: Risk Factors and Clinical Impact†

    OpenAIRE

    Aloush, Valerie; Navon-Venezia, Shiri; Seigman-Igra, Yardena; Cabili, Shaltiel; Carmeli, Yehuda

    2006-01-01

    Pseudomonas aeruginosa, a leading nosocomial pathogen, may become multidrug resistant (MDR). Its rate of occurrence, the individual risk factors among affected patients, and the clinical impact of infection are undetermined. We conducted an epidemiologic evaluation and molecular typing using pulsed-field gel electrophoresis (PFGE) of 36 isolates for 82 patients with MDR P. aeruginosa and 82 controls matched by ward, length of hospital stay, and calendar time. A matched case-control study iden...

  14. Responding to suicidal risks: bridging between research and clinical practice.

    OpenAIRE

    McGowan, J.; Hickey, L.

    2012-01-01

    Here is an audio slideshow of a recent presentation by our Academic Director Dr John McGowan and regular supervisor Dr Lucy Hickey of Oxleas NHS Trust. This is based on a presentation they gave to the European Symposium of Suicide and Suicidal Behavior in September 2012. It offers a model for clinical decision making when confronted with the risk of suicide or self-harm.

  15. Childhood trauma associates with clinical features of schizophrenia in a sample of Chinese inpatients.

    Science.gov (United States)

    Li, Xian-Bin; Li, Qi-Yong; Liu, Jin-Tong; Zhang, Liang; Tang, Yi-Lang; Wang, Chuan-Yue

    2015-08-30

    This study examined the association between childhood trauma and clinical features, comorbid anxiety and post-traumatic stress disorder (PTSD) symptoms, and suicidal and aggressive behaviors in Chinese patients with schizophrenia. The Childhood Trauma Questionnaire - Short Form (CTQ-SF), the Impact of Events Scale - Revised (IES-R), and the State-Trait Anxiety Inventory (STAI) were administered to 182 Chinese inpatients with schizophrenia. The relationship between the severity and the number of traumic experiences and clinical features were analyzed. Physical neglect (PN) in childhood was reported in 71.7% of this sample, followed by emotional neglect (EN, 58.6%), sexual abuse (SA, 39.9%), emotional abuse (EA, 31.7%) and physical abuse (PA, 22.2%). Significant negative correlations existed between age of onset and the EA scores. Significant positive correlations were found between the subscores of IES-R, STAI and CTQ-SF. Patients with history of suicidal or aggressive behaviors had significantly higher trauma scores than patients without such behaviors. Exposure to childhood trauma is associated with early age of onset, more PTSD and anxiety symptoms, and history of suicidal and aggressive behaviors. A dose-effect may exist between severity, number of trauma experiences, and clinical features. PMID:26096662

  16. The clinical features of 17 patients with steroid-responsive encephalopathy associated with autoimmune thyroiditis

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    CHEN Hai

    2013-06-01

    Full Text Available Objective To investigate the onset pattern, clinical manifestations, laboratory findings and imaging features of 17 Chinese patients with steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT. Methods The clinical data of 17 SREAT patients were collected. Retrospective analysis of their clinical features, as well as their serum levels of anti-thyroid, cerebrospinal fluid (CSF biochemical indicators, MRI and therapy was performed. Results The initial symptoms of those patients were seizures (4 cases, psychiatric symptoms (4 cases, hypomnesis (4 cases, walking unsteadiness (2 cases, headache (2 cases and dysarthria (1 case. Three cases were acute onset, 5 cases subacute onset and 9 cases chronic onset. The anti-thyroid peroxidase antibody (anti-TPO of 17 cases were significantly increased, average (928.63 ± 406.28 × 10 3 IU/L. The anti?thyroglobulin antibody (anti-TG of 15 cases was increased, average (601.27 ± 1014.12 × 10 3 IU/L. The protein in CSF was mildly increased, average (513.75 ± 283.15 mg/L. The EEG of 5 patients presented slow wave and the EEG of 2 patients showed epileptiform discharge. The brain MRI of 11 patients showed multifocal lesions in frontal lobe, temporal lobe, parietal lobe, basal ganglia, centrum ovale, corpus callosum, thalamus, cerebellum, and brain stem. The findings of clinical immunological index and tumor markers were normal. Besides, the prognosis of 11 patients treated with methylprednisolone and 3 patients treated with dexamethasone were good. Recurrence occurred in 2 patients. Conclusion Basically, the clinical features of Chinese SREAT patients present seizures, hypomnesis and psychiatric symptoms associated with increased anti-thyroid and multifocal lesions in gray and white matter of brain.

  17. Risk stratification in non-ST elevation acute coronary syndromes: Risk scores, biomarkers and clinical judgment

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    David Corcoran

    2015-09-01

    Clinical guidelines recommend an early invasive strategy in higher risk NSTE-ACS. The Global Registry of Acute Coronary Events (GRACE risk score is a validated risk stratification tool which has incremental prognostic value for risk stratification compared with clinical assessment or troponin testing alone. In emergency medicine, there has been a limited adoption of the GRACE score in some countries (e.g. United Kingdom, in part related to a delay in obtaining timely blood biochemistry results. Age makes an exponential contribution to the GRACE score, and on an individual patient basis, the risk of younger patients with a flow-limiting culprit coronary artery lesion may be underestimated. The future incorporation of novel cardiac biomarkers into this diagnostic pathway may allow for earlier treatment stratification. The cost-effectiveness of the new diagnostic pathways based on high-sensitivity troponin and copeptin must also be established. Finally, diagnostic tests and risk scores may optimize patient care but they cannot replace patient-focused good clinical judgment.

  18. Multiple risk factor evaluation in a hypertension clinic.

    Science.gov (United States)

    Thom, S; Bunker, J; Callister, W; Poulter, N; Sever, P; Zographos, D

    1989-12-01

    Hypertension is associated with abnormal lipoprotein metabolism, which may be exacerbated by some groups of antihypertensive drugs and represents an additional powerful coronary heart disease risk factor. Of our Hypertension Clinic population, 75% had a total fasting serum cholesterol greater than 5.2 mmol/l. Dietary advice and adjustment of antihypertensive therapy has achieved significant reductions in total cholesterol, serum triglycerides and body weight (14%, 18% and 4.3%, respectively) in a cohort of 65 patients reassessed over a period of 3-21 months. The reduction in cholesterol is likely to represent at least a 28% reduction in the risk of a major coronary heart disease event, even before taking account of any improvement in other coronary heart disease risk factors. PMID:2632734

  19. STUDY OF RISK FACTORS AND CLINICAL PROFILE OF ACUTE STROKE

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    Tomar

    2014-05-01

    Full Text Available `INTRODUCTION: Stroke is the third leading cause of death in developed countries after cardiovascular disease and cancer. In India Community Surveys have shown a crude prevalence rate for hemiplegia 200 per 1, 00, 000 population. It accounts for nearly 1.5% of all urban admissions, 4.5 % of all medical and about 20% of neurological cases. AIMS AND OBJECTIVE: Identification of risk factors and evaluation of clinical profile of acute stroke. MATERIAL AND METHOD: INCLUSION CRITERIA: Cases of acute stoke admitted in SGMH hospital were selected for the study. EXCLUSION CRITERIA: Brain injury cases, infective, neoplastic cases producing stroke were excluded. RESULTS: Stroke was more common in male, 58 % patients were male and 42% patients were female. It was more common in 5th and 6th decade. Most common etiology was infarction. Most common risk factor was hypertension followed by smoking. In addition to limb weakness, headache and vomiting were most common presenting symptoms followed by convulsion. These symptoms were more common in hemorrhagic stroke. Right sided hemiplegia was more common than left sided. Middle cerebral artery was involved in majority of cases in atherothrombotic stroke whereas basal ganglion was most common site of bleed in hemorrhagic stroke. Coma and mortality were more in hemorrhagic stroke. CONCLUSION: The risk factors and clinical profile of acute stroke in India are similar to that of Western countries. Common risk factors are hypertension, smoking, diabetes mellitus and hyperlipidemia

  20. Untreated periodontal disease in Indonesian adolescents : Longitudinal clinical data and prospective clinical and microbiological risk assessment

    NARCIS (Netherlands)

    Timmerman, MF; Van der Weijden, GA; Abbas, F; Arief, EM; Armand, S; Winkel, EG; Van Winkelhoff, AJ; Van der Velden, U

    2000-01-01

    Background, aims: In order to investigate the role of various putative clinical and microbiological risk markers, a longitudinal study was initiated in a young population deprived of regular dental care. In 1987 all inhabitants in the age range 15-25 years living in a village with approximately 2000

  1. Clinical Features and Molecular Analysis of Hb H Disease in Taiwan

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    Yu-Hua Chao

    2014-01-01

    Full Text Available Thalassemia is highly prevalent in Taiwan, but limited data are available about the association between genotypes and clinical manifestations in Taiwanese patients with Hb H disease. Here, we studied α-globin gene abnormalities and clinical features in Taiwanese patients with Hb H disease. Of the 90 patients, sixty-four (71.1% were deletional and twenty-six (28.9% were nondeletional Hb H disease. The (- -SEA type of α0-thalassemia mutation was detected in the majority of patients (>95%. The most common genotype was (- -SEA/-α3.7, followed by (- -SEA/αcsα. After further investigation of the genotype-phenotype correlation in 68 patients, we found that patients with nondeletional Hb H disease had more severe clinical features than those with deletional Hb H disease, including younger age at diagnosis, more requirement of blood transfusions, and larger proportion of patients with splenomegaly, hepatomegaly or jaundice. This is probably a consequence of the lower hemoglobin levels and the higher Hb H levels. The clinical severity was highly variable even among patients with an identical genotype, and the diversity was much more profound among patients with (- -/αcsα genotype. Therefore, predicting the phenotype directly from the genotype in Hb H disease remains relatively difficult in Taiwan.

  2. Clinical and Pathological Features of Primary Gastrointestinal Non-Hodgkin's Lymphoma

    Institute of Scientific and Technical Information of China (English)

    KangzhiWu; JianminYang; DaliMa; XionminSong; WeipingZhang; XiaopingXu; BiheMin; JianminWang

    2004-01-01

    OBJECTIVE The study was initiated to obtain histologic distribution, clinical features, and treatment results in patients with primary gastrointestinal non-Hodgkin's lymphomas.METHODS Between January 1990 and January 2000, 89 PGI NHL patients were eligible to evaluate clinical features. Histological and immunohistological studies were routinely used and all the specimens were reclassified according to the recently published WHO classification system.RESULTS (1)Clinically, among the 89 patients, there were 24 patients in stage IE,33 in stage IIE,19 in stage IIIE,and 13 in stage IVE. (2)Immunohistological studies revealed 72 patients were with B-cell type and only 17 with T-cell type. (3)Altogether, 15 MALT lymphoma were diagnosed among 89 PGI NHL patients, and 14/15 were found primary in the stomach.(4)The 3-year and 5-year overall survival were 77.0% (57/74) and 53.6% (30/56)for the total group.CONCLUSION No clinical symptoms and signs were found to be specific for the diagnosis of PGI NHL. Most patients were in stage IE and liE when diagnosed and the intermediate grade and B-cell type were more common than the others. Surgical resection of the tumor and standard combined chemotherapy post surgery were suggested to be the most effective measures for the long term survival of the PGI NHL patients.

  3. Clinical and histological features of non-Alcoholic steatohepatitis in Iranian patients

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    "Ebrahimi Daryani N

    2003-05-01

    Full Text Available Non-alcoholic steatohepatitis (NASH is a disease of unknown origin characterized histologically by alcoholic-like liver injury in the absence in the absence of significant alcohol intake. This study was conducted to assess the clinical and pathological features of NASH patients in Iran. Patients with elevated liver transaminases, negative serologic markers of viral or autoimmune hepatitis and no findings in favor of metabolic liver disease were enrolled. A careful history was taken with special attention to alcohol intake and ultrasonography and liver biopsy were performed in those with no evidence of significant alcohol intake. A histology showing moderate to gross macrovesicular fatty change with inflammation (lobular or portal, with or without Mallory bodies, fibrosis, or cirrhosis, was considered diagnostic for NASH. Patients with mild steatosis were rechecked for the presence of hepatitis C virus (HCV infection. Fifty-three patients who met the above criteria entered the study. Thirty-two patients (60.4% were male and 21 (39.6% were female with the mean age of 37.8±11.3 years. Twenty-six patients (55.3% were diabetic. Mean AST to ALT ratio was 0.95±0.52; 65.3%of patients had a ratio below than 1, and 95.9% were below of 2. Ultrasonography was abnormal in 32 (76.2% patients. Liver biopsy showed mild steatosis in 35.7% moderate steatosis in 53.6% and severe forms in 10.7%. In 80.2% of patients, portal inflammation was present, and 15.1% had some degrees of fibrosis. The amount of increase in liver enzymes bore no relationship with the presence of fibrosis, portal inflammation, and degree of steatosis (P>0.05. The patients wee somewhat younger than other studies, and most of them were male which might be due to the low rate of alcohol consumption in our country. Most of the patients had body mass index (BMI higher than normal. Our findings show that NASH must not be considered a disease confined to high-risk groups only, and its impact be

  4. Female Breast Cancer: Epidemiological And Clinical Study Of Some Risk Factors Among Egyptian Females- Multi Clinics Study

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    E. A. El-Moselhy; M. A. S. Ahmed*; A. M. Abdel-Fattah

    2005-03-01

    Full Text Available This study was conducted on 390 female breast cancer patients and an equal number of females as controls. The patients were attending some University and Teaching Hospitals in Cairo and Assuit. Ninety of them were newly operated. A retrospective, case-control, clinic based study was chosen to carry out this research. The aim of the study was to describe the sociodemographic, characteristics and clinical features of female breast cancer and to determine its risk factors among Egyptian women. All the patients and the controls had undergone physical examinations. Laboratory investigations were done for the newly operated patients and their controls. The most important characteristics of breast cancer patients were breast mass as the main presenting symptom (92.1% and treated by modified radical mastectomy (77.2%. Low means level of serum vitamin D and high levels of serum cholesterol and triglyceride were found more among the patients. Age at first full term pregnancy 30 years, age at menopause 45 years, pregnancy termination and/or abortion and never married were important gynaecological and reproductive risk factors (OR=4.44, 3.14, 2.84 and 2.67, respectively. Also, exposure to radiation and/or environmental factors, history of benign breast disease and alcohol use were important associated risk factors (OR=5.05, 4.63 and 4.10, respectively. Moreover, the sister as the nearest female relative with breast cancer, total number of female relatives with breast cancer 2 and relative(s age at diagnosis <50 years were important family history risk factors (OR=9.19, 8.84 and 7.91, respectively. Lastly, high consumption of canned foods, fat rich foods and low consumption of fresh fruits and vegetables were important dietary risk factors (OR=3.39, 1.76 and 1.51, respectively.

  5. Estimating the re-identification risk of clinical data sets

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    Dankar Fida

    2012-07-01

    Full Text Available Abstract Background De-identification is a common way to protect patient privacy when disclosing clinical data for secondary purposes, such as research. One type of attack that de-identification protects against is linking the disclosed patient data with public and semi-public registries. Uniqueness is a commonly used measure of re-identification risk under this attack. If uniqueness can be measured accurately then the risk from this kind of attack can be managed. In practice, it is often not possible to measure uniqueness directly, therefore it must be estimated. Methods We evaluated the accuracy of uniqueness estimators on clinically relevant data sets. Four candidate estimators were identified because they were evaluated in the past and found to have good accuracy or because they were new and not evaluated comparatively before: the Zayatz estimator, slide negative binomial estimator, Pitman’s estimator, and mu-argus. A Monte Carlo simulation was performed to evaluate the uniqueness estimators on six clinically relevant data sets. We varied the sampling fraction and the uniqueness in the population (the value being estimated. The median relative error and inter-quartile range of the uniqueness estimates was measured across 1000 runs. Results There was no single estimator that performed well across all of the conditions. We developed a decision rule which selected between the Pitman, slide negative binomial and Zayatz estimators depending on the sampling fraction and the difference between estimates. This decision rule had the best consistent median relative error across multiple conditions and data sets. Conclusion This study identified an accurate decision rule that can be used by health privacy researchers and disclosure control professionals to estimate uniqueness in clinical data sets. The decision rule provides a reliable way to measure re-identification risk.

  6. Clinical features of patients with dysthymia in a large cohort of Han Chinese women with recurrent major depression.

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    Wenqing Wu

    Full Text Available BACKGROUND: Dysthymia is a form of chronic mild depression that has a complex relationship with major depressive disorder (MDD. Here we investigate the role of environmental risk factors, including stressful life events and parenting style, in patients with both MDD and dysthymia. We ask whether these risk factors act in the same way in MDD with and without dysthymia. RESULTS: We examined the clinical features in 5,950 Han Chinese women with MDD between 30-60 years of age across China. We confirmed earlier results by replicating prior analyses in 3,950 new MDD cases. There were no significant differences between the two data sets. We identified sixteen stressful life events that significantly increase the risk of dysthymia, given the presence of MDD. Low parental warmth, from either mother or father, increases the risk of dysthymia. Highly threatening but short-lived threats (such as rape are more specific for MDD than dysthymia. While for MDD more severe life events show the largest odds ratio versus controls, this was not seen for cases of MDD with or without dysthymia. CONCLUSIONS: There are increased rates of stressful life events in MDD with dysthymia, but the impact of life events on susceptibility to dysthymia with MDD differs from that seen for MDD alone. The pattern does not fit a simple dose-response relationship, suggesting that there are moderating factors involved in the relationship between environmental precipitants and the onset of dysthymia. It is possible that severe life events in childhood events index a general susceptibility to chronic depression, rather than acting specifically as risk factors for dysthymia.

  7. Perineural Infiltration of Cutaneous Squamous Cell Carcinoma and Basal Cell Carcinoma Without Clinical Features

    International Nuclear Information System (INIS)

    Purpose: To review the factors that influence outcome and patterns of relapse in patients with cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) with perineural infiltration (PNI) without clinical or radiologic features, treated with surgery and radiotherapy. Methods and Materials: Between 1991 and 2004, 222 patients with SCC or BCC with PNI on pathologic examination but without clinical or radiologic PNI features were identified. Charts were reviewed retrospectively and relevant data collected. All patients were treated with curative intent; all had radiotherapy, and most had surgery. The primary endpoint was 5-year relapse-free survival from the time of diagnosis. Results: Patients with SCC did significantly worse than those with BCC (5-year relapse-free survival, 78% vs. 91%; p < 0.01). Squamous cell carcinoma with PNI at recurrence did significantly worse than de novo in terms of 5-year local failure (40% vs. 19%; p < 0.01) and regional relapse (29% vs. 5%; p < 0.01). Depth of invasion was also a significant factor. Of the PNI-specific factors for SCC, focal PNI did significantly better than more-extensive PNI, but involved nerve diameter or presence of PNI at the periphery of the tumor were not significant factors. Conclusions: Radiotherapy in conjunction with surgery offers an acceptable outcome for cutaneous SCC and BCC with PNI. This study suggests that focal PNI is not an adverse feature.

  8. Perineural Infiltration of Cutaneous Squamous Cell Carcinoma and Basal Cell Carcinoma Without Clinical Features

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Charles, E-mail: Charles_Lin@health.qld.gov.au [Cancer Care Services, Royal Brisbane and Women' s Hospital, Brisbane, Queensland (Australia); Tripcony, Lee; Keller, Jacqui [Cancer Care Services, Royal Brisbane and Women' s Hospital, Brisbane, Queensland (Australia); Poulsen, Michael [Mater Hospital, Brisbane, Queensland (Australia); Martin, Jarad [St. Andrews Hospital, Toowoomba, Queensland (Australia); Jackson, James; Dickie, Graeme [Cancer Care Services, Royal Brisbane and Women' s Hospital, Brisbane, Queensland (Australia)

    2012-01-01

    Purpose: To review the factors that influence outcome and patterns of relapse in patients with cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) with perineural infiltration (PNI) without clinical or radiologic features, treated with surgery and radiotherapy. Methods and Materials: Between 1991 and 2004, 222 patients with SCC or BCC with PNI on pathologic examination but without clinical or radiologic PNI features were identified. Charts were reviewed retrospectively and relevant data collected. All patients were treated with curative intent; all had radiotherapy, and most had surgery. The primary endpoint was 5-year relapse-free survival from the time of diagnosis. Results: Patients with SCC did significantly worse than those with BCC (5-year relapse-free survival, 78% vs. 91%; p < 0.01). Squamous cell carcinoma with PNI at recurrence did significantly worse than de novo in terms of 5-year local failure (40% vs. 19%; p < 0.01) and regional relapse (29% vs. 5%; p < 0.01). Depth of invasion was also a significant factor. Of the PNI-specific factors for SCC, focal PNI did significantly better than more-extensive PNI, but involved nerve diameter or presence of PNI at the periphery of the tumor were not significant factors. Conclusions: Radiotherapy in conjunction with surgery offers an acceptable outcome for cutaneous SCC and BCC with PNI. This study suggests that focal PNI is not an adverse feature.

  9. Endovascular treatment of high-risk tentorial dural arteriovenous fistulas: clinical outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Chuhan; Lv, Xianli; Li, Youxiang; Zhang, Jingbo; Wu, Zhongxue [Capital Medical University, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Beijing (China)

    2009-02-15

    An increasing number of intracranial dural arteriovenous fistulas (DAVFs) are amenable to endovascular treatment with Onyx-18. We reviewed our experience with the endovascular management of tentorial dural arteriovenous fistulas (TDAVFs) treated transarterially and transvenously. Clinical records for 19 consecutive patients (three women, 16 men) with TDAVFs treated endovascularly between 2005 and 2008 were reviewed to determine their presenting symptoms, angiographic features, endovascular treatments, and clinical outcomes. Most patients (78.9%) presented with intracranial hemorrhage (ICH). All patients had high-risk angiographic features such as leptomeningeal venous varix. Transarterial embolization was performed in 19 patients. Transvenous embolization was additionally performed in two patients and caused one death. At the time of the last follow-up evaluation, 16 (84.2%) patients had good or excellent outcomes (modified Rankin score, 0 or 1) and one (5.3%) was deceased. Six patients had a residual fistula and were treated with gamma knife radiosurgery. The overall morbidity and mortality rate was 10.5%. High-risk TDAVFs can be successfully managed with good outcomes. When anatomic features can be accessed endovascularly, endovascular treatment is indicated. Patients with residual filling of the DAVF should be considered for adjuvant therapy, including further radiosurgery. (orig.)

  10. Risk of Breast Cancer in Women with False-Positive Results according to Mammographic Features.

    Science.gov (United States)

    Castells, Xavier; Torá-Rocamora, Isabel; Posso, Margarita; Román, Marta; Vernet-Tomas, Maria; Rodríguez-Arana, Ana; Domingo, Laia; Vidal, Carmen; Baré, Marisa; Ferrer, Joana; Quintana, María Jesús; Sánchez, Mar; Natal, Carmen; Espinàs, Josep A; Saladié, Francina; Sala, María

    2016-08-01

    Purpose To assess the risk of breast cancer in women with false-positive screening results according to radiologic classification of mammographic features. Materials and Methods Review board approval was obtained, with waiver of informed consent. This retrospective cohort study included 521 200 women aged 50-69 years who underwent screening as part of the Spanish Breast Cancer Screening Program between 1994 and 2010 and who were observed until December 2012. Cox proportional hazards regression analysis was used to estimate the age-adjusted hazard ratio (HR) of breast cancer and the 95% confidence interval (CI) in women with false-positive mammograms as compared with women with negative mammograms. Separate models were adjusted for screen-detected and interval cancers and for screen-film and digital mammography. Time without a breast cancer diagnosis was plotted by using Kaplan-Meier curves. Results When compared with women with negative mammograms, the age-adjusted HR of cancer in women with false-positive results was 1.84 (95% CI: 1.73, 1.95; P breast cancer, particularly women who had calcifications at mammography. Women who had more than one examination with false-positive findings and in whom the mammographic features changed over time had a highly increased risk of breast cancer. Previous mammographic features might yield useful information for further risk-prediction models and personalized follow-up screening protocols. (©) RSNA, 2016 Online supplemental material is available for this article. PMID:26878225

  11. Do clinical features and MRI suggest the same nerve root in acute cervical radiculopathy

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    M. Conradie

    2006-02-01

    Full Text Available Different proposed pathophysiological mechanisms can result in variable clinical presentations of cervical radiculopathy (CR, often making it difficult to detect minor nerve root (NR conditions. This descriptive study determined (1 the level(s of  NR involvement suggested by the distribution patterns of clinical features and detected by magnetic resonance imaging (MRI and (2 the most common associations between the different variables in patients diagnosed with acute CR by a neurosurgeon. A physiotherapist blinded to the level(s of NR involvement performed a standardized interview on 21 subjects to determine the distribution patterns of pain and paraesthesia, and a neurological examination. The Fisher exact test was used to determine associations between the different variables. Only seven subjects presented clinically and radiologically with the same single-level NR involvement. Multiple- level presentations occurred which might be due to dermatomal overlapping, central sensitization or the possible involvement of two adjacent NR levels. Distribution patterns of motor weakness, pain and paraesthesia, and to a lesser extent sensory and reflex changes, have value in identifying the compressed NR level. For this sample the distri-bution patterns of radicular features identified C6 and C8 with more certainty than C7.

  12. Chronic idiopathic urticaria: Comparison of clinical features with positive autologous serum skin test

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    George Mamatha

    2008-01-01

    Full Text Available Background: Chronic idiopathic urticaria (CIU, in its extremely severe form, can pose a therapeutic challenge to the treating physician. It has been noted that in one third of such patients, autoantibodies against the IgE receptor are seen and such patients have more severe and unremitting urticaria. Aim: To compare clinical features of autoimmune urticaria with those of other CIU patients. Methods: We conducted a prospective study in an attempt to correlate the clinical features with autoantibodies, indirectly detected via the autologous serum skin test (ASST, which is the simplest and the best in vivo clinical test for detection of basophil histamine-releasing activity. Discussion: Out of 100 patients with chronic idiopathic urticaria, 34 showed a positive reaction to the autologous serum skin test and it was found that the frequency and severity of attacks was higher in these patients. Conclusion: ASST may be used as a simple and cost-effective test for the classification of chronic urticaria, which has proven to be a therapeutic challenge to the treating physician.

  13. Bacterial brain abscess in patients with nasopharyngeal carcinoma following radiotherapy: microbiology, clinical features and therapeutic outcomes

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    Fang Peng-Hsiang

    2012-09-01

    Full Text Available Abstract Background This study aimed to analyze the clinical features, causative pathogens, neuro-imaging findings, and therapeutic outcomes of bacterial brain abscess in patients with nasopharyngeal carcinoma (NPC following radiotherapy. Methods NPC patients with bacterial brain abscess were evaluated. Their clinical data were collected over a 22-year period. For comparison, the clinical features, causative pathogens, neuro-imaging findings, and therapeutic outcomes between NPC and non-NPC patients were analyzed. Results NPC accounted for 5.7% (12/210 of the predisposing factors, with Viridans streptococci and Staphylococcus aureus as the two most common causative pathogens. Significant statistical analysis between the two groups (NPC and non-NPC patients included chronic otitis media (COM as the underlying disease, post-radiation necrosis by neuro-imaging, and the temporal lobe as the most common site of brain abscesses. The fatality rate in patients with and without NPC was 16.7% and 20.7%, respectively. Conclusions NPC patients with bacterial brain abscess frequently have COM as the underlying disease. Neuro-imaging often reveals both post-radiation necrosis and the temporal lobe as the most common site of brain abscesses, the diagnosis of which is not always a straightforward process. Radiation necrosis can mimic brain abscess on neuro-imaging and pose significant diagnostic challenges. Early diagnosis and treatment is essential for survival.

  14. Clinical features and anesthetic management of multiple endocrine neoplasia as sociated with pheochromocytoma

    Institute of Scientific and Technical Information of China (English)

    罗爱伦; 郭向阳; 任洪智; 黄宇光; 叶铁虎

    2003-01-01

    Objective To investigate clinical features and anesthetic management of multiple endocrine neoplasia (MEN) associated with pheochromocytoma.Methods Medical records of patients who were diagnosed as multiple endocrine neoplasia a ssociated with pheochromocytoma in our hospital from April 1977 to April 2001 were reviewed retrospectively. The demographic data, clinical presentations, fami ly history, biochemical examinations, type of MEN, sequence of different surgica l procedures, anesthetic methods and hemodynamics during surgery were analyzed. Results Thirteen cases of MEN associated with pheochromocytoma were investigated, accounting for 6% (13/213) of the pheochromocytoma patients admitted into our hospital. Nine of the 13 patients presented as type Ⅱa MEN (Sipple syndrome), on e as type Ⅱb MEN, and three as mixed MEN. Four patients with typeⅡa MEN had a family history of similar disease. Five patients with other coexisting endocri ne disorders first underwent excision of the pheochromocytomas, although only tw o had hypertensive symptoms at the time of admittance. Seven patients without h istories of hypertension received surgical treatment for pheochromocytoma second ly. The excision of pheochromocytoma was performed under general anesthesia in 8 patients and epidural block in 4 patients. Marked hemodynamic fluctuation was recorded in 8 patients. No perioperative death was recorded. Conclusion Pheochromocytoma may be linked to other endocrine disorders during MEN, either as the main clinical presentation or most frequently as an occult tumor. Recognition of this feature of pheochromocytoma is of importance to the improvement of diagnosis and treatment both for pheochromocytoma and MEN.

  15. Analysis on Clinical Features of 2168 Patients with Lung Cancer Diagnosed by Bronchoscope

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    Yu Zhang

    2013-06-01

    Full Text Available Objective: To analyze the clinical features of lung cancer diagnosed by bronchoscopy. Methods: The clinical features of 2168 patients with lung cancer diagnosed by bronchoscopy were retrospectively analyzed, including gender, age, pathological type, diseased region, manifestations under bronchoscopy and methods of drawing materials. Results: The ratio of male/female was 4.8:1 and the peak onset age was 60 - 69 years old. The major pathological type was squamous cell carcinoma (44.5%, then adenocarcinoma (25.9% and small cell lung cancer (18.3%. The incidence of squamous cell carcinoma was the highest in males (50.6%, while that of adenocarcinoma in females (56.2%. The positive diagnostic rates of forceps biopsy, brush biopsy, bronchial alveolar lavage and transbronchial needle aspiration were 81.6%, 49.4%, 18.2% and 62.6%, respectively, whereas that of biopsy combined with brush biopsy came up to 89.0%. Conclusion: Bronchoscopy is an important method in diagnosis of lung cancer. Different ages and genders of patients with lung cancer have different onset, and the distribution of pathological types is diverse. Attaching more importance to bronchoscopy and improving biopsy technique can significantly improve the diagnostic rate and provide reliable evidences for clinical treatment.

  16. Analysis on Clinical Features of 2168 Patients with Lung Cancer Diagnosed by Bronchoscope

    Institute of Scientific and Technical Information of China (English)

    Zhang Yu; Yu Like; Xie Haiyan; Hu Weihua; Hao Keke; Xia Ning

    2013-01-01

    Objective: To analyze the clinical features of lung cancer diagnosed by bronchoscopy. Methods:The clinical features of2168 patients with lung cancer diagnosed by bronchoscopy were retrospectively analyzed, including gender, age, pathological type, diseased region, manifestations under bronchoscopy and methods of drawing materials. Results:The ratio of male/female was 4.8:1 and the peak onset age was 60~69 years old. The major pathological type was squamous cell carcinoma (44.5%), then adenocarcinoma (25.9%) and small cell lung cancer (18.3%). The incidence of squamous cell carcinoma was the highest in males (50.6%), while that of adenocarcinoma in females (56.2%). The positive diagnostic rates of forceps biopsy, brush biopsy, bronchial alveolar lavage and transbronchial needle aspiration were 81.6%, 49.4%, 18.2% and 62.6%, respectively, whereas that of biopsy combined with brush biopsy came up to 89.0%. Conclusion: Bronchoscopy is an important method in diagnosis of lung cancer. Different ages and genders of patients with lung cancer have different onset, and the distribution of pathological types is diverse. Attaching more importance to bronchoscopy and improving biopsy technique can signiifcantly improve the diagnostic rate and provide reliable evidences for clinical treatment.

  17. 探讨重度子痫前期并发多器官功能障碍综合征的发病危险因素及临床特点%Risk factors and clinical features of multiple organ dysfunction syndromes of patients with severe preeclampsia

    Institute of Scientific and Technical Information of China (English)

    王清

    2014-01-01

    Objective To investigate the risk factors and clinical features of severe preeclampsia(SP) complicated with multiple organ dysfunction syndrome (Multiple Organ Dysfunction Syndrome,MODS) in order to provide reference for clinical practice.Methods Three hundred and ninety-one cases with severe preeclampsia were selected as our subjects,who hospitalized from February 2005 to February 2014 in our hospital.All subjects were divided into observation group (48 cases with MODS) and control group (343 cases without MODS).Clinical data were collected including age,gravidity,parity,gestational age,gestational age termination of pregnancy,uterine scar,prenatal care,medical history,treatment,mother child outcomes.Results There were significant differences between two groups in terms of weeks of termination of pregnancy,rate of uterine scar,rate of regular check-up of pregnancy,rate of chronic hypertension and renal disease.Logistic results showed that there were relationships between SP complicated with MO)S and the occurrence of termination of pregnancy with gestational age <28 weeks (OR =2.046,95% CI:1.03 ~ 3.74,P =0.034),uterine scar (OR =2.401,95% CI:1.16 ~ 4.09,P =0.008),non-regular prenatal care (OR =3.167,95% CI:1.96 ~ 5.23,P =0.002),chronic hypertension (OR =3.348,95% CI:2.23 ~ 5.78,P =0.001),renal disease (OR =3.064,95% CI:1.77 ~ 5.18,P =0.038).The rate of underwent special treatment,preterm children,neonatal asphyxia,perinatal death,intracranial hemorrhage in observation group were 77.08%,79.17%,29.17%,20.83%,4.17%,higher than that in control group (23.62%,45.19%,13.70%,8.45%,1.17% respectively; x2 =10.471,12.147,4.519,8.644,6.648,all P < 0.05).The degree of organ injury score in gestational age ≥ 33 weeks and < 33 weeks were (1.34 ± 0.28) points and (3.64 ± 0.69) points,and the difference was significant.The gestational week in gestational age ≥ 33 weeks and <33 weeks were (35.48 ±2.06) weeks and (29.87 ± 1

  18. Clinical, radiologic, and genetic features of Korean patients with Mucopolysaccharidosis IVA

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    Na Hee Lee

    2012-11-01

    Full Text Available &lt;B&gt;Purpose:&lt;/B&gt; Mucopolysaccharidosis IVA (MPS IVA; Morquio A syndrome is rare lysosomal storage disorder caused by &lt;I&gt;N&lt;/I&gt;-acetylgalactosamine- 6-sulfatase (GALNS deficiency. Only a few MPS IVA cases have been reported in the Korean literature; there is a paucity of research about clinical or radiologic findings for this disorder. Therefore, we studied clinical findings, radiological features, and genetic data of Korean MPS IVA patients for determining factors that may allow early diagnosis and that may thus improve the patients’ quality of life. &lt;B&gt;Method:&lt;/B&gt; MPS IVA was confirmed via assay for enzymatic activity of leukocytes in 10 patients. The &lt;I&gt;GALNS&lt;/I&gt; gene was analyzed. Patients’ charts were retrospectively reviewed for obtaining clinical features and evaluated for radiological skeletal surveys, echocardiography, pulmonary function test, and ophthalmologic test results. &lt;B&gt;Result:&lt;/B&gt; Nine patients had severe clinical phenotype, and 1 had an intermediate phenotype, on the basis of clinical phenotype criteria. Radiologic findings indicated skeletal abnormalities in all patients, especially in the hips and extremities. Eight patients had an odontoid hypoplasia, and 1 showed mild atlantoaxial subluxation and cord myelopathy. Genetic analysis indicated 10 different &lt;I&gt;GALNS&lt;/I&gt; mutations. Two mutations, c.451C&gt;A and c.1000C&gt;T, account for 37.5% (6/16 and 25% (4/16 of all mutations in this samples, respectively. &lt;B&gt;Conclusion:&lt;/B&gt; An understanding of the clinical and radiological features involved in MPS IVA may allow early diagnosis of MPS IVA. Adequate evaluations and therapy in the early stages may improve the quality of life of patients suffering from skeletal abnormalities and may reduce life-threatening effects of

  19. Oral acantholytic squamous cell carcinoma shares clinical and histological features with angiosarcoma

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    Kleinheinz Johannes

    2008-07-01

    Full Text Available Abstract Background acantholytic squamous cell carcinomas (ASCC and intraoral angiosarcoma share similar histopathological features. Aim of this study was to find marker for a clear distinction. Methods Four oral acantholytic squamous cell carcinomas and one intraoral angiosarcoma are used to compare the eruptive intraoral growth-pattern, age-peak, unfavourable prognosis and slit-like intratumorous spaces in common histological staining as identical clinical and histopathological features. Immunohistochemical staining for pancytokeratin, cytokeratin, collagen type IV, γ2-chain of laminin-5, endothelial differentiation marker CD31 and CD34, F VIII-associated antigen, Ki 67-antigen, β-catenin, E-cadherin, α-smooth-muscle-actin and Fli-1 were done. Results Cytokeratin-immunoreactive cells can be identified in both lesions. The large vascularization of ASCC complicates the interpretation of vascular differential markers being characteristic for angiosarcoma. Loss of cell-cell-adhesion, monitored by loss of E-cadherin and β-catenin membrane-staining, are indetified as reasons for massive expression of invasion-factor ln-5 in ASCC and considered responsible for unfavourable prognosis of ASCC. Expression of Fli-1 in angiosarcoma and cellular immunoreaction for ln-5 in ASCC are worked out as distinguishing features of both entities. Conclusion Fli-1 in angiosarcoma and ln-5 in ASCC are distinguishing features.

  20. Clinical and laboratory features of 48 feline hyperthyroidism cases in Japan

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    Shinichi Namba

    2014-02-01

    Full Text Available Feline hyperthyroidism (HT is a common endocrine disorder worldwide, but clinical and laboratory features might vary geographically. The aim of this retrospective study was to evaluate feline HT in Japan, and compare results to those of previous study for feline HT. We evaluated 48 feline HT cases clinical and laboratory features. Surprisingly, the youngest patient was 32 months of age (2 year 9 months. There was no significant difference among the study subjects in sex, but frequency of spayed/castrated cats was high (85.4%. Median age was 186 months (32-272 months. 91.3% (n=42 of subjects were over 10 years of age, and 8.7% (n=4 were under 10 years of age. Clinical symptoms included vomiting, 56.3% (n=27; diarrhea, 2.1% (n=1; hyperactivity, 12.5% (n=6; emaciation, 41.7% (n=20; polyuria and polydipsia, 22.9% (n=11; chronic weight loss, 60.4% (n=29; and palpated enlarged thyroid, 2.1% (n=1. Concurrent findings included chronic kidney disease, 20.8% (n=10; congestive heart failure, 20.8% (n=10; tachycardia (over 240 beats/min, 18.8% (n=9; gallop rhythm, 31.3% (n=15; neurological disorders such as hind-limb paralysis, 14.6% (n=7; cystitis, 8.7% (n=4; gingivitis, 4.2% (n=2; diabetes mellitus, 4.2% (n=2; and arterial thromboembolism, 6.3% (n=3. In addition, laboratory features (complete blood counts and biochemistry differed from those of previous reports in certain respects. Our results show that it might be important for practitioners to comprehend epidemiologic differences regarding feline HT worldwide.

  1. Parieto-occipital encephalomalacia in children; clinical and electrophysiological features of twenty-seven cases

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    Pakize Karaoglu

    2015-01-01

    Full Text Available Context: Brain injuries occurring at a particular time may cause damages in well-defined regions of brain. Perinatal hypoxic ischemic encephalopathy and hypoglycemia are some of the most common types of brain injuries. Neonatal hypoglycemia can cause abnormal myelination in parietal and occipital lobes resulting in parieto-occipital encephalomalacia. There is a small number of studies about clinical and electroencephalographic (EEG features of children with parieto-occipital encephalomalacia. They might have important neurologic sequelae such as cortical visual loss, seizures, and psychomotor retardation. Aims: We aimed to evaluate the causes of parieto-occipital encephalomalacia and evaluate the clinical and electrophysiological features of children with parieto-occipital encephalomalacia. Settings and Design: We evaluated clinical features and EEGs of 27 children with parieto-occipital encephalomalacia. Statistical Analysis Used: Descriptive statistics were used. Results: Hospitalization during the neonatal period was the most common cause (88.9% of parieto-occipital brain injury. Eleven patients (40.7% had a history of neonatal hypoglycemia. Twenty-three patients (85.2% had epilepsy and nine of the epileptic patients (39% had refractory seizures. Most of the patients had bilateral (50% epileptic discharges originating from temporal, parietal, and occipital lobes (56.2%. However, some patients had frontal sharp waves and some had continuous spike and wave discharges during sleep. Visual abnormalities were evident in 15 (55.6% patients. Twenty-two (81.5% had psychomotor retardation. Fine motor skills, social contact and language development were impaired more than gross motor skills. Conclusions: In our study, most of the patients with parieto-occipital encephalomalacia had an eventful perinatal history. Epilepsy, psychomotor retardation, and visual problems were common neurologic complications.

  2. Clinical Features, Presence of Human Herpesvirus-8 and Treatment Results in Classic Kaposi Sarcoma

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    Özlem Su

    2008-12-01

    Full Text Available Background and Design: Classic Kaposi sarcoma (KS occurs predominantly among the elderly, with Jews, Italians and Greeks. Classic KS has been seen relatively frequently in Turkey. Our aim was to evaluate the demographic, clinical features of Kaposi sarcoma and etiopathological role of human herpesvirus-8 (HHV-8. Treatment results of 18 classic Kaposi’s sarcoma were also concluded.Material and Method: Eighteen cases of classic Kaposi sarcoma diagnosed as clinically and histopathologically between January 2001 and August 2008 in our dermatology department were taken to this study. Demographic, clinical features and treatment results were reviewed retrospectively in all patients. HHV-8 was investigated in the lesional skin of 7 patients.Results: A male/female ratio of 2/1 was found. Mean age at diagnosis was 67.2 (37-94 years. Bilaterally lower extremities were involved in 15 patients (83.3%, the trunk was involved in 3 patients (16.6%. Plaques and nodules were the common type of lesions (66.6% and 55.5%. Nine patients had no symptoms (50%. Edema was the most common symptom (38.8%. A second primary malignancy was found in 2 patients (11.1%. HHV-8 was detected in 6 of the 7 patients(85.7%. Majority of the patients were treated with interferon alfa (subcutaneously and cryotherapy as a monotherapy or a combination therapy. Imiquimod was the second agent in combined treatment (27.7%. Conclusion: We suggest that interferon alfa and imiquimod can be used as first line therapy agents with their antiviral and immunmodulatuar features in the treatment of KKS. (Turkderm 2008; 42: 122-6

  3. Statistical methods for detecting differentially abundant features in clinical metagenomic samples.

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    James Robert White

    2009-04-01

    Full Text Available Numerous studies are currently underway to characterize the microbial communities inhabiting our world. These studies aim to dramatically expand our understanding of the microbial biosphere and, more importantly, hope to reveal the secrets of the complex symbiotic relationship between us and our commensal bacterial microflora. An important prerequisite for such discoveries are computational tools that are able to rapidly and accurately compare large datasets generated from complex bacterial communities to identify features that distinguish them.We present a statistical method for comparing clinical metagenomic samples from two treatment populations on the basis of count data (e.g. as obtained through sequencing to detect differentially abundant features. Our method, Metastats, employs the false discovery rate to improve specificity in high-complexity environments, and separately handles sparsely-sampled features using Fisher's exact test. Under a variety of simulations, we show that Metastats performs well compared to previously used methods, and significantly outperforms other methods for features with sparse counts. We demonstrate the utility of our method on several datasets including a 16S rRNA survey of obese and lean human gut microbiomes, COG functional profiles of infant and mature gut microbiomes, and bacterial and viral metabolic subsystem data inferred from random sequencing of 85 metagenomes. The application of our method to the obesity dataset reveals differences between obese and lean subjects not reported in the original study. For the COG and subsystem datasets, we provide the first statistically rigorous assessment of the differences between these populations. The methods described in this paper are the first to address clinical metagenomic datasets comprising samples from multiple subjects. Our methods are robust across datasets of varied complexity and sampling level. While designed for metagenomic applications, our software

  4. Lipid-Rich Carcinoma of the Breast With Unusual Clinical and Histopathological Features.

    Science.gov (United States)

    Gaspar, Balan Louis; Kumar, Mukin; Gupta, Rahul; Garg, Rashi; Singh, Rajinder; Vasishta, Rakesh Kumar

    2016-09-01

    Lipid-rich carcinoma of the breast is a rare form of invasive breast carcinoma of special type. Most cases are grade 3, hormone receptor negative, and associated with aggressive clinical behavior. We report an unusual case of lipid-rich carcinoma with morphological and immunophenotypical features different from those of cases reported so far in the literature. The index case underscores the fact that there is no consensus with regard to the exact nature of this tumor. Hence, larger studies are needed to draw meaningful conclusions. PMID:26920701

  5. Specific features of the clinical course and angiographic pattern of chronic coronary occlusion

    International Nuclear Information System (INIS)

    Particular features of coronary angiography and clinical presentation of myocardial ischemia (MI) have been studied in patients with chronic total coronary occlusion. Chronic total coronary occlusion is defined as TIMI 0 or TIMI 1 type flow in the artery for more than three days. MI patients with coronary occlusion have more severe course of coronary artery disease as compared to patients free of occlusion: they more often suffer myocardial infarction and high gradations of stenocardia. Myocardial function is much more affected it there is occlusion of left descending artery, or there are no signs of intercoronary collaterals

  6. Assessment of Sociodemographic and Clinical Features in Patients with Adolescent and Post-adolescent Acne

    OpenAIRE

    Safiye Kutlu; İlknur Kıvanç Altunay; Adem Köşlü; Sevim Purisa

    2010-01-01

    Background and Design: Acne is an inflammatory disease of the pilosebaceous follicle and is generally accepted as a disorder of the adolescence period. However, an increased frequency during post-adolescence has been reported recently, especially in adult women. We aimed to compare sociodemographic and clinical features of patients with adolescent and post-adolescent acne in order to determine whether there are differences between these two groups.Material and Method: Üç yüz on dört patients ...

  7. Differences in clinical features and mental health service use in bipolar disorder across the lifespan

    OpenAIRE

    Depp, Colin A.; Lindamer, L A; Folsom, D P; Gilmer, T; Hough, R L; Garcia, P.; Jeste, D V

    2005-01-01

    Objective: Because of the scarcity of research in geriatric bipolar disorder, the authors examined the prevalence, clinical features, and service use of persons with bipolar disorder among older adults treated in a large public mental health system. Methods: From San Diego County's Adult and Older-Adult Mental Health Services database (N=34,970, fiscal year 2002-2003), the authors selected patients with bipolar disorder, divided them into three age-groups (young: age 18-39, middle-aged: age 4...

  8. Esophageal toxicity of radiation therapy: Clinical risk factors and management

    International Nuclear Information System (INIS)

    Acute radiation-induced esophagitis includes all clinical symptoms (odynophagia, dysphagia) occurring within 90 days after thoracic irradiation start. Its severity can be graded using RTOG and CTCAE scales. The clinical risk factors are: age, female gender, initial performance status, pre-therapeutic body mass index, pre-therapeutic dysphagia, tumoral and nodal stage, delivered dose, accelerated hyperfractionated radiotherapy, concomitant association of chemotherapy to radiotherapy and response to the treatment. The dosimetric parameters predictive of esophagitis are: mean dose, V20 Gy, V30 Gy, V40 Gy, V45 Gy and V50 Gy. Amifostine is the only drug to have a proven radioprotective efficacy (evidence level C, ESMO recommendation grade III). The medical management of esophagitis associates a diet excluding irritant food, medication against gastroesophageal reflux, analgesic treatment according to the WHO scale and management of dehydration and de-nutrition by enteral feeding. (authors)

  9. Clinical, haematobiochemical, radiographic and ultrasonographic features of traumatic reticuloperitonitis in bovines

    International Nuclear Information System (INIS)

    Study was conducted to compare the clinical, haematobiochemical, radiographic and ultrasonographic features of traumatic reticuloperitonitis in bovines. Clinical cases (4 cows and 17 buffaloes) presented with a history of anorexia, fever, decreased milk yield and loss of defecation/scant faeces, were used. Haematological picture revealed neutrophilic leucocytosis with left shift and blood biochemical status showed elevated levels of total protein, albumin, and fibrinogen. Decreased plasma concentration of sodium, potassium and chloride was observed in majority of the cases. Radiographic examination revealed presence of multiple metallic foreign densities in the reticulum of the bovines. Ultrasonographically, morphological changes of reticular wall and reticulophrenic adhesions in cases of localised peritonitis were visualized. The presence of anechoic fluid without echogenic margins, not restricted to reticulum and sometimes with floating fibrinous shreds was observed in cases of diffuse peritonitis. Ultrasonography in B mode and B+ mode found helpful for the diagnosis of traumatic reticuloperitonitis and differentiation of localised peritonitis from diffuse peritonitis

  10. Atypical Clinical and Diagnostic Features in Ménétrier's Disease in a Child

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    Michael Chung

    2011-01-01

    Full Text Available Ménétrier's disease is one of the rarest protein-losing gastropathies in childhood. It is characterized clinically by non-specific gastrointestinal symptoms and edema, biochemically by hypoalbuminemia, and pathologically by enlarged gastric folds. In adults, this disease can be devastating with significant morbidity and mortality. In childhood, it is a self-limiting, transient and benign illness. Its treatment is largely supportive with total parenteral nutrition (TPN while oral intake is encouraged. Acute onset of vomiting in healthy school age children can be initially explained by acute viral gastroenteritis. However, persistent vomiting associated with hematemesis and severe abdominal pain should warrant further work-up. This case report illustrates a self-limiting and rare cause of protein-losing enteropathy called Ménétrier's disease that presented with several variant clinical features not typically described in association with this entity.

  11. Clinical-epidemiological features of meningococcal infection in children during sporadic morbidity

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    G. P. Martynova

    2015-07-01

    Full Text Available Purpose: to evaluate epidemiologic situation as to meningococcal infection and reveal clinical-epidemiological features of the disease on the territory of Krasnoyarsk сity and Krasnoyarsk Krai at the present stage. Data and methods: The research gives the analysis of MI morbidity and mortality rates in children of the region according to official information from the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in Krasnoyarsk Krai for the period 2000–2014. The work studies clinical and epidemiological features of the disease in 53 patients with the generalized form of meningococcal infection (GFMI who were treated in the infectious disease department of the Regional Interdistrict Children’s Clinical Hospital of Krasnoyarsk for the period 2010–2014. Results: The epidemiological situation as to MI in Krasnoyarsk for the period 2000-2013 years is characterized by the signs of interepidemic period with morbidity rises in the winter-spring period. Children from 1 year to 3 years (54,7% prevail over all MI diseased. The number of children in the first year of life decreased almost two times (from 40% to 20,7%. At the same time the proportion of children older than 4 years increased. The leading serotype among laboratory-confirmed cases of MI in Krasnoyarsk Krai is still the B group meningitis (64,7%. Conclusion: On the territory of Krasnoyarsk Krai the MI morbidity is sporadic. The generalized forms of meningococcal infection are characterized by early overt symptoms which make it possible to set a diagnosis. The clinical picture of the generalized forms of the disease almost did not change significantly. 

  12. Analysis of clinical features, serologic and cerebrospinal fluid tests in patients with neurosyphilis at different stages

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    Bao-jie WANG

    2016-08-01

    Full Text Available Objective To summarize the clinical features, serologic, cerebrospinal fluid (CSF tests in patients with neurosyphilis at different stages.  Methods A retrospective analysis was made on the clinical features, imaging, serologic and CSF tests, treatment and prognosis of 12 cases diagnosed as neurosyphilis. In those cases, 5 cases were early-stage neurosyphilis, including 4 syphilitic meningitis (meningomyelitis and one meningovascular syphilis; 7 cases were late-stage neurosyphilis, all of whom were general paresis.  Results The serum Treponema pallidum antibody (TP-Ab and rapid plasma regain (RPR tests were positive in all 12 cases. The CSF TP-Ab tests of 12 cases were all positive and CSF RPR tests were positive in 9 cases. In 5 cases of early-stage neurosyphilis, one case had elevated intracranial pressure (ICP, 3 cases presented with elevated white blood cell (WBC, 4 cases had elevated protein concentration. In 7 cases of late-stage neurosyphilis, one case had elevated ICP, 7 cases presented with elevated WBC and protein concentration. CSF cytology showed lymphocyte reaction, mainly small lymphocytes. All cases were treated with different doses of intravenous penicillin or ceftriaxone sodium by intramuscular injection, among whom 8 cases presented improved neuropsychiatric symptoms, while 4 cases had no significant improvement.  Conclusions Neurosyphilis is easy to be misdiagnosed because of various styles of onset and nontypical clinical manifestations. A definite diagnosis depends on clinical manifestations and serologic and CSF examinations. Early diagnosis and standard treatment is essential for improving prognosis and reducing complications. DOI: 10.3969/j.issn.1672-6731.2016.07.005

  13. Clinical and laboratory features of antihistamine-resistant chronic idiopathic urticaria.

    Science.gov (United States)

    Magen, Eli; Mishal, Joseph; Zeldin, Yuri; Schlesinger, Menachem

    2011-01-01

    Chronic idiopathic (spontaneous) urticaria (CIU) is sometimes resistant to the conventional and high doses of antihistamines (AHs). This study compares the clinical and laboratory characteristics of AH responsive and AH-resistant CIU subjects. Clinical and laboratory data were retrospectively collected from 385 CIU patients. Urticaria activity score (UAS), concomitant angioedema, dermatographism, positive autologous serum skin (ASST), and laboratory data were collected. The control group consisted of 44 sex- and age-matched healthy individuals. Two hundred forty-five CIU patients controlled with AH medications were included in the CIU group. Forty-six patients failed to show clinical improvement during 8 weeks of treatment with fourfold AH doses and were included in the resistant CIU (R-CIU) group. The R-CIU group was characterized with a higher incidence (58.7%) of angioedema than the CIU group (28.5%; p CIU versus 12.2% in CIU; p = 0.014), more positive ASST (73.9% in R-CIU versus 45.4% in CIU; p CIU versus 3.32 ± 1.25 in CIU; CIU was characterized with more severe basopenia (0.04 ± 0.07 cell/mm(3) versus 0.16 ± 0.13 cell/mm(3); p CIU is a clinically more severe disease with laboratory features of low-grade inflammation and platelet activation. PMID:22221441

  14. Incidence and clinical feature of pulmonary embolism in patients with deep vein thrombosis: A prospective study

    International Nuclear Information System (INIS)

    In 169 patients with suspected deep vein thrombosis (DVT), the incidence and clinical feature of pulmonary enbolism (PE) was prospectively studied by means of noninvasive thrombosis tests (uptake tests, radionuclide venography) and combined ventilation (133Xe, 81mKr) and perfusion (99mTc microspheres) lung scanning. DVT was detected in 62% of patients (105/169). The incidence of PE in patients with confirmed DVT was 57% (60/105), a figure which is in excellent agreement with data from autopsy studies. Concerning the thrombotic source of emboli, the incidence of PE was 46% in patients with DVT confined to the calf but increased to 67% if the tigh, and to 77% if the pelvic veins were involved as well. Fifty-nine percent of PE were clinically silent, 19% had ''minor signs'', and 22% ''major signs'' (such as chest pain, dyspnea, tachycardia or shock). The size of the perfusion defects correlated significantly with clinical symptoms. Only 23% of clinically symptomatic patients had a pathological chest X-ray. Incidence of both DVT and PE increased with advancing age, but in old patients the incidence of PE rose disproportionately. (orig.)

  15. MRI features of patients with heroin spongiform leukoencephalopathy of different clinical stages

    International Nuclear Information System (INIS)

    Objective: To investigate radiological features of patients with heroin spongiform leukoencephalopathy (HSLE) of different clinical stages and discuss the evolutional characteristics of the disease. Methods: Thirty two patients with HSLE underwent precontrast MRI and postcontrast MRI. The history of addiction, clinical presentations, and brain MRI were analyzed and summarized according to the patient's clinical staging. There are 6 cases in I stage, 21 cases in II stage, 5 cases in III stage. Results: All patients had history of heroin vapor inhalation. Most of the cases developed subacute cerebellar impairment in earlier period. Brain MRI revealed symmetrical lesion within bilateral cerebellum in all patients. Splenium of the corpus callosum, posterior limb of the internal capsule, deep white matter of the occipital and parietal lobes, were gradually involved with progressive deterioration of HSLE. The brain stem and deep white matter of the frontal and temporal lobes were involved in some cases. Conclusions: The history of heated heroin vapor inhalation was the prerequisite for the diagnosis of HSLE. Brain MRI presented the characteristic lesion and its evolution of HSLE. Brain MRI was very important for accurate diagnosis and helpful to judge the clinical stages according to the involved brain region. (authors)

  16. Cervical spine degenerative diseases: An evaluation of clinical and imaging features in surgical decisions

    International Nuclear Information System (INIS)

    In clinically severe cervical spondylosis, imaging plays a vital role in surgical decisions. A prime factor is acquired canal stenosis with cord compression. To validate this concept, the clinical and imaging features of 20 patients with spondylitic myelopathy and 24 with radiculopathy were retrospectively reviewed. All had computed tomographic myelography (CTM) as part of their clinical work-up. The patients' clinical severity was graded as mild, moderate and severe; the age, length of illness and a history of eventual surgery or otherwise were recorded. At the level of maximum compression the following parameters were obtained from the axial CTM images: surface area and ratio of the anteroposterior to the transverse diameter of the cord; subarachnoid space and vertebral canal areas. Data were statistically analysed. A significant association exists between surgery and increasing severity of symptoms (P=0.04), and advancing age (P=0.01). These associations hold true for myelopathy and radiculopathy. A strong association is present between surgery and the surface area of the cord (P=0.01), being applicable to myelopathy only. The other parameters show no association with surgical decisions. It is concluded that with myelopathy a narrow cord area at the level of maximum compression, and moderate-severe functional impairment are indicators for surgical intervention. (authors)

  17. [SOME CLINICAL AND CYTOKINE FEATURES OF THE CLINICAL COURSE OF RECURRENT RESPIRATORY SYSTEM DISEASES IN CHILDREN WITH THE TOXOCARIASIS INVASION].

    Science.gov (United States)

    Dralova, A; Usachova, E

    2015-12-01

    The aim of the present study was to analyze clinical and cytokine features of recurrent respiratory system diseases in children with toxocariasis. 50 children aged 1 to 17 years (mean age - 10±5 years) with recurrent current of respiratory system disorders were studied. During the survey such clinical manifestations of the respiratory system disorders as obstructive bronchitis (50%), bronchial asthma (30%), pneumonia (10%) and laryngotracheitis (10%) have been revealed. Statistical analysis of the results was performed using the software package STATISTICA 6.1 (SNANSOFT). We have shown that the disorders of respiratory system in case of toxocariasis invasion often occur with severe intoxication and bronchial obstruction syndromes, temperature reaction, respiratory insufficiency and hepatomegaly. A prolonged course of the disease has been noted. "Inflammatory" indicators of general blood analysis, such as leukocytosis and increased of ESR have been recorded in patients with respiratory system disorders in children with T.canis infection significantly more often, significant "allergic" laboratory changes were in the form of eosinophilia. High average levels of pro-inflammatory IL-6, as well as low levels of IL 5 have been determined in children suffering from the respiratory system disorders and with toxocariasis invasion in the anamnesis. The obtained findings require further study. PMID:26719552

  18. Microinvasive ductal carcinoma in situ: Clinical presentation, imaging features, pathologic findings, and outcome

    International Nuclear Information System (INIS)

    Objective: The purpose of our study was to describe the clinical features, imaging characteristics, pathologic findings and outcome of microinvasive ductal carcinoma in situ (DCISM). Materials and methods: The records of 21 women diagnosed with microinvasive ductal carcinoma in situ (DCISM) from November 1993 to September 2006 were retrospectively reviewed. The clinical presentation, imaging and histopathologic features, and clinical follow-up were reviewed. Results: The 21 lesions all occurred in women with a mean age of 56 years (range, 27-79 years). Clinical findings were present in ten (48%): 10 with palpable masses, four with associated nipple discharge. Mean lesion size was 21 mm (range, 9-65 mm). The lesion size in 62% was 15 mm or smaller. Mammographic findings were calcifications only in nine (43%) and an associated or other finding in nine (43%) [mass (n = 7), asymmetry (n = 1), architectural distortion (n = 1)]. Three lesions were mammographically occult. Sonographic findings available in 11 lesions showed a solid hypoechoic mass in 10 cases (eight irregular in shape, one round, one oval). One lesion was not seen on sonography. On histopathologic examination, all lesions were diagnosed as DCISM, with a focus of invasive carcinoma less than or equal to 1 mm in diameter within an area of DCIS. Sixteen (76%) lesions were high nuclear grade, four (19%) were intermediate and one was low grade (5%). Sixteen (76%) had the presence of necrosis. Positivity for ER and PR was noted in 75% and 38%. Nodal metastasis was present in one case with axillary lymph node dissection. Mean follow-up time for 16 women was 36 months without evidence of local or systemic recurrence. One patient developed a second primary in the contralateral breast 3 years later. Conclusion: The clinical presentation and radiologic appearance of a mass are commonly encountered in DCISM lesions (48% and 57%, respectively), irrespective of lesion size, mimicking findings seen in invasive carcinoma

  19. Microinvasive ductal carcinoma in situ: Clinical presentation, imaging features, pathologic findings, and outcome

    Energy Technology Data Exchange (ETDEWEB)

    Vieira, Cristina C. [Department of Radiology, New York University School of Medicine (United States); Mercado, Cecilia L. [Department of Radiology, New York University School of Medicine (United States)], E-mail: Cecilia.mercado@nyumc.org; Cangiarella, Joan F. [Department of Pathology, New York University School of Medicine (United States); Moy, Linda; Toth, Hildegard K. [Department of Radiology, New York University School of Medicine (United States); Guth, Amber A. [Department of Surgery, New York University School of Medicine (United States)

    2010-01-15

    Objective: The purpose of our study was to describe the clinical features, imaging characteristics, pathologic findings and outcome of microinvasive ductal carcinoma in situ (DCISM). Materials and methods: The records of 21 women diagnosed with microinvasive ductal carcinoma in situ (DCISM) from November 1993 to September 2006 were retrospectively reviewed. The clinical presentation, imaging and histopathologic features, and clinical follow-up were reviewed. Results: The 21 lesions all occurred in women with a mean age of 56 years (range, 27-79 years). Clinical findings were present in ten (48%): 10 with palpable masses, four with associated nipple discharge. Mean lesion size was 21 mm (range, 9-65 mm). The lesion size in 62% was 15 mm or smaller. Mammographic findings were calcifications only in nine (43%) and an associated or other finding in nine (43%) [mass (n = 7), asymmetry (n = 1), architectural distortion (n = 1)]. Three lesions were mammographically occult. Sonographic findings available in 11 lesions showed a solid hypoechoic mass in 10 cases (eight irregular in shape, one round, one oval). One lesion was not seen on sonography. On histopathologic examination, all lesions were diagnosed as DCISM, with a focus of invasive carcinoma less than or equal to 1 mm in diameter within an area of DCIS. Sixteen (76%) lesions were high nuclear grade, four (19%) were intermediate and one was low grade (5%). Sixteen (76%) had the presence of necrosis. Positivity for ER and PR was noted in 75% and 38%. Nodal metastasis was present in one case with axillary lymph node dissection. Mean follow-up time for 16 women was 36 months without evidence of local or systemic recurrence. One patient developed a second primary in the contralateral breast 3 years later. Conclusion: The clinical presentation and radiologic appearance of a mass are commonly encountered in DCISM lesions (48% and 57%, respectively), irrespective of lesion size, mimicking findings seen in invasive carcinoma

  20. Exploring the color feature power for psoriasis risk stratification and classification: A data mining paradigm.

    Science.gov (United States)

    Shrivastava, Vimal K; Londhe, Narendra D; Sonawane, Rajendra S; Suri, Jasjit S

    2015-10-01

    A large percentage of dermatologist׳s decision in psoriasis disease assessment is based on color. The current computer-aided diagnosis systems for psoriasis risk stratification and classification lack the vigor of color paradigm. The paper presents an automated psoriasis computer-aided diagnosis (pCAD) system for classification of psoriasis skin images into psoriatic lesion and healthy skin, which solves the two major challenges: (i) fulfills the color feature requirements and (ii) selects the powerful dominant color features while retaining high classification accuracy. Fourteen color spaces are discovered for psoriasis disease analysis leading to 86 color features. The pCAD system is implemented in a support vector-based machine learning framework where the offline image data set is used for computing machine learning offline color machine learning parameters. These are then used for transformation of the online color features to predict the class labels for healthy vs. diseased cases. The above paradigm uses principal component analysis for color feature selection of dominant features, keeping the original color feature unaltered. Using the cross-validation protocol, the above machine learning protocol is compared against the standalone grayscale features with 60 features and against the combined grayscale and color feature set of 146. Using a fixed data size of 540 images with equal number of healthy and diseased, 10 fold cross-validation protocol, and SVM of polynomial kernel of type two, pCAD system shows an accuracy of 99.94% with sensitivity and specificity of 99.93% and 99.96%. Using a varying data size protocol, the mean classification accuracies for color, grayscale, and combined scenarios are: 92.85%, 93.83% and 93.99%, respectively. The reliability of the system in these three scenarios are: 94.42%, 97.39% and 96.00%, respectively. We conclude that pCAD system using color space alone is compatible to grayscale space or combined color and grayscale

  1. Clinical and Polysomnographic Features of Kleine-Levin Syndrome: Case Seriesv

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    Murat ERDEM

    2013-09-01

    Full Text Available Kleine-Levin Syndrome (KLS is a rare disorder characterized intermittent hypersomnia, hyperphagia, hypersexuality, abnormal behaviors, and confusion. Patients are asymptomatic between episodes. The aim of this case series study was to determine the clinical features of patients with KLS and to compare the polysomnography (PSG findings between symptomatic and asymptomatic periods.We compared the results of PSG investigations performed in symptomatic and asymptomatic periods in six patients diagnosed with KLS at Gulhane Military Medical Faculty Sleep Research Center between 1998 and 2005. The age at onset of KLS was approximately 18 years, the diagnosis delayed 2.67 years, hypersomnia episodes lasted approximately 11.5 days, until the correct diagnosis, the patients had experienced on average 5 episodes. Total sleep time in KLS patients during symptomatic period and stage 2 sleep percent was higher than in asymptomatic period. REM latency was shorter and stage 3 and REM percent was lower in asymptomatic period. The clinical features including the age of onset and episode duration are compatible with those from the previous studies. It was observed that the sleep architecture during symptomatic period was different from that in asymptomatic period. (Archives of Neuropsychiatry 2013; 50: 288-290

  2. Clinical Features in Juvenile-Onset Ankylosing Spondylitis Patients Carrying Different B27 Subtypes

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    Yikun Mou

    2015-01-01

    Full Text Available Background. Ankylosing spondylitis (AS is a common rheumatic disease and is characterized by inflammation of the axial skeleton. HLA-B27 is strongly associated with AS. Juvenile-onset AS (JAS with disease onset before 16 years of age differs from adult-onset AS (AAS in many respects. Objective. To compare the clinical features in JAS with different B27 subtypes and analyze the differences between JAS and AAS. Methods. 145 JAS and 360 AAS patients were included. The demographic data, clinical manifestations, laboratory markers, Bath AS indices, and B27 subtypes were recorded. Results. Peripheral arthritis, enthesitis, BASDAI, ESR, and CRP were significantly higher in JAS patients with HLA-B*2704 than those with B27-negative. Enthesitis and ESR were significantly higher in patients with HLA-B*2705 than those with B27-negative. The onset age of HLA-B*2715 group was much earlier than the other groups. The peripheral arthritis, enthesitis, and hip joint involvement in JAS with HLA-B*2704 were significantly higher than those in AAS with HLA-B*2704. Conclusion. JAS with different B27 subtypes had similar features in most of manifestations; JAS and AAS patients with the same subtype could have distinctive courses. Early diagnosis, hip detection, and control of systemic active inflammation in JAS patients will be helpful for improving the prognosis.

  3. A rare cutaneous malignancy with poorly described clinical features: Lymphoepithelioma-like carcinoma of the skin

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    Lale Mehdi

    2015-09-01

    Full Text Available Lymphoepithelioma-like carcinoma can be originated from different organs, including nasopharynx, larynx, stomach, salivary glands, lung, thymus, cervix and bladder. Lymphoepithelioma-like carcinoma of the skin is a rare malignancy with low metastatic potential and is defined by a histologic picture simulating indifferentiated nasopharynx carcinoma. There are only a few case reports in the literature and the clinical features of the tumor are not well described. It presents usually with flesh-colored or reddish firm nodules and plaques which are nonspecific. The head and neck region is the predilection site of the tumor, but it can be seen in many other areas. We present here an 84-year-old male admitted to the dermatovenereology department with a slowly growing purplish-red asymptomatic plaque, 2x2 cm in diameter which was diagnosed as lymphoepithelioma-like carcinoma of the skin upon histopathologic examination. The tumor was excised and metastasis was not detected. Local recurrence was not observed in a one-year follow-up period. Lymphoepithelioma-like carcinoma of the skin should also be considered in the clinical differential diagnosis of slowly growing solitary nodules and infiltrated plaques. An other important feature of our case was the arm localization of the tumor which has been very rarely reported.

  4. Clinical features and prognosis of patients with extrahepatic metastases from hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Kiminori Uka; Kazuaki Chayama; Hiroshi Aikata; Shintaro Takaki; Hiroo Shirakawa; Soo Cheol Jeong; Keitaro Yamashina; Akira Hiramatsu; Hideaki Kodama; Shoichi Takahashi

    2007-01-01

    AIM: To assess the clinical features and prognosis of 151 patients with extrahepatic metastases from primary hepatocellular carcinoma (HCC), and describe the treatment strategy for such patients.METHODS: After the diagnosis of HCC, all 995consecutive HCC patients were followed up at regular intervals and 151 (15.2%) patients were found to have extrahepatic metastases at the initial diagnosis of primary HCC or developed such tumors during the follow-up period. We assessed their clinical features,prognosis, and treatment strategies.RESULTS: The most frequent site of extrahepatic metastases was the lungs (47%), followed by lymph nodes (45%), bones (37%), and adrenal glands (12%).The cumulative survival rates after the initial diagnosis of extrahepatic metastases at 6, 12, 24, and 36 mo were 44.1%, 21.7%, 14.2%, 7.1%, respectively. The median survival time was 4.9 mo (range, 0-37 mo). Fourteen patients (11%) died of extrahepatic HCC, others died of primary HCC or liver failure.CONCLUSION: The prognosis of HCC patients with extrahepatic metastases is poor. With regard to the cause of death, many patients would die of intrahepatic HCC and few of extrahepatic metastases. Although most of HCC patients with extrahepatic metastases should undergo treatment for the primary HCC mainly,treatment of extrahepatic metastases in selected HCC patients who have good hepatic reserve, intrahepatic tumor stage (T0-T2), and are free of portal venous invasion may improve survival.

  5. Clinical, Pathological, and Molecular Features of Lung Adenocarcinomas with AXL Expression.

    Science.gov (United States)

    Sato, Katsuaki; Suda, Kenichi; Shimizu, Shigeki; Sakai, Kazuko; Mizuuchi, Hiroshi; Tomizawa, Kenji; Takemoto, Toshiki; Nishio, Kazuto; Mitsudomi, Tetsuya

    2016-01-01

    The receptor tyrosine kinase AXL is a member of the Tyro3-Axl-Mer receptor tyrosine kinase subfamily. AXL affects several cellular functions, including growth and migration. AXL aberration is reportedly a marker for poor prognosis and treatment resistance in various cancers. In this study, we analyzed clinical, pathological, and molecular features of AXL expression in lung adenocarcinomas (LADs). We examined 161 LAD specimens from patients who underwent pulmonary resections. When AXL protein expression was quantified (0, 1+, 2+, 3+) according to immunohistochemical staining intensity, results were 0: 35%; 1+: 20%; 2+: 37%; and 3+: 7% for the 161 samples. AXL expression status did not correlate with clinical features, including smoking status and pathological stage. However, patients whose specimens showed strong AXL expression (3+) had markedly poorer prognoses than other groups (P = 0.0033). Strong AXL expression was also significantly associated with downregulation of E-cadherin (P = 0.025) and CD44 (P = 0.0010). In addition, 9 of 12 specimens with strong AXL expression had driver gene mutations (6 with EGFR, 2 with KRAS, 1 with ALK). In conclusion, we found that strong AXL expression in surgically resected LADs was a predictor of poor prognosis. LADs with strong AXL expression were characterized by mesenchymal status, higher expression of stem-cell-like markers, and frequent driver gene mutations. PMID:27100677

  6. Clinical features, management and visual outcome of polypoidal choroidal vasculopathy in Indian patients

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    Anantharaman Giridhar

    2010-01-01

    Full Text Available Aims: To present the clinical, indocyanine green angiography (ICGA features and results of treatment for polypoidal choroidal vasculopathy (PCV in Indian patients by a retrospective chart review.Materials and Methods: Forty five patients with PCV underwent complete ocular examination, fluorescein angiography (FFA and ICGA. Treatment was advised for patients with macular involvement and progressive loss of visual acuity. Demographic data, clinical features and results of treatment were analyzed.Results: Mean age at presentation was 61.06 years. Mean follow up was 18 months. The disease was more prevalent in males. Forty three patients had unilateral disease. The most common location of polyps in ICGA was subfoveal (42.5%. Exudative form was seen in 34 of the 47 eyes and the remaining 13 eyes had a hemorrhagic presentation. Thirty four eyes underwent treatment which included thermal laser (n = 11, photodynamic therapy (PDT (n = 11 and transpupillary thermo therapy (TTT (n = 12. Statistical analysis was done using the Chi-square test. Subgroup analysis of visual outcome following various modalities of treatment showed that the results of PDT (P < 0.001 and thermal laser (P < 0.001 were statistically significant. Conclusions: PCV is an important differential diagnosis in patients presenting with serosanginous maculopathy and submacular hemorrhage. The disease was more prevalent in males and was unilateral in the Indian population. Timely intervention in cases with symptomatic polyps could achieve stabilization of visual acuity. Thermal laser and PDT were safe and effective.

  7. The relationships between initial clinical features and prognosis in 14 cases of diffuse alveolar hemorrhage syndrome

    International Nuclear Information System (INIS)

    Diffuse pulmonary alveolar hemorrhage (DAH) is caused by various disorders and is a medical emergency that often results in acute respiratory failure requiring prompt diagnosis and aggressive treatment. However, the relationships between the prognosis and the initial clinical feature in DAH remain unclear. We investigated the relationships between initial clinical features and prognosis in 14 cases of DAH. We examined 14 patients with DAH about laboratory data, CT scan findings, treatment and outcome. Three of 14 patients died of acute respiratory failure due to DAH. In the laboratory data on admission, the patients with over 230 IU/L of serum lactate dehydrogenase (LDH) levels had a poor outcome. In pulmonary function data on admission, the patients with under 300 of PaO2/FiO2 (P/F) ratio had poor outcome. On CT scan findings on admission, the patients with consolidation shadows had a poor outcome compared to the patients with ground-glass shadows. In our data, serum LDH concentration, P/F ratio and CT scan findings on admission are important factors in the prognosis of DAH. (author)

  8. Severe myoclonic epilepsy of infancy (Dravet syndrome: Clinical and genetic features of nine Turkish patients

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    Meral Özmen

    2011-01-01

    Full Text Available Purpose: Mutations of the a-1 subunit sodium channel gene (SCN1A cause severe myoclonic epilepsy of infancy (SMEI. To date, over 300 mutations related to SMEI have been described. In the present study, we report new SCN1A mutations and the clinical features of SMEI cases. Materials and Methods: We studied the clinical and genetic features of nine patients diagnosed with SMEI at the Pediatric Neurology Department of Istanbul Medical Faculty. Results: Five patients had nonsense mutations, two had missense mutations, one had a splice site mutation and one had a deletion mutation of the SCN1A gene. Mutations at c.3705+5G splice site, p.trip153X nonsense mutation and deletion at c.2416_2946 have not been previously described. The seizures started following whole cell pertussis vaccination in all patients. The seizures ceased in one patient and continued in the other eight patients. Developmental regression was severe in three patients, with frequent status epilepticus. The type of mutation was not predictive for the severity of the disease. Two of the three patients with severe regression had nonsense and missense mutations. Conclusions : Dravet syndrome can be result of several different types of mutation in SCN1A gene. Onset of the seizures after pertussis vaccination is an important clue for the diagnosis and neuro- developmental delay should be expected in all patients.

  9. Identifying the biting species in snakebite by clinical features: an epidemiological tool for community surveys.

    Science.gov (United States)

    Pathmeswaran, A; Kasturiratne, A; Fonseka, M; Nandasena, S; Lalloo, D G; de Silva, H J

    2006-09-01

    The outcome of snakebite is related to the biting species but it is often difficult to identify the biting snake, particularly in community settings. We have developed a clinical scoring system suitable for use in epidemiological surveys, with the main aim of identifying the presumed biting species in those with systemic envenoming who require treatment. The score took into account ten features relating to bites of the five medically important snakes in Sri Lanka, and an algorithm was developed applying different weightings for each feature for different species. A systematically developed artificial data set was used to fine tune the score and to develop criteria for definitive identification. The score was prospectively validated using 134 species-confirmed snakebites. It correctly differentiated the bites caused by the three snakes that commonly cause major clinical problems (Russell's viper (RV), kraits and cobra) from other snakes (hump-nosed viper (HNV) and saw-scaled viper (SSV)) with 80% sensitivity and 100% specificity. For individual species, sensitivity and specificity were, respectively: cobra 76%, 99%; kraits 85%, 99%; and RV 70%, 99%. As anticipated, the score was insensitive in the identification of bites due to HNV and SSV. PMID:16412486

  10. Prevalence and clinical features of migraine in a population of visually impaired subjects in Curitiba, Brazil.

    Science.gov (United States)

    Kowacs, P A; Piovesan, E J; Lange, M C; Werneck, L C; Tatsui, C E; Ribas, L C; Scapucin, L; Marques, L E; Moreira, A T

    2001-11-01

    To investigate the relevance of lacking or diminished visual input on the expression of migraine, we evaluated its prevalence and clinical features in a population of visually impaired subjects. Between September 1999 and April 2000, 203 visually impaired subjects with a headache inventory were surveyed. Those with headache were assessed according to IHS criteria for the presence of migraine. Migraineurs had their symptoms further detailed through an interview and a headache diary. Of the 104 subjects reporting headaches during the last 6 months, 29 had migraine (14.2%). The prevalence of migraine was not influenced by whether the visual impairment was complete or partial. Mean frequency of migraine attacks was 2.7/month. Most subjects (96%) reported severe and/or moderate attacks. Nausea, vomiting, aggravation by activity and phonophobia were reported by 62%, 37.9%, 86.2% and 96.6% of the subjects, respectively. Visual impairment does not seem to influence prevalence of migraine or its clinical features. PMID:11903284

  11. Evalution of Clinical and Sociodemograpic Features of Patients with Psoriasis in the Konya Region

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    Caner Aykol

    2011-11-01

    Full Text Available Objective: Psoriasis is a chronic inflammatory dermatosis with silvery-white coloured squamas and is characterized by erythematous papules and plaques. Psoriasis is seen in 1-2% of the normal population. In this study we aim to introduce the clinical and demographic features of patients with psoriasis in our region.Materials and Methods: 640 patients being followed in our psoriasis polyclinic between May 2006 and April 2010 were evaluated retrospectively.Results: Patients diagnosed with psoriasis constituted the 0.7% who visited our polyclinic. Three hundred and twenty one of the patients were female and 319 were male. A history of psoriasis was observed in at least one of the first or second degree relatives of 25.6% of patients with psoriasis. The most common concomitant disease in patients was hypertension. 97.6% of the patients had psoriasis vulgaris and 2.34% had pustular psoriasis. Nail involvement and psoriatic arthritis were detected in 37.6% and 5.62% of the patients.Conclusion: In our study, the clinical and sociodemographic features of psoriasis is found to be similar to other studies carried out in Turkey and in European societies. Female/Male ratio is equal.The most prevalent psoriasis type is plaque type and the most frequent nail finding is pitting. The onset of the disease is more widespread in the third decade. The most common comorbidity is hypertension.

  12. Clinical Assessment of Risk Management: an INtegrated Approach (CARMINA).

    Science.gov (United States)

    Tricarico, Pierfrancesco; Tardivo, Stefano; Sotgiu, Giovanni; Moretti, Francesca; Poletti, Piera; Fiore, Alberto; Monturano, Massimo; Mura, Ida; Privitera, Gaetano; Brusaferro, Silvio

    2016-08-01

    Purpose - The European Union recommendations for patient safety calls for shared clinical risk management (CRM) safety standards able to guide organizations in CRM implementation. The purpose of this paper is to develop a self-evaluation tool to measure healthcare organization performance on CRM and guide improvements over time. Design/methodology/approach - A multi-step approach was implemented including: a systematic literature review; consensus meetings with an expert panel from eight Italian leader organizations to get to an agreement on the first version; field testing to test instrument feasibility and flexibility; Delphi strategy with a second expert panel for content validation and balanced scoring system development. Findings - The self-assessment tool - Clinical Assessment of Risk Management: an INtegrated Approach includes seven areas (governance, communication, knowledge and skills, safe environment, care processes, adverse event management, learning from experience) and 52 standards. Each standard is evaluated according to four performance levels: minimum; monitoring; outcomes; and improvement actions, which resulted in a feasible, flexible and valid instrument to be used throughout different organizations. Practical implications - This tool allows practitioners to assess their CRM activities compared to minimum levels, monitor performance, benchmarking with other institutions and spreading results to different stakeholders. Originality/value - The multi-step approach allowed us to identify core minimum CRM levels in a field where no consensus has been reached. Most standards may be easily adopted in other countries. PMID:27477931

  13. Unique sequence features of the Human Adenovirus 31 complete genomic sequence are conserved in clinical isolates

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    Darr Sebastian

    2009-11-01

    Full Text Available Abstract Background Human adenoviruses (HAdV are causing a broad spectrum of diseases. One of the most severe forms of adenovirus infection is a disseminated disease resulting in significant morbidity and mortality. Several reports in recent years have identified HAdV-31 from species A (HAdV-A31 as a cause of disseminated disease in children following haematopoetic stem cell transplantation (hSCT and liver transplantation. We sequenced and analyzed the complete genome of the HAdV-A31 prototype strain to uncover unique sequence motifs associated with its high virulence. Moreover, we sequenced coding regions known to be essential for tropism and virulence (early transcription units E1A, E3, E4, the fiber knob and the penton base of HAdV-A31 clinical isolates from patients with disseminated disease. Results The genome size of HAdV-A31 is 33763 base pairs (bp in length with a GC content of 46.36%. Nucleotide alignment to the closely related HAdV-A12 revealed an overall homology of 84.2%. The genome organization into early, intermediate and late regions is similar to HAdV-A12. Sequence analysis of the prototype strain showed unique sequence features such as an immunoglobulin-like domain in the species A specific gene product E3 CR1 beta and a potentially integrin binding RGD motif in the C-terminal region of the protein IX. These features were conserved in all analyzed clinical isolates. Overall, amino acid sequences of clinical isolates were highly conserved compared to the prototype (99.2 to 100%, but a synonymous/non synonymous ratio (S/N of 2.36 in E3 CR1 beta suggested positive selection. Conclusion Unique sequence features of HAdV-A31 may enhance its ability to escape the host's immune surveillance and may facilitate a promiscuous tropism for various tissues. Moderate evolution of clinical isolates did not indicate the emergence of new HAdV-A31 subtypes in the recent years.

  14. Clinical Features of Adult/Adolescent Atopic Dermatitis and Chinese Criteria for Atopic Dermatitis

    Institute of Scientific and Technical Information of China (English)

    Ping Liu; Yan Zhao; Zhang-Lei Mu; Qian-Jin Lu; Li Zhang; Xu Yao; Min Zheng

    2016-01-01

    Background:Atopic dermatitis (AD) is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching.Most patients have personal and/or family history of atopic diseases.Several criteria have been proposed for the diagnosis of AD.Although the clinical features of childhood AD have been widely studied,there has been less large-scale study on adult/adolescent AD.The aim of this study was to investigate the clinical features of adult/adolescent patients with chronic symmetrical eczema/AD and to propose Chinese diagnostic criteria for adult/adolescent AD.Methods:A hospital-based study was performed.Forty-two dermatological centers participated in this study.Adult and adolescent patients (12 years and over) with chronic symmetrical eczema or AD were included in this study.Questionnaires were completed by both patients and investigators.The valid questionnaires were analyzed using EpiData 3.1 and SPSS 17.0 software.Results:A total of 2662 valid questionnaires were collected (1369 male and 1293 female).Of all 2662 patients,2062 (77.5%) patients had the disease after 12 years old,while only 600 (22.5%) patients had the disease before 12 years old,suggesting late-onset eczema/AD is common.Two thousand one hundred and thirty-nine (80.4%) patients had the disease for more than 6 months.One thousand one hundred and forty-four (43.0%) patients had a personal and/or family history of atopic diseases.One thousand five hundred and forty-eight (58.2%) patients had an elevated total serum IgE and/or eosinophilia and/or positive allergen-specific IgE.Based on these clinical and laboratory features,we proposed Chinese criteria for adult/adolescent AD.Of all 2662 patients,60.3% were satisfied with our criteria,while only 48.2% satisfied with Hanifin Rajka criteria and 32.7% satisfied with Williams criteria,suggesting a good sensitivity of our criteria in adult/adolescent AD patients.Conclusion:Late-onset of eczema or AD is common

  15. Clinical Characteristics, Radiological Features and Gene Mutation in 10 Chinese Families with Spinocerebellar Ataxias

    Institute of Scientific and Technical Information of China (English)

    Jian-Wen Chen; Li Zhao; Feng Zhang; Lan Li; Yu-Hang Gu; Jing-Yuan Zhou; Hui Zhang

    2015-01-01

    Background:Spinocerebellar ataxias (SCAs) are a group ofneurodegenerative disorders that primarily cause the degeneration in the cerebellum,spinal cord,and brainstem.We study the clinical characteristics,radiological features and gene mutation in Chinese families with SCAs.Methods:In this study,we investigated 10 SCAs Chinese families with SCA1,SCA3/Machado-Joseph disease (MJD),SCA7,SCAB.There were 27 people who were genetically diagnosed as SCA,of which 21 people showed clinical symptoms,and 6 people had no clinical phenotype that we called them presymptomatic patients.In addition,3 people with cerebellar ataxia and cataracts were diagnosed according to the Harding diagnostic criteria but failed to be recognized as SCAs on genetic testing.Clinical characteristic analyses of each type of SCAs and radiological examinations were performed.Results:We found that SCA3/MJD was the most common subtype in Han population in China,and the ratio of the pontine tegmentum and the posterior fossa area was negatively correlated with the number of cytosine-adenine-guanine (CAG) repeats;the disease duration was positively correlated with the International Cooperative Ataxia Rating Scale score;and the CAG repeats number of abnormal alleles was negatively correlated with the age of onset.Conclusions:Collectively our study is a systematic research on SCAs in China,which may help for the clinical diagnosis and prenatal screening of this disease,and it may also aid toward better understanding of this disease.

  16. Combined central and peripheral demyelination: Clinical features, diagnostic findings, and treatment.

    Science.gov (United States)

    Cortese, A; Franciotta, D; Alfonsi, E; Visigalli, N; Zardini, E; Diamanti, L; Prunetti, P; Osera, C; Gastaldi, M; Berzero, G; Pichiecchio, A; Piccolo, G; Lozza, A; Piscosquito, G; Salsano, E; Ceroni, M; Moglia, A; Bono, G; Pareyson, D; Marchioni, E

    2016-04-15

    Combined central and peripheral demyelination (CCPD) is rare, and current knowledge is based on case reports and small case series. The aim of our study was to describe the clinical features, diagnostic results, treatment and outcomes in a large cohort of patients with CCPD. Thirty-one patients entered this retrospective, observational, two-center study. In 20 patients (65%) CCPD presented, after an infection, as myeloradiculoneuropathy, encephalopathy, cranial neuropathy, length-dependent peripheral neuropathy, or pseudo-Guillain-Barré syndrome. Demyelinating features of peripheral nerve damage fulfilling European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) electrodiagnostic criteria for CIDP were found in 23 patients (74%), and spatial dissemination of demyelinating lesions on brain MRI fulfilling the 2010 McDonald criteria for multiple sclerosis (MS) in 11 (46%). Two thirds of the patients had a relapsing or progressive disease course, usually related to the appearance of new spinal cord lesions or worsening of the peripheral neuropathy, and showed unsatisfactory responses to high-dose corticosteroids and intravenous immunoglobulins. The clinical presentation of CCPD was severe in 22 patients (71%), who were left significantly disabled. Our data suggest that CCPD has heterogeneous features and shows frequent post-infectious onset, primary peripheral nervous system or central nervous system involvement, a monophasic or chronic disease course, inadequate response to treatments, and a generally poor outcome. We therefore conclude that the current diagnostic criteria for MS and CIDP may not fully encompass the spectrum of possible manifestations of CCPD, whose pathogenesis remains largely unknown. PMID:27000248

  17. Clinical features and pitfalls in the laboratory diagnosis of dengue in travellers

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    Frank Christina

    2006-07-01

    Full Text Available Abstract Background Several enzyme-linked immunosorbent assay (ELISA-kits are commercially available for the rapid diagnosis of dengue infection, and have demonstrated good sensitivity and specificity in paired serum samples. In practice, however, often only one blood sample is available from febrile travellers returning from dengue endemic areas. Methods To evaluate the diagnostic value of positive dengue antibody-titres performed by a standard ELISA (PanBio IgM- and IgG-ELISA in single serum samples (regarded as "probable infection", 127 positive samples were further analyzed using envelope/membrane IgM-, and nonstructural protein 1 IgM- and IgG-ELISAs, immunofluorescence assays, and real-time reverse transcription polymerase chain reaction assays (RT-PCR. A combination of the test-results served as the diagnostic "gold standard". A total of 1,035 febrile travellers returning from dengue-endemic countries with negative dengue-serology and RT-PCR served as controls to compare clinical and haematological features. Results Overall, only 64 (positive predictive value = 50% of the probable cases were confirmed by additional analysis and 54 (42.5% were confirmed to be "false-positive". Rash was the only clinical feature significantly associated with confirmed dengue fever. The combination of thrombocytopenia and leucopenia was present in 40.4% of confirmed and in 6.1% of false-positive cases. Thus, the positive predictive value for the combination of positive PanBio-ELISA plus the two haematological features was 90.5%. Conclusion The examination of paired serum samples is considered the most reliable serodiagnostic procedure for dengue. However, if only one blood sample is available, a single positive ELISA-result carries a high rate of false-positivity and should be confirmed using a second and more specific diagnostic technique. In the absence of further testing, platelet and white blood cell counts are helpful for the correct interpretation.

  18. Clinical features of HIV/AIDS patients presenting to an inner city clinic in Ho Chi Minh City, Vietnam.

    Science.gov (United States)

    Klotz, Stephen A; Nguyen, Hao Cong; Van Pham, Tam; Nguyen, Liem Thanh; Ngo, Dong Thi Anh; Vu, Son Nhoc

    2007-07-01

    An outpatient HIV clinic was opened in March 2005 in Binh Thanh District, a poor section of Ho Chi Minh City, Vietnam. Over 1500 patients were seen in the first year. The average age of patients was 27 years. Men represented 77% of the clinic population, women, 23% and children under the age of 16 years of age, 5% of the population. The most common risk factor among men was being an injecting drug user (IDU), 76%, and among women, being married to an IDU HIV-positive man, 35%. Physical signs of disease were uncommon: lymphadenopathy in 24% and hepatomegaly and splenomegaly in 4% and 3%, respectively. Men and women were anaemic at presentation, with a mean haemoglobin of 11.9 g/dL and 11.1 g/dL, respectively. An overwhelming majority of patients had profound immunodeficiency. The mean CD4+ cell count was 164 cells/mL and the median was 69 cells/mL. No correlation was found between the World Health Organization's stage of disease and the CD4+ cell count. Thus, the former is a poor predictor of immunity in this population. Data regarding opportunistic infections diagnosed at the first visit were studied. Candidiasis of the oral pharynx, oesophagus or vagina was found in 34.5% of the patients, and pulmonary and extrapulmonary tuberculosis was found in 32% of the patients. Pneumocystis carinii pneumonia (PCP) was diagnosed in only 3% of the patients. Cotrimoxazole prophylaxis is advocated for HIV-infected Vietnamese, but the incidence of PCP is negligible and resources could be spent elsewhere. The various opportunistic infections seen in this resource-poor clinic setting is likely to be a pattern of presentation of HIV-infected Vietnamese for some time to come. PMID:17623507

  19. Prevalence and clinical features of Thought-Perception-Sensitivity Symptoms: results from a community survey of Korean high school students.

    Science.gov (United States)

    Kang, Nam-In; Park, Tae-Won; Yang, Jong-Chul; Oh, Keun-Young; Shim, Shi-Ha; Chung, Young-Chul

    2012-08-15

    Epidemiologic research indicates that psychosis and depression most frequently develop during adolescence. Hence, an efficient strategy for improving youth mental health would be to focus on detection of early-stage psychosis and depression in adolescence. In this study, 1461 high school students were surveyed using self-report scales. Students who scored equal to or above the cut-off value on any of the scales and who agreed to a further examination proceeded to a second assessment, using the Kiddie Schedule for Affective Disorders and Schizophrenia and Comprehensive Assessment of At-Risk Mental States along with self-reporting scales. The estimated prevalence of adolescents at ultra-high risk (UHR) for psychosis and of depression-spectrum disorders was 1.26 and 3.69% respectively. Compared with the normal group, experiences of bullying, suicidal ideation, and suicide attempts were significantly higher in these two groups; the subjects at UHR for psychosis were found to have significantly lower academic performance and lower ratings on SCRS; and submissive behavior was more prevalent in the depression-spectrum group. Our results reveal several clinical features of adolescents at UHR for psychosis and with depression-spectrum disorder and underscore the importance of accurate assessment of and early appropriate care for these adolescents. PMID:22475525

  20. Dust related risks of clinically relevant lung functional deficits

    Energy Technology Data Exchange (ETDEWEB)

    Cowie, H.A.; Miller, B.G.; Rawbone, R.G.; Soutar, C.A. [Institute of Occupational Medicine, Edinburgh (United Kingdom)

    2006-05-15

    The aim was to quantify the risks of clinically important deficits of FEV1 in coal miners in relation to cumulative and average concentrations of respirable dust. Data were studied from over 7000 men who had been surveyed in the late 1970s. Linear regression equations for the association between FEV1 and self-reported breathlessness on mild exertion were used to define clinically important levels of FEV1 deficit, and the probabilities that individuals with different dust exposures would experience these deficits were calculated. Levels of FEV1 were lower among breathless men than among others, with a large overlap of the distributions. The relations between standardised FEV1 and breathlessness were constant over all age and smoking groups. FEV1 deficits of 20.367, 20.627, and 20.993 I (designated as 'small', 'medium', and 'large' deficits) were, on average, associated with proportional increases of risks of breathlessness by factors of 1.5, 2.0, and 3.0 respectively. Cumulative respirable dust exposure ranged up to 726 gh/m{sup 3}, mean 136 gh/m{sup 3} (British Medical Research Council measurement convention). An increase of 50 gh/m{sup 3} was associated with an increase of about 2% in the proportion of men with small deficits in FEV1. For medium deficits the increases ranged from 1.5% to 2%, depending on age. A similar pattern was seen for large deficits, but with smaller increases. In the unlikely event of continuous exposure at the proposed new maximum respirable dust limit for British mines of 3 mg/m{sup 3} (ISO-CEN measurement convention) for a working lifetime, the risk of a medium deficit of FEV1 for a non-smoker at age 60 would be estimated to be 34%, compared with 25% for zero dust exposure; for smokers, about 54% compared with 44%.

  1. Irritable bowel syndrome subtypes: clinical and psychological features, body mass index and comorbidities

    Directory of Open Access Journals (Sweden)

    Cristiane Kibune-Nagasako

    2016-02-01

    Full Text Available Background: Irritable bowel syndrome (IBS is classified into subtypes according to bowel habit. Objective: To investigate whether there are differences in clinical features, comorbidities, anxiety, depression and body mass index (BMI among IBS subtypes. Methods: The study group included 113 consecutive patients (mean age: 48 ± 11 years; females: 94 with the diagnosis of IBS. All of them answered a structured questionnaire for demographic and clinical data and underwent upper endoscopy. Anxiety and depression were assessed by the Hospital Anxiety and Depression scale (HAD. Results: The distribution of subtypes was: IBS-diarrhea (IBS-D, 46%; IBS-constipation (IBS-C, 32%, and mixed IBS (IBS-M, 22%. IBS overlap with gastroesophageal reflux disease (GERD, functional dyspepsia, chronic headache and fibromyalgia occurred in 65.5%, 48.7%, 40.7% and 22.1% of patients, respectively. Anxiety and/or depression were found in 81.5%. Comparisons among subgroups showed that bloating was significantly associated with IBS-M compared to IBS-D (odds ratio-OR-5.6. Straining was more likely to be reported by IBS-M (OR 15.3 and IBS-C (OR 12.0 compared to IBS-D patients, while urgency was associated with both IBS-M (OR 19.7 and IBS-D (OR 14.2 compared to IBS-C. In addition, IBS-M patients were more likely to present GERD than IBS-D (OR 6.7 and higher scores for anxiety than IBS-C patients (OR 1.2. BMI values did not differ between IBS-D and IBS-C. Conclusion: IBS-M is characterized by symptoms frequently reported by both IBS-C (straining and IBS-D (urgency, higher levels of anxiety, and high prevalence of comorbidities. These features should be considered in the clinical management of this subgroup.

  2. Correlation between CT features and clinical severity stratification in acute pulmonary embolism

    International Nuclear Information System (INIS)

    Objective: To analyze the correlation factors between CT imaging features of pulmonary embolism (PE) and clinical severity stratification, to explore the value of CT pulmonary angiography (CTPA) in acute PE severity stratification. Methods: According to the clinical severity, 48 patients with acute PE proved by CTPA were classified into two groups, including 21 critical and 27 non-critical patients. Embolism index, ratio of central pulmonary involvement, ratio of right ventricle maximum minor axis (RVMMA) to left ventricle maximum minor axis (LVMMA), namely RV: LV, dilation of main pulmonary and/or right pulmonary trunk, and dilation of bronchial arteries in both groups were analyzed comparatively. The correlation factors between CT imaging features and PE clinical severity stratification were explored. The correlation between RV: LV and embolism index of 48 patients was analyzed. Results: Pulmonary embolism index (22.0%-85.0%, median 38.0%), ratio of central pulmonary involvement (42.5%), RV: LV (0.90-1.90, median 1.30), dilation of pulmonary artery (14 eases), and dilation of bronchial artery (8 eases) in critical group (21 eases) were higher than those corresponding factors (5%-48%, median 21.5%, 31.25%, 0.80-1.40, median 1.00, 5 cases, and 3 cases) in non-critical group (27 cases) (Z=4.27, χ2=5.40, Z=2.58, χ2=11.45, χ2=4.87, P<0.05). There was remarkable correlation between RV: LV and embolism index (r=0.61, P<0.05). Conclusion: CTPA is feasible in evaluating PE severity stratification. The higher the embolism index, RV:LV, and the ratio of central pulmonary involvement, the higher probability of serious hemodynamic changes in PE patients. (authors)

  3. Clinical and imaging features of intra-articular osteoid osteoma in the femoral neck

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical and imaging characteristics of osteoid osteoma in femoral neck and to improve diagnostic accuracy of this disease. Methods: Twenty-one patients (18 males and 3 females, age, 7-26 years, median age, 13 years) with pathologically proven osteoid osteoma of the femoral neck were retrospectively analyzed for their clinical profile and radiologic features. CT and X-ray examinations were performed in all patients, 10 of them performed post-contrast CT scan and 4 of them performed MRI examinations. Results: Nineteen patients had hip pain (pain worse at night in 11, and 8 received salicylates treatment with good response), and 2 patients only with intermittent claudication. The duration ranged from 2 months to 54 months (median duration 12 months). X-ray: Nidus was seen on plain film in 10 cases, 18 cases showed different degrees of bone sclerosis of the nidus. CT: Nidus was demonstrated in all cases. Among them, 8 were intracortical, 6 were subperiosteal, 7 were endosteal. Twenty cases showed different degrees of bone sclerosis of the nidus-extra-articular anteromedial cortical surface of the femur neck. Nineteen cases showed 'vascular groove sign'. MRI: Nidus was seen in 4 cases. Bone sclerosis was low signal on all sequences. Three cases had joint effusion, 4 cases had bone marrow edema, and 2 cases had synovial thickening. Conclusions: Although osteoid osteoma of femoral neck has non-specific clinical features, the radiographic findings are usually typical. The nidus of osteoid osteoma is often located within the joint. Bony sclerosis occurs at the area of extra-articular anteromedial cortical surface of the femur neck.CT examination remains an optimal method to identify the nidus. (authors)

  4. Overlap of clinical features of Smith-Magenis & Down Syndrome in newborns and infants

    Energy Technology Data Exchange (ETDEWEB)

    Thomson, K.A.; Finucane, B.M.; Bauer, M.S. [Integrated Genetics, West Paterson, NJ (United States)] [and others

    1994-09-01

    Smith-Magenis Syndrome (SMS) frequently goes unrecognized in newborns and infants as these patients do not yet demonstrate the characteristic behavioral phenotype and may only present with developmental delay and physical dysmorphism. Six of Hall`s ten cardinal features of trisomy 21 in the newborn are also frequently found in newborns with SMS, leading to an early presumptive diagnosis of DS in many of these patients. CASE No. 1: Based on clinical findings, a presumptive diagnosis of DS was given to the patient in the newborn period. Chromosome analysis of peripheral blood revealed a normal 46,XX karyotype. Given this result, the possibility of mosaic DS was raised, and a skin fibroblast study done. Again, the karyotype was reported as normal. Clinical features and cytogenetic analysis confirmed a diagnosis of SMS when the patient was 8 years old. CASE No. 2: A presumptive diagnosis of DS was made in an infant with hypotonia, facial dysmorphisms and congenital heart defects. A routine chromosome analysis was ordered, which revealed a 46,XY,del(17)(p11.2p11.2) karyotype. Indeed, approximately 38% of blood samples referred to our laboratory to rule out DS in an infant failed to demonstrate trisomy for chromosome 21. Given the high degree of clinical overlap with Down Syndrome, the diagnosis of SMS should be considered in all such patients. Additional analysis should be done to look for deletion 17p11.2 when faced with a {open_quotes}normal{close_quotes} karyotype in an infant referred to rule out DS.

  5. Comparing patients with Apert and Crouzon syndromes--clinical features and cranio-maxillofacial surgical reconstruction.

    Science.gov (United States)

    Stavropoulos, Dimitrios; Tarnow, Peter; Mohlin, Bengt; Kahnberg, Karl-Erik; Hagberg, Catharina

    2012-01-01

    Cranio-maxillofacial malformations, as seen in Crouzon and Apert syndromes, may impose an immense distress on both function and aesthetics of the person affected. The aims of this study were to describe and compare the main facial and intraoral features of patients with Apert and Crouzon syndromes, the clinical manifestations that may be present, additionally to the main syndromic traits, as well as the cranio-maxillofacial surgical treatment protocols followed.Twenty-three patients with Apert syndrome (6 males, 17 females), and 28 patients with Crouzon syndrome (20 males, 8 females) were evaluated for general medical aspects, craniofacial characteristics, dentoalveolar traits before and after the final orthognathic surgery, and types and timing of cranio-maxillofacial operations. Mental retardation, associated additional malformations, cleft palate, and extensive lateral palatal soft tissue swellings were more common in children with Apert syndrome. In both syndromes, clinical findings included concave profile, negative overjet, posterior crossbites, anterior openbite, and dental midline deviation, which were corrected in almost all cases with the final orthognathic surgery, with the exception of the lateral crossbites, including more than one tooth pair, which were persisting in about half of the cases. Cranial vault decompression and/or reshaping, midfacial and orbital advancement procedures, often in conjunction with a mandibular setback, were the most frequent cranio-maxillofacial operations performed. In conclusion, Apert syndrome is more asymmetric in nature and a more severe clinical entity than Crouzon syndrome. The syndromic dentofacial features of both conditions could be significantly improved after a series of surgical procedures in almost all cases with the exception of the posterior crossbites, with haIf of them persisting post-surgically. PMID:22611902

  6. Comparison of clinical features between primary and drug-induced sleep-related eating disorder

    Directory of Open Access Journals (Sweden)

    Komada Y

    2016-05-01

    Full Text Available Yoko Komada,1 Yoshikazu Takaesu,2 Kentaro Matsui,3 Masaki Nakamura,3 Shingo Nishida,3 Meri Kanno,3,† Akira Usui,3 Yuichi Inoue1,3 1Department of Somnology, 2Department of Psychiatry, Tokyo Medical University, 3Japan Somnology Center, Institute of Neuropsychiatry, Tokyo, Japan †Meri Kanno passed away on March 1, 2016 Purpose: The aim of this study was to ascertain the clinical characteristics of drug-induced sleep-related eating disorder (SRED. Patients and methods: We retrospectively reviewed the medical records of 30 patients with primary SRED (without any comorbid sleep disorders and who were not taking any possible causative medications, and ten patients with drug-induced SRED (occurrence of SRED episodes after starting nightly medication of sedative drugs, which completely resolved after dose reduction or discontinuation of the sedatives. Results: All patients with drug-induced SRED took multiple types of sedatives, such as benzodiazepines or benzodiazepine receptor agonists. Clinical features of drug-induced SRED compared with primary SRED were as follows: higher mean age of onset (40 years old in drug-induced SRED vs 26 years old in primary SRED, significantly higher rate of patients who had total amnesia during most of their SRED episodes (75.0% vs 31.8%, significantly lower rate of comorbidity of night eating syndrome (0% vs 63.3%, and significantly lower rate of history of sleepwalking (10.0% vs 46.7%. Increased doses of benzodiazepine receptor agonists may be responsible for drug-induced SRED. Conclusion: The clinical features of drug-induced SRED were different from those of primary SRED, possibly reflecting differences in the underlying mechanisms between these two categories of SREDs. Keywords: nocturnal eating syndrome, night eating, eating disorder, hypnotics, amnesia, sleepwalking, benzodiazepine

  7. Insightful monitoring of natural flood risk management features using a low-cost and participatory approach

    Science.gov (United States)

    Starkey, Eleanor; Barnes, Mhari; Quinn, Paul; Large, Andy

    2016-04-01

    Pressures associated with flooding and climate change have significantly increased over recent years. Natural Flood Risk Management (NFRM) is now seen as being a more appropriate and favourable approach in some locations. At the same time, catchment managers are also encouraged to adopt a more integrated, evidence-based and bottom-up approach. This includes engaging with local communities. Although NFRM features are being more readily installed, there is still limited evidence associated with their ability to reduce flood risk and offer multiple benefits. In particular, local communities and land owners are still uncertain about what the features entail and how they will perform, which is a huge barrier affecting widespread uptake. Traditional hydrometric monitoring techniques are well established but they still struggle to successfully monitor and capture NFRM performance spatially and temporally in a visual and more meaningful way for those directly affected on the ground. Two UK-based case studies are presented here where unique NFRM features have been carefully designed and installed in rural headwater catchments. This includes a 1km2 sub-catchment of the Haltwhistle Burn (northern England) and a 2km2 sub-catchment of Eddleston Water (southern Scotland). Both of these pilot sites are subject to prolonged flooding in winter and flash flooding in summer. This exacerbates sediment, debris and water quality issues downstream. Examples of NFRM features include ponds, woody debris and a log feature inspired by the children's game 'Kerplunk'. They have been tested and monitored over the 2015-2016 winter storms using low-cost techniques by both researchers and members of the community ('citizen scientists'). Results show that monitoring techniques such as regular consumer specification time-lapse cameras, photographs, videos and 'kite-cams' are suitable for long-term and low-cost monitoring of a variety of NFRM features. These techniques have been compared against

  8. Risk of discontinuation of Advanced Therapy Medicinal Products clinical trials

    Science.gov (United States)

    Hanna, Eve; Rémuzat, Cecile; Auquier, Pascal; Toumi, Mondher

    2016-01-01

    Objective Advanced therapy medicinal products (ATMPs) constitute a class of innovative products that encompasses gene therapy, somatic cell therapy, and tissue-engineered products (TEP). There is an increased investment of commercial and non-commercial sponsors in this field and a growing number of ATMPs randomized clinical trials (RCT) and patients enrolled in such trials. RCT generate data to prove the efficacy of a new therapy, but the discontinuation of RCTs wastes scarce resources. Our objective is to identify the number and characteristics of discontinued ATMPs trials in order to evaluate the rate of discontinuation. Methods We searched for ATMPs trials conducted between 1999 to June 2015 using three databases, which are Clinicaltrials.gov, the International Clinical Trials Registry Platform (ICTRP), and the EU Drug Regulating Authorities Clinical Trials (EudraCT). We selected the ATMPs trials after elimination of the duplicates. We identified the disease areas and the sponsors as commercial or non-commercial organizations. We classified ATMPs by type and trial status, that is, ongoing, completed, terminated, discontinued, and prematurely ended. Then, we calculated the rate of discontinuation. Results Between 1999 and June 2015, 143 withdrawn, terminated, or prematurely ended ATMPs clinical trials were identified. Between 1999 and June 2013, 474 ongoing and completed clinical trials were identified. Therefore, the rate of discontinuation of ATMPs trials is 23.18%, similar to that for non-ATMPs drugs in development. The probability of discontinuation is, respectively, 27.35, 16.28, and 16.34% for cell therapies, gene therapies, and TEP. The highest discontinuation rate is for oncology (43%), followed by cardiology (19.2%). It is almost the same for commercial and non-commercial sponsors; therefore, the discontinuation reason may not be financially driven. Conclusion No failure risk rate per development phase is available for ATMPs. The discontinuation rate may

  9. BRUCELLOSIS: REVIEW OF CLINICAL AND LABORATORY FEATURES AND THERAPEUTIC REGIMENS IN 44 CHILDREN

    Directory of Open Access Journals (Sweden)

    S Afsharpaiman

    2008-12-01

    Full Text Available "nBrucellosis is not uncommon in children in endemic areas. We described clinical and laboratory features and therapeutic regimens for brucellosis in children under 14 who admitted in the Pediatric Medical Center Hospital, Tehran, Iran from March 1988 until February 2001. The male: female ratio was 2:1. Family history of brucellosis and consumption of un-pasteurized milk and dairy products was positive in 20.4% and 65.9%, respectively. The common clinical findings were arthritis (79.5%, fever (77.4%, anorexia (61.4%, sweating (52.3%, splenomegaly (43.2%, hepatomegaly (34.1% and lymphadenopathy (13.65. Anemia, leukopenia and thrombocytopenia were recorded in 56.8%, 31.8% and 9.1%, respectively. Out of all patients, seropositivity rate for brucellosis was found in 97.7% using serum agglutination test. Culture of blood and bone marrow specimen were positive in 30% and 50% of samples obtained, respectively. Rifampin and co-trimoxazole were the most commonly used combination in 68.1%. The overall relapse rate was 13.6%. Arthritis and fever were the most common clinical findings of brucellosis. Wright test is a very sensitive method to detect brucella infection. Public education and control measures should be applied to prevent the zoonotic and human brucellosis. 

  10. EPIDEMIOLOGY, CLINICAL AND LABORATORY FEATURES OF CRIMEAN-CONGO HEMORRHAGIC FEVER IN GEORGIA.

    Science.gov (United States)

    Vashakidze, E; Mikadze, I

    2015-10-01

    Crimean-Congo hemorrhagic fever virus transmitted to humans by Hyalomma ticks or by direct contact with the blood of infected humans or domestic animals. The most common clinical signs of CCHF are fever, nausea, headache, diarrhea, myalgia, petechial rash, and bleeding. CCHF is a severe disease in humans with a fatality rate up to 15-85%. This study was undertaken to determine the predictors of fatality among patients with CCHF based on epidemiological, clinical, and laboratory findings. 34 patients were enrolled in the study, aged 4 to 77; 17 - male and 17 female. 3 of them were fatal cases. All of them were from Shua Kartli: Khashuri, Gori and Kaspi districts, involved in farming/handling livestock and the history of tick bite was present in most of patients. Evaluation of the epidemiological characteristics of this cases showed that the female to male ratio was nearly similar. The disease is common in the rural areas of the region, mostly in the actively working age group and almost all patients were farmers. The results of our study show that the most cardinal clinical and laboratory features of Crimean-Congo hemorrhagic fever are - acute beginning of disease, high fever, intoxication and hemorrhagic symptoms, thrombocytopenia, high level of aminotransferases and creatine. Predictors of fatality are: an altered mental status, in early stage of disease dramatic decreased thrombocytes count and significantly high level of aspartate aminotransferase, also longer the mean prothrombin time and INR. PMID:26483375

  11. CT scanning in pediatric head trauma: correlation of clinical features with CT scan diagnosis

    International Nuclear Information System (INIS)

    A retrospective review was conducted on 205 cases of pediatric head trauma for which cranial computed tomography scans were done at the Makati Medical Center, to determine which clinical features might positively predict an abnormality on CT scan. The clinical findings of loss of consciousness, GCS < 12, vomiting headache, seizures, and focal abnormalities on Neurologic Examination were significantly associated with abnormal findings on CT scan. However, a significant discrepancy does exist as to how accurately clinical findings do in fact predict normal and abnormal CT scan findings. Such a discrepancy allows us to conclude that a more liberal use of CT Scanning in cases of pediatric head trauma must be stressed to insure proper diagnosis. This study shows that when a patient presents with the aforementioned positive signs and symptoms, or with a focal neurologic deficit, or in combination, a 60-100 % positive prediction of abnormal CT Scan can be made. However, prediction of normal CT Scan is only 0-40%. (Author)

  12. Clinical features of the head injury caused by child abuse in infants

    International Nuclear Information System (INIS)

    The diagnosis and managements of the head injury in battered children are greatly complicated by medical history and the mechanisms of injury. In the present study, we evaluated the clinical features of the head injury in battered children. Clinical signs and symptoms, the mechanisms of injury, intracranial pathology, and prognosis of 25 battered children with head injury treated between 1984 and 2003 were retrospectively analyzed. The age of 25 children was between 1 month and 2 years old. The average of the ages was 7 months old. In 68% of 25 patients, the age was 6 months or less. The medical history of head injury was unclear in 16 children. The chief complains were disturbance of consciousness, convulsion, vomiting and hypothermia. Retinal hemorrhages were recognized in 88% of the patients and these were bilateral in 68%. Acute subdural hematomas (19 cases) and chronic subdural hematomas (6 cases) were shown on CTs or MRIs. In four cases, cerebral contusions were complicated as intracranial pathology. In 44% of the patients, the hypoxic-ischemic injury was confirmed on CTs or MRIs. Fractures of limbs and ribs were recognized on skeletal survey in 40% of the patients. 71% of 17 survival cases had moderate or severe psychomotor disabilities at the end of follow-up periods. In children under 2 years of age with subdural hematomas, clinical investigations other than CT and MRI, included ophthalmoscopy by ophthalmologist and skeletal survey, are crucial and mandatory for early diagnosis of the child abuse. (author)

  13. Clinical features and prognosis of obese breast cancer patients:a retrospective study*

    Institute of Scientific and Technical Information of China (English)

    Zhendong Zheng; Heng Cao; Shuxian Qu; Yongye Liu; Ying Piao; Xiaodong Xie

    2013-01-01

    Objective:The aim of our study was to investigate the prognosis of obese breast cancer patients. Methods:This study was conducted on a total of 317 breast cancer patients who were histopathological y and clinical y diagnosed at the General Hospital of Shenyang Military Region (China) from 2004 to 2006. Clinical data including height, weight, age at diagnosis, tumor size, lymph node status, menopausal status, family history of cancer and hormone receptor status were col-lected. Log-rank test was performed to compare the disease free survival (DFS) and overal survival (OS). Cox proportional hazards regression analysis was conducted to make multivariate analysis. The Chi square test was used to compare the clinical features among normal weight group, overweight group, and obese group. Results:Obesity was an independent prognostic factor for DFS (P=0.022) and OS (P=0.032) in breast cancer patients. In the stratified analysis based on the hormone receptor status, obesity was independently associated with OS in patients with negative ER/PR (P=0.002), but such association was not observed in patients with positive hormone receptors. Obesity was also associated with lymph node status (P=0.001) and smoking (P=0.009). Conclusion:Obesity is associated with poor DFS and OS in patients with breast cancer. Therefore, maintaining normal weight may benefit breast cancer patients.

  14. Clinical features and prognosis of a sample of patients with trisomy 13 (Patau syndrome) from Brazil.

    Science.gov (United States)

    Petry, Patrícia; Polli, Janaina B; Mattos, Vinícius F; Rosa, Rosana C M; Zen, Paulo R G; Graziadio, Carla; Paskulin, Giorgio A; Rosa, Rafael F M

    2013-06-01

    Trisomy 13 or Patau syndrome (PS) is a chromosomal disorder characterized by a well known presentation of multiple congenital anomalies. Our objective was to determine the clinical features and prognosis observed in a sample of patients with PS. The series was composed of patients with diagnosis of PS consecutively evaluated by a Clinical Genetics Service from a reference hospital of southern Brazil, in the period between 1975 and 2012. Statistical analysis was performed using PEPI program (version 4.0), with two-tailed Fisher's exact test for comparison of frequencies (P<0.05). The sample consisted of 30 patients, 60% male, median age at first evaluation of 9 days. Full trisomy of chromosome 13 was the main cytogenetic alteration (73%). The major clinical findings included: cryptorchidism (78%), abnormal auricles (77%), congenital heart defects (76%), polydactyly (63%), microphthalmia (60%) and micrognathia (50%). Four patients (13%) simultaneously had micro/anophthalmia, oral clefts and polydactyly. Some findings were only observed in our sample and included, among others, preauricular tags (10%), duplication of the hallux (3%) and spots following the lines of Blaschko (3%). Mosaicism (20% of cases) had a statistically significant association only with absence of cryptorchidism. The median of survival was 26 days. Patients with and without mosaicism had similar median of survival. Our findings, in agreement with the literature, show that the anomalies in patients with PS can be quite variable, sometimes even atypical. There is no pathognomonic finding, which may make the early identification of these patients challenging. PMID:23613355

  15. Features for culturally appropriate avatars for behavior-change promotion in at-risk populations

    Directory of Open Access Journals (Sweden)

    Lisetti C

    2009-09-01

    Full Text Available We explore how avatars can be used as social orthotics defined as therapeutic computer-based social companions aimed at promoting healthy behaviors. We review some of the health interventions deployed in helping at-risk populations along with some of the unique advantages that computer-based interventions can add to face-to-face interventions. We posit that artificial intelligence has rendered possible the creation of culturally appropriate dialog-agents for interventions and we identify specific features for social avatars that are important - if not necessary - when applied to the domain of social orthotic systems for health promotion.

  16. Beyond breast cancer: mammographic features and mortality risk in a population of healthy women.

    Directory of Open Access Journals (Sweden)

    Rachel A Murphy

    Full Text Available BACKGROUND: Breast fibroglandular (dense tissue is a risk factor for breast cancer. Beyond breast cancer, little is known regarding the prognostic significance of mammographic features. METHODS: We evaluated relationships between nondense (fatty breast area and dense area with all-cause mortality in 4,245 initially healthy women from the Breast Cancer Detection Demonstration Project; 1,361 died during a mean follow-up of 28.2 years. Dense area and total breast area were assessed using planimeter measurements from screening mammograms. Percent density reflects dense area relative to breast area and nondense area was calculated as the difference between total breast area and dense area. Hazard ratios (HRs and 95% confidence intervals (CIs were estimated by Cox proportional hazards regression. RESULTS: In age-adjusted models, greater nondense and total breast area were associated with increased risk of death (HR 1.17, 95% CI 1.10-1.24 and HR 1.13, 95% CI 1.06-1.19, per SD difference while greater dense area and percent density were associated with lower risk of death (HR 0.91, 95% CI 0.86-0.95 and HR 0.87, 95% CI 0.83-0.92, per SD difference. Associations were not attenuated with adjustment for race, education, mammogram type (x-ray or xerogram, smoking status, diabetes and heart disease. With additional adjustment for body mass index, associations were diminished for all features but remained statistically significant for dense area (HR 0.94, 95% CI 0.89-0.99, per SD difference and percent density (HR 0.93, 95% CI 0.87-0.98, per SD difference. CONCLUSIONS: These data indicate that dense area and percent density may relate to survival in healthy women and suggest the potential utility of mammograms beyond prediction of breast cancer risk.

  17. Sarcoidosis in children. Epidemiology in Danes, clinical features, diagnosis, treatment and prognosis.

    Science.gov (United States)

    Milman, N; Hoffmann, A L; Byg, K E

    1998-08-01

    This paper reviews current knowledge of childhood sarcoidosis with regard to the epidemiology in Danes, clinical presentation, diagnostic procedures, treatment and prognosis. Sarcoidosis is a granulomatous disease of unknown aetiology, with multiorgan involvement. The diagnosis is confirmed by the demonstration of epitheloid cell granulomas in tissue biopsy specimens. During the period 1980-92, three cases of childhood sarcoidosis were recorded in Copenhagen County, which has a total population of 610,000. The approximate incidence of clinically recognized sarcoidosis in Danish children younger than 15 y of age was 0.22-0.27/100,000 children per year, corresponding to approximately three new cases in Denmark each year. The true incidence is unknown, since the disease is often asymptomatic and resolves without a clinical diagnosis being made. In children younger than 5 y of age, the disease is characterized by involvement of skin, eyes and joints, whereas in older children involvement of lungs, lymph nodes and eyes predominate. The mainstay of treatment consists of oral corticosteroids. The risk/benefit ratio of using long-term corticosteroids needs to be evaluated in each individual patient. Some patients may benefit from additional therapy with methotrexate. The long-term prognosis is not well established, but it seems to be poorer in children younger than 5 y. Older children appear to have as favourable a prognosis as young adults. PMID:9736236

  18. Knowledge of causes, clinical features and diagnosis of common zoonoses among medical practitioners in Tanzania

    Directory of Open Access Journals (Sweden)

    Mfinanga Godfrey S

    2008-12-01

    Full Text Available Abstract Background Many factors have been mentioned as contributing to under-diagnosis and under-reporting of zoonotic diseases particularly in the sub-Sahara African region. These include poor disease surveillance coverage, poor diagnostic capacity, the geographical distribution of those most affected and lack of clear strategies to address the plight of zoonotic diseases. The current study investigates the knowledge of medical practitioners of zoonotic diseases as a potential contributing factor to their under-diagnosis and hence under-reporting. Methods The study was designed as a cross-sectional survey. Semi-structured open-ended questionnaire was administered to medical practitioners to establish the knowledge of anthrax, rabies, brucellosis, trypanosomiasis, echinococcosis and bovine tuberculosis in selected health facilities within urban and rural settings in Tanzania between April and May 2005. Frequency data were analyzed using likelihood ratio chi-square in Minitab version 14 to compare practitioners' knowledge of transmission, clinical features and diagnosis of the zoonoses in the two settings. For each analysis, likelihood ratio chi-square p-value of less than 0.05 was considered to be significant. Fisher's exact test was used where expected results were less than five. Results Medical practitioners in rural health facilities had poor knowledge of transmission of sleeping sickness and clinical features of anthrax and rabies in humans compared to their urban counterparts. In both areas the practitioners had poor knowledge of how echinococcosis is transmitted to humans, clinical features of echinococcosis in humans, and diagnosis of bovine tuberculosis in humans. Conclusion Knowledge of medical practitioners of zoonotic diseases could be a contributing factor to their under-diagnosis and under-reporting in Tanzania. Refresher courses on zoonotic diseases should be conducted particularly to practitioners in rural areas. More emphasis

  19. Clinical features and phylogenetic analysis of Coxsackievirus A9 in Northern Taiwan in 2011

    Directory of Open Access Journals (Sweden)

    Huang Yi-Chuan

    2013-01-01

    Full Text Available Abstract Background Coxsackievirus A9 (CA9 was one of the most prevalent serotype of enteroviral infections in Taiwan in 2011. After several patient series were reported in the 1960s and 1970s, few studies have focused on the clinical manifestations of CA9 infections. Our study explores and deepens the current understanding of CA9. Methods We analyzed the clinical presentations of 100 culture-proven CA9-infected patients in 2011 by reviewing their medical records and depicted the CA9 phylogenetic tree. Results Of the 100 patients with culture-proven CA9 infections, the mean (SD age was 4.6 (3.4 years and the male to female ratio was 1.9. For clinical manifestations, 96 patients (96% had fever and the mean (SD duration of fever was 5.9 (3.4 days. Sixty one patients (61% developed a skin rash, and the predominant pattern was a generalized non-itchy maculopapular rash without vesicular changes. While most patients showed injected throat, oral ulcers were found in only 19 cases (19%, among whom, 6 were diagnosed as herpangina. Complicated cases included: aseptic meningitis (n=8, bronchopneumonia (n=6, acute cerebellitis (n=1, and polio-like syndrome (n=1. Phylogenetic analysis for current CA9 strains is closest to the CA9 isolate 27-YN-2008 from the border area of mainland China and Myanmar. Conclusions The most common feature of CA9 during the 2011 epidemic in Taiwan is generalized febrile exanthema rather than herpangina or hand, foot, and mouth disease. Given that prolonged fever and some complications are possible, caution should be advised in assessing patients as well as in predicting the clinical course.

  20. Clinical features of GH deficiency and effects of 3 years of GH replacement in adults with controlled Cushing's disease

    DEFF Research Database (Denmark)

    Höybye, Charlotte; Ragnarsson, Oskar; Jönsson, Peter J;

    2010-01-01

    Patients in remission from Cushing's disease (CD) have many clinical features that are difficult to distinguish from those of concomitant GH deficiency (GHD). In this study, we evaluated the features of GHD in a large cohort of controlled CD patients, and assessed the effect of GH treatment....