Renal Embolization and Urothelial Sclerotherapy for Recurrent Obstructive Urosepsis and Intractable Haematuria from Upper Tract Urothelial Carcinoma

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Brown, Nicholas, E-mail: nibrown@cantab.net [St Vincent’s Hospital, Department of Interventional Radiology (Australia); Olayos, Elizabeth; Elmer, Sandra; Wong, Lih-Ming [St Vincent’s Hospital, Department of Urology (Australia); Brooks, Duncan M; Jhamb, Ashu [St Vincent’s Hospital, Department of Interventional Radiology (Australia)

2016-03-15

Management of intractable haematuria and obstructive urosepsis from upper tract urothelial carcinoma can be problematic in patients not suitable for surgery, chemotherapy or radiotherapy. Interventional radiology techniques provide alternative approaches in this setting, such as complete kidney embolization to cease urine output, percutaneous nephrostomy, antegrade injection of sclerotherapy agents and sterilisation of the upper collecting system. Related approaches have been successfully employed to sclerose renal cysts, lymphoceles, chyluria and intractable lower tract haemorrhage. No reports of percutaneous, antegrade sclerotherapy in the upper urinary tract have previously been published. We present a case of recurrent haematuria and obstructive urosepsis caused by invasive upper tract urothelial carcinoma in a non-operative patient, which was treated with renal embolisation and percutaneous upper tract urothelial sclerotherapy.

Upper aerodigestive tract disorders and gastro-oesophageal reflux disease.

Science.gov (United States)

Ciorba, Andrea; Bianchini, Chiara; Zuolo, Michele; Feo, Carlo Vittorio

2015-02-16

A wide variety of symptoms and diseases of the upper aerodigestive tract are associated to gastro-oesophageal reflux disease (GORD). These disorders comprise a large variety of conditions such as asthma, chronic otitis media and sinusitis, chronic cough, and laryngeal disorders including paroxysmal laryngospasm. Laryngo-pharyngeal reflux disease is an extraoesophageal variant of GORD that can affect the larynx and pharynx. Despite numerous research efforts, the diagnosis of laryngopharyngeal reflux often remains elusive, unproven and controversial, and its treatment is then still empiric. Aim of this paper is to review the current literature on upper aerodigestive tract disorders in relation to pathologic gastro-oesophageal reflux, focusing in particular on the pathophysiology base and results of the surgical treatment of GORD.

Treatment of calculus of upper urinary tract with mini-percutaneous nephrolithotomy under ultrasound guidance

International Nuclear Information System (INIS)

Gao Feng; Ye Chunhua; Wang Kanger; Sun Yan

2009-01-01

Objective: To evaluate the feasibility and availability of minimally invasive percutaneous nephrolithotomy (MPCNL) under ultrasound guidance for treatment of calculus of upper urinary tract. Methods: The clinical data of 48 cases with calculus of upper urinary tract undergoing MPCNL were reviewed. Results: In 48 cases, cutaneous-nephric passages were successfully constructed by ultrasound guidance, stone-free rate was 90%. The average operation time was 90 minutes, the average hospitalization was 8 days. No major complications were noted. Conclusion: Under ultrasound guidance, MPCNL with holmium laser is a simply, safe and effective method for treating calculus of upper urinary tract. (authors)

High EDSS can predict risk for upper urinary tract damage in patients with multiple sclerosis.

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Ineichen, Benjamin V; Schneider, Marc P; Hlavica, Martin; Hagenbuch, Niels; Linnebank, Michael; Kessler, Thomas M

2018-04-01

Neurogenic lower urinary tract dysfunction (NLUTD) is very common in patients with multiple sclerosis (MS), and it might jeopardize renal function and thereby increase mortality. Although there are well-known urodynamic risk factors for upper urinary tract damage, no clinical prediction parameters are available. We aimed to assess clinical parameters potentially predicting urodynamic risk factors for upper urinary tract damage. A consecutive series of 141 patients with MS referred from neurologists for primary neuro-urological work-up including urodynamics were prospectively evaluated. Clinical parameters taken into account were age, sex, duration, and clinical course of MS and Expanded Disability Status Scale (EDSS). Multivariate modeling revealed EDSS as a clinical parameter significantly associated with urodynamic risk factors for upper urinary tract damage (odds ratio = 1.34, 95% confidence interval (CI) = 1.06-1.71, p = 0.02). Using receiver operator characteristic (ROC) curves, an EDSS of 5.0 as cutoff showed a sensitivity of 86%-87% and a specificity of 52% for at least one urodynamic risk factor for upper urinary tract damage. High EDSS is significantly associated with urodynamic risk factors for upper urinary tract damage and allows a risk-dependent stratification in daily neurological clinical practice to identify MS patients requiring further neuro-urological assessment and treatment.

New technologies for upper tract urothelial carcinoma management

NARCIS (Netherlands)

Baard, Joyce; Freund, Jan Erik; de La Rosette, Jean J. M. C. H.; Laguna, Maria P.

2017-01-01

Purpose of review Image enhancement techniques and optical diagnostic tools have emerged in the quest to improve diagnostics and treatment in patients with upper urinary tract carcinoma (UTUC). The aim of the present report is to describe their mechanisms of action and to assess the current evidence

Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised controlled trial.

NARCIS (Netherlands)

Aardweg, M.T. van den; Boonacker, C.W.; Rovers, M.M.; Hoes, A.W.; Schilder, A.G.M.

2011-01-01

OBJECTIVE: To assess the effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections. DESIGN: Open randomised controlled trial. SETTING: 11 general hospitals and two academic centres. PARTICIPANTS: 111 children aged 1-6 with recurrent upper respiratory tract

Contemporary surgical trends in the management of upper tract calculi.

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Oberlin, Daniel T; Flum, Andrew S; Bachrach, Laurie; Matulewicz, Richard S; Flury, Sarah C

2015-03-01

Upper tract nephrolithiasis is a common surgical condition that is treated with multiple surgical techniques, including shock wave lithotripsy, ureteroscopy and percutaneous nephrolithotomy. We analyzed case logs submitted to the ABU by candidates for initial certification and recertification to help elucidate the trends in management of upper tract urinary calculi. Annualized case logs from 2003 to 2012 were analyzed. We used logistic regression models to assess how surgeon specific attributes affected the way that upper tract stones were treated. Cases were identified by the CPT code of the corresponding procedure. A total of 6,620 urologists in 3 certification groups recorded case logs, including 2,275 for initial certification, 2,381 for first recertification and 1,964 for second recertification. A total of 441,162 procedures were logged, of which 54.2% were ureteroscopy, 41.3% were shock wave lithotripsy and 4.5% were percutaneous nephrolithotomy. From 2003 to 2013 there was an increase in ureteroscopy from 40.9% to 59.6% and a corresponding decrease in shock wave lithotripsy from 54% to 36.3%. For new urologists ureteroscopy increased from 47.6% to 70.9% of all stones cases logged and for senior clinicians ureteroscopy increased from 40% to 55%. Endourologists performed a significantly higher proportion of percutaneous nephrolithotomies than nonendourologists (10.6% vs 3.69%, p <0.0001) and a significantly smaller proportion of shock wave lithotripsies (34.2% vs 42.2%, p = 0.001). Junior and senior clinicians showed a dramatic adoption of endoscopic techniques. Treatment of upper tract calculi is an evolving field and provider specific attributes affect how these stones are treated. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

CLINICAL EFFICACY OF IBUPROFEN IN THERAPY FOR VIRAL UPPER RESPIRATORY TRACT INFECTIONS IN INFANTS

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I.O. Skugarevskaya

2006-01-01

Full Text Available A study of use of ibuprofen in cases of viral upper respiratory tract infections (Vuri in children of early childhood has proved its' safety and efficacy. This medical agent has not only terminate fever but also diminished some other symptoms of Vuri.Key words: ibuprofen, viral upper respiratory tract infections, children.

Prevalence of upper urinary tract anomalies in hospitalized premature infants with urinary tract infection.

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Vachharajani, A; Vricella, G J; Najaf, T; Coplen, D E

2015-05-01

The 2011 American Academy of Pediatrics (AAP) guidelines address imaging after initial febrile urinary tract infection (UTI) in infants >2 months of age. We sought to determine the frequency of upper urinary tract anomalies (hydronephrosis and vesicoureteral reflux (VUR)) in hospitalized premature infants with UTI. We retrospectively reviewed the electronic medical records of neonatal intensive care unit (NICU) admissions at a tertiary care children's hospital between 1 January 2006 and 31 December 2010. We queried the records for UTI, renal ultrasound (US) and voiding cystourethrogram (VCUG). We identified 3518 unique admissions. UTI occurred in 118 infants (3%). Sixty-nine (60%) had a normal US. Renal dilation was predominantly renal pelvic dilation (12%) and isolated caliectasis (22%). VUR was identified in 15 (14%) infants evaluated with a VCUG. VUR was identified in nine (12%) infants without and in seven (16%) with an abnormality on US. Reflux was identified in 7% of male and 38% of female infants with a UTI. Anatomic abnormalities of the upper urinary tract are uncommon in premature infants with a UTI that occurs during neonatal hospitalization. In concordance with the AAP guidelines, a VCUG may not be required in all NICU infants under age 2 months after a single UTI.

Complete upper urinary tract obstruction caused by penetrating ...

African Journals Online (AJOL)

Complete upper urinary tract obstruction caused by penetrating pellet injury of the ureter. M.T. Gulpinar, S.K. Keskin, A Yildirim, T Caskurlu. Abstract. Ureteral injuries due to gunshots are tend to be misdiagnosed because of concomitant vascular and intraabdominal organ wounds. Our case is a 23-year old man who was ...

Upper tract urothelial carcinomas: frequency of association with mismatch repair protein loss and lynch syndrome.

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Harper, Holly L; McKenney, Jesse K; Heald, Brandie; Stephenson, Andrew; Campbell, Steven C; Plesec, Thomas; Magi-Galluzzi, Cristina

2017-01-01

Increased risk for upper tract urothelial carcinoma is described in patients with Lynch syndrome, caused by germline mutations in mismatch repair genes. We aimed to identify the frequency of mismatch repair protein loss in upper tract urothelial carcinoma and its potential for identifying an association with Lynch syndrome. We queried our database to identify upper tract urothelial carcinomas. Patients were cross-referenced for history of colorectal carcinoma or other common Lynch syndrome-associated neoplasms to enrich for potential Lynch syndrome cases. Tumor histopathologic characteristics were reviewed and each case was analyzed for loss of mismatch repair proteins, MLH1, MSH2, MSH6, and PMS2, by immunohistochemistry. Of 444 patients with upper tract urothelial carcinoma, a subset of 215 (encompassing 30 with upper tract urothelial carcinoma and another common Lynch syndrome-associated neoplasm) was analyzed for loss of mismatch repair protein expression. Of 30 patients with Lynch syndrome-associated neoplasms, six had documented Lynch syndrome, including two with Muir-Torre syndrome. Mismatch repair protein loss was identified in 7% of total upper tract urothelial carcinomas and 30% of patients with Lynch syndrome-associated neoplasms (including all patients with Lynch syndrome/Muir-Torre syndrome). Of patients without history of Lynch syndrome-associated neoplasms, 5 of 184 (2.7%) had loss of mismatch repair protein expression. Twelve cases with mismatch repair protein loss demonstrated loss of MSH2 and MSH6, and 2 had isolated loss of MSH6. MLH1 and PMS2 expression were consistently retained. Although increased intratumoral lymphocytes, inverted growth, pushing tumor-stromal interface, and lack of nuclear pleomorphism were more commonly seen in cases with mismatch repair protein loss, only intratumoral lymphocytes and presence of pushing borders were statistically significant. MLH1 and PMS2 testing appear to have little utility in upper tract urothelial

Upper respiratory tract infections in athletes.

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Page, Clifton L; Diehl, Jason J

2007-07-01

Upper respiratory tract infections (URTIs) represent the most common acute illnesses in the general population and account for the leading acute diagnoses in the outpatient setting. Given the athlete's expectation to return to activity as soon as possible, the sports medicine physician should be able to accurately diagnose and aggressively treat these illnesses. This article discusses the common pathogens, diagnosis, treatment options, and return-to-play decisions for URTIs, with a focus on the common cold, sinusitis, pharyngitis, and infectious mononucleosis in the athlete.

Upper respiratory tract infection, heterologous immunisation and meningococcal disease

NARCIS (Netherlands)

Scholten, R. J.; Bijlmer, H. A.; Tobi, H.; Dankert, J.; Bouter, L. M.

1999-01-01

To test the hypothesis that an episode of upper respiratory tract infection or heterologous immunisation is a predisposing factor for the occurrence of meningococcal disease, data from 377 cases of meningococcal disease and their household contacts (n = 1124) were analysed by conditional logistic

Long-Term Lithium Use and Risk of Renal and Upper Urinary Tract Cancers

DEFF Research Database (Denmark)

Pottegård, Anton; Hallas, Jesper; Jensen, Boye L

2015-01-01

Lithium induces proliferation in the epithelium of renal collecting ducts. A recent small-scale cohort study reported a strong association between use of lithium and increased risk of renal neoplasia. We therefore conducted a large-scale pharmacoepidemiologic study of the association between long...... stratified by stage and subtype of upper urinary tract cancer revealed slight but nonsignificant increases in the ORs for localized disease (OR, 1.6; 95% CI, 0.8-3.0) and for renal pelvis/ureter cancers (OR, 1.7; 95% CI, 0.5-5.4). In conclusion, in our nationwide case-control study, use of lithium......-term use of lithium and risk of upper urinary tract cancer, including renal cell cancer and cancers of the renal pelvis or ureter. We identified all histologically verified upper urinary tract cancer cases in Denmark between 2000 and 2012 from the Danish Cancer Registry. A total of 6477 cases were matched...

Endoluminal pharmacologic stimulation of the upper urinary tract.

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Jakobsen, Jørn Skibsted

2013-05-01

The experiments performed in this PhD thesis were conducted at the Institute of Experimental Surgery, Skejby Hospital, Aarhus, Denmark and at the Laboratory of Animal Science, Odense University Hospital, Denmark. The thesis is based on 3 peer review articles published in international journals and a review. Diagnostic or therapeutic endoscopic upper urinary tract procedures are usually characterised as minimal invasive procedures and associated with a low complication rate. Most often fever or pain are seen and sometimes septicaemia. However, mucosa lesion or even ureteric ruptures are known complications. Research has suggested that high renal pelvic pressures generated during these procedures, might contribute to per-/postoperative complications seen, and even possible renal parenchymal damage. Nevertheless, local administration (endoluminal) of a relaxant drug has not previously been tried in order to lower renal pelvic pressure. The purposes of this thesis were to examine the effect of local administration (endoluminal) of the nonspecific β-adrenergic agonist ISOproterenol (ISO) on: 1) The normal pressure flow relation in porcine ureter, 2) The effect of endoluminal ISO perfusion during flexible ureterorenoscopy, 3) The pressure flow relation during semirigid ureterorenoscopy and 4) The cardiovascular system. Among other receptor-types β-adrenergic receptor are located in the upper urinary tract and the activation thereof mediates smooth muscle relaxation. We have shown - in an animal experimental model - that ISO added to the irrigation fluid had significant impact on the renal pelvic pressures generated during upper urinary tract endoscopy. ISO significantly and dose dependently reduced the normal pressure flow relations by approximately 80% without concomitant cardiovascular side effects or measurable plasma levels of ISO. During flexible ureterorenoscopy 0.1 µg/ml ISO added to the irrigation fluid significantly reduced renal pelvic pressure during

Longitudinal study of the impact of psychological distress symptoms on new-onset upper gastrointestinal symptoms in World Trade Center responders.

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Litcher-Kelly, Leighann; Lam, Yvette; Broihier, Julie A; Brand, Douglas L; Banker, Suvin V; Kotov, Roman; Bromet, Evelyn; Bucobo, Juan Carlos; Shaw, Robert D; Luft, Benjamin J

2014-01-01

Research on the health of workers involved in the cleanup after the attack on the World Trade Center (WTC) on September 11, 2001, has documented high rates of psychological distress and upper gastrointestinal (GI) symptoms. The current article examines the concurrent and longitudinal associations of psychological distress with development of new-onset upper GI symptoms in a large sample of WTC responders. A cohort of 10,953 WTC responders monitored by the WTC Health Program participated in the study. Two occupational groups were examined, police and nontraditional responders. The cohort was free of upper GI symptoms or diagnoses at their first visit (3 years after September 11, 2001). Logistic regression was used to analyze the relationships between concurrent and preceding psychological distress symptoms of depression, generalized anxiety, panic, and probable posttraumatic stress disorder with the development of new-onset upper GI symptoms at 3-year follow-up (6 years after September 11, 2001). Across both occupation groups, psychological distress symptoms at Visit 1 were significantly related to the development of GI symptoms by Visit 2 (odd ratios ranging from 1.9 to 5.4). The results for the concurrent relationships were similar. In addition, there were significant dose-response relationships between the number of co-occurring psychological distress symptoms at Visits 1 and 2, and increased new-onset upper GI symptoms at Visit 2. In this large sample of WTC responders, psychological distress symptoms assessed at 3 years after 9/11 are related to reporting upper GI symptoms 6 years after 9/11.

Impact of endoscopic ultrasonography (EUS) on surgical decision-making in upper gastrointestinal tract cancer

DEFF Research Database (Denmark)

Mortensen, Michael Bau; Edwin, B; Hünerbein, M

2007-01-01

BACKGROUND: Endoscopic ultrasonography (EUS) is an integrated part of the pretherapeutic evaluation program for patients with upper gastrointestinal (GI) tract cancer. Whether the clinical impact of EUS differs between surgeons from different countries is unknown. The same applies to the potential...... clinical influence of EUS misinterpretations. The aim of this study was to evaluate the interobserver agreement on predefined treatment strategies between surgeons from four different countries, with and without EUS, and to evaluate the clinical consequences of EUS misinterpretations. METHODS: One hundred...... patients with upper GI tract cancer were randomly selected from all upper GI tract cancer patients treated at Odense University Hospital between 1997 and 2000. Based on patient records and EUS database results, a case story was created with and without the EUS result for each patient. Four surgeons were...

Universal Point of Care Testing for Lynch Syndrome in Patients with Upper Tract Urothelial Carcinoma.

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Metcalfe, Michael J; Petros, Firas G; Rao, Priya; Mork, Maureen E; Xiao, Lianchun; Broaddus, Russell R; Matin, Surena F

2018-01-01

Patients with Lynch syndrome are at risk for upper tract urothelial carcinoma. We sought to identify the incidence and most reliable means of point of care screening for Lynch syndrome in patients with upper tract urothelial carcinoma. A total of 115 consecutive patients with upper tract urothelial carcinoma without a history of Lynch syndrome were universally screened during followup from January 2013 through July 2016. We evaluated patient and family history using AMS (Amsterdam criteria) I and II, and tumor immunohistochemistry for mismatch repair proteins and microsatellite instability. Patients who were positive for AMS I/II, microsatellite instability or immunohistochemistry were classified as potentially having Lynch syndrome and referred for clinical genetic analysis and counseling. Patients with known Lynch syndrome served as positive controls. Of the 115 patients 16 (13.9%) screened positive for potential Lynch syndrome. Of these patients 7.0% met AMS II criteria, 11.3% had loss of at least 1 mismatch repair protein and 6.0% had high microsatellite instability. All 16 patients were referred for germline testing, 9 completed genetic analysis and counseling, and 6 were confirmed to have Lynch syndrome. All 7 patients with upper tract urothelial carcinoma who had a known history of Lynch syndrome were positive for AMS II criteria and at least a single mismatch repair protein loss while 5 of 6 had high microsatellite instability. We identified 13.9% of upper tract urothelial carcinoma cases as potential Lynch syndrome and 5.2% as confirmed Lynch syndrome at the point of care. These findings have important implications for universal screening of upper tract urothelial carcinoma, representing one of the highest rates of undiagnosed genetic disease in a urological cancer. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Concepts and controversies in disorders of upper gastrointestinal tract

African Journals Online (AJOL)

The upper gastrointestinal tract is one part of the digestive system where tremendous innovations and advancements in knowledge have been recorded in the last several decades. The discovery of Helicobacter pylori by Warren and Marshal in 1983 and the introduction of Rome process for the classification, diagnosis and ...

UPPER GASTROINTESTINAL TRACT HEMORRHAGE AND NONSTEROIDALANTIINFLAMMATORY DRUGS (NSAIDs – A 5-YEAR PROSPECTIVE STUDY

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Pavel Skok

2002-03-01

Full Text Available Background. Adverse effects of nonsteroidal antiinflammatory drugs (NSAIDs are a common cause of digestive tract hemorrhage.Study aims. The purpose of the study was to ascertain the percent of patients taking NSAIDs with upper digestive tract hemorrhage.Type of study. Prospective, analytical.Patients and methods. The study includes patients in which urgent endoscopic investigations of the upper digestive tract were carried out due to gastrointestinal hemorrhage between 1 January 1994 and 31 December 1998.Results. 3366 patients were investigated: 1222 women and 2144 men; the average age of our patients was 57.5 years (SD ± 17.1, a 2–97 year span. In 2905 patients (86.3% the source of bleeding was confirmed in the upper gastrointestinal tract. Among our patients 55% were aged over 60 years, 26.7% were older than 80 years. Sequelae of peptic ulcer disease were the most significant cause of gastrointestinal hemorrhage, in 47.7% of our patients (1387/2905. In the last week prior to bleeding, 19% of patients (552/2905 were taking regularly NSAIDs, corticosteroids, salycilates or anticoagulant therapy at least in single daily dose. The majority of patients, 94.5%, were taking NSAIDs or salycilates. Among NSAIDs they were taking most often ketoprofen, diclofenac or naproxen/ naproxen natrium, less often ibuprofen, nabumeton, etodolac or piroxicam.Conclusions. Upper digestive tract hemorrhage is a serious complication of NSAIDs medication, particularly in older patients

[The response of the upper respiratory tract to the impact of atmospheric pollution].

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Mukhamadiev, R A; Ismagilov, Sh M

2015-01-01

The present literature review characterizes the environmental conditions in the Russian Federation in general and the Republic of Tatarstan in particular with special reference to the influence of atmospheric pollution on the development and the clinical picture of the diseases of the respiratory organs including pathology of the upper respiratory tract in the populations of the industrial centres and other environmentally unfriendly areas. The views of the domestic and foreign authors concerning the role of the environmental factors in the clinical picture of the upper respiratory tract disorders are described in detail. The authors emphasize the necessity of the further investigationsinto this problem and the development of the methods for the prevention of diseases of the upper respiratory react.

MR urography versus retrograde pyelography/ureteroscopy for the exclusion of upper urinary tract malignancy

Energy Technology Data Exchange (ETDEWEB)

Lee, K.S., E-mail: kslee@bidmc.harvard.ed [Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States); Zeikus, E. [Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States); DeWolf, W.C. [Department of Surgery, Division of Urology, Beth Israel Deaconess Medical Center, Boston, MA (United States); Rofsky, N.M.; Pedrosa, I. [Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States)

2010-03-15

Aim: To evaluate the diagnostic performance of magnetic resonance urography (MRU) versus retrograde pyelography and/or ureteroscopy (RPU) in the detection of upper urinary tract neoplasms. Materials and methods: This retrospective study included 35 patients with suspected upper urinary tract malignancy who underwent MRU and RPU within 6-months in our institution during the study period (February 2002 to January 2007). MRU and RPU reports were reviewed and results recorded. For each patient, the urinary tract was sub-divided into four regions for analysis: left kidney/renal pelvis, left ureter, right kidney/renal pelvis, and right ureter. MRU and RPU results for each patient were compared to a reference standard and the diagnostic performance of both techniques was compared. Results: A total of 113 regions were analysed on MRU and 90 regions on RPU. Nineteen neoplasms were identified. Sensitivity, specificity, positive predictive value, and negative predictive value for the detection of urinary tract neoplasms were 63, 91, 60, and 92% for MRU, respectively, and 53, 97, 83, and 88% for RPU, respectively. These differences were not statistically significant (p > 0.05). Conclusion: The high negative predictive value of MRU in the present series supports its use as a non-invasive screening examination for excluding the presence of upper urinary tract malignancy.

Dysbiosis of upper respiratory tract microbiota in elderly pneumonia patients

NARCIS (Netherlands)

Piters, Wouter A. A. de Steenhuijsen; Huijskens, Elisabeth G. W.; Wyllie, Anne L.; Biesbroek, Giske; van den Bergh, Menno R.; Veenhoven, Reinier H.; Wang, Xinhui; Trzcinski, Krzysztof; Bonten, Marc J.; Rossen, John W. A.; Sanders, Elisabeth A. M.; Bogaert, Debby

Bacterial pneumonia is a major cause of morbidity and mortality in elderly. We hypothesize that dysbiosis between regular residents of the upper respiratory tract (URT) microbiome, that is balance between commensals and potential pathogens, is involved in pathogen overgrowth and consequently

A Rare Cause of Testicular Metastasis: Upper Tract Urothelial Carcinoma

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Alper Nesip Manav

2014-01-01

Full Text Available Metastatic testicular cancers are rare. Primary tumor sources are prostate, lung, and gastrointestinal tract for metastatic testicular cancers. Metastasis of urothelial carcinoma (UC to the testis is extremely rare. Two-thirds of upper tract urothelial carcinoma (UTUC is of invasive stage at diagnosis and metastatic sites are the pelvic lymph nodes, liver, lung, and bone. We report a rare case of metastatic UTUC to the testis which has not been reported before, except one case in the literature. Testicular metastasis of UC should be considered in patients with hematuria and testicular swelling.

Non-invasive investigation of the upper gastrointestinal tract using technetium - 99m

Energy Technology Data Exchange (ETDEWEB)

Taylor, T V [Royal Infirmary, Edinburgh (UK)

1979-01-01

The use of technetium - 99m in the non-invasive investigation of the upper gastrointestinal tract is discussed with particular reference to the evolution of a method of assessing gastric function or gastric acid secretion non-invasively and to the applications of this method in the investigation of surgical patients with disease of the upper gastrointestinal tract. The assessment of maximal acid output and the insulin response is described and the use of the test in the diagnosis of pernicious anaemia, hypo- and hyperchlorhydric states, gastric cancer, hiatus hernia and Barrett's oesophagus, coeliac disease, Meckel's diverticulum, and abdominal aortic aneurism outlined. The use of chemicals labelled with this tracer in hepatobilary scanning is briefly described.

Prospective comparison of molecular signatures in urothelial cancer of the bladder and the upper urinary tract--is there evidence for discordant biology?

Science.gov (United States)

Krabbe, Laura-Maria; Lotan, Yair; Bagrodia, Aditya; Gayed, Bishoy A; Darwish, Oussama M; Youssef, Ramy F; Bolenz, Christian; Sagalowsky, Arthur I; Raj, Ganesh V; Shariat, Shahrokh F; Kapur, Payal; Margulis, Vitaly

2014-04-01

Upper tract urothelial carcinoma is rare and less well studied than bladder cancer. It remains questionable if findings in bladder cancer can safely be extrapolated to upper tract urothelial carcinoma. We prospectively evaluate molecular profiles of upper tract urothelial carcinoma and bladder cancer using a cell cycle biomarker panel. Immunohistochemical staining for p21, p27, p53, cyclin E and Ki-67 was prospectively performed for 96 patients with upper tract urothelial carcinoma and 159 patients with bladder cancer with nonmetastatic high grade urothelial carcinoma treated with extirpative surgery. Data were compared between the groups according to pathological stage. Primary outcome was assessment of differences in marker expression. Secondary outcome was difference in survival according to marker status. During a median followup of 22.0 months 31.2% of patients with upper tract urothelial carcinoma and 28.3% of patients with bladder cancer had disease recurrence, and 20.8% and 27.7% died of upper tract urothelial carcinoma and bladder cancer, respectively. The number of altered markers was not significantly different between the study groups. Overall 34 patients (35.4%) with upper tract urothelial carcinoma and 62 (39.0%) with bladder cancer had an unfavorable marker score (more than 2 markers altered). There were no significant differences between upper tract urothelial carcinoma and bladder cancer in the alteration status of markers, the number of altered markers and biomarker score when substratified by pathological stage. There were no significant differences in survival outcomes between patients with upper tract urothelial carcinoma and those with bladder cancer according to the number of altered markers and biomarker score. Our results demonstrate the molecular similarity of upper tract urothelial carcinoma and bladder cancer in terms of cell cycle and proliferative tissue markers. These findings have important implications and support the further

[Cefazolin efficacy and antibiotic sensitivity against pathogenic bacteria in pediatric with acute upper urinary tract infection].

Science.gov (United States)

Fuke, Toshiya; Abe, Yoshifusa; Hoshino, Akihiro; Oto, Hideyasu; Sakai, Naho; Murayama, Junichiro; Yoshida, Koichiro; Itabashi, Kazuo

2010-05-01

Acute upper urinary tract infection may cause sepsis, especially in neonates and infants, mandating the choice of appropriate, effective antibacterials minimizing increasing bacterial resistance. Frequently prescribing broad-spectrum cephalosporinin is one such example. Different antibacterial therapies are initiated clinically due to treatment protocol differences among institutions, disease severity, etc. We studied the efficacy of cefazolin (CEZ), a first-generation cephalosporin, as first-line parenteral treatment in acute upper urinary tract infection. We found that 88.9% of microbial infections have indications for CEZ. CEZ efficacy is 91.3%, and 97.2% of urine cultures show negative results. Escherichia coli sensitivity to antibacterial agents is 90.9% of the minimal inhibitory concentration (MIC) pediatric therapy in acute upper urinary tract infection.

[Evaluation of upper urinary tract function in patients undergoing autoplastic surgery for hydronphrosis of the intrarenal pelvis].

Science.gov (United States)

Kurbanaliev, R M; Usupbaev, A Ch; Kolesnichenko, I V; Sadyrbekov, N Zh; Sultanov, B M

2018-05-01

To investigate the functional state of the upper urinary tract in patients undergoing autoplastic surgery for a hydronophrosis of the intrarenal pelvis. The study comprised 78 patients with the intrarenal pelvis and impaired urinary outflow due to stricture of the ureteropelvic junction and vascular conflict (interatrial and arteriovenous narrowing), who underwent pyeloplasty using autologous tunica vaginalis. All patients underwent an incision of ureteropelvic stricture and resection of the parietal layer of the tunica vaginalis which was used to repair the obstruction site and internal stenting of the upper urinary tract. The patients were examined at baseline and during follow-up ranging from 3 months to 3 years. At three months after surgery, there was a decrease in the size of the renal pelvis and calyces with an improvement of all parameters of uro- and hemodynamics. At three years after surgery, the structural and functional parameters of the upper urinary tract were completely restored. Obstructive uropathy, resulting from the intrarenal pelvis, leads to persistently impaired urinary outflow from the upper urinary tract. Surgical intervention is the only curative treatment able to restore the urinary flow. In men with the intrarenal pelvis, the autoplastic surgery of the ureteropelvic junction obstruction using a parietal layer of the tunica vaginalis is an effective surgical modality improving renal pelvis capacity and contributing to the recovery of urinary outflow from the upper urinary tract.

CFD heat transfer simulation of the human upper respiratory tract for oronasal breathing condition

Directory of Open Access Journals (Sweden)

Kambiz Farahmand

2012-01-01

Full Text Available Injuries due to inhalation of hot gas are commonly encountered when dealing with fire and combustible material, which is harmful and threatens human life. In the literature, various studies have been conducted to investigate heat and mass transfer characteristics in the human respiratory tract (HRT. This study focuses on assessing the injury taking place in the upper human respiratory tract and identifying acute tissue damage, based on level of exposure. A three-dimensional heat transfer simulation is performed using Computational Fluid Dynamics (CFD software to study the temperature profile through the upper HRT consisting of the nasal cavity, oral cavity, trachea, and the first two generations of bronchi. The model developed is for the simultaneous oronasal breathing during the inspiration phase with a high volumetric flow rate of 90 liters/minute and the inspired air temperature of 100 degrees Celsius. The geometric model depicting the upper HRT is generated based on the data available and literature cited. The results of the simulation give the temperature distribution along the center and the surface tissue of the respiratory tract. This temperature distribution will help to assess the level of damage induced in the upper respiratory tract and appropriate treatment for the damage. A comparison of nasal breathing, oral breathing, and oronasal breathing is performed. Temperature distribution can be utilized in the design of the respirator systems where inlet temperature is regulated favoring the human body conditions.

Seasonal and pandemic human influenza viruses attach better to human upper respiratory tract epithelium than avian influenza viruses.

Science.gov (United States)

van Riel, Debby; den Bakker, Michael A; Leijten, Lonneke M E; Chutinimitkul, Salin; Munster, Vincent J; de Wit, Emmie; Rimmelzwaan, Guus F; Fouchier, Ron A M; Osterhaus, Albert D M E; Kuiken, Thijs

2010-04-01

Influenza viruses vary markedly in their efficiency of human-to-human transmission. This variation has been speculated to be determined in part by the tropism of influenza virus for the human upper respiratory tract. To study this tropism, we determined the pattern of virus attachment by virus histochemistry of three human and three avian influenza viruses in human nasal septum, conchae, nasopharynx, paranasal sinuses, and larynx. We found that the human influenza viruses-two seasonal influenza viruses and pandemic H1N1 virus-attached abundantly to ciliated epithelial cells and goblet cells throughout the upper respiratory tract. In contrast, the avian influenza viruses, including the highly pathogenic H5N1 virus, attached only rarely to epithelial cells or goblet cells. Both human and avian viruses attached occasionally to cells of the submucosal glands. The pattern of virus attachment was similar among the different sites of the human upper respiratory tract for each virus tested. We conclude that influenza viruses that are transmitted efficiently among humans attach abundantly to human upper respiratory tract, whereas inefficiently transmitted influenza viruses attach rarely. These results suggest that the ability of an influenza virus to attach to human upper respiratory tract is a critical factor for efficient transmission in the human population.

Oncolytic virotherapy in upper gastrointestinal tract cancers

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Yokoda R

2018-03-01

Full Text Available Raquel Yokoda,1 Bolni M Nagalo,1 Mansi Arora,1 Jan B Egan,1 James M Bogenberger,1 Thomas T DeLeon,1 Yumei Zhou,1 Daniel H Ahn,1 Mitesh J Borad1–3 1Division of Hematology/Oncology, Department of Medicine, Mayo Clinic, Scottsdale, AZ, 2Department of Molecular Medicine, Center for Individualized Medicine, Mayo Clinic, Rochester, MN, 3Department of Oncology, Mayo Clinic Cancer Center, Phoenix, AZ, USA Abstract: Upper gastrointestinal tract malignancies are among the most challenging cancers with regard to response to treatment and prognosis. Cancers of the esophagus, stomach, pancreas, liver, and biliary tree have dismal 5-year survival, and very modest improvements in this rate have been made in recent times. Oncolytic viruses are being developed to address these malignancies, with a focus on high safety profiles and low off-target toxicities. Each viral platform has evolved to enhance oncolytic potency and the clinical response to either single-agent viral therapy or combined viral treatment with radiotherapy and chemotherapy. A panel of genomic alterations, chimeric proteins, and pseudotyped capsids are the breakthroughs for vector success. This article revisits developments for each viral platform to each tumor type, in an attempt to achieve maximum tumor selectivity. From the bench to clinical trials, the scope of this review is to highlight the beginnings of translational oncolytic virotherapy research in upper gastrointestinal tract malignancies and provide a bioengineering perspective of the most promising platforms. Keywords: oncolytic viruses, hepatopancreatobiliary, gastric cancer, pancreatic cancer, liver cancer, biliary cancer

Multiple primary malignant tumors of upper gastrointestinal tract:A novel role of ~(18)F-FDG PET/CT

Institute of Scientific and Technical Information of China (English)

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2010-01-01

AIM: To evaluate the capacity of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for detecting multiple primary cancer of upper gastrointestinal (UGI) tract. METHODS: Fifteen patients (12 without cancer histories and 3 with histories of upper GI tract cancer) were investigated due to the suspicion of primary cancer of UGI tract on X-ray barium meal and CT scan. Subsequent whole body 18F-FDG PET/CT scan was carried out for initial staging or restaging. All the patient...

A study by upper digestive tract scintigraphy of cases with recurrent pneumonia after gastrectomy

International Nuclear Information System (INIS)

Yokomura, Ichiro; Fukabori, Takashi; Mizobuchi, Kazuya; Yoneda, Mitsuru; Yagi, Yasuo; Nakamura, Mitsuo

1997-01-01

Five patients with recurrent pneumonia after gastrectomy were studied by upper digestive tract scintigraphy. Severe gastroesophageal reflux was noted in three of the five patients in the supine position. In the other two patients, the same kind of reflux was easily induced by changing position. Esophageal dysfunction was suspected in four patients. The frequency of pneumonia decreased after we instructed the patients how to avoid reflux. We therefore diagnosed it as the chronic aspiration pneumonia. We concluded that upper digestive tract scintigraphy is useful for evaluating gastroesophageal reflux and esophageal function in patients after gastrectomy. (author)

A study by upper digestive tract scintigraphy of cases with recurrent pneumonia after gastrectomy

Energy Technology Data Exchange (ETDEWEB)

Yokomura, Ichiro; Fukabori, Takashi; Mizobuchi, Kazuya; Yoneda, Mitsuru; Yagi, Yasuo; Nakamura, Mitsuo [Shakaihoken Kobe Central Hospital (Japan)

1997-03-01

Five patients with recurrent pneumonia after gastrectomy were studied by upper digestive tract scintigraphy. Severe gastroesophageal reflux was noted in three of the five patients in the supine position. In the other two patients, the same kind of reflux was easily induced by changing position. Esophageal dysfunction was suspected in four patients. The frequency of pneumonia decreased after we instructed the patients how to avoid reflux. We therefore diagnosed it as the chronic aspiration pneumonia. We concluded that upper digestive tract scintigraphy is useful for evaluating gastroesophageal reflux and esophageal function in patients after gastrectomy. (author)

Hyaluronic Acid: Perspectives in Upper Aero-Digestive Tract. A Systematic Review.

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Manuele Casale

Full Text Available To date, topical therapies guarantee a better delivery of high concentrations of pharmacologic agents to the mucosa of the upper aerodigestive tract (UADT. The use of topical drugs, which are able to reduce mucosal inflammation and to improve healing tissues, can represent a relevant therapeutic advance. Topical sodium hyaluronate (SH has recently been recognized as adjuvant treatment in the chronic inflammatory disease of the UADT.The aim of our work was to review the published literature regarding all the potential therapeutic effects of SH in the chronic inflammatory disease of UADT.Relevant published studies were searched in Pubmed, Google Scholar, Ovid using keywords ("sodium hyaluronate" and "upper airways" or Medical Subject Headings.At the end of our selection process, sixteen publications have been included. Six of them in the post-operative period of nasal-sinus surgery, 2 of them in pediatric patients affected by recurrent upper respiratory tract infections, 4 of them in reducing symptoms and preventing exacerbations of chronic upper airways in adult population, 4 of them in patients with chronic inflammatory disease of UADT, including gastro-esophageal reflux disease (GERD.Topical administration of SH plays a pivotkey role in the postoperative phase of patients undergoing FESS and nasal surgery, and positive results are generally observed in all the patients suffering from UADT chronic inflammatory disease.

Programmed Death-ligand 1 Expression in Upper Tract Urothelial Carcinoma.

Science.gov (United States)

Skala, Stephanie L; Liu, Tzu-Ying; Udager, Aaron M; Weizer, Alon Z; Montgomery, Jeffrey S; Palapattu, Ganesh S; Siddiqui, Javed; Cao, Xuhong; Fields, Kristina; Abugharib, Ahmed E; Soliman, Moaaz; Hafez, Khaled S; Miller, David; Lee, Cheryl T; Alva, Ajjai; Chinnaiyan, Arul M; Morgan, Todd M; Spratt, Daniel E; Jiang, Hui; Mehra, Rohit

2017-10-01

Urothelial carcinoma (UC) is the most common malignancy of the urinary tract. Upper tract (renal pelvis and ureter) urothelial carcinomas (UTUC) account for approximately 5% of UCs but a significant subset are invasive and associated with poor clinical outcomes. To evaluate programmed death-ligand 1 (PD-L1) expression in UTUC. UTUC cases from 1997-2016 were retrospectively identified from the surgical pathology database at a single large academic institution. The cohort included 149 cases: 27 low-grade and 24 high-grade pathologic T (pT)a, 29 pT1, 23 pT2, 38 pT3, and eight pT4. PD-L1 immunohistochemistry (IHC) was performed on representative whole tumor sections using anti-PD-L1 primary antibody clone 5H1. PD-L1 expression was evaluated using a previously established cut-off for positivity (≥ 5% membranous staining). Association between PD-L1 IHC expression and clinicopathologic parameters was examined with Fisher's exact test; the effect of PD-L1 expression on cancer-specific mortality was assessed using the Cox proportional hazard model. Approximately one-third (32.7%) of invasive primary UTUC and 23.5% of all primary UTUC (invasive and noninvasive tumors) demonstrated positive PD-L1 expression. Positive PD-L1 expression was associated with high histologic grade, high pathologic stage, and angiolymphatic invasion. Cancer-specific survival was not significantly associated with positive PD-L1 expression using a 5% cut-off. Study limitations include the retrospective nature and the fact that PD-L1 expression by IHC is an imperfect surrogate for response to therapy. Positive PD-L1 expression in approximately one-third of primary invasive UTUC and association with high-risk clinicopathologic features provide a rational basis for further investigation of PD-L1-based immunotherapeutics in these patients. Upper tract urothelial carcinoma is often associated with poor clinical outcome. While current treatment options for advanced upper tract urothelial carcinoma are

[Upper respiratory tract infections and sports].

Science.gov (United States)

Boffi El Amari, Emmanuelle

2010-08-11

Upper respiratory tract infections are frequent in athletes. Mainly of viral origin, they are treated symptomatically. Infectious mononucleosis is associated with an estimated 2% per hundred risk of splenic rupture, which occurs between day four and twenty one of the illness. Therefore return to play guidelines recommend avoiding, exercice during the first twenty one days. Physical exercise seems to influence the immune system, depending on the intensity and length of it. But the relationship between physical exercise and risk of infections remains controversial: some articles showing an increase in risk, whereas others suggesting a certain degree of protection, in athletes. The actual generally accepted working theory is the J-curve proposed by Nieman. This model remains to be formally proven.

Malignant tumors of the upper aerodigestive tract as seen in a ...

African Journals Online (AJOL)

and nasal cavity are more commonly affected than the oral cavity unlike in other populations. Nonepithelial tumors are extremely rare below the age of 20 years. Key words: Malignant tumors, Nigeria, upper aerodigestive tract. Date of Acceptance: 28‑May‑2014. Address for correspondence: Dr. Sabageh Donatus,.

Rhinovirus genome variation during chronic upper and lower respiratory tract infections.

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Caroline Tapparel

Full Text Available Routine screening of lung transplant recipients and hospital patients for respiratory virus infections allowed to identify human rhinovirus (HRV in the upper and lower respiratory tracts, including immunocompromised hosts chronically infected with the same strain over weeks or months. Phylogenetic analysis of 144 HRV-positive samples showed no apparent correlation between a given viral genotype or species and their ability to invade the lower respiratory tract or lead to protracted infection. By contrast, protracted infections were found almost exclusively in immunocompromised patients, thus suggesting that host factors rather than the virus genotype modulate disease outcome, in particular the immune response. Complete genome sequencing of five chronic cases to study rhinovirus genome adaptation showed that the calculated mutation frequency was in the range observed during acute human infections. Analysis of mutation hot spot regions between specimens collected at different times or in different body sites revealed that non-synonymous changes were mostly concentrated in the viral capsid genes VP1, VP2 and VP3, independent of the HRV type. In an immunosuppressed lung transplant recipient infected with the same HRV strain for more than two years, both classical and ultra-deep sequencing of samples collected at different time points in the upper and lower respiratory tracts showed that these virus populations were phylogenetically indistinguishable over the course of infection, except for the last month. Specific signatures were found in the last two lower respiratory tract populations, including changes in the 5'UTR polypyrimidine tract and the VP2 immunogenic site 2. These results highlight for the first time the ability of a given rhinovirus to evolve in the course of a natural infection in immunocompromised patients and complement data obtained from previous experimental inoculation studies in immunocompetent volunteers.

Appropriateness of antibiotic prescribing for upper respiratory tract infections in general practice

DEFF Research Database (Denmark)

Sigurdardottir, N. R.; Nielsen, A. B. S.; Munck, A.

2015-01-01

Objective: To compare the appropriateness of antibiotic prescribing for upper respiratory tract infections (URTIs) in two countries with different prevalence of antimicrobial resistance: Denmark and Iceland.Design: A cross-sectional study. Settings and subjects. General practitioners (GPs...

Experience of curing serious obstruction of advanced-stage upper digestive tract tumor using laser under endoscope

Science.gov (United States)

Mu, Hai-Bin; Zhang, Man-Ling; Zhang, Xiao-Qiang; Zhang, Feng-Qiu; Kong, De-Jia; Tang, Li-Bin

1998-11-01

The patients who suffer from upper digestive tract tumor, such as cancer of esophagus, cancer of cardia, all have serious obstruction and fail to get nutrition and can not bear the strike of the radiotherapy and chemotherapy. In order to reduce the obstruction symptom and suffering of the patients and to prolong their life time, since 1989, our hospital used the laser to cure the upper digestive tract tumor 11 cases with serious obstruction and got remarkable curative effect.

NASAL-Geom, a free upper respiratory tract 3D model reconstruction software

Science.gov (United States)

Cercos-Pita, J. L.; Cal, I. R.; Duque, D.; de Moreta, G. Sanjuán

2018-02-01

The tool NASAL-Geom, a free upper respiratory tract 3D model reconstruction software, is here described. As a free software, researchers and professionals are welcome to obtain, analyze, improve and redistribute it, potentially increasing the rate of development, and reducing at the same time ethical conflicts regarding medical applications which cannot be analyzed. Additionally, the tool has been optimized for the specific task of reading upper respiratory tract Computerized Tomography scans, and producing 3D geometries. The reconstruction process is divided into three stages: preprocessing (including Metal Artifact Reduction, noise removal, and feature enhancement), segmentation (where the nasal cavity is identified), and 3D geometry reconstruction. The tool has been automatized (i.e. no human intervention is required) a critical feature to avoid bias in the reconstructed geometries. The applied methodology is discussed, as well as the program robustness and precision.

Diffusion-Weighted Magnetic Resonance Imaging of Urinary Epithelial Cancer with Upper Urinary Tract Obstruction: Preliminary Results

International Nuclear Information System (INIS)

Takeuchi, M.; Matsuzaki, K.; Kubo, H.; Nishitani, H.

2008-01-01

Background: Various malignant tumors of the body show high signal intensity on diffusion-weighted magnetic resonance imaging (DWI). In the genitourinary region, DWI is expected to have a role in detecting urinary epithelial cancer noninvasively. Purpose: To demonstrate the feasibility of DWI for the diagnosis of urinary epithelial cancer with upper urinary tract obstruction. Material and Methods: Twenty upper urinary tract cancers in 16 patients were evaluated by high-b-value DWI (b=800s/mm2). The signal intensity was visually evaluated, and the apparent diffusion coefficients (ADCs) were measured. Results: All urinary epithelial cancers showed high signal intensity on DWI. The ADC in cancerous lesions was 1.31±0.27 x 10 -3 mm 2 /s, which was significantly lower than that of the lumens of the ureter or renal pelvis (3.32±0.44 x 10 -3 mm 2 /s; P<0.001). Maximum intensity projection images of DWI in combination with static-fluid MR urography provided three-dimensional entire urinary tract imaging with the extension of tumors. Conclusion: DWI is useful in the tumor detection and in evaluating the tumor extension of urinary epithelial cancer in patients with upper urinary tract obstruction

Patients with Urinary Incontinence Appear More Likely to Develop Upper Urinary Tract Stones: A Nationwide, Population-Based Study with 8-Year Follow-Up

Science.gov (United States)

Chung, Hsiao-Jen; Lin, Alex Tong-Long; Lin, Chih-Chieh; Chen, Tzeng-Ji; Chen, Kuang-Kuo

2016-01-01

This study aimed to investigate associations between primary urinary incontinence and development of upper urinary tract stones in a nationwide population in Taiwan. Data of 1,777 adults with primary urinary incontinence and 26,655 controls (groups A, B, and C) without urinary incontinence at study inception were retrieved from the National Health Insurance System database in Taiwan and were analyzed retrospectively. No enrolled subjects had previous diagnosis of upper urinary tract stones or spinal cord injury. All subjects were followed through end of 2009, with a minimum follow-up of 8 years. A greater percentage of study subjects (334/1777, 18.8%) developed upper urinary tract stones than that of control groups A (865/8885, 9.7%) and B (888/8885, 10%), and C (930/8885, 10.5%) (all p-values Urinary incontinence was associated with significantly increased risk of developing urinary tract stones (HR 1.99, 95% CI, 1.70–2.34, p urinary tract stones (both p-values urinary incontinence was still associated with a significantly increased risk of developing upper urinary tract stones (HR 1.99, 95% CI = 1.76–2.26, p urinary incontinence suggests that urinary incontinence is associated with a significantly increased risk of developing upper urinary tract stones. Study findings suggest that physicians treating patients with urinary incontinence should give attention to early detection of upper urinary tract stones. PMID:27536881

Patients with Urinary Incontinence Appear More Likely to Develop Upper Urinary Tract Stones: A Nationwide, Population-Based Study with 8-Year Follow-Up.

Science.gov (United States)

Chung, Hsiao-Jen; Lin, Alex Tong-Long; Lin, Chih-Chieh; Chen, Tzeng-Ji; Chen, Kuang-Kuo

2016-01-01

This study aimed to investigate associations between primary urinary incontinence and development of upper urinary tract stones in a nationwide population in Taiwan. Data of 1,777 adults with primary urinary incontinence and 26,655 controls (groups A, B, and C) without urinary incontinence at study inception were retrieved from the National Health Insurance System database in Taiwan and were analyzed retrospectively. No enrolled subjects had previous diagnosis of upper urinary tract stones or spinal cord injury. All subjects were followed through end of 2009, with a minimum follow-up of 8 years. A greater percentage of study subjects (334/1777, 18.8%) developed upper urinary tract stones than that of control groups A (865/8885, 9.7%) and B (888/8885, 10%), and C (930/8885, 10.5%) (all p-values Urinary incontinence was associated with significantly increased risk of developing urinary tract stones (HR 1.99, 95% CI, 1.70-2.34, p urinary tract stones (both p-values urinary incontinence was still associated with a significantly increased risk of developing upper urinary tract stones (HR 1.99, 95% CI = 1.76-2.26, p urinary incontinence suggests that urinary incontinence is associated with a significantly increased risk of developing upper urinary tract stones. Study findings suggest that physicians treating patients with urinary incontinence should give attention to early detection of upper urinary tract stones.

Changes in alcohol intake and risk of upper digestive tract cancer

DEFF Research Database (Denmark)

Thygesen, Lau C; Keiding, Niels; Johansen, Christoffer

2007-01-01

of these cancers. MATERIAL AND METHODS: In the Copenhagen City Heart Study we assessed alcohol intake among 4 896 men and 6 239 women who participated at both the first (1976-1978) and second (1981-1983) examination of the study. Alcohol intake changes on risk of upper digestive tract cancer 1981-2002 were...

Local Acetaldehyde—An Essential Role in Alcohol-Related Upper Gastrointestinal Tract Carcinogenesis

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Mikko T. Nieminen

2018-01-01

Full Text Available The resident microbiome plays a key role in exposure of the upper gastrointestinal (GI tract mucosa to acetaldehyde (ACH, a carcinogenic metabolite of ethanol. Poor oral health is a significant risk factor for oral and esophageal carcinogenesis and is characterized by a dysbiotic microbiome. Dysbiosis leads to increased growth of opportunistic pathogens (such as Candida yeasts and may cause an up to 100% increase in the local ACH production, which is further modified by organ-specific expression and gene polymorphisms of ethanol-metabolizing and ACH-metabolizing enzymes. A point mutation in the aldehyde dehydrogenase 2 gene has randomized millions of alcohol consumers to markedly increased local ACH exposure via saliva and gastric juice, which is associated with a manifold risk for upper GI tract cancers. This human cancer model proves conclusively the causal relationship between ACH and upper GI tract carcinogenesis and provides novel possibilities for the quantitative assessment of ACH carcinogenicity in the human oropharynx. ACH formed from ethanol present in “non-alcoholic” beverages, fermented food, or added during food preparation forms a significant epidemiologic bias in cancer epidemiology. The same also concerns “free” ACH present in mutagenic concentrations in multiple beverages and foodstuffs. Local exposure to ACH is cumulative and can be reduced markedly both at the population and individual level. At best, a person would never consume tobacco, alcohol, or both. However, even smoking cessation and moderation of alcohol consumption are associated with a marked decrease in local ACH exposure and cancer risk, especially among established risk groups.

Effect of formaldehyde on the upper respiratory tract _ormal flora of ...

African Journals Online (AJOL)

Background: Formaldehyde is a chemical that is used to fix a tissue after death or removal from the body to prevent autolysis and putrefaction. Exposure to formaldehyde can occur as a result of occupation. Objective: To determine the effect of the formaldehyde on the throat and nasal flora of upper respiratory tract of rabbits ...

Factors influencing the development of otitis media among Sicilian children affected by upper respiratory tract infections.

Science.gov (United States)

Martines, Francesco; Salvago, Pietro; Ferrara, Sergio; Messina, Giuseppe; Mucia, Marianna; Plescia, Fulvio; Sireci, Federico

2016-01-01

Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Environmental, epidemiologic and familial risk factors for otitis media (such as sex, socioeconomic and educational factors, smoke exposure, allergy or duration of breastfeeding) have been previously reported, but actually no data about their diffusion among Sicilian children with upper respiratory tract infections are available. To investigate the main risk factors for otitis media and their prevalence in Sicilian children with and without upper respiratory tract infections. A case-control study of 204 children with upper respiratory tract infections who developed otitis media during a 3 weeks monitoring period and 204 age and sex-matched healthy controls. Seventeen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis and multivariate logistic regression analysis were used to examine the association between risk factors and occurrence of otitis media. Otitis media resulted strongly associated to large families, low parental educational attainment, schooling within the third years of life (potitis media in the presence of asthma, cough, laryngopharyngeal reflux disease, snoring and apnea (potitis media in children exposed to smoke respectively of 166% and 277% (potitis media are common childhood diseases strongly associated with low parental educational attainment (p=0.0001), exposure to smoke (p=0.0001), indoor exposure to mold (p=0.0001), laryngopharyngeal reflux disease (p=0.0002) and the lack of breast-feeding (p=0.0014); an increased risk of otitis media recurrences was observed in the presence of allergy, persistent cough and runny nose (p=0

Increasing dwell time of mitomycin C in the upper tract with a reverse thermosensitive polymer.

Science.gov (United States)

Wang, Agnes J; Goldsmith, Zachariah G; Neisius, Andreas; Astroza, Gaston M; Oredein-McCoy, Olugbemisola; Iqbal, Muhammad W; Simmons, W Neal; Madden, John F; Preminger, Glenn M; Inman, Brant A; Lipkin, Michael E; Ferrandino, Michael N

2013-03-01

Abstract Background and Purpose: Topical chemotherapy for urothelial cancer is dependent on adequate contact time of the chemotherapeutic agent with the urothelium. To date, there has not been a reliable method of maintaining this contact for renal or ureteral urothelial carcinoma. We evaluated the safety and feasibility of using a reverse thermosensitive polymer to improve dwell times of mitomycin C (MMC) in the upper tract. Using a porcine model, four animals were treated ureteroscopically with both upper urinary tracts receiving MMC mixed with iodinated contrast. One additional animal received MMC percutaneously. The treatment side had ureteral outflow blocked with a reverse thermosensitive polymer plug. MMC dwell time was monitored fluoroscopically and intrarenal pressures measured. Two animals were euthanized immediately, and three animals were euthanized 5 days afterward. In control kidneys, drainage occurred at a mean of 5.3±0.58 minutes. Intrarenal pressures stayed fairly stable: 9.7±14.0 cm H20. In treatment kidneys, dwell time was extended to 60 minutes, when the polymer was washed out. Intrarenal pressures in the treatment kidneys peaked at 75.0±14.7 cm H20 and reached steady state at 60 cm H20. Pressures normalized after washout of the polymer with cool saline. Average washout time was 11.8±9.6 minutes. No histopathologic differences were seen between the control and treatment kidneys, or with immediate compared with delayed euthanasia. A reverse thermosensitive polymer can retain MMC in the upper urinary tract and appears to be safe from our examination of intrarenal pressures and histopathology. This technique may improve the efficacy of topical chemotherapy in the management of upper tract urothelial carcinoma.

Hypercalcemia in Upper Urinary Tract Urothelial Carcinoma: A Case Report and Literature Review

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Keiko Asao

2013-01-01

Full Text Available Objective. We here report a patient with upper urinary tract urothelial carcinoma with hypercalcemia likely due to elevated 1,25-dihydroxyvitamin D. Methods. We present a clinical case and a summary of literature search. Results. A 57-year-old man, recently diagnosed with a left renal mass, for which a core biopsy showed renal cell carcinoma, was admitted for hypercalcemia of 11.0 mg/mL He also had five small right lung nodules with a negative bone scan. Both intact parathyroid hormone and parathyroid hormone-related peptide were appropriately low, and 1,25-dihydroxyvitamin D was elevated at 118 pg/dL. The patient’s calcium was normalized after hydration, and he underwent radical nephrectomy. On the postoperative day 6, a repeat 1,25-dihydroxyvitamin D was 24 pg/mL with a calcium of 8.1 mg/dL. Pathology showed a 6 cm high-grade urothelial carcinoma with divergent differentiation. We identified a total of 27 previously reported cases with hypercalcemia and upper tract urothelial carcinoma in English. No cases have a documented elevated 1,25-dihydroxyvitamin D level. Conclusion. This clinical course suggests that hypercalcemia in this case is from the patient’s tumor, which was likely producing 1,25-dihydroxyvitamin D. Considering the therapeutic implications, hypercalcemia in patients with upper urinary tract urothelial carcinoma should be evaluated with 1,25-dihydroxyvitamin D.

Absorbed dose to the skin in radiological examinations of upper and lower gastrointestinal tract

International Nuclear Information System (INIS)

Zonca, G.; Brusa, A.; Somigliana, A.; Pasqualotto, C.; Sichirollo, A.E.; Bellomi, M.; Cozzi, G.; Severini, A.

1995-01-01

Absorbed doses to the skin in radiological examinations of the upper and lower gastronintestinal tract in conventional and digital radiology are evaluated and compared. Absorbed doses were measured with LiF thermoluminescence dosemeters placed on the lower pelvis, umbilicus and forehead of the patient to evaluate the absorbed dose in and outside the primary beam. On 10 patients a reduction in absorbed dose of about 34% for double contrast barium enema and of 66% for upper gastrointestinal tract examinations was revealed with digital radiography equipment. In our working conditions the lower dose requirement for digital radiography is mainly due to image intensifiers and television chains and also, due to our equipment settings, to the dose reduction with digital spot fluorography compared with conventional spot film radiography. (Author)

Outcomes of surgical treatment for upper urinary tract transitional cell carcinoma: Comparison of retroperitoneoscopic and open nephroureterectomy

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Sujijantararat Phichaya

2008-01-01

Full Text Available Abstract Objectives To determine the surgical and oncologic outcomes in patients who underwent retroperitoneoscopic nephroureterectomy (RNU in comparison to standard open nephroureterectomy (ONU for upper urinary tract transitional cell carcinoma (TCC. Patients and methods From April 2001 to January 2007, 60 total nephroureterectomy were performed for upper tract TCC at Siriraj Hospital. Of the 60 patients, thirty-one were treated with RNU and open bladder cuff excision, and twenty-nine with ONU. Our data were reviewed and analyzed retrospectively. The recorded data included sex, age, history of bladder cancer, type of surgery, tumor characteristics, postoperative course, disease recurrence and progression. Results The mean operative time was longer in the RNU group than in the ONU group (258.8 versus 190.6 min; p = 0. Conclusion Retroperitoneoscopic nephroureterectomy is less invasive than open surgery and is an oncological feasible operation. Thus, the results of our study supported the continued development of laparoscopic technique in the management of upper tract TCC.

Fatal respiratory distress syndrome due to coronavirus infection in a child with severe combined immunodeficiency

OpenAIRE

Szczawinska‐Poplonyk, Aleksandra; Jonczyk‐Potoczna, Katarzyna; Breborowicz, Anna; Bartkowska‐Sniatkowska, Alicja; Figlerowicz, Magdalena

2012-01-01

Please cite this paper as: Szczawinska‐Poplonyk et al. (2012) Fatal respiratory distress syndrome due to coronavirus infection in a child with severe combined immunodeficiency. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12059. Coronaviruses have been demonstrated to contribute substantially to respiratory tract infections among the child population. Though infected children commonly present mild upper airway symptoms, in high‐risk patients with underlying conditions, particularl...

Clinicopathological characteristics of patients with upper urinary tract urothelial cancer with loss of immunohistochemical expression of the DNA mismatch repair proteins in universal screening.

Science.gov (United States)

Urakami, Shinji; Inoshita, Naoko; Oka, Suguru; Miyama, Yu; Nomura, Sachio; Arai, Masami; Sakaguchi, Kazushige; Kurosawa, Kazuhiro; Okaneya, Toshikazu

2018-02-01

To assess the detection rate of putative Lynch syndrome-associated upper urinary tract urothelial cancer among all upper urinary tract urothelial cancers and to examine its clinicopathological characteristics. A total of 143 patients with upper urinary tract urothelial cancer who had received total nephroureterectomy were immunohistochemically stained for the expression of mismatch repair proteins MLH1, PMS2, MSH2 and MSH6. For all suspected mismatch repair-deficient cases, MMR genetic testing was recommended and clinicopathological features were examined. Loss of mismatch repair proteins was found in seven patients (5%) who were thus categorized as putative Lynch syndrome-associated upper urinary tract urothelial cancer. Five of these patients showed dual loss of MSH2/MSH6. Two patients were confirmed to be MSH2 germline mutation carriers. Histologically, all seven tumors were low-grade atypical urothelial carcinoma and showed its unique histological features, such as an inverted papilloma-like growth pattern and a villous to papillary structure with mild stratification of tumor cells. Six tumors had no invasion of the muscularis propria. No recurrence or cancer-related deaths were reported in these seven patients. Just three patients met the revised Amsterdam criteria. This is the first report that universally examined mismatch repair immunohistochemical screening for upper urinary tract urothelial cancers. The prevalence (5%) of putative Lynch syndrome-associated upper urinary tract urothelial cancers is much higher than we had expected. We ascertained that putative Lynch syndrome-associated upper urinary tract urothelial cancers were clinically in the early stage and histologically classified into low-grade malignancy with its characteristic pathological features. The clinicopathological characteristics that we found in the present study could become additional possible markers in the diagnosis of Lynch syndrome-associated upper urinary tract urothelial cancers

Carriage of Mycoplasma pneumoniae in the Upper Respiratory Tract of Symptomatic and Asymptomatic Children : An Observational Study

NARCIS (Netherlands)

Spuesens, Emiel B. M.; Fraaij, Pieter L. A.; Visser, Eline G.; Hoogenboezem, Theo; Hop, Wim C. J.; van Adrichem, Leon N. A.; Weber, Frank; Moll, Henriette A.; Broekman, Berth; Berger, Marjolein Y.; van Rijsoort-Vos, Tineke; van Belkum, Alex; Schutten, Martin; Pas, Suzan D.; Osterhaus, Albert D. M. E.; Hartwig, Nico G.; Vink, Cornelis; van Rossum, Annemarie M. C.

Background: Mycoplasma pneumoniae is thought to be a common cause of respiratory tract infections (RTIs) in children. The diagnosis of M. pneumoniae RTIs currently relies on serological methods and/or the detection of bacterial DNA in the upper respiratory tract (URT). It is conceivable, however,

[Analysis of development, safety and efficacy of percutaneous nephrolithotomy for management of upper urinary tract calculi in pediatric patients].

Science.gov (United States)

Yu, L P; Xu, T

2017-08-18

To evaluate the development, safety and efficacy of percutaneous nephrolithotomy(PNL) for management of upper urinary tract calculi in pediatric patients. In the study, 77 pediatric patients undergoing 87 PNLs through mini or standard tract for upper urinary tract calculi between January 2005 and December 2016 in Peking University People's hospital were reviewed, including 69 renal calculi, 6 upper ureteral calculi, 12 renal and upper ureteral calculi, 35 single calculi, 43 multiple calculi and 9 staghorn calculi. The development and efficacy of PNL in pediatric patients were studied by analyzing the characteristics and clinical indexes, and by reviewing the associated literature. The Clavien classification system was used to evaluate the complications after PNL. A total of 87 PNLs were performed in 77 pediatric patients. Eighty-one upper urinary tract calculi were managed through a single tract(93.1%), 5 pediatric patients were managed through 2 tracts(5.7%), and 1 pediatric patient was managed through 3 tracts(1.2%). The mean operating time was (77.0±29.8) min. The stone-free rate after one session was 100% for single calculi and 71.2% for multiple or staghorn calculi, 5(5.8%) children underwent auxiliary procedure to remove the residual calculi and the final stone-free rate of PNL was 88.5%. One of the main complications of pediatric PNL was fever. Sixteen (18.4%) had moderate fever(38-39 °C), 5 (5.7%) had high fever (39-40 °C) and there were no severe complications of infection, such as sepsis or septic shock. The mean hemoglobin loss was (10.3±16.1) g/L and the serum creatinine rise was (7.0±13.3) μmol/L. One(1.2%) pediatric patient suffered ureteroscopic lithotripsy because of the obstruction by the residual stone in ureter. No injury of organs or retroperitoneal urinary extravasation occurred. General assessment of the complications showed Clavien grade I complications in 14 (16.1%) pediatric patients, grade II in 7(8.0%) children and grade III in 1

Method of X-ray examination of upper respiratory tracts

International Nuclear Information System (INIS)

Portnoj, L.M.; Surenchik, V.I.; Shuster, M.A.; Sal'nikova, Eh.A.

1982-01-01

Method of X-ray examination of upper respiratory tracts by radiography both in direct and lateral projection with an introduction of radiocontrast media through tracheostoma is described. The main objective of the invention is to improve accuracy of diagnostics of larynx and trachea cicatrix structures in children. The objective is attained by the examination under general anesthesia; barium sulfate is simultaneously introduced through laryngoscope and tracheostoma, and polypositional radiography is accomplished just in the moment of air introduction under 130-170 mm Hg pressure in the amounts of 60-200 ml

Alcohol dehydrogenase 3 genotype as a risk factor for upper aerodigestive tract cancers

DEFF Research Database (Denmark)

Nishimoto, Inês Nobuko; Pinheiro, Nidia A; Rogatto, Silvia R

2004-01-01

OBJECTIVE: To assess alcohol dehydrogenase 3 (ADH3) polymorphism at position Ile349Val as indicator of risk factor for upper aerodigestive tract (UADT) cancer to verify its association with UADT cancer in nonalcoholic or nonsmoking individuals. DESIGN: Cross-sectional study. SETTING: Primary care...

Tumor, serum and urine carcinoembryonic antigen (CEA) in upper urinary tract urothelial cancer

International Nuclear Information System (INIS)

Stefanovic, V.; Ignjatovic, M.

1987-01-01

The aim of this investigation was to study the possible diagnostic value of a CEA test in cancer of the renal pelvis and ureter. Thirty-eight patients with upper urinary tract cancer, 15 patients with transitional cell carcinoma of the bladder, 6 kidney carcinoma patients and 25 healthy adults were studied. CEA was determined in tumor tissue, serum and urine, by using a monoclonal radioimmunoassay. Increased serum CEA level was found in 7 out of 27 patients (26%) with active cancer of the renal pelvis and ureter. None of 11 patients with inactive cancer had an increased serum CEA level. No significant correlation was found between the serum CEA level and the histological grading. The tumor CEA content varied markedly, from values obtainted in normal urothelium up to 840 ng/g wet weight. CEA content of tumor tissue did not correlate with the serum level. Our data suggest that serum and urine CEA have not diagnostic accuracy for clinical diagnosis of upper tract urothelial cancer. (orig.) [de

Indications for ureteropyeloscopy based on radiographic findings and urine cytology in detection of upper urinary tract carcinoma

International Nuclear Information System (INIS)

Takao, Akira; Saika, Takashi; Uehara, Shinya; Monden, Koichi; Abarzua, F.; Nasu, Yasutomo; Kumon, Hiromi

2010-01-01

The objective of this study was to verify the indication of diagnostic ureteropyeloscopy based on clinical features for upper urinary tract urothelial cancer with over 100 patients and over a 10-year series. From January 1997 to December 2008, consecutive 129 units in 124 patients underwent ureteropyeloscopy to obtain a definitive diagnosis of upper urinary tract cancer or to rule out a malignancy. Patients were divided into four subgroups based on voided urine cytology and preoperative radiographic findings: group A (n=8), positive urine cytology and positive radiographic findings; group B (n=4), positive cytology and negative radiographic findings; group C (n=55), negative cytology and positive radiographic findings and group D (n=62), gross hematuria originating from the upper urinary tract with negative cytology and negative radiographic findings. Ureteropyeloscopic findings were compared with radiographic and cytological results. Adverse effects were also investigated. In group A, all patients had confirmed cancer. In group B, one revealed small cancer and the remaining three confirmed carcinoma in situ by biopsy with ureteropyeloscopy. In groups C and D, 33 patients (60%) and four (6.5%) revealed cancer. Seventy-eight patients out of 80 (97.5%) in groups C and D were confirmed to have benign disease. No patient was found with malignancy during follow up after negative finding of ureteropyeloscopy. Ureteropyeloscopy can help in detecting upper urinary tract cancer or to rule out malignancy for patients with negative voiding cytology. However, ureteropyeloscopy is redundant for patients with positive radiographic findings and positive voiding cytology. (author)

Increased risks of upper tract urothelial carcinoma in male and female chinese herbalists.

Science.gov (United States)

Yang, Hsiao-Yu; Wang, Jung-Der; Lo, Tsai-Chang; Chen, Pau-Chung

2011-03-01

It has been shown that herbs that contain aristolochic acid induce urological cancer. Chinese herbalists have easy access to such herbs. Our previous mortality study has shown a significantly increased risk of urological cancer in female but not male herbalists. To re-examine this risk in male herbalists, the incidence of urological cancer was analyzed. We enrolled all 6550 Chinese herbalists in Taiwan registered during 1985-2000, and we retrospectively followed the development of cancer until 2001 by analysis of data collected from the Taiwan Cancer Registry. Standardized incidence ratios (SIRs) were calculated for urological cancers in herbalists and compared with those for the general population in Taiwan. There were 30 newly diagnosed cases of urological cancer and most of them were transitional cell carcinoma (93.1%). The mean age at diagnosis for urothelial carcinoma was 51.6 years, and 51.9% were in the upper urinary tract. After adjustment for age and sex, the SIR for all urological cancers was 3.51 [(95% confidence interval (CI): 2.37-5.01]. When stratified by location, the SIRs for kidney and upper urinary tract cancers and bladder cancer were 4.24 (95% CI: 2.47-6.80) and 2.86 (95% CI: 1.52-4.89), respectively. When analyzed by sex, the SIRs for all urological cancers, kidney and upper urinary tract cancers, and bladder cancer were also significantly increased in male herbalists. The significant risk of urothelial carcinoma noted in male herbalists increases our suspicion that this is an occupational disease that renders regular health assessment of herbalists an urgent necessity. Copyright © 2011 Formosan Medical Association & Elsevier. Published by Elsevier B.V. All rights reserved.

Aftereffect of radiotherapy of upper aero-digestive tracts in odontological care

International Nuclear Information System (INIS)

Schiochet, Luc

2010-01-01

In its first part, this thesis proposes a detailed presentation of the upper aero-digestive tract cancer. The author defines the cancerous process, describes anatomic aspects, and discusses epidemiological aspects (occurrence, mortality, survival, and epidemiological data in different countries). In the second part, the author discusses the role of radiotherapy and of dental surgery in taking a cancerous patient into care (general principles of radiotherapy, therapeutic options and choices, association of radiotherapy, chemotherapy and surgery). Principles of radiotherapy are then more precisely addressed: physical principles (X rays, gamma rays, electrons, neutrons, and protons), radioactivity doses, radiotherapy effect, main equipment, radiotherapy techniques (conformational or intensity-modulated radiotherapy, computed tomography, Cyberknife, external radiotherapy, brachytherapy). The third part addresses early oral-facial complications induced by radiotherapy: factors favouring these complications, nervous effects, effects on the blood system and on the skin, hyposialia and xerostomia, radio-induced mucositis of upper aero-digestive tracts. The next part addresses late effects: late cutaneous after-effects, late radio-mucositis, limitation of mouth opening, tooth decays, osteoradionecrosis. The last part addresses the role of the dental surgeon in taking into care a patient whose head and neck have been irradiated: role before irradiation, during irradiation, and after irradiation [fr

Effect of High-Dose vs Standard-Dose Wintertime Vitamin D Supplementation on Viral Upper Respiratory Tract Infections in Young Healthy Children.

Science.gov (United States)

Aglipay, Mary; Birken, Catherine S; Parkin, Patricia C; Loeb, Mark B; Thorpe, Kevin; Chen, Yang; Laupacis, Andreas; Mamdani, Muhammad; Macarthur, Colin; Hoch, Jeffrey S; Mazzulli, Tony; Maguire, Jonathon L

2017-07-18

Epidemiological studies support a link between low 25-hydroxyvitamin D levels and a higher risk of viral upper respiratory tract infections. However, whether winter supplementation of vitamin D reduces the risk among children is unknown. To determine whether high-dose vs standard-dose vitamin D supplementation reduces the incidence of wintertime upper respiratory tract infections in young children. A randomized clinical trial was conducted during the winter months between September 13, 2011, and June 30, 2015, among children aged 1 through 5 years enrolled in TARGet Kids!, a multisite primary care practice-based research network in Toronto, Ontario, Canada. Three hundred forty-nine participants were randomized to receive 2000 IU/d of vitamin D oral supplementation (high-dose group) vs 354 participants who were randomized to receive 400 IU/d (standard-dose group) for a minimum of 4 months between September and May. The primary outcome was the number of laboratory-confirmed viral upper respiratory tract infections based on parent-collected nasal swabs over the winter months. Secondary outcomes included the number of influenza infections, noninfluenza infections, parent-reported upper respiratory tract illnesses, time to first upper respiratory tract infection, and serum 25-hydroxyvitamin D levels at study termination. Among 703 participants who were randomized (mean age, 2.7 years, 57.7% boys), 699 (99.4%) completed the trial. The mean number of laboratory-confirmed upper respiratory tract infections per child was 1.05 (95% CI, 0.91-1.19) for the high-dose group and 1.03 (95% CI, 0.90-1.16) for the standard-dose group, for a between-group difference of 0.02 (95% CI, -0.17 to 0.21) per child. There was no statistically significant difference in number of laboratory-confirmed infections between groups (incidence rate ratio [RR], 0.97; 95% CI, 0.80-1.16). There was also no significant difference in the median time to the first laboratory-confirmed infection: 3.95 months

Colonization of the lower urogenital tract with Ureaplasma parvum can cause asymptomatic infection of the upper reproductive system in women: a preliminary study.

Science.gov (United States)

Kasprzykowska, Urszula; Elias, Joanna; Elias, Marek; Mączyńska, Beata; Sobieszczańska, Beata Magdalena

2014-05-01

Genital ureaplasmas are considered opportunistic pathogens of human genitourinary tract involved in adverse pregnancy sequelae and infertility. While association of Ureaplasma urealyticum with urogenital tract infections is well established, the role of Ureaplasma parvum in these infections is still insufficient. In the study, we compared how often cervicovaginal colonization with U. parvum is associated with the presence of these microorganisms in the upper genitourinary tract of fertile and infertile women. We used PCR assay to determine the prevalence of U. parvum and U. urealyticum in pairs of specimens, i.e., vaginal swabs and Douglas' pouch fluid samples from consecutive 40 women with no symptoms of genital tract infection. In total, 19 (47.5 %) of the 40 samples were positive for ureaplasmas. U. parvum was simultaneously detected in pairs of samples in five (55.5 %) of the nine (47.4 %) women positive in PCR assay. As many as 5 (18.5 %) of the 27 infertile women and 1 (7.7 %) of the 13 fertile women showed infection of the upper genital tract with U. parvum. The results of the study demonstrated that colonization of the lower genital tract with U. parvum can produce asymptomatic infection of the upper reproductive system in women. These findings also imply that U. parvum may be present in the upper genital tract at the time of conception and might be involved in adverse pregnancy outcomes.

Concurrent Preoperative Presence of Hydronephrosis and Flank Pain Independently Predicts Worse Outcome of Upper Tract Urothelial Carcinoma.

Science.gov (United States)

Yeh, Hsin-Chih; Jan, Hau-Chern; Wu, Wen-Jeng; Li, Ching-Chia; Li, Wei-Ming; Ke, Hung-Lung; Huang, Shu-Pin; Liu, Chia-Chu; Lee, Yung-Chin; Yang, Sheau-Fang; Liang, Peir-In; Huang, Chun-Nung

2015-01-01

To investigate the impact of preoperative hydronephrosis and flank pain on prognosis of patients with upper tract urothelial carcinoma. In total, 472 patients with upper tract urothelial carcinoma managed by radical nephroureterectomy were included from Kaohsiung Medical University Hospital Healthcare System. Clinicopathological data were collected retrospectively for analysis. The significance of hydronephrosis, especially when combined with flank pain, and other relevant factors on overall and cancer-specific survival were evaluated. Of the 472 patients, 292 (62%) had preoperative hydronephrosis and 121 (26%) presented with flank pain. Preoperative hydronephrosis was significantly associated with age, hematuria, flank pain, tumor location, and pathological tumor stage. Concurrent presence of hydronephrosis and flank pain was a significant predictor of non-organ-confined disease (multivariate-adjusted hazard ratio = 2.10, P = 0.025). Kaplan-Meier analysis showed significantly poorer overall and cancer-specific survival in patients with preoperative hydronephrosis (P = 0.005 and P = 0.026, respectively) and in patients with flank pain (P hydronephrosis and flank pain independently predicted adverse outcome (hazard ratio = 1.98, P = 0.016 for overall survival and hazard ratio = 1.87, P = 0.036 for and cancer-specific survival, respectively) in multivariate Cox proportional hazards models. In addition, concurrent presence of hydronephrosis and flank pain was also significantly predictive of worse survival in patient with high grade or muscle-invasive disease. Notably, there was no difference in survival between patients with hydronephrosis but devoid of flank pain and those without hydronephrosis. Concurrent preoperative presence of hydronephrosis and flank pain predicted non-organ-confined status of upper tract urothelial carcinoma. When accompanied with flank pain, hydronephrosis represented an independent predictor for worse outcome in patients with upper tract

Impact of smoking on the age at diagnosis of upper tract urothelial carcinoma: Subanalysis of the Japanese Urological Association multi-institutional national database.

Science.gov (United States)

Miyazaki, Jun; Nishiyama, Hiroyuki; Fujimoto, Hiroyuki; Ohyama, Chikara; Koie, Takuya; Hinotsu, Shiro; Kikuchi, Eiji; Sakura, Mizuaki; Inokuchi, Junichi; Hara, Tomohiko

2015-11-01

To examine the influence of smoking history on the diagnosis and other tumor characteristics of upper tract urothelial carcinoma in Japan. A total of 1509 patients with upper tract urothelial carcinoma who were diagnosed in 2005 from 348 Japanese institutions were registered using the multi-institutional national database of the Japanese Urological Association and included in this analysis. Clinical data of the patients were collected in 2011. The associations between the patients' self-reported smoking history and their age at the diagnosis of upper tract urothelial carcinoma, sex, pathological T stage and tumor grade were analyzed. The mean age at the diagnosis of upper tract urothelial carcinoma was approximately 5 years earlier for the 238 current smokers than for the 618 current non-smokers (P smokers, the age at diagnosis for the smoking ≥ 20 cigarettes per day group was 6.5 years lower than that of the perspective of both healthcare and medical economies. © 2015 The Japanese Urological Association.

Comparison of computed tomographic urography, magnetic resonance urography and the combination of diffusion weighted imaging in diagnosis of upper urinary tract cancer

Energy Technology Data Exchange (ETDEWEB)

Wu, Guang-yu; Lu, Qing; Wu, Lian-ming [Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630, Dongfang Road, Pudong, Shanghai 200120 (China); Zhang, Jin [Department of Urinary Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630, Dongfang Road, Pudong, Shanghai 200120 (China); Chen, Xiao-xi [Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630, Dongfang Road, Pudong, Shanghai 200120 (China); Xu, Jian-rong, E-mail: renjixujr@163.com [Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630, Dongfang Road, Pudong, Shanghai 200120 (China)

2014-06-15

Purpose: To evaluate the performance of computed tomographic urography (CTU), static-fluid magnetic resonance urography (static-fluid MRU) and combinations of CTU, static-fluid MRU and diffusion weighted imaging (DWI) in the diagnosis of upper urinary tract cancer. Material and Methods: Between January 2010 and June 2011, patients with suspected UUT cancer underwent CTU, static-fluid MRU and DWI (b = 1000 s/mm{sup 2}) within a 1-week period. The diagnostic performances of CTU, static-fluid MRU and combinations of CTU, static-fluid MRU and DWI for upper urinary tract cancer were prospectively evaluated. The ureteroscopic and histopathologic findings were compared with the imaging findings. Results: Compared to static-fluid MRU alone (sensitivity: 76/75%, reader 1/reader 2), combining DWI with MRI can increase the sensitivity (sensitivity: 84/84%, p = 0.031/p = 0.016) of upper urinary tract cancer diagnosis. CTU had greater sensitivity (95/94%) and accuracy (92/91%) than both static-fluid MRU (sensitivity: p < 0.001/p < 0.001 and accuracy: 83/81%, p = 0.001/p < 0.001) and static-fluid MRU with DWI (sensitivity: p = 0.023/p = 0.039 and accuracy: 87/85%, p = 0.042/p = 0.049) for the diagnosis of upper urinary tract cancers. Compared with CTU alone, CTU with DWI did not significantly increase sensitivity, specificity or accuracy. However, the diagnostic confidence was improved when the combined technique was used (p = 0.031/p = 0.024). Moreover, there was no significant change in sensitivity, specificity, accuracy or diagnostic confidence when static-fluid MRU was used in combination with CTU and DWI. Conclusion: Although there is a potential role for static-fluid MRU and static-fluid MRU with DWI in urinary tract imaging, CTU is still the better choice for the diagnosis of upper urinary tract cancer. Combining DWI with CTU can help improve confidence in upper urinary tract cancer diagnoses.

Additional Value of Upper GI Tract Endoscopy in the Diagnostic Assessment of Childhood IBD

NARCIS (Netherlands)

Hummel, Thalia Z.; ten Kate, Fiebo J. W.; Reitsma, Johannes B.; Benninga, Marc A.; Kindermann, Angelika

2012-01-01

Objectives: For the choice of treatment in children with inflammatory bowel disease (IBD), it is important to make a distinction between Crohn disease (CD) and ulcerative colitis (UC). To look for pathognomonic features of CD, upper gastrointestinal tract (UGT) endoscopy has become part of the

Transcatheter arterial embolization for upper gastrointestinal tract bleeding.

Science.gov (United States)

Širvinskas, Audrius; Smolskas, Edgaras; Mikelis, Kipras; Brimienė, Vilma; Brimas, Gintautas

2017-12-01

Transcatheter arterial embolization is a possible treatment for patients with recurrent bleeding from the upper gastrointestinal tract after failed endoscopic management and is also an alternative to surgical treatment. To analyze the outcomes of transcatheter arterial embolization and identify the clinical and technical factors that influenced the rates of morbidity and mortality. A retrospective analysis was carried out, based on the data of 36 patients who underwent transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding in 2013 to 2015 in our center. An analysis was performed between early rebleeding rates, mortality and the following factors: patient sex, age, number of units of packed red blood cells and packed plasma administered to the patients, length of hospital stay, therapeutic or prophylactic embolization. The technical success rate of the embolization procedure was 100%. There were 15 (41.70%) therapeutic embolizations and 21 (58.3%) prophylactic embolizations. There was a 77.8% clinical success rate. Following embolization, 10 (27.80%) patients had repeated bleeding and 9 (25.0%) patients died. Significant associations were found between rebleeding and prophylactic embolization (OR = 10.53; p = 0.04) and between mortality and prophylactic embolization (OR = 10.53; p = 0.04) and units of packed red blood cells (OR = 1.25; p < 0.01). In our experience, transcatheter arterial embolization is a safe treatment method for acute nonvariceal upper gastrointestinal bleeding and a possible alternative to surgery for high-risk patients.

The associations of humorous coping styles, affective states, job demands and job control with the frequency of upper respiratory tract infection

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Sibe Doosje

2011-05-01

Research purpose: The purpose of this study was to test a model including these variables as well as job-related affect, in order to explore their role in the explanation of the frequency of upper respiratory tract infection. Motivation of the study: This study has been conducted in order to extend our understanding of the role of traditional variables like job demands and job control with humorous coping styles and affective variables with regard to the explanation of the frequency of URTI. Research design, approach and method: A sample of 2094 employees filled out questionnaires assessing job demands, job control, generic (MSHS-C, antecedent-focused and responsefocused humorous coping (QOHC and job-related affect (JAWS. Main findings: Job demands were indirectly related to the frequency of upper respiratory tract infections, mediated by their relationships with job control and negative job-related affect. Generic and response-focused humorous coping were less relevant for the explanation of the frequency of upper respiratory tract infections than the presumably ‘healthy’ antecedentfocused humorous coping style. The latter showed a negative association with negative jobrelated affect. The frequency of upper respiratory tract infections was better predicted by job control and negative job-related affect than by humorous coping, in the expected directions. Practical/managerial implication: These findings may have practical relevance for the improvement of stress management interventions in organisations. Contribution/value-add: Although it was shown that healthy humorous coping does contribute to decreases in upper respiratory tract infection, job demands, job resources and negative affective state seem the most important predictors.

Socioeconomic factors associated with risk of upper aerodigestive tract cancer in Europe.

LENUS (Irish Health Repository)

Conway, D I

2010-02-01

In the European Union, there are 180,000 new cases of upper aerodigestive tract (UADT) cancer cases per year--more than half of whom will die of the disease. Socioeconomic inequalities in UADT cancer incidence are recognised across Europe. We aimed to assess the components of socioeconomic risk both independently and through their influence on the known behavioural risk factors of smoking, alcohol consumption and diet.

The peculiarities of combined pathology of the upper gastrointestinal tract with allergic dermatoses in children

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T.V. Sorokman

2017-04-01

Full Text Available Background. The recent studies indicate that one of the causes of allergic dermatoses (AD in children and adults is pathology of the gastrointestinal tract. However, many problems of the emergence of these combinations have not yet been resolved. The purpose of the study was to establish the incidence and the nature of lesions of the upper gastrointestinal tract (UGIT in children with allergic dermatoses. Materials and methods. On the base of the Chernivtsi Regional Children’s Hospital, 40 children with allergic dermatoses combined with the pathology of the upper gastrointestinal tract and 20 patients with AD, but without the UGIT pathology, aged 3 to 18 years were examined. A clinical and laboratory studies were conducted twice (routine clinical tests, chamber scratch test with non-infectious allergens during AD remission, as well as fibrogastroduodenoscopy, ultrasound, pH-measuring biochemical blood tests (alanine aminotransferase (ALT, aspartate aminotransferase (AST, gamma glutaminetransferase (GGTP, alkaline phosphatase, cholesterol, identification of H.pylori. Results. It was indicated that out of 40 examined children with AD, 30 (75 % persons had various lesions of the esophagus, stomach and duodenum. In 10 (25 % children, the functional changes, such as duodenogastral reflex (70 % and failure of the cardia (30 %, were detected. A multiple nature of reflux was observed in 85.7 % of children with chronic gastroduodenitis and in 100 % of children with esophagitis and duodenal ulcer disease. The contamination with H.pylori was detected in 72.5 % of cases. The increased activity of ALT and AST, GGTP, alkaline phosphatase and serum cholesterol was established. Conclusion. In 75 % of children with allergic dermatoses, an organic pathology of the upper gastrointestinal tract was diagnosed, thus, a gastroenterological examination should be recommended to all patients.

[Massive hemorrhage of upper gastrointestinal tract caused by gastrointestinal stromal tumor of the stomach--case report].

Science.gov (United States)

Lalović, Nenad; Dukić Vladicić, Nikolina; Marić, Radmil; Cuk, Mirjana; Simatović, Milan; Jokanović, Dragana

2012-01-01

Acute bleeding from the upper gastrointestinal system is a medical emergency which is followed by high mortality rate, ranging from 6 to 15% in spite of modern diagnostic methods and treatment. Bleeding from the upper gastrointestinal system may be caused by gastrointestinal stromal tumors of the stomach, which are mainly characterized by occult bleeding, while profuse bleeding rarely occurs accompanied by hemorrhagic shock. Gastrointestinal stromal tumors of stomach are the most common mesenchimal tumors of the gastrointestinal tract. In our study we showed a 60-year-old female patient with profuse bleeding from the stomach and the clinical picture of severe hemorrhagic shock, caused by gastrointestinal stromal tumor. An ovoid junction, raised towards the lumen, covered with ulcerated mucosa in several places and followed by massive arterial bleeding was found intraoperatively, after the performed gastrotomy. Histopathological examination with immunohistochemical analysis confirmed that this was a gastrointestinal stromal tumor of the stomach. Acute bleeding from the digestive system is a sudden and serious condition of the body. Urgent esophagogastroduodenoscopy is a sensitive and specific diagnostic and therapeutic method of choice. Massive bleeding from the upper gastrointestinal tract is very rarely caused by gastrointestinal stromal tumors, whose clinical picture is very heterogeneous and depends on tumor size and location. Abundant bleeding from the tumor is an indication for urgent surgical intervention. According to the literature massive hemorrhage of the upper digestive system can rarely be caused by gastrointestinal stromal tumor of the stomach. It is shown that abundant hemorrhage of the upper digestive tract can be caused with gastric gastrointestinal stromal tumor. Surgical resection is the main form of treatment of gastrointestinal stromal tumors of the digestive system and bleeding from these tumors caused by failure of endoscopic hemostasis.

[Gastrointestinal bleeding--concepts of surgical therapy in the upper gastrointestinal tract].

Science.gov (United States)

Knoefel, W T; Rehders, A

2006-02-01

Bleeding of the upper gastrointestinal tract is the main symptom of a variety of possible conditions and still results in considerable mortality. Endoscopy is the first diagnostic modality, enabling rapid therapeutic intervention. In case of intractable or relapsing bleeding, surgery is often inevitable. However, emergency operations result in significantly higher mortality rates. Therefore the option of early elective surgical intervention should be considered for patients at increased risk of relapsing bleeding. If bleeding is symptomatic due to a complex underlying condition such as hemosuccus pancreaticus or hemobilia, angiography is now recognized as the definitive investigation. Angiographic hemostasis can be achieved in most cases. Due to the underlying condition, surgical management still remains the mainstay in treating these patients. This paper reviews surgical strategy in handling upper gastrointestinal bleeding.

Congenital upper urinary tract abnormalities: new images of the same diseases

Energy Technology Data Exchange (ETDEWEB)

Maranhao, Carol Pontes de Miranda; Santos, Carla Jotta dos [Clinica de Medicina Nuclear e Radiologia de Maceio (MedRadiUS), AL (Brazil); Miranda, Christiana Maia Nobre Rocha de; Farias, Lucas de Padua Gomes de; Padilha, Igor Gomes, E-mail: maiachristiana@globo.com [Universidade Federal de Alagoas (UFAL), Maceio, AL (Brazil)

2013-01-15

Congenital upper urinary tract abnormalities imply a variable clinical spectrum of morphofunctional changes ranging from asymptomatic conditions to renal failure and incompatibility with life. Computed tomography, which has overcome excretory urography imaging, has been playing a key role in the diagnosis of congenital anomalies, serving as a better guidance in the therapeutic and surgical decision-making process, besides acting as an essential tool in the identification of associated complications and aiding in the performance of minimally invasive surgery techniques. (author)

Can the Pelargonium sidoides root extract EPs® 7630 prevent asthma attacks during viral infections of the upper respiratory tract in children?

Science.gov (United States)

Tahan, Fulya; Yaman, Melih

2013-01-15

Asthma is a chronic disease characterized by airway inflammation. Viral infection initiates an immune inflammatory response that may produce asthma attacks. There is no effective preventing therapy for asthma attack during upper respiratory tract viral infections. To investigate the efficacy of 5 days of Pelargonium sidoides therapy for preventing asthma attack during upper respiratory tract viral infections. Sixty one asthmatic children with upper respiratory tract viral infection were enrolled in the study. The patients were randomized to receive Pelargonium sidoides daily for 5 days (n=30) or not (n=31). Before and after treatment, they all were examined and symptom scores were determined. Following five days treatment, children were evaluated whether or not they had an asthma attack. Treatment with Pelargonium sidoides was not associated with a statistically significant differences in fever and muscle aches (p>0.05, Chi-square test). There were significant differences in cough frequency and nasal congestion between the groups (pasthma attack between the groups (pasthma attack. Our study shows that Pelargonium sidoides may prevent asthma attacks during upper respiratory tract viral infections. Copyright © 2012 Elsevier GmbH. All rights reserved.

A rational approach to imaging the upper urinary tract in children with pyelonephritis

International Nuclear Information System (INIS)

Merrick, M.V.; Glass, J.; Uttley, W.S.

1982-01-01

At least seven techniques of imaging the urinary tract are commonly used for the investigation of children in whom infection is suspected or proven, namely Excretion Urography (EU), Micturating Cysto-Urethrography (MCU), Isotope Renography (IR), Indirect Radionucleide Voiding Cysto-Urethrography (IRVC), Renal Scintigraphy (RS), Direct Radionucleide Voiding Cysto-Urethrography (DRVC) and Ultrasonography (US). There is at the present time no single investigation which is clearly suitable for use as a stand-alone screening test for predicting risk of progressive renal damage in children with upper tract infections. Radioisotope renography, associated with indirect radionuclide voiding cysto-urethrography, and supplemented by ultrasound may be the combination of tests which give the maximum information for the lowest radiation dose

Absent upper blind Pouch in a case of tracheo-esophageal fistula

Directory of Open Access Journals (Sweden)

Man Mohan Harjai

2015-01-01

Full Text Available A common upper airway and digestive tract is a rare congenital anomaly that is usually fatal and its exact incidence is not known. It is a diagnostic challenge as it requires high index of suspicion. It should be considered in a neonate with respiratory distress in a non-vigorous baby requiring endotracheal intubation, which is difficult even in expert hand. We present a newborn with suspected tracheo-esophageal fistula that was diagnosed intraoperatively to have absent upper blind pouch of the esophagus and on autopsy found to have laryngeal atresia with absent vocal cords and a common aerodigestive tract continuing distally with trachea. The neonate was ventilated with endotracheal tube (ETT placement which in retrospect we came to know that it was in the esophagus. The neonate also had associated multiple congenital anomalies of VACTERL association. The importance of teamwork between neonatologist, pediatric surgeon, anesthesiologist, and radiologist is highlighted for diagnosis and management of such rare cases.

PERFORATION AS A COMPLICATION OF THE DIAGNOSTIC UPPER AND LOWER ENDOSCOPY OF THE GASTROINTESTINAL TRACT

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Ivailo P. Vazharov

2012-08-01

Full Text Available Purpose: The purpose of this examination is to evaluate the risk of perforation during endoscopy of upper and lower gastrointestinal tract.Patients and methods used: 1210 diagnostic gastroduodenoscopies and 412 colonoscopies of hospitalized patients were performed by two experienced endoscopists for the period March 2007 – March 2012 at MHAT Varna, MMA. The endoscopies were performed without premedication and sedation. The patients were examined for complications of the procedure during and after the endoscopy. One of the most serious complications is the perforation of the oesophagus, stomach or the large intestine.Results: We had no perforations caused by the examination during the 1210 upper endoscopies performed. We had 2 perforations (0,48% from the 412 colonoscopies performed, which were treated successfully surgically.Conclusions: The perforation is a rare but serious complication of the endoscopy of gastrointestinal tract, which can be healed completely.

Efficacy of deep biopsy for subepithelial lesions in the upper gastrointestinal tract.

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Vaicekauskas, Rolandas; Stanaitis, Juozas; Valantinas, Jonas

2016-01-01

Accurate diagnosis of subepithelial lesions (SELs) in the gastrointestinal tract depends on a variety of methods: endoscopy, endoscopic ultrasound and different types of biopsy. Making an error-free diagnosis is vital for the subsequent application of an appropriate treatment. To evaluate the efficacy of deep biopsy via the endoscopic submucosal dissection (ESD) technique for SELs in the upper gastrointestinal tract. It was a case series study. Deep biopsy via the ESD technique was completed in 38 patients between November 2012 and October 2014. Thirty-eight SELs in the upper gastrointestinal tract of varying size (very small ≤ 1 cm, small 1-2 cm and large ≥ 2 cm) by means of the ESD technique after an incision with an electrosurgical knife of the overlying layers and revealing a small part of the lesion were biopsied under direct endoscopic view. Deep biopsy via the ESD technique was diagnostic in 28 of 38 patients (73.3%; 95% CI: 59.7-89.7%). The diagnostic yield for SELs with a clear endophytic shape increased to 91.3%. An evident endophytic appearance of a subepithelial lesion, the mean number of biopsied samples (6.65 ±1.36) and the total size in length of all samples per case (19.88 ±8.07 mm) were the main criteria influencing the positiveness of deep biopsy in the diagnostic group compared to the nondiagnostic one (p = 0.001; p = 0.025; p = 0.008). Deep biopsy via the ESD technique is an effective and safe method for the diagnosis of SELs especially with a clear endophytic appearance in a large number of biopsied samples.

Treatment of Postoperative Leaks of the Upper Gastrointestinal Tract with Colonic Self-Expandable Metal Stents.

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Sousa, Paula; Castanheira, António; Martins, Diana; Pinho, Juliana; Araújo, Ricardo; Cancela, Eugénia; Ministro, Paula; Silva, Américo

2017-07-01

The use of self-expandable metal stents (SEMS) for the treatment of postoperative leaks of the upper gastrointestinal tract is already established. However, there are discrepancies between the relatively small caliber of the esophageal stents available and the postsurgical luminal size, which may determine an inadequate juxtaposition. As colonic stents have a bigger diameter, they might be more adequate. Additionally, stents with a larger diameter might have a lower risk of migration. The aim of this study was to evaluate the efficacy and complications associated with the use of colonic fully covered SEMS (FSEMS) in the treatment of postoperative leaks in critical patients. All patients with postoperative leaks of the upper gastrointestinal tract treated with colonic stents (Hanarostent® CCI) between 2010 and 2013 were retrospectively included. Four patients with postoperative leaks were treated with colonic SEMS. The underlying surgeries were a gastric bypass, an esophagogastrectomy for Boerhaave syndrome, a primary repair of esophagopleural fistula due to Boerhaave syndrome, and an esophagectomy due to esophageal cancer. The leaks were detected on average 17 days after the initial surgery. All patients needed admission to a critical care unit after index surgery. Stent placement was technically feasible in all patients. The median residence time of the stents was 7 weeks, and no complications were verified when they were removed. There were no cases of stent migration. The treatment was successful in all patients, with complete healing of the leaks. The placement of colonic FSEMS seems to be successful and safe in the treatment of postoperative leaks of the upper gastrointestinal tract.

Changes in the serum protein profile during radiotherapy to the upper respiratory and gastro-intestinal tracts

International Nuclear Information System (INIS)

David, M.; Lobera, A.; Legrand, E.

1984-01-01

Patients with a cancer of the upper airways of upper gastro-intestinal tract present a state of malnutrition as a result of the disease itself and, more importantly, as a result of its localisation. Loco-regional radiotherapy often leads to an aggravation, of this state. The protein profile, consisting of nine serum proteins, was determined each week in 54 patients with cancer of the upper respirato-gastro-intestinal tract receiving radiotherapy. During the course of radiotherapy, the already altered nutritional state of these patients deteriorated further, as shown by a regular and significant downturn in the weight curve. The weekly monitoring of the protein profile showed a gradual and significant decrease in the levels of nutritional proteins (prealbumin, retinol binding protein, transferrin) and immunoglobulins (IgM, IgA) and a small variation in the levels of inflammatory proteins (haptoglobin, orosomucoid, C3 complement fraction, alpha 1 -antitrypsin). The protein profile, established on the basis of carefully selected proteins, can provide useful information in the monitoring of a patient's nutritional state [fr

Changes in the serum protein profile during radiotherapy to the upper respiratory and gastro-intestinal tracts

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David, M; Lobera, A; Legrand, E [Fondation Bergorie, Bordeaux (France)

1984-01-01

Patients with a cancer of the upper airways on upper gastro-intestinal tract present a state of malnutrition as a result of the disease itself and, more importantly, as a result of its localisation. Loco-regional radiotherapy often leads to an aggravation, of this state. The protein profile, consisting of nine serum proteins, was determined each week in 54 patients with cancer of the upper respirato-gastro-intestinal tract receiving radiotherapy. During the course of radiotherapy, the already altered nutritional state of these patients deteriorated further, as shown by a regular and significant downturn in the weight curve. The weekly monitoring of the protein profile showed a gradual and significant decrease in the levels of nutritional proteins (prealbumin, retinol binding protein, transferrin) and immunoglobulins (IgM, IgA) and a small variation in the levels of inflammatory proteins (haptoglobin, orosomucoid, C3 complement fraction, alpha/sub 1/-antitrypsin). The protein profile, established on the basis of carefully selected proteins, can provide useful information in the monitoring of a patient's nutritional state.

The aetiology of upper aerodigestive tract cancers among young adults in Europe: the ARCAGE study.

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Macfarlane, Tatiana V

2010-12-01

The incidence of cancers of the upper aerodigestive tract (UADT) is increasing throughout the world. To date the increases have been proportionally greatest among young people. Several reports have suggested that they often do not have a history of tobacco smoking or heavy alcohol consumption.

Comparison of Electrohydraulic and Electromagnetic Shock Wave Lithotripsy for Upper Urinary Tract Stones in Elderly Patients

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Yi-Zhong Chen

2017-09-01

Conclusions: Our study showed that elderly patients with upper urinary tract stones undergoing ESWL with EH and EM machines had comparable stone free rates and complication rates, but a higher retreatment rate was seen with EM machines.

Dose distributions of patients from chest fluoroscopy, upper GI-tract radiography and cinematography in Japan

International Nuclear Information System (INIS)

Kusama, T.; Kai, M.; Ohta, K.

1996-01-01

The per caput dose from medical exposure in Japan is several times higher than in other developed countries. There are no dose limitations for medical exposure. Then, the appropriate applications of radiation diagnosis/treatments (justification of practices) and the quality control of diagnosis/treatments (optimization of protection) are needed to reduce the doses from medical exposure. It is well documented that patient doses from a X-ray diagnosis are distributed in the broad range. Recently, the IAEA introduced guidance levels for some typical X-ray diagnosis and in vivo nuclear medicines. We carried out the investigation of dose distribution of patients from the X-ray examinations of chest, cardiovascular cinematography and upper GI-tract X-ray examination in order to give the basic information on the quality control of each X-ray diagnosis. These X-ray diagnoses are performed frequently in Japan, and especially chest X-ray examinations are carried out periodically to all population more than 18 years old as legal health check and GI-tract X-ray examinations to the persons more than 35 years old. The cardiovascular cinematography and the upper GI-tract X-ray examination bring higher effective dose for patients. More information is therefore, needed for the reduction and quality control of medical exposure in Japan. (author)

Management of pharynx fistula after upper digestive tract instrumentation

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Bogdan Popescu

2017-05-01

Full Text Available Pharynx fistula is a pathological state that can pose serious problems for both physician and patient and can lead up to the death of the patient in complicated cases. The authors describe a series of guidelines for the management of the pharynx fistula regarding the complications of the instrumentation of the upper digestive tract. Most of the cases that are addressed to our clinic can be treated with a conservative approach and a nutrition therapy plan tailored to each case. In selected cases surgery is the method of choice for therapy. The management of the pharynx fistula can be well managed in a multidisciplinary approach using resources from the E.N.T. and H.N.S. department and more important from the ICU department.

Prescribing patterns for upper respiratory tract infections in general practice in France and in the Netherlands.

NARCIS (Netherlands)

Rosman, S.; Vaillant, M. le; Schellevis, F.; Clerc, P.; Verheij, R.; Pelletier-Fleury, N.

2008-01-01

BACKGROUND: France and the Netherlands are often presented as two contrasting countries with regard to drug prescriptions and consumption. This study aimed to analyse general practitioners' (GP's) prescription patterns for upper respiratory tract infections (URTI). METHODS: Data on diagnoses and

[Treatment of fungal infections of upper respiratory tract and ear].

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Kurnatowski, Piotr; Kurnatowska, Agnieszka K

2007-01-01

Fungi, in comparison with other pathogenic factors, have high pathogenicity. The number of fungal species which are able to infect people is over 500. The upper respiratory tract and ear have permanent contact with external environment which makes their ontocenoses open to continuous exchange of microorganisms of which they consist. In etiology of inflammatory processes 21 species which belonging to 3 genera (Zygomycota, Ascomycota, Basidiomycota) of fungi play important role. Administration of antifungal drugs can be: prophylactic, empiric preemptive and therapeutic. Physicians may prescribe antibiotics (mainly pollens: amphotericin B, natamycin and nystatin) and chemiotherapeutics (mainly azoles and fluorpirymidins, pigments, chlorhexidine and chlorquinaldol). In ENT practice topical and systemic drugs can be administrated. Topical lozenges include amphotericin B, clotrimazole, chlorhexidine or chlorquinaldol and oral gels: nystatin and miconazole. Some of drugs are in the form of suspension/solution, which can be used for inhalation, into the sinus, for swabbing or for lavage: amphotericin B, natamycin, nystatin, clotrimazol, flucytosine, miconazole, fluconazole, vorykonazole, caspofungin. It should be underlined that only a few of dugs can be absorbed from the digestive tract: flucytosine, fluconazole, itraconazole, ketoconazole, miconazole, vorykonazole.

NORMAL NASOPHARYNGEAL MICROFLORA AS A RESERVOIR OF MULTIRESISTANT STRAINS OF UPPER RESPIRATORY TRACT INFECTIONS

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Minukhin V.V.

2015-05-01

Full Text Available Nasopharinheal carriage of bacteria may play a central role in the development and spread of respiratory infections. In addition, so-called "healthy" carriage is often transformed under the influence of various factors into an active infection.It is necessary to take into account not only the range of possible pathogens, but also trends in the development of antibiotic resistance of leading etiologic agents while choosing tactics of antimicrobial therapy. The investigation was designed to study the role of normal microflora of the nasopharynx as a reservoir of resistant strains of respiratory infections. Materials and Methods. Fifty three healthy individuals and 168 patients with acute upper respiratory tract infections who had been treated in CEHC "Kharkiv Municipal Clinical Hospital № 30" were examined. Microbiological study included isolation and identification of pathogens in accordance with the Order of the Ministry of Health Care № 535 from 22.04.1985., determination of the sensitivity of microorganisms to antibiotics by diffusion method according to the Order of the Ministry of Health Care of Ukraine № 167 from 05.04.2007. Results and discussion. Bacteriological study of nasal swabs of healthy people showed that the composition of the microflora of the nasopharynx contained potentially pathogenic microorganisms. Among the isolated microorganisms essential place was occupied by S. epidermidis and S. aureus, both in monoculture and association. Epidermal staphylococcus was isolated in 36 % and Staphylococcus aureus in 27% of cases. Pneumococcus and hemolytic streptococcus of group A were isolated in 23 and 14% of cases, respectively. One hundred and eighty strains of opportunistic microorganisms were isolated in the study of nasopharyngeal microflora of patients with acute upper respiratory tract infection. The leading role belonged to S. pyogenes (40.5% and S.epidermidis (33,3%. S. aureus (12,8% and S.pneumoniae (10,6% were next

Procalcitonin Testing to Guide Antibiotic Therapy in Acute Upper and Lower Respiratory Tract Infections.

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Schuetz, Philipp; Wirz, Yannick; Mueller, Beat

2018-03-06

Is the use of procalcitonin for guiding antibiotic decisions in patients with acute upper and lower respiratory tract infections associated with improved clinical outcomes compared with usual care? Among patients with varying types and severity of acute respiratory infection, using procalcitonin to guide decisions about antibiotics is associated with lower rates of antibiotic exposure, antibiotic-related adverse effects, and mortality.

Efficacy of Systemic Chemotherapy Plus Radical Nephroureterectomy for Metastatic Upper Tract Urothelial Carcinoma.

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Seisen, Thomas; Jindal, Tarun; Karabon, Patrick; Sood, Akshay; Bellmunt, Joaquim; Rouprêt, Morgan; Leow, Jeffrey J; Vetterlein, Malte W; Sun, Maxine; Alanee, Shaheen; Choueiri, Toni K; Trinh, Quoc-Dien; Menon, Mani; Abdollah, Firas

2017-05-01

Given the growing body of evidence supporting the benefit of primary tumor control for a wide range of metastatic malignancies, we hypothesized that chemotherapy plus radical nephroureterectomy (RNU) is associated with an overall survival (OS) benefit compared to chemotherapy alone for metastatic upper tract urothelial carcinoma (mUTUC). Within the National Cancer Data Base (2004-2012), we identified 398 (38.4%) and 637 (61.6%) patients who received chemotherapy plus RNU and chemotherapy alone, respectively. Inverse probability of treatment weighting (IPTW)-adjusted Kaplan-Meier curves showed that 3-yr OS was 16.2% (95% confidence interval [CI] 12.1-20.3) for chemotherapy plus RNU and 6.4% (95%CI 4.1-8.7) for chemotherapy alone (pchemotherapy plus RNU was associated with a significant OS benefit (hazard ratio 0.70, 95% CI 0.61-0.80; pbenefit for fit patients who received chemotherapy plus RNU for mUTUC relative to their counterparts treated with chemotherapy alone. We examined the role of radical nephroureterectomy in addition to systemic chemotherapy for metastatic upper tract urothelial carcinoma. We found that such treatment may be associated with an overall survival benefit compared to chemotherapy alone in fit patients. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Upper and Lower Urinary Tract Endoscopy Training on Thiel-embalmed Cadavers.

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Bele, Uros; Kelc, Robi

2016-07-01

To evaluate Thiel-embalmed cadavers as a new training model for urological endoscopy procedures. Twelve urologists performed upper and lower urinary tract endoscopies on 5 different Thiel-embalmed cadavers to evaluate this potentially new training model in urological endoscopic procedural training. Using a 5-point Likert scale, the participants assessed the quality of the tissue and the overall experience of the endoscopy in comparison to a live patient procedure. Thiel-embalmed cadavers have shown to mimic live patient endoscopy of the upper and lower urinary tract in terms of almost identical overall anatomical conditions and manipulation characteristics of the tissue. The mucosa of the urethra and ureters showed similar colors and consistency in comparison to a live patient, whereas bladder mucosa was lacking the visibility of the vessels, thus was unsuitable for identifying any mucosal abnormalities. The flexibility of the muscles allowed for proper patient positioning, whereas the loss of muscle tonus made ureteroscopy more difficult although sufficiently comparable to the procedure done in a live patient. Thiel-embalmed cadavers have already been proven to be a suitable training model for several medical procedures. They are known for preserving tissue color, consistency, and flexibility without the irritant odors or risk of infection, which make them resemble live patients with real-life surgical challenges. The results of our study strongly suggest that despite some minor drawbacks, Thiel-embalmed cadavers are a suitable simulation model for initial training of urethrocystoscopy and ureteroscopy. Copyright © 2016 Elsevier Inc. All rights reserved.

Follow-up strategies in head and neck cancer other than upper aerodigestive tract squamous cell carcinoma

NARCIS (Netherlands)

Digonnet, Antoine; Hamoir, Marc; Andry, Guy; Vander Poorten, Vincent; Haigentz, Missak; Langendijk, Johannes A.; de Bree, Remco; Hinni, Michael L.; Mendenhall, William M.; Paleri, Vinidh; Rinaldo, Alessandra; Werner, Jochen A.; Takes, Robert P.; Ferlito, Alfio

Post-therapy follow-up for patients with head and neck cancer other than upper aerodigestive tract squamous cell carcinoma should meet several objectives: to detect both local, regional or distant recurrences, to evaluate acute and long-term treatment-related side effects, to guide the

[Diagnosis of upper urinary tract tumors. A pending challenge].

Science.gov (United States)

Westendarp, M; Laguna, M P; de la Rosette, J J M C

2014-07-01

Early diagnosis of upper urinary tract tumors is not easy. The development of endoscopic equipment has expanded the group of patients candidates for minimally invasive treatment. Only by providing accurate tumor staging and grading can clinicians decide which patients should be offered conservative therapies. We need diagnostic methods that allow us to make an early and accurate diagnosis for these lesions, as well as safe follow-up. Our proposal is to present a review of the most used diagnostic method, their features, and future diagnostic tools. The diagnostic arsenal requires further improvement. Only through accurate diagnosis, we will be able to safely provide conservative treatment. Developing new diagnostic techniques seem to move us closer to this goal even more. We propose a working algorithm on the management of these lesions.

Survival of Lactobacillus rhamnosus strains in the upper gastrointestinal tract.

Science.gov (United States)

Pitino, Iole; Randazzo, Cinzia Lucia; Mandalari, Giuseppina; Lo Curto, Alberto; Faulks, Richard Martin; Le Marc, Yvan; Bisignano, Carlo; Caggia, Cinzia; Wickham, Martin Sean John

2010-12-01

In the present study six probiotic Lactobacillus rhamnosus strains were investigated for their ability to survive in the human upper gastrointestinal tract through a dynamic gastric model of digestion. MRS broth was used as delivery vehicle and survival was investigated during in vitro gastric and gastric plus duodenal digestion. Results highlighted that all tested strains showed good survival rate during both gastric and duodenal digestion. In particular, three strains exhibited a great survival showing a recovery percentage in the range between 117 and 276%. In agreement with survival data, high lactic acid production was detected for all strains, confirming their metabolic activity during digestion. Copyright © 2010 Elsevier Ltd. All rights reserved.

Cancer chemotherapy of the upper aero digestive tract

International Nuclear Information System (INIS)

Vedrine, L.; Chargari, C.; Le Moulec, S.; Fayolle, M.; Ceccaldi, B.; Bauduceau, O.

2008-01-01

Tumours of the upper aero digestive tract represent the sixth most frequent kind of cancer in France and throughout the world. If the localised forms may be controlled in the long run in two thirds of cases by surgery or radiotherapy, only one third of locally advanced forms are accessible to a cure after association from radiotherapy and chemotherapy. Besides, with a median of survival less than six months, metastatic tumours present a catastrophic spontaneous prognosis among patients with a medical ground that is often heavily deteriorated by prolonged exposure to alcohol and tobacco. Thus, there is a necessity to implement adapted therapeutic strategies to each patient and based on satisfactory proof levels of effectiveness. Optimisation of existing chemotherapy protocols and development of new therapies, in particular of targeted therapies, remain an important objective in the hope to improve results of treatments in locally advanced and metastatic cancers of the oral cavity. (authors)

Effect of hyoscine butylbromide on gastroesophageal reflux in barium studies of the upper gastrointestinal tract

Energy Technology Data Exchange (ETDEWEB)

McLaughlin, R.F.; Mathieson, J.R.; Chipperfield, P.M.; Grymaloski, M.R.; Wong, A.D.

1994-12-01

The presence or absence and severity of gastroesophageal reflux before and after intravenous injection of 120 mg Buscopan were evaluated in 112 consecutive patients undergoing upper gastrointestinal examination. The study was undertaken to test the hypothesis that hyoscine butylbromide (Buscopan) could artificially induce gastroesophageal reflux during barium examination of the upper intestinal tract. Gastroesophageal reflux was seen in 49 (44%) of the patients. There was no significant difference in the overall occurrence or degree of gastroesophageal reflux before and after injection of Buscopan. The routine use of Buscopan was therefore unlikely to spuriously increase the frequency or degree of gastroesophageal reflux observed on upper gastrointestinal barium studies. The study also showed that Buscopan had a satisfactory antispasmodic effect and few side effects. 7 refs., 1 tab.

A sex-specific association between a 15q25 variant and upper aerodigestive tract cancers.

LENUS (Irish Health Repository)

Chen, Dan

2011-04-01

Sequence variants located at 15q25 have been associated with lung cancer and propensity to smoke. We recently reported an association between rs16969968 and risk of upper aerodigestive tract (UADT) cancers (oral cavity, oropharynx, hypopharynx, larynx, and esophagus) in women (OR = 1.24, P = 0.003) with little effect in men (OR = 1.04, P = 0.35).

Symptoms of reproductive tract infections and mental distress among women in low-income urban neighborhoods of Beirut, Lebanon.

Science.gov (United States)

Khawaja, Marwan; Kaddour, Afamia; Zurayk, Huda; Choueiry, Nathalie; El-Kak, Faysal

2009-10-01

The aim of this study was to examine the association between symptoms of reproductive tract infections (RTIs) and mental distress among women residing in three low-income urban neighborhoods in Greater Beirut. A cross-sectional survey of currently married women aged 15-49 years (n = 1506) from the 2003 Urban Health Study was undertaken. The dependent variables were complaining of vaginal discharge, pelvic pain, and pain during intercourse. The main independent variable was mental distress, measured using the General Health Questionnaire-12 (GHQ). Other variables included decision-making power, "comfort" with husband, age, education, income, household wealth, employment, community of residence, displacement by war, presence of chronic disease, reported reproductive health problem, membership in any group, receipt of favor last month, and smoking. Analysis was conducted using logistic regression models on the complaint of any symptom of RTIs and on individual complaints. Forty-two percent of the interviewed women reported at least one symptom of RTIs. Vaginal discharge was the most commonly reported symptom, with 33% of currently married women complaining from it. Mental distress was significantly associated with any reported RTI symptom (odds ratio [OR] = 1.41; 95% confidence interval [CI] = 1.09-1.83), pelvic pain (OR = 2.38; CI = 1.71-3.30), vaginal discharge (OR = 1.35; CI = 1.03-1.77), and pain during intercourse (OR = 2.37; CI = 1.66-3.40) after adjusting for demographic, socioeconomic, and health risk factors. A significant association between mental distress and reported RTI symptoms was established by this study. A new approach to gynecological morbidity is needed, one that integrates biomedical and psychosocial factors into a unified framework.

Carcinosarcoma of the upper urinary tract with an aggressive angiosarcoma component

Science.gov (United States)

Cuadra-Urteaga, José Luis; Font, Albert; Tapia, Gustavo; Areal, Juan; Taron, Miquel

2016-01-01

ABSTRACT Carcinosarcomas (CS) are biphasic tumors with malignant epithelial and mesenchymal elements. The sarcomatoid elements of CS can include chondrosarcoma, malignant fibrous histiocytoma, osteosarcoma, leiomyosarcoma, fibrosarcoma, or liposarcoma. CS of the upper urinary tract are extremely rare but are associated with a poor prognosis. We report a case of a 44-year-old man with a localized right renal pelvis mass treated with a right nephroureterectomy. The pathological examination showed a high-grade urothelial carcinoma of the renal pelvis, stage III (pT3aNxM0). A few days later, he developed lower back pain, hematuria, cough with hemoptoic sputum and progressive dyspnea. Radiological explorations showed multiple bilateral lung nodules and a retroperitoneal mass. A CT-guided biopsy of the retroperitoneal mass revealed a high-grade angiosarcoma. A review of the nephrectomy specimen showed a microscopic focus of angiosarcoma in the urothelial carcinoma. Therefore, the initial diagnosis was changed to CS of the renal pelvis with an angiosarcoma component. The patient developed progressive respiratory failure and died 8 weeks after surgery. An autopsy revealed a large retroperitoneal mass with metastatic nodules to the abdominal wall, diaphragm, small intestine, liver, spleen, and lung. All lesions were angiosarcoma, with no evidence of urothelial carcinoma. This is the first case reported of a patient with CS of the upper urinary tract with an angiosarcoma component with a very aggressive course that caused the immediate appearance of multiple angiosarcoma metastases. We also describe the clinical and molecular characteristics of CS, which will help to contribute to a better understanding of this type of tumor. PMID:26891233

Different frequencies of Porphyromonas gingivalis infection in cancers of the upper digestive tract.

Science.gov (United States)

Yuan, Xiang; Liu, Yiwen; Kong, Jinyu; Gu, Bianli; Qi, Yijun; Wang, Xinshuai; Sun, Man; Chen, Pan; Sun, Wei; Wang, Huizhi; Zhou, Fuyou; Gao, Shegan

2017-09-28

The high incidence rate of multiple carcinomas in the upper digestive tract is often explained in terms of involvement of the same underlying risk factors. It has been reported that the oral bacterium Streptococcus anginosus is associated with esophageal, gastric, and pharyngeal cancers. We previously reported occurrence of Porphyromonas gingivalis (P. gingivalis) DNA in esophagus cancer. In this study, the presence of P. gingivalis in specimens of various types of cancer from the upper digestive tract was investigated. Here we report that P. gingivalis was preferentially and frequently present in specimens of esophageal cancer as well as in those from dysplasia of the esophagus but rarely in matched noncancerous portions and are quite low or absent in cancers from the cardia or stomach. Therefore, it led us to propose that, the microorganism does not survive in conditions of high acidity. We then investigate the pH dependence of survival of P. gingivalis as well as the acid tolerance of it. We found that, exposure to acidic buffers of a wide range of pH values led to a decline in colony forming units of P. gingivalis, thus, providing a possible explanation for variations in frequencies of P. gingivalis infection in this study. Copyright © 2017 Elsevier B.V. All rights reserved.

Monitoring of the upper urinary tract in patients with bladder cancer

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Rajinikanth Ayyathurai

2011-01-01

Full Text Available Upper urinary tract (UUT transitional cell carcinoma (TCC is relatively rare tumor. Approximately 0.7-4% of patients with primary bladder cancer develops UUT-TCC. The symptoms related to an UUT-TCC often occur with an advanced stage which leads one to emphasize a surveillance strategy to monitor the UUT to allow for an earlier diagnosis. Although the risk of UUT-TCC after bladder cancer is well established, there is a paucity of recommendations suggesting the optimal method and frequency of monitoring the UUT and there is no consensus among them. This article reviews the recommendations on monitoring the UUT in patients with bladder cancer.

The clinical application of static-fluid MRU and enhanced MRU for the diagnosis of upper urinary tract disease

International Nuclear Information System (INIS)

Hu Bing; Ye Binbin; Kang Zhuang; Zou Yan

2005-01-01

Objective: To evaluate the clinical utility of heavy T 2 -weighted MR urography (static-fluid MRU) and gadolinium-enhanced T 1 -weighted MR urography (enhanced MRU) for the diagnosis of upper urinary tract disease. Methods: Eleven patients were examined with static-fluid MRU and enhanced MRU. The images of static-fluid MRU and enhanced MRU were ranked and diagnosed by two radiologists. And the results were compared later. Results: The ranked image quality was analyzed with a Wilcoxon sign-rank test. The difference between two kinds of MRU images was not significant (P>0.05). The number of correct diagnosis of static-fluid MRU was 19(86.4%) by observer A and 18 (81.8%) by observer B; of enhanced MRU was 21 (95.5%) by observer A and 19 (86.4%) by observer B. Conclusion: With static-fluid MRU, the intraluminal anatomy of urinary tract can be displayed, but the function of kidney can not be evaluated. With enhanced MRU, the intraluminal anatomy can be displayed, and the function of kidney can be evaluated as well. Most of upper urinary tract disease could be diagnosed by static-fluid MRU or enhanced MRU. (authors)

The contribution of Chlamydia-specific CD8⁺ T cells to upper genital tract pathology.

Science.gov (United States)

Vlcek, Kelly R; Li, Weidang; Manam, Srikanth; Zanotti, Brian; Nicholson, Bruce J; Ramsey, Kyle H; Murthy, Ashlesh K

2016-02-01

Genital chlamydial infections lead to severe upper reproductive tract pathology in a subset of untreated women. We demonstrated previously that tumor necrosis factor (TNF)-α-producing CD8(+) T cells contribute significantly to chlamydial upper genital tract pathology in female mice. In addition, we observed that minimal chlamydial oviduct pathology develops in OT-1 transgenic (OT-1) mice, wherein the CD8(+) T-cell repertoire is restricted to recognition of the ovalbumin peptide Ova(257-264), suggesting that non-Chlamydia-specific CD8(+) T cells may not be responsible for chlamydial pathogenesis. In the current study, we evaluated whether antigen-specific CD8(+) T cells mediate chlamydial pathology. Groups of wild-type (WT) C57BL/6J, OT-1 mice, and OT-1 mice replete with WT CD8(+) T cells (1 × 10(6) cells per mouse intravenously) were infected intravaginally with C. muridarum (5 × 10(4) IFU/mouse). Serum total anti-Chlamydia antibody and total splenic anti-Chlamydia interferon (IFN)-γ and TNF-α responses were comparable among the three groups of animals. However, Chlamydia-specific IFN-γ and TNF-α production from purified splenic CD8(+) T cells of OT-1 mice was minimal, whereas responses in OT-1 mice replete with WT CD8(+) T cells were comparable to those in WT animals. Vaginal chlamydial clearance was comparable between the three groups of mice. Importantly, the incidence and severity of oviduct and uterine horn pathology was significantly reduced in OT-1 mice but reverted to WT levels in OT-1 mice replete with WT CD8(+) T cells. Collectively, these results demonstrate that Chlamydia-specific CD8(+) T cells contribute significantly to upper genital tract pathology.

Neurogenic period of ascending tract neurons in the upper lumbar spinal cord of the rat

International Nuclear Information System (INIS)

Nandi, K.N.; Beal, J.A.; Knight, D.S.

1990-01-01

Although the neurogenic period for neurons in the lumbar spinal cord has been clearly established (Days 12 through 16 of gestation), it is not known when the neurogenesis of ascending tract neurons is completed within this period. The purpose of the present study was to determine the duration of the neurogenic period for projection neurons of the ascending tracts. To label neurons undergoing mitosis during this period, tritiated thymidine was administered to fetal rats on Embryonic (E) Days E13 through E16 of gestation. Ascending tract neurons of the lumbar cord were later (Postnatal Days 40-50) labeled in each animal with a retrograde tracer, Fluoro-Gold, applied at the site of a hemisection at spinal cord segment C3. Ascending tract neurons which were undergoing mitosis in the upper lumbar cord were double labeled, i.e., labeled with both tritiated thymidine and Fluoro-Gold. On Day E13, 89-92% of the ascending tract neurons were double labeled; on Day E14, 35-37%; and on Day E15, 1-4%. Results showed, then, that some ascending tract neurons were double labeled through Day E15 and were, therefore, proliferating in the final one-third of the neurogenic period. Ascending tract neurons proliferating on Day E15 were confined to laminae III, IV, V, and X and the nucleus dorsalis. Long tract neurons in the superficial dorsal horn (laminae I and II), on the other hand, were found to have completed neurogenesis on Day E14 of gestation. Results of the present study show that spinal neurogenesis of ascending projection neurons continues throughout most of the neurogenic period and does not completely follow the well-established ventral to dorsal gradient

Voice disorders in residual paracoccidioidomycosis in upper airways and digestive tract.

Science.gov (United States)

da Costa, Ananda Dutra; Vargas, Amanda Pereira; Lucena, Marcia Mendonça; Ruas, Ana Cristina Nunes; Braga, Fernanda da Silva Santos; Bom-Braga, Mateus Pereira; Bom-Braga, Frederico Pereira; do Valle, Antonio Carlos Francesconi; Igreja, Ricardo Pereira; Valete-Rosalino, Cláudia Maria

Paracoccidioidomycosis (PCM) is a systemic mycosis of acute and chronic evolution, caused by species belonging to the genus Paracoccidioides. It is considered the most prevalent systemic endemic mycosis in Latin America, with cases in the tropical and subtropical regions. Residual PCM refers to the fibrotic scar sequelae resulting from the disease treatment which, when associated with collagen accumulation, leads to functional and anatomic alterations in the organs. The aim of this study was to evaluate the vocal function of patients with residual PCM in upper airways and digestive tract. We performed a cross-sectional study in 2010 in a cohort of 21 patients with residual PCM in upper airways and digestive tract. The average age was 49.48±9.1 years, and only two (9.5%) patients were female. The study was performed in the 1-113 month-period (median 27) after the end of drug treatment. Five (23.8%) patients had alterations in the larynx as a sequela of the disease. However, all patients had vocal changes in vocal auditory perceptual analysis by GRBASI scale. The computerized acoustic analysis using the software Vox Metria, showed that 11 patients (52.4%) presented alterations in jitter, 15 (71.4%) in shimmer, 8 (38.1%) in F0, 4 (19%) in glottal to noise excitation (GNE), 7 (33.3%) in the presence of noise and 12 (57.1%) in the presence of vibratory irregularity. The great frequency of alterations in residual PCM suggests that the patients in such phase could benefit from a multidisciplinary treatment, offering them integral monitoring of the disease, including speech rehabilitation after the PCM is healed. Copyright © 2017 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.

Differential expression of the MERS-coronavirus receptor in the upper respiratory tract of humans and dromedary camels

NARCIS (Netherlands)

Widagdo, W; Raj, V Stalin; Schipper, Debby; Kolijn, Kimberley; van Leenders, Geert J L H; Bosch, Berend J; Bensaid, Albert; Segalés, Joaquim; Baumgärtner, Wolfgang; Osterhaus, Albert D M E; Koopmans, Marion P; van den Brand, Judith M A; Haagmans, Bart L

Middle East respiratory syndrome coronavirus (MERS-CoV) is not efficiently transmitted between humans, but it is highly prevalent in dromedary camels. Here we report that the MERS-CoV receptor - dipeptidyl peptidase 4 (DPP4) - is expressed in the upper respiratory tract epithelium of camels but not

Upper gastrointestinal tract injuries by intraoperative radiotherapy for pancreatic cancer

Energy Technology Data Exchange (ETDEWEB)

Tabata, I; Isawa, T; Satomi, T; Tazima, T [Tokyo Metropolitan Komagome Hospital (Japan)

1981-08-01

Twenty-one patients with unresectable carcinoma of the pancreas were treated by intraoperative irradiation with a large electron dose of 1500 - 3000 rads and upper gastrointestinal complications were encountered in five cases. All of those five cases were for carcinoma of the pancreatic head, and were seen for gastrointestinal tract injuries of the duodenum as follows, gastric ulcer in 2 cases, ulcer of the 1st duodenal portion in one case and ulcer with severe stenosis of the 2nd or 3rd duodenal portion in one case, respectively. Endoscopic features of these postirradiation gastrointestinal ulcers were characterized by deep, punched-out ulcers with grayish bases and sharp margins. Clinically these ulcers and stenosis were very difficult to treat, so by-pass operations were performed in two cases, resulting in prolonged survival.

A 15-Month-Old Boy With Respiratory Distress and Parapharyngeal Abscess: A Case Report

Directory of Open Access Journals (Sweden)

Behdad Gharib

2017-01-01

Full Text Available Parapharyngeal abscess is a life-threatening disease. Upper respiratory tract infection is the main cause in children. We present a 15-month-old boy admitted to the emergency ward with the chief complaint of difficulty in breathing caused by parapharyngealabscess. His condition deteriorated gradually, and he transferred to the operation theater quickly for abscess drainage and because of the difficulty in orotracheal intubation; a tracheostomy was performed. His respiratory condition deteriorated 2 days after PICU admission, and the medical team noticed an unexplainable respiratory distress. A chest x ray obtained and showed a right side pneumothorax and subcutaneous emphysema around theneck area. The case presented here, had not been diagnosed at the first examination; however, there were enough clinical clues (such as respiratory distress, drooling, torticollis, bulging of theneck, previous viral respiratory infection, possible pharyngeal trauma. The story of this case reminds us the importance of the precise physical exam and history taking which could be life-saving.

Bighorn sheep (Ovis canadensis) sinus tumors are associated with coinfections by potentially pathogenic bacteria in the upper respiratory tract.

Science.gov (United States)

Fox, Karen A; Rouse, Natalie M; Huyvaert, Kathryn P; Griffin, Karen A; Killion, Halcyon J; Jennings-Gaines, Jessica; Edwards, William H; Quackenbush, Sandra L; Miller, Michael W

2015-01-01

Bighorn sheep (Ovis canadensis) sinus tumors are hyperplastic to neoplastic, predominantly stromal masses of the paranasal sinuses that expand the sinus lining and obstruct the sinus cavities. Obstruction of the sinus cavities and disruption of normal sinus lining anatomy may interfere with clearance of bacterial pathogens from the upper respiratory tract. To examine this possibility, we explored whether the presence of sinus tumor features (tumor score) affected the likelihood of detecting potentially pathogenic bacteria from upper respiratory sinus lining tissues in bighorn sheep. We developed or used existing PCR assays for the detection of leukotoxigenic Pasteurellaceae and Mycoplasma ovipneumoniae in sinus lining tissues collected from 97 bighorn sheep in Colorado, US from 2009 to 2012. With the use of logistic regression analyses we found that tumor score was a good predictor of the probability of detecting potentially pathogenic bacteria in sinus lining tissues; we were more likely to detect potentially pathogenic bacteria from samples with high tumor scores. These findings add to our understanding of possible mechanisms for the maintenance and shedding of bacterial agents from the upper respiratory tracts of bighorn sheep.

RSV-induced bronchiolitis but not upper respiratory tract infection is accompanied by an increased nasal IL-18 response

NARCIS (Netherlands)

van Benten, Inesz J.; van Drunen, Cornelis M.; Koopman, Laurens P.; Kleinjan, Alex; van Middelkoop, Barbara C.; de Waal, Leon; Osterhaus, Albert D. M. E.; Neijens, Herman J.; Fokkens, Wytske J.

2003-01-01

The aim of this study was to investigate potential differences in the local nasal immune response between bronchiolitis and upper respiratory tract infection induced by respiratory syncytial virus (RSV). Nasal brush samples were obtained from 14 infants with RSV bronchiolitis and from 8 infants with

Computed tomography-urography for upper urinary tract imaging: is it required for all patients who present with hematuria?

NARCIS (Netherlands)

Cauberg, Evelyne C. C.; Nio, C. Y.; de la Rosette, Jean M. C. H.; Laguna, M. Pilar; de Reijke, Theo M.

2011-01-01

To define in which patients who present with microscopic or macroscopic hematuria CT urography (CTU) is indicated as an imaging mode for the upper urinary tract (UUT). We conducted a prospective study on consecutive patients who attended a modern protocol-driven hematuria clinic from January 2006 to

Seasonal and pandemic human influenza viruses attach better to human upper respiratory tract epithelium than avian influenza viruses

NARCIS (Netherlands)

D.A.J. van Riel (Debby); M.A. den Bakker (Michael); L.M.E. Leijten (Lonneke); S. Chutinimitkul (Salin); V.J. Munster (Vincent); E. de Wit (Emmie); G.F. Rimmelzwaan (Guus); R.A.M. Fouchier (Ron); A.D.M.E. Osterhaus (Albert); T. Kuiken (Thijs)

2010-01-01

textabstractInfluenza viruses vary markedly in their efficiency of human-to-human transmission. This variation has been speculated to be determined in part by the tropism of influenza virus for the human upper respiratory tract. To study this tropism, we determined the pattern of virus attachment by

Prevalence of Human Papillomavirus (HPV in upper respiratory tract mucosa in a group of pre-school children

Directory of Open Access Journals (Sweden)

Jaroslaw Szydłowski

2014-11-01

Full Text Available [b]introduction[/b]. Human Papillomavirus (HPV is a group of DNA viruses which is an etiological factor of many benign and malignant diseases of the upper respiratory tract mucosa, female genital tract and the skin. HPV infection is considered a sexually-transmitted infection, but can also be transmitted by non-sexual routes, including perinatal vertical transmission, physical contact, iatrogenic infection and autoinoculation. Recurrent Respiratory Papillomatosis (RRP in children is connected with HPV infection transmitted vertically from mother to child during the passage of the foetus through an infected birth canal. [b]objective. [/b]The aim of this study was to establish the level of Human Papillomaviruses carrier state in upper respiratory tract mucosa in healthy pre-school children, and to identify potential risk factors for HPV infection. [b]materials and method[/b]. After obtaining consent from their parents, 97 pre-school children were examined – 51 girls and 46 boys between the ages of 3 – 5 years; average age – 4 years and 5 months. 68 children were urban dwellers and 29 came from a rural environment. A questionnaire with detailed history was taken including parents’ and child`s personal data, as well as perinatal risk factors in pregnancy. Socio-demographic information was also obtained, including the standard of living, and chosen environmental factors. Routine ENT examination was performed. Exfoliated oral squamous cells were collected from swabs and analysed for the presence of DNA papillomaviruses by polymerase chain reaction. [b]results.[/b] The presence of HPV in the respiratory tract in children was detected in 19.6% cases. ‘High oncogenic potential’ HPVs, such as HPV-16 and HPV-18, were not observed in squamous cell mucosa of the respiratory tract in the children. No significant differences were observed between the HPV carrier state in urban and rural inhabitants.

Development of cholecystokinin binding sites in rat upper gastrointestinal tract

International Nuclear Information System (INIS)

Robinson, P.H.; Moran, T.H.; Goldrich, M.; McHugh, P.R.

1987-01-01

Autoradiography using 125 I-labeled Bolton Hunter-CCK-33 was used to study the distribution of cholecystokinin binding sites at different stages of development in the rat upper gastrointestinal tract. Cholecystokinin (CCK) binding was present in the distal stomach, esophagus, and gastroduodenal junction in the rat fetus of gestational age of 17 days. In the 20-day fetus, specific binding was found in the gastric mucosa, antral circular muscle, and pyloric sphincter. Mucosal binding declined during postnatal development and had disappeared by day 15. Antral binding declined sharply between day 10 and day 15 and disappeared by day 50. Pyloric muscle binding was present in fetal stomach and persisted in the adult. Pancreatic CCK binding was not observed before day 10. These results suggest that CCK may have a role in the control of gastric emptying and ingestive behavior in the neonatal rat

Embolization for non-variceal upper gastrointestinal tract haemorrhage: A systematic review

Energy Technology Data Exchange (ETDEWEB)

Mirsadraee, S.; Tirukonda, P.; Nicholson, A. [Department of Radiology, Leeds General Infirmary, Leeds (United Kingdom); Everett, S.M. [Department of Gastroenterology, Leeds General Infirmary, Leeds (United Kingdom); McPherson, S.J., E-mail: simon.mcpherson@leedsth.nhs.u [Department of Radiology, Leeds General Infirmary, Leeds (United Kingdom)

2011-06-15

Aim: To assess the published evidence on the endovascular treatment of non-variceal upper gastrointestinal haemorrhage. Materials and methods: An Ovid Medline search of published literature was performed (1966-2009). Non-English literature, experimental studies, variceal haemorrhage and case series with fewer than five patients were excluded. The search yielded 1888 abstracts. Thirty-five articles were selected for final analysis. Results: The total number of pooled patients was 927. The technical and clinical success of embolization ranged from 52-100% and 44-100%, respectively. The pooled mean technical/clinical success rate in primary upper gastrointestinal tract haemorrhage (PUGITH) only, trans-papillary haemorrhage (TPH) only, and mixed studies were 84%/67%, 93%/89%, and 93%/64%, respectively. Clinical outcome was adversely affected by multi-organ failure, shock, corticosteroids, transfusion, and coagulopathy. The anatomical source of haemorrhage and procedural variables did not affect the outcome. A successful embolization improved survival by 13.3 times. Retrospective comparison with surgery demonstrated equivalent mortality and clinical success, despite embolization being applied to a more elderly population with a higher prevalence of co-morbidities. Conclusions: Embolization is effective in this very difficult cohort of patients with outcomes similar to surgery.

'Horses for courses' in the upper gastrointestinal tract: a rational approach to diagnosis

International Nuclear Information System (INIS)

Mendelson, R.M.

1989-01-01

In Australia, the number of barium studies performed in teaching hospitals has fallen markedly while in the community at large a 113% increase occurred in the number of upper gastrointestinal endoscopic procedures performed between 1980 and 1986. Protagonists of primary endoscopy cite studies that report on the superiority of oesophagogastroduodenoscopy in patients with dyspepsia and related symptoms but several studies have shown that upper gastrointestinal barium studies miss very few important lesions. Fibreoptic endoscopy and radiology each have strengths and weaknesses which determine their respective places in the investigation of the different symptom complexes that are referable to the upper gastrointestinal tract. Double-contrast barium-meal examination is the suggested imaging modality for simple dyspepsia, for the oesophagitis-reflux-hiatus hernia complex and for dysphagia; while oesophagogastroduodenoscopy is the method of choice for the investigation of complicated dyspepsia, haematemesis and melaena. In patients who have previously undergone gastric surgery, endoscopy and radiology are complementary procedures - the former more accurate in the diagnosis of recurrent disease like ulceration, and the later useful for the delineation of anatomical changes. The time for the across-the-board replacement of barium studies by primary endoscopy has not yet arrived. 57 refs

Role of medical history and medication use in the aetiology of upper aerodigestive tract cancers in Europe: the ARCAGE study.

LENUS (Irish Health Repository)

Macfarlane, T V

2012-04-01

The study aimed to investigate the role of medical history (skin warts, Candida albicans, herpetic lesions, heartburn, regurgitation) and medication use (for heartburn; for regurgitation; aspirin) in the aetiology of upper aerodigestive tract (UADT) cancer.

Longitudinal change in renal function after nephroureterectomy in patients with upper tract urothelial carcinoma

Directory of Open Access Journals (Sweden)

Chih-Yuan Chou

2015-06-01

Conclusion: In this study, it was found that the average renal function of the patients with upper tract urothelial carcinoma is not as good as the general population. More than half of the normal renal function patients have new onset chronic kidney disease after surgery. For preventing further deterioration of renal function, the implication of partial nephrectomy or segmental ureterectomy for selected patients with localized urothelial carcinoma should be re-examined. Besides, neoadjuvant chemotherapy should be considered for those who are not good candidates for local treatment.

Clinical impact of endoscopic ultrasound-guided fine needle aspiration biopsy in patients with upper gastrointestinal tract malignancies. A prospective study

DEFF Research Database (Denmark)

Mortensen, M B; Pless, T; Durup, J

2001-01-01

BACKGROUND AND STUDY AIMS: Several studies have evaluated the accuracy of endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) in the upper gastrointestinal tract, but so far no studies have specifically evaluated the clinical impact of EUS-FNAB in upper gastrointestinal tract......% in esophageal, gastric, and pancreatic cancer, respectively. The staging-related clinical impact was similar for all three types of cancer (11-12.5%), whereas the diagnosis-related impact was highest in pancreatic cancer patients (86%). EUS-FNAB was inadequate in 13% and gave false-negative results in 5......%. The overall sensitivity, specificity and accuracy for EUS-FNAB were 80%, 78% and 80%, respectively. No complications related to the biopsy procedure were seen. CONCLUSIONS: If EUS-FNAB was performed only in cases where a positive malignant result would change patient management, then approximately one out...

Development of cholecystokinin binding sites in rat upper gastrointestinal tract

Energy Technology Data Exchange (ETDEWEB)

Robinson, P.H.; Moran, T.H.; Goldrich, M.; McHugh, P.R.

1987-04-01

Autoradiography using /sup 125/I-labeled Bolton Hunter-CCK-33 was used to study the distribution of cholecystokinin binding sites at different stages of development in the rat upper gastrointestinal tract. Cholecystokinin (CCK) binding was present in the distal stomach, esophagus, and gastroduodenal junction in the rat fetus of gestational age of 17 days. In the 20-day fetus, specific binding was found in the gastric mucosa, antral circular muscle, and pyloric sphincter. Mucosal binding declined during postnatal development and had disappeared by day 15. Antral binding declined sharply between day 10 and day 15 and disappeared by day 50. Pyloric muscle binding was present in fetal stomach and persisted in the adult. Pancreatic CCK binding was not observed before day 10. These results suggest that CCK may have a role in the control of gastric emptying and ingestive behavior in the neonatal rat.

Molecular grading of tumors of the upper urothelial tract using FGFR3 mutation status identifies patients with favorable prognosis

OpenAIRE

Fernandez, Cecilia; Lyle,Stephen; Hsieh,; Shuber,Anthony

2012-01-01

Stephen R Lyle,1 Chung-Cheng Hsieh,1 Cecilia A Fernandez,2 Anthony P Shuber21University of Massachusetts, Worcester, MA, 2Predictive Biosciences Inc., Lexington, MA, USABackground: Mutations in FGFR3 have been shown to occur in tumors of the upper urothelial tract and may be indicative of a good prognosis. In bladder tumors, the combination of FGFR3 mutation status and Ki-67 level has been used to define a tumor's molecular grade and predict survival. Pathological evaluation of upper ...

Distress and worry as mediators in the relationship between psychosocial risks and upper body musculoskeletal complaints in highly automated manufacturing.

Science.gov (United States)

Wixted, Fiona; Shevlin, Mark; O'Sullivan, Leonard W

2018-03-15

As a result of changes in manufacturing including an upward trend in automation and the advent of the fourth industrial revolution, the requirement for supervisory monitoring and consequently, cognitive demand has increased in automated manufacturing. The incidence of musculoskeletal disorders has also increased in the manufacturing sector. A model was developed based on survey data to test if distress and worry mediate the relationship between psychosocial factors (job control, cognitive demand, social isolation and skill discretion), stress states and symptoms of upper body musculoskeletal disorders in highly automated manufacturing companies (n = 235). These constructs facilitated the development of a statistically significant model (RMSEA 0.057, TLI 0.924, CFI 0.935). Cognitive demand was shown to be related to higher distress in employees, and distress to a higher incidence of self-reported shoulder and lower back symptoms. The mediation model incorporating stress states (distress, worry) as mediators is a novel approach in linking psychosocial risks to musculoskeletal disorders. Practitioners' Summary With little requirement for physical work in many modern automated manufacturing workplaces, there is often minimal management focus on Work-Related Musculoskeletal Disorders (WRMSDs) as important occupational health problems. Our model provides evidence that psychosocial factors are important risk factors in symptoms of WRMSD and should be managed.

Upper and lower respiratory tract microbiota in horses: bacterial communities associated with health and mild asthma (inflammatory airway disease) and effects of dexamethasone.

Science.gov (United States)

Bond, Stephanie L; Timsit, Edouard; Workentine, Matthew; Alexander, Trevor; Léguillette, Renaud

2017-08-23

The microbial composition of the equine respiratory tract, and differences due to mild equine asthma (also called Inflammatory Airway Disease (IAD)) have not been reported. The primary treatment for control of IAD in horses are corticosteroids. The objectives were to characterize the upper and lower respiratory tract microbiota associated with respiratory health and IAD, and to investigate the effects of dexamethasone on these bacterial communities using high throughput sequencing. The respiratory microbiota of horses was dominated by four major phyla, Proteobacteria (43.85%), Actinobacteria (21.63%), Firmicutes (16.82%), and Bacteroidetes (13.24%). Fifty genera had a relative abundance > 0.1%, with Sphingomonas and Pantoea being the most abundant. The upper and lower respiratory tract microbiota differed in healthy horses, with a decrease in richness in the lower airways, and 2 OTUs that differed in abundance. There was a separation between bacterial communities in the lower respiratory tract of healthy and IAD horses; 6 OTUs in the tracheal community had different abundance with disease status, with Streptococcus being increased in IAD horses. Treatment with dexamethasone had an effect on the lower respiratory tract microbiota of both heathy and IAD horses, with 8 OTUs increasing in abundance (including Streptococcus) and 1 OTU decreasing. The lower respiratory tract microbiota differed between healthy and IAD horses. Further research on the role of Streptococcus in IAD is warranted. Dexamethasone treatment affected the lower respiratory tract microbiota, which suggests that control of bacterial overgrowth in IAD horses treated with dexamethasone could be part of the treatment strategy.

HEAT AND MOISTURE EXCHANGE CAPACITY OF THE UPPER RESPIRATORY TRACT AND THE EFFECT OF TRACHEOTOMY BREATHING ON ENDOTRACHEAL CLIMATE

NARCIS (Netherlands)

Scheenstra, Renske J.; Muller, Sara H.; Vincent, Andrew; Hilgers, Frans J. M.

2011-01-01

Background. The aim of this study was to assess the heat and moisture exchange (HME) capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate in patients with head and neck cancer. Methods. We plotted the subglottic temperature and humidity measurements

Heat and moisture exchange capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate

NARCIS (Netherlands)

Scheenstra, R.J.; Muller, S.H.; Vincent, A.; Hilgers, F.J.M.

2011-01-01

Background. The aim of this study was to assess the heat and moisture exchange (HME) capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate in patients with head and neck cancer. Methods. We plotted the subglottic temperature and humidity measurements

Risk Factors for Upper and Lower Urinary Tract Cancer Death in a Japanese Population: Findings from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study).

Science.gov (United States)

Washio, Masakazu; Mori, Mitsuru; Mikami, Kazuya; Miki, Tsuneharu; Watanabe, Yoshiyuki; Nakao, Masahiro; Kubo, Tatsuhiko; Suzuki, Koji; Ozasa, Kotaro; Wakai, Kenji; Tamakoshi, Akiko

2016-01-01

The incidence of bladder cancer is lower in Asian than in Western countries. However, the crude incidence and mortality of bladder cancer have recently increased in Japan because of the increased number of senior citizens. We have already reported risk factors for urothelial cancer in a large populationbased cohort study in Japan (JACC study). However, we did not evaluate the cancer risk in the upper and lower urinary tract separately in our previous study. Here we evaluated the risk of cancer death in the upper and lower urinary tracts, separately, using the database of the JACC study. The analytic cohort included 46,395 males and 64,190 females aged 40 to 79 years old. The Cox proportional hazard model was used to determine hazard ratios and their 95% confidence intervals. Current smoking increased the risk of both upper and lower urinary tract cancer deaths. A history of kidney disease was associated with an increased risk of bladder cancer death, even after controlling for age, sex and smoking status. The present study confirmed that current smoking increases the risk of both upper and lower urinary tract cancer deaths and indicated the possibility that a history of kidney disease may be a risk factor for bladder cancer death in the Japanese population.

Intraperitoneal lactate/pyruvate ratio and the level of glucose and glycerol concentration differ between patients surgically treated for upper and lower perforations of the gastrointestinal tract

DEFF Research Database (Denmark)

Sabroe, Jonas E; Axelsen, Anne R; Ellebæk, Mark B

2017-01-01

collected every 4th hour for up to 7 postoperative days. Samples were analysed for concentrations of glucose, lactate, pyruvate and glycerol. RESULTS: Microdialysis results showed that patients with upper gastrointestinal tract lesions had significantly higher levels of postoperative intraperitoneal glucose...... and glycerol concentrations, as well as lower lactate/pyruvate ratios and lactate/glucose ratios. In the group with perforation of the lower gastrointestinal tract, those patients with a complicated course showed lower levels of postoperative intraperitoneal glucose concentration and glycerol concentration...... and higher lactate/pyruvate ratios and lactate/glucose ratios than those patients with an uncomplicated course. CONCLUSION: Patients with upper and lower gastrointestinal tract lesions showed differences in postoperative biomarker levels. A difference was also seen between patients with complicated...

Anaerobic bacteria in upper respiratory tract and head and neck infections: microbiology and treatment.

Science.gov (United States)

Brook, Itzhak

2012-04-01

Anaerobes are the predominant components of oropharyngeal mucous membranes bacterial flora, and are therefore a common cause of bacterial infections of endogenous origin of upper respiratory tract and head and neck. This review summarizes the aerobic and anaerobic microbiology and antimicrobials therapy of these infections. These include acute and chronic otitis media, mastoiditis and sinusitis, pharyngo-tonsillitis, peritonsillar, retropharyngeal and parapharyngeal abscesses, suppurative thyroiditis, cervical lymphadenitis, parotitis, siliadenitis, and deep neck infections including Lemierre Syndrome. The recovery from these infections depends on prompt and proper medical and when indicated also surgical management. Copyright © 2012 Elsevier Ltd. All rights reserved.

Ultrasonography to visualize the upper urinary tract in children with meningomyelocele.

Science.gov (United States)

Abrahamsson, Kate; Jodal, Ulf; Stokland, Eira; Nordvall, Anders; Sillén, Ulla

2006-10-01

To evaluate the frequency of difficulties when using ultrasonography (US, commonly used to visualize the upper urinary tract) to evaluate renal length and dilatation in children and adolescents with meningomyelocele (MMC), who have excessive obesity or a distorted spine. The records of all children with MMC investigated during 1996-2002 were assessed retrospectively and the last investigation used for analysis. In addition to the US results, the body mass index (BMI) and angulation of the spine were recorded. Of the 160 children investigated, US was not evaluable in 46 (29%), i.e. in 35 (22%) for renal length, in one (1%) for dilatation and in 10 (6%) for both. In 99 patients with a straight spine and mild to moderate angulation, renal length was not measurable in 14 (14%), while dilatation was not evaluable in two (2%). In 61 patients with a severely angled spine, the corresponding values were 31 (51%) and nine (15%), respectively. In eight patients with a BMI of >or= 27 kg/m2 and a straight spine, four of the investigations were not completely evaluable, while six were not in the eight patients with both a BMI of >or= 27 kg/m2 and severe angulation. Both severe spinal angulation and a BMI of >or= 27 kg/m2 significantly reduced the possibility of evaluating the urinary tract by US. However, in an unselected group of children with MMC, dilatation could be evaluated in >90% and renal length in approximately 70%.

Adenocarcinoma at Anastomotic Site of Ureterosigmoidostomy Potentially of Urothelial Origin Spreading to the Upper Urinary Tract

Directory of Open Access Journals (Sweden)

Katsuhiro Makino

2015-01-01

Full Text Available Ureterosigmoidostomy is associated with the risk of several late complications including cancer development at anastomotic sites. We present an unusual case with adenocarcinoma of the anastomotic site associated with multiple adenocarcinoma lesions in the upper urinary tract. A 69-year-old man complained of persistent melena and hematuria. He had undergone radical cystectomy for high-grade bladder cancer and ureterosigmoidostomy 30 years before. Colonoscopy showed a tumor at the right ureterocolonic anastomosis, which was endoscopically resected and histologically diagnosed as adenocarcinoma. Seven years later, a tumor of the left ureterocolonic anastomosis associated with hydronephrosis was found. He underwent temporal percutaneous nephrostomy followed by sigmoidectomy and left ureterocutaneostomy. Eighteen months after the operation, computed tomography (CT detected left renal pelvic tumor with a mass along the former nephrostomy tract. Left nephroureterectomy and resection of the nephrostomy tract tumor revealed adenocarcinoma with multiple lesions of adenocarcinoma in the ureter. These tumors showed atypical immunohistochemistry as a colonic adenocarcinoma: positive for cytokeratin 7, negative for cytokeratin 20, and negative for β-catenin nuclear accumulation. Anastomotic site adenocarcinoma of the present case is potentially of urothelial origin because of unusual clinical manifestation and immunohistochemistry as a colon cancer.

The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy

Directory of Open Access Journals (Sweden)

Chi-Hang Yee

2017-06-01

Full Text Available Purpose The aims of this study were to investigate the prevalence of upper tract involvement in ketamine-associated uropathy, and to determine the predictors of hydronephrosis in patients with a history of ketamine abuse. Methods This was a cross-sectional study of a prospective cohort of patients with ketamine-associated uropathy. Data including demographics, pattern of ketamine abuse, pelvic pain and urgency or frequency (PUF symptom score, uroflowmetry (UFM parameters, serum renal function, and liver function tests were collected. Upon consultation, ultrasonography was performed to assess the function of the urinary system. Results From December 2011 to October 2015, we treated 572 patients with ketamine-associated uropathy. Of these patients, 207 (36.2% had managed to achieve abstinence at the time of their first consultation. Ninety-six patients (16.8% in the cohort were found to have hydronephrosis on ultrasonography. Univariate analysis identified age, duration of ketamine abuse, PUF symptom score, voided volume on UFM, serum creatinine levels >100 μmol/L, and an abnormal serum liver enzyme profile as factors associated with hydronephrosis. Logistic regression revealed the following parameters to be statistically related to hydronephrosis: age (adjusted odds ratio [OR], 1.090; 95% confidence interval [CI], 1.020–1.166; P=0.012, functional bladder capacity (adjusted OR, 0.997; 95% CI, 0.995–0.999; P=0.029, serum creatinine >100 μmol/L (adjusted OR, 3.107; 95% CI, 1.238–7.794; P=0.016, and an abnormal serum liver enzyme profile (adjusted OR, 1.967; 95% CI, 1.213–3.187; P=0.006. Conclusions Ketamine-associated uropathy can involve the upper urinary tract. Patient demographics as well as investigations of UFM, renal function tests, and liver function tests may allow us to identify at-risk patients.

Incidence of upper tract abnormalities in patients with neurovesical dysfunction secondary to multiple sclerosis: analysis of risk factors at initial urologic evaluation.

Science.gov (United States)

Lemack, Gary E; Hawker, Kathleen; Frohman, Elliot

2005-05-01

To determine the incidence of upper tract abnormalities on renal ultrasonography in patients with multiple sclerosis (MS) referred for urologic evaluation, as well as to identify any risk factors present on the basis of the historical information and urodynamic findings. Data were derived from all patients with MS referred to the neurourology clinic during a 4-year period. The database was specifically queried for patients found to have upper tract abnormalities on screening renal ultrasonography. Demographic parameters, as well as laboratory values (creatinine) and urodynamic results, were evaluated for risk factors associated with abnormal upper tract findings. Of the 113 patients referred and evaluated, 66 completed both urodynamic testing and renal ultrasonography. Eleven (16.7%) had abnormal ultrasound findings, with focal caliectasis the most common finding. No demographic parameter (age, sex, time since MS diagnosis, MS pattern) was associated with a greater likelihood of abnormal renal ultrasonography on univariate analysis. Neither serum creatinine nor any urodynamic finding (including the presence of dyssynergia or the threshold and amplitude of detrusor overactivity) was associated with abnormal renal ultrasound findings. No patients in our series had any indication of obstructive uropathy more severe than mild hydronephrosis. Of the 16.7% of patients with any abnormal findings, most were noted to have minor caliectasis, likely to be of little clinical significance. Although no factors identifying patients at risk of renal abnormalities at presentation were found, ongoing evaluation of patients with baseline findings will serve to identify those at risk of progression.

The clinical significance of diuresis studies on the patients with dilated upper urinary tract

International Nuclear Information System (INIS)

Kuroda, Noriyuki; Ueda, Toyofumi; Amano, Takuya; Kaji, Shinichi; Ichiya, Yuichi

1983-01-01

In order to determine the clinical value of diuresis urogram and diuresis renogram as the urodynamic assessment in dilated upper urinary tract, 21 kidneys of 17 patients (12 men and 5 women) with hydronephrosis or hydronephroureter were examined. The kidneys examined by diuresis urogram were divided into four grades - grade a (more than 22% of dilation), grade b (between 10 and 22%), grade c (less than 10%), and grade d (wash-out). Of 10 preoperative kidneys of 9 patients, 4 kidneys were in grade a (40%), 4 in grade b (40%), 2 in grade c (20%), and none in grade d (0%). Of 12 postoperative kidneys of 12 patients, 2 kidneys were in grade a (16.6%), 2 in grade b (16.7%), 4 in grade c (33.3%), and 4 in grade d (33.3%). The kidneys examined by diuresis renogram were divided into groups II, IIIb and IIIa in accordance with diuresis excretion index (DEI) and renogram pattern. Of 11 preoperative kidneys of 9 patients, 4 kidneys were in group II (36.7%), 2 in group IIIb (18.2%), and 5 in group IIIa (45.1%). Of 12 postoperative kidneys of 11 patients, 2 kidneys were in group II (16.7%), 2 in group IIIb (16.7%), and 8 in group IIIa (66.6%). There was no significant correlation between % dilation of diuresis urogram and DEI of diuresis renogram. Diuresis urogram and renogram give valuable information about the degree of obstruction in the dilated upper urinary tract, but do not always the same value on the same kidney each other. (J.P.N.)

Medicine use practices in management of symptoms of acute upper respiratory tract infections in children (≤12 years) in Kampala city, Uganda.

Science.gov (United States)

Ocan, Moses; Aono, Mary; Bukirwa, Clare; Luyinda, Emmanuel; Ochwo, Cathy; Nsambu, Elastus; Namugonza, Stella; Makoba, Joseph; Kandaruku, Enock; Muyende, Hannington; Nakawunde, Aida

2017-09-21

Medicines are commonly accessed and used for management of illness in children without a prescription. This potentially increases the risk of unwanted treatment outcomes. We investigated medicine use practices in management of symptoms of acute upper respiratory tract infections among children (≤12 years) in households in Nakawa division, Kampala city. This was a cross-sectional study conducted among 390 randomly selected children. Data on use of medicines in children (≤12 years) during recent episode of acute upper respiratory tract infection was collected from their care takers using an interviewer administered questionnaire. A recall period of two weeks (14 days) was used in during data collection. The prevalence of giving children non-prescription antimicrobial medicines was 44.8% (38.3-52.2). The most common disease symptoms that the children reportedly had included flu, 84.9% (331/390), cough, 83.1% (324/390), and undefined fever, 69.7% (272/390). Medicines commonly given to children included, paracetamol 53.1% (207/390), Coartem 29.7% (116/390), cough linctus 20.8% (81/390), amoxicillin 18.9% (74/390), Co-trimoxazole 18.5% (72/390), and diphenhydramine 15.4% (60/390). The major sources of medicines given to the children was hospital/clinic, 57.26% (223/390). Most of the children, 81% were given more than one medicine at a time. The majority, 62.3% (243/390) of the care takers who gave the children medicine during the recent illness were not aware of any medicine (s) that should not be given to children. The predictors of non-prescription use of antimicrobial medicines in managing symptoms of acute upper respiratory tract infections in children included, medicines obtained from drug shop (PR: 1.45, CI: 1.14-1.85), medicines at home (PR: 1.8, CI: 0.83-1.198) and type of medicine (antimalarial) (PR: 2.8, CI: 1.17-6.68). Children are commonly given multiple medicines during episodes of acute upper respiratory tract infections with most antimicrobial

Pattern of presentation and management of benign upper urinary ...

African Journals Online (AJOL)

Background: Upper urinary tract obstruction is a common cause of severe symptoms, recurrent urinary tract infection and deterioration or complete loss of renal function when intervention is not timely. Objective: To document the pattern of presentation and the management options for the benign upper urinary tract ...

IMPROVING THE DIAGNOSIS AND TREATMENT OF RETENTION DISORDERS OF THE UPPER URINARY TRACT IN PATIENTS WITH STAGES IIB–III CANCER OF THE CERVIX UTERI

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A. D. Kaprin

2012-01-01

Full Text Available Study investigates the prevalence, diagnosis and treatment in patients with retention disorders upper urinary tract cervical cancer stage IIB III after more than 3 months after combined radiotherapy. In the apartment complex to the diagnosis of renal ultrasound and radioisotope study of renal excretory function added to the study ureteral emissions by color Doppler sonography. Information on ureteral emissions revealed a violation of the early passage of urine in 23.1 % of patients with renal ultrasound revealed no pathology. On the basis of violations ureteral emissions increase in the number of patients, respectively, are assigned to nonoperative treatment (anti-inflammatory, spasmolytic therapy. As a result, decreased by 14.2 % (p = 0.034, female patients, which showed drainage of the upper urinary tract.

Adolescent Mental Health: Neighborhood Stress and Emotional Distress

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Snedker, Karen A.; Herting, Jerald R.

2016-01-01

The purpose of this article is to explore the role of neighborhood characteristics, specifically economic disadvantage/advantage, residential instability, and racial/ethnic heterogeneity on emotional distress (depressed affect, anxiety, hopelessness) among youth. Using a regional sample of adolescents and matching their data to census tracts, we…

The Role of Endoscopic Ultrasound in the Diagnostic Assessment of Subepithelial Lesions of the Upper Gastrointestinal Tract

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Francisca Dias de Castro

2016-11-01

Conclusion: EUS is the method of choice in the study of subepithelial lesions of the upper gastrointestinal tract, in most cases defining a diagnosis. The need for a definitive diagnosis or therapeutic approaches can be based on ultrasound risk features, presented, in the majority, at presentation. This study shows that EUS is capable of safely and accurately define those subepithelial lesions that can be managed only with surveillance ultrasound while waiting for better results with fine needle aspiration.

Urinary tract infections of Escherichia coli strains of chaperone-usher system.

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Zalewska-Piatek, Beata M

2011-01-01

Urinary tract infections are a very serious health and economic problem affecting millions of people each year worldwide. The most common etiologic agent of this type of bacterial infections, involving the upper and lower urinary tract, are E. coli strains representing approximately 80% of cases. Uropathogenic E. coli strains produce several urovirulence factors which can be divided into two main types, surface virulence factors and exported virulence factors. Surface-exposed structures include mainly extracellular adhesive organelles such as fimbriae/pili necessary in adhesion, invasion, biofilm formation and cytokine induction. Among the surface-exposed polymeric adhesive structures there are three most invasive groups, type 1 pili, type P pili and Dr family of adhesins which are bioassembled via the conserved, among Gram-negative bacteria, chaperone-usher secretion system. Type 1 and P-piliated E. coli cause cystitis and pyelonephritis. The Dr family of adhesins recognizing DAF receptor is responsible for cystitis, pyelonephritis (especially in pregnant women) and diarrhoea (in infants). In addition, Dr-positive E. coli strains carry the risk of recurrent urinary tract infections. Pyelonephritis in pregnant women leads to a series of complications such as bacteremia, urosepsis, acute respiratory distress syndrome and even death. In the era of increasing drug resistance of bacteria, the development of vaccines, drugs termed pilicides and inhibitors of adhesion may be a promising tool in the fight against urogenital infections.

The associations of humorous coping styles, affective states, job demands and job control with the frequency of upper respiratory tract infection

NARCIS (Netherlands)

Doosje, S.; De Goede, M.P.M.; Van Doornen, L.J.P.; Van de Schoot, R.

2011-01-01

Orientation: There is some evidence that job demands and job resources such as job control and humorous coping may contribute to the risk of upper respiratory tract infections (URTI). Research purpose: The purpose of this study was to test a model including these variables as well as job-related

Emerging and established global life-style risk factors for cancer of the upper aero-digestive tract.

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Gupta, Bhawna; Johnson, Newell W

2014-01-01

Upper aero-digestive tract cancer is a multidimensional problem, international trends showing complex rises and falls in incidence and mortality across the globe, with variation across different cultural and socio-economic groups. This paper seeks some explanations and identifies some research and policy needs. The literature illustrates the multifactorial nature of carcinogenesis. At the cellular level, it is viewed as a multistep process involving multiple mutations and selection for cells with progressively increasing capacity for proliferation, survival, invasion, and metastasis. Established and emerging risk factors, in addition to changes in incidence and prevalence of cancers of the upper aero-digestive tract, were identified. Exposure to tobacco and alcohol, as well as diets inadequate in fresh fruits and vegetables, remain the major risk factors, with persistent infection by particular so-called "high risk" genotypes of human papillomavirus increasingly recognised as also playing an important role in a subset of cases, particularly for the oropharynx. Chronic trauma to oral mucosa from poor restorations and prostheses, in addition to poor oral hygiene with a consequent heavy microbial load in the mouth, are also emerging as significant risk factors. Understanding and quantifying the impact of individual risk factors for these cancers is vital for health decision-making, planning and prevention. National policies and programmes should be designed and implemented to control exposure to environmental risks, by legislation if necessary, and to raise awareness so that people are provided with the information and support they need to adopt healthy lifestyles.

Risk factors and features of recurrent bacterial complications of upper respiratory tract viral infections in children

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Karpenko A.V.

2017-10-01

Full Text Available The aim of the study was to determine risk factors for recurrent bacterial complications of the upper respiratory tract viral infection (URTI in children, as well as the clinical and immunological features of the course of such complications. We enrolled 214 children aged 3-18 years with URTIs complicated with acute otitis media or acute bacterial rhinosinusitis. Frequency of bacterial complications of URI in 128 children was low (group I and in 86 children it met the criteria of recurrent course (group II. In addition to the standard examination, lysozyme levels in the oropharyngeal secretion were determined three times during the disease. It was found that children of group II were characterized by an early debut of respiratory morbidity (at the age of 6.00 (4.00, 12.00 months against 13.00 (4.50, 16.00 months in children of group I (p<0,0001, as well as a longer duration of catarrhal and intoxication syndromes in similar forms of the disease. The most significant risk factors for the formation of the recurring complication pattern were maternal smoking (OR=2.73, 95% CI [1.34, 5.48], along with gastroenterological pathology and frequent URTI in the mother and a shortened period of breastfeeding. In children with recurrent bacterial complications of URTI, there was an impaired local resistance of the upper respiratory tract mucous membranes (as a decrease in the concentrations of lysozyme in all periods of the disease, which persisted after recovery.

The development of lavage procedures for the upper and lower respiratory tract of the cat

International Nuclear Information System (INIS)

McCarthy, Grainne; Quinn, P.J.

1986-01-01

New techniques for routine bronchopulmonary lavage (BPL) and nasal flushing in the anaesthetized cat which are safe, reproducible and simple to use have been developed. Five adult mixed-breed cats from a specific pathogen-free colony were selected, fasted overnight and weighed. The feeding tube was passed through the endotracheal tube and down the trachea until it became wedged in the bronchus. Nasal flushing was then immediately carried out after the BPL with the endotracheal tube in position. Radiological and fluoroscopic examinations were carried out to determine the position of the feeding tube in the lung. Lateral and dorsoventral views of the thorax of each cat were taken. These examinations identified the tube most frequently in the caudal lobe of the lung. The lavage techniques described provide a definite procedure for investigating the cellular and humoral mechanisms operating in the upper and lower respiratory tract of the cat. These methods can be used to sample directly the cellular and humoral constituents contributing to defence mechanisms in the feline respiratory tract and to monitor the local changes accompanying respiratory disease

Upper Gastrointestinal (GI) Series

Science.gov (United States)

... standard barium upper GI series, which uses only barium a double-contrast upper GI series, which uses both air and ... evenly coat your upper GI tract with the barium. If you are having a double-contrast study, you will swallow gas-forming crystals that ...

Impact of environmental pollution on the incidence of malignant neoplasms of upper respiratory tract in the population of Mysłowice, Imielin and Chełm Śląski

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Jerzy Stockfisch

2014-03-01

Full Text Available Background. The paper presents a retrospective analysis of cases of the upper respiratory tract malignant tumors in the settlement: Mysłowice, Imielin, Chełm Śląski based on the patients’ medical history treated in a hospital laryngological ward in Mysłowice between 1995 and 2004. The inspiration to write the paper was the significant frequency of the upper respiratory tract malignant tumor cases in the main areas of Mysłowice; Piasek and Rymera estate. The aim of the study was the assessment of relationship between environmental pollution and territorial diversity in the morbidity of head and neck cancer. Material and methods. The study involved a group of 130 patients with cancer of the upper respiratory tract and a control group of 145 healthy subjects of similar age and sex, living in the different regions of the surveyed towns in the comparable proportions and in the group of patients. The paper aimed to assess the relationship between territorial diversity of the upper respiratory tract cancers, and environmental risk factors. Results. The analysis was based on environmental pollution data. It was confirmed that the geographic picture of the incidence of the upper airways malignant tumors showed that Mysłowice central districts: Piasek and estate Rymera, indicated this region to be particularly critical one. Conclusions. The increased number of morbidity cases in these districts may be associated with: environmental risk factors, increased consumption of high percentage alcohol, excessive amount of smoked cigarette and low socio-economic status of the patients.

Heat and moisture exchange capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate.

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Scheenstra, Renske J; Muller, Sara H; Vincent, Andrew; Hilgers, Frans J M

2011-01-01

The aim of this study was to assess the heat and moisture exchange (HME) capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate in patients with head and neck cancer. We plotted the subglottic temperature and humidity measurements in 10 patients with head and neck cancer with a temporary precautionary tracheotomy during successive 10-minute periods of nose, mouth, and tracheotomy breathing in a randomized sequence. End-inspiratory temperatures of nose, mouth, and tracheotomy breathing were 31.1, 31.3, and 28.3°C, respectively. End-inspiratory humidity measurements of nose, mouth, and tracheotomy breathing were 29.3, 28.6, and 21.1 mgH₂O/L, respectively. There was a trend toward lower end-inspiratory humidity in patients with radiotherapy or with large surgery-induced oropharyngeal mucosal defects, whereas temperatures were similar. This study gives objective information about the HME capacity of the upper respiratory tract in patients with head and neck cancer with precautionary tracheotomy, and thus provides target values for HMEs for laryngectomized and tracheotomized patients. © 2010 Wiley Periodicals, Inc. Head Neck, 2011.

[The Life Impacts and Symptom Distress in Women With Pelvic Organ Prolapse Syndrome Before Pelvic Reconstruction Surgery].

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Ko, I-Chen; Lo, Tsia-Shu; Lu, Yu-Ying; Tsao, Lee-Ing

2017-02-01

The decision whether or not to undergo pelvic reconstructive surgery is difficult for women suffering from pelvic organ prolapse. However, little research has examined the symptom distress and life impacts that these women face prior to this surgery. Thus, it is crucial that gynecology nurses learn about these life impacts and symptom distresses in order to help these women make the best decisions with regard to surgery. To explore the life impacts and degree of symptom distress in pre-surgery women with pelvic organ prolapse; to explore the relationships between demographic data and the variables of life impact and degree of symptom distress; and to identify the factors that relate to the explainable variance in the life impacts of these women. A cross-sectional and correlational research design was used and a total of 110 women with pelvic organ prolapse who had not yet undergone pelvic reconstruction surgery were recruited in the gynecological clinics of one medical center in Taiwan. Daytime urination frequency was the most prevalent urinary tract symptom noted by the participants; vaginal protrusion was the most prevalent pelvis-related symptom noted; and depression and anxiety were the most prevalent life impacts noted. Moreover, greater lower-urinary-tract symptom distress was associated with greater pelvic-symptom distress. Furthermore, greater lower urinary tract and pelvic symptom distresses were associated with a greater negative impact on life. Education background and pelvis-related symptoms were the explained variances in pre-surgery life impacts. Women with pelvic organ prolapse should pay particular attention to symptoms that include: daytime urinary frequency, vaginal protrusion, and emotional problems including depression and anxiety. Education background and level of symptom distress should be taken into consideration when caring for the life impacts of this vulnerable group of women.

Behavioral Effects of Upper Respiratory Tract Illnesses: A Consideration of Possible Underlying Cognitive Mechanisms

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Andrew P. Smith

2012-03-01

Full Text Available Previous research has shown that both experimentally induced upper respiratory tract illnesses (URTIs and naturally occurring URTIs influence mood and performance. The present study investigated possible cognitive mechanisms underlying the URTI-performance changes. Those who developed a cold (N = 47 had significantly faster, but less accurate, performance than those who remained healthy (N = 54. Illness had no effect on manipulations designed to influence encoding, response organisation (stimulus-response compatilibility or response preparation. Similarly, there was no evidence that different components of working memory were impaired. Overall, the present research confirms that URTIs can have an effect on performance efficiency. Further research is required to identify the physiological and behavioral mechanisms underlying these effects.

Performance of Urinary Markers for Detection of Upper Tract Urothelial Carcinoma: Is Upper Tract Urine More Accurate than Urine from the Bladder?

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Simone Bier

2018-01-01

Full Text Available Objectives. To assess the performance of urine markers determined in urine samples from the bladder compared to samples collected from the upper urinary tract (UUT for diagnosis of UUT urothelial carcinoma (UC. Patients and Methods. The study comprised 758 urine samples either collected from the bladder (n=373 or UUT (n=385. All patients underwent urethrocystoscopy and UUT imaging or ureterorenoscopy. Cytology, fluorescence in situ hybridization (FISH, immunocytology (uCyt+, and nuclear matrix protein 22 (NMP22 were performed. Results. UUT UC was diagnosed in 59 patients (19.1% (UUT urine and 27 patients (7.2% (bladder-derived urine. For UUT-derived samples, sensitivities for cytology, FISH, NMP22, and uCyt+ were 74.6, 79.0, 100.0, and 100.0, while specificities were 66.6, 50.7, 5.9, and 66.7%, respectively. In bladder-derived samples, sensitivities were 59.3, 52.9, 62.5, and 50.0% whereas specificities were 82.9, 85.0, 31.3, and 69.8%. In UUT-derived samples, concomitant bladder cancer led to increased false-positive rates of cytology and FISH. Conclusions. Urine markers determined in urine collected from the UUT exhibit better sensitivity but lower specificity compared to markers determined in bladder-derived urine. Concomitant or recent diagnosis of UC of the bladder can further influence markers determined in UUT urine.

Medicine use practices in management of symptoms of acute upper respiratory tract infections in children (≤12 years in Kampala city, Uganda

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Moses Ocan

2017-09-01

Full Text Available Abstract Background Medicines are commonly accessed and used for management of illness in children without a prescription. This potentially increases the risk of unwanted treatment outcomes. We investigated medicine use practices in management of symptoms of acute upper respiratory tract infections among children (≤12 years in households in Nakawa division, Kampala city. Methods This was a cross-sectional study conducted among 390 randomly selected children. Data on use of medicines in children (≤12 years during recent episode of acute upper respiratory tract infection was collected from their care takers using an interviewer administered questionnaire. A recall period of two weeks (14 days was used in during data collection. Results The prevalence of giving children non-prescription antimicrobial medicines was 44.8% (38.3-52.2. The most common disease symptoms that the children reportedly had included flu, 84.9% (331/390, cough, 83.1% (324/390, and undefined fever, 69.7% (272/390. Medicines commonly given to children included, paracetamol 53.1% (207/390, Coartem 29.7% (116/390, cough linctus 20.8% (81/390, amoxicillin 18.9% (74/390, Co-trimoxazole 18.5% (72/390, and diphenhydramine 15.4% (60/390. The major sources of medicines given to the children was hospital/clinic, 57.26% (223/390. Most of the children, 81% were given more than one medicine at a time. The majority, 62.3% (243/390 of the care takers who gave the children medicine during the recent illness were not aware of any medicine (s that should not be given to children. The predictors of non-prescription use of antimicrobial medicines in managing symptoms of acute upper respiratory tract infections in children included, medicines obtained from drug shop (PR: 1.45, CI: 1.14-1.85, medicines at home (PR: 1.8, CI: 0.83-1.198 and type of medicine (antimalarial (PR: 2.8, CI: 1.17-6.68. Conclusion Children are commonly given multiple medicines during episodes of acute upper respiratory

Reduced nasal IL-10 and enhanced TNFalpha responses during rhinovirus and RSV-induced upper respiratory tract infection in atopic and non-atopic infants

NARCIS (Netherlands)

van Benten, I. J.; van Drunen, C. M.; Koevoet, J. L. M.; Koopman, L. P.; Hop, W. C. J.; Osterhaus, A. D. M. E.; Neijens, H. J.; Fokkens, W. J.

2005-01-01

Rhinovirus and respiratory syncytial virus (RSV) are the most prevalent inducers of upper respiratory tract infections (URTI) in infants and may stimulate immune maturation. To estimate the amount of immune stimulation, nasal immune responses were examined during rhinovirus and RSV-induced URTI in

A chicken influenza virus recognizes fucosylated α2,3 sialoglycan receptors on the epithelial cells lining upper respiratory tracts of chickens.

Science.gov (United States)

Hiono, Takahiro; Okamatsu, Masatoshi; Nishihara, Shoko; Takase-Yoden, Sayaka; Sakoda, Yoshihiro; Kida, Hiroshi

2014-05-01

Influenza viruses recognize sialoglycans as receptors. Although viruses isolated form chickens preferentially bind to sialic acid α2,3 galactose (SAα2,3Gal) glycans as do those of ducks, chickens were not experimentally infected with viruses isolated from ducks. A chicken influenza virus, A/chicken/Ibaraki/1/2005 (H5N2) (Ck/IBR) bound to fucose-branched SAα2,3Gal glycans, whereas the binding towards linear SAα2,3Gal glycans was weak. On the epithelial cells of the upper respiratory tracts of chickens, fucose-branched SAα2,3Gal glycans were detected, but not linear SAα2,3Gal glycans. The growth of Ck/IBR in MDCK-FUT cells, which were genetically prepared to express fucose-branched SAα2,3Gal glycans, was significantly higher than that in the parental MDCK cells. The present results indicate that fucose-branched SAα2,3Gal glycans existing on the epithelial cells lining the upper respiratory tracts of chickens are critical for recognition by Ck/IBR. Copyright © 2014 Elsevier Inc. All rights reserved.

Urinary Tract Infections in Children : EAU/ESPU Guidelines

NARCIS (Netherlands)

Stein, Raimund; Dogan, Hasan S.; Hoebeke, Piet; Kocvara, Radim; Nijman, Rien J. M.; Radmayr, Christian; Tekgul, Serdar

Context: In 30% of children with urinary tract anomalies, urinary tract infection (UTI) can be the first sign. Failure to identify patients at risk can result in damage to the upper urinary tract. Objective: To provide recommendations for the diagnosis, treatment, and imaging of children presenting

[Clinical, ureteroscopic and photodynamic diagnosis of urothelial carcinomas of the upper tract: state-of-the art review for the yearly scientific report of the French National Association of Urology].

Science.gov (United States)

Nison, L; Bozzini, G; Rouprêt, M; Traxer, O; Colin, P

2014-11-01

To propose a state-of-the art of current knowledge about clinical, ureteroscopic and photodynamic for the diagnosis of the upper urinary tract cancer (UTUC). A systematic review of the literature search was performed from the database Medline (NLM, Pubmed), focused on the following keywords: urothelial carcinomas; upper urinary tract; ureter; renal pelvis; diagnosis; fluorescence; ureteroscopy; photodynamic technique; biopsy; cytology. Gross hematuria and flank pain are the two main clinical symptoms revealing a UTUC in daily clinical practice. Urinary cystoscopy and cystoscopy are mandatory to rule out a concomittant synchronous bladder tumour. Flexible ureteroscopy has revolutionized the management of UTUC by allowing a full exploration of upper urinary tract, an endoscopi vizualization of the tumour and assessment of grade with biopsies. A flexible ureteroscopy is mandatory in diagnostic evaluation of UTUC as soon as a conservative management is being considered. New investigation technologies such as fluorescence, narrow band imaging and optical coherence tomography (± combined with ultra sound), are promising for a near future. It has to be understood that the diagnostic work-up of a UTUC has to be exhaustive and particularly the search of another urothelial carcinoma within the urinary tract. Flexible ureterosocopy has revolutionized the diagnosis and management of UTUC and belongs fully to its initial evaluation. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Should Complete and Incomplete Spinal Cord Injury Patients Receive the Same Attention in Urodynamic Evaluations and Ultrasonography Examinations of the Upper Urinary Tract?

Science.gov (United States)

Akkoc, Yesim; Cinar, Yasemin; Kismali, Erkan

2012-01-01

The aim of the study was to compare urodynamic findings and upper urinary tract (UUT) abnormalities detected by ultrasonography in complete and incomplete suprasacral spinal cord injury (SCI) patients with neurogenic detrusor overactivity. Thirty-eight suprasacral SCI patients who underwent ultrasonography evaluation of the UUT and urodynamic…

Patient presentation and physician management of upper respiratory tract infections: a retrospective review of over 5 million primary clinic consultations in Hong Kong.

Science.gov (United States)

Kung, Kenny; Wong, Carmen Ka Man; Wong, Samuel Yeung Shan; Lam, Augustine; Chan, Christy Ka Yan; Griffiths, Sian; Butler, Chris

2014-05-13

Upper respiratory tract infection (URTI) has a significant healthcare burden worldwide. Considerable resources are consumed through health care consultations and prescribed treatment, despite evidence for little or no effect on recovery. Patterns of consultations and care including use of symptomatic medications and antibiotics for upper respiratory tract infections are poorly described. We performed a retrospective review of computerized clinical data on patients presenting to all public primary care clinics in Hong Kong with symptoms of respiratory tract infections. International Classification of Primary care (ICPC)codes used to identify patients included otitis media (H71), streptococcal pharyngitis (R72), acute URTI (R74), acute sinusitis (R75), acute tonsillitis (R76), acute laryngitis (R77), and influenza (R80). Sociodemographic variables such as gender, age, chronic illness status, attendance date, type and duration of drug prescribed were also collected. Of the 5,529,755 primary care consultations for respiratory symptoms from 2005 to 2010, 98% resulted in a prescription. Prescription patterns of symptomatic medication were largely similar across the 5 years. In 2010 the mean number of drugs prescribed per consultation was 3.2, of which the commonly prescribed medication were sedating antihistamines (79.9%), analgesia (58.9%), throat lozenges (40.4%) and expectorant cough syrup (33.8%). During the study period, there was an overall decline in antibiotic prescription (8.1% to 5.1%). However, in consultations where the given diagnosis was otitis media (H71), streptococcal pharyngitis (R72), acute sinusitis (R75) or acute laryngitis (R76), over 90% resulted in antibiotic prescription. There was a decline in overall antibiotic prescription over the study period. However, the use of antibiotics was high in some conditions e.g. otitis media and acute laryngitis a. Multiple symptomatic medications were given for upper respiratory tract infections. Further

Are the Saudi parents aware of antibiotic role in upper respiratory tract infections in children?

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Abdulaziz S. Alrafiaah

2017-09-01

Full Text Available Upper respiratory tract infection (URTI is considered to be the most common reason for children’s visits to emergency departments or outpatient clinics. The misuse and overuse of antibiotics are currently major public health problems worldwide. This study aimed to assess Saudi parents’ knowledge, attitude, and practice (KAP regarding the use of antibiotics in URTIs in children.This cross-sectional study was conducted in Saudi Arabia using a previously validated questionnaire, which was distributed using Twitter. A total of 385 individuals completed the questionnaire. For the majority of the participants (77%, physicians were the primary source of information regarding the use of antibiotics. Forty-four percent of parents agreed that most URTIs are caused by viruses, and 81% were aware that inappropriate use of antibiotics leads to the development of antibiotic resistance. Fever was the primary symptom (27% that led parents to ask for prescriptions for antibiotics. Although women had a higher attitude score (p = 0.01, there was no difference between genders regarding knowledge and practice. Older participants (41 years or more had a lower attitude score (p = 0.02. Furthermore, participants with five children or more had lower attitude and practice scores (p = 0.006, 0.04, respectively. Participants who lived in large cities had greater knowledge compared to the inhabitants of small cities (p = 0.01. In conclusion, the findings of this study demonstrated that most of the participants were educated but lacked knowledge regarding antibiotic use in URTIs in children. This lack of knowledge led to inappropriate attitude and practice. Thus, launching public educational campaigns and encouraging physicians to educate parents regarding the proper use of antibiotics are recommended. Keywords: Upper respiratory tract infections, Parents, Children, Antibiotic, Saudi Arabia

The role of neutrophils in the upper and lower respiratory tract during influenza virus infection of mice

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Reading Patrick C

2008-08-01

Full Text Available Abstract Background Neutrophils have been shown to play a role in host defence against highly virulent and mouse-adapted strains of influenza virus, however it is not clear if an effective neutrophil response is an important factor moderating disease severity during infection with other virus strains. In this study, we have examined the role of neutrophils during infection of mice with influenza virus strain HKx31, a virus strain of the H3N2 subtype and of moderate virulence for mice, to determine the role of neutrophils in the early phase of infection and in clearance of influenza virus from the respiratory tract during the later phase of infection. Methods The anti-Gr-1 monoclonal antibody (mAb RB6-8C5 was used to (i identify neutrophils in the upper (nasal tissues and lower (lung respiratory tract of uninfected and influenza virus-infected mice, and (ii deplete neutrophils prior to and during influenza virus infection of mice. Results Neutrophils were rapidly recruited to the upper and lower airways following influenza virus infection. We demonstrated that use of mAb RB6-8C5 to deplete C57BL/6 (B6 mice of neutrophils is complicated by the ability of this mAb to bind directly to virus-specific CD8+ T cells. Thus, we investigated the role of neutrophils in both the early and later phases of infection using CD8+ T cell-deficient B6.TAP-/- mice. Infection of B6.TAP-/- mice with a low dose of influenza virus did not induce clinical disease in control animals, however RB6-8C5 treatment led to profound weight loss, severe clinical disease and enhanced virus replication throughout the respiratory tract. Conclusion Neutrophils play a critical role in limiting influenza virus replication during the early and later phases of infection. Furthermore, a virus strain of moderate virulence can induce severe clinical disease in the absence of an effective neutrophil response.

Confocal Laser Endomicroscopy for the Diagnosis of Urothelial Carcinoma in the Bladder and the Upper Urinary Tract: Protocols for Two Prospective Explorative Studies.

Science.gov (United States)

Liem, Esmee Iml; Freund, Jan Erik; Baard, Joyce; de Bruin, D Martijn; Laguna Pes, M Pilar; Savci-Heijink, C Dilara; van Leeuwen, Ton G; de Reijke, Theo M; de la Rosette, Jean Jmch

2018-02-07

Visual confirmation of a suspicious lesion in the urinary tract is a major corner stone in diagnosing urothelial carcinoma. However, during cystoscopy (for bladder tumors) and ureterorenoscopy (for tumors of the upper urinary tract) no real-time histopathologic information can be obtained. Confocal laser endomicroscopy (CLE) is an optical imaging technique that allows for in vivo high-resolution imaging and may allow real-time tumor grading of urothelial lesions. The primary objective of both studies is to develop descriptive criteria for in vivo CLE images of urothelial carcinoma (low-grade, high-grade, carcinoma in situ) and normal urothelium by comparing CLE images with corresponding histopathology. In these two prospective clinical trials, CLE imaging will be performed of suspicious lesions and normal tissue in the urinary tract during surgery, prior to resection or biopsy. In the bladder study, CLE will be performed in 60 patients using the Cystoflex UHD-R probe. In the upper urinary tract study, CLE will be performed in 25 patients during ureterorenoscopy, who will undergo radical treatment (nephroureterectomy or segmental ureter resection) thereafter. All CLE images will be analyzed frame by frame by three independent, blinded observers. Histopathology and CLE-based diagnosis of the lesions will be evaluated. Both studies comply with the IDEAL stage 2b recommendations. Presently, recruitment of patients is ongoing in both studies. Results and outcomes are expected in 2018. For development of CLE-based diagnosis of urothelial carcinoma in the bladder and the upper urinary tract, a structured conduct of research is required. This study will provide more insight in tissue-specific CLE criteria for real-time tumor grading of urothelial carcinoma. Confocal Laser Endomicroscopy: ClinicalTrials.gov NCT03013894; https://clinicaltrials.gov /ct2/show/NCT03013894?term=NCT03013894&rank=1 (Archived by WebCite at http://www.webcitation.org/6wiPZ378I); and Dutch Central

FEATURES OF THE MICROBIOME OF THE UPPER RESPIRATORY TRACT IN CHILDREN WITH RECURRENT RESPIRATORY DISEASES

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A. V. Shabaldin

2017-01-01

Full Text Available Studies of the metagenome of the upper respiratory tract in children showed the presence of five major bacterial phyla: Proteobacteria, Firmicutes, Bacteroidetes, Actinobacteria and Fusobacteria. Were revealed population differences in the distribution of weights of the above listed phyla, but subject to the dominance of the Firmicutes. Proved the role of environmental factors and time of year for representation in these biotopes of the phyla: Firmicutes, Proteobacteria, Bacteroidetes. Recurrent respiratory infections, hypertrophy of the tonsils of the lymphoid pharyngeal ring, secretory middle ear infections in children is associated with carriage of Haemophilus (H. parainfluenzae, H. paraphrohaemolyticus, Gemella (G. haemolysans, G. morbillorum, G. sanguinis, Streptococcus (S. pneumoniae, S. pseudopneumoniae, S. intermedius, S. agalactiae. 

SIgA response and incidence of upper respiratory tract infections during intensified training in youth basketball players.

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Moraes, H; Aoki, M S; Freitas, C G; Arruda, Afs; Drago, G; Moreira, A

2017-03-01

The aim of the present study was to examine the effect of an intensified training phase followed by a tapering phase on the salivary immunoglobulin A concentration and on the upper respiratory tract infection (URTI) symptoms in young male basketball players. The session rating of perceived exertion method was used to quantify the internal training load, and the Wisconsin Upper Respiratory Symptom Survey-21 questionnaire was used to assess URTI symptoms. The Yo-Yo IR1 test and saliva collection were carried out at the beginning of the study (T1), after the intensified phase (T2), and after tapering (T3). A higher internal training load was observed for the intensified phase compared with the tapering phase (t=19.10; ptraining load followed by a tapering period negatively affects the mucosal immune function with no significant change in severity of URTI in young basketball players.

The cryptic plasmid is more important for Chlamydia muridarum to colonize the mouse gastrointestinal tract than to infect the genital tract.

Directory of Open Access Journals (Sweden)

Lili Shao

Full Text Available Chlamydia has been detected in the gastrointestinal tracts of both animals and humans. However, the mechanism by which Chlamydia colonizes the gut remains unclear. Chlamydia muridarum is known to spread from the genital to the gastrointestinal tracts hematogenously. The C. muridarum plasmid is a key pathogenic determinant in the mouse upper genital tract although plasmid-deficient C. muridarum is still able to colonize the upper genital tract. We now report that plasmid-deficient C. muridarum exhibits significantly delayed/reduced spreading from the mouse genital to the gastrointestinal tracts. C. muridarum with or without plasmid maintained similar levels in the mouse circulatory system following intravenous inoculation but the hematogenous plasmid-deficient C. muridarum was significantly less efficient in colonizing the gastrointestinal tract. Consistently, plasmid-deficient C. muridarum failed to restore normal colonization in the gastrointestinal tract even after intragastric inoculation at a high dose. Thus, we have demonstrated a plasmid-dependent colonization of C. muridarum in the gastrointestinal tract, supporting the concept that C. muridarum may have acquired the plasmid for adaptation to the mouse gastrointestinal tract during oral-fecal transmission. Since the plasmid is more important for C. muridarum to colonize the gastrointestinal tract than to infect the genital tract, the current study has laid a foundation for further defining the host pathways targeted by the plasmid-encoded or -regulated chlamydial effectors.

Electrophysiological and mechanical activity of the upper gastrointestinal tract after duodenoplasty or segmental resection of benign gastric outlet stenosis.

Science.gov (United States)

Peiper, C; Titkova, S M; Polivoda, M; Anurov, M; Arlt, G; Ottinger, A P; Schumpelick, V

2000-03-01

In an animal experimental study we examined the postoperative recovery of the motility of the upper gastrointestinal tract after operative treatment of a benign gastric outlet obstruction. At 45 Days after induction, a duodenal stenosis was resected in six dogs, and resolved by Finney's duodenoplasty in another six dogs. Fourteen days after segmental resection, the gastric emptying was faster [half evacuation time (T1/2) for semisolid food = 44.4 +/- 16.8 min] than following duodenoplasty [T1/2 = 56.8 +/- 25.3). Here motor migrating complexes (MMCs) started in the antrum and could be traced down to the jejunum. After segmental resection we recognized MMC only distal to the anastomosis. The duration of the whole MMC cycle (69.0 +/- 18.6 min) as well as of the single phases was significantly shorter in the resection group than after duodenoplasty (108.0 +/- 15.1 min). At 28 days after operation the differences in the electromyographic findings were smaller (82.0 +/- 15.1 min vs. 111.4 +/- 11.2 min), but still significant. Obviously humoral transmitters and the extrinsic neural system lead to good propagation of the MMC across the anastomosis, even before the intramural pathways are reestablished. Concerning the fast recovery of the motility of the upper gastrointestinal tract, duodenoplasty is superior to segmental duodenal resection.

The value of dynamic renal 99Tcm-diethylene triamine penta acetic acid imaging in rabbits with acute upper urinary tract obstruction

International Nuclear Information System (INIS)

Yan Jun; Li Xianfeng; Wang Jin; Li Sijin; Liu Jianzhong; Cheng Yan; Wu Zhifeng

2008-01-01

Objective: To research the degression of renal function of 99 Tc m -diethylene triamine pentaaceticacid ( 99 Tc m -DTPA) renal imaging in rabbits with acute upper urinary tract obstruction and its early recovery after relief. Methods: Twenty-four health rabbit models with left acute upper urinary tract obstruction were built up. 99 Tc m -DTPA renal imaging was performed before making model and after obstruction 1, 3, 5-7 and more than 8 weeks respectively and 4 weeks after relief of obstruction. Results: After obstnrction 1 and 3 weeks, 99 Tc m -DTPA imaging showed development in left renal. Values of glomemlar filtration rate (GFR) and uptake ratio decreased, while time to reach the peak increased. These are obviously different compared with those before obstruction (t=2.916, t=7.034, P 99 Tc m -DTPA imagingshowed cortex developert. Values of GFR and uptake ratio decreased obvious, while time to reach the peak increased obviously. These are obviously different compared with those before obstruction (t=6.722, t=7.470, t=3.678, P 99 Tc m -DTPA imaging showed no obvious development. In those rabbits with durations of 1-3 weeks obstructions, the renal function could almost recover within 4 weeks after relief of obstruction. GRF is 31.23 ± 14.4 (t=2.627, P 0.05). With obstruction of 5-7 weeks, the GRF and uptake ratio, could recover partly to some extent. But with obstruction for more than 8 weeks, the renal function could not recover. Conclusions: For the acute upper urinary tract obstruction, the renal function is most remarkable decreased in the early time, and can be restored after lelief. For long time obstruction, even if relieved, the renal function is not easily to restore. The dynamic renal imaging can reflect the extent of the renal damage and its recovery, and could be used as a reliable indicator. (authors)

Radiological imaging of the upper gastrointestinal tract. Pt. 1. The esophagus

International Nuclear Information System (INIS)

Hansmann, J.; Grenacher, L.

2006-01-01

In the diagnosis of diseases of the esophagus, conventional x-ray evaluation still plays a more important role than endoscopy in the visualization of stenoses. CT plays a major role in the staging of malignancies of the esophagus, while MRI plays does not play a major part in the diagnostic evaluation of the upper GI-tract but is equal to CT for the staging and evaluation of the extent of local infiltration. The main indication for the radiological examination of the esophagus by barium studies is dysphagia. The use of barium allows a functional examination of esophageal motility. Swallow motility disorders can be diagnosed by videofluorography using high frame rate imaging. Zenker's diverticulum and other pulsion diverticula should also be investigated by functional esophageal imaging. Candida esophagitis can be identified by its characteristic ulcerations using barium swallow. The extension of gastroesophageal hernias are more accurately evaluated with barium studies than with endoscopy. The diagnosis of gastroesophageal reflux disease should be made by barium studies, but discrete inflammation as well as epithelial dysplasia are best investigated by classic endoscopy and modern endoscopic techniques. In cases of esophageal carcinoma, radiology adds to the findings of endoscopy and endosonography. (orig.) [de

Airway inflammation and upper respiratory tract infection in athletes: is there a link?

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Bermon, Stéphane

2007-01-01

Upper Respiratory Tract Infection (URTI) is regarded as the most common medical condition affecting both highly trained and elite athletes, in particular those participating in endurance events. The causes of these disturbances, also occurring during training, remain unclear. Viruses such as rhinovirus, adenovirus and para-influenza virus are frequently reported as the source of URTI. However, in a few comprehensive laboratory and epidemiological studies which reported at least a 30% incidence of URTI, no identifiable pathogens were either reported or studied. A recent, longitudinal study investigated symptomatology and pathogenic etiology in sedentary controls, recreational and elite athletes. The highest incidence of URTI occurred in elite athletes. However; only 11 out of 37 illness episodes overall had pathogenic origins, and most of the unidentified upper respiratory illnesses were shorter in duration and less severe than infectious ones. This concept of inflammation without infection in athletes is quite new and leads us to consider other explanatory pathophysiological conditions. Increases in airway neutrophils, eosinophils and lymphocytes have been described under resting conditions in endurance sports, swimmers and cross-country skiers. These inflammatory patterns may be due to pollutants or chlorine-related compounds in swimmers. After intense exercise similar airways cellular profiles have been reported, with a high amount of bronchial epithelial cells. This increase in airway inflammatory cells in athletes can result from a hyperventilation-induced increase in airway osmolarity stimulating bronchial epithelial cells to release chemotactic factors. Fortunately, in most cases, these inflammatory cells express rather low level of adhesion molecules, explaining why airway inflammation may appear blunted in athletes despite numerous inflammatory cellular elements. However it can be hypothesized that a transient loss of control of this local inflammation, due

Modern diagnostic assessment of the upper urinary tract using multislice CT urography; Moderne Diagnostik des oberen Harntraktes mittels Mehrschicht-CT-Urographie

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Kemper, J.; Adam, G.; Nolte-Ernsting, C. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany)

2006-11-15

The advent of Multislice Computed Tomography (MSCT) has made evaluation of the entire urinary tract with high-resolution sections during a single breath-hold a reality. Acquisition of multiple thin overlapping slices provides excellent two-dimensional (2D) and three-dimensional (3D) reformations of the urinary tract. The concept of 'Multislice CT Urography (MSCTU)' has emerged from this technical improvement. As a result, a wide range of pathologies inside and outside the urinary tract can be identified. During the last several years, MSCTU has challenged intravenous urography (IVU) in the evaluation of urinary tract abnormalities. Compared with IVU, MSCT(U) is more sensitive and specific in the detection and characterization of a variety of urinary tract disorders, including renal masses and urolithiasis. The main advantage of IVU has been its ability to offer excellent delineation of kidney basin cup system and ureteral anatomy and to depict subtle uroepithelial abnormalities. MSCTU has already shown promising results for overcoming this challenge. Optimal opacification and distension appear to be an essential requirement for a thorough evaluation of the collecting system. Dedicated preparation strategies have been developed to meet these technical difficulties. The biggest disadvantage of MSCTU is the significant radiation exposure. For broad routine clinical application, there is still a need for dose reduction protocols despite the ongoing technical developments in MSCTU. In this article, we outline the different concepts of technical processing for MSCTU and summarize the current role of MSCTU in the evaluation of the upper urinary tract. (orig.)

Mucosal immunity and upper respiratory tract symptoms in recreational endurance runners.

Science.gov (United States)

Ihalainen, Johanna K; Schumann, Moritz; Häkkinen, Keijo; Mero, Antti A

2016-01-01

The present study investigated the effects of a 12-week endurance-training intervention on salivary proteins and upper respiratory tract symptoms (URS) in 25 young men. Saliva samples of 25 recreational male endurance runners (age 34.6 years, body mass index = 23.8 kg·m(-2), peak aerobic capacity = 47.2 mL·kg(-1)·min(-1)) were collected before (PRE) and after (POST) the training intervention, in a fasting state, as well as both before and after a maximal incremental treadmill run. The training consisted of both continuous and interval training sessions, 4-6 times per week based on the polarized training approach. Participants filled in Wisconsin Upper Respiratory Symptom Survey-21 and were retrospectively divided into 2 groups according to whether they reported URS (URS group, n = 13) or not (HEALTHY group, n = 12). Basal salivary immunoglobulin A (sa-sIgA) levels were significantly higher (+70%, p < 0.05) in the HEALTHY group both at PRE and POST whereas no significant differences were observed in salivary immunoglobulin M, salivary immunoglobulin G, lysozyme, or salivary α-amylase activity (sAA). Sa-sIgA concentration at PRE significantly correlated with the number of sick-days (R = -0.755, p < 0.001) in all subjects. The incremental treadmill run acutely increased sAA significantly (p < 0.05) at PRE (200%) and POST (166%) in the HEALTHY group but not in the URS group. This study demonstrated that subjects, who experienced URS during the 12 weeks of progressive endurance training intervention, had significantly lower basal sa-sIgA levels both before and after the experimental endurance training period. In addition to sa-sIgA, acute sAA response to exercise might be a possible determinant of susceptibility to URS in endurance runners.

The radiological and endoscopie appearances of Crohn's disease of the upper gastro-intenstinal tract

International Nuclear Information System (INIS)

Kurtz, B.; Steinhardt, H.J.; Malchow, H.; Tuebingen Univ.

1982-01-01

Involvement of the upper gastrointestinal tract (oesophagus, stomach, duodenum, jejunum) accounted for 13% of endoscopically proven Crohn's disease in patients at the University Clinic, Tuebingen between 1973 and 1980. The basis for the diagnosis was the presence of epitheloid granulomas. The diagnosis was suspected in 26% of patients in endoscopic appearances alone. In these two groups, the appearances were similar, consisting of atypical or linear ulcers, cobble-stone lesions, chronic erosions, aphthous ulcers, stenoses, coarsening of the mucosa and areas of engorgement and granularity. Most patients were also examined radiologically. The radiological findings correspond with the endoscopic observations. Using a double contrast technique, mucosal changes could be demonstrated which, up to now, were only seen by endoscopy. If these findings are observed either radiologically or endoscopically, it is essential to examine the distal portions of the gut. (orig.) [de

Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE).

NARCIS (Netherlands)

Nagel, Gabriele; Stafoggia, Massimo; Pedersen, Marie; Andersen, Zorana J; Galassi, Claudia; Munkenast, Jule; Jaensch, Andrea; Sommar, Johan; Forsberg, Bertil; Olsson, David; Oftedal, Bente; Krog, Norun H; Aamodt, Geir; Pyko, Andrei; Pershagen, Göran; Korek, Michal; De Faire, Ulf; Pedersen, Nancy L; Östenson, Claes-Göran; Fratiglioni, Laura; Sørensen, Mette; Tjønneland, Anne; Peeters, Petra H; Bueno-de-Mesquita, Bas; Vermeulen, Roel; Eeftens, Marloes; Plusquin, Michelle; Key, Timothy J; Concin, Hans; Lang, Alois; Wang, Meng; Tsai, Ming-Yi; Grioni, Sara; Marcon, Alessandro; Krogh, Vittorio; Ricceri, Fulvio; Sacerdote, Carlotta; Ranzi, Andrea; Cesaroni, Giulia; Forastiere, Francesco; Tamayo-Uria, Ibon; Amiano, Pilar; Dorronsoro, Miren; de Hoogh, Kees; Beelen, Rob; Vineis, Paolo; Brunekreef, Bert; Hoek, Gerard; Raaschou-Nielsen, Ole; Weinmayr, Gudrun

2018-01-01

Air pollution has been classified as carcinogenic to humans. However, to date little is known about the relevance for cancers of the stomach and upper aerodigestive tract (UADT). We investigated the association of long-term exposure to ambient air pollution with incidence of gastric and UADT cancer

Evaluation of patient doses from upper gastrointestinal tract examinations based on the dosimetry in an anthropomorphic phantom

International Nuclear Information System (INIS)

Hirofuji, Yoshiaki; Aoyama, Takahiko; Koyama, Shuji; Kawaura, Chiyo

2005-01-01

The objective of this study was to evaluate organ dose and effective dose to patients from examinations of the upper gastrointestinal (GI) tract. Absorbed doses of various tissues and organs were measured using novel photodiode dosimeters installed in an anthropomorphic phantom representing a standard Japanese adult body. The organ dose and the effective dose were assessed from the absorbed doses according to the definitions seen in the publications of the International Commission on Radiological Protection. Dose measurements were performed for each projection of the upper GI tract examination in seven procedures at four hospitals and in a mobile coach, and organ and effective doses were assessed for each procedure. Organ doses obtained in the observation areas such as the stomach, esophagus and colon were in the order of several to more than 60 mGy, though they decreased to less than 1 mGy for tissues and organs distant from the observation areas. Organ doses and effective doses differed largely according to tube voltage, filtration and tube current or mAs value of the x-ray generator used, and by examination protocol, number of images, fluoroscopy time, and imaging units such as screen/film, computed radiography, digital radiography and flat panel detector. The number of images and the fluoroscopy time were 7 and 1.5 min for the examination in the mobile coach, and 18-22 and 2-6 min in the hospitals. Evaluated effective dose for the examination in the mobile coach was 2.9 mSv, and that in the hospitals ranged from 4.0-13.4 mSv at a ratio of more than three. (author)

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract: An Evidence-Based Review Article

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Pedro Magalhães-Costa

2016-05-01

Full Text Available Gastrointestinal foreign bodies (FB are comprised of food bolus impaction and intentionally or unintentionally ingested or inserted true FB. Food bolus impaction and true FB ingestion represent a recurrent problem and a true challenge in gastrointestinal endoscopy. More than 80–90% of the ingested true FB will pass spontaneously through the gastrointestinal tract without complications. However, in 10–20% of the cases an endoscopic intervention is deemed necessary. True FB ingestion has its greatest incidence in children, psychiatric patients and prisoners. On the other hand, food bolus impaction typically occurs in the elderly population with an underlying esophageal pathology. The most serious situations, with higher rates of complications, are associated with prolonged esophageal impaction, ingestion of sharp and long objects, button batteries and magnets. Physicians should recognize early alarm symptoms, such as complete dysphagia, distressed patients not able to manage secretions, or clinical signs of perforation. Although many papers are yearly published regarding this subject, our knowledge is mainly based on case-reports and retrospective series. Herein, the authors summarize the existing evidence and propose an algorithm for the best approach to FB ingestion.

Urinary tract infection in childhood: lower or upper level? DMSA scintigraphic validation of a new clinical risk index

International Nuclear Information System (INIS)

Bayet-Papin, B.; Decomps-Hofmann, A.; Bovier-Lapierre, M.

2001-01-01

Urinary tract infection in children can be limited most of time at the lower level of the urinary tractus but an extension to the upper level of the tractus should not be neglected due to the asymptomatic nature of the disease. In our study, we suggest a new graph to predict the probability of acute pyelonephritis only if the bacteriological urinary analyse were obtained in good conditions and without any treatment. In the other cases, a DMSA scintigram should be proposed at the earlier phase of the diagnosis not to underestimate the risk of asymptomatic pyelonephritis. (authors)

Inappropriate antibiotic prescribing and demand for antibiotics in patients with upper respiratory tract infections is hardly different in female versus male patients as seen in primary care

DEFF Research Database (Denmark)

Bagger, Kathrine; Nielsen, Anni Brit Sternhagen; Siersma, Volkert

2015-01-01

Background: Unnecessary prescribing of antibiotics is a major public health concern. General practitioners (GPs) prescribe most antibiotics, often for upper respiratory tract infections (URTIs), and have in general been shown to prescribe antibiotics more often to women. No studies have examined...

Radiology of upper gastrointestinal tract with ASGB (adjustable silicone gastric banding) for morbid obesity

International Nuclear Information System (INIS)

Nowicki, Grzegorz; Maliborski, Artur; Żukowski, Paweł; Bogusławska, Romana

2010-01-01

Metabolic syndrome is a result of multiple risk factors of atherosclerosis and diabetes. Obesity is an especially well recognized etiological factor. A rapidly increasing number of obese people constitutes a major social health problem in the developed, as well as developing countries. Bariatric surgeries are among methods of obesity treatment that gain on popularity. They include adjustable silicone gastric banding (ASGB), and adjustable laparoscopic gastric banding (ALGB). The aim of our study was to analyze and present the most typical radiological images obtained during 130 upper gastrointestinal tract examinations in patients after ASGB or ALGB in the last three years. ASGB and ALGB are effective and safe. However, they are connected with some postoperative complications. Application of these surgical procedures requires periodic, long-term radiological evaluations and cooperation between surgeons and radiologists. The radiologist must be familiar with bariatric surgical techniques, their complications and typical radiological presentations

Evaluation of upper urinary tract tumors by FISH in Chinese patients.

Science.gov (United States)

Shan, Zhengfei; Wu, Peng; Zheng, Shaobin; Tan, Wanlong; Zhou, Haikuan; Zuo, Yi; Qi, Huan; Zhang, Peng; Peng, Hongmei; Wang, Yanfen

2010-12-01

Upper urinary tract tumor (UUTT) usually presents a high grade and stage, and recurs frequently. The aim of this study was to evaluate the utility of a fluorescence in situ hybridization (FISH) assay on chromosomes 3, 7, 9, and 17 as a reliable and noninvasive method for the diagnosis of Chinese patients with UUTT. Urine specimens from 50 patients with UUTT and 25 donors without evidence of urothelial tumors were analyzed by cytology and FISH. Voided urine samples from 20 normal individuals were used to establish the cut-off values for FISH assay. The McNemar test was applied for sensitivity and specificity. The overall sensitivity of FISH was statistically significantly greater than that of cytology (84.0 vs. 40.0%, P = 0.000). The overall specificities of FISH and urine cytology were all 96.0% (P = 1.000). Polysomy in chromosomes 3, 7, and 17 were 38, 42, and 30%, respectively. Heterozygous and homozygous loss of the p16 locus was found in 36 and 32%, respectively. FISH analysis performed on cells collected from voided urine is feasible, and FISH could prove to be a reliable and less invasive ancillary test and improve the sensitivity of urine cytology in the diagnosis of UUTT. Copyright © 2010 Elsevier Inc. All rights reserved.

Treatment of Upper Respiratory Tract Infections in Primary Care: A Randomized Study Using Aromatic Herbs

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Eran Ben-Arye

2011-01-01

Full Text Available This study is a prospective randomized double-blind controlled trial whose aim was to investigate the clinical effects of aromatic essential oils in patients with upper respiratory tract infections. The trial was conducted in six primary care clinics in northern Israel. A spray containing aromatic essential oils of five plants (Eucalyptus citriodora, Eucalyptus globulus, Mentha piperita, Origanum syriacum, and Rosmarinus officinalisas applied 5 times a day for 3 days and compared with a placebo spray. The main outcome measure was patient assessment of the change in severity of the most debilitating symptom (sore throat, hoarseness or cough. Sixty patients participated in the study (26 in the study group and 34 in the control group. Intention-to-treat analysis showed that 20 minutes following the spray use, participants in the study group reported a greater improvement in symptom severity compared to participants in the placebo group (=.019. There was no difference in symptom severity between the two groups after 3 days of treatment (=.042. In conclusion, spray application of five aromatic plants reported in this study brings about significant and immediate improvement in symptoms of upper respiratory ailment. This effect is not significant after 3 days of treatment.

Tc-99m DTPA renal function tests and diuretic renogram in the dilated upper urinary tract

Energy Technology Data Exchange (ETDEWEB)

Sakagami, Yoshinari; Yamaguchi, Osamu; Suzuki, Takayuki; Kameoka, Hiroshi; Shiraiwa, Yasuo; Suzuki, Akira (Fukushima Medical Coll. (Japan))

1992-09-01

The authors studied patients with dilated upper urinary tracts (16 patients) using radioisotopic split renal function tests and diuretic renogram with [sup 99]mTc-diethylenetriaminepentaacetic acid (Tc-99m DTPA). The etiology was ureteropelvic function stenosis, 11; primary megaureter, 3; ureteral stenosis, 1; and aberrant vessel, 1. Response to diuresis was classified into 3 groups: i.e., obstructive pattern, non-obstructive pattern and partial obstructive pattern. In the non-obstructive group, split renal function was good, and thus an operation was not indicated. In the obstructive group, split renal function was significantly decreased and these patients underwent surgery. In the partial obstructive group, if function of the obstructed kidney was approximately the same as that of the non-obstructed side, then surgery was considered unnecessary. (author).

Tc-99m DTPA renal function tests and diuretic renogram in the dilated upper urinary tract

International Nuclear Information System (INIS)

Sakagami, Yoshinari; Yamaguchi, Osamu; Suzuki, Takayuki; Kameoka, Hiroshi; Shiraiwa, Yasuo; Suzuki, Akira

1992-01-01

The authors studied patients with dilated upper urinary tracts (16 patients) using radioisotopic split renal function tests and diuretic renogram with 99 mTc-diethylenetriaminepentaacetic acid (Tc-99m DTPA). The etiology was ureteropelvic function stenosis, 11; primary megaureter, 3; ureteral stenosis, 1; and aberrant vessel, 1. Response to diuresis was classified into 3 groups: i.e., obstructive pattern, non-obstructive pattern and partial obstructive pattern. In the non-obstructive group, split renal function was good, and thus an operation was not indicated. In the obstructive group, split renal function was significantly decreased and these patients underwent surgery. In the partial obstructive group, if function of the obstructed kidney was approximately the same as that of the non-obstructed side, then surgery was considered unnecessary. (author)

Imaging of transitional cell carcinomas of the urinary tracts

International Nuclear Information System (INIS)

Ozmen, M.

2012-01-01

Full text: Transitional cell carcinoma (TCC) is the most common urothelial neoplasm to involve the upper urinary tract and bladder. Prognosis significantly worsens with deeper invasion. The role of imaging is to detect the tiniest urothelial neoplasms while still potentially resectable and curable. In case of advance disease, imaging should identify the extent of disease. Intravenous or retrograde urography, ultrasonography, computed tomography or magnetic resonance imaging have been used for diagnosis of TCC. The diagnostic performances of these imaging modalities differ from each other. A recent review regarding imaging of TCC by Razavi et al states that the retrieved sensitivity/specificity for the detection of TCC of upper urinary tract for CT urography (CTU), MR urography, excretory urography, and retrograde urography were 96%/99%, 69%/97%, 80%/81%, and 96%/96%, respectively. For detecting bladder cancer, the retrieved sensitivity/specificity for CT cystography, MR cystography, and ultrasonography were 94%/98%, 91%/95%, and 78%/96%, respectively. They conclude that CT urography is the best imaging technique for confirming or excluding malignancy in the upper urinary tract, whereas CT cystography has the best diagnostic performance for diagnosing bladder cancer. While cystoscopy is still considered by most to be the gold-standard for evaluation of the urinary bladder, CTU is playing an increasing role in the detection of urinary bladder urothelial neoplasms. As with the upper urinary tract, bladder urothelial neoplasms typically present as a filling defect, a focal mass, or an area of abnormal focal wall thickening. Magnetic resonance imaging is superior for evaluation of the depth of tumour invasion into the bladder wall, but this knowledge may not ultimately affect treatment as feasibility for radical cystectomy depends on staging by a combination of clinical, histopathological and imaging findings. Radical cystectomy may include resection of adjacent organs

Lithium and renal and upper urinary tract tumors - results from a nationwide population-based study

DEFF Research Database (Denmark)

Kessing, Lars Vedel; Gerds, Thomas Alexander; Feldt-Rasmussen, Bo

2015-01-01

OBJECTIVES: A recent alarming finding suggested an increased risk of renal tumors among long-term lithium users. The objectives of the present study were to estimate rates of renal and upper urinary tract tumors (RUT), malignant and benign, among individuals exposed to successive prescriptions...... for lithium, anticonvulsants, and other psychotropic agents used for bipolar disorder, and among unexposed individuals. METHODS: This was a nationwide, population-based longitudinal study including time-specific data from all individuals exposed to lithium (n = 24,272) or anticonvulsants (n = 386,255), all...... individuals with a diagnosis of bipolar disorder (n = 9,651), and a randomly selected sample of 1,500,000 from the Danish population. The study period was from 1995 to 2012, inclusive. Outcomes were hazard rate ratios (HR) for RUT in three groups: (i) combined malignant and benign, (ii) malignant, and (iii...

Inverse association between toothbrushing and upper aerodigestive tract cancer risk in a Japanese population.

Science.gov (United States)

Sato, Fumihito; Oze, Isao; Kawakita, Daisuke; Yamamoto, Noriyuki; Ito, Hidemi; Hosono, Satoyo; Suzuki, Takeshi; Kawase, Takakazu; Furue, Hiroki; Watanabe, Miki; Hatooka, Shunzo; Yatabe, Yasushi; Hasegawa, Yasuhisa; Shinoda, Masayuki; Ueda, Minoru; Tajima, Kazuo; Tanaka, Hideo; Matsuo, Keitaro

2011-11-01

Oral hygiene is attracting increasing attention as a potential risk factor for cancers. To investigate the association between toothbrushing frequency and upper aerodigestive tract (UADT) cancer, the authors conducted a large-scale case-control study. A total of 856 UADT cancer case participants and 2696 age- and sex-matched control subjects without cancer were included. Edentulous or participants with unknown frequency of toothbrushing or number of remaining teeth were excluded. Associations were assessed by odds ratios and 95% confidence intervals in logistic regression models with adjustment for potential confounders. Compared with toothbrushing once per day, the adjusted odds ratio for brushing twice or more was 0.82 (95% confidence interval: 0.68, 0.99) whereas that for not brushing was 1.79 (0.79, 4.05). This association was observed especially in subjects who had a history of heavy smoking or drinking. The authors suggest that toothbrushing could have a protective effect for UADT cancer. Copyright © 2010 Wiley Periodicals, Inc.

Association of viridans group streptococci from pregnant women with bacterial vaginosis and upper genital tract infection.

Science.gov (United States)

Rabe, L K; Winterscheid, K K; Hillier, S L

1988-06-01

The prevalence and role of viridans group streptococci in the female genital tract have not been well described. In this study of 482 pregnant women, 147 (30%) were culture positive for viridans group streptococci. Of 392 women with predominant Lactobacillus morphotypes by Gram stain (normal), 110 (28%) were colonized with viridans group streptococci, compared with 37 (41%) of 90 women with bacterial vaginosis (BV) (P = 0.02). To determine whether any species were associated with BV, 177 consecutively isolated viridans group streptococci from the vagina were identified to the species level by using the Facklam scheme. The most frequently isolated species from the vagina was Streptococcus intermedius (13%), followed by Streptococcus acidominimus (6%), Streptococcus constellatus (5%), Streptococcus sanguis II (4%), Streptococcus mitis (2%), Streptococcus salivarius (2%), Streptococcus morbillorum (2%), Streptococcus sanguis I (1%), Streptococcus mutans (0.2%), and Streptococcus uberis (0.2%) with an average of 1.2 species per woman. The distribution of the species among women with BV compared with normal women was not significantly different, with the exception of two species which were associated with BV: S. acidominimus (18% versus 3%, P less than 0.001) and S. morbillorum (6% versus 0.7%, P = 0.005). Amniotic fluid and placenta cultures yielded 54 isolates: S. sanguis II (13 isolates), S. acidominimus (9 isolates), S. intermedius (10 isolates), S. constellatus (3 isolates), S. mitis (4 isolates), S. sanguis I (4 isolates), S. morbillorum (5 isolates), S. mutans (2 isolates), S. uberis (1 isolate), mannitol-positive S. intermedius (1 isolate), and 2 isolates which were not classified. The distribution of species isolated from the upper genital tract was not a reflection of the distribution in the lower genital tract. Dextran-producing species of viridans group streptococci may have a greater pathogenic potential in the placenta than the non

A mixed methods study to understand patient expectations for antibiotics for an upper respiratory tract infection.

Science.gov (United States)

Gaarslev, Christina; Yee, Melissa; Chan, Georgi; Fletcher-Lartey, Stephanie; Khan, Rabia

2016-01-01

Antimicrobial resistance is a public health challenge supplemented by inappropriate prescribing, especially for an upper respiratory tract infection in primary care. Patient/carer expectations have been identified as one of the main drivers for inappropriate antibiotics prescribing by primary care physicians. The aim of this study was to understand who is more likely to expect an antibiotic for an upper respiratory tract infection from their doctor and the reasons underlying it. This study used a sequential mixed methods approach: a nationally representative cross sectional survey ( n  = 1509) and four focus groups. The outcome of interest was expectation and demand for an antibiotic from a doctor when presenting with a cold or flu. The study found 19.5 % of survey respondents reported that they would expect the doctor to prescribe antibiotics for a cold or flu. People younger than 65 years of age, those who never attended university and those speaking a language other than English at home were more likely to expect or demand antibiotics for a cold or flu. People who knew that 'antibiotics don't kill viruses' and agreed that 'taking an antibiotic when one is not needed means they won't work in the future' were less likely to expect or demand antibiotics. The main reasons for expecting antibiotics were believing that antibiotics are an effective treatment for a cold or flu and that they shortened the duration and potential deterioration of their illness. The secondary reason centered around the value or return on investment for visiting a doctor when feeling unwell. Our study found that patients do not appear to feel they have a sufficiently strong incentive to consider the impact of their immediate use of antibiotics on antimicrobial resistance. The issue of antibiotic resistance needs to be explained and reframed as a more immediate health issue with dire consequences to ensure the success of future health campaigns.

A mixed methods study to understand patient expectations for antibiotics for an upper respiratory tract infection

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Christina Gaarslev

2016-10-01

Full Text Available Abstract Background Antimicrobial resistance is a public health challenge supplemented by inappropriate prescribing, especially for an upper respiratory tract infection in primary care. Patient/carer expectations have been identified as one of the main drivers for inappropriate antibiotics prescribing by primary care physicians. The aim of this study was to understand who is more likely to expect an antibiotic for an upper respiratory tract infection from their doctor and the reasons underlying it. Methods This study used a sequential mixed methods approach: a nationally representative cross sectional survey (n = 1509 and four focus groups. The outcome of interest was expectation and demand for an antibiotic from a doctor when presenting with a cold or flu. Results The study found 19.5 % of survey respondents reported that they would expect the doctor to prescribe antibiotics for a cold or flu. People younger than 65 years of age, those who never attended university and those speaking a language other than English at home were more likely to expect or demand antibiotics for a cold or flu. People who knew that ‘antibiotics don’t kill viruses’ and agreed that ‘taking an antibiotic when one is not needed means they won’t work in the future’ were less likely to expect or demand antibiotics. The main reasons for expecting antibiotics were believing that antibiotics are an effective treatment for a cold or flu and that they shortened the duration and potential deterioration of their illness. The secondary reason centered around the value or return on investment for visiting a doctor when feeling unwell. Conclusion Our study found that patients do not appear to feel they have a sufficiently strong incentive to consider the impact of their immediate use of antibiotics on antimicrobial resistance. The issue of antibiotic resistance needs to be explained and reframed as a more immediate health issue with dire consequences to ensure the

Survival of Lactobacillus acidophilus NCFM® and Bifidobacterium lactis HN019 encapsulated in chocolate during in vitro simulated passage of the upper gastrointestinal tract

DEFF Research Database (Denmark)

Klindt-Toldam, Stine; Larsen, Susanne K.; Saaby, Lasse

2016-01-01

Probiotic microorganisms are exposed to different types of stress both before and after consumption which strongly influences probiotic survival. Here the viability of 2 different probiotic bacteria incorporated in different types of chocolate was investigated during storage and passage of the up......Probiotic microorganisms are exposed to different types of stress both before and after consumption which strongly influences probiotic survival. Here the viability of 2 different probiotic bacteria incorporated in different types of chocolate was investigated during storage and passage...... of the upper gastro-intestinal tract using both a static and a dynamic gastric in vitro model. Lactobacillus acidophilus NCFM® and Bifidobacterium lactis HN019 equalling a total concentration of 2 × 108, 2 × 109 and 2 × 1010 CFU/g chocolate were added to samples of milk chocolate, 57% and 72% dark chocolate...... dairy and juice based probiotic products, chocolate was an excellent carrier for probiotic delivery, because of very good survival of probiotics during simulated passage of the upper GI tract. The viability of B. lactis was slightly higher than Lb. acidophilus and survival rates were >6.5 log CFU...

Bacterial Composition of the Human Upper Gastrointestinal Tract Microbiome Is Dynamic and Associated with Genomic Instability in a Barrett's Esophagus Cohort.

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Alevtina Gall

Full Text Available The incidence of esophageal adenocarcinoma (EAC has increased nearly five-fold over the last four decades in the United States. Barrett's esophagus, the replacement of the normal squamous epithelial lining with a mucus-secreting columnar epithelium, is the only known precursor to EAC. Like other parts of the gastrointestinal (GI tract, the esophagus hosts a variety of bacteria and comparisons among published studies suggest bacterial communities in the stomach and esophagus differ. Chronic infection with Helicobacter pylori in the stomach has been inversely associated with development of EAC, but the mechanisms underlying this association remain unclear.The bacterial composition in the upper GI tract was characterized in a subset of participants (n=12 of the Seattle Barrett's Esophagus Research cohort using broad-range 16S PCR and pyrosequencing of biopsy and brush samples collected from squamous esophagus, Barrett's esophagus, stomach corpus and stomach antrum. Three of the individuals were sampled at two separate time points. Prevalence of H. pylori infection and subsequent development of aneuploidy (n=339 and EAC (n=433 was examined in a larger subset of this cohort.Within individuals, bacterial communities of the stomach and esophagus showed overlapping community membership. Despite closer proximity, the stomach antrum and corpus communities were less similar than the antrum and esophageal samples. Re-sampling of study participants revealed similar upper GI community membership in two of three cases. In this Barrett's esophagus cohort, Streptococcus and Prevotella species dominate the upper GI and the ratio of these two species is associated with waist-to-hip ratio and hiatal hernia length, two known EAC risk factors in Barrett's esophagus. H. pylori-positive individuals had a significantly decreased incidence of aneuploidy and a non-significant trend toward lower incidence of EAC.

Multiple factor analysis of metachronous upper urinary tract transitional cell carcinoma after radical cystectomy

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P. Wang

2007-07-01

Full Text Available Transitional cell carcinoma (TCC of the urothelium is often multifocal and subsequent tumors may occur anywhere in the urinary tract after the treatment of a primary carcinoma. Patients initially presenting a bladder cancer are at significant risk of developing metachronous tumors in the upper urinary tract (UUT. We evaluated the prognostic factors of primary invasive bladder cancer that may predict a metachronous UUT TCC after radical cystectomy. The records of 476 patients who underwent radical cystectomy for primary invasive bladder TCC from 1989 to 2001 were reviewed retrospectively. The prognostic factors of UUT TCC were determined by multivariate analysis using the COX proportional hazards regression model. Kaplan-Meier analysis was also used to assess the variable incidence of UUT TCC according to different risk factors. Twenty-two patients (4.6%. developed metachronous UUT TCC. Multiplicity, prostatic urethral involvement by the bladder cancer and the associated carcinoma in situ (CIS were significant and independent factors affecting the occurrence of metachronous UUT TCC (P = 0.0425, 0.0082, and 0.0006, respectively. These results were supported, to some extent, by analysis of the UUT TCC disease-free rate by the Kaplan-Meier method, whereby patients with prostatic urethral involvement or with associated CIS demonstrated a significantly lower metachronous UUT TCC disease-free rate than patients without prostatic urethral involvement or without associated CIS (log-rank test, P = 0.0116 and 0.0075, respectively. Multiple tumors, prostatic urethral involvement and associated CIS were risk factors for metachronous UUT TCC, a conclusion that may be useful for designing follow-up strategies for primary invasive bladder cancer after radical cystectomy.

Pediatric urinary tract infection

Energy Technology Data Exchange (ETDEWEB)

Blickman, J.G.

1991-02-06

Acute urinary tract infection (UTI) is an important cause of morbidity in children and may be complicated by congenital urinary tract abnormalities of a functional or anatomic nature which, predispose to recurrent UTI's that in turn may lead to renal failure and hypertension. Early radiologic and ultrasonographic investigations may reveal these anatomic anomalies in particular because the urinary tract, specifically in children, is not readily accessible to adequate clinical examinations Excretory urography (EU) has been considered as the 'gold standard' of upper urinary tract visualization, while the voiding cystourethrogram (VCUG) was thought to be the preferential method of imaging of the lower urinary tract. Recently, major technical advances have altered this commonly accepted diagnostic workup. Although ultrasonography, radio-nuclide scanning and urodynamics have become important contributors to the understanding of pathophysiology of UTI's their value and place in assessment of the sequence of imaging has not been comprehensively studied. This thesis deals about the optimization of the choice and the order of the different imaging techniques used in the evaluation of children, younger than six year with UTI. (author). 243 refs.; 23 figs.; 8 tabs.

Pediatric urinary tract infection

International Nuclear Information System (INIS)

Blickman, J.G.

1991-01-01

Acute urinary tract infection (UTI) is an important cause of morbidity in children and may be complicated by congenital urinary tract abnormalities of a functional or anatomic nature which, predispose to recurrent UTI's that in turn may lead to renal failure and hypertension. Early radiologic and ultrasonographic investigations may reveal these anatomic anomalies in particular because the urinary tract, specifically in children, is not readily accessible to adequate clinical examinations Excretory urography (EU) has been considered as the 'gold standard' of upper urinary tract visualization, while the voiding cystourethrogram (VCUG) was thought to be the preferential method of imaging of the lower urinary tract. Recently, major technical advances have altered this commonly accepted diagnostic workup. Although ultrasonography, radio-nuclide scanning and urodynamics have become important contributors to the understanding of pathophysiology of UTI's their value and place in assessment of the sequence of imaging has not been comprehensively studied. This thesis deals about the optimization of the choice and the order of the different imaging techniques used in the evaluation of children, younger than six year with UTI. (author). 243 refs.; 23 figs.; 8 tabs

Distinction between upper and lower gastrointestinal perforation: Usefulness of the periportal free air sign on computed tomography

International Nuclear Information System (INIS)

Cho, Hyun Sun; Yoon, Seong Eon; Park, Seong Hoon; Kim, Hyewon; Lee, Young-Hwan; Yoon, Kwon-Ha

2009-01-01

Purpose: To evaluate the usefulness of the periportal free air (PPFA) sign on computed tomography (CT) to distinguish upper from lower gastrointestinal (GI) tract perforation. Materials and methods: During a 30-month period, we retrospectively analyzed abdominal CT images of 53 consecutive patients with surgically proven GI tract perforation. We divided the patients into two groups, i.e. upper and lower GI tract perforation groups. According to the distribution of free air, we divided the peritoneal cavity into supramesocolic compartment and inframesocolic compartment. We observed the presence or absence of free air in each compartment in each group. When there was free air in the periportal area, it was defined as periportal free air (PPFA) and the sign was positive. To evaluate the usefulness of the PPFA sign, we compared the PPFA sign with the falciform ligament sign and the ligamentum teres sign, both of which are well-known CT signs of pneumoperitoneum. Statistical analyses were performed with univariate and multivariate analyses using SPSS version 11.5 for significant findings among the CT signs. Results: Free air was seen in supramesocolic compartment in 29 of 30 (97%) patients in the upper GI perforation group and in 17 of 23 (74%) in the lower GI perforation group. Free air in inframesocolic compartment did not show significant difference in either group (p = .16). The PPFA sign was seen in 28 of 30 (93%) patients with upper GI tract perforation, but in only 8 of 23 (35%) patients with lower GI tract perforation (p < .0001). The falciform ligament sign was seen in 24 of 30 (80%) patients with upper GI tract perforation and in 10 of 23 (43%) patients with lower GI tract perforation (p = .020). The ligamentum teres sign was seen in 16 of 30 (53%) patients with upper GI tract perforation and in 2 of 23 (8%) patients with lower GI tract perforation (p = .008). Multivariate logistic regression analysis showed that the PPFA sign was the only variable, which

Distinction between upper and lower gastrointestinal perforation: Usefulness of the periportal free air sign on computed tomography

Energy Technology Data Exchange (ETDEWEB)

Cho, Hyun Sun; Yoon, Seong Eon; Park, Seong Hoon; Kim, Hyewon; Lee, Young-Hwan [Department of Radiology, Wonkwang University School of Medicine, 344-2 Sinyong-dong, Iksan, Jeonbuk 570-711 (Korea, Republic of); Yoon, Kwon-Ha [Department of Radiology, Wonkwang University School of Medicine, 344-2 Sinyong-dong, Iksan, Jeonbuk 570-711 (Korea, Republic of)], E-mail: khy1646@wonkwang.ac.kr

2009-01-15

Purpose: To evaluate the usefulness of the periportal free air (PPFA) sign on computed tomography (CT) to distinguish upper from lower gastrointestinal (GI) tract perforation. Materials and methods: During a 30-month period, we retrospectively analyzed abdominal CT images of 53 consecutive patients with surgically proven GI tract perforation. We divided the patients into two groups, i.e. upper and lower GI tract perforation groups. According to the distribution of free air, we divided the peritoneal cavity into supramesocolic compartment and inframesocolic compartment. We observed the presence or absence of free air in each compartment in each group. When there was free air in the periportal area, it was defined as periportal free air (PPFA) and the sign was positive. To evaluate the usefulness of the PPFA sign, we compared the PPFA sign with the falciform ligament sign and the ligamentum teres sign, both of which are well-known CT signs of pneumoperitoneum. Statistical analyses were performed with univariate and multivariate analyses using SPSS version 11.5 for significant findings among the CT signs. Results: Free air was seen in supramesocolic compartment in 29 of 30 (97%) patients in the upper GI perforation group and in 17 of 23 (74%) in the lower GI perforation group. Free air in inframesocolic compartment did not show significant difference in either group (p = .16). The PPFA sign was seen in 28 of 30 (93%) patients with upper GI tract perforation, but in only 8 of 23 (35%) patients with lower GI tract perforation (p < .0001). The falciform ligament sign was seen in 24 of 30 (80%) patients with upper GI tract perforation and in 10 of 23 (43%) patients with lower GI tract perforation (p = .020). The ligamentum teres sign was seen in 16 of 30 (53%) patients with upper GI tract perforation and in 2 of 23 (8%) patients with lower GI tract perforation (p = .008). Multivariate logistic regression analysis showed that the PPFA sign was the only variable, which

Perioperative respiratory adverse events in children with active upper respiratory tract infection who received general anesthesia through an orotracheal tube and inhalation agents

OpenAIRE

Kim, So Yeon; Kim, Jeong Min; Lee, Jae Hoon; Kang, Young Ran; Jeong, Seung Ho; Koo, Bon-Nyeo

2013-01-01

Background Active upper respiratory tract infection (URI), orotracheal intubation and use of inhalation anesthetics are known risk factors for perioperative respiratory adverse events (RAE). This study investigated the risk factors of perioperative RAE in children with these risk factors. Methods The records of 159 children who underwent general anesthesia with an orotracheal tube and inhalation were reviewed. These patients also had at least one of the following URI symptoms on the day of su...

The Utility of Endoscopic Biopsies in Patients with Normal Upper Endoscopy

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Anouar Teriaky

2016-01-01

Full Text Available Background and Aims. Upper endoscopy is a valuable tool in the workup of gastrointestinal (GI complaints. The purpose of this study is to determine cost and yield of taking biopsies in a normal upper GI tract. Methods. This is a retrospective study where all upper GI biopsies were identified between May 2012 and April 2013, at a tertiary care center. Clinical, procedural, and pathology reports were reviewed to identify patient demographics, procedure information, and pathology diagnosis. Results. Biopsies of the upper GI tract were taken in 1297 patients with normal upper endoscopies. In patients with normal upper endoscopy, 22% of esophageal, 44% of gastric, and 12% of duodenal biopsies were abnormal. The most frequent abnormality was reflux esophagitis in 16% of esophageal biopsies, chronic gastritis in 23% of gastric biopsies, and increased intraepithelial lymphocytes in 6% of duodenal biopsies. The additional cost for taking biopsies in a normal upper GI tract for a diagnosis of eosinophilic esophagitis was $2963 Canadian (CAD, H. pylori associated gastritis was $1404 CAD, and celiac disease was $3024 CAD. Conclusions. The yield of biopsy in normal upper endoscopy varied with location, but the additional expense can be costly and should be tailored to appropriate clinical situations.

The adenoid as a key factor in upper airway infections.

Science.gov (United States)

van Cauwenberge, P B; Bellussi, L; Maw, A R; Paradise, J L; Solow, B

1995-06-01

The adenoids (and the nasopharynx) play a key role in the normal functioning and in various pathologies of the upper respiratory tract. In this paper the role of adenoidal pathology and the beneficial effect of adenoidectomy in some upper respiratory tract and facial anomalies and diseases are discussed; otitis media with effusion, recurrent acute otitis media, sinusitis, snoring and sleep apnea and abnormal patterns in the midface growth and development.

Congenital anomalies of the urinary tract.

Science.gov (United States)

Pohl, Hans G; Belman, A Barry

2014-01-01

The upper urinary tract forms as a consequence of the reciprocal inductive signals between the metanephric mesenchyme and ureteric bud. A clue to the timing of events leading to an abnormality of the upper urinary tract can be the presence also of associated anomalies of internal genitalia since separation of these systems occurs at about the 10th week of gestation. Prenatal sonography has facilitated the detection of urological abnormalities presenting with hydronephrosis. Hydronephrosis suggests obstruction, but by itself cannot be equated with it. Instead, further radiographic imaging is required to delineate anatomy and function. Now, moreover, non-surgical management of CAKUT should be considered whenever possible. Despite the widespread use of prenatal screening sonography that usually identifies the majority of congenital anomalies of the urinary tract, many children still present with febrile urinary tract infection (UTI). Regardless of the etiology for the presentation, the goal of management is preservation of renal function through mitigation of the risk for recurrent UTI and/or obstruction. In the past many children underwent surgical repair aimed at normalization of the appearance of the urinary tract. Today, management has evolved such that in most cases surgical reconstruction is performed only after a period of observation - with or without urinary prophylaxis. The opinions presented in this section are not espoused by all pediatric urologists but represent instead the practice that has evolved at Children's National Medical Center (Washington DC) based significantly on information obtained by nuclear renography, in addition to sonography and contrast cystography.

Curcumin induces apoptosis of upper aerodigestive tract cancer cells by targeting multiple pathways.

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A R M Ruhul Amin

Full Text Available Curcumin, a natural compound isolated from the Indian spice "Haldi" or "curry powder", has been used for centuries as a traditional remedy for many ailments. Recently, the potential use of curcumin in cancer prevention and therapy urges studies to uncover the molecular mechanisms associated with its anti-tumor effects. In the current manuscript, we investigated the mechanism of curcumin-induced apoptosis in upper aerodigestive tract cancer cell lines and showed that curcumin-induced apoptosis is mediated by the modulation of multiple pathways such as induction of p73, and inhibition of p-AKT and Bcl-2. Treatment of cells with curcumin induced both p53 and the related protein p73 in head and neck and lung cancer cell lines. Inactivation of p73 by dominant negative p73 significantly protected cells from curcumin-induced apoptosis, whereas ablation of p53 by shRNA had no effect. Curcumin treatment also strongly inhibited p-AKT and Bcl-2 and overexpression of constitutively active AKT or Bcl-2 significantly inhibited curcumin-induced apoptosis. Taken together, our findings suggest that curcumin-induced apoptosis is mediated via activating tumor suppressor p73 and inhibiting p-AKT and Bcl-2.

DYNAMIC CHANGES IN THE UPPER RESPIRATORY TRACT MICROFLORA OF THE BLACK SEA AND PACIFIC BOTTLENOSE DOLPHINS IN NOOGENIC HABITAT: POSSIBLE INFLUENCE OF ENVIROMENTAL CONDITIONS.

OpenAIRE

T. Tserodze; D. Jgenti; M. Mgeladze; I. Gambashidze; N. Chkheidze; E. Jaiani; E. Didebulidze; N. Janelidze; R. Goradze; M. Tediashvili.

2018-01-01

Infectious diseases of upper respiratory tract (URT) represent serious problem for marine mammals adapted to noogenic conditions. Anthropogenic contamination of pool water is considered as an important source of potentially harmful bacteria. The changes in climatic conditions, nutrition and stress of animals living in an artificial environment can result in bacterial overgrowth and disease development with possible spread in the community. Treatment of already advanced disease is complicated ...

Procalcitonin and C-reactive protein in urinary tract infection diagnosis.

Science.gov (United States)

Xu, Rui-Ying; Liu, Hua-Wei; Liu, Ji-Ling; Dong, Jun-Hua

2014-05-30

Urinary infections are a common type of pediatric disease, and their treatment and prognosis are closely correlated with infection location. Common clinical manifestations and laboratory tests are insufficient to differentiate between acute pyelonephritis and lower urinary tract infection. This study was conducted to explore a diagnostic method for upper and lower urinary tract infection differentiation. The diagnostic values of procalcitonin (PCT) and C-reactive protein (CRP) were analyzed using the receiver operating characteristic curve method for upper and lower urinary tract infection differentiation. PCT was determined using chemiluminescent immunoassay. The PCT and CRP values in children with acute pyelonephritis were significantly higher than those in children with lower urinary tract infection (3.90 ± 3.51 ng/ml and 68.17 ± 39.42 mg/l vs. 0.48 ± 0.39 ng/ml and 21.39 ± 14.92 mg/l). The PCT values were correlated with the degree of renal involvement, whereas the CRP values failed to show such a significant correlation. PCT had a sensitivity of 90.47% and a specificity of 88% in predicting nephropathia, whereas CRP had sensitivity of 85.71% and a specificity of 48%. Both PCT and CRP can be used for upper and lower urinary tract infection differentiation, but PCT has higher sensitivity and specificity in predicting pyelonephritis than CRP. PCT showed better results than CRP. PCT values were also correlated with the degree of renal involvement.

Influence of the Biliary System on Biliary Bacteria Revealed by Bacterial Communities of the Human Biliary and Upper Digestive Tracts.

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Fuqiang Ye

Full Text Available Biliary bacteria have been implicated in gallstone pathogenesis, though a clear understanding of their composition and source is lacking. Moreover, the effects of the biliary environment, which is known to be generally hostile to most bacteria, on biliary bacteria are unclear. Here, we investigated the bacterial communities of the biliary tract, duodenum, stomach, and oral cavity from six gallstone patients by using 16S rRNA amplicon sequencing. We found that all observed biliary bacteria were detectable in the upper digestive tract. The biliary microbiota had a comparatively higher similarity with the duodenal microbiota, versus those of the other regions, but with a reduced diversity. Although the majority of identified bacteria were greatly diminished in bile samples, three Enterobacteriaceae genera (Escherichia, Klebsiella, and an unclassified genus and Pyramidobacter were abundant in bile. Predictive functional analysis indicated enhanced abilities of environmental information processing and cell motility of biliary bacteria. Our study provides evidence for the potential source of biliary bacteria, and illustrates the influence of the biliary system on biliary bacterial communities.

Fungi-Induced Upper and Lower Respiratory Tract Allergic Diseases: One Entity

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Aleksandra Barac

2018-04-01

Full Text Available Introduction:Aspergillus can cause different allergic diseases including allergic bronchopulmonary aspergillosis (ABPA and allergic fungal rhinosinusitis (AFRS. ABPA is allergic pulmonary disease against Aspergillus antigens. AFRS is a type of chronic rhinosinusitis (CRS presented as hypersensitivity reactions to the fungal presence in sinuses. The aim of the present study was to clarify if ABPA and AFRS could be considered as a common disease entity.Methodology: The prospective cohort study included 75 patients with ABPA. Patients were divided into two groups and compared with each other: (i patients with CT confirmation of rhinosinusitis and presence of fungi in sinuses (ABPA+AFRS group and (ii patients without CT or without mycological evidence of AFRS (ABPA group.Results: Findings of this study were: (i AFRS was confirmed in 80% of patients with ABPA; (ii all ABPA+AFRS patients had allergic mucin while fungal hyphae were present in 60% sinonasal aspirate; (iii ABPA+AFRS patients had more often complicated CRS with (nasal polyps NP (p < 0.001 and more severe forms of CRS; (iv culture of sinonasal aspirate revealed fungal presence in 97% patients with ABPA+AFRS; (v patients with ABPA+AFRS had more common positive skin prick test (SPT for A. fumigatus (p = 0.037, while patients without AFRS had more common positive SPT for Alternaria alternata and Penicillium notatum (p = 0.04 and p = 0.03, respectively; (vi 67% of ABPA patients had Aspergillus induced AFRS; (vii larger number of fungi was isolated from the air-samples obtained from homes of patients with ABPA+AFRS than from the homes of patients without AFRS, while the most predominant species were A. fumigatus and A. niger isolated from almost 50% of the air-samples.Conclusion: The pathogenesis of ABPA and AFRS is similar, and AFRS can be considered as the upper airway counterpart of ABPA. Fungi-induced upper and lower respiratory tract allergic diseases present common entity. Next studies

Bacterial Composition of the Human Upper Gastrointestinal Tract Microbiome Is Dynamic and Associated with Genomic Instability in a Barrett’s Esophagus Cohort

Science.gov (United States)

Gall, Alevtina; Fero, Jutta; McCoy, Connor; Claywell, Brian C.; Sanchez, Carissa A.; Blount, Patricia L.; Li, Xiaohong; Vaughan, Thomas L.; Matsen, Frederick A.; Reid, Brian J.; Salama, Nina R.

2015-01-01

Background The incidence of esophageal adenocarcinoma (EAC) has increased nearly five-fold over the last four decades in the United States. Barrett’s esophagus, the replacement of the normal squamous epithelial lining with a mucus-secreting columnar epithelium, is the only known precursor to EAC. Like other parts of the gastrointestinal (GI) tract, the esophagus hosts a variety of bacteria and comparisons among published studies suggest bacterial communities in the stomach and esophagus differ. Chronic infection with Helicobacter pylori in the stomach has been inversely associated with development of EAC, but the mechanisms underlying this association remain unclear. Methodology The bacterial composition in the upper GI tract was characterized in a subset of participants (n=12) of the Seattle Barrett’s Esophagus Research cohort using broad-range 16S PCR and pyrosequencing of biopsy and brush samples collected from squamous esophagus, Barrett’s esophagus, stomach corpus and stomach antrum. Three of the individuals were sampled at two separate time points. Prevalence of H. pylori infection and subsequent development of aneuploidy (n=339) and EAC (n=433) was examined in a larger subset of this cohort. Results/Significance Within individuals, bacterial communities of the stomach and esophagus showed overlapping community membership. Despite closer proximity, the stomach antrum and corpus communities were less similar than the antrum and esophageal samples. Re-sampling of study participants revealed similar upper GI community membership in two of three cases. In this Barrett’s esophagus cohort, Streptococcus and Prevotella species dominate the upper GI and the ratio of these two species is associated with waist-to-hip ratio and hiatal hernia length, two known EAC risk factors in Barrett’s esophagus. H. pylori-positive individuals had a significantly decreased incidence of aneuploidy and a non-significant trend toward lower incidence of EAC. PMID:26076489

gastrointestinal tract

Directory of Open Access Journals (Sweden)

Rolandas Vaicekauskas

2016-07-01

Full Text Available Introduction : Accurate diagnosis of subepithelial lesions (SELs in the gastrointestinal tract depends on a variety of methods: endoscopy, endoscopic ultrasound and different types of biopsy. Making an error-free diagnosis is vital for the subsequent application of an appropriate treatment. Aim: To evaluate the efficacy of deep biopsy via the endoscopic submucosal dissection (ESD technique for SELs in the upper gastrointestinal tract. Material and methods: It was a case series study. Deep biopsy via the ESD technique was completed in 38 patients between November 2012 and October 2014. Thirty-eight SELs in the upper gastrointestinal tract of varying size (very small ≤ 1 cm, small 1–2 cm and large ≥ 2 cm by means of the ESD technique after an incision with an electrosurgical knife of the overlying layers and revealing a small part of the lesion were biopsied under direct endoscopic view. Results: Deep biopsy via the ESD technique was diagnostic in 28 of 38 patients (73.3%; 95% CI: 59.7–89.7%. The diagnostic yield for SELs with a clear endophytic shape increased to 91.3%. An evident endophytic appearance of a subepithelial lesion, the mean number of biopsied samples (6.65 ±1.36 and the total size in length of all samples per case (19.88 ±8.07 mm were the main criteria influencing the positiveness of deep biopsy in the diagnostic group compared to the nondiagnostic one (p = 0.001; p = 0.025; p = 0.008. Conclusions : Deep biopsy via the ESD technique is an effective and safe method for the diagnosis of SELs especially with a clear endophytic appearance in a large number of biopsied samples.

Anatomy and Physiology of the Urinary Tract: Relation to Host Defense and Microbial Infection.

Science.gov (United States)

Hickling, Duane R; Sun, Tung-Tien; Wu, Xue-Ru

2015-08-01

The urinary tract exits to a body surface area that is densely populated by a wide range of microbes. Yet, under most normal circumstances, it is typically considered sterile, i.e., devoid of microbes, a stark contrast to the gastrointestinal and upper respiratory tracts where many commensal and pathogenic microbes call home. Not surprisingly, infection of the urinary tract over a healthy person's lifetime is relatively infrequent, occurring once or twice or not at all for most people. For those who do experience an initial infection, the great majority (70% to 80%) thankfully do not go on to suffer from multiple episodes. This is a far cry from the upper respiratory tract infections, which can afflict an otherwise healthy individual countless times. The fact that urinary tract infections are hard to elicit in experimental animals except with inoculum 3-5 orders of magnitude greater than the colony counts that define an acute urinary infection in humans (105 cfu/ml), also speaks to the robustness of the urinary tract defense. How can the urinary tract be so effective in fending off harmful microbes despite its orifice in a close vicinity to that of the microbe-laden gastrointestinal tract? While a complete picture is still evolving, the general consensus is that the anatomical and physiological integrity of the urinary tract is of paramount importance in maintaining a healthy urinary tract. When this integrity is breached, however, the urinary tract can be at a heightened risk or even recurrent episodes of microbial infections. In fact, recurrent urinary tract infections are a significant cause of morbidity and time lost from work and a major challenge to manage clinically. Additionally, infections of the upper urinary tract often require hospitalization and prolonged antibiotic therapy. In this chapter, we provide an overview of the basic anatomy and physiology of the urinary tract with an emphasis on their specific roles in host defense. We also highlight the

Characterization of the contents and histology of the gastrointestinal tracts of White Sturgeon (Acipenser transmontanus) captured from Upper Lake Roosevelt, Washington, October 2008

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Parsley, Michael J.; van der Leeuw, Bjorn K.; Elliott, Diane G.

2010-01-01

The gastrointestinal tracts of 37 juvenile white sturgeon (Acipenser transmontanus) captured from the upper part of Lake Roosevelt during October 2008, were examined to identify prey taxa and to determine if the fish were consuming smelter slag along with other sediments. Histological examination of the gastrointestinal tract tissues and comparison with similar tissues from hatchery-reared fish also was performed. The contents of the gastro-intestinal tracts (guts) indicated that white sturgeon were actively foraging on various benthic invertebrates and the diet was quite diverse, with more than 50 percent of the fish feeding on five or more different taxa. Slag was present in 76 percent of the guts examined. Although not all guts contained slag particles, larger fish tended to have greater amounts of slag in their guts. Histology of the gut tissues showed the presence of a chronic inflammatory response, and the severity of the response had a significant positive correlation (P = 0.01) with fish length and weight suggesting that the inflammation represented a response to long-term exposure to one or more stressors. However, additional work is needed to determine if the physical or chemical properties of slag contributed to this response.

Protection against Chlamydia trachomatis infection and upper genital tract pathological changes by vaccine-promoted neutralizing antibodies directed to the VD4 of the major outer membrane protein

DEFF Research Database (Denmark)

Olsen, Anja W.; Follmann, Frank; Erneholm, Karin Susanne

2015-01-01

bacterial numbers in vagina and prevention of pathological changes in the upper genital tract. Adoptive transfer of serumand T-cell depletion experiments demonstrated a dominant role for antibodies and CD4+ T cells in the protective immune response. Integrating a multivalent VD4 construct into the sequence...

Associations between pathogens in the upper respiratory tract of young children: interplay between viruses and bacteria.

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Menno R van den Bergh

Full Text Available High rates of potentially pathogenic bacteria and respiratory viruses can be detected in the upper respiratory tract of healthy children. Investigating presence of and associations between these pathogens in healthy individuals is still a rather unexplored field of research, but may have implications for interpreting findings during disease.We selected 986 nasopharyngeal samples from 433 6- to 24-month-old healthy children that had participated in a randomized controlled trial. We determined the presence of 20 common respiratory viruses using real-time PCR. Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus were identified by conventional culture methods. Information on risk factors was obtained by questionnaires. We performed multivariate logistic regression analyses followed by partial correlation analysis to identify the overall pattern of associations. S. pneumoniae colonization was positively associated with the presence of H. influenzae (adjusted odds ratio 1.60, 95% confidence interval 1.18-2.16, M. catarrhalis (1.78, 1.29-2.47, human rhinoviruses (1.63, 1.19-2.22 and enteroviruses (1.97, 1.26-3.10, and negatively associated with S. aureus presence (0.59, 0.35-0.98. H. influenzae was positively associated with human rhinoviruses (1.63, 1.22-2.18 and respiratory syncytial viruses (2.78, 1.06-7.28. M. catarrhalis colonization was positively associated with coronaviruses (1.99, 1.01-3.93 and adenoviruses (3.69, 1.29-10.56, and negatively with S. aureus carriage (0.42, 0.25-0.69. We observed a strong positive association between S. aureus and influenza viruses (4.87, 1.59-14.89. In addition, human rhinoviruses and enteroviruses were positively correlated (2.40, 1.66-3.47, as were enteroviruses and human bocavirus, WU polyomavirus, parainfluenza viruses, and human parechovirus. A negative association was observed between human rhinoviruses and coronaviruses.Our data revealed high viral and

Microencapsulation increases survival of the probiotic Lactobacillus plantarum IS-10506, but not Enterococcus faecium IS-27526 in a dynamic, computer-controlled in vitro model of the upper gastrointestinal tract.

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Surono, I; Verhoeven, J; Verbruggen, S; Venema, K

2018-02-23

To test the effect of microencapsulation on the survival of two probiotic strains isolated from Dadih, Indonesian fermented buffalo milk, in a dynamic, computer-controlled in vitro model of the upper gastrointestinal (GI) tract (TIM-1), simulating human adults. Free or microencapsulated probiotics, Lactobacillus plantarum IS-10506 or Enterococcus faecium IS-27526, resuspended in milk were studied for survival in the complete TIM-1 system (stomach + small intestine) or in the gastric compartment of TIM-1 only. Hourly samples collected after the ileal-caecal valve or after the pylorus were plated on MRS agar (for Lactobacillus) or S&B agar (for Enterococcus). Survival of the free cells after transit through the complete TIM-1 system was on average for the E. faecium and L. plantarum 15·0 and 18·5% respectively. Survival of the microencapsulated E. faecium and L. plantarum was 15·7 and 84·5% respectively. The free cells were further assessed in only the gastric compartment of TIM-1. E. faecium and L. plantarum showed an average survival of 39 and 32%, respectively, after gastric passage. There is similar sensitivity to gastric acid as well as survival after complete upper GI tract transit of free cells, but microencapsulation only protected L. plantarum. Survival of microencapsulated L. plantarum IS-10506 is increased compared to free cells in a validated in vitro model of the upper GI tract. It increases its use as an ingredient of functional foods. © 2018 The Society for Applied Microbiology.

Urinary Tract Infection and Bacteriuria in Pregnancy.

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Glaser, Alexander P; Schaeffer, Anthony J

2015-11-01

Bacteriuria during pregnancy may be classified as asymptomatic bacteriuria, infections of the lower urinary tract (cystitis), or infections of the upper urinary tract (pyelonephritis). Lower tract bacteriuria is associated with an increased risk of developing pyelonephritis in pregnancy, which is itself associated with adverse maternal and fetal outcomes. Pregnant women should be screened for the presence of bacteriuria early in pregnancy. All bacteriuria in pregnancy should be treated, and antimicrobial choice in pregnancy should reflect safety for both the mother and the fetus. After treatment of bacteriuria, patients should be followed closely due to risk of recurrent bacteriuria. Copyright © 2015 Elsevier Inc. All rights reserved.

Feasibility of MR urography in neonates and infants with anomalies of the upper urinary tract

International Nuclear Information System (INIS)

Riccabona, M.; Ruppert-Kohlmayr, A.; Fotter, R.; Simbrunner, J.; Ebner, F.; Ring, E.

2002-01-01

The aim of this study was to evaluate the feasibility and diagnostic potential of dynamic MR urography (MRU) in neonates and infants with sonographically detected abnormalities of the upper urinary tract. Thirty infants (age range 5 days to 3 years, mean age 7.9 months; male:female: 22:8) underwent MRU using T2 and contrast-enhanced dynamic T1-weighted sequences. The results were compared with the findings of ultrasound (n=30), intravenous urography (IVU, n=19) and/or scintigraphy (n=25) based on the criteria suggestive of obstructive uropathy. Oral sedation was sufficient to perform MRU with diagnostic quality in 20 of 21 patients younger than 1 year; 9 older patients needed intravenous sedation. Diagnosis of the 66 renal units (58 kidneys, 29 successful examinations) included normal systems (contralateral units), duplex systems, vesico-ureteral reflux, obstructive megaureter, ureteropelvic junction obstruction and accompanying renal parenchymal disease, with complex pathology in 10 patients. Magnetic resonance urography demonstrated anatomy better than IVU, particularly the renal parenchyma, (ectopic) ureters, and poorly functioning dilated systems. Magnetic resonance urography was superior to US in showing ureteral pathology. Tiny cysts in dysplastic kidneys were better seen by US. Gadolinium-enhanced dynamic MRU allowed accurate assessment of obstruction applying IVU criteria. Here MRU matched IVU results, and most of the scintigraphic findings. Magnetic resonance urography can be performed in young infants with diagnostic quality using oral sedation. Magnetic resonance urography correctly depicts anatomy and allows assessment of the urinary tract better than US and IVU, with additional functional information. Magnetic resonance urography thus has the potential to replace IVU for many indications. (orig.)

Absorption and excretion of zinc, cadmium and mercury in the gastrointestinal tract

Energy Technology Data Exchange (ETDEWEB)

Shibata, H [National Inst. of Radiological Sciences, Chiba (Japan)

1975-10-01

The absorption and excretion of inorganic zinc, cadmium and mercury in the gastrointestinal tract were compared using /sup 65/Zn, /sup 109/Cd and /sup 203/Hg. A single dose of /sup 65/Zn, /sup 109/Cd or /sup 203/Hg was administered orally or injected intravenously to investigate the distribution, excretion into bile and excretion into feces or urine. Absorption and excretion through the gastrointestinal tract of mice were studied by the tied loop method. Groups of eight mice or rats were used to measure the radioactivity in sample with a scintillation counter. Most of the orally administered /sup 65/Zn, /sup 109/Cd or /sup 203/Hg was excreted into feces and was less absorbed by the gastrointestinal tract, respectively. Absorption rate in the gastrointestinal tract was as follows: /sup 203/Hg>/sup 65/Zn>/sup 109/Cd. Intravenously injected /sup 65/Zn, /sup 109/Cd or /sup 203/Hg was escreted into the gastrointestinal tract through the gastrointestinal wall and bile duct, respectively. Excretion rate in the gastrointestinal tract was as follows: /sup 65/Zn>/sup 203/Hg>/sup 109/Cd. When comparing the absorption and excretion in each gastrointestinal tract divided into 10 parts, /sup 65/Zn, and /sup 109/Cd were relatively well absorbed from the upper and lower part of small intestine and excreted into the upper, middle, lower part. /sup 203/Hg was relatively well absorbed from the upper, lower part of small intestine and excreted into the stomach and the caecum. The major organs that accumulated absorbed /sup 65/Zn, /sup 109/Cd or /sup 203/Hg were the pancreas and liver, liver and kidney, kidney and liver, respectively.

Cow's Milk and Immune Function in the Respiratory Tract: Potential Mechanisms.

Science.gov (United States)

Perdijk, Olaf; van Splunter, Marloes; Savelkoul, Huub F J; Brugman, Sylvia; van Neerven, R J Joost

2018-01-01

During the last decades, the world has witnessed a dramatic increase in allergy prevalence. Epidemiological evidence shows that growing up on a farm is a protective factor, which is partly explained by the consumption of raw cow's milk. Indeed, recent studies show inverse associations between raw cow's milk consumption in early life and asthma, hay fever, and rhinitis. A similar association of raw cow's milk consumption with respiratory tract infections is recently found. In line with these findings, controlled studies in infants with milk components such as lactoferrin, milk fat globule membrane, and colostrum IgG have shown to reduce respiratory infections. However, for ethical reasons, it is not possible to conduct controlled studies with raw cow's milk in infants, so formal proof is lacking to date. Because viral respiratory tract infections and aeroallergen exposure in children may be causally linked to the development of asthma, it is of interest to investigate whether cow's milk components can modulate human immune function in the respiratory tract and via which mechanisms. Inhaled allergens and viruses trigger local immune responses in the upper airways in both nasal and oral lymphoid tissue. The components present in raw cow's milk are able to promote a local microenvironment in which mucosal immune responses are modified and the epithelial barrier is enforced. In addition, such responses may also be triggered in the gut after exposure to allergens and viruses in the nasal cavity that become available in the GI tract after swallowing. However, these immune cells that come into contact with cow's milk components in the gut must recirculate into the blood and home to the (upper and lower) respiratory tract to regulate immune responses locally. Expression of the tissue homing-associated markers α4β7 and CCR9 or CCR10 on lymphocytes can be influenced by vitamin A and vitamin D3, respectively. Since both vitamins are present in milk, we speculate that raw

Multidetector computed tomography urography for diagnosing upper urinary tract urothelial tumour.

Science.gov (United States)

Cowan, Nigel C; Turney, Ben W; Taylor, Nia J; McCarthy, Catherine L; Crew, Jeremy P

2007-06-01

To evaluate multidetector computed tomography urography (MDCTU) for diagnosing upper urinary tract (UUT) urothelial tumour by comparison with retrograde ureteropyelography (RUP). MDCTU and RUP were used in a selected series of adult patients presenting with haematuria. Entry criteria were based on findings on intravenous urography and were chosen to ensure a high prevalence of UUT urothelial tumour to allow a valid retrospective comparison of the diagnostic techniques. MDCTU and RUP studies were scored for the presence and absence of UUT urothelial tumour by two radiologists, retrospectively and independently, and while unaware of the demographic and clinical information. The reference standards were the histopathology and clinical follow-up. MDCTU and RUP were used in 106 patients over a 24-month period. RUP was attempted in 151 of 212 UUTs; the corresponding MDCTU for each UUT was reviewed. MDCTU was a true-positive (TP) for urothelial tumour in 31, true-negative (TN) in 111, false-positive (FP) in eight and false-negative (FN) in one UUT, giving a sensitivity of 0.97, a specificity of 0.93, a positive predictive value (PPV) of 0.79 and a negative PV (NPV) of 0.99. RUP was technically successful and diagnostic in 96% of the UUTs (143/151). For diagnosing urothelial tumour, RUP was TP in 26, TN in 112, FP in four and FN in one UUT, giving a sensitivity of 0.97, specificity of 0.93, a PPV of 0.79 and NPV of 0.99. This study validates quantitatively the use of MDCTU for diagnosing UUT urothelial tumour.

Navigating moral distress using the moral distress map.

Science.gov (United States)

Dudzinski, Denise Marie

2016-05-01

The plethora of literature on moral distress has substantiated and refined the concept, provided data about clinicians' (especially nurses') experiences, and offered advice for coping. Fewer scholars have explored what makes moral distress moral If we acknowledge that patient care can be distressing in the best of ethical circumstances, then differentiating distress and moral distress may refine the array of actions that are likely to ameliorate it. This article builds upon scholarship exploring the normative and conceptual dimensions of moral distress and introduces a new tool to map moral distress from emotional source to corrective actions. The Moral Distress Map has proven useful in clinical teaching and ethics-related debriefings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Dysbiosis of upper respiratory tract microbiota in elderly pneumonia patients.

Science.gov (United States)

de Steenhuijsen Piters, Wouter A A; Huijskens, Elisabeth G W; Wyllie, Anne L; Biesbroek, Giske; van den Bergh, Menno R; Veenhoven, Reinier H; Wang, Xinhui; Trzciński, Krzysztof; Bonten, Marc J; Rossen, John W A; Sanders, Elisabeth A M; Bogaert, Debby

2016-01-01

Bacterial pneumonia is a major cause of morbidity and mortality in elderly. We hypothesize that dysbiosis between regular residents of the upper respiratory tract (URT) microbiome, that is balance between commensals and potential pathogens, is involved in pathogen overgrowth and consequently disease. We compared oropharyngeal microbiota of elderly pneumonia patients (n=100) with healthy elderly (n=91) by 16S-rRNA-based sequencing and verified our findings in young adult pneumonia patients (n=27) and young healthy adults (n=187). Microbiota profiles differed significantly between elderly pneumonia patients and healthy elderly (PERMANOVA, P<0.0005). Highly similar differences were observed between microbiota profiles of young adult pneumonia patients and their healthy controls. Clustering resulted in 11 (sub)clusters including 95% (386/405) of samples. We observed three microbiota profiles strongly associated with pneumonia (P<0.05) and either dominated by lactobacilli (n=11), Rothia (n=51) or Streptococcus (pseudo)pneumoniae (n=42). In contrast, three other microbiota clusters (in total n=183) were correlated with health (P<0.05) and were all characterized by more diverse profiles containing higher abundances of especially Prevotella melaninogenica, Veillonella and Leptotrichia. For the remaining clusters (n=99), the association with health or disease was less clear. A decision tree model based on the relative abundance of five bacterial community members in URT microbiota showed high specificity of 95% and sensitivity of 84% (89% and 73%, respectively, after cross-validation) for differentiating pneumonia patients from healthy individuals. These results suggest that pneumonia in elderly and young adults is associated with dysbiosis of the URT microbiome with bacterial overgrowth of single species and absence of distinct anaerobic bacteria. Whether the observed microbiome changes are a cause or a consequence of the development of pneumonia or merely coincide with

Impacts of upper respiratory tract disease on olfactory behavior of the Mojave desert tortoise

Science.gov (United States)

Germano, Jennifer; Van Zerr, Vanessa E.; Esque, Todd C.; Nussear, Ken E.; Lamberski, Nadine

2014-01-01

Upper respiratory tract disease (URTD) caused by Mycoplasma agassizii is considered a threat to desert tortoise populations that should be addressed as part of the recovery of the species. Clinical signs can be intermittent and include serous or mucoid nasal discharge and respiratory difficulty when nares are occluded. This nasal congestion may result in a loss of the olfactory sense. Turtles are known to use olfaction to identify food items, predators, and conspecifics; therefore, it is likely that URTD affects not only their physical well-being but also their behavior and ability to perform necessary functions in the wild. To determine more specifically the impact nasal discharge might have on free-ranging tortoises (Gopherus agassizii), we compared the responses of tortoises with and without nasal discharge and both positive and negative for M. agassizii antibodies to a visually hidden olfactory food stimulus and an empty control. We found that nasal discharge did reduce sense of smell and hence the ability to locate food. Our study also showed that moderate chronic nasal discharge in the absence of other clinical signs did not affect appetite in desert tortoises.

STUDY ON CAMPHOR-FREE NATURAL TOPICAL MEDICINE FOR UPPER RESPIRATORY TRACT INFECTIONS IN CHILDREN

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Zubair Ali

2016-12-01

Full Text Available Upper respiratory tract infections (URTI are the most common acute illnesses that are often of viral origin. Cough and chest congestion are the common symptoms of this disease. Children are prescribed with drugs that are considered to relive the symptoms of this disease. The topical medications contain vegetable camphor for more than a century that relieve chest congestion and cough caused by URTI. The use of camphor in such products remains questionable especially in children who are more sensitive to its side effects. Herbion “Chest Rub” for children is a camphor-free formulation that contains eucalyptus oil mixture, menthol,turpentine and clove oils and is used to relieve symptoms of URTI.The objective of the present investigationwas to determine the effectiveness of the chest rub inchildren suffering with congestion and cough caused by URTI. The study compared the results of the chest rub applied to a group of infected children with a placebo group. Patients were selected randomly on the basis of the criteria set for the study. The results indicated that the chest rub was quite effective in majority of the cases in relieving the symptoms of URTI as compared to the placebo group.

Upper Tract Urothelial Carcinomas Accompanied by Previous or Synchronous Nonmuscle-Invasive Bladder Cancer and Preoperative Hydronephrosis Might Have Worse Oncologic Outcomes After Radical Nephroureterectomy.

Science.gov (United States)

Liang, Chengcai; Chi, Runmin; Huang, Liqun; Wang, Jinliang; Liu, Hailong; Xu, Ding; Qian, Subo; Qian, Xiaoqiang; Qi, Jun

2016-10-01

The purpose of the study was to identify predictors of clinicopathologic features and oncologic outcomes in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy (RNU). The medical records of 172 patients treated with RNU from January 2001 to September 2014 were retrospectively reviewed. Logistic regression and survival analysis methodology were respectively used to evaluate predictors of clinicopathologic features and oncologic outcomes. Of the enrolled 172 patients, 80 (46.5%) had renal pelvic tumors, 67 (39%) had ureteral tumors, and the remaining 25 (14.5%) patients had multifocal tumors. Compared with patients with renal pelvic tumors, those with ureteral and multifocal tumors were more likely to have previous or synchronous nonmuscle-invasive bladder cancer (NMIBC) and severe hydronephrosis (P = .001 and P hydronephrosis independently predicted worse renal function and positive lymph node or lymphovascular invasion status (P = .001 and P = .007, respectively). Moreover, severe hydronephrosis was an independent risk factor for overall survival and cancer-specific survival in multivariate analysis (P = .025 and P = .045, respectively). Multifocality and previous or synchronous NMIBC were significantly associated with bladder-recurrence-free survival (P = .023 and P = .001, respectively). Upper tract urothelial carcinoma accompanied by previous or synchronous NMIBC and preoperative severe hydronephrosis could have worse oncologic outcomes after RNU. These common accompanied diagnoses could be valuable for guiding preoperative planning and postoperative adjuvant therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

Respiratory tract infection during Hajj

Directory of Open Access Journals (Sweden)

Alzeer Abdulaziz

2009-01-01

Full Text Available Respiratory tract infection during Hajj (pilgrimage to Mecca is a common illness, and it is responsible for most of the hospital admissions. Influenza virus is the leading cause of upper respiratory tract infection during Hajj, and pneumonia can be serious. Taking into account the close contacts among the pilgrims, as well as the crowding, the potential for transmission of M. tuberculosis is expected to be high. These pilgrims can be a source for spreading infection on their return home. Although vaccination program for influenza is implemented, its efficacy is uncertain in this religious season. Future studies should concentrate on prevention and mitigation of these infections.

Foreign bodies in upper gastrointestinal tract and urgent endoscopic interventions – review of a ten-year period

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Pavel Skok

2005-07-01

Full Text Available Background: Foreign bodies in the upper digestive tube are rarely the cause of an urgent condition in gastroenterology. They usually enter the digestive tube during nutrition or by mistake. However, certain groups of the population such as convicts or psychiatric patients tend to swallow them intentionally. The authors aim was to assess the percentage of patients in which urgent endoscopic investigation revealed true foreign bodies in the upper digestive tube, to evaluate the success of endoscopic procedures and the resolution of eventual complications.Patients and methods: The study includes patients in which urgent endoscopic investigations of the upper digestive tract were performed in a 10-year period (1 January 1994 to 31 December 2003.Results: Altogether 6416 patients were investigated, mean age 59.3 years, SD ± 17.2 years, range 1–106 years, 2452 females and 3964 males. In 51 patients, 0.8% of all subjects, foreign bodies were detected in the esophagus or stomach. In these patients a total of 65 endoscopic investigations were performed, in 94% the foreign bodies were removed endoscopically (48/51 patients, in three cases the endoscopic procedures were not successful. Among the foreign bodies removed were various metal or plastic objects: coins, keys, screws, hooks, batteries, razor blades, needles, parts of kitchen, toilet or writing utensils, lighters, buttons, toys, a toothbrush as well as impacted pieces of bone. In the patients with successful endoscopic removal of the objects, no significant complications were noted. In 3 patients (3/48, 6.3% only mild hemorrhages from the region of the esophagogastric junction were observed.Conclusions: The technological development of endoscopic instruments made it possible to carry out different therapeutic procedures. The method has proved successful in removing foreign bodies from the upper digestive tube. Various factors affect the success of the procedure, the more important being adequate

Studies on the function of upper urinary tract, 13

International Nuclear Information System (INIS)

Osaka, Uichi

1980-01-01

In order to clarify the changes of the ureteral function after ureterolithotomy, 131 I-Hippuran renograms were recorded at 3 times before, immediately after (i.e. 1 - 2 days after) and 10 days after the lithotomy in 52 patients. The influences of preoperative hydronephrosis or urinary tract infection upon the postoperative renogram patterns were studied. The following results were obtained. 1. In the renogram findings of the preoperative 52 cases, 28 delayed excretion types, 15 obstructive types and 9 standard types were shown. 2. The postoperative renogram patterns showed a tendency of increased obstruction immediately after the operation (56.9%) irrespective of the location of the calculi in the ureter, and the recovering excretion phases became visible on the 10th postoperative day (51.1%). 3. In the findings on the postoperative renograms, a tendency of increased obstruction was noted in many of the patients of the non-hydronephrotic group than the hydronephrotic group immediately after the operation, but no statistically significant difference was noted. On the 10th postoperative day, slightly more patients of the hydronephrotic group tended to show improvements of obstruction than those of the non-hydronephrotic group, but with no statistically significant difference. 4. In the relationship between the hydronephrosis and urinary tract infection, the infection rate was 26.9% (7 out of 26) in the non-hydronephrotic group and 52.4% (11 out of 21) in the hydronephrotic group. 5. In the findings on the renograms viewed from presence of urinary tract infection, slightly more cases of increased obstruction were found out immediately after the operation in the non-infected group than in the infected group. On the 10th postoperative day, slightly more cases of improvements of obstruction were noted in the infected group than in the non-infected group, but no statistically significant difference was seen between the two groups at either of the two points. (author)

Efficacy and safety of Sultamicillin (Ampicillin/Sulbactan) and Amoxicillin/Clavulanic acid in the treatment of upper respiratory tract infections in adults--an open-label, multicentric, randomized trial.

Science.gov (United States)

Ferreira, João Batista; Rapoport, Priscila Bogar; Sakano, Eulália; Kós, Arthur Octávio De Avila; Piltcher, Otávio B; Pignatari, Shirley Shizue Nagata; Pinheiro, Sebastião Diógenes; Mocellin, Marcos

2006-01-01

Upper respiratory tract infections are the most common causes of medical visits in children and adults, demanding massive use of antibiotics. Bacterial resistance caused by beta-lactamase is one of the most serious problems in this matter. Sultamicillin, a double pro-drug of Ampicillin/Sulbactan, is a potent beta-lactamase inhibitor which can face this challenge. Evaluate efficacy, safety and tolerability of Ampicillin/Sulbactan compared to Amoxicillin/Clavulanate in upper respiratory tract infections in adults. 102 patients were enrolled and randomized to receive Ampicillin/Sulbactan or Amoxicillin/Clavulanate during 10 days. They were evaluated 10 and 30 days after treatment to learn about the therapeutic response. There were no differences between the two groups respecting cure at the end of treatment (visit 2) or at the end of the study (visit 3). Cure ratio was 61.7% and 93.2% (visits 2 and 3) in the Amoxicillin/Clavulanate group compared to 64.4% and 97.4%, respectively, in Ampicillin/Sulbactan group. The adverse events ratio for the two groups was the same (p=0.940). The number of patients with diarrhea was greater in the group of patients receiving Amoxicillin/Clavulanate (70.6%) than in the group receiving Ampicillin/Sulbactan (29.4%) (p=0.0164). Ampicillin/Sulbactan is as safe and efficient as Amoxicillin/Clavulanate in the empiric treatment of upper respiratory infections in adults. The low occurrence of diarrhea in the group receiving Ampicillin/Sulbactan needs confirmation in other studies.

BACTERIAL PROFILE, ANTIBIOTIC SENSITIVITY AND RESISTANCE OF LOWER RESPIRATORY TRACT INFECTIONS IN UPPER EGYPT

Directory of Open Access Journals (Sweden)

Gamal Agmy

2013-09-01

Full Text Available BACKGROUND: Lower respiratory tract infections (LRTI account for a considerable proportion of morbidity and antibiotic use. We aimed to identify the causative bacteria, antibiotic sensitivity and resistance of hospitalized adult patients due to LRTI in Upper Egypt. METHODS: A multicentre prospective study was performed at 3 University Hospitals for 3 years. Samples included sputum or bronchoalveolar lavage (BAL for staining and culture, and serum for serology. Samples were cultured on 3 bacteriological media (Nutrient, Chocolate ,MacConkey's agars.Colonies were identified via MicroScan WalkAway-96. Pneumoslide IgM kit was used for detection of atypical pathogens via indirect immunofluorescent assay. RESULTS: The predominant isolates in 360 patients with CAP were S.pneumoniae (36%, C. pneumoniae (18%, and M. pneumoniae (12%. A higher sensitivity was recorded for moxifloxacin, levofloxacin, macrolides, and cefepime. A higher of resistance was recorded for doxycycline, cephalosporins, and β-lactam-β-lactamase inhibitors. The predominant isolates in 318 patients with HAP were, methicillin-resistant Staphylococcus aureus; MRSA (23%, K. pneumoniae (14%, and polymicrobial in 12%. A higher sensitivity was recorded for vancomycin, ciprofloxacin, and moxifloxacin. Very high resistance was recorded for β-lactam-β-lactamase inhibitors and cephalosporins. The predominant organisms in 376 patients with acute exacerbation of chronic obstructive pulmonary diseases (AECOPD were H. influnzae (30%, S. pneumoniae (25%, and M. catarrhalis(18%. A higher sensitivity was recorded for moxifloxacin, macrolides and cefepime. A higher rate of resistance was recorded for aminoglycosides and cephalosporins CONCLUSIONS: The most predominant bacteria for CAP in Upper Egypt are S. pneumoniae and atypical organisms, while that for HAP are MRSA and Gram negative bacteria. For acute exacerbation of COPD,H.influnzae was the commonest organism. Respiratory quinolones

Association between polymorphic markers of IL-10 gene and chronic diseases of the upper respiratory tract in children living under technogenic pressure

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Lyudmila Borisovna Masnavieva

2015-03-01

Full Text Available Respiratory diseases are among the leading causes of infant morbidity. Disturbances of functioning of the immune system play an important role in their development. Interleukin-10 (IL-10 is a key regulator of the immune response. Mononucleotide substitutions at positions (-1082, (-819 and (-592 of IL-10 gene results in low level of the protein production. Our purpose was to study the associations between polymorphic markers of IL-10 gene and chronic respiratory diseases in children living under conditions of anthropogenic pressure. 189 adolescents living in a city with high levels of air pollution and 82 from a city with a moderate level of contamination were examined. Children with chronic upper airway pathology in remission were identified. Blood samples from all children were tested for allelic variants -1082G / A, -592C / A, -819C / T of IL-10 gene in. Analysis of associations between polymorphic variants and the presence of chronic respiratory diseases was conducted. The -592C allele of IL-10 gene was less common among children with chronic diseases of the respiratory tract living in conditions of moderate air pollution than in the healthy comparison group. Similar association has not been established in thr group of children living in conditions of high air pollution. Thus, the C allele of the polymorphic -592C/A locus marks resistance to the development of a chronic disease of the upper respiratory tract in children living in conditions of moderate air pollution, while in conditions of high level of pollution contribution of genetic factors in its development is leveled.

[Antibiotic prescribing in acute respiratory tract infections in general practice].

Science.gov (United States)

Malo, S; Bjerrum, L; Feja, C; Lallana, M J; Poncel, A; Rabanaque, M J

2015-06-01

Antimicrobial resistance is a worldwide threat to public health. Acute respiratory tract infections are the main reason for antibiotic prescribing in the Spanish paediatric population. The aim of the study was to describe the frequency of antibiotic prescription and their pattern of use in acute respiratory tract infections diagnosed in children in Primary Care in Aragón (Spain). A study was conducted over a 1-year period on children between 0 and 14 years-old, recording all episodes of acute otitis, acute pharyngotonsillitis, non-specific upper respiratory infection, and acute bronchitis. The proportion of episodes within each diagnosis receiving an antibiotic prescription was calculated, and the prescribing pattern was determined. Half (50%) of the children in Aragón were diagnosed with a respiratory tract infection during the study period. Non-specific upper respiratory infection was the most frequent diagnosis. An antibiotic was prescribed in 75% of pharyngotonsillitis episodes, 72% of otitis, 27% of bronchitis, and 16% of non-specific upper respiratory infections. Broad spectrum antibiotics, mainly amoxicillin and amoxicillin-clavulanic, were predominantly prescribed. Antibiotic prescribing in respiratory tract infections in children was generally high, and the choice of antibiotics was probably inappropriate in a high percentage of cases. Therefore an improvement in antibiotic prescribing in children appears to be needed. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Diagnostic Ureteroscopy Prior to Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma Increased the Risk of Intravesical Recurrence.

Science.gov (United States)

Tan, Ping; Xie, Nan; Yang, Lu; Liu, Liangren; Tang, Zhuang; Wei, Qiang

2018-01-01

To assess the impact of diagnostic ureteroscopy (URS) prior to radical nephroureterectomy (RNU) on intravesical recurrence (IVR) in patients with upper tract urothelial carcinoma (UTUC). A systematic literature search of the Medline, Embase, PubMed, and Cochrane library was performed in August 2017. Cumulative analyses of available hazard ratios (HRs) and their 95% CI were conducted using Stata version 12.0. Eleven studies including 4,057 participants were included, with a total of 1,403 patients diagnosed with IVR during the follow-up period. The pooled HRs of eight studies suggested that diagnostic URS prior to RNU significantly increased the IVR risk after RNU (HR 1.53, 95% CI 1.31-1.77; p guides decisions in UTUC, more future studies should be performed to find a novel way to mitigate the potential risk of IVR after RNU, such as chemoprophylaxis after endoscopy. © 2017 S. Karger AG, Basel.

Diet and upper-aerodigestive tract cancer in Europe: the ARCAGE study.

LENUS (Irish Health Repository)

Lagiou, Pagona

2009-06-01

There is suggestive, but inconclusive, evidence that dietary factors may affect risk of cancers of the upper aerodigestive tract (UADT). In the context of the alcohol-related cancers and genetic susceptibility in Europe study, we have examined the association of dietary factors with UADT cancer risk. We have analyzed data from 2,304 patients with UADT cancer and 2,227 control subjects recruited in 14 centers in 10 European countries. Dietary data were collected through a semi-quantitative food frequency questionnaire that also assessed preferred temperature of hot beverages. Statistical analyses were conducted through multiple logistic regression controlling for potential confounding variables, including alcohol intake and smoking habits. Consumption of red meat (OR per increasing tertile = 1.14, 95% CI: 1.05-1.25), but not poultry, was significantly associated with increased UADT cancer risk and the association was somewhat stronger for esophageal cancer. Consumption of fruits (OR per increasing tertile = 0.68, 95% CI: 0.62-0.75) and vegetables (OR per increasing tertile = 0.73, 95% CI: 0.66-0.81) as well as of olive oil (OR for above versus below median = 0.78, 95% CI 0.67-0.90) and tea (OR for above versus below median = 0.83, 95% CI 0.69-0.98) were significantly associated with reduced risk of UADT cancer. There was no indication that an increase in tea or coffee temperature was associated with increased risk of UADT overall or cancer of the esophagus; in fact, the association was, if anything, inverse. In conclusion, the results of this large multicentric study indicate that diet plays an important role in the etiology of UADT cancer.

Nitrofurantoin-induced acute respiratory distress syndrome during pregnancy: A case report

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Sherif S. Wahba

2014-01-01

Full Text Available Acute respiratory distress syndrome (ARDS is a rarely seen complication with nitrfurantoin. We report improvement of a parturient who was admitted to our hospital’s obstetrical unit with life threatening nitrofurantoin-induced acute respiratory failure. She had been taking nitrofurantoin for one week for urinary tract infection (UTI. Her chest radiography showed bilateral parenchymal infiltrates of the lung. The patient responded well to nitrofurantoin discontinuation and methylprednisolone infusion 1 mg/kg/day.

The effect of profiling report on antibiotic prescription for upper respiratory tract infection

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Mohd Fozi K

2013-10-01

Full Text Available Introduction: Upper respiratory tract infection (URTI is a common encounter in primary care and mostly viral in origin. Despite frequent reminders to primary care providers on judicious use of antibiotics for URTI, the practice is still rampant. Methods: As part of quality improvement initiative, an intervention was designed by distributing a profiling report on individual prescriber’s performance in comparison to colleagues on usage of antibiotic for URTI. The data were generated from electronic health record in three public primary care clinics in Malaysia and emailing monthly throughout 2011 to all providers. Results: There were 22,328 consultations for URTI in 2010 and 22,756 in 2011 with the incidence rates of URTI among overall consultations of 15.7% and 15.9% respectively. 60 doctors and medical assistants had performed consultations during the 2 year period. Following the intervention in 2011, the prescription rate of antibiotic for URTI is significantly reduced from 33.5% in 2010 to 23.3 % in 2011. Before intervention, individual prescription rate varies from 9.7% to 88.9% and reduced to 4.3% to 50.5% after intervention. Conclusion: Profiling report is a potential method of changing antibiotic prescribing habit among public primary care providers in Malaysia especially if the baseline adherence was poor and higher variation of prescribing rate.

[Urinary tract infections in adults].

Science.gov (United States)

Michno, Mikolaj; Sydor, Antoni

Review of urinary tract infections in adults including etiology, pathogenesis, classification and the most important therapeutic recommendations. Urinary tract infections are still a common clinical problem occurring more often in sexually active women, pregnancy, elderly , after catherization of a urinary bladder and urological surgery as well as in the co-existence of diabetes or nephrolithiasis. Due to the anatomical differences, women suffer more often than men. The main etiological factor is Escherichia coli, even though it plays a lesser role in the complicated infections, than in non-complicated ones. Apart from that, the infections may also be caused by atypical microbes, viruses and fungi. Relapses as well as reinfections are typical features of urinary tract infections and in some cases prolonged infections can spread from lower to upper urinary tract contributing to pyelonephritis, urosepsis or even death. These long-term infections can progress in a hidden, insidious, oligosymptomatic or asymptomatic manner leading to irreversible, progressive deterioration of renal function. They can also mask other diseases such as tuberculosis or neoplasms of the urinary tract, which leads to the delayed diagnosis and treatment. Diagnosis and treatment of urinary tract infections is a complex problem, often requiring specialized procedures as well as hospitalization. The choice of a therapy is determined by the type of infection, general condition, age and coexisting diseases. Rapid diagnosis and implementation of proper pharmacotherapy may shorten the time of treatment and hospitalization, preventing serious complications and reinfections.

Not all infantile respiratory distress in winter is bronchiolitis: congenital lobar emphysema.

Science.gov (United States)

Taqvi, Laura; Griksaitis, Michael; Eastham, Katherine

2011-10-20

The authors report the case of a 4-week-old male infant presented during the winter period with respiratory distress. He had a 3 day history of cough and coryza, and a 2 day history of breathlessness and reduced feeding. He had evidence of tachypnoea, subcostal recession and hypoxia on examination. An initial diagnosis of bronchiolitis was made. The authors explore how the correct diagnosis of congenital lobar emphysema (CLE) was reached, highlighting key clinical signs and investigations. He had evidence of a hyperinflated right middle lobe, with collapse of right upper and lower lobes and left upper lobe with associated mediastinal shift on chest x-ray (CXR) and CT scan. He was referred to the regional Paediatric Cardiothoracic Centre where right middle lobectomy was performed with complete resolution of his respiratory distress and re-expansion of the compressed lobes on CXR. Current literature concerning CLE is reviewed.

A study of the barrier function of the upper respiratory tract covering epithelium in the event of combined respiratory tract injuries

International Nuclear Information System (INIS)

Ivanov, Z.; Kolev, K.; Dermendzhiev, Kh.; Nikolova, M.; Kantardzhiev, V.

1976-01-01

Functional and morphologic impairment of upper respiratory tract mucous membranes after chronic exposure to the three major occupational noxious agents in ore mining - radon-222, silica dust, and respirable dust - has been studied experimentally. Over a 6-month period, rats were given daily treatments, with the agents applied either individually or in combination. Radon-222 (at 1 x 10 -10 Ci/l, corresponding to the maximum permissible concentrotion in uranium mine atmospheres) and respirable dust (dispersed silicogen at 100 mg/m 3 ) were administered four hours daily in toxicological chambers. Monodisperse silica dust was given by tracheal tube, at 50 mg in 1 ml of saline per rat. At the end of the treatment period, the barrier function of the respiratory epithelium was tested, and found to have been affected, by measuring beta radioactivity in blood following introduction into -the animal's nasopharynx of a 32 P-labelled staphylococcus culture. The most severe degree if impairment was found to result from simultaneous exposure to radon and respirable dust. Any of ti'e agents given individually caused a similar degree of impairment. Intratracheal administration of silicic acid anhydride appeared to have no deleterious consequences. The evidence for functional impairment was supported by histologic findings, indicating Jevelopment of ulcerous bronchitis, metaplasia of cylindrical epithelium, etc., after both individual and combined radon exposure. (A.B.)

Tumor markers for diagnosis, monitoring of recurrence and prognosis in patients with upper gastrointestinal tract cancer.

Science.gov (United States)

Jing, Jie-Xian; Wang, Yan; Xu, Xiao-Qin; Sun, Ting; Tian, Bao-Guo; Du, Li-Li; Zhao, Xian-Wen; Han, Cun-Zhi

2014-01-01

To evaluate the value of combined detection of serum CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS for the clinical diagnosis of upper gastrointestinal tract (GIT) cancer and to analyze the efficacy of these tumor markers (TMs) in evaluating curative effects and prognosis. A total of 573 patients with upper GIT cancer between January 2004 and December 2007 were enrolled in this study. Serum levels of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were examined preoperatively and every 3 months postoperatively by ELISA. The sensitivity of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were 26.8%, 36.2%, 42.9%, 2.84%, 25.4%, 34.6%, 34.2% and 30.9%, respectively. The combined detection of CEA+CA199+CA242+CA724 had higher sensitivity and specificity in gastric cancer (GC) and cardiac cancer, while CEA+CA199+CA242+SCC was the best combination of diagnosis for esophageal cancer (EC). Elevation of preoperative CEA, CA19-9 and CA24-2, SCC and CA72-4 was significantly associated with pathological types (pCEA, CA19-9, CA24-2, CA72-4 and SCC decreased obviously 3 months after operations. When metastasis and recurrence occurred, the levels of TMs significantly increased. On multivariate analysis, high preoperative CA72-4, CA24-2 and SCC served as prognostic factors for cardiac carcinoma, GC and EC, respectively. combined detection of CEA+CA199+CA242+SCC proved to be the most economic and practical strategy in diagnosis of EC; CEA+CA199+CA242+CA724 proved to be a better evaluation indicator for cardiac cancer and GC. CEA and CA19-9, CA24-2, CA72-4 and SCC, examined postoperatively during follow-up, were useful to find early tumor recurrence and metastasis, and evaluate prognosis. AFP, TPA and TPS have no significant value in diagnosis of patients with upper GIT cancer.

Survival of probiotic lactobacilli in the upper gastrointestinal tract using an in vitro gastric model of digestion.

Science.gov (United States)

Lo Curto, Alberto; Pitino, Iole; Mandalari, Giuseppina; Dainty, Jack Richard; Faulks, Richard Martin; John Wickham, Martin Sean

2011-10-01

The aim of this study was to investigate survival of three commercial probiotic strains (Lactobacillus casei subsp. shirota, L. casei subsp. immunitas, Lactobacillus acidophilus subsp. johnsonii) in the human upper gastrointestinal (GI) tract using a dynamic gastric model (DGM) of digestion followed by incubation under duodenal conditions. Water and milk were used as food matrices and survival was evaluated in both logarithmic and stationary phase. The % of recovery in logarithmic phase ranged from 1.0% to 43.8% in water for all tested strains, and from 80.5% to 197% in milk. Higher survival was observed in stationary phase for all strains. L. acidophilus subsp. johnsonii showed the highest survival rate in both water (93.9%) and milk (202.4%). Lactic acid production was higher in stationary phase, L. casei subsp. shirota producing the highest concentration (98.2 mM) after in vitro gastric plus duodenal digestion. Copyright © 2011 Elsevier Ltd. All rights reserved.

Experiences of violence among adolescents: gender patterns in types, perpetrators and associated psychological distress.

Science.gov (United States)

Landstedt, Evelina; Gillander Gådin, Katja

2011-08-01

To explore the psychological distress associations of experiences of several types of violence and the victim-perpetrator relationship of physical violence, a gender analysis was applied. Data were derived from a cross-sectional questionnaire study among 17-year-old upper secondary school students (N = 1,663). Variables in focus were: self-reported psychological distress, experiences of physical violence, sexual assault, bullying and sexual harassment. Logistic regressions were used to examine associations. Experiences of physical violence, sexual assault, bullying and sexual harassment were associated with psychological distress in boys and girls. The perpetrators of physical violence were predominately males. Whether the perpetrator was unknown or known to the victim seem to be linked to psychological distress. Victimisation by a boyfriend was strongly related to psychological distress among girls. Experiences of several types of violence should be highlighted as factors associated with mental health problems in adolescents. The victim-perpetrator relationships of violence are gendered and likely influence the psychological distress association. Gendered hierarchies and norms likely influence the extent to which adolescents experience violence and how they respond to it in terms of psychological distress.

LATERAL CEPHALOMETRIC RADIOGRAPHY FOR EVALUATION OF UPPER AIRWAY

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Miesje Karmiati Purwanegara

2015-06-01

Full Text Available The influenced of respiration to dentocraniofacial growth and development is still controversial. The accurate radiologic examination is important factor for proper diagnosis. Deviation of upper airway (i.e. nasopharynx, oropharymx and nasal cavity could be evaluated by lateral and anteroposterior cephalometric projection technique. This paper explains several methods to evaluate upper respiratory tract by lateral radiograph.

Early or Up-Front Radiotherapy Improved Survival of Localized Extranodal NK/T-Cell Lymphoma, Nasal-Type in the Upper Aerodigestive Tract

International Nuclear Information System (INIS)

Huang Meijuan; Jiang Yu; Liu Weiping; Li Zhiping; Li Mei; Zhou Lin; Xu Yong; Yu Chunhua; Li Qiu; Peng Feng; Liu Jiyan; Luo Feng; Lu You

2008-01-01

Purpose: To investigate the role of early or up-front radiotherapy (RT), the optimal RT dose required to achieve appropriate treatment outcome and prognostic factors for patients with localized extranodal NK/T-cell lymphoma, nasal-type, in the upper aerodigestive tract. Methods and Materials: Eighty-two patients were reviewed. Eight patients were treated with chemotherapy (CT) alone, 9 patients received RT alone, and 65 patients were given combined modality treatment of CT and RT (CMT). Of those 74 patients receiving RT, 31 patients were given up-front RT, whereas CT was the initial therapy for 43 patients and 41 of those 43 patients received early RT. Results: Five-year overall survival (OS) and disease-free survival (DFS) were 52.3% and 39.2%, respectively. RT was the only independent prognostic factor for both OS and DFS at both the univariate and multivariate level. The 5-year OS and DFS were better in patients receiving ≥54 Gy of RT as compared with that of <54 Gy (5-year OS 75.5% vs. 46.1%, p = 0.019; 5-year DFS 60.3% vs. 33.4%, p = 0.004). Up-front RT presented better survival in Stage I patients when compared with that of initial CT followed by early RT (5-year OS 90.0% vs. 48.9%, p = 0.012; 5-year DFS 78.7% vs. 39.9%, p = 0.021). Conclusion: Early or up-front RT had an essential role in improved OS and DFS in patients with localized extranodal NK/T-cell lymphoma, nasal-type, in the upper aerodigestive tract. The recommended tumor dose was at least 54 Gy. Up-front RT may yield more benefits on survival in patients with Stage I disease

Unexpected Inflammatory Effects of Intravaginal Gels (Universal Placebo Gel and Nonoxynol-9 on the Upper Female Reproductive Tract: A Randomized Crossover Study.

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Karen Smith-McCune

Full Text Available Intravaginal anti-HIV microbicides could provide women with a self-controlled means for HIV prevention, but results from clinical trials have been largely disappointing. We postulated that unrecognized effects of intravaginal gels on the upper female reproductive tract might contribute to the lower-than-expected efficacy of HIV microbicides. Our objective was to study the effects of intravaginal gels on the immune microenvironment of the cervix and uterus. In this randomized crossover study, 27 healthy female volunteers used a nightly application of intravaginal nonoxynol-9 (N9 gel as a "failed" microbicide or the universal placebo gel (UPG as a "safe" gel (intervention cycles, or nothing (control cycle from the end of menses to the mid-luteal phase. At a specific time-point following ovulation, all participants underwent sample collection for measurements of T-cell phenotypes, gene expression, and cytokine/chemokine protein concentrations from 3 anatomic sites above the vagina: the cervical transformation zone, the endocervix and the endometrium. We used hierarchical statistical models to estimate mean (95% CI intervention effects, for N9 and UPG relative to control. Exposure to N9 gel and UPG generated a common "harm signal" that included transcriptional up-regulation of inflammatory genes chemokine (C-C motif ligand 20 (macrophage inflammatory factor-3alpha and interleukin 8 in the cervix, decreased protein concentrations of secretory leukocyte protease inhibitor, and transcriptional up-regulation of inflammatory mediators glycodelin-A and osteopontin in the endometrium. These results need to be replicated with a larger sample, but underscore the need to consider the effects of microbicide agents and gel excipients on the upper female reproductive tract in studies of vaginal microbicides.

Molecular Characterization of Urothelial Carcinoma of the Bladder and Upper Urinary Tract

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Ji Yun Lee

2018-02-01

Full Text Available PURPOSE: A better understanding of the molecular basis of urothelial carcinoma (UC is needed to refine the clinical decision-making process. METHODS AND MATERIALS: We performed next-generation sequencing to investigate the mutational and transcriptional profiles of commonly mutated genes in UC using Ampliseq v2. Copy number variations (CNVs were detected with nCounter assay. Genetic alterations between upper tract UC (UTUC and urinary bladder UC (UBUC were compared. RESULTS: Tumor samples from 31 UTUC and 61 UBUC patients were included in analysis. The two groups showed similar clinicopathologic features including tumor grade and stage. Median survival was longer in UTUC than UBUC patients, though this was statistically nonsignificant (59 vs 41 months, P = .137. In total, we found 982 genetic alterations from 92 samples: single nucleotide variants were the most common type of somatic mutation (479/508, 94.3%. Frequently detected somatic mutations included TP53 (68.5%, KDR (41.3%, and PIK3CA (17.4%. Notably, RB1 mutations were the only mutations significantly different between the UBUC and UTUC groups (19.7% vs. 0%, P = .020. The most common types of CNVs included amplifications (56/62, 90.3%: 17.7% of patients identified amplifications in NOTCH1. We also identified five translocations in the entire study population, including one case with FGFR3-TACC3 (Chr4 fusion. CONCLUSION: Within a small study population, we identified similar genetic alterations in both UTUC and UBUC patients, indicating a basis for similar management strategies.

Population attributable risk of tobacco and alcohol for upper aerodigestive tract cancer.

LENUS (Irish Health Repository)

Anantharaman, Devasena

2011-08-01

Tobacco and alcohol are major risk factors for upper aerodigestive tract (UADT) cancer and significant variation is observed in UADT cancer rates across Europe. We have estimated the proportion of UADT cancer burden explained by tobacco and alcohol and how this varies with the incidence rates across Europe, cancer sub-site, gender and age. This should help estimate the minimum residual burden of other risk factors to UADT cancer, including human papillomavirus. We analysed 1981 UADT cancer cases and 1993 controls from the ARCAGE multicentre study. We estimated the population attributable risk (PAR) of tobacco alone, alcohol alone and their joint effect. Tobacco and alcohol together explained 73% of UADT cancer burden of which nearly 29% was explained by smoking alone, less than 1% due to alcohol on its own and 44% by the joint effect of tobacco and alcohol. Tobacco and alcohol together explained a larger proportion of hypopharyngeal\\/laryngeal cancer (PAR=85%) than oropharyngeal (PAR=74%), esophageal (PAR=67%) and oral cancer (PAR=61%). Tobacco and alcohol together explain only about half of the total UADT cancer burden among women. Geographically, tobacco and alcohol explained a larger proportion of UADT cancer in central (PAR=84%) than southern (PAR=72%) and western Europe (PAR=67%). While the majority of the UADT cancers in Europe are due to tobacco or the joint effect of tobacco and alcohol, our results support a significant role for other risk factors in particular, for oral and oropharyngeal cancers and also for UADT cancers in southern and western Europe.

Asymptomatic bacteriuria and symptomatic urinary tract infections during pregnancy.

Science.gov (United States)

Macejko, Amanda M; Schaeffer, Anthony J

2007-02-01

Urinary tract infections are common complications of pregnancy; upper tract infections in particular may lead to significant morbidity for both the mother and fetus. Bacteriuria is a significant risk factor for developing pyelonephritis in pregnant women. Therefore, proper screening and treatment of bacteriuria during pregnancy is necessary to prevent complications. All women should be screened for bacteriuria in the first trimester, and women with a history of recurrent urinary tract infections or anomalies should have repeat bacteriuria screening throughout pregnancy. Treatment of bacteriuria should include 3-day therapy with appropriate antimicrobials, and women should be followed closely after treatment because recurrence may occur in up to one third of patients.

Occupation and risk of upper aerodigestive tract cancer: the ARCAGE study.

LENUS (Irish Health Repository)

Richiardi, Lorenzo

2012-05-15

We investigated the association between occupational history and upper aerodigestive tract (UADT) cancer risk in the ARCAGE European case-control study. The study included 1,851 patients with incident cancer of the oral cavity, oropharynx, hypopharynx, larynx or esophagus and 1,949 controls. We estimated odds ratios (OR) and 95% confidence intervals (CI) for ever employment in 283 occupations and 172 industries, adjusting for smoking and alcohol. Men (1,457 cases) and women (394 cases) were analyzed separately and we incorporated a semi-Bayes adjustment approach for multiple comparisons. Among men, we found increased risks for occupational categories previously reported to be associated with at least one type of UADT cancer, including painters (OR = 1.74, 95% CI: 1.01-3.00), bricklayers (1.58, 1.05-2.37), workers employed in the erection of roofs and frames (2.62, 1.08-6.36), reinforced concreters (3.46, 1.11-10.8), dockers (2.91, 1.05-8.05) and workers employed in the construction of roads (3.03, 1.23-7.46), general construction of buildings (1.44, 1.12-1.85) and cargo handling (2.60, 1.17-5.75). With the exception of the first three categories, risks both increased when restricting to long duration of employment and remained elevated after semi-Bayes adjustment. Increased risks were also found for loggers (3.56, 1.20-10.5) and cattle and dairy farming (3.60, 1.15-11.2). Among women, there was no clear evidence of increased risks of UADT cancer in association with occupations or industrial activities. This study provides evidence of an association between some occupational categories and UADT cancer risk among men. The most consistent findings, also supported by previous studies, were obtained for specific workers employed in the construction industry.

Endoscopic prosthesis for advanced esophageal cancer

NARCIS (Netherlands)

Tytgat, G. N.; den Hartog Jager, F. C.; Bartelsman, J. F.

1986-01-01

Dysphagia, regurgitation and hypersalivation due to local destruction or incessant coughing in the presence of a tracheo-broncho-esophageal fistula become the most important distressing factors in the end stage of malignancies in the upper gastrointestinal tract. Inevitably such patients have a

Potential latitudinal variation in orodigestive tract cancers in Africa

African Journals Online (AJOL)

A latitudinal relationship has been found between the ... Africa should be focused in terms of regional variations to make best use of the fiscal allocation ..... Squamous cell carcinoma of the upper aerodigestive tract: Precursors and problematic.

The myocardium functional reserve indicators in junior children with recurrent acute upper respiratory tract infection

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L.S. Ovcharenko

2017-02-01

Full Text Available Background. The problem of early diagnosis of cardiovascular diseases in children is relevant throughout the world and in Ukraine, as in childhood the health and quality of life of an adult are formed. The psychoemotional stress in junior children as well as increasingly complicating school curriculum, information overload with electronic gadgets, increased frequency of colds in children cause physical inactivity. In addition, infectious agents have a toxic effect on the myocardium, altering its functional state. All these together adversely affect the formation and development of the cardiovascular and respiratory systems of children. The aim was to study the functional reserve of the myocardium in junior children, depending on the frequency of upper respiratory tract infection (URTI. Materials and methods. The study examined 1109 children aged 6 to 9 years old. The URTI incidence was analyzed depending on the age. In the study, the children were divided into two groups. Group 1 consisted of the children with URTI — 210. Group 2 involved the children with occasional URTI — 899. Results. Among 210 surveyed children with upper respiratory infections 171 schoolboys (81.4 % had reduced functional reserve of the myocardium, which is consistent with findings from other studies. In children aged 7 and 9 years old, the number of reduced functional reserve of the myocardium varies from 70 to 82 % in seven-year children, among the schoolboys aged 6 and 8 years old the incidence of reduced functional reserve of the myocardium increased from 83 to 100 % in six-year children. Conclusions. Children with URTI have a reduced functional reserve of the myocardium. Children with episodic URTI have higher rates of functional reserve of the myocardium, therefore reducing the incidence of URTI will lead to the improvement of the myocardium functional state.

Cow’s Milk and Immune Function in the Respiratory Tract: Potential Mechanisms

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Olaf Perdijk

2018-02-01

Full Text Available During the last decades, the world has witnessed a dramatic increase in allergy prevalence. Epidemiological evidence shows that growing up on a farm is a protective factor, which is partly explained by the consumption of raw cow’s milk. Indeed, recent studies show inverse associations between raw cow’s milk consumption in early life and asthma, hay fever, and rhinitis. A similar association of raw cow’s milk consumption with respiratory tract infections is recently found. In line with these findings, controlled studies in infants with milk components such as lactoferrin, milk fat globule membrane, and colostrum IgG have shown to reduce respiratory infections. However, for ethical reasons, it is not possible to conduct controlled studies with raw cow’s milk in infants, so formal proof is lacking to date. Because viral respiratory tract infections and aeroallergen exposure in children may be causally linked to the development of asthma, it is of interest to investigate whether cow’s milk components can modulate human immune function in the respiratory tract and via which mechanisms. Inhaled allergens and viruses trigger local immune responses in the upper airways in both nasal and oral lymphoid tissue. The components present in raw cow’s milk are able to promote a local microenvironment in which mucosal immune responses are modified and the epithelial barrier is enforced. In addition, such responses may also be triggered in the gut after exposure to allergens and viruses in the nasal cavity that become available in the GI tract after swallowing. However, these immune cells that come into contact with cow’s milk components in the gut must recirculate into the blood and home to the (upper and lower respiratory tract to regulate immune responses locally. Expression of the tissue homing-associated markers α4β7 and CCR9 or CCR10 on lymphocytes can be influenced by vitamin A and vitamin D3, respectively. Since both vitamins are present

EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies ), 2013. Scientific Opinion on the substantiation of a health claim related to Yestimun ® and defence against pathogens in the upper respiratory tract pursuant to Article 13(5) of R egulation (EC) No 1924/2006

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Tetens, Inge

substantiation of a health claim related to Yestimun® and defence against pathogens in the upper respiratory tract. The food that is the subject of the health claim, Yestimun®, which consists of (1,3)-(1,6)-β-D-glucans from brewer’s yeast cell wall, is sufficiently characterised. The claimed effect, defence...... established between the consumption of Yestimun® ((1,3)-(1,6)-β-D-glucans from brewer’s yeast cell wall) and defence against pathogens in the upper respiratory tract. © European Food Safety Authority, 2013...

Segregation of virulent influenza A(H1N1 variants in the lower respiratory tract of critically ill patients during the 2010-2011 seasonal epidemic.

Directory of Open Access Journals (Sweden)

Antonio Piralla

Full Text Available BACKGROUND: Since its appearance in 2009, the pandemic influenza A(H1N1 virus circulated worldwide causing several severe infections. METHODS: Respiratory samples from patients with 2009 influenza A(H1N1 and acute respiratory distress attending 24 intensive care units (ICUs as well as from patients with lower respiratory tract infections not requiring ICU admission and community upper respiratory tract infections in the Lombardy region (10 million inhabitants of Italy during the 2010-2011 winter-spring season, were analyzed. RESULTS: In patients with severe ILI, the viral load was higher in bronchoalveolar lavage (BAL with respect to nasal swab (NS, (p<0.001 suggesting a higher virus replication in the lower respiratory tract. Four distinct virus clusters (referred to as cluster A to D circulated simultaneously. Most (72.7%, n = 48 of the 66 patients infected with viruses belonging to cluster A had a severe (n = 26 or moderate ILI (n = 22. Amino acid mutations (V26I, I116M, A186T, D187Y, D222G/N, M257I, S263F, I286L/M, and N473D were observed only in patients with severe ILI. D222G/N variants were detected exclusively in BAL samples. CONCLUSIONS: Multiple virus clusters co-circulated during the 2010-2011 winter-spring season. Severe or moderate ILI were associated with specific 2009 influenza A(H1N1 variants, which replicated preferentially in the lower respiratory tract.

Life course social mobility and risk of upper aerodigestive tract cancer in men.

LENUS (Irish Health Repository)

Schmeisser, N

2010-03-01

The aim of this study was to explore associations between social mobility and tumours of the upper aero-digestive tract (UADT), focussing on life-course transitions in social prestige (SP) based on occupational history. 1,796 cases diagnosed between 1993 and 2005 in ten European countries were compared with 1585 controls. SP was classified by the Standard International Occupational Prestige Scale (SIOPS) based on job histories. SIOPS was categorised in high (H), medium (M) and low (L). Time weighted average achieved and transitions between SP with nine trajectories: H --> H, H --> M, H --> L, M --> H, M --> M, M --> L, L --> H, L --> M and L --> L were analysed. Odds ratios (ORs) and 95%-confidence intervals [95%-CIs] were estimated with logistic regression models including age, consumption of fruits\\/vegetables, study centre, smoking and alcohol consumption. The adjusted OR for the lowest versus the highest of three categories (time weighted average of SP) was 1.28 [1.04-1.56]. The distance of SP widened between cases and controls during working life. The downward trajectory H --> L gave an OR of 1.71 [0.75-3.87] as compared to H --> H. Subjects with M --> M and L --> L trajectories ORs were also elevated relative to subjects with H --> H trajectories. The association between SP and UADT is not fully explained by confounding factors. Downward social trajectory during the life course may be an independent risk factor for UADT cancers.

A contemporary review of management and prognostic factors of upper tract urothelial carcinoma.

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Leow, Jeffrey J; Orsola, Anna; Chang, Steven L; Bellmunt, Joaquim

2015-04-01

Upper tract urothelial carcinoma (UTUC) accounts for management and potentially improve outcomes. This article systematically reviews current literature on prognostic factors and management options for UTUC. A comprehensive literature search was performed to identify all studies examining prognostic factors and management options for UTUC. The search included the Medline, Embase, Cochrane Central Register of Controlled Trials databases, and abstracts from the American Society of Clinical Oncology meetings up to November 2014. An updated systematic review was performed. Preoperative prognostic factors for UTUC patients include age, race, performance status, obesity, smoking status, elevated fibrinogen levels, hydronephrosis, tumor size, multi-focality, location, clinical grade and previous/synchronous bladder cancer. Postoperative variables include tumor stage/grade, multifocality, nodal involvement, lympho-vascular invasion, initial ureteral location, necrosis, sessile architecture, variant histologies and presence of tissue ALDH1 and SOX2. Curative treatment of choice is NU, with lymphadenectomy conferring survival benefits. Minimally invasive surgery has equivalent oncologic and better peri-operative outcomes compared to open surgery. Conservative therapy includes adjuvant BCG and intravesical mitomycin C. Two randomized trials investigating postoperative instillation of mitomycin C suggest bladder recurrence benefits. Adjuvant chemo-radiotherapy may be useful for patients with advanced T3/4 and/or N+ disease. Gold-standard treatment for UTUC remains NU, increasingly performed using minimally invasive surgery. Nomograms including pre- and post-operative variables can aid prognostication and guide further therapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Use of remifentanil to reduce propofol injection pain and the required propofol dose in upper digestive tract endoscopy diagnostic tests.

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Uliana, Gustavo Nadal; Tambara, Elizabeth Milla; Baretta, Giorgio Alfredo Pedroso

2015-01-01

The introduction of propofol (2,6-diisopropylphenol) as a sedative agent has transformed the area of sedation for endoscopic procedures. However, a major drawback of sedation with the use of propofol is its high incidence of injection pain. The most widely used technique in reducing propofol injection pain is through the association of other drugs. The aim of this study was to evaluate the effect of remifentanil-propofol combination on the incidence of propofol injection pain and its influence on the total dose of propofol required for sedation in upper digestive tract endoscopy (UDE) diagnostic tests. One hundred and five patients undergoing upper digestive tract endoscopy were evaluated and randomly divided into 3 groups of 35 patients each. The Control Group received propofol alone; Study-group 1 received remifentanil at a fixed dose of 0.2mg/kg combined with propofol; Study-group 2 received remifentanil at a fixed dose of 0.3mg/kg combined with propofol. The incidence of propofol injection pain and the total dose of propofol required for the test were evaluated. The sample was very similar regarding age, weight, height, sex, and physical status. Statistical analysis was performed according to the nature of the evaluated data. Student's t-test was used to compare the mean of age, weight, height (cm), and dose (mg/kg) variables between groups. The χ(2) test was used to compare sex, physical status, and propofol injection pain between groups. The significance level was αpain and total dose of propofol (mg/kg) used. However, there were no statistical differences between the two study groups for these parameters. We conclude that the use of remifentanil at doses of 0.2mg/kg and 0.3mg/kg was effective for reducing both the propofol injection pain and the total dose of propofol used. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

Alpha-Synuclein Pathology in Sensory Nerve Terminals of the Upper Aerodigestive Tract of Parkinson's Disease Patients.

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Mu, Liancai; Chen, Jingming; Sobotka, Stanislaw; Nyirenda, Themba; Benson, Brian; Gupta, Fiona; Sanders, Ira; Adler, Charles H; Caviness, John N; Shill, Holly A; Sabbagh, Marwan; Samanta, Johan E; Sue, Lucia I; Beach, Thomas G

2015-08-01

Dysphagia is common in Parkinson's disease (PD) and causes significant morbidity and mortality. PD dysphagia has usually been explained as dysfunction of central motor control, much like other motor symptoms that are characteristic of the disease. However, PD dysphagia does not correlate with severity of motor symptoms nor does it respond to motor therapies. It is known that PD patients have sensory deficits in the pharynx, and that impaired sensation may contribute to dysphagia. However, the underlying cause of the pharyngeal sensory deficits in PD is not known. We hypothesized that PD dysphagia with sensory deficits may be due to degeneration of the sensory nerve terminals in the upper aerodigestive tract (UAT). We have previously shown that Lewy-type synucleinopathy (LTS) is present in the main pharyngeal sensory nerves of PD patients, but not in controls. In this study, the sensory terminals in UAT mucosa were studied to discern the presence and distribution of LTS. Whole-mount specimens (tongue-pharynx-larynx-upper esophagus) were obtained from 10 deceased human subjects with clinically diagnosed and neuropathologically confirmed PD (five with dysphagia and five without) and four age-matched healthy controls. Samples were taken from six sites and immunostained for phosphorylated α-synuclein (PAS). The results showed the presence of PAS-immunoreactive (PAS-ir) axons in all the PD subjects and in none of the controls. Notably, PD patients with dysphagia had more PAS-ir axons in the regions that are critical for initiating the swallowing reflex. These findings suggest that Lewy pathology affects mucosal sensory axons in specific regions of the UAT and may be related to PD dysphagia.

Language barriers in Hispanic patients: relation to upper-extremity disability.

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Menendez, Mariano E; Eberlin, Kyle R; Mudgal, Chaitanya S; Ring, David

2015-06-01

Although upper-extremity disability has been shown to correlate highly with various psychosocial aspects of illness (e.g., self-efficacy, depression, kinesiophobia, and pain catastrophizing), the role of language in musculoskeletal health status is less certain. In an English-speaking outpatient hand surgery office setting, we sought to determine (1) whether a patient's primary native language (English or Spanish) is an independent predictor of upper-extremity disability and (2) whether there are any differences in the contribution of measures of psychological distress to disability between native English- and Spanish-speaking patients. A total of 122 patients (61 native English speakers and 61 Spanish speakers) presenting to an orthopaedic hand clinic completed sociodemographic information and three Patient-Reported Outcomes Measurement Information System (PROMIS)-based computerized adaptive testing questionnaires: PROMIS Pain Interference, PROMIS Depression, and PROMIS Upper-Extremity Physical Function. Bivariate and multivariable linear regression modeling were performed. Spanish-speaking patients reported greater upper-extremity disability, pain interference, and symptoms of depression than English-speaking patients. After adjusting for sociodemographic covariates and measures of psychological distress using multivariable regression modeling, the patient's primary language was not retained as an independent predictor of disability. PROMIS Depression showed a medium correlation (r = -0.35; p Spanish-speaking patients. PROMIS Pain Interference had a large correlation with disability in both patient cohorts (Spanish-speaking: r = -0.66; p immigration to the USA did not correlate with disability among Spanish speakers. Primary language has less influence on symptom intensity and magnitude of disability than psychological distress and ineffective coping strategies. Interventions to optimize mood and to reduce pain interference should be considered in

Are antibiotics over-prescribed in Poland? Management of upper respiratory tract infections in primary health care region of Warszawa, Wola.

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Windak, A; Tomasik, T; Jacobs, H M; de Melker, R A

1996-10-01

Concern about the increasing numbers of multiple resistant strains resulting from over- and misuse of antibiotics is growing world-wide. A questionnaire based on two cases related to respiratory tract infections for which antibiotic prescription was disputable was sent to primary care physicians in the health care district of Warszawa, Wola, Poland. The prescription percentage for both cases was high, with a large variety in choice of antibiotic therapy made by the doctors. This finding was striking when compared with the more restrictive prescription behaviour of Dutch general practitioners. Moreover, this high prescription percentage was combined with other abundant activities. In the case of the patient with acute tonsillitis, 53% of the primary care physicians would have ordered additional tests, 94% would have advised bed-rest and 9% would have referred. In the sinusitis case, these figures were 88, 74 and 54% respectively. No correlations were found between choice of antibiotics and characteristics of the physicians such as age, gender, experience with working in primary health care or degree of specialization. In conclusion, the results of this small pilot study indicate that Polish first-contact doctors have an inadequate prescription behaviour in cases with upper respiratory tract infections. Our results underline the need for courses in pharmacotherapy within the postgraduate education course in family medicine recently introduced in Poland.

How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel.

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Piltcher, Otávio Bejzman; Kosugi, Eduardo Macoto; Sakano, Eulalia; Mion, Olavo; Testa, José Ricardo Gurgel; Romano, Fabrizio Ricci; Santos, Marco Cesar Jorge; Di Francesco, Renata Cantisani; Mitre, Edson Ibrahim; Bezerra, Thiago Freire Pinto; Roithmann, Renato; Padua, Francini Greco; Valera, Fabiana Cardoso Pereira; Lubianca Neto, José Faibes; Sá, Leonardo Conrado Barbosa; Pignatari, Shirley Shizue Nagata; Avelino, Melissa Ameloti Gomes; Caixeta, Juliana Alves de Souza; Anselmo-Lima, Wilma Terezinha; Tamashiro, Edwin

Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Late xerostomia after intensity-modulated conformational radiotherapy of upper aero-digestive tract cancers: study 2004-03 by the head and neck oncology and radiotherapy Group (Gortec)

International Nuclear Information System (INIS)

Toledano, I.; Lapeyre, M.; Graff, P.; Serre, C.; Bensadoun, R.J.; Bensadoun, R.J.; Ortholan, C.; Calais, G.; Alfonsi, M.; Giraud, P.; Racadot, S.

2010-01-01

The authors report a retrospective assessment of late xerostomia according to the RTOG (Radiation Therapy Oncology Group) classification of the European Organization for Research and Treatment of Cancer (EORTC) among patients treated by intensity-modulated conformational radiotherapy (IMRT) and suffering from upper aero-digestive tract carcinomas of different stages. Some of these patients have bee operated, and some have been treated by chemotherapy. It appears that the IMRT results in a reduction of late xerostomia, and even in an absence of salivary toxicity. Short communication

Urinary tract infections in children: EAU/ESPU guidelines.

Science.gov (United States)

Stein, Raimund; Dogan, Hasan S; Hoebeke, Piet; Kočvara, Radim; Nijman, Rien J M; Radmayr, Christian; Tekgül, Serdar

2015-03-01

In 30% of children with urinary tract anomalies, urinary tract infection (UTI) can be the first sign. Failure to identify patients at risk can result in damage to the upper urinary tract. To provide recommendations for the diagnosis, treatment, and imaging of children presenting with UTI. The recommendations were developed after a review of the literature and a search of PubMed and Embase. A consensus decision was adopted when evidence was low. UTIs are classified according to site, episode, symptoms, and complicating factors. For acute treatment, site and severity are the most important. Urine sampling by suprapubic aspiration or catheterisation has a low contamination rate and confirms UTI. Using a plastic bag to collect urine, a UTI can only be excluded if the dipstick is negative for both leukocyte esterase and nitrite or microscopic analysis is negative for both pyuria and bacteriuria. A clean voided midstream urine sample after cleaning the external genitalia has good diagnostic accuracy in toilet-trained children. In children with febrile UTI, antibiotic treatment should be initiated as soon as possible to eradicate infection, prevent bacteraemia, improve outcome, and reduce the likelihood of renal involvement. Ultrasound of the urinary tract is advised to exclude obstructive uropathy. Depending on sex, age, and clinical presentation, vesicoureteral reflux should be excluded. Antibacterial prophylaxis is beneficial. In toilet-trained children, bladder and bowel dysfunction needs to be excluded. The level of evidence is high for the diagnosis of UTI and treatment in children but not for imaging to identify patients at risk for upper urinary tract damage. In these guidelines, we looked at the diagnosis, treatment, and imaging of children with urinary tract infection. There are strong recommendations on diagnosis and treatment; we also advise exclusion of obstructive uropathy within 24h and later vesicoureteral reflux, if indicated. Copyright © 2014 European

Probiotics for preventing acute upper respiratory tract infections.

Science.gov (United States)

Hao, Qiukui; Dong, Bi Rong; Wu, Taixiang

2015-02-03

Probiotics may improve a person's health by regulating their immune function. Some trials have shown that probiotic strains can prevent respiratory infections. Even though the previous version of our review showed benefits of probiotics for acute upper respiratory tract infections (URTIs), several new studies have been published. To assess the effectiveness and safety of probiotics (any specified strain or dose), compared with placebo, in the prevention of acute URTIs in people of all ages, at risk of acute URTIs. We searched CENTRAL (2014, Issue 6), MEDLINE (1950 to July week 3, 2014), EMBASE (1974 to July 2014), Web of Science (1900 to July 2014), the Chinese Biomedical Literature Database, which includes the China Biological Medicine Database (from 1978 to July 2014), the Chinese Medicine Popular Science Literature Database (from 2000 to July 2014) and the Masters Degree Dissertation of Beijing Union Medical College Database (from 1981 to July 2014). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for completed and ongoing trials on 31 July 2014. Randomised controlled trials (RCTs) comparing probiotics with placebo to prevent acute URTIs. Two review authors independently assessed the eligibility and quality of trials, and extracted data using the standard methodological procedures expected by The Cochrane Collaboration. We included 13 RCTs, although we could only extract data to meta-analyse 12 trials, which involved 3720 participants including children, adults (aged around 40 years) and older people. We found that probiotics were better than placebo when measuring the number of participants experiencing episodes of acute URTI (at least one episode: odds ratio (OR) 0.53; 95% confidence interval (CI) 0.37 to 0.76, P value school absence (OR 0.10; 95% CI 0.02 to 0.47, very low quality evidence). Probiotics and placebo were similar when measuring the rate ratio of episodes of acute

Site Specific Effect of Tobacco Addiction in Upper Aerodigestive Tract Tumors: A Retrospective Clinicopathological Study

Directory of Open Access Journals (Sweden)

Ashok Kumar

2014-01-01

Full Text Available An institutional study was carried out in 102 patients to investigate the site specific effect of addictions, that is, tobacco smoking and tobacco chewing (smokeless, both independently and synergistically in development of malignancies in upper aerodigestive tract through retrograde questionnaire. The histopathologically proven cases were interviewed regarding different forms of addictions followed by clinical examination and investigations for grading (according to Modified Broadmann’s method and TNM staging (according to UICC according to the tumor site. Statistical analysis was done by Pearson test. Out of all proven cases of cancers, 29.4% were only tobacco chewers (smokeless, 25.5% were only smokers, 42.2% were having both types of tobacco addictions (smoke and smokeless, and only 2.9% were having no addiction. Out of only tobacco chewers (smokeless, 83.3% were of oral cavity cancers, 6.7% were of oro- and hypopharynx and the rest were of others. Among only smokers, 69.2% cases were of laryngeal and oro- and hypopharynx as compared to 11.5% of oral cavity cancers (nearly 6 times. Tobacco (smokeless chewing is associated with oral cancers whereas tobacco smoking is associated with laryngeal and hypopharyngeal carcinoma. Both smoking and smokeless tobacco act in synergy with each other.

Study on doctor shopping behavior: insight from patients with upper respiratory tract infection in Taiwan.

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Wang, Ming-Jye; Lin, Shu-Ping

2010-01-01

Based on the actual medical records of ambulatory care visits, this study analyzed patients' healthcare seeking behavior and doctor shopping behavior (DSB), and investigated the underlying factors and the impact on the depletion of the healthcare resources for health policy makers to build a better health delivery system. Among a cohort comprised of 200,000 patients randomly chosen from the National Health Insurance Research Database of Taiwan in 2004, only the patients seeking ambulatory care visits for upper respiratory tract infection (URI) were analyzed. Among the 45,951 URI patients, 2875 of them exhibited DSB (prevalence 6.3%). The DSB showed a reverse U-shaped relationship with the patient age (the highest DSB in age 18-34 years). The episodes of the URI had a negative impact on the DSB. The odds ratios of gender and the frequency of consultation versus DSB were 1.10 and 4.72, respectively, and the depletion of days of medication and repeat prescription increased with doctor shopping. Health education to raise DSB awareness is necessary, especially for female's age 18-34 years. Implementing a proper referral system with efficient data exchange, setting up control parameters in the IC cards, and strengthening the integrated care plan could reduce the unnecessary waste of the healthcare resources.

Scientific Opinion on the substantiation of a health claim related to Bifidobacterium bifidum CNCM I-3426 and defence against pathogens in the upper respiratory tract pursuant to Article 13(5) of Regulation (EC) No 1924/2006

DEFF Research Database (Denmark)

Tetens, Inge

2015-01-01

Following an application from Lallemand Health Solutions, submitted pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of France, the Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific substantiation...... effect. The Panel considers that no conclusions can be drawn from either of the human studies for the scientific substantiation of the claim. In the absence of evidence of an effect of B. bifidum CNCM I3426 on defence against pathogens in the upper respiratory tract in humans, the results of the in vitro...... study submitted cannot be used as a source of data for the scientific substantiation of the claim. The Panel concludes that a cause and effect relationship has not been established between the consumption of B. bifidum CNCM I-3426 and defence against pathogens in the upper respiratory tract....

Acupuncture therapy for fever induced by viral upper respiratory tract infection (URTI) in military medical service: a case series.

Science.gov (United States)

Kwon, SeungWon; Shin, KyoungHo; Jung, WooSang; Moon, SangKwan; Cho, KiHo

2014-12-01

We report the cases of eight military patients with fever (≥38°C) induced by viral upper respiratory tract infection (URTI) who requested treatment with acupuncture in the military medical service room. All patients were treated immediately after diagnosis with classical acupuncture (GV14, GB20, TE8 points) and a new type of acupuncture, equilibrium acupuncture (Feibing and Ganmao points). After one treatment session (20 min), reduction of body temperature was confirmed in all patients. Accompanying symptoms such as headache, myalgia and nasal obstruction also showed a tendency to decrease. Within 3 days of treatment, six of the eight patients had recovered from the URTI. No adverse effects of acupuncture treatment were reported. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Idioms of Distress.

Science.gov (United States)

Desai, Geetha; Chaturvedi, Santosh K

2017-08-01

The presentations of psychosocial distress and cultural conflicts are often bodily symptoms, especially in traditional societies and village backgrounds. These might not meet the criteria of the current psychiatric diagnostic systems. Sociocultural milieu contributes to the unique presentations of the stress in the form of idioms of distress. The latter are alternative modes of expressing distress and indicate manifestations of distress in relation to personal and cultural meaning. Health professionals often consider these as hysterical, functional or having functional overlays, and abnormal illness behaviors. Management of idioms of distress would need cultural competence and sensitivity. This article highlights the common idioms of distress in India with specific focus on bodily symptoms.

Upper Gastrointestinal Tract Motility Disorders in Women, Gastroparesis, and Gastroesophageal Reflux Disease.

Science.gov (United States)

Zia, Jasmine K; Heitkemper, Margaret M

2016-06-01

This article reviews the sex differences in upper gastrointestinal (GI) motility for both healthy and common dysmotility conditions. It focuses on gastroesophageal reflux disease and other esophageal motor disorders for the esophagus and on gastroparesis and accelerated gastric emptying for the stomach. It also describes differences in upper GI motility signs and symptoms during each female hormonal stage (ie, menstrual cycle, pregnancy, perimenopause, menopause) for both healthy participants and those suffering from one of the aforementioned upper GI dysmotility conditions. More research still needs to be conducted to better understand sex differences in upper GI motility. Copyright © 2016 Elsevier Inc. All rights reserved.

Upper Gastrointestinal Stent Insertion in Malignant and Benign Disorders

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Kang, Hyoun Woo

2015-01-01

Upper gastrointestinal (GI) stents are increasingly being used to manage upper GI obstructions. Initially developed for palliative treatment of esophageal cancer, upper GI stents now play an emerging role in benign strictures of the upper GI tract. Because recurrent obstruction and stent-related complications are common, new modifications of stents have been implemented. Self-expandable metal stents (SEMS) have replaced older plastic stents. In addition, newly designed SEMS have been developed to prevent complications. This review provides an overview of the various types, indications, methods, complications, and clinical outcomes of upper GI stents in a number of malignant and benign disorders dividing the esophagus and gastroduodenum. PMID:26064817

Upper aerodigestive tract burn: a case report of firework injury.

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Kerekhanjanarong, V; Supiyaphun, P; Saengpanich, S

2001-02-01

The case of a 46 year-old German man with upper aerodigestive burn by firework was reported. He presented with the symptoms and signs of upper airway obstruction. Tracheostomy was done and direct laryngoscopy with microscopic examination revealed swelling and denudation of the mucosa of the oral cavity and supraglottic area. Intravenous steroids and antibiotics were administrated for treatment. It is suggested that proper management needs an understanding of the mechanism and effect of the corrosive agent. Careful airway management resulted in a good outcome in this patient.

Combined Effects of Medicinal Plants on Induced Upper ...

African Journals Online (AJOL)

Combined Effects of Medicinal Plants on Induced Upper Gastrointestinal Tract Injury ... treated in different doses of single and combined extracts of Allium sativum, ... was no visible sign of ulceration or perforation observed on the stomach and ...

[Laparoscopic Proximal Gastrectomy as a Surgical Treatment for Upper Third Early Gastric Cancer].

Science.gov (United States)

Park, Do Joong; Park, Young Suk; Ahn, Sang Hoon; Kim, Hyung Ho

2017-09-25

Recently, the incidence of upper third gastric cancer has increased, and with it the number of endoscopic submucosal dissection (ESD) procedures performed has been increasing. However, if ESD is not indicated or non-curable, surgical treatment may be necessary. In the case of lower third gastric cancer, it is possible to preserve the upper part of the stomach; however, in the case of upper third gastric cancer, total gastrectomy is still the standard treatment option, regardless of the stage. This is due to the complications associated with upper third gastric cancer, such as gastroesophageal reflux after proximal gastrectomy rather than oncologic problems. Recently, the introduction of the double tract reconstruction method after proximal gastrectomy has become one of the surgical treatment methods for upper third early gastric cancer. However, since there has not been a prospective comparative study evaluating its efficacy, the ongoing multicenter prospective randomized controlled trial (KLASS-05) comparing laparoscopic proximal gastrectomy with double tract reconstruction and laparoscopic total gastrectomy is expected to be important for determining the future of treatment of upper third early gastric cancer.

Alpha-Synuclein Pathology in Sensory Nerve Terminals of the Upper Aerodigestive Tract of Parkinson’s Disease Patients

Science.gov (United States)

Mu, Liancai; Chen, Jingming; Sobotka, Stanislaw; Nyirenda, Themba; Benson, Brian; Gupta, Fiona; Sanders, Ira; Adler, Charles H.; Caviness, John N.; Shill, Holly A.; Sabbagh, Marwan; Samanta, Johan E.; Sue, Lucia I.; Beach, Thomas G.

2015-01-01

Dysphagia is common in Parkinson’s disease (PD) and causes significant morbidity and mortality. PD dysphagia has usually been explained as dysfunction of central motor control, much like other motor symptoms that are characteristic of the disease. However, PD dysphagia does not correlate with severity of motor symptoms nor does it respond to motor therapies. It is known that PD patients have sensory deficits in the pharynx, and that impaired sensation may contribute to dysphagia. However, the underlying cause of the pharyngeal sensory deficits in PD is not known. We hypothesized that PD dysphagia with sensory deficits may be due to degeneration of the sensory nerve terminals in the upper aerodigestive tract (UAT). We have previously shown that Lewy-type synucleinopathy (LTS) is present in the main pharyngeal sensory nerves of PD patients, but not in controls. In this study, the sensory terminals in UAT mucosa were studied to discern the presence and distribution of LTS. Whole-mount specimens (tongue-pharynx-larynx-upper esophagus) were obtained from 10 deceased human subjects with clinically diagnosed and neuropathologically confirmed PD (five with dysphagia and five without) and four age-matched healthy controls. Samples were taken from six sites and immunostained for phosphorylated α-synuclein (PAS). The results showed the presence of PAS-immunoreactive (PAS-ir) axons in all the PD subjects and in none of the controls. Notably, PD patients with dysphagia had more PAS-ir axons in the regions that are critical for initiating the swallowing reflex. These findings suggest that Lewy pathology affects mucosal sensory axons in specific regions of the UAT and may be related to PD dysphagia. PMID:26041249

Upper gastrointestinal sensory-motor dysfunction in diabetes mellitus

Science.gov (United States)

Zhao, Jing-Bo; Frøkjær, Jens Brøndum; Drewes, Asbjørn Mohr; Ejskjaer, Niels

2006-01-01

Gastrointestinal (GI) sensory-motor abnormalities are common in patients with diabetes mellitus and may involve any part of the GI tract. Abnormalities are frequently sub-clinical, and fortunately only rarely do severe and life-threatening problems occur. The pathogenesis of abnormal upper GI sensory-motor function in diabetes is incompletely understood and is most likely multi-factorial of origin. Diabetic autonomic neuropathy as well as acute suboptimal control of diabetes has been shown to impair GI motor and sensory function. Morphological and biomechanical remodeling of the GI wall develops during the duration of diabetes, and may contribute to motor and sensory dysfunction. In this review sensory and motility disorders of the upper GI tract in diabetes is discussed; and the morphological changes and biomechanical remodeling related to the sensory-motor dysfunction is also addressed. PMID:16718808

Brain size and white matter content of cerebrospinal tracts determine the upper cervical cord area: evidence from structural brain MRI

Energy Technology Data Exchange (ETDEWEB)

Engl, Christina; Arsic, Milan; Boucard, Christine C.; Biberacher, Viola; Nunnemann, Sabine; Muehlau, Mark [Technische Universitaet Muenchen, Department of Neurology, Klinikum rechts der Isar, Munich (Germany); Technische Universitaet Muenchen, TUM-Neuroimaging Center, Klinikum rechts der Isar, Munich (Germany); Schmidt, Paul [Technische Universitaet Muenchen, Department of Neurology, Klinikum rechts der Isar, Munich (Germany); Ludwig-Maximilians-University Muenchen, Department of Statistics, Munich (Germany); Roettinger, Michael [Technische Universitaet Muenchen, Department of Radiology, Klinikum rechts der Isar, Munich (Germany); Muenchner Institut fuer Neuroradiologie, Munich (Germany); Etgen, Thorleif [Technische Universitaet Muenchen, Department of Neurology, Klinikum rechts der Isar, Munich (Germany); Klinikum Traunstein, Department of Neurology, Traunstein (Germany); Koutsouleris, Nikolaos; Meisenzahl, Eva M. [Ludwig-Maximilians-Universitaet Muenchen, Department of Psychiatry and Psychotherapy, Munich (Germany); Reiser, Maximilian [Ludwig-Maximilians-Universitaet, Department of Radiology, Munich (Germany)

2013-08-15

Measurement of the upper cervical cord area (UCCA) from brain MRI may be an effective way to quantify spinal cord involvement in neurological disorders such as multiple sclerosis. However, knowledge on the determinants of UCCA in healthy controls (HCs) is limited. In two cohorts of 133 and 285 HCs, we studied the influence of different demographic, body-related, and brain-related parameters on UCCA by simple and partial correlation analyses as well as by voxel-based morphometry (VBM) across both cerebral gray matter (GM) and white matter (WM). First, we confirmed the known but moderate effect of age on UCCA in the older cohort. Second, we studied the correlation of UCCA with sex, body height, and total intracranial volume (TIV). TIV was the only variable that correlated significantly with UCCA after correction for the other variables. Third, we studied the correlation of UCCA with brain-related parameters. Brain volume correlated stronger with UCCA than TIV. Both volumes of the brain tissue compartments GM and WM correlated with UCCA significantly. WM volume explained variance of UCCA after correction for GM volume, whilst the opposite was not observed. Correspondingly, VBM did not yield any brain region, whose GM content correlated significantly with UCCA, whilst cerebral WM content of cerebrospinal tracts strongly correlated with UCCA. This latter effect increased along a craniocaudal gradient. UCCA is mainly determined by brain volume as well as by WM content of cerebrospinal tracts. (orig.)

Prostatic Artery Embolization (PAE) for Benign Prostatic Hyperplasia (BPH) with Haematuria in the Absence of an Upper Urinary Tract Pathology.

Science.gov (United States)

Tapping, Charles R; Macdonald, Andrew; Hadi, Mo; Mortensen, Chloe; Crew, Jeremy; Protheroe, Andrew; Little, Mark W; Boardman, Phil

2018-03-26

To assess the effectiveness of prostate artery embolization (PAE) in the control of haematuria and in patients with benign prostatic hyperplasia (BPH) and normal upper urinary tracts. Twelve consecutive patients with haematuria were included in the prospective study. All patients had prior imaging and cystoscopy to exclude other causes of haematuria. Patients prostate arteries were embolized with particles (200-500 μm), and they were followed up at 3, 12 and 18 months following the procedure. QOL questionnaires, IPSS, IIEF and clinical review were all employed to assess the success of the treatment. To allow useful comparison, patients were age- and prostate volume-matched and compared to patients treated with PAE for BPH without haematuria. All 12/12 cases were technically successful with bilateral PAE being performed. All cases of haematuria resolved by the 3-month follow-up (100%). There was one case of recurrence during the 12-month follow-up (overall clinical success at 18 months 92%). This was due to over anticoagulation and ceased once corrected. There was a reduction in lower urinary tract symptoms noted by improvements in QOL indices, IPSS and IIEF. There was continued success even if the patient was subsequently anticoagulated. There was no associated sexual dysfunction. There was more prostatic arterial branching and volume of embolic required to achieve stasis in BPH and haematuria than in BPH alone (p BPH allows a significant improvement in QOL.

Urinary Tract Cancer in Lynch Syndrome; Increased Risk in Carriers of MSH2 Mutations

DEFF Research Database (Denmark)

Joost, Patrick; Therkildsen, Christina; Dominguez-Valentin, Mev

2015-01-01

and microsatellite instability in 23% of the tumors. Mutations in MSH2 were overrepresented (73%), and MSH2 mutation carriers were at a significantly increased risk of developing urinary tract cancer compared with individuals with mutations in MLH1 or MSH6. CONCLUSION: Cancers of the upper urinary tract...

Urinary tract infections in patients with spinal cord injuries.

Science.gov (United States)

D'Hondt, Frederiek; Everaert, Karel

2011-12-01

Spinal cord injuries (SCI) result in different lower urinary tract dysfunctions. Because of both the disease and the bladder drainage method, urinary tract infections (UTIs) are one of the most frequent conditions seen in SCI patients. Diagnosis is not always easy due to lack of symptoms. Asymptomatic bacteriuria needs no treatment. If symptoms occur, antibiotherapy is indicated. Duration depends mainly on severity of illness and upper urinary tract or prostatic involvement. Choice of antibiotherapy should be based on local resistance profiles, but fluoroquinolones seems to be an adequate empirical treatment. Prevention of UTI is important, as lots of complications can be foreseen. Catheter care, permanent low bladder pressure and clean intermittent catheterization (CIC) with hydrophilic catheters are interventions that can prevent UTI. Probiotics might be useful, but data are limited.

Characteristics of Streptococcus pneumoniae Strains Colonizing Upper Respiratory Tract of Healthy Preschool Children in Poland

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Izabela Korona-Glowniak

2012-01-01

Full Text Available Antibiotic resistant and invasive pneumococci may spread temporally and locally in day care centers (DCCs. We examined 267 children attending four DCCs located in the same city and 70 children staying at home in three seasons (autumn, winter, and spring to determine prevalence, serotype distribution, antibiotic resistance patterns, and transmission of pneumococcal strains colonizing upper respiratory tract of healthy children without antipneumococcal vaccination. By pheno- and genotyping, we determined clonality of pneumococci, including drug-resistant strains. The average carriage of pneumococci in three seasons was 38.2%. 73.4% and 80.4% of the isolates belonged to serotypes present in 10- and 13-valent conjugate vaccine, respectively. Among the pneumococcal strains, 33.3% were susceptible to all antimicrobial tested and 39.2% had decreased susceptibility to penicillin. Multidrug resistance was common (35.7%; 97.5% of drug-resistant isolates represented serotypes included to 10- and 13-valent conjugate vaccine. According to BOX-PCR, clonality definitely was observed only in case of serotype 14. Multivariate analysis determined DCC attendance as strongly related to pneumococcal colonization in all three seasons, but important seasonal differences were demonstrated. In children attending DCCs, we observed dynamic turnover of pneumococcal strains, especially penicillin nonsusceptible and multidrug resistant, which were mostly distributed among serotypes included to available pneumococcal conjugate vaccines.

In vivo digestion of bovine milk fat globules: effect of processing and interfacial structural changes. II. Upper digestive tract digestion.

Science.gov (United States)

Gallier, Sophie; Zhu, Xiang Q; Rutherfurd, Shane M; Ye, Aiqian; Moughan, Paul J; Singh, Harjinder

2013-12-01

The aim of this research was to study the effect of milk processing on the in vivo upper digestive tract digestion of milk fat globules. Fasted rats were serially gavaged over a 5h period with cream from raw, pasteurised, or pasteurised and homogenised milk. Only a few intact dietary proteins and peptides were present in the small intestinal digesta. Significantly (Praw (448 mg g(-1) digesta dry matter (DDM)) and homogenised creams (528 mg g(-1) DDM), as compared to pasteurised and homogenised cream (249 mg g(-1) DDM). Microscopy techniques were used to investigate the structural changes during digestion. Liquid-crystalline lamellar phases surrounding the fat globules, fatty acid soap crystals and lipid-mucin interactions were evident in all small intestinal digesta. Overall, the pasteurised and homogenised cream appeared to be digested to a greater extent. Copyright © 2013 Elsevier Ltd. All rights reserved.

Virtual endoscopy of the upper urinary tract based on contrast material-enhanced MR urography data sets; Virtuelle Endoskopie des oberen Harntraktes auf der Basis kontrastangehobener MR-Urographie Datensaetze

Energy Technology Data Exchange (ETDEWEB)

Nolte-Ernsting, C.C.A.; Krombach, G.; Staatz, G.; Kilbinger, M.; Adam, G.B.; Guenther, R.W. [RWTH Aachen (Germany). Klinik fuer Radiologische Diagnostik

1999-06-01

Purpose: To investigate the feasibility of reconstructing a virtual endoscopy from MR imaging data sets of the upper urinary tract. Method: The data obtained from 28 contrast-enhanced MR urographic examinations (5 normal; 23 pathologic) were post-processed to reconstruct a virtual ureterorenoscopy (VURS) using a threshold image segmentation. The visualization of the upper urinary tract was based on the acquisition of T{sub 1}-weighted 3D gradient-echo sequences after intravenous administration of gadolinium-DTPA and a prior injection of low-dose furosemide. Results: The employed MR urography technique created in all 28 cases a complete and strong contrast enhancement of the urinary tract. These 3D sequence data allowed the reconstruction of a VURS, even when the collecting system was not dilated. The best accuracy was provided by the MR urography sequences with the smallest voxel size. Moreover, the data acquisition based on a breath-hold technique has proved superior to that using a respiratory gating. Inside the renal pelvis, all calices could be assessed by turning the virtual endoscope in the appropriate direction. The visualization of the ureteral orifices in the bladder was also possible. All filling defects that were diagnosed by MR urography could be evaluated from the endoluminal view using the VURS. The exact characterization of the lesions based only on the assessment of the surface structure was difficult. Conclusion: A virtual endoscopy of the upper urinary tract can be successfully reconstructed using the data sets of high-resolution 3D MR urography sequences. (orig.) [Deutsch] Ziel: Untersuchungen zur Anwendung der virtuellen Endoskopie auf MR-tomographische Datensaetze des oberen Harntraktes. Methoden: Die Daten von 28 kontrastangehobenen MR-Urographien (5 normal; 23 pathologisch) wurden zur Erstellung einer virtuellen Ureterorenoskopie (VURS) mittels Schwellenwert-Bildsegmentierung nachverarbeitet. Als Grundlage fuer die Darstellung des Harntraktes

Human herpesviruses respiratory infections in patients with acute respiratory distress (ARDS).

Science.gov (United States)

Bonizzoli, Manuela; Arvia, Rosaria; di Valvasone, Simona; Liotta, Francesco; Zakrzewska, Krystyna; Azzi, Alberta; Peris, Adriano

2016-08-01

Acute respiratory distress syndrome (ARDS) is today a leading cause of hospitalization in intensive care unit (ICU). ARDS and pneumonia are closely related to critically ill patients; however, the etiologic agent is not always identified. The presence of human herpes simplex virus 1, human cytomegalovirus and Epstein-Barr virus in respiratory samples of critically ill patients is increasingly reported even without canonical immunosuppression. The main aim of this study was to better understand the significance of herpesviruses finding in lower respiratory tract of ARDS patients hospitalized in ICU. The presence of this group of herpesviruses, in addition to the research of influenza viruses and other common respiratory viruses, was investigated in respiratory samples from 54 patients hospitalized in ICU, without a known microbiological causative agent. Moreover, the immunophenotype of each patient was analyzed. Herpesviruses DNA presence in the lower respiratory tract seemed not attributable to an impaired immunophenotype, whereas a significant correlation was observed between herpesviruses positivity and influenza virus infection. A higher ICU mortality was significantly related to the presence of herpesvirus infection in the lower respiratory tract as well as to impaired immunophenotype, as patients with poor outcome showed severe lymphopenia, affecting in particular T (CD3+) cells, since the first days of ICU hospitalization. In conclusion, these results indicate that herpesviruses lower respiratory tract infection, which occurs more frequently following influenza virus infection, can be a negative prognostic marker. An independent risk factor for ICU patients with ARDS is an impaired immunophenotype.

Adverse effects of anticoagulation treatment: clinically significant upper gastrointestinal hemorrhage

Directory of Open Access Journals (Sweden)

Pavel Skok

2006-12-01

Full Text Available Background: Over the last years, the use of oral anticoagulant treatment has increased dramatically, principally for the prevention of venous thrombosis and thrombembolic events. This treatment is demanding, especially among the elderly with concommitant diseases and different medication. Aim of the study to evaluate the rate of serious complications, clinically significant hemorrhage from upper gastointestinal tract in patients treated with oral antiocoagulants in a prospective cohort study.Patients and methods: Included were patients admitted to our institution between January 1, 1994 and December 31, 2003 due to gastrointestinal hemorrhage. Emergency endoscopy and laboratory testing was performed in all patients.Results: 6416 patients were investigated: 2452 women (38.2 % and 3964 men (61.8 %, mean age 59.1 years, SD 17.2. Among our patients, 55 % were aged over 60 years. In 86.4 % of patients the source of bleeding was confirmed in the upper gastrointestinal tract. In the last week prior to bleeding, 20.4 % (1309/6416 of all patients were regularly taking nonsteroidal anti-inflammatory drugs, anticoagulant therapy or antiplatelet agents in single daily doses at least. 6.3 % of patients (82/1309 with abundant hemorrhage from upper gastrointestinal tract were using oral anticoagulant therapy and had INR > 5 at admission, 25.6 % of them had INR > 10. The mortality of patients using oral anticoagulants and INR > 5 was 17.1 %.Conclusions: Upper gastrointestinal hemorrhage is a serious complication of different medications, particularly in elderly patients. Safe use of anticoagulant therapy is based on careful selection of patients and correct intake of the prescribed drugs.

Primary Small Cell Carcinoma of the Upper Urinary Tract

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Victor Ka-Siong Kho

2010-03-01

Full Text Available We report a case of primary extrapulmonary small cell carcinoma of the distal ureter, with a synchronous small cell carcinoma of the ipsilateral renal pelvis. These tumors, rarely reported in the urinary tract, are locally aggressive and have a poor prognosis. A 77-year-old male bedridden patient presented with fever and chills with left side-flank pain for 3 days. Following a diagnosis of ureteral urothelial carcinoma, hand-assisted laparoscopic nephroureterectomy with bladder cuff excision was carried out. Adjuvant chemotherapy was given after pathologic report of primary small cell carcinoma of the distal ureter and a synchronous small cell carcinoma of the ipsilateral renal pelvis. After 3 cycles of combination chemotherapy, the patient died 4 months postoperatively due to sepsis.

Distress screening using distress thermometer in head and neck cancer patients undergoing radiotherapy and evaluation of causal factors predicting occurrence of distress

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Shirley Lewis

2013-01-01

Full Text Available Introduction: Distress is commonly seen in head and neck cancer patients undergoing radiotherapy. Causal factors of distress are multifactorial; which encompasses physical, psychological, spiritual, and existential factors with complex interrelationship among the factors. Materials and Methods: Thirty patients undergoing head and neck radiotherapy were included in the study. Patients were screened for pain scores, distress scores, physical and psychological symptoms, and spiritual and emotional distress. Results: Significant increasing trend seen for pain score, distress score, and total number of symptoms during 2 nd week, 4 th week, and on completion of radiotherapy treatment (all P′s < 0.001 compared to pretreatment. Those who had chemotherapy (CT along with radiation had significantly greater pain score (t = 5.54, P = 0.03 and distress score (t = 3.9, P = 0.05 at 2 weeks into radiotherapy compared to those who did not receive CT. There was significantly higher grade of skin toxicity in those with spiritual distress (Somers′ d = 0.36, P = 0.02 and higher grade of mucositis in those with existential distress (d = 0.34, P = 0.02 at 4 weeks into radiotherapy. Conclusion: Positive correlation between distress score and pain score and occurrence of physical symptoms. Increasing trend seen for pain score, distress score, and total number of symptoms during 2 nd week, 4 th week, and completion of radiotherapy treatment compared to pretreatment. Increase in distress score in those with existential and spiritual distress.

Phytase in non-ruminant animal nutrition: a critical review on phytase activities in the gastrointestinal tract and influencing factors

OpenAIRE

Dersjant-Li, Yueming; Awati, Ajay; Schulze, Hagen; Partridge, Gary

2014-01-01

This review focuses on phytase functionality in the digestive tract of farmed non-ruminant animals and the factors influencing in vivo phytase enzyme activity. In pigs, feed phytase is mainly active in the stomach and upper part of the small intestine, and added phytase activity is not recovered in the ileum. In poultry, feed phytase activities are mainly found in the upper part of the digestive tract, including the crop, proventriculus and gizzard. For fish with a stomach, phytase activities...

[Respiratory distress in three newborns after mask disinfection with Endosporine. Probable role of glutaraldehyde].

Science.gov (United States)

Testud, F; Bubnic, A; Valancogne, A; Assaf, G; Vray, C; Cottin, X; Bourgeois, J; Descotes, J

2000-05-01

Disinfectants for medical devices are uncommonly a cause of iatrogenic adverse effects. Nevertheless, when misused, they can induce severe complications. Three cases of acute respiratory distress in newborns probably induced by glutaraldehyde are reported. Three children born by Caesarean section between 8 and 19 May 1999 in the same hospital presented acute respiratory distress requiring hospitalization in the neonatal intensive care unit; one child was premature. The clinical appearance, which was initially normal, deteriorated with a respiratory distress in 30 to 60 minutes. Recovery was uneventful in all cases. The diagnosis considered was a hyaline membrane disease. The enquiry conducted after this cluster onset identified, as a main contributing factor, the disinfection procedure recently introduced in the surgical theater. Review of toxicologic data on glutaraldehyde shows this is a highly irritating chemical for the respiratory tract, even at low concentrations. Clinical and radiologic features in these three neonates are compatible with a pulmonary sub-edema on an immature alveolar setting. The hypothesis proposed is that glutaraldehyde, the active ingredient of the biocidal formula used to disinfect the respiratory masks, was massively desorbed from the rubber and foam of which masks are made.

A Bamboo Joint-Like Appearance is a Characteristic Finding in the Upper Gastrointestinal Tract of Crohn's Disease Patients: A Case-Control Study.

Science.gov (United States)

Fujiya, Mikihiro; Sakatani, Aki; Dokoshi, Tatsuya; Tanaka, Kazuyuki; Ando, Katsuyoshi; Ueno, Nobuhiro; Gotoh, Takuma; Kashima, Shin; Tominaga, Motoya; Inaba, Yuhei; Ito, Takahiro; Moriichi, Kentaro; Tanabe, Hiroki; Ikuta, Katsuya; Ohtake, Takaaki; Yokota, Kinnichi; Watari, Jiro; Saitoh, Yusuke; Kohgo, Yutaka

2015-09-01

The clinical importance of Crohn's disease (CD)-specific lesions in the upper gastrointestinal tract (upper GIT) has not been sufficiently established. The aim of this case-control study is to investigate the characteristic findings of CD in the upper GIT. In 2740 patients who underwent gastroduodenoscopy at Asahikawa Medical University between April 2011 and December 2012, 81 CD patients, 81 gender- and age-matched non-IBD patients, and 66 ulcerative colitis (UC) patients were investigated in the present study. (1) The diagnostic ability and odds ratio of each endoscopic finding (a bamboo joint-like appearance in the cardia, erosions, and/or ulcers in the antrum, notched signs, and erosions and/or ulcers in the duodenum) were compared between the CD and non-IBD patients or UC patients. (2) The interobserver agreement of the diagnosis based on the endoscopic findings was evaluated by 3 experienced and 3 less-experienced endoscopists. The incidence of detecting a bamboo joint-like appearance, notched signs, and erosions and/or ulcers in the duodenum was significantly higher in the CD patients than in the non-IBD and UC patients. In addition, the diagnostic ability and odds ratio of a bamboo joint-like appearance for CD were higher than those for the other findings. Kendall's coefficients of concordance in the group of experienced and less-experienced endoscopists were relatively high for a bamboo joint-like appearance (0.748 and 0.692, respectively). A cardiac bamboo joint-like appearance is a useful finding for identifying high-risk groups of CD patients using only gastroduodenoscopy.

Upper Gastrointestinal Tract Cancers at Endoscopy in Kano, North ...

African Journals Online (AJOL)

Cancer registration in Nigeria is poorly done, this is even so in North-Western Nigeria. It is only of recent that attempts are being made to know the profile of cancers seen in clinical practice in our environment. This study was done to establish the pattern of upper gastrointestinal cancers at Kano, North-Western Nigeria.

Seven cases of upper gastrointestinal bleeding after cold biopsy

OpenAIRE

Alneaimi, Khaled; Abdelmoula, Ali; Vincent, Magalie; Savale, Camille; Baye, Birane; Lesur, Gilles

2016-01-01

Background and study aims: Routine biopsy of the upper gastrointestinal tract is performed with increasing frequency. It is generally considered to be safe without significant complication. However, gastrointestinal bleeding as a result of cold biopsy is a known complication. We report seven cases of upper gastrointestinal bleeding after cold biopsy and discuss clinical data, risks factors, severity and management of this event. We suggest that physicians must be more cautious with this rare ...

Urinary tract trauma

Energy Technology Data Exchange (ETDEWEB)

Campbell, J.E. (Sunnybrook Medical Centre, Toronto, Ontario (Canada))

1983-09-01

From a practical point of view, a woman who has blunt injury to the pelvic area with hematuria from the lower urinary tract, has a contused or ruptured bladder. In a man, such a situation calls for retrograde urethrography to determine if the injury is in the urethra or the bladder because the two organs are investigated differently. In both sexes, such injuries are usually associated with pelvic fractures. Massive bladder displacement and severe hemorrhage should alert one to the need for pelvic angiography to find and embolize the bleeding site within the first 24 hours after injury. For blunt trauma to the upper urinary tract an intravenous urogram with tomography is still the main examination. However, a normal intravenous urogram does not exclude serious injury. Therefore, if signs or symptoms persist, a computerized tomographic (CT) examination should be performed if available. Otherwise, a radionuclide study is advisable. Non-excretion on intravenous urography with tomography calls for selective renal arteriography to delineate the etiology. There can be serious renal trauma in the absence of hematuria, which may occur with renal pedicle injury or avulsion of the ureter. Minor forniceal ruptures may occasionally mask severe posterior renal lacerations.

Effects of upper respiratory tract illnesses, ibuprofen and caffeine on reaction time and alertness.

Science.gov (United States)

Smith, Andrew P; Nutt, David J

2014-05-01

Compared with healthy individuals, those with upper respiratory tract illnesses (URTIs) report reduced alertness and have slower reaction times. It is important to evaluate medication that can remove this behavioural malaise. The aim of this study was to compare the effects of a combination of ibuprofen plus caffeine with ibuprofen and caffeine alone, and placebo on malaise associated with URTIs, as measured by psychomotor performance and mood testing. Volunteers were randomly assigned to one of four medication conditions as follows: 200 mg ibuprofen and 100 mg caffeine; 200 mg ibuprofen; 100 mg caffeine; placebo. A single oral dose was given and testing followed for 3 h. Efficacy variables were based on the volunteers' performance, measured by psychomotor performance and mood. The pre-drug results confirmed that those with an URTI had a more negative mood and impaired performance. Results from the simple reaction time task, at both 55- and 110-min post-dosing, showed that a single-dose of caffeinated products (I200/C100 and CAF100) led to significantly faster reaction times than IBU200 and placebo. These effects were generally confirmed with the other performance tasks. Subjective measures showed that the combination of ibuprofen and caffeine was superior to the other conditions. There were no serious adverse events reported, and study medication was well tolerated. The results from the post-drug assessments suggest that a combination of ibuprofen and caffeine was the optimum treatment for malaise associated with URTIs in that it had significant effects on objective performance and subjective measures.

The association of benign prostatic hyperplasia with lower urinary tract stones in adult men: A retrospective multicenter study

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Jae Hung Jung

2018-04-01

Full Text Available Objective: To examine the relationship between benign prostatic hyperplasia (BPH and the presence of lower urinary tract stones. Methods: We retrospectively reviewed the records of men with lower urinary tract stones who presented to three clinical centers in Korea over a 4-year period. We divided the patients into two groups based on the location of urinary stones: Group 1 (bladder calculi and Group 2 (urethral calculi. We compared the characteristics of both groups and performed univariate and multivariate analyses with a logistic regression model to investigate the relationship between BPH and lower urinary tract stones. Results: Of 221 patients, 194 (87.8% had bladder calculi and 27 (12.2% had urethral calculi. The mean age of Group 1 was higher than that of Group 2 (68.96 ± 12.11 years vs. 55.74 ± 14.20 years, p < 0.001. The mean prostate volume of Group 1 was higher than that of Group 2 (44.47 ± 27.14 mL vs. 24.70 ± 6.41 mL, respectively, p < 0.001. Multivariate logistic regression showed that age (OR = 1.075, 95%CI: 1.023–1.129 and prostate volume (OR = 1.069, 95%CI: 1.017–1.123 were independently associated with increased risk for bladder calculi. Upper urinary tract stones and/or hydronephrosis conferred a 3-fold risk for urethral calculi (OR = 3.468, 95%CI: 1.093–10.999. Conclusion: Age and prostate volume are independent risk factors for bladder calculi. In addition, men with upper urinary tract disease are at greater risk for urethral calculi, which may migrate from the upper urinary tract rather than from the bladder. Keywords: Prostatic hyperplasia, Urethra, Urinary bladder, Urolithiasis, Lower urinary tract stones

Loss and benefit of DR system in mass screening for upper GI-tracts. Comparison with an II-TV based DR system and 100-mm roll-film system

International Nuclear Information System (INIS)

Ogura, Toshihiro; Fujita, Hiroshi.

1995-01-01

A 2048 x 2048 matrix II-TV based digital radiography (DR) system, a fully digital imaging system with diagnosis on the CRT monitor, had been introduced to Cancer Institute Hospital for the GI-tracts examinations since January 1990. Furthermore, we had applied it to the mass screening of upper GI-tract since November 1992. In the present study, a retrospective study on clinical evaluation and features of the DR system for the mass screening were investigated and compared with the screening data taken by conventional 100-mm roll-film technique in the previous year. The loss ratios and appearance of the mucosal patterns in upper gastric images were studied as well. Also determined was the reading time of those images in the mass screening situation. It was found that the loss ratio on the subject image information in 100-mm roll-film images was smaller than that in DR images. However, the DR images processed by windowing technique provided the perfect information without partially over or under density area. It was shown that the clinical image quality greatly depended on the radiographic technique by radiologists or technologists rather than on the imaging modality itself employed; even in II/TV-DR system, the radiographic technique is important. Because of some issues, including the size of CRT monitor, eyestrain for CRT monitor, and windowing operation regard to reading system, the reading time of CRT images was 1.44-2.05 times longer than that of 100-mm roll-film images. (author)

Prescribing patterns for upper respiratory tract infections: a prescription-review of primary care practice in Kedah, Malaysia, and the implications.

Science.gov (United States)

Rezal, Rabiatul Salmi; Hassali, Mohamed Azmi; Alrasheedy, Alian A; Saleem, Fahad; Yusof, Faridah Aryani Md; Kamal, Mardhiyah; Mohd Din, Rosminah; Godman, Brian

2015-01-01

It is necessary to ascertain current prescribing of antibiotics for upper respiratory tract infections (URTIs) to address potential overuse. A retrospective analysis was conducted of all prescriptions for URTIs among 10 public primary healthcare centers in Kedah, Malaysia, from 1 January to 31 March 2014. A total of 123,524 prescriptions were screened and analyzed. Of these, 7129 prescriptions were for URTI, with 31.8% (n = 2269) containing antibiotics. Macrolides were the most commonly prescribed antibiotic, constituting 61% (n = 1403) of total antibiotics prescribed. There was a statistically significant association between different prescribers and diagnoses (p = 0.001) and a weak positive trend suggesting family medicine specialists are more competent in antibiotic prescribing, followed by medical officers and assistant medical officers (τ = 0.122). Prescribing practices of some prescribers were inconsistent with current guidelines encouraging resistance development. National antimicrobial stewardship programs and further educational initiatives are ongoing in Malaysia to improve antibiotic use.

Survival Following Kidney Sparing Management of Upper Urinary ...

African Journals Online (AJOL)

Survival Following Kidney Sparing Management of Upper Urinary Tract Transitional Cell Carcinoma is Adversely Affected By Prior History of Bladder Cancer. ... The tumor biology rather than the surgical approach dictates prognosis. Patients with higher stage and grade disease may be better served with a more aggressive ...

A Case of Pyriform Sinus Fistula Infection with Double Tracts

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Masato Shino

2014-01-01

Full Text Available Pyriform sinus fistula is a rare clinical entity and the precise origin remains controversial. The fistula is discovered among patients with acute suppurative thyroiditis or deep neck infection of the left side of the neck and is usually located in the left pyriform sinus. To the best of our knowledge, only a single tract has been reported to be responsible for pyriform sinus fistula infection. We present a case of a 13-year-old female patient with a pyriform sinus fistula that caused a deep infection of the left side of the neck and showed double-tract involvement discovered during surgical resection of the entire fistula. Both tracts arose around the pyriform sinus and terminated at the upper portion of the left lobe of the thyroid.

Disentangling Tinnitus Distress and Tinnitus Presence by Means of EEG Power Analysis

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Martin Meyer

2014-01-01

Full Text Available The present study investigated 24 individuals suffering from chronic tinnitus (TI and 24 nonaffected controls (CO. We recorded resting-state EEG and collected psychometric data to obtain information about how chronic tinnitus experience affects the cognitive and emotional state of TI. The study was meant to disentangle TI with high distress from those who suffer less from persistent tinnitus based on both neurophysiological and behavioral data. A principal component analysis of psychometric data uncovers two distinct independent dimensions characterizing the individual tinnitus experience. These independent states are distress and presence, the latter is described as the perceived intensity of sound experience that increases with tinnitus duration devoid of any considerable emotional burden. Neuroplastic changes correlate with the two independent components. TI with high distress display increased EEG activity in the oscillatory range around 25 Hz (upper β-band that agglomerates over frontal recording sites. TI with high presence show enhanced EEG signal strength in the δ-, α-, and lower γ-bands (30–40 Hz over bilateral temporal and left perisylvian electrodes. Based on these differential patterns we suggest that the two dimensions, namely, distress and presence, should be considered as independent dimensions of chronic subjective tinnitus.

Human milk probiotic Lactobacillus fermentum CECT5716 reduces the incidence of gastrointestinal and upper respiratory tract infections in infants.

Science.gov (United States)

Maldonado, José; Cañabate, Francisco; Sempere, Luis; Vela, Francisco; Sánchez, Ana R; Narbona, Eduardo; López-Huertas, Eduardo; Geerlings, Arjan; Valero, Antonio D; Olivares, Mónica; Lara-Villoslada, Federico

2012-01-01

The aim of the study was to examine the effects of a follow-on formula containing Lactobacillus fermentum CECT5716 (L. fermentum) on the incidence of infections in infants between the ages of 6 and 12 months. A randomized double-blinded controlled study including infants at the age of 6 months was conducted. Infants were assigned randomly to either follow-on formula supplemented with L. fermentum plus galactooligosaccharide (experimental group, EG), or the same formula supplemented with only galactooligosaccharide (control group, CG). The main outcome was the incidence of infections for the 6-month duration of the study. The EG showed a significant 46% reduction in the incidence rate (IR) of gastrointestinal infections (EG: 0.196 ± 0.51, CG: 0.363 ± 0.53, IR ratio 0.54, 95% confidence interval [CI] 0.307-0.950, P = 0.032), 27% reduction in the incidence of upper respiratory tract infections (EG: 0.969 ± 0.96, CG: 1.330 ± 1.23, IR ratio 0.729, 95% CI 0.46-1.38, P = 0.026), and 30% reduction in the total number of infections (EG: 1.464 ± 1.15, CG: 2.077 ± 1.59, IR ratio 0.70, 95% CI 0.46-1.38, P = 0.003), at the end of the study period compared with CG. Administration of a follow-on formula with L. fermentum CECT5716 may be useful for the prevention of community-acquired gastrointestinal and upper respiratory infections.

Upper Gastrointestinal Involvement in Crohn Disease: Histopathologic and Endoscopic Findings.

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Diaz, Liege; Hernandez-Oquet, Rafael Enrique; Deshpande, Amar R; Moshiree, Baharak

2015-11-01

Studies describing the prevalence of upper gastrointestinal (GI) Crohn disease (CD) and its histopathologic changes have been inconsistent as a result of different definitions used for upper GI involvement, diverse populations, and varying indications for endoscopy. We reviewed the literature describing endoscopic findings and histologic lesions in gastric and duodenal mucosa of patients with established CD. PubMed, EMBASE, and the Cochrane Library were searched for gastroduodenal biopsy findings in patients with CD from 1970 to 2014. We included all retrospective and prospective studies in adults. We calculated the prevalence of the most common endoscopic and histopathological findings among patients with overall CD and upper GI CD. Of the 385 articles identified, 20 eligible studies were included. A total of 2511 patients had CD and 815 had upper GI CD. In the CD group, the most common histopathological finding was nonspecific gastric inflammation in 32% of patients, followed by gastric granuloma in 7.9%. Focal gastritis was prevalent in 30.9% of patients. In the upper GI CD group, gastric inflammation was present in 84% of patients, followed by duodenal inflammation in 28.2% and gastric granuloma in 23.2%. The most common gastric endoscopic finding in patients with CD was erythema in 5.9%, followed by erosions in 3.7%. Duodenal endoscopic findings included ulcers and erythema in 5.3% and 3.0% of patients, respectively. We found a prevalence of 34% for CD involving the upper GI tract across these 20 studies. Routine upper endoscopy with biopsies of the upper GI tract in the diagnostic workup of patients with CD can correctly classify the distribution and extent of the disease.

Malignant tumours in the digestive tract of employees of the gas industry

International Nuclear Information System (INIS)

Manz, A.; Berger, J.; Waltsgott, H.; Kersting, A.

1991-01-01

An epidemiological study was carried out to investigate whether the influences of a person's working environment can lead to the development of malignant tumours in the digestive tract. The subjects of the study were employees of a large gas company, 4.928 men and 592 women. It appears that the workers at the furnace block were relatively more affected by tumors of the digestive tract than the other groups. The SMR as compared with the office workers and administrative personnel is 2.838, and compared with the other industrial employees is 1.333. The differences in both cases are statistically significant. Smoking habits have even less effects on the development of carcinomas of the digestive tract than on those of the respiratory tract. Apart from this, it is only the upper section of the digestive tract (the oral cavity, esophagus and stomach) which could be influenced by smoking. Psychological/nervous strain seems to accelerate the formation of such tumours, especially in the stomach region. (orig.) [de

Augmentation of Radiation Response by Panitumumab in Models of Upper Aerodigestive Tract Cancer

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Kruser, Tim J.; Armstrong, Eric A.; Ghia, Amol J.; Huang Shyhmin; Wheeler, Deric L.; Radinsky, Robert; Freeman, Daniel J.; Harari, Paul M.

2008-01-01

Purpose: To examine the interaction between panitumumab, a fully human anti-epidermal growth factor receptor monoclonal antibody, and radiation in head-and-neck squamous cell carcinoma and non-small-cell lung cancer cell lines and xenografts. Methods and Materials: The head-and-neck squamous cell carcinoma lines UM-SCC1 and SCC-1483, as well as the non-small-cell lung cancer line H226, were studied. Tumor xenografts in athymic nude mice were used to assess the in vivo activity of panitumumab alone and combined with radiation. In vitro assays were performed to assess the effect of panitumumab on radiation-induced cell signaling, apoptosis, and DNA damage. Results: Panitumumab increased the radiosensitivity as measured by the clonogenic survival assay. Radiation-induced epidermal growth factor receptor phosphorylation and downstream signaling through mitogen-activated protein kinase (MAPK) and signal transducer and activator of transcription 3 (STAT3) was inhibited by panitumumab. Panitumumab augmented radiation-induced DNA damage by 1.2-1.6-fold in each of the cell lines studied as assessed by residual γ-H 2 AX foci after radiation. Radiation-induced apoptosis was increased 1.4-1.9-fold by panitumumab, as evidenced by Annexin V-fluorescein isothiocyanate staining and flow cytometry. In vivo, the combination therapy of panitumumab and radiation was superior to panitumumab or radiation alone in the H226 xenografts (p = 0.01) and showed a similar trend in the SCC-1483 xenografts (p = 0.08). In vivo, immunohistochemistry demonstrated the ability of panitumumab to augment the antiproliferative and antiangiogenic effects of radiation. Conclusion: These studies have identified a favorable interaction in the combination of radiation and panitumumab in upper aerodigestive tract tumor models, both in vitro and in vivo. These data suggest that clinical investigations examining the combination of radiation and panitumumab in the treatment of epithelial tumors warrant

Outcomes of radical nephroureterectomy: a series from the Upper Tract Urothelial Carcinoma Collaboration.

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Margulis, Vitaly; Shariat, Shahrokh F; Matin, Surena F; Kamat, Ashish M; Zigeuner, Richard; Kikuchi, Eiji; Lotan, Yair; Weizer, Alon; Raman, Jay D; Wood, Christopher G

2009-03-15

The literature on upper tract urothelial carcinoma (UTUC) has been limited to small, single center studies. A large series of patients treated with radical nephroureterectomy for UTUC were studied, and variables associated with poor prognosis were identified. Data on 1363 patients treated with radical nephroureterectomy at 12 academic centers were collected. All pathologic slides were re-reviewed by genitourinary pathologists according to strict criteria. Pathologic review revealed renal pelvis location (64%), necrosis (21.6%), lymphovascular invasion (LVI) (24.8%), concomitant carcinoma in situ (28.7%), and high-grade disease (63.7%). A total of 590 patients (43.3%) underwent concurrent, lymphadenectomy and 135 (9.9%) were lymph node (LN) -positive. Over a mean follow-up of 51 months, 379 (28%) patients experienced disease recurrence outside of the bladder and 313 (23%) died of UTUC. The 5-year recurrence-free and cancer-specific survival probabilities (+/-SD) were 69%+/-1% and 73%+/-1%, respectively. On multivariate analysis, high tumor grade (hazards ratio [HR]: 2.0, P<.001), advancing pathologic T stage (P-for-trend<.001), LN metastases (HR: 1.8, P<.001), infiltrative growth pattern (HR: 1.5, P<.001), and LVI (HR: 1.2, P=.041) were associated with disease recurrence. Similarly, patient age (HR: 1.1, P=.001), high tumor grade (HR: 1.7, P=.001), increasing pathologic T stage (P-for-trend<.001), LN metastases (HR: 1.7, P<.001), sessile architecture (HR: 1.5, P=.002), and LVI (HR: 1.4, P=.02) were independently associated with cancer-specific survival. Radical nephroureterectomy provided durable local control and cancer-specific survival in patients with localized UTUC. Pathologic tumor grade, T stage, LN status, tumor architecture, and LVI were important prognostic variables associated with oncologic outcomes, which could potentially be used to select patients for adjuvant systemic therapy. Copyright (c) 2009 American Cancer Society.

[COMPLICATED URINARY TRACT INFECTIONS IN THE ELDERLY].

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Ćosić, I; Ćosić, V

2016-12-01

Urinary tract infections (UTI) are the most common bacterial infections involving lower (cystitis, prostatitis) or upper (pyelonephritis, renal abscess, perinephric abscess) urinary tract. Differentiation of complicated and uncomplicated UTI is usually based on the presence of structural or functional urinary tract abnormalities, which can increase the risk of treatment failure and development of serious complications. Factors that increase the risk are foreign bodies, stones, obstruction, neurogenic bladder, kidney transplantation, immunosuppression, and pregnancy. Complicated UTI includes a spectrum of conditions that increase the risk of treatment failure, as well as of serious complications such as bacteremia and sepsis, perinephric abscess, renal impairment and emphysematous pyelonephritis. To avoid the potentially devastating outcomes, appropriate diagnostic procedures, antibiotic and surgical treatment, and appropriate follow-up are required. The incidence of complicated UTI will grow in the future due to general aging of the population, increasing incidence of diabetes, and ever growing number of immunocompromised and immunosuppressed patients. It is of key importance to recognize complicated UTI on time, and treat it wisely and aggressively to reduce duration of the disease and the risk of antibiotic resistance.

Prognostic impact of preoperative statin use after radical nephroureterectomy for upper urinary tract urothelial carcinoma.

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Lim, Ju Hyun; Jeong, In Gab; Park, Jong Yeon; You, Dalsan; Hong, Bumsik; Hong, Jun Hyuk; Ahn, Hanjong; Kim, Choung-Soo

2015-07-01

The objective was to investigate the impact of statin use on prognosis after radical nephroureterectomy for upper urinary tract urothelial carcinoma (UTUC). A retrospective review of medical records identified 277 patients who underwent radical nephroureterectomy for primary UTUC at Asan Medical Center between January 2006 and December 2011. Information on preoperative statin use was obtained from patient charts in an electronic database. We assessed the impact of statin use on recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS). Of these 277 patients, 62 (22.4%) were taking statin medications. Compared to the statin nonusers, the statin users were older, had a higher body mass index, and had higher rates of cardiovascular disease and diabetes. The 5-year RFS rates of statin users and nonusers were 78.5% and 72.5%, respectively (p=0.528); the 5-year CSS rates were 85.6% and 77.7%, respectively (p=0.516); and the 5-year OS rates were 74.5% and 71.4%, respectively (p=0.945). In the multivariate analysis, statin use was not an independent prognostic factor for RFS (hazard ratio, 0.47; p=0.056), CSS (hazard ratio, 0.46; p=0.093), or OS (hazard ratio, 0.59; p=0.144) in patients who underwent radical nephroureterectomy for UTUC. Statin use was not associated with improved RFS, CSS, or OS in the sample population of patients with UTUC.

Inverse association between yoghurt intake and upper aerodigestive tract cancer risk in a Japanese population.

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Kawakita, Daisuke; Sato, Fumihito; Hosono, Satoyo; Ito, Hidemi; Oze, Isao; Watanabe, Miki; Hanai, Nobuhiro; Hatooka, Shunzo; Hasegawa, Yasuhisa; Shinoda, Masayuki; Tajima, Kazuo; Murakami, Shingo; Tanaka, Hideo; Matsuo, Keitaro

2012-09-01

Although the combination of tobacco smoking and alcohol drinking account for approximately 80% of upper aerodigestive tract (UADT) cancer risk, the role of dietary factors, including dairy products, in the risk of these cancers remains controversial. We aimed to evaluate the association between dairy product intake and UADT cancer risk in a Japanese population. We conducted a case-control study in 959 patients with UADT cancer and 2877 sex- and age-matched noncancer control subjects who visited the Aichi Cancer Center in Nagoya, Japan. Data on lifestyle factors, including diet, were obtained by self-administered questionnaire. Associations were assessed by multivariate logistic regression models that considered potential confounders. We found a significant inverse association between yoghurt intake and UADT cancer risk with multivariate-adjusted odds ratios and 95% confidence intervals for <1 time/week, ≥ 1 time/week and <1 time/day, and ≥ 1 time/day consumption of yoghurt of 0.70 (95% confidence interval: 0.54-0.91), 0.67 (0.54-0.84), and 0.73 (0.55-0.95) relative to nonconsumers (P trend=0.005). When stratified by primary tumor site, this association was significant among patients with hypopharyngeal, laryngeal, and esophageal cancer. However, we saw no significant association between milk or butter intake and UADT cancer risk. In this study, we found that a high intake of yoghurt may lower the risk of developing UADT cancer in a Japanese population. Further investigation of this association is warranted.

Novel 16-channel receive coil array for accelerated upper airway MRI at 3 Tesla.

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Kim, Yoon-Chul; Hayes, Cecil E; Narayanan, Shrikanth S; Nayak, Krishna S

2011-06-01

Upper airway MRI can provide a noninvasive assessment of speech and swallowing disorders and sleep apnea. Recent work has demonstrated the value of high-resolution three-dimensional imaging and dynamic two-dimensional imaging and the importance of further improvements in spatio-temporal resolution. The purpose of the study was to describe a novel 16-channel 3 Tesla receive coil that is highly sensitive to the human upper airway and investigate the performance of accelerated upper airway MRI with the coil. In three-dimensional imaging of the upper airway during static posture, 6-fold acceleration is demonstrated using parallel imaging, potentially leading to capturing a whole three-dimensional vocal tract with 1.25 mm isotropic resolution within 9 sec of sustained sound production. Midsagittal spiral parallel imaging of vocal tract dynamics during natural speech production is demonstrated with 2 × 2 mm(2) in-plane spatial and 84 ms temporal resolution. Copyright © 2010 Wiley-Liss, Inc.

The association of benign prostatic hyperplasia with lower urinary tract stones in adult men: A retrospective multicenter study.

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Jung, Jae Hung; Park, Jinsung; Kim, Won Tae; Kim, Hong Wook; Kim, Hyung Joon; Hong, Sungwoo; Yang, Hee Jo; Chung, Hong

2018-04-01

To examine the relationship between benign prostatic hyperplasia (BPH) and the presence of lower urinary tract stones. We retrospectively reviewed the records of men with lower urinary tract stones who presented to three clinical centers in Korea over a 4-year period. We divided the patients into two groups based on the location of urinary stones: Group 1 (bladder calculi) and Group 2 (urethral calculi). We compared the characteristics of both groups and performed univariate and multivariate analyses with a logistic regression model to investigate the relationship between BPH and lower urinary tract stones. Of 221 patients, 194 (87.8%) had bladder calculi and 27 (12.2%) had urethral calculi. The mean age of Group 1 was higher than that of Group 2 (68.96 ± 12.11 years vs. 55.74 ± 14.20 years, p  urinary tract stones and/or hydronephrosis conferred a 3-fold risk for urethral calculi (OR = 3.468, 95%CI: 1.093-10.999). Age and prostate volume are independent risk factors for bladder calculi. In addition, men with upper urinary tract disease are at greater risk for urethral calculi, which may migrate from the upper urinary tract rather than from the bladder.

Role of endoscopy in evaluating upper gastrointestinal tract lesions in rural population

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Sharanabasavaraj Javali

2015-01-01

Full Text Available Background and Objectives: Before the advent of endoscopy direct access to the lesion for the confirmation of the diagnosis was difficult, this posed difficulty in contemplating adequate and appropriate surgery. Endoscopy as a diagnostic and therapeutic tool has grown in recent years. Upper gastrointestinal (GI endoscopy is one of the most fascinating branch which serves not only as a means of resolving or amplifying the diagnosis made clinically or by X-ray, but also a primary diagnostic procedure for conditions not otherwise diagnosable on unoperated case. Fiber optic upper GI endoscopy has already become firmly established as a reliable, quick and inexpensive tool. This study was done to detect the upper gastrointestinal lesions in rural population of Kolar District, the distribution pattern of various upper GI lesions in patients presenting with upper GI symptoms and to follow the endoscopic diagnosis for medical and surgical management. Materials and Methods: The study group includes patients reporting to outpatient department and also the inpatients in wards of General Surgery and other departments, who have upper GI symptoms, were advised endoscopy at R. L. JALAPPA Hospital and Research Centre, Kolar, from a period of December 2011 to August 2013. Results: Of the 600 cases, 370 were males, and 230 were females. Disease incidence was highest in 51-70 years age group, that is, 21.6%. Pain abdomen was the most common symptom. Epigastric tenderness was the most common sign among the patients clinically. Reflux esophagitis and diffuse gastritis formed most common cases (307 cases. The incidence of duodenitis - 7.83%, peptic ulcer -3.3%, esophageal varices - 1.5%, the incidence of carcinoma esophagus and carcinoma stomach was approximately same that is, 4.5% and 4.6% respectively. The incidence of esophageal candidiasis was 4.16%. The majority of the patients had a normal study that is, 14.5%. Conclusion: Upper GI lesions were more common in

Studies on the cellular immune response in patients with upper urinary tract carcinoma compawed with those in patients with bladder carcinoma and it's postoperative change

International Nuclear Information System (INIS)

Sakai, Shunsuke

1980-01-01

Non-specific cellular immunity of patients with upper urinary tract carcinoma was studied by PPD reaction (in vivo or in vitro), lymphocytes subpopulation and macrophage migration inhibition test and the results were compared with those of patients with bladder carcinoma or benign urological diseases. 1) The preoperative cellular immunity of the malignant tumor group gave low values as compared to that in the benign disease group. Although the cellular immunity of patients with renal cell carcinoma showed no difference in the points of their grade and stage, significant differences were noted in patients with bladder carcinoma. The patients with renal pelvic and ureter carcinoma appeared to be similar to the patients with bladder carcinoma in the aspects of immune reactions. 2) In the majority of patients with upper urinary tract and bladder carcinoma, the cellular immunity after complete removal of the carcinoma gave an increased value of each marker as compared to the preoperative value. 3) The cellular immunity after irradiation decreased in the majority of the cases in terms of PPD reaction and T-cell ratio in lymphocyte subpopulation. Irradiation of 4000 - 6000 Rad. showed greater influence on T-cell than on B-cell, but influence of irradiation on cellular immunity was not different by irradiation dose. 4) The cellular immunity indicated decreased values for one to two months after discontinuation of irradiation, but then it showed a tendency to increase in terms of PPD and lymphocytes subpopulation in the patients with satisfactory postoperative courses. 5) Through the pre and postoperative courses, the immunity of the carcinomatous stage seems to be reflected better by the T-cell ratio than by the absolute number of T-cell. It is likely that macrophage migration inhibition test shows much sharper reaction than PPD reaction. (author)

The peculiarities of macroscopic status of the upper gastrointestinal tract mucosa in patients with hepatic and extrahepatic portal hypertension

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Stepanov Yu.M.

2018-03-01

Full Text Available Identification of endoscopic signs of concomitant pathology of the upper gastrointestinal tract allows to determine the tactics of managing patients with different forms of portal hypertension (PG. The analysis of macroscopic picture of esophagus, stomach and duodenum mucosa was carried out in 104 patients with portal hypertension (88 patients with hepatic portal hypertension, 46 – with extrahepatic portal hypertension, 16 – without portal hypertension. The frequency of changes in the esophagus, specific for gastroesophageal reflux disease did not differ significantly in the researched groups. The frequency and severity of varicose veins of the esophagus were diagnosed more often in patients with hepatic form of portal hypertension (OR=10.0, p<0.05. The predominance of different pathological changes of the gastric mucosa in patients with extrahepatic form of portal hypertension was revealed. Portal gastropathy in this group was 5.3 times higher than in patients with hepatic hypertension and 21 times higher than in the III group (without portal hypertension (p<0.01. There were no significant differences of endoscopic picture of the duodenum mucosa between the researched groups.

The consumption of propolis and royal jelly in preventing upper respiratory tract infections and as dietary supplementation in children

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Sevda Yuksel

2016-09-01

Full Text Available Propolis and royal jelly (RJ, two important honeybee products, have been used commonly all over the World as traditional and ethnopharmacological nutrients since ancient times. Both of them have a lot of active ingredients, which are known to be effective for several medical conditions. In this article, medical databases were searched for the usage of RJ and propolis in upper respiratory tract infections (URTI and as a dietary supplementation, together and separately. 10-hydroxy-2-decenoic acid (10-HDA is the most prominent active compound showing antimicrobial effect within RJ. Caffeic acid phenethyl ester (CAPE is the most famous one that shows antimicrobial and anti-inflammatory effect within propolis. When compared with propolis, RJ was found to have richer content for all three main nutrients; proteins, carbohydrates, and lipids. More clinical, experimental, and basic studies are needed to find out the best-standardized mixture to cope with URTI in which RJ and propolis will be main ingredients in addition to the other secondary compounds that have health-beneficial effects. [J Complement Med Res 2016; 5(3.000: 308-311

Involvement of Mycoplasma synoviae in Respiratory Distress Cases of Broilers

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S. Ehtisham-ul-Haque*, S. U. Rahman, M. Siddique and A. S. Qureshi1

2011-04-01

Full Text Available Mycoplasma synoviae (MS is an important pathogen of poultry worldwide, causing respiratory tract infection and infectious synovitis in chickens and turkeys. The study was designed to detect M. synoviae through serology, culture isolation and polymerase chain reaction (PCR assay to document the involvement of MS infection in respiratory distress cases of broiler birds. The validated PCR assay amplifying the conserved gene region of 16SrRNA gene was applied for the detection of M. synoviae from culture as well as in clinical samples. The results indicated that 04 out of total 17 commercial broiler flocks showing respiratory distress signs were found positive with M. synoviae infection indicating 76.57% sero-positivity as, determined with rapid serum agglutination (RSA test. Out of 85 clinical specimens (collected from sero-positive birds; M. synoviae culture isolation was successfully attained in 36 (42.35% samples. Whereas, PCR test has detected 84 (98.82% positive cases. The prevalence of MS in broiler birds was observed maximum as measured through PCR. It is suggested that the true prevalence of MS may best be reflected by combining RSA and PCR test findings.

Neonatal respiratory distress syndrome

Science.gov (United States)

Hyaline membrane disease (HMD); Infant respiratory distress syndrome; Respiratory distress syndrome in infants; RDS - infants ... improves slowly after that. Some infants with severe respiratory distress syndrome will die. This most often occurs ...

Measuring death-related anxiety in advanced cancer: preliminary psychometrics of the Death and Dying Distress Scale.

Science.gov (United States)

Lo, Christopher; Hales, Sarah; Zimmermann, Camilla; Gagliese, Lucia; Rydall, Anne; Rodin, Gary

2011-10-01

The alleviation of distress associated with death and dying is a central goal of palliative care, despite the lack of routine measurement of this outcome. In this study, we introduce the Death and Dying Distress Scale (DADDS), a new, brief measure we have developed to assess death-related anxiety in advanced cancer and other palliative populations. We describe its preliminary psychometrics based on a sample of 33 patients with advanced or metastatic cancer. The DADDS broadly captures distress about the loss of time and opportunity, the process of death and dying, and its impact on others. The initial version of the scale has a one-factor structure and good internal reliability. Dying and death-related distress was positively associated with depression and negatively associated with spiritual, emotional, physical, and functional well-being, providing early evidence of construct validity. This distress was relatively common, with 45% of the sample scoring in the upper reaches of the scale, suggesting that the DADDS may be a relevant outcome for palliative intervention. We conclude by presenting a revised 15-item version of the scale for further study in advanced cancer and other palliative populations.

Pituitary adenylate cyclase-activating polypeptide: occurrence and relaxant effect in female genital tract

DEFF Research Database (Denmark)

Steenstrup, B R; Alm, P; Hannibal, J

1995-01-01

The distribution, localization, and smooth muscle effects of pituitary adenylate cyclase-activating polypeptide (PACAP) were studied in the human female genital tract. The concentrations of PACAP-38 and PACAP-27 were measured by radioimmunoassays, and both peptides were found throughout the genital...... was observed. The findings suggest a smooth muscle regulatory role of PACAP in the human female reproductive tract....... tract. The highest concentrations of PACAP-38 were detected in the ovary, the upper part of vagina, and the perineum. The concentrations of PACAP-27 were generally low, in some regions below the detection limit and in other regions 1 to 5% of the PACAP-38 concentrations. Immunocytochemistry revealed...

Development and psychometric testing of a new tool for detecting moral distress: the Moral Distress Thermometer.

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Wocial, Lucia D; Weaver, Michael T

2013-01-01

To report the development and psychometric testing of the Moral Distress Thermometer. The Moral Distress Thermometer is a new screening tool to measure moral distress in nurses who practise in the hospital setting. Moral distress occurs when one knows the ethically correct thing to do, but is prevented from acting on that perceived obligation. It is a well documented phenomenon with negative consequences that may be experienced by nurses. Creating an instrument to effectively and efficiently measure moral distress in a timely way has been identified as a priority for nursing. This study used a cross-sectional survey design. Data collection for this research occurred in 2009. Participants simultaneously completed either the adult or pediatric version of the Moral Distress Scale version 2009 and the Moral Distress Thermometer. A total of 529 participants from various clinical areas completed both tools. Coefficients alpha were adequate for both Adult (0·90) and Pediatric (0·92) Moral Distress Scale 2009 scales. Statistically significant Pearson correlations were found for the Moral Distress Thermometer with Adult Moral Distress Scale 2009 and Pediatric Moral Distress Scale 2009 and higher Moral Distress Thermometer, Adult Moral Distress Scale 2009 and Pediatric Moral Distress Scale 2009 means for participants who had left or who considered leaving a position because of moral distress. These findings provide support for the validity of the Moral Distress Thermometer. © 2012 Blackwell Publishing Ltd.

Population diversity and dynamics of Streptococcus mitis, Streptococcus oralis, and Streptococcus infantis in the upper respiratory tracts of adults, determined by a nonculture strategy

DEFF Research Database (Denmark)

Bek-Thomsen, Malene; Tettelin, H; Hance, I

2008-01-01

. A culture-independent method was used, based on cloning and sequencing of PCR amplicons of the housekeeping gene gdh, which shows remarkable, yet species-specific, genetic polymorphism. Samples were collected from all potential ecological niches in the oral cavity and pharynx of two adults on two occasions......We reinvestigated the clonal diversity and dynamics of Streptococcus mitis and two other abundant members of the commensal microbiota of the upper respiratory tract, Streptococcus oralis and Streptococcus infantis, to obtain information about the origin of frequently emerging clones in this habitat...... with loss and acquisition from contacts. These findings provide a platform for understanding the mechanisms that govern the balance within the complex microbiota at mucosal sites and between the microbiota and the mucosal immune system of the host....

Comprehensive MR Urography Protocol: Equally Good Diagnostic Performance and Enhanced Visibility of the Upper Urinary Tract Compared to Triple-Phase CT Urography.

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Mazen Sudah

Full Text Available To prospectively compare the diagnostic performance and the visualization of the upper urinary tract (UUT using a comprehensive 3.0T- magnetic resonance urography (MRU protocol versus triple-phase computed tomography urography (CTU.During the study period (January-2014 through December-2015, all consecutive patients in our tertiary university hospital scheduled by a urologist for CTU to exclude UUT malignancy were invited to participate. Diagnostic performance and visualization scores of 3.0T-MRU were compared to CTU using Wilcoxon matched-pairs test.Twenty patients (39 UUT excreting units were evaluated. 3.0T-MRU and CTU achieved equal diagnostic performances. The benign etiology of seven UUT obstructions was clarified equally with both methods. Another two urinary tract malignant tumors and one benign extraurinary tumor were detected and confirmed. Diagnostic visualization was slightly better in the intrarenal cavity areas with CTU but worsened towards distal ureter. MRU showed consistently slightly better visualization of the ureter. In the comparison, full 100% visualizations were detected in all areas in 93.6% (with 3.0T-MRU and 87.2% (with CTU and >75% visualization in 100% (3.0T-MRU and 93.6% (CTU. Mean CTU effective radiation dose was 9.2 mSv.Comprehensive 3.0T-MRU is an accurate imaging modality achieving comparable performance with CTU; since it does not entail exposure to radiation, it has the potential to become the primary investigation technique in selected patients.ClinicalTrials.gov NCT02606513.

Upper respiratory tract infection and mucosal immunity in young ice hockey players during the pre-tournament training period.

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Orysiak, Joanna; Witek, Konrad; Malczewska-Lenczowska, Jadwiga; Zembron-Lacny, Agnieszka; Pokrywka, Andrzej; Sitkowski, Dariusz

2018-02-27

The aim of this study was to determine the effects of 17 days of training during preparation for the Ice Hockey Under 18 World Championship of the Polish ice hockey national team on the mucosal immune function and monitor upper respiratory tract infection (URTI) incidence before, during and after the competition. Twelve male ice hockey players (age 17.7±0.5 years) were recruited for this study. The first saliva/blood collection took place at the beginning of the training camp (without training at the training camp), the second one was conducted on the 9th day of the training camp immediately after the intensification of training, and the third collection was carried out on the 13th day of training (4 days before leaving for the World Championship) in the tapering phase. To assess the mucosal immune function, concentrations of secretory immunoglobulin A (sIgA), sIgA1, and sIgA2 were analyzed in saliva. Cortisol concentration and creatine kinase activity were determined in blood, as indicators of stress and muscle damage, respectively. The Wisconsin Upper Respiratory Symptom Survey-21 questionnaire was used to assess URTI symptoms. A significant increase in the sIgA1 and sIgA2 concentrations was observed in the third collection compared with the second time point (114.45±33.00 vs 77.49±27.29 and 88.97±25.33 vs 71.65±32.44 U, respectively). There were no statistically significant correlations between the URTI incidence and saliva variables. In conclusion, the tapering period positively affects the mucosal immune function, especially sIgA1 and sIgA2 concentrations, with no significant change in frequency of URTI in young ice hockey players.

Microbiota of male genital tract: impact on the health of man and his partner.

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Mändar, Reet

2013-03-01

This manuscript describes the male genital tract microbiota and the significance of it on the host's and his partner's health. Microbiota exists in male lower genital tract, mostly in urethra and coronal sulcus while high inter-subject variability exists. Differences appear between sexually transmitted disease positive and negative men as well as circumcised and uncircumcised men. Upper genital tract is generally germ-free, except in case of infections. Prostatitis patients have frequently abundant polymicrobial communities in their semen, expressed prostatic secretion and/or post-massage urine. Coryneform bacteria have ambivalent role in male urogenital tract being frequently commensals but sometimes associated with prostatitis and urethritis. Interactions between male and female genital tract microbiota are highly likely yet there are very scarce studies on the couples' genital tract microbiota. Increase of bacterial vaginosis-type microbiota and coliforms are the most typical findings in men while the adverse effect of male genital tract bacteria on in vitro fertilization and pregnancy outcome has also been indicated. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Risk for the development of upper gastrointestinal bleeding in children in an intensive care unit].

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Gutiérrez-Gutiérrez, Glenda Karina; Villasís-Keever, Miguel Angel; González-Ortiz, Beatriz; Troconis-Trens, Germán; Tapia-Monge, Dora María; Flores-Calderón, Judith

2014-01-01

Although gastrointestinal tract bleeding can occur at any age, most studies trying to establish causes or risk factors for its development have been conducted in adults. The aim of this study was to determine risk factors in children admitted in a pediatric intensive care unit. A retrospective case-control study was conducted. Children who developed upper gastrointestinal bleeding children during their stay at the intensive care unit were considered the cases. Variables were obtained from medical records including age, sex, nutritional status, mechanical ventilation, use of nasogastric tube, development of complications, presence of coagulopathy, use of prophylaxis for upper gastrointestinal tract bleeding, fasting and use of steroids. Using a multivariate analysis, risk factors were identified, with odds ratios (OR) and 95 % confidence intervals (95 % CI) calculations. Out of 165 patients, 58 had upper gastrointestinal bleeding (35 %). Risk factors identified were prolonged clotting times (OR = 3.35), thrombocytopenia (OR = 2.39), development of sepsis (OR = 6.74) or pneumonia (OR = 4.37). Prophylaxis for upper gastrointestinal bleeding was not a protective factor. Upper gastrointestinal bleeding frequency in children hospitalized in an intensive care unit was high. Identifying risk factors should help to reduce upper gastrointestinal bleeding frequency.

Upper and Lower Urinary Tract Outcomes in Adult Myelomeningocele Patients: A Systematic Review

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Veenboer, Paul W.; Bosch, J. L. H. Ruud; van Asbeck, Floris W. A.; de Kort, Laetitia M. O.

2012-01-01

Background The introduction of sophisticated treatment of bladder dysfunction and hydrocephalus allows the majority of SB patients to survive into adulthood. However, no systematic review on urological outcome in adult SB patients is available and no follow-up schemes exist. Objectives To systematically summarize the evidence on outcome of urinary tract functioning in adult SB patients. Methods A literature search in PubMed and Embase databases was done. Only papers published in the last 25 years describing patients with open SB with a mean age >18 years were included. We focused on finding differences in the treatment strategies, e.g., clean intermittent catheterization and antimuscarinic drugs versus early urinary diversion, with regard to long-term renal and bladder outcomes. Results A total of 13 articles and 5 meeting abstracts on urinary tract status of adult SB patients were found describing a total of 1564 patients with a mean age of 26.1 years (range 3–74 years, with a few patients incontinence. Renal function was studied in 1128 adult patients. In 290/1128 (25.7%; range 3–81.8%) patients some degree of renal damage was found and end-stage renal disease was seen in 12/958 (1.3%) patients. Detrusor-sphincter dyssynergy and detrusor-overactivity acted as adverse prognostic factors for the development of renal damage. Conclusions These findings should outline follow-up schedules for SB patients, which do not yet exist. Since renal and bladder deterioration continues beyond adolescence, follow-up of these individuals is needed. We recommend standardization in reporting the outcome of urinary tract function in adult SB patients. PMID:23119003

Risk factors for lower respiratory tract infections in children

International Nuclear Information System (INIS)

Silfeler, I.; Tanidir, I.C.

2012-01-01

Objectives: Acute respiratory tract infections are divided into two groups as upper and lower respiratory tract infections. These are very common diseases in childhood. In this study, we aimed to determine risk factors for lower respiratory tract in this region. Methodology: Hospital were included in our study. Their examinations, backgrounds, family histories and information about environmental factors were recorded in questionnaire forms. Results: Lack of vaccination, duration of breast feeding, onset age of cow's milk, family history for asthma and food allergy, number of hospitalized people in the same room, number of people who live in same house and smoking around the children were evaluated for the presence of LRTI, and LRTI risks of these factors were respectively observed as 1.69, 1.71, 1.61, 1.69, 1.20, 1.47, 1.56 and 2.63 fold increased. Conclusion: Standardization of clinical diagnosis, accurate and realistic use of antibiotics, correction of nutrition, improvement of socio-economic situation and the elimination of Respiratory Infections. (author)

Children’s pain and distress while undergoing an acute radiographic examination

International Nuclear Information System (INIS)

Björkman, B.; Nilsson, S.; Sigstedt, B.; Enskär, K.

2012-01-01

Pain has been highlighted as a main concern for children in conjunction with an acute radiographic examination. The aim of this study was to further investigate children’s pain and distress while undergoing an acute radiographic examination. The study comprised 29 participants with an age range of 5–15 years who were injured and submitted to an acute radiographic examination of the upper or lower extremity when the question at issue was fracture. The Coloured Analogue Scale (CAS) and the Facial Affective Scale (FAS) were used as self-reporting scales to measure the children’s pain and distress. The Face, Legs, Activity, Cry and Consolability Behavioural scale (FLACC) was used as an observation tool to assess behaviours associated with pain in children. Descriptive statistics were used when analysing the scores, and the results showed that children experience pain and distress in conjunction with a radiographic examination after an injury. Spearman’s correlation was used to compare variables, and significant correlations were obtained between the self-reported pain and the observed pain behaviour. Fischer’s Exact test was used to compare groups, and when using the cut-off 3.0 on the self-reporting scale no significant correlation was found concerning the pain reported by children diagnosed with and without a fracture. No significant correlations were found concerning the self-reported distress and pain either, regardless of whether it was a first-time visit and whether a parent was near during the examination.

Hemostatic powder TC-325 in the management of upper and lower gastrointestinal bleeding: a two-year experience at a single institution.

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Chen, Yen-I; Barkun, Alan; Nolan, Sabrina

2015-02-01

TC-325 is a novel endoscopic hemostatic powder. Our aim was to describe a single-center experience with the use of TC-325 in the upper and lower gastrointestinal tract, while for the first time attempting to determine how long the powder remains on a lesion. The charts of consecutive patients receiving TC-325 therapy between July 2011 and July 2013 were reviewed retrospectively. Primary endpoints included immediate hemostasis and early rebleeding (≤ 72 hours). Overall, 60 patients received 67 treatments with TC-325: 21 for nonmalignant nonvariceal upper gastrointestinal bleeding, 19 for malignant upper gastrointestinal bleeding, 11 for lower gastrointestinal bleeding, and 16 for intra-procedural bleeding. Immediate hemostasis was achieved in 66 cases (98.5 %), with 6 cases (9.5 %) of early rebleeding. No serious adverse events were noted. No TC-325 powder was identified in the 11 patients who underwent second-look endoscopy, performed within 24 hours in 4 patients. TC-325 appears safe and effective for managing bleeding in the upper and lower gastrointestinal tract with a variety of causes. The time during which the powder remains in the gastrointestinal tract is short, with complete elimination from the gastrointestinal tract as early as within 24 hours after use. © Georg Thieme Verlag KG Stuttgart · New York.

Macroscopic sessile tumor architecture is a pathologic feature of biologically aggressive upper tract urothelial carcinoma.

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Fritsche, Hans-Martin; Novara, Giacomo; Burger, Maximilian; Gupta, Amit; Matsumoto, Kazumasa; Kassouf, Wassim; Sircar, Kanishka; Zattoni, Filiberto; Walton, Tom; Tritschler, Stefan; Baba, Shiro; Bastian, Patrick J; Martínez-Salamanca, Juan I; Seitz, Christian; Otto, Wolfgang; Wieland, Wolf Ferdinand; Karakiewicz, Pierre I; Ficarra, Vincenzo; Hartmann, Arndt; Shariat, Shahrokh F

2012-09-01

Macroscopic sessile tumor architecture was associated with adverse outcomes after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). Before inclusion in daily clinical decision-making, the prognostic value of tumor architecture needs to be validated in an independent, external dataset. We tested whether macroscopic tumor architecture improves outcome prediction in an international cohort of patients. We retrospectively studied 754 patients treated with RNU for UTUC without neoadjuvant chemotherapy at 9 centers located in Asia, Canada, and Europe. Tumor architecture was macroscopically categorized as either papillary or sessile. Univariable and multivariable Cox regression analyses were used to address recurrence-free (RFS) and cancer-specific survival (CSS) estimates. Macroscopic sessile architecture was present in 20% of the patients. Its prevalence increased with advancing pathologic stage and it was significantly associated with established features of biologically aggressive UTUC, such as tumor grade, lymph node metastasis, lymphovascular invasion, and concomitant CIS (all P values architecture were 85% and 90%, compared with 58% and 66% for those with macroscopic sessile architecture, respectively (P values architecture was an independent predictor of both RFS (hazard ratio {HR}: 1.5; P = 0.036) and CSS (HR: 1.5; P = 0.03). We confirmed the independent prognostic value of macroscopic tumor architecture in a large, independent, multicenter UTUC cohort. It should be reported in every pathology report and included in post-RNU predictive models in order to refine current clinical decision making regarding follow-up protocol and adjuvant therapy. Copyright © 2012 Elsevier Inc. All rights reserved.

Lifetime risk of distinct upper aerodigestive tract cancers and consumption of alcohol, betel and cigarette.

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Hsu, Wan-Lun; Chien, Yin-Chu; Chiang, Chun-Ju; Yang, Hwai-I; Lou, Pei-Jen; Wang, Cheng-Ping; Yu, Kelly J; You, San-Lin; Wang, Li-Yu; Chen, Shu-Yuan; Yang, Czau-Siung; Chen, Chien-Jen

2014-09-15

The cancer of upper aerodigestive tract (UADT) is a common cancers in the world. However, its lifetime risk by consumption of alcohol, betel and cigarettes remain to be elucidated. This study aimed to estimate lifetime risk of distinct UADT cancers and assess their associations with alcohol, betel and cigarette consumption. Three cohorts of 25,611 men were enrolled in 1982-1992 in Taiwan. The history of alcohol, betel and cigarette consumption was enquired through questionnaire interview. Newly developed UADT cancers were ascertained through computerized linkage with national cancer registry profile. Lifetime (30-80 years old) risk and multivariate-adjusted hazard ratio (HRadj) of distinct UADT cancers by alcohol, betel and cigarette consumption were estimated. A total of 269 pathologically confirmed cases of UADT cancers were newly-diagnosed during 472,096 person-years of follow-up. The lifetime risk of UADT cancer was 9.42 and 1.65% for betel chewers and nonchewers, 3.22 and 1.21% for cigarette smokers and nonsmokers and 4.77 and 1.85% for alcohol drinkers and nondrinkers. The HRadj (95% confidence interval) of developing UADT cancer was 3.36 (2.51-4.49), 2.02 (1.43-2.84), 1.90 (1.46-2.49), respectively, for the consumption of betel, cigarette and alcohol. Alcohol, betel and cigarette had different effect on cancers at various anatomical sites of UADT. The cancer risk from the mouth, pharynx, esophagus to larynx increased for alcohol and cigarette consumption, but decreased for betel consumption. Alcohol, betel and cigarette consumption are independent risk predictors for distinct UADT cancers. © 2014 UICC.

Pregnancy outcome after 1st-trimester inadvertent exposure to barium sulphate as a contrast media for upper gastrointestinal tract radiography.

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Han, B H; Lee, K S; Han, J Y; Choi, J S; Ahn, H K; Ryu, H M; Yang, J H; Han, H W; Nava-Ocampo, A A

2011-10-01

Despite barium being used as a contrast media for decades, the specific assessment of its safety in pregnant women is scarce. We are reporting the favourable pregnancy outcome in women who were inadvertently exposed to barium swallow and associated ionising radiation, early in pregnancy. A control group of age- and gravidity-matched unexposed pregnant women was also included. There were 32 live-born babies in the exposed group and 94 in the control group. Women had undergone diagnostic upper gastrointestinal tract (UGT) fluoroscopic examination at 3.3 ± 1.5 weeks' gestation. Estimated maternal radiation dose secondary to barium swallow varied widely, the maximum dose was estimated to be 2.45 mSv. Similar pregnancy outcomes were observed between the groups. The number of babies born with major malformations was not significantly different (p = 1.0) between cases and controls: one (3.1%) vs three (3.2%), respectively. In conclusion, our small prospective cohort study of women suggests no association between inadvertent exposure to ionising radiation and barium sulphate during fluoroscopic barium swallow and adverse fetal outcomes.

Imaging in childhood urinary tract infection.

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Riccabona, Michael

2016-05-01

Urinary tract infection (UTI) is a common query in pediatric radiology. Imaging for and after UTI is still a heavily debated topic with different approaches, as thorough evidence to decide upon a definite algorithm is scarce. This review article tries to address the clinical rational of the various approaches (general imaging, top-down or bottom-up, selected and individualized imaging concepts…), describes the available imaging modalities and the respective findings in imaging children with UTI, and proposes an imaging algorithm for the work-up of children during and after UTI discussing the "pros and cons" of the different attitudes. In summary, imaging by US is generally considered for all infants and children with a febrile or complicated (upper) UTI, particularly without previously known urinary tract anatomy. The further work-up (searching for renal scarring and assessment of vesico-ureteric reflux) is then decided according to these initial findings as well as the clinical presentation, course, and scenario.

Bladder chondrosarcoma plus urothelial carcinoma in recurred transitional cell carcinoma of the upper urinary tract: a case report and literature review.

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Cho, Min Hyun; Kim, Sung Han; Park, Weon Seo; Joung, Jae Young; Seo, Ho Kyung; Chung, Jinsoo; Lee, Kang Hyun

2016-10-20

Sarcomatoid urothelial carcinoma (SUC) is a rare malignant neoplasm of the urinary bladder comprising 0.2-0.6 % of all histological bladder tumor subtypes. It presents as a high-stage malignancy and exhibits aggressive biological behavior, regardless of the treatment employed. It is defined as histologically indistinguishable from sarcoma and as a high-grade biphasic neoplasm with malignant epithelial and mesenchymal components. The mean age of patients presenting with SUC is 66 years, and the male-to-female ratio is 3:1. In addition, gross hematuria is usually present. The prognosis of SUC is poorer than that of typical urothelial carcinoma because of uncertainty concerning the optimal treatment regimen. We report the case of a 77-year-old woman with SUC containing a chondrosarcoma component who, 12 years previously, had undergone a nephroureterectomy for pT3N0M0 ureter cancer of the contralateral upper urinary tract. From the 4th year of follow-up after nephroureterectomy, multiple recurrent bladder tumors staged as Ta transitional cell carcinoma developed, and six transurethral resections of the bladder (TURB) with multiple intravesical instillations were performed without any evidence of metastases and upper tract recurrences. In 2015, a right partial distal ureterectomy and an additional TURB were performed due to a papillary mass at the right contralateral ureterovesical junction of the bladder, which was confirmed as a high-grade pT1 transitional cell carcinoma. After a further 2 years of follow-up, total pelvic exenteration with an ileal conduit diversion was performed to remove the mass, which was a pT4N0M0 tumor composed of carcinomatous and sarcomatous elements compatible with a sarcomatoid carcinoma including grade 3 transitional cell carcinoma and chondrosarcoma. Immunohistochemical examination showed that tumor cells were positive for vimentin and p63 and negative for NSE and Cd56 markers. In the first postoperative month, a metastatic lung nodule

PATTERN OF ANTIMICROBIAL USE FOR URINARY TRACT INFECTION DURING PREGNANCY IN A TERTIARY CARE TEACHING HOSPITAL

OpenAIRE

Haldia Priyanka, Sharma Taruna, Nautiyal Ruchira

2015-01-01

Background: Urinary Tract Infection (UTI) may be classified as lower (cystitis and asymptomatic bacteriuria) or upper urinary tract infections (pyelonephritis). The recommended antibiotics for use in pregnancy for management of ASB include amoxicillin, oral cephalosporins and nitrofurantoin; and for the treatment of lower UTI during pregnancy include penicillins, oral cephalosporins. Data from the antibiotic usage study in UTI during pregnancy will help in establishing a proper antibiotic uti...

Prevalence of allergy and upper respiratory tract symptoms in runners of the London marathon.

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Robson-Ansley, Paula; Howatson, Glyn; Tallent, Jamie; Mitcheson, Kelly; Walshe, Ian; Toms, Chris; DU Toit, George; Smith, Matt; Ansley, Les

2012-06-01

The prevalence of self-reported upper respiratory tract (URT) symptoms in athletes has been traditionally associated with opportunistic infection during the temporal suppression of immune function after prolonged exercise. There is little evidence for this, and a competing noninfectious hypothesis has been proposed, whereby the exercise-induced immune system modulations favor the development of atopy and allergic disease, which manifests as URT symptoms. The aim of this study was to examine the association between allergy and URT symptoms in runners after an endurance running event. Two hundred eight runners from the 2010 London Marathon completed the validated Allergy Questionnaire for Athletes (AQUA) and had serum analyzed for total and specific immunoglobulin E response to common inhalant allergens. Participants who completed the marathon and nonrunning controls who lived in the same household were asked to complete a diary on URT symptoms. Forty percent of runners had allergy as defined by both a positive AQUA and elevated specific immunoglobulin E. Forty-seven percent of runners experienced URT symptoms after the marathon. A positive AQUA was a significant predictor of postmarathon URT symptoms in runners. Only 19% of nonrunning controls reported symptoms. The prevalence of allergy in recreational marathon runners was similar to that in elite athletes and higher than that in the general population. There was a strong association between a positive AQUA and URT symptoms. The low proportion of households in which both runners and nonrunners were symptomatic suggests that the nature of symptoms may be allergic or inflammatory based rather than infectious. Allergy is a treatable condition, and its potential effect on performance and health may be avoided by accurate clinical diagnosis and management. Both athletes' and coaches' awareness of the potential implications of poorly managed allergy needs to be raised.

Treatment of upper urinary tract stones with extracorporeal shock wave lithotripsy (ESWL) Sonolith vision.

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Nakamura, Kogenta; Tobiume, Motoi; Narushima, Masahiro; Yoshizawa, Takahiko; Nishikawa, Genya; Kato, Yoshiharu; Katsuda, Remi; Zennami, Kenji; Aoki, Shigeyuki; Yamada, Yoshiaki; Honda, Nobuaki; Sumitomo, Makoto

2011-12-12

The aim was to retrospectively assess the results of treatment of upper urinary tract stones with the Sonolith vision manufactured by EDAP, and purchased in 2004. The subjects were 226 Japanese patients who underwent extracorporeal shock wave lithotripsy (ESWL) alone as an initial treatment and could be followed up for at least 3 months, selected from 277 candidate patients who underwent this therapy between 2004 and 2006. Treatment effect was evaluated by kidney, ureter, and bladder X-ray or renal ultrasonography at 1 and 3 months after treatment. A stone-free status or status of stone fragmentation to 4 mm or smaller was considered to indicate effective treatment. At 3 months after treatment, the stone-free rate was 69.4% and the efficacy rate was 77.4% for renal stones, while these rates were 91.5 and 93.3%, respectively for ureteral stones. Assessment of treatment effect classified by the location of stones revealed a stone-free rate of 94.6% and an efficacy rate of 94.6% for lower ureteral stones (4.0 mm or smaller, 1 subject; 4.1-10.0 mm, 31 subjects; 10.1-20.0 mm, 5 subjects: number of treatment sessions, 1 or 2 sessions [mean: 1.03 sessions]). Complications of this therapy included renal subcapsular hematoma and pyelonephritis in 1 case each. ESWL with the Sonolith vision manufactured by EDAP produced a treatment effect equivalent to those achieved with other models of ESWL equipment. ESWL seems to be an effective first-line treatment also in patients who have lower ureteral stones 10 mm or larger but do not wish to undergo TUL, if measures such as suitable positioning of the patient during treatment are taken.

Treatment of upper urinary tract stones with extracorporeal shock wave lithotripsy (ESWL Sonolith vision

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Nakamura Kogenta

2011-12-01

Full Text Available Abstract Background The aim was to retrospectively assess the results of treatment of upper urinary tract stones with the Sonolith vision manufactured by EDAP, and purchased in 2004. Methods The subjects were 226 Japanese patients who underwent extracorporeal shock wave lithotripsy (ESWL alone as an initial treatment and could be followed up for at least 3 months, selected from 277 candidate patients who underwent this therapy between 2004 and 2006. Treatment effect was evaluated by kidney, ureter, and bladder X-ray or renal ultrasonography at 1 and 3 months after treatment. A stone-free status or status of stone fragmentation to 4 mm or smaller was considered to indicate effective treatment. Results At 3 months after treatment, the stone-free rate was 69.4% and the efficacy rate was 77.4% for renal stones, while these rates were 91.5 and 93.3%, respectively for ureteral stones. Assessment of treatment effect classified by the location of stones revealed a stone-free rate of 94.6% and an efficacy rate of 94.6% for lower ureteral stones (4.0 mm or smaller, 1 subject; 4.1-10.0 mm, 31 subjects; 10.1-20.0 mm, 5 subjects: number of treatment sessions, 1 or 2 sessions [mean: 1.03 sessions]. Complications of this therapy included renal subcapsular hematoma and pyelonephritis in 1 case each. Conclusions ESWL with the Sonolith vision manufactured by EDAP produced a treatment effect equivalent to those achieved with other models of ESWL equipment. ESWL seems to be an effective first-line treatment also in patients who have lower ureteral stones 10 mm or larger but do not wish to undergo TUL, if measures such as suitable positioning of the patient during treatment are taken.

Seroepidemiology of upper respiratory tract disease in the desert tortoise of California

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Brown, Mary B.; Berry, Kristin H.; Schumacher, Isabella M.; Nagy, Kenneth A.; Christopher, Mary M.; Klein, Paul A.

1999-01-01

Several factors have combined with an upper respiratory tract disease (URTD) to produce declines on some population numbers of desert tortoises (Gopherus agassizii) in the western USA. This study was designed to determine the seroepidemiology of URTD in a population of wild adult tortoises at the Desert Tortoise Research Natural Area (DTNA) study site in Kern County (California, USA). Prior to initiation of the study, there was a dramatic decline in the number of individuals in this population. At each individual time point, samples were obtained from 12 to 20 tortoises with radiotransmitters during winter, spring, summer, and fall from 1992 through 1995. During the course of the study, 35 animals were sampled at one or more times. Only 10 animals were available for consistent monitoring throughout the 4 yr period. Specific antibody (Ab) levels to Mycoplasma agassizii were determined for individual tortoises by an enzyme-linked immunosorbent assay (ELISA) test. Specific Ab levels were not influenced by the gender of the tortoise. Levels of Ab and distribution of ELISA+, ELISA– and suspect animals were not consistently affected by season within a single year or for a season among the study years. Significantly more tortoises presented with clinical signs in 1992 and 1995. The profile of ELISA+ animals with clinical signs shifted from 5% (1992) to 42% (1995). In 1992, 52% of tortoises lacked clinical signs and were ELISA–. In 1995, this category accounted for only 19% of tortoises. Based on the results of this study, we conclude that URTD was present in this population as evidenced by the presence of ELISA+ individual animals, and that the infectious agent is still present as evidenced by seroconversion of previously ELISA– animals during the course of the study. There is evidence to suggest that animals may remain ELISA+ without showing overt disease, a clinical pattern consistent with the chronic nature of most mycoplasmal infections. Further, there are

Recent Update of Embolization of Upper Gastrointestinal Tract Bleeding

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Shin, Ji Hoon [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

2012-02-15

Nonvariceal upper gastrointestinal (UGI) bleeding is a frequent complication with significant morbidity and mortality. Although endoscopic hemostasis remains the initial treatment modality, severe bleeding despite endoscopic management occurs in 5-10% of patients, necessitating surgery or interventional embolotherapy. Endovascular embolotherapy is now considered the first-line therapy for massive UGI bleeding that is refractory to endoscopic management. Interventional radiologists need to be familiar with the choice of embolic materials, technical aspects of embolotherapy, and the factors affecting the favorable or unfavorable outcomes after embolotherapy for UGI bleeding.

Difficult identification of Haemophilus influenzae, a typical cause of upper respiratory tract infections, in the microbiological diagnostic routine.

Science.gov (United States)

Hinz, Rebecca; Zautner, Andreas Erich; Hagen, Ralf Matthias; Frickmann, Hagen

2015-03-01

Haemophilus influenzae is a key pathogen of upper respiratory tract infections. Its reliable discrimination from nonpathogenic Haemophilus spp. is necessary because merely colonizing bacteria are frequent at primarily unsterile sites. Due to close phylogenetic relationship, it is not easy to discriminate H. influenzae from the colonizer Haemophilus haemolyticus. The frequency of H. haemolyticus isolations depends on factors like sampling site, patient condition, and geographic region. Biochemical discrimination has been shown to be nonreliable. Multiplex PCR including marker genes like sodC, fucK, and hpd or sequencing of the 16S rRNA gene, the P6 gene, or multilocus-sequence-typing is more promising. For the diagnostic routine, such techniques are too expensive and laborious. If available, matrix-assisted laser-desorption-ionization time-of-flight mass spectrometry is a routine-compatible option and should be used in the first line. However, the used database should contain well-defined reference spectra, and the spectral difference between H. influenzae and H. haemolyticus is small. Fluorescence in-situ hybridization is an option for less well-equipped laboratories, but the available protocol will not lead to conclusive results in all instances. It can be used as a second line approach. Occasional ambiguous results have to be resolved by alternative molecular methods like 16S rRNA gene sequencing.

What Is Respiratory Distress Syndrome?

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... Home / Respiratory Distress Syndrome Respiratory Distress Syndrome Also known as What Is Respiratory ... This condition is called apnea (AP-ne-ah). Respiratory Distress Syndrome Complications Depending on the severity of ...

Results of endoscopic vacuum-assisted closure device for treatment of upper GI leaks.

Science.gov (United States)

Bludau, Marc; Fuchs, Hans F; Herbold, Till; Maus, Martin K H; Alakus, Hakan; Popp, Felix; Leers, Jessica M; Bruns, Christiane J; Hölscher, Arnulf H; Schröder, Wolfgang; Chon, Seung-Hun

2018-04-01

Esophageal perforations and postoperative leakage of esophagogastrostomies are considered to be life-threatening conditions due to the potential development of mediastinitis and consecutive sepsis. Vacuum-assisted closure (VAC) techniques, a well-established treatment method for superficial infected wounds, are based on a negative pressure applied to the wound via a vacuum-sealed sponge. Endoluminal VAC (E-VAC) therapy as a treatment for GI leakages in the rectum was introduced in 2008. E-VAC therapy is a novel method, and experience regarding esophageal applications is limited. In this retrospective study, the experience of a high-volume center for upper GI surgery with E-VAC therapy in patients with leaks of the upper GI tract is summarized. To our knowledge, this series presents the largest patient cohort worldwide in a single-center study. Between October 2010 and January 2017, 77 patients with defects in the upper gastrointestinal tract were treated using the E-VAC application. Six patients had a spontaneous perforation, 12 patients an iatrogenic injury, and 59 patients a postoperative leakage in the upper gastrointestinal tract. Complete restoration of the esophageal defect was achieved in 60 of 77 patients. The average duration of application was 11.0 days, and a median of 2.75 E-VAC systems were used. For 21 of the 77 patients, E-VAC therapy was combined with the placement of self-expanding metal stents. This study demonstrates that E-VAC therapy provides an additional treatment option for esophageal wall defects. Esophageal defects and mediastinal abscesses can be treated with E-VAC therapy where endoscopic stenting may not be possible. A prospective multi-center study has to be directed to bring evidence to the superiority of E-VAC therapy for patients suffering from upper GI defects.

Moral distress in emergency nurses.

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Fernandez-Parsons, Robin; Rodriguez, Lori; Goyal, Deepika

2013-11-01

For nurses, moral distress leads to burnout, attrition, compassion fatigue, and patient avoidance. Using a quantitative, cross-sectional, and descriptive design, we assessed the frequency, intensity, and type of moral distress in 51 emergency nurses in 1 community hospital using a 21-item, self-report, Likert-type questionnaire. Results showed a total mean moral distress level of 3.18, indicative of overall low moral distress. Situations with the highest levels of moral distress were related to the competency of health care providers and following family wishes to continue life support, also known as futile care. Moral distress was the reason given by 6.6% of registered nurses for leaving a previous position, 20% said that they had considered leaving a position but did not, and 13.3% stated that they are currently considering leaving their position because of moral distress. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

Phytase in non-ruminant animal nutrition: a critical review on phytase activities in the gastrointestinal tract and influencing factors.

Science.gov (United States)

Dersjant-Li, Yueming; Awati, Ajay; Schulze, Hagen; Partridge, Gary

2015-03-30

This review focuses on phytase functionality in the digestive tract of farmed non-ruminant animals and the factors influencing in vivo phytase enzyme activity. In pigs, feed phytase is mainly active in the stomach and upper part of the small intestine, and added phytase activity is not recovered in the ileum. In poultry, feed phytase activities are mainly found in the upper part of the digestive tract, including the crop, proventriculus and gizzard. For fish with a stomach, phytase activities are mainly in the stomach. Many factors can influence the efficiency of feed phytase in the gastrointestinal tract, and they can be divided into three main groups: (i) phytase related; (ii) dietary related and (iii) animal related. Phytase-related factors include type of phytase (e.g. 3- or 6-phytase; bacterial or fungal phytase origin), the pH optimum and the resistance of phytase to endogenous protease. Dietary-related factors are mainly associated with dietary phytate content, feed ingredient composition and feed processing, and total P, Ca and Na content. Animal-related factors include species, gender and age of animals. To eliminate the antinutritional effects of phytate (IP6), it needs to be hydrolyzed as quickly as possible by phytase in the upper part of the digestive tract. A phytase that works over a wide range of pH values and is active in the stomach and upper intestine (along with several other characteristics and in addition to being refractory to endogenous enzymes) would be ideal. © 2014 The Authors. Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Antibiotic Resistance of Urinary Tract Infection of Children Under 14 Years Admitted To The Pediatric Clinic of Imam Sajjad Hospital, 2012

OpenAIRE

F Asadi Manesh F; A Sharifi; Z Mohammad Hosini; H Nasrolahi; N Hosseini; A Kalantari; SAM Khosravani

2014-01-01

Background & aim: Urinary tract infection is the most common childhood infections after upper respiratory tract infection. Early diagnosis, proper treatment and appropriate patient follow-up can lead to a significant reduction in symptoms. The purpose of this study was to determine the antimicrobial resistance of urinary tract infection in children under 14 years admitted to the pediatric clinic of Imam Sajjad (AS) Yasooj. Methods: Methods: In this cross-sectional study antibiotic sensiti...

Carbohydrate-Dependent, Exercise-Induced Gastrointestinal Distress

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Erick Prado de Oliveira

2014-10-01

Full Text Available Gastrointestinal (GI problems are a common concern of athletes during intense exercise. Ultimately, these symptoms can impair performance and possibly prevent athletes from winning or even finishing a race. The main causes of GI problems during exercise are mechanical, ischemic and nutritional factors. Among the nutritional factors, a high intake of carbohydrate and hyperosmolar solutions increases GI problems. A number of nutritional manipulations have been proposed to minimize gastrointestinal symptoms, including the use of multiple transportable carbohydrates. This type of CHO intake increases the oxidation rates and can prevent the accumulation of carbohydrate in the intestine. Glucose (6% or glucose plus fructose (8%–10% beverages are recommended in order to increase CHO intake while avoiding the gastric emptying delay. Training the gut with high intake of CHO may increase absorption capacity and probably prevent GI distress. CHO mouth rinse may be a good strategy to enhance performance without using GI tract in exercises lasting less than an hour. Future strategies should be investigated comparing different CHO types, doses, and concentration in exercises with the same characteristics.

Parental views of antibiotic use in children with upper respiratory ...

African Journals Online (AJOL)

Purpose: To assess the knowledge, attitudes and practices of parents towards antibiotics use for upper respiratory tract infections (URTIs) in Jordan. Methods: A cross-sectional study was carried out at 10 private outpatients' pediatric clinics across Amman-Jordan from September to December 2013. During the study period, ...

New markers of urinary tract infection.

Science.gov (United States)

Masajtis-Zagajewska, Anna; Nowicki, Michal

2017-08-01

Urinary tract infection (UTI) is the most common bacterial infection independent of age. It is also one of the most common causes of hospitalizations for infections among elderly people and the most common indication for antibiotic prescriptions in primary care. Both diagnostics and management of lower and upper urinary tract infections provide challenges in clinical practice due to their high prevalence and recurrence, and worldwide increase of antibiotic resistance. The clinical symptoms of UTI are often uncharacteristic or asymptomatic. The accurate diagnosis and early treatment are crucial due to risk of septicaemia and long-term consequences. Currently the diagnosis of urinary tract infection is based on the presence of clinical symptoms in combination with the results of nitrite strip test indicating the presence of bacteria in urine and semi-quantitative measurement of white blood cells count in urine. Although urine culture is the gold standard in UTI diagnostics it is both time-consuming and costly. Searching for novel biomarkers of UTI has attracted much attention in recent years. The article reviews several promising serum and urine biomarkers of UTI such as leukocyte esterase, C-reactive protein, procalcitonin, interleukins, elastase alpha (1)-proteinase inhibitor, lactofferin, secretory immunoglobulin A, heparin-binding protein, xanthine oxidase, myeloperoxidase, soluble triggering receptor expressed on myeloid cells-1, α-1 microglobulin (α1Mg) and tetrazolium nitroblue test (TNB). Copyright © 2017 Elsevier B.V. All rights reserved.

47 CFR 80.1111 - Distress alerting.

Science.gov (United States)

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates...

[Efficacy and tolerance of fenspiride in adult patients with acute respiratory tract infections].

Science.gov (United States)

Płusa, T; Nawacka, D

1998-12-01

Fenspiride is an antiinflammatory drug targeted for the respiratory tract. In our study clinical efficacy and tolerance of drug were evaluated in 392 adult patients with acute respiratory tract infections. According to clinical criteria all observed symptoms were classified as mild, moderate and severe. The most of observed patients were included into moderate symptom score. Cough and nose obturation were dominant symptoms. All noticed changes in the upper respiratory tract were decreased after fenspiride therapy in 7 days trial. In 168 observed patients systemic and in 60 local acting antibiotics were successfully applied. Excellent tolerance of fenspiride was documented in 59% and good tolerance --in 34% of patients. Observed adverse reactions were classified as mild and in 20 patients fenspiride was rejected. Authors suggest that fenspiride therapy is save and successful in patient with acute respiratory tract infection. Good results in patients with bronchitis in decreasing of bronchospasm indicate fenspiride as a good tool in bronchial infection.

Assessment of work intensification by managers and psychological distressed and non-distressed employees: a multilevel comparison.

Science.gov (United States)

Bamberger, Simon Grandjean; Larsen, Anelia; Vinding, Anker Lund; Nielsen, Peter; Fonager, Kirsten; Nielsen, René Nesgaard; Ryom, Pia; Omland, Øyvind

2015-01-01

Work intensification is a popular management strategy to increase productivity, but at the possible expense of employee mental stress. This study examines associations between ratings of work intensification and psychological distress, and the level of agreement between compared employee-rated and manager-rated work intensification. Multi-source survey data were collected from 3,064 employees and 573 company managers from the private sector in 2010. Multilevel regression models were used to compare different work intensification ratings across psychological distress strata. Distressed employees rated higher degree of total work intensification compared to non-distressed employees, and on three out of five sub ratings there were an increased prevalence of work intensification in the case group. In general, there was poor agreement between employee and company work intensification rating. Neither manager-rated work intensification nor employee/manager discrepancy in work intensification ratings was associated with psychological distress. Distressed employees had a higher total score of employee/manager agreed work intensification, and a higher prevalence of increased demands of labour productivity. This study demonstrates higher ratings of employee/manager agreed work intensification in distressed employees compared to non-distressed employees, challenging previous findings of reporting bias in distressed employees' assessment of work environment.

Psychological distress among homeless adults.

Science.gov (United States)

Gelberg, L; Linn, L S

1989-05-01

Recent studies have reported a high prevalence of mental illness among the homeless. As part of a community-based survey of 529 homeless adults, we developed and tested a model to increase our understanding of the factors related to their psychological distress. Using a previously validated and reliable scale of perceived psychological distress, we found that homeless adults were more likely to report psychological distress than the general population (80% vs. 49%). Distress levels were not associated with most demographic or homeless characteristics or general appearance. However, distress was related to unemployment, greater cigarette and alcohol use, worse physical health, fewer social supports, and perceived barriers to obtaining needed medical care. Since mental, physical, and social health are strongly related among homeless adults, alleviating distress among them may be most effectively done by implementing a broad-based health services package coupled with employment programs provided in an accessible service delivery setting.

Radiation necrosis of the optic chiasm, optic tract, hypothalamus, and upper pons after radiotherapy for pituitary adenoma, detected by gadolinium-enhanced, T1-weighted magnetic resonance imaging: Case report

International Nuclear Information System (INIS)

Tachibana, O.; Yamaguchi, N.; Yamashima, T.; Yamashita, J.

1990-01-01

A 26-year-old woman was treated for a prolactin secreting pituitary adenoma by surgery and radiotherapy (5860 rads). Fourteen months later, she developed right hemiparesis and dysarthria. A T1-weighted magnetic resonance imaging scan using gadolinium contrast showed a small, enhanced lesion in the upper pons. Seven months later, she had a sudden onset of loss of vision, and radiation optic neuropathy was diagnosed. A T1-weighted magnetic resonance imaging scan showed widespread gadolinium-enhanced lesions in the optic chiasm, optic tract, and hypothalamus. Magnetic resonance imaging is indispensable for the early diagnosis of radiation necrosis, which is not visualized by radiography or computed tomography

A roentgenologic study of diverticular throughout the entire gastrointestinal tract

International Nuclear Information System (INIS)

Sohn, Myung Hee; Song, Ho Young; Lim, Kyu Yeob

1983-01-01

Diverticulum is considered as a common lesion involving any gastrointestinal tract from the pharynx to the rectum. We reviewed 5,806 cases of upper G-I series and 801 cases of double contrast barium enema during the period from Jan.1978 to Dec. 1981 in the Department of Radiology, School of Medicine, Jeonbug National University Hospital to analyze diverticula of the entire gastrointestinal tract. The results were as follows: 1. Roentgen examination of 5,806 esophagus, stomachs, duodenums and small bowels, and 801 colons during the past four years: diverticula of the esophagus, 60 cases (1.0%); diverticula of the stomach, 42 cases (0.7%); diverticula of the duodenum, 358 cases (6.2%); diverticula of the small bowel, 20 cases (0.3%); diverticula of the colon, 26 cases (3.2%). The location of diverticula in order of frequency was duodenum, colon, esophagus, stomach and small bowel. 2. The most common site of diverticula of each gastrointestinal tract was as follows: diverticula of the esophagus, middle portion (84.7%); diverticula of the stomach, the cardia (59.5%); diverticula of the duodenum, the second portion (81.3%); diverticula of the small bowel, the jejunum (96.4%)-especially the larger percentage were observed at the upper jejunum near the ligament of Treitz; diverticula of the colon, the right sided colon (80.8%)-the cecum and ascending colon (57.1%). 3. Diverticula may occur at any age. The majority of diverticula of the entire gastrointestinal tract were observed over 40 years of age. Especially in diverticula of the duodenum and colon, their frequency increase with age. 4. Duodenal diverticula were observed more frequently in woman than in man but in diverticula of the esophagus, stomach, small bowel and colon, male was more frequently affected. 5. The size of diverticula of the entire gastrointestinal tract was variable. The majority of diverticula of the esophagus, stomach, duodenum and small bowel were intermediate in size (10-49 mm). Diverticula of

Who is Distressed Applying the Diabetes Related Distress Scale in a Diabetes Clinic

Science.gov (United States)

2017-06-09

59 MDW /SGVU SUBJECT: Professional Presentation Approval 7APR 2017 1. Your paper, entitled Who is Distressed? Applying the Diabetes -Related Distress...Scale in A Diabetes Clinic presented at/published to American Diabetes Association 2017 Meeting, San Francisco, CA (National Conference), 9-16 June...as a publication/presentation, a new 59 MOW Form 3039 must be submitted for review and approval.) Using the Diabetes -Related Distress Scale in

Diagnostic accuracy of indirect laryngoscopy and x-ray neck in the diagnosis of fish bone impaction in upper aero digestive tract

International Nuclear Information System (INIS)

Kundi, N.; Mehmood, T.

2015-01-01

This study was aimed at finding the validity of indirect laryngoscopy (IDL) and neck X-Rays in the diagnosis of fish bone impaction. Study Design: Validation study. Place and Duration of Study: CMH Nowshera from August 2012 to February 2013. Material and Methods: A total of 50 patients were selected by consecutive sampling presenting with history of fishbone impaction in aerodigestive tract. IDL examination and neck X-rays were performed and findings were recorded. Those with no fishbone on both the investigations were discharged from hospital with follow up after 03 days. Those with fishbone detected on either of investigations underwent removal. Fishbone easily approachable were removed under local anaesthesia with foreceps and in others Endoscopy (Direct laryngoscopy or Oesophagoscopy) was performed under General Anaesthesia. Sensitivities and specificities of both the modalities were calculated using standard 2/2 Table. ROC curve analysis was carried out and significance level p < 0.05 was taken as significant. Results: In 20 patients no fishbone was found, 26 patients were diagnosed on IDL and in 04 patients fishbone was detected by neck X-Rays. Most common site for fishbone impaction was pharyngeal tonsil. In 22 patients fishbone was removed with foreceps and in 08 patients endoscopy was performed. Diagnostic accuracy for IDL 86% and Neck X-Rays 48% was calculated. ROC curve analysis revealed AUC for IDL 0.933 and Significance level (P) as <0.0001. ROC curve analysis for X-ray gives AUC of 0.567 and Significance level (p) 0.4132. Conclusion: IDL shows higher diagnostic accuracy than neck X-Rays for detection of fishbone in upper aerodigestive tract. Neck X-rays are more useful for impacted foreign bodies in oesophagus. (author)

Idioms of distress: alternatives in the expression of psychosocial distress: a case study from South India.

Science.gov (United States)

Nichter, M

1981-12-01

This paper focuses attention on alternative modes of expressing distress and the need to analyze particular manifestations of distress in relation to personal and cultural meaning complexes as well as the availability and social implications of coexisting idioms of expression. To illustrate this point the case of South Kanarese Havik Brahmin women is presented. These women are described as having a weak social support network and limited opportunities to ventilate feelings and seek counsel outside the household. Alternative means of expressing psychosocial distress resorted to by Havik women are discussed in relation to associated Brahminic values, norms and stereotypes. Somatization is focused upon as an important idiom through which distress is communicated. Idioms of distress more peripheral to the personal or cultural behavioral repertoire of Havik women are considered as adaptive responses in circumstances where other modes of expression fail to communicate distress adequately or provide appropriate coping strategies. The importance of an 'idioms of distress' approach to psychiatric evaluation is noted.

Knowledge, attitudes, and behaviors regarding antibiotic use for upper respiratory tract infections: a survey of Thai students.

Science.gov (United States)

Saengcharoen, Woranuch; Lerkiatbundit, Sanguan; Kaewmang, Kanchana

2012-09-01

The objectives of this study were to determine knowledge, attitudes, and behaviors of antibiotic use in upper respiratory tract infections (URI) among students at different educational levels (Grade 12 students and high vocational students) and to examine factors influencing antibiotic use for URI. A cross sectional questionnaire survey was used with students in one large and one small city in Thailand. Of 712 respondents, more than 75% of all groups had misconceptions on the benefits of antibiotics. Grade 12 students, especially those in the big city, had the highest knowledge scores about antibiotic use in URI, while high vocational students had the lowest. Incomplete taking of a course of antibiotic treatment recommended by health providers was found in more than 45% of respondents in each group. In addition, approximately half of them had taken antibiotics for less than 5 days. Knowledge about antibiotic use in URI, attitudes towards antibiotic use, attitudes towards antibiotic prescribing for treating colds by physicians and by drugstores, belief in the common use of antibiotics for colds, and expectations of receiving antibiotics from physicians significantly influenced intentions and behaviors about antibiotic use. Students had misconceptions on antibiotic use for URI. The Ministry of Education should incorporate information on proper antibiotic use in the formal health education. Reliable sources of information on the correct use of antibiotics should also be more widely available to improve the use of antibiotics.

Bronchiolitis from nitrous fumes

Energy Technology Data Exchange (ETDEWEB)

Darke, C S; Warrack, A J.N.

1958-01-01

Gases of low solubility (e.g., NO/sub 2/) may not irritate upper respiratory tract but may act insidiously on lower tract producing edema and bronchiolitis. Cases of bronchiolitis (1 resulting in death) from exposure to brown nitrous fumes are reported. There were no or slight symptoms at first but severe ones after about 1 wk. Pathology appears as acute pulmonary edema with damage and desquamation of alveolar epithelium particularly and that of respiratory bronchioles somewhat. Patchy atelectasis, bronchopneumonia and disruption of fibers in cell walls may also occur. Severe cases have obliteration of lumen (bronchiolitis obliterans) with extreme distress and death.

Quantification of tumor infiltrating Foxp3+ regulatory T cells enables the identification of high-risk patients for developing synchronous cancers over upper aerodigestive tract.

Science.gov (United States)

Wang, Wen-Lun; Chang, Wei-Lun; Yang, Hsiao-Bai; Chang, I-Wei; Lee, Ching-Tai; Chang, Chi-Yang; Lin, Jaw-Town; Sheu, Bor-Shyang

2015-07-01

Patients with squamous cell carcinomas (SCC) of upper aerodigestive tract, either over head and neck (HNSCC) or esophagus (ESCC), frequently developed synchronous multiple cancers, leading to worse prognosis. This study validated whether suppression of host cancer immunosurveillance mediated by regulatory T cells (Treg) may predispose to the development of synchronous cancers. Tumor tissues of 200 patients (100 ESCC only, 50 HNSCC only, and 50 synchronous SCCs) were quantitatively accessed for the tumor infiltrating Treg by immunohistochemistry. The density of Treg was also correlated to the level of Treg-associated inhibitory cytokines (IL-10, IL-35 and TGF-β1), and chemokine (CCL22). The density of tumor infiltrating Treg in the index tumor (i.e. the first malignancy diagnosed) of synchronous SCC group was higher than those of HNSCC or ESCC only (prisk of synchronous cancer development to initiate a proper surveillance program. Copyright © 2015 Elsevier Ltd. All rights reserved.

Acute respiratory distress syndrome

Science.gov (United States)

... page: //medlineplus.gov/ency/article/000103.htm Acute respiratory distress syndrome To use the sharing features on this page, please enable JavaScript. Acute respiratory distress syndrome (ARDS) is a life-threatening lung ...

[Diagnosis and clinical management of urinary tract infection].

Science.gov (United States)

Heilberg, Ita Pfeferman; Schor, Nestor

2003-01-01

A review about recent aspects on diagnosis and clinical management of urinary tract infection (UTI) is presented. There is a wide variation in clinical presentation of UTI which include different forms as cystitis, pyelonephritis, urethral syndrome and the clinical relevance of asymptomatic bacteriuria and low-count bacteriuria that must be distinguished from contamination. Pathogenetic aspects concerning bacterial virulence as well as host factors in susceptibility to UTI as urinary tract obstruction, vesicoureteral reflux, indwelling bladder catheters, pregnancy, diabetes mellitus, sexual activity, contraceptive methods, prostatism, menopause, advanced age and renal transplantation are discussed. Diagnostic criteria and the most common tests utilized for differentiation between lower and upper UTI have been reviewed. The authors conclude that a careful evaluation of the underlying factors is required for the correct diagnosis of UTI and to prevent recurrence and that appropriate strategies and specific therapeutic regimens may maximize the benefit while reducing costs and adverse reactions.

A genome-wide association study of upper aerodigestive tract cancers conducted within the INHANCE consortium.

LENUS (Irish Health Repository)

McKay, James D

2011-03-01

Genome-wide association studies (GWAS) have been successful in identifying common genetic variation involved in susceptibility to etiologically complex disease. We conducted a GWAS to identify common genetic variation involved in susceptibility to upper aero-digestive tract (UADT) cancers. Genome-wide genotyping was carried out using the Illumina HumanHap300 beadchips in 2,091 UADT cancer cases and 3,513 controls from two large European multi-centre UADT cancer studies, as well as 4,821 generic controls. The 19 top-ranked variants were investigated further in an additional 6,514 UADT cancer cases and 7,892 controls of European descent from an additional 13 UADT cancer studies participating in the INHANCE consortium. Five common variants presented evidence for significant association in the combined analysis (p ≤ 5 × 10⁻⁷). Two novel variants were identified, a 4q21 variant (rs1494961, p = 1×10⁻⁸) located near DNA repair related genes HEL308 and FAM175A (or Abraxas) and a 12q24 variant (rs4767364, p =2 × 10⁻⁸) located in an extended linkage disequilibrium region that contains multiple genes including the aldehyde dehydrogenase 2 (ALDH2) gene. Three remaining variants are located in the ADH gene cluster and were identified previously in a candidate gene study involving some of these samples. The association between these three variants and UADT cancers was independently replicated in 5,092 UADT cancer cases and 6,794 controls non-overlapping samples presented here (rs1573496-ADH7, p = 5 × 10⁻⁸); rs1229984-ADH1B, p = 7 × 10⁻⁹; and rs698-ADH1C, p = 0.02). These results implicate two variants at 4q21 and 12q24 and further highlight three ADH variants in UADT cancer susceptibility.

A genome-wide association study of upper aerodigestive tract cancers conducted within the INHANCE consortium.

Directory of Open Access Journals (Sweden)

James D McKay

2011-03-01

Full Text Available Genome-wide association studies (GWAS have been successful in identifying common genetic variation involved in susceptibility to etiologically complex disease. We conducted a GWAS to identify common genetic variation involved in susceptibility to upper aero-digestive tract (UADT cancers. Genome-wide genotyping was carried out using the Illumina HumanHap300 beadchips in 2,091 UADT cancer cases and 3,513 controls from two large European multi-centre UADT cancer studies, as well as 4,821 generic controls. The 19 top-ranked variants were investigated further in an additional 6,514 UADT cancer cases and 7,892 controls of European descent from an additional 13 UADT cancer studies participating in the INHANCE consortium. Five common variants presented evidence for significant association in the combined analysis (p ≤ 5 × 10⁻⁷. Two novel variants were identified, a 4q21 variant (rs1494961, p = 1×10⁻⁸ located near DNA repair related genes HEL308 and FAM175A (or Abraxas and a 12q24 variant (rs4767364, p =2 × 10⁻⁸ located in an extended linkage disequilibrium region that contains multiple genes including the aldehyde dehydrogenase 2 (ALDH2 gene. Three remaining variants are located in the ADH gene cluster and were identified previously in a candidate gene study involving some of these samples. The association between these three variants and UADT cancers was independently replicated in 5,092 UADT cancer cases and 6,794 controls non-overlapping samples presented here (rs1573496-ADH7, p = 5 × 10⁻⁸; rs1229984-ADH1B, p = 7 × 10⁻⁹; and rs698-ADH1C, p = 0.02. These results implicate two variants at 4q21 and 12q24 and further highlight three ADH variants in UADT cancer susceptibility.

Association of sugary beverages with survival among patients with cancers of the upper aerodigestive tract

Science.gov (United States)

Miles, Fayth L.; Chang, Shen-Chih; Morgenstern, Hal; Tashkin, Donald; Rao, Jian-Yu; Cozen, Wendy; Mack, Thomas; Lu, Qing-Yi

2017-01-01

Purpose The role of consumption of added sugars in cancers of the upper aerodigestive tract (UADT) is unclear. We examined associations between sugary beverages and susceptibility to UADT cancer as well as overall survival among UADT cancer patients. Methods The association between dietary added sugar and susceptibility to UADT cancers or overall survival among 601 UADT cancer cases was evaluated using data from a population-based case–control study conducted in Los Angeles County. Unconditional logistic regression was used to estimate odds ratios and 95 % confidence intervals (CI) for cancer susceptibility, and Cox regression was used to estimate hazards ratios (HRs) with 95 % CIs for survival, adjusting for relevant confounders. Results A total of 248 deaths were observed during follow-up (median 12.1 years). A positive association was observed with consumption of grams of sugar from beverages, including soft drinks and fruit juices, and poorer survival among UADT cancer cases (aHR, Q4 vs. Q1:1.88; 95 % CI 1.29, 2.72; p for trend = 0.002), as well as servings of sugary beverages (aHR, Q4 vs. Q1: 95 % CI 1.97, 95 % CI 1.32–2.93). This was due largely to consumption of sugars from soft drinks. Particularly, high consumption of sugary beverages was associated with poorer survival among esophageal cancer cases, driven by squamous cancers. No association was observed between sugary beverages and cancer susceptibility. Conclusion These findings suggest that consumption of sugary beverages may decrease survival associated with UADT cancers. Additional studies should be conducted to examine survival among cancer patients consuming high amounts of added or refined sugars. Such studies may highlight prognostic factors for UADT cancers. PMID:27539643

Human Papillomavirus and Upper Aerodigestive Tract Neoplasm: A Review Literature from Mexico and Colombia / Virus del papiloma humano y el cáncer de cabeza y cuello: revisión de la literatura desde México y Colombia

OpenAIRE

Rocha Buelvas, Anderson; Grupo de Gestión del Conocimiento de Observatorios, Registros y Sistemas de Información, Dirección de Epidemiología y Demografía, Ministerio de Salud y Protección Social, Bogotá; Bologna Molina, Ronell; Escuela de Odontología, Universidad Juárez del Estado de Durango; Rocha Buelvas, Cristian; Universidad Nacional de Colombia sede Bogotá

2013-01-01

Background: Papillomavirus or papilovirus is considered the most prevalent group of virusesthat cause tumors of head and neck associated with infection with human papillomavirus (HPV). Purpose: Carry out a systematic review of literature on HPV as causal agentof upper aerodigestive tract neoplasm (UADTN), according to epidemiological and clinicaldata. Methods: Pertinent biomedical literature was searched in several databases such asMedline, Proquest, Science Direct, Ovid and Cochrane, as well...

Moral Distress, Workplace Health, and Intrinsic Harm.

Science.gov (United States)

Weber, Elijah

2016-05-01

Moral distress is now being recognized as a frequent experience for many health care providers, and there's good evidence that it has a negative impact on the health care work environment. However, contemporary discussions of moral distress have several problems. First, they tend to rely on inadequate characterizations of moral distress. As a result, subsequent investigations regarding the frequency and consequences of moral distress often proceed without a clear understanding of the phenomenon being discussed, and thereby risk substantially misrepresenting the nature, frequency, and possible consequences of moral distress. These discussions also minimize the intrinsically harmful aspects of moral distress. This is a serious omission. Moral distress doesn't just have a negative impact on the health care work environment; it also directly harms the one who experiences it. In this paper, I claim that these problems can be addressed by first clarifying our understanding of moral distress, and then identifying what makes moral distress intrinsically harmful. I begin by identifying three common mistakes that characterizations of moral distress tend to make, and explaining why these mistakes are problematic. Next, I offer an account of moral distress that avoids these mistakes. Then, I defend the claim that moral distress is intrinsically harmful to the subject who experiences it. I conclude by explaining how acknowledging this aspect of moral distress should reshape our discussions about how best to deal with this phenomenon. © 2015 John Wiley & Sons Ltd.

Barium peritonitis following upper gastrointestinal series: A case report

Energy Technology Data Exchange (ETDEWEB)

Ko, Su Jin; Hwang, Ji Young; Kim, Yong Jin; Hong, Seong Sook [Soonchunhyang University College of Medicine, Seoul Hospital, Seoul (Korea, Republic of)

2017-06-15

We report a rare case of barium peritonitis following an upper gastrointestinal (GI) series and its imaging findings in a 74-year-old female. Barium peritonitis is a rare but life-threatening complication of GI contrast investigation. Therefore, clinical awareness of barium peritonitis as a complication of GI tract contrast investigation would help to prevent such a complication and manage the patients properly.

Barium peritonitis following upper gastrointestinal series: A case report

International Nuclear Information System (INIS)

Ko, Su Jin; Hwang, Ji Young; Kim, Yong Jin; Hong, Seong Sook

2017-01-01

We report a rare case of barium peritonitis following an upper gastrointestinal (GI) series and its imaging findings in a 74-year-old female. Barium peritonitis is a rare but life-threatening complication of GI contrast investigation. Therefore, clinical awareness of barium peritonitis as a complication of GI tract contrast investigation would help to prevent such a complication and manage the patients properly

Girls in Distress in Israel.

Science.gov (United States)

Steiner, Yosepha

The typical girl in distress in Israel comes from a Jewish family of oriental origin. Her distress is partially due to the strains of immigrating to Israel from, in most cases, North Africa. Authority models in distressed girls' families feature either the role of the father as the commanding familial authority figure; the mother as the dominant…

Distinguishing Between Spiritual Distress, General Distress, Spiritual Well-Being, and Spiritual Pain Among Cancer Patients During Oncology Treatment.

Science.gov (United States)

Schultz, Michael; Meged-Book, Tehilah; Mashiach, Tanya; Bar-Sela, Gil

2017-07-01

Spiritual distress is present in approximately 25% of oncology patients. We examined the extent to which this measure is identical to a variety of other measures, such as spiritual well-being, spiritual injury, spiritual pain, and general distress. Structured interview of oncology outpatients over 12 months, approached nonselectively. The presence or absence of spiritual distress was compared against spiritual pain and two spiritual well-being tools: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12-Item Scale (FACIT-Sp-12) and the Spiritual Injury Scale (SIS). We also examined whether a general distress visual analogue scale sufficed to identify spiritual distress. Other questions concerned demographic and clinical data. Of 416 patients approached, 202 completed the interview, of whom 23% reported spiritual distress. All measures showed significant correlation (receiver operating characteristic, area under the curve: SIS 0.79; distress thermometer [DT] 0.68; FACIT-Sp-12 0.67), yet none were identical with spiritual distress (sensitivity/specificity: SIS 64%/79%; spiritual pain 72%/76%; DT 41%/76%; FACIT-Sp-12 57%/72%). Of the FACIT-Sp-12 subscales, only peace correlated with spiritual distress. A significant predictor of spiritual distress was patients' self-evaluation of grave clinical condition (odds ratio 3.3; 95% CI 1.1-9.5). Multivariable analysis of individual measure items suggests an alternative three-parameter model for spiritual distress: not feeling peaceful, feeling unable to accept that this is happening, and perceived severity of one's illness. The DT is not sufficient to identify spiritual distress. The peace subscale of FACIT-Sp-12 is a better match than the measure as a whole. The SIS is the best match for spiritual distress, although an imperfect one. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Vitamin D-deficient mice have more invasive urinary tract infection.

Science.gov (United States)

Hertting, Olof; Lüthje, Petra; Sullivan, Devin; Aspenström, Pontus; Brauner, Annelie

2017-01-01

Vitamin D deficiency is a common health problem with consequences not limited to bone and calcium hemostasis. Low levels have also been linked to tuberculosis and other respiratory infections as well as autoimmune diseases. We have previously shown that supplementation with vitamin D can induce the antimicrobial peptide cathelicidin during ex vivo infection of human urinary bladder. In rodents, however, cathelicidin expression is not linked to vitamin D and therefore this vitamin D-related effect fighting bacterial invasion is not relevant. To determine if vitamin D had further protective mechanisms during urinary tract infections, we therefore used a mouse model. In vitamin D-deficient mice, we detected more intracellular bacterial communities in the urinary bladder, higher degree of bacterial spread to the upper urinary tract and a skewed cytokine response. Furthermore, we show that the vitamin D receptor was upregulated in the urinary bladder and translocated into the cell nucleus after E. coli infection. This study supports a more general role for vitamin D as a local immune response mediator in the urinary tract.

Acute upper gastrointestinal bleeding (UGIB) - initial evaluation and management.

Science.gov (United States)

Khamaysi, Iyad; Gralnek, Ian M

2013-10-01

Acute upper gastrointestinal bleeding (UGIB) is the most common reason that the 'on-call' gastroenterologist is consulted. Despite the diagnostic and therapeutic capabilities of upper endoscopy, there is still significant associated morbidity and mortality in patients experiencing acute UGIB, thus this is a true GI emergency. Acute UGIB is divided into non-variceal and variceal causes. The most common type of acute UGIB is 'non-variceal' and includes diagnoses such as peptic ulcer (gastric and duodenal), gastroduodenal erosions, Mallory-Weiss tears, erosive oesophagitis, arterio-venous malformations, Dieulafoy's lesion, and upper GI tract tumours and malignancies. This article focuses exclusively on initial management strategies for acute upper GI bleeding. We discuss up to date and evidence-based strategies for patient risk stratification, initial patient management prior to endoscopy, potential causes of UGIB, role of proton pump inhibitors, prokinetic agents, prophylactic antibiotics, vasoactive pharmacotherapies, and timing of endoscopy. Copyright © 2013 Elsevier Ltd. All rights reserved.

47 CFR 80.314 - Distress communications.

Science.gov (United States)

2010-10-01

... radiotelephone distress call consists of: (1) The distress signal MAYDAY spoken three times; (2) The words THIS IS; (3) The call sign (or name, if no call sign assigned) of the mobile station in distress, spoken...

Upper urinary tract stone disease in patients with poor performance status: active stone removal or conservative management?

Science.gov (United States)

Yamashita, Shimpei; Kohjimoto, Yasuo; Hirabayashi, Yasuo; Iguchi, Takashi; Iba, Akinori; Higuchi, Masatoshi; Koike, Hiroyuki; Wakamiya, Takahito; Nishizawa, Satoshi; Hara, Isao

2017-11-16

It remains controversial as to whether active stone removal should be performed in patients with poor performance status because of their short life expectancy and perioperative risks. Our objectives were to evaluate treatment outcomes of active stone removal in patients with poor performance status and to compare life prognosis with those managed conservatively. We retrospectively reviewed 74 patients with Eastern Cooperative Oncology Group performance status 3 or 4 treated for upper urinary tract calculi at our four hospitals between January 2009 and March 2016. Patients were classified into either surgical treatment group or conservative management group based on the presence of active stone removal. Stone-free rate and perioperative complications in surgical treatment group were reviewed. In addition, we compared overall survival and stone-specific survival between the two groups. Cox proportional hazards analysis was performed to investigate predictors of overall survival and stone-specific survival. Fifty-two patients (70.3%) underwent active stone removal (surgical treatment group) by extracorporeal shock wave lithotripsy (n = 6), ureteroscopy (n = 39), percutaneous nephrolithotomy (n = 6) or nephrectomy (n = 1). The overall stone-free rate was 78.8% and perioperative complication was observed in nine patients (17.3%). Conservative treatment was undergone by 22 patients (29.7%) (conservative management group). Two-year overall survival rates in surgical treatment and conservative management groups were 88.0% and 38.4%, respectively (p performance status could be performed safely and effectively. Compared to conservative management, surgical stone treatment achieved longer overall survival and stone-specific survival.

Expression of Phospho-ELK1 and Its Prognostic Significance in Urothelial Carcinoma of the Upper Urinary Tract

Directory of Open Access Journals (Sweden)

Satoshi Inoue

2018-03-01

Full Text Available Using preclinical models, we have recently found that ELK1, a transcriptional factor that activates downstream targets, including c-fos proto-oncogene, induces bladder cancer outgrowth. Here, we immunohistochemically determined the expression status of phospho-ELK1, an activated form of ELK1, in upper urinary tract urothelial carcinoma (UUTUC. Overall, phospho-ELK1 was positive in 47 (47.5%; 37 weak (1+ and 10 moderate (2+ of 99 UUTUCs, which was significantly (P = 0.002 higher than in benign urothelium (21 (25.3% of 83; 17 1+ and 4 2+ and was also associated with androgen receptor expression (P = 0.001. Thirteen (35.1% of 37 non-muscle-invasive versus 34 (54.8% of 62 muscle-invasive UUTUCs (P = 0.065 were immunoreactive for phospho-ELK1. Lymphovascular invasion was significantly (P = 0.014 more often seen in phospho-ELK1(2+ tumors (80.0% than in phospho-ELK1(0/1+ tumors (36.0%. There were no statistically significant associations between phospho-ELK1 expression and tumor grade, presence of concurrent carcinoma in situ or hydronephrosis, or pN status. Kaplan-Meier and log-rank tests revealed that patients with phospho-ELK1(2+ tumor had marginally and significantly higher risks of disease progression (P = 0.055 and cancer-specific mortality (P = 0.008, respectively, compared to those with phospho-ELK1(0/1+ tumor. The current results thus support our previous observations in bladder cancer and further suggest that phospho-ELK1 overexpression serves as a predictor of poor prognosis in patients with UUTUC.

131I-labelling of frozen ram sperma and distribution pattern of sperma in the genital tract of sheep, following artificial insemination

International Nuclear Information System (INIS)

Brueckner, G.; Kaempfer, I.

1983-01-01

The method of 131 I-labelling of ram sperma was applied to frozen sperma and used in experimental insemination to test the spermatozoa for both migratory capacity and distribution in the genital tract of sheep. The penetration rate of frozen sperma into the upper genital tract was found to be slower than that of native sperma. The two sperma variants were compared also for migratory performance, and the distance travelled into the upper genital tract by frozen sperma one hour after insemination amounted to only 40 per cent of the distance covered by native sperma in the same period of time. The ratio of native to frozen sperma in the tubal region was 100 : 75.3. Sperma population in the tubal region was higher than that in the uterus, two hours after insemination, which seems to indicate a certain reservoir function. Pronounced asymmetrical distribution patterns in the oviducts were equally recordable from native and frozen sperma. (author)

Diuretic renography in evaluating dilated upper urinary tract in children

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Ireton, R.C.; Parker, R.M.; Hayden, P.

1987-01-01

The diuretic renogram provides a previously unavailable noninvasive method for assessing and following urinary tract dilation of diverse cause, and defining true obstruction in children. Technetium-99m-DTPA (diethylenetriaminepentaacetic acid) is injected intravenously and a posteriorly placed gamma scintillation camera used to image the kidneys, ureters, and bladder. Furosemide is subsequently injected to stimulate a diuresis, and the washout pattern of isotope is monitored (time-activity histogram). Nonobstructive, obstructive, and poor renal function patterns were seen. Forty patients with varying degrees of hydroureteronephrosis were evaluated. Tracings were performed serially and compared with the clinical course in time, as well as with pressure flow studies and operative findings. All patients with a nonobstructed diuretic renogram did well, except for 1 boy in whom ureteropelvic obstruction developed later. Difficulty in evaluating the obstructive renogram pattern occurred only in some children with severe (grade V) hydronephrosis. Further standardization of the diuretic renogram with regard to time of diuretic injection, state of patient hydration, and regions of imaging may improve diagnostic accuracy

The value of Tc-99m DTPA diuretic renography for assessment of dilated upper urinary tract in children

International Nuclear Information System (INIS)

Yang, Ki Ra; Lim, Gye Yeon; Sohn, Hyung Sun; Hahn, Seong Tae; Lee, Jae Mun

1999-01-01

The purpose of this study was to evaluate the accuracy of Tc-99m DTPA diuretic renal scans in children with dilated upper urinary tract. We reviewed diuretic renal scans of 14 pediatric patients (age range: 3 days to 4 years) with unilateral hydronephrosis diagnosed by ultrasonography. Diuretic renal scan was done using Tc-99m DTPA and standardized protocol. In 3 neonates, diuretic renal scans were performed within 1 week and 3-7 months after birth. Six patients required pyeloplasty and eight were managed conservatively. All 6 patients requiring pyeloplasty were diagnosed as having ureteropelvic junction obstruction in the diuretic renal scan. In these 6 patients, post-operative renal scans 3-12 months after surgery were converted to nonobstructive pattern in 5 and a nonfunctioning pattern in 1. In 3 patients who underwent diuretic renal scan within 1 week after birth, nonobstructive patterns of initial scan were converted to obstructive patterns in the follow-up scan. However, all patients with nonobstructive diuretic renal scans performed after the neonatal period did well on serial ultrasonography and showed favorable clinical outcome without progression to obstruction. Tc-99m DTPA diuretic renal scan with standardized protocol is useful in assessing suspected ureteropelvic junction obstruction in children as an initial diagnostic or post-operative follow-up modality. Nonobstructive or indeterminate scan results in the neonatal period requires follow-up scan to monitor development of the obstructive pattern

A critical prognostic analysis of neutrophil-lymphocyte ratio for patients undergoing nephroureterectomy due to upper urinary tract urothelial carcinoma.

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Altan, Mesut; Haberal, Hakan Bahadır; Akdoğan, Bülent; Özen, Haluk

2017-10-01

To determine preoperative serum complete blood count parameters that affects survival of patients who underwent surgery for upper urinary tract urothelial cancer (UUT-UC). Since 1990, 150 patients underwent nephroureterectomy with bladder cuff excision for UUT-UC at Hacettepe University. Patients with a history of muscle-invasive bladder cancer, adjuvant chemotherapy or metastasis at the time of diagnosis were excluded. One hundred and thirteen patients without infective symptoms and with a full set of serum data were evaluated retrospectively. Effects of the neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), and leukocyte count on disease-free survival (DFS) and progression-free survival (PFS) were investigated. Threshold values for each parameter to predict PFS were calculated. The mean age and median follow-up were 63.7 ± 11.1 years and 34 (3-186) months, respectively. Male to female ratio was 86/27. The 5-years PFS (bladder recurrence was excluded) and DFS were 59.6 and 38.4%, respectively. In multivariate analysis, NLR was independent prognostic factor for PFS and DFS (p = 0.006 and p = 0.021, respectively) while LMR was prognostic only for PFS (p = 0.037). For UUT-UC, NLR is a prognostic factor for PFS and DFS, while LMR is a prognostic indicator for PFS in present series.

Upper Gastrointestinal Function in Morbidly Obese Adolescents Before and 6 Months After Gastric Banding

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Singendonk, M.; Kritas, S.; Omari, T.; Feinle-Bisset, C.; Page, A. J.; Frisby, C. L.; Kentish, S. J.; Ferris, L.; McCall, L.; Kow, L.; Chisholm, J.; Khurana, S.

2017-01-01

The effects of laparoscopic adjustable gastric band (LAGB) placement on upper gastrointestinal tract function in obese adolescents are unknown. Therefore, our aim was to determine the short-term effects of LAGB on esophageal motility, gastroesophageal reflux, gastric emptying, appetite-regulatory

Diffusion tensor imaging for long-term follow-up of corticospinal tract degeneration in amyotrophic lateral sclerosis

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Jacob, S.; Ehrenreich, H. [Max-Planck-Institute for Experimental Medicine, Georg-August-University, Hermann-Rein-Strasse 3, 37075, Goettingen (Germany); Departments of Neurology and Psychiatry, Georg-August-University, Goettingen (Germany); Finsterbusch, J.; Frahm, J. [Biomedizinische NMR Forschungs GmbH, Max-Planck-Institute for Biophysical Chemistry, Georg-August-University, Goettingen (Germany); Weishaupt, J.H. [Departments of Neurology and Psychiatry, Georg-August-University, Goettingen (Germany); Khorram-Sefat, D. [Department of Neuroradiology, Georg-August-University, Goettingen (Germany)

2003-09-01

Amyotrophic lateral sclerosis (ALS) is a predominantly clinical and electromyographic diagnosis. Conventional MRI reveals atrophy of the motor system, particularly the pyramidal tract, in the advanced stages but does not provide a sensitive measure of disease progression. Three patients with different principal symptoms of ALS, i.e., with predominant involvement of the upper (UMN) or lower (UMN) motor neurons, or bulbar disease, respectively, underwent serial clinical examination including lung function tests, conventional MRI, and diffusion tensor imaging (DTI). MRI demonstrated changes in of the pyramidal tract without measurable variation on follow-up. The patient with UMN involvement showed remarkable progressive loss of diffusion anisotropy in the pyramidal tract. DTI might be useful, together with clinical follow-up, as an objective morphological marker in therapeutic trials. (orig.)

Outcome of index upper gastrointestinal endoscopy in patients presenting with dysphagia in a tertiary care hospital-A 10 years review

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Qureshi, Nafees A; Hallissey, Michael T; Fielding, John W

2007-01-01

Background Patients with malignant tumours of the upper gastrointestinal tract tumours exhibit important alarm symptoms such as dysphagia that warrant clinical investigations. An endoscopic examination of the upper gastrointestinal tract will be required in most cases. This study evaluates the diagnostic potential of index endoscopy in a random population of patients with dysphagia. Methods This is a retrospective analysis of prospectively collected data over 10 years. Patients with previous endoscopic evaluation or upper gastrointestinal pathology were excluded from the study. Data was analysed to see the number and frequency of abnormal findings in upper gastrointestinal tract, and their significance in relation to the presenting symptoms. Results Total number of index endoscopies was 13, 881. 913 patients were included in the study including 465 males (age range: 17–92 years, median: 55 years) and 448 females (age range: 18–100, median: 59 years), with male to female ratio of 1.04: 1. Oesophagus was abnormal in 678 cases (74%) and biopsies were taken in 428 patients (47%). Superficial oesophagitis, Barrett's oesophagus, oesophageal cancer, and oesophageal ulcer were main histological findings. Age more than 50 years and weight loss were significant predictors of oesophageal cancer (p dysphagia, especially males above the age of 50 years. Patients may be started on treatment or referred for further investigations, for example, a barium meal in the absence of any anatomical abnormality. PMID:18034883

Radiologic findings of childhood lower respiratory tract infection by influenza virus

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Song, Ho Taek; Park, Choong Ki; Shin, Hee Jung; Choi, Yo Won; Jeon, Seok Chol; Hahm, Chang Kok; Hern, Ahn You [Hanyang University College of Medicine, Seoul (Korea, Republic of)

2002-08-01

After the RS (respiratory syncytial) virus, the influenza virus is the most common cause of childhood lower respiratory tract infection. We assessed the radiologic findings of childhood lower respiratory tract infection by the influenza virus. A total of 105 pediatric patients (76 males and 29 females; mean age, 2.4 years) with symptoms of respiratory tract infection were examined between March 1997 and April 2000. Nasopharyngeal aspirates were obtained and influenza virus infection was confirmed by direct or indirect immunofluorescent assays. Peribronchial infiltration, hyperinflation, atelectasis, pulmonary consolidation, and hilar lymphadenopathy were evaluated retrospectively at simple chest radiography. Bilateral perihiler peribronchial infiltration was noted in 78.1% of patients (n=82), hyperinflation in 63.8% (n=67), atelectasis in 3.8% (n=4, segmental 50%, lobar 50%), and pulmonary consolidation in 16.2% [n=17; segmental 70.6% (n=12), lobar 29.4% (n=5)]. Hilar lymphadenopathy was noted in one patient in whom there was no pleural effusion, and subglottic airway narrowing in 12 of 14 in whom the croup symptom complex was present. The major radiologic findings of influenza virus infection were bilateral perihilar peribronchial infiltration and hyperinflation. In some patients, upper respiratory tract infection was combined with subgolttic airway narrowing. Atelectasis or pleural effusion was rare.

Beta-band intermuscular coherence: a novel biomarker of upper motor neuron dysfunction in motor neuron disease

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Fisher, Karen M.; Zaaimi, Boubker; Williams, Timothy L.; Baker, Stuart N.

2012-01-01

In motor neuron disease, the focus of therapy is to prevent or slow neuronal degeneration with neuroprotective pharmacological agents; early diagnosis and treatment are thus essential. Incorporation of needle electromyographic evidence of lower motor neuron degeneration into diagnostic criteria has undoubtedly advanced diagnosis, but even earlier diagnosis might be possible by including tests of subclinical upper motor neuron disease. We hypothesized that beta-band (15–30 Hz) intermuscular coherence could be used as an electrophysiological marker of upper motor neuron integrity in such patients. We measured intermuscular coherence in eight patients who conformed to established diagnostic criteria for primary lateral sclerosis and six patients with progressive muscular atrophy, together with 16 age-matched controls. In the primary lateral sclerosis variant of motor neuron disease, there is selective destruction of motor cortical layer V pyramidal neurons and degeneration of the corticospinal tract, without involvement of anterior horn cells. In progressive muscular atrophy, there is selective degeneration of anterior horn cells but a normal corticospinal tract. All patients with primary lateral sclerosis had abnormal motor-evoked potentials as assessed using transcranial magnetic stimulation, whereas these were similar to controls in progressive muscular atrophy. Upper and lower limb intermuscular coherence was measured during a precision grip and an ankle dorsiflexion task, respectively. Significant beta-band coherence was observed in all control subjects and all patients with progressive muscular atrophy tested, but not in the patients with primary lateral sclerosis. We conclude that intermuscular coherence in the 15–30 Hz range is dependent on an intact corticospinal tract but persists in the face of selective anterior horn cell destruction. Based on the distributions of coherence values measured from patients with primary lateral sclerosis and control

Foreign bodies in gastrointestinal tract

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Ayşe Kefeli

2014-03-01

Full Text Available Objective: Ingested foreign bodies in gastrointestinal tract are a common event which can cause serious morbidity and mortality in the children and adult population. For this reason, early diagnosis and treatment are crucial for preventing these life threatening complications. In this study, we aimed to analyze the characteristics of the patients with upper gastrointestinal foreign bodies that were treated in our department. Methods: Patients diagnosed with upper gastrointestinal foreign bodies who were admitted to our hospital between February 2010 and August2013 were evaluated retrospectively. The data regarding their age, gender, clinical profile, type and localization of the esophageal foreign body, performed endoscopic procedure and initial symptoms of the patients were noted and analyzed statistically. Results: Thirty-eight patients with a diagnosis of gastrointestinal foreign body were included in this study. Of these patients, 21 were male and 17 were female. The youngest patient was 17 years old and the oldest patient was 79 years old. Most of the foreign bodies (%55.3 detected in the stomach. Food waste and metallic objects in 21 and 16 patients respectively. The most common complaint was dysphagia (%50. After endoscopic intervention three of the patients were directed to surgery. Conclusion: Early recognition and treatment of gastrointestinal foreign bodies is important as their complications are life threatening. The best method of removal of foreign bodies is controversial. Early management with upper gastrointestinal endoscopy is the most efficient and safe treatment method in current conditions.

Development of the lower urinary tract and its functional disorders

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Peco-Antić Amira

2015-01-01

Full Text Available A normal development of lower urinary tract function control evolves from involuntary bladder empting (incontinence during infancy to daytime urinary continence, and finally a successful day and night continence that is generally achieved by the 5th to 7th year of age. This gradual process primarily depends on the progressive maturation of the neural control of the lower urinary tract, but it is also influenced by behavioral training that evolves through social support. Functional voiding disorders (bladder dysfunction are common problems during childhood. They are present in 5-15 % of general pediatric population, and in one-fifth of school-age children or in over one-third of patients of the pediatric urologist or nephrologist. More than half of children with bladder dysfunction have vesicoureteral reflux, and more than two-thirds have recurrent urinary tract infections. There is also a frequent association of bladder dysfunction with constipation and encopresis (dysfunctional elimination syndrome. Bladder dysfunction may cause a permanent damage to the upper urinary tract and kidneys. In addition, urinary incontinence, as the most common manifestation of bladder dysfunction can be the cause of major stress in schoolage children and have a negative effect on the child’s feeling of self-esteem. Thus, a timely detection and treatment of this group of disorders in children is highly significant.

Non-contrast thin-section helical CT of urinary tract calculi in children

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Strouse, Peter J.; Bates, Gregory D.; Bloom, David A.; Goodsitt, Mitchell M.

2002-01-01

Background: Non-contrast thin-section helical CT has gained acceptance for the diagnosis of urinary tract calculi in adults, but experience with the technique in children is limited. Purpose: To evaluate the utility of non-contrast thin section helical CT for the diagnosis of urinary tract calculi in children. Materials and methods: Radiology databases at three pediatric institutions were searched to identify all pediatric patients evaluated by ''renal stone'' protocol CT scans (no oral or intravenous contrast, scans covering the entire urinary tract obtained in helical mode with narrow collimation (< 5 mm)). CT scans were reviewed for the primary finding of urinary tract calculi, for secondary signs of acute urinary tract obstruction and for evidence of alternative diagnoses. Medical records were reviewed to determine clinical presentation and to confirm the eventual diagnosis. Results: One hundred thirty-seven scans of 113 children (mean age: 11.2 years) were studied. Thirty-eight of 94 examinations (40%) performed on 82 children for acute pain and/or hematuria showed ureteral calculi. Alternative diagnoses were suggested by CT on 16 scans (17%). Twenty-eight scans were performed on 10 asymptomatic children with known calculus disease confirming renal stone burden on 21 scans (75%) and persistent ureteral calculi on 6 scans (21%). Upper tract calculi were demonstrated on 10 of 15 scans (67%) performed to evaluate for calculi in patients with known non-calculus genitourinary tract abnormalities. Conclusions: Non-contrast thin section helical CT is a useful method to diagnose urinary tract calculi in children. Radiation dose in this retrospective study may exceed the lowest possible radiation dose for diagnostic accuracy. Further research is needed to optimize CT imaging parameters, while maintaining diagnostic accuracy and minimizing radiation dose. (orig.)

Moral distress in nursing personnel

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Barlem,Edison Luiz Devos; Lunardi,Valéria Lerch; Lunardi,Guilherme Lerch; Tomaschewski-Barlem,Jamila Geri; Silveira,Rosemary Silva da; Dalmolin,Graziele de Lima

2013-01-01

OBJECTIVE: to analyze the frequency and intensity of moral distress experienced by nursing personnel in southern Brazil, covering elements of their professional practice. METHOD: a survey was undertaken in two hospitals in Rio Grande do Sul, Brazil, with 247 nurses. Data was collected by means of the adapted Moral Distress Scale. RESULTS: the perception of situations that lead to moral distress is enhanced in nurses and in nursing staff working in institutions with greater openness to dialogu...

Scintigraphic Evaluation of Esophageal Motility and Gastroesophageal Reflux in Patients Presenting with Upper Respiratory Tract Symptoms

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Amalachandran, Jaykanth; Simon, Shelley; Elangoven, Indirani; Jain, Avani; Sivathapandi, Thangalakshmi

2018-01-01

Purpose of Study: The purpose is to evaluate the findings and utility of esophageal transit scintigraphy (ETS) and gastroesophageal reflux scintigraphy (GES) in patients presenting with upper respiratory tract (URT) symptoms suspected to be due to gastroesophageal reflux (GER) disease. Materials and Methods: Thirty patients aged between 19 and 60 years underwent nasopharyngolaryngoscopy (NPL), ETS, and GES. Correlation between GER, esophageal motility, and NPL was evaluated. Inclusion criteria include patients with recurrent URT symptoms such as chronic dry cough/hoarseness of voice and itching/foreign body sensation in throat. Those with typical gastrointestinal (GI) symptoms of GER, URT symptoms relieved by antibiotics, surgical intervention in abdomen, cardiac/hepatobiliary diseases, etc. were excluded from the study. Results: Significant correlation was found between GER and NPL in 28/30 patients. More the grade of reflux, more severe was the NPL findings. Two patients with Grade II reflux had normal NPL suggesting structural inflammatory changes due to acidic pH of refluxate which have not yet manifested or symptoms could be due to nonacid refluxate. Incidence of esophageal motility disorder was statistically significant in patients with GER disease (GERD). Patients who had symptoms, but no demonstrable GER showed delayed ET in supine position suggesting the presence of esophageal motility disorder even before GERD. Conclusion: GES demonstrated GER in patients presenting with URT symptoms without typical GI symptoms. ETS showed coexistence of esophageal motility disorder in most patients presenting with URT symptoms even without an associated reflux disease. We hypothesize that primary abnormal esophageal motility leads to delayed esophageal clearance and consequently to URT symptoms. Addition of ETS to GES is easily feasible with no significant additional cost, time, or radiation burden. PMID:29430111

Initial experience of functional imaging of upper urinary tract neoplasm by diffusion-weighted magnetic resonance imaging

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Yoshida, Soichiro; Masuda, Hitoshi; Saito, Kazutaka; Kawakami, Satoru; Kihara, Kazunori; Ishii, Chikako

2008-01-01

Diffusion-weighted (DW) magnetic resonance imaging (MRI) provides functional information widely used in the diagnosis of acute cerebral stroke. We reported our initial experience of this imaging technique of upper urinary tract (UUT) urothelial carcinoma (UC). Diffusion-weighted magnetic resonance imaging was carried out in 10 consecutive patients with suspected UUT UC. With conventional imaging, seven were diagnosed as having renal pelvic tumors and two were highly suspected of having UUT UC. These nine patients were diagnosed histopathologically as having renal pelvic UC by subsequent operation. The last patient was confirmed as experiencing benign stenosis. DW MRI was obtained with a 1.5-T MR imager without a breath-holding sequence. The apparent diffusion coefficient (ADC) values of renal parenchyma, dilated collecting system, and tumor were calculated. The differences were analyzed using Wilcoxon t-test. On DW MRI, all nine tumors showed hyperintensity with negligible urinary intensity. Two cases of highly suspected UUT UC with unclear conventional MRI had high signal intensity and contrast. The case of benign stenosis had negative DW MRI. The median (range) ADC value of the tumor (0.803 [0.412-0.958] x 10 -3 mm 2 /s) was significantly lower than those of the dilated collecting system (2.19 [1.42-2.40] x 10 -3 ) and renal parenchyma (1.28 [0.922-1.45] x 10 -3 , respectively (P<0.01 and P<0.01). This is the first report on the application of DW MRI for a series of UUT UC. With this technique, a clear demonstration of UUT UC could be obtained. Moreover, this imaging technique is potentially useful to identify small lesions if they have a low diffusion coefficient. (author)

Toys in the upper aerodigestive tract: evidence on their risk as emerging from the ESFBI study.

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Foltran, Francesca; Gregori, Dario; Passàli, Desiderio; Bellussi, Luisa; Caruso, Giuseppe; Passàli, Francesco Maria; Passàli, Giulio Cesare

2011-10-01

Foreign body inhalation/aspiration or ingestion is a relatively common event in young children and, despite many efforts made in several Countries to reach acceptable safety levels for products devoted to children, small toys or toy parts are frequently mentioned among risky foreign bodies. The aim of the present study is to characterize the risk of complications and prolonged hospitalization due to toys inhalation/aspiration or ingestion according to age and gender of patients, FB characteristics and FB location, circumstances of the accident, as emerging from the ESFBI study. A retrospective study in major hospitals of 19 European Countries was realized on children aged 0-14 having inhaled/aspired or ingested a toy, with regard to the characteristics of the child and the FB (shape, volume, consistency), the FB location, the hospitalization's details and the occurrence of complications. In the years 2000-2003 a total of 2094 FB injuries occurred in children aged 0-14 years. Among them 121 (5.8%) were due to toys (mainly parts of toys) and 95 (4.5%) occurred in the lower/upper aero-digestive tract. 58 children needed hospitalization. The first determinant of a damage requiring hospitalization is the rigid consistence of the object. Almost 27% of toys related injuries happened under adults' supervision. Despite the adoption of preventive strategies, including products modification by manufacturers, has resulted in a decrease of children's mortality rate for choking in the last decades, our results seem to testify that preventive strategies imposing a regulation of industrial production, even if fundamental, are not sufficient and need to be integrated with other preventive intervention addressed to improve parents ability to be conscious of FB injuries and attentive toward a proper surveillance of children. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Prospective evaluation of a clinical guideline recommending hospital length of stay in upper gastrointestinal tract hemorrhage.

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Hay, J A; Maldonado, L; Weingarten, S R; Ellrodt, A G

Upper gastrointestinal tract hemorrhage (UGIH) is a common and potentially life-threatening disorder. Resource utilization can vary without adverse effect on patient outcome. Clinical practice guidelines are a potential solution to reduce variation in practice while improving patient outcomes. To validate prospectively the safety, acceptability, and impact of a clinical practice guideline defining the medically appropriate length of stay (LOS) for patients hospitalized with UGIH. Prospective, controlled time-series study with an alternate-month design. Outcome surveyors and patients were blinded to study group allocation. GUIDELINE: A retrospectively validated scoring system using 4 independent variables: hemodynamics, time from bleeding, comorbidity, and esophagogastroduodenoscopy (EGD) findings to predict risk of adverse events. The quantitative risk for the low-risk subset was 0.6% (95% confidence interval [CI], 0.0%-2.0%) for subsequent complications and 0% (95% CI, 0.0%-0.9%) for life-threatening complications from this retrospective evaluation. A 1000-bed, not-for-profit, university-affiliated teaching hospital. Consecutive adult patients hospitalized for acute UGIH. Concurrent feedback of guideline recommendation (same-day hospital discharge) to physicians caring for patients at low risk for complication. No risk information was provided during control months. Seventy percent (209/299) of UGIH patients achieved low-risk status according to the guideline and were therefore potentially suitable for early discharge from the hospital. Providing real-time quantitative risk information (intervention group only) was associated with an increase in guideline compliance from 30% to 70% (Preduction of 1.7 days per patient; P<.001). No differences in complications, patient health status, or patient satisfaction were found when measured 1 month after discharge. An independent variable predicting decreased hospital LOS for low-risk UGIH patients was early EGD

The microbiota continuum along the female reproductive tract and its relation to uterine-related diseases.

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Chen, Chen; Song, Xiaolei; Wei, Weixia; Zhong, Huanzi; Dai, Juanjuan; Lan, Zhou; Li, Fei; Yu, Xinlei; Feng, Qiang; Wang, Zirong; Xie, Hailiang; Chen, Xiaomin; Zeng, Chunwei; Wen, Bo; Zeng, Liping; Du, Hui; Tang, Huiru; Xu, Changlu; Xia, Yan; Xia, Huihua; Yang, Huanming; Wang, Jian; Wang, Jun; Madsen, Lise; Brix, Susanne; Kristiansen, Karsten; Xu, Xun; Li, Junhua; Wu, Ruifang; Jia, Huijue

2017-10-17

Reports on bacteria detected in maternal fluids during pregnancy are typically associated with adverse consequences, and whether the female reproductive tract harbours distinct microbial communities beyond the vagina has been a matter of debate. Here we systematically sample the microbiota within the female reproductive tract in 110 women of reproductive age, and examine the nature of colonisation by 16S rRNA gene amplicon sequencing and cultivation. We find distinct microbial communities in cervical canal, uterus, fallopian tubes and peritoneal fluid, differing from that of the vagina. The results reflect a microbiota continuum along the female reproductive tract, indicative of a non-sterile environment. We also identify microbial taxa and potential functions that correlate with the menstrual cycle or are over-represented in subjects with adenomyosis or infertility due to endometriosis. The study provides insight into the nature of the vagino-uterine microbiome, and suggests that surveying the vaginal or cervical microbiota might be useful for detection of common diseases in the upper reproductive tract.Whether the female reproductive tract harbours distinct microbiomes beyond the vagina has been a matter of debate. Here, the authors show a subject-specific continuity in microbial communities at six sites along the female reproductive tract, indicative of a non-sterile environment.

Upper functional gastrointestinal disorders in young adults.

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Adibi, Peyman; Behzad, Ebrahim; Shafieeyan, Mohammad; Toghiani, Ali

2012-01-01

Functional Gastrointestinal disorders (FGID) are common disorders in gastroenterology which are common in young adults. The aim of this study is evaluating the prevalence of upper FGID in iranian young adults. This was a cross-sectional study which was on 995 persons who were going to marry. A ROME III based questionnaire was used to determine the frequency of upper GI Syndromes among the sample population. Our results determined 74 subjects had functional dyspepsia (36 subjects diagnosed as postprandial distress syndrome patient and Epigastric pain syndrome was seen in 38 subjects). Functional heartburn was diagnosed in 52 participants. Globus was seen in 35 subjects and 41 had unspecified excessive belching. Many epidemiologic studies were done all around the world but there are different reports about prevalence and incidence of FGIDs. Our results were agreed with reported prevalence of FGIDs in Iran in adults. And our findings were agreed with some other Asian studies.

The peculiarities of food allergies in accordance with the level of injury of respiratory tract in children of Eastern Siberia.

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Borisova, Irina V; Smirnova, Svetlana V

2013-01-01

To determine the course of food allergy in accordance with the level of respiratory tract injury in children of Eastern Siberia. We have examined 70 children aged 2-16 , who have food sensibilization. We divided them into 2 groups: group I (n = 32) with diseases of the upper and middle respiratory tract; and group II (n = 38) with diseases of the lower respiratory tract. Allergological medical history, clinical laboratory examination and immunological examination, including the determination of IgA, IgM, IgG and IgE in blood serum. In cases where causal allergens were found, elimination diets were recommended. Onset of upper respiratory tract injury in group I was more often registered in children aged 0-1; in group II, it was in the 3-7 age group. Isolated food sensibilization was more often marked in group I as compared to group II. Atopic mechanisms of respiratory tract injuries were more often registered in group II children. In the course of the elimination diet, we marked positive dynamics in 100% of group I and in 75% of group II. The most frequent allergens that cause respiratory forms of food allergy are hen eggs, cow milk, nutritive cereals, vegetables and fruit. Indices of a humoral link of immunity in the examined patients were more often registered as normal or their level is increased. Timely etiotropic therapy in the majority of cases allows for a stabilization of allergic inflammation.

Urinary Tract Infection (UTI)

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... Home A-Z Health Topics Urinary tract infections Urinary tract infections > A-Z Health Topics Urinary tract infections (PDF, ... Embed Subscribe To receive Publications email updates Submit Urinary tract infections Urinary tract infections (UTIs) are most often caused ...

Moral distress and moral conflict in clinical ethics.

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Fourie, Carina

2015-02-01

Much research is currently being conducted on health care practitioners' experiences of moral distress, especially the experience of nurses. What moral distress is, however, is not always clearly delineated and there is some debate as to how it should be defined. This article aims to help to clarify moral distress. My methodology consists primarily of a conceptual analysis, with especial focus on Andrew Jameton's influential description of moral distress. I will identify and aim to resolve two sources of confusion about moral distress: (1) the compound nature of a narrow definition of distress which stipulates a particular cause, i.e. moral constraint, and (2) the distinction drawn between moral dilemma (or, more accurately, moral conflict) and moral distress, which implies that the two are mutually exclusive. In light of these concerns, I argue that the definition of moral distress should be revised so that moral constraint should not be a necessary condition of moral distress, and that moral conflict should be included as a potential cause of distress. Ultimately, I claim that moral distress should be understood as a specific psychological response to morally challenging situations such as those of moral constraint or moral conflict, or both. © 2013 John Wiley & Sons Ltd.

PREVALENCE OF GASTROINTESTINAL TRACT DISEASES AND EFFICACY OF ERADICATION THERAPY FOR H.PYLORI INFECTION IN CHILDREN

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I.A. Zhdanova

2006-01-01

Full Text Available Prevalence of upper gastrointestinal tract pathology and estimations of clinical and pharmacoeconomic efficacy of different algorithms of therapy for H. pyloria assosiated diseases in children dwelling in Krasnodar region are presented in this article.Key words: h. Pylori, prevalence, treatment, eradication therapy, children.

SU-C-204-01: A Dosimetric Investigation Into the Effects of Yttrium-90 Radioembolization On the GI Tract: In-Vivo and Histological Analysis in An Animal Model

Energy Technology Data Exchange (ETDEWEB)

Pasciak, A [University of Tennessee Medical Center, Knoxville, TN (United States); The University of Tennessee Graduate School of Medicine, Knoxville, TN (United States); Nodit, L; Bourgeois, A; Bradley, Y [The University of Tennessee Graduate School of Medicine, Knoxville, TN (United States); Paxton, B [Duke university medical center, Durham, NC (United States); Arepally, A [Vanderbilt University Medical Center, Nashville, TN (United States)

2016-06-15

Purpose: In Yttrium-90 (90Y) radioembolization, non-target embolization (NTE) to the stomach or small bowel can result in ulceration, a rare but difficult to manage clinical complication. However, dosimetric thresholds for toxicity to these tissues from radioembolization have never been evaluated in a controlled setting. We performed an analysis of the effect of 90Y radioembolization in a porcine model at different absorbed-dose endpoints. Methods: Under approval of the University of Tennessee IACUC, 6 female pigs were included in this study. Animals underwent transfemoral angiography and infusion of calibrated dosages of 90Y resin microspheres into arteries supplying part of the gastric wall. A 99mTc-MAA simulation study was performed first to determine perfused tissue volume for treatment planning along with contrast-enhanced CT. The pigs were monitored for side effects for 9 weeks, after which time they were euthanized and their upper gastrointestinal tracts were harvested for analysis. Results: 90Y radioembolization was infused resulting in average absorbed doses of between 35.5 and 91.9 Gy to the gastric wall. No animal exhibited any signs of pain or gastrointestinal distress through the duration of the study. Excised tissue showed 1–2 small (<3.0 cm2) healed or healing superficial gastric lesions in 5 out of 6 animals. Histologic analysis demonstrated that lesion location was superficial to areas of abnormally high microsphere deposition. An analysis of microsphere deposition patterns within the gastric wall indicated a high preference for submucosal deposition. Dosimetric evaluation at the luminal mucosa performed based on microsphere deposition patterns confirmed that 90Y dosimetry techniques conventionally used in hepatic dosimetry provide a reasonable estimate of absorbed dose. Conclusion: The upper gastrointestinal tract may be less sensitive to 90Y radioembolization than previously thought. Lack of charged-particle equilibrium at the luminal mucosa

ARDS (Acute Respiratory Distress Syndrome)

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... Also known as What Is ARDS, or acute respiratory distress syndrome, is a lung condition that leads ... treat ARDS. Other Names Acute lung injury Adult respiratory distress syndrome Increased-permeability pulmonary edema Noncardiac pulmonary ...

The sensitivity and the specifity of rapid antigen test in streptococcal upper respiratory tract infections.

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Gurol, Yesim; Akan, Hulya; Izbirak, Guldal; Tekkanat, Zuhal Tazegun; Gunduz, Tehlile Silem; Hayran, Osman; Yilmaz, Gulden

2010-06-01

It is aimed to detect the sensitivity and specificity of rapid antigen detection of group A beta hemolytic streptococci from throat specimen compared with throat culture. The other goal of the study is to help in giving clinical decisions in upper respiratory tract infections according to the age group, by detection of sensitivity and positive predictive values of the rapid tests and throat cultures. Rapid antigen detection and throat culture results for group A beta hemolytic streptococci from outpatients attending to our university hospital between the first of November 2005 and 31st of December 2008 were evaluated retrospectively. Throat samples were obtained by swabs from the throat and transported in the Stuart medium and Quickvue Strep A [Quidel, San Diego, USA] cassette test was applied and for culture, specimen was inoculated on 5% blood sheep agar and identified according to bacitracin and trimethoprim-sulphametaxazole susceptibility from beta hemolytic colonies. During the dates between the first of November 2005 and 31st of December 2008, from 453 patients both rapid antigen detection and throat culture were evaluated. Rapid antigen detection sensitivity and specificity were found to be 64.6% and 96.79%, respectively. The positive predictive value was 80.95% whereas negative predictive value was 92.82%. Kappa index was 0.91. When the results were evaluated according to the age groups, the sensitivity and the positive predictive value of rapid antigen detection in children were 70%, 90.3% and in adults 59.4%, 70.4%. When bacterial infection is concerned to prevent unnecessary antibiotic use, rapid streptococcal antigen test (RSAT) is a reliable method to begin immediate treatment. To get the maximum sensitivity of RSAT, the specimen collection technique used and education of the health care workers is important. While giving clinical decision, it must be taken into consideration that the sensitivity and the positive predictive value of the RSAT is quite

Consumer knowledge and perceptions about antibiotics and upper respiratory tract infections in a community pharmacy.

Science.gov (United States)

Fredericks, Ian; Hollingworth, Samantha; Pudmenzky, Alex; Rossato, Laurence; Syed, Shahzad; Kairuz, Therése

2015-12-01

Overuse of antibiotics is a global concern and the World Health Organisation (WHO) has warned of relapsing to an era with no effective antibiotics. In Australia, various national consumer campaigns had been running since 2000, and the concern was prioritised in 2011, when the need for a national approach to address antibiotic resistance was identified. The aim of this study was to explore consumer attitudes and knowledge about (upper respiratory tract) infections, colds and flu, and antibiotics, and to identify factors contributing to antibiotic misuse which could be addressed by tailored patient counselling. A community pharmacy in an area of Brisbane, Australia. A self-administered anonymous questionnaire was distributed among pharmacy consumers. Perceptions of, and knowledge about antibiotics were measured using a 5-point Likert-type scale of agreement/disagreement. The proportion of self-diagnosers and non self-diagnosers who agreed/disagreed with the attitude statement, "I know that I need antibiotics before I visit my doctor"; and the proportion of mistaken and non-mistaken who agreed/disagreed with the statement, "I will get better faster if I take antibiotics when I have a cold or flu". Over a third of the 252 participants believed that they would recover faster by taking antibiotics when suffering from a cold or flu, and nearly one-fifth felt that antibiotics would cure viral infections. More females (62.2 vs. 43.9 %) self-diagnosed (p = 0.002) although more males (42.1 vs. 30.8 %) were mistaken about the efficacy of antibiotics for treating colds and flus. Mistaken respondents were more likely than non-mistaken respondents to self-diagnose (p = 0.01). This study confirms a lack of knowledge among consumers about the efficacy of antibiotics in treating viral infections despite education campaigns. The findings strongly suggest there is a need for pharmacists and other health care professionals to elicit consumer beliefs and understanding about antibiotics

Study on antitussive effects of eprazinone dihydrochloride on radiation induced inflammation of upper respiratory tract due to postoperative irradiation of breast cancer

International Nuclear Information System (INIS)

Taoya, Koichiro

1977-01-01

Discussion was made of antitussive effects of Eprazinone hydrochloride (Resplen) on radiation induced inflammation of the upper respiratory tract in 15 cases irradiated after an operation of breast cancer. Depth dose at 3 cm was 200 rads/day, and 5000 rad/25 times/5 weeks was irradiated with telecobalt. Mainly abnormal sensation and pain in the throat and cough appeared and patients complained of suffering from a common cold, because a part of irradiation field included the throat, trachea, and esophagus. At the same time as manifestation of symptoms, 120 mg/day of Eprazinone Dihydrochloride was administered. In 8 cases, other drugs were added to, or irradiation schedule was changed because the symptoms were not improved or were exaggerated. The symptoms disappeared up to 5000 rad irradiation in one case, up to 4000 - 5000 rad irradiation in 4 cases, and up to 4000 rad irradiation in 2 cases. It is impossible to decide effective rate of this drug because of shortage of clinical cases, but it is suggested that there is a significance to increase cases treated successively with this drug in future. (Tsunoda, M.)

Descriptive Study on Parents’ Knowledge, Attitudes and Practices on Antibiotic Use and Misuse in Children with Upper Respiratory Tract Infections in Cyprus

Science.gov (United States)

Rousounidis, Andreas; Papaevangelou, Vassiliki; Hadjipanayis, Adamos; Panagakou, Sotiria; Theodoridou, Maria; Syrogiannopoulos, George; Hadjichristodoulou, Christos

2011-01-01

Upper respiratory tract infections (URTIs) are common in children and represent a significant cause of antibiotic abuse which contributes to the development of antibiotic resistance. A survey was conducted in Cyprus in 2006 to assess parents’ and pediatricians’ Knowledge, Attitude and Practices (KAP) concerning the role of antibiotics in children with URTIs. A school-based stratified geographic clustering sampling was used and a pre-tested KAP questionnaire was distributed. A different questionnaire was distributed to paediatricians. Demographic factors associated with antibiotic misuse were identified by backward logistic regression analysis. The parental overall response rate was 69.3%. Parents (N = 1,462) follow pediatricians advice and rarely administer antibiotics acquired over the counter. Although a third expects an antibiotic prescription for URTI symptoms, most deny pressuring their doctors. Low parental education was the most important independent risk factor positively related to antibiotic misuse (OR = 2.88, 95%CI 2.02 to 4.12, p parental pressure but admit that parents ask for antibiotics and believe they expect antibiotic prescriptions even when not needed. In conclusion, Cypriotic parents trust their primary care providers. Although it appears that antibiotic misuse is not driven by parental pressure, the pediatricians’ view differs. PMID:21909304

Study on antitussive effects of Eprazinone dihydrochloride on radiation--induced inflammation of upper respiratory tract due to postoperative irradiation of breast cancer

Energy Technology Data Exchange (ETDEWEB)

Taoya, K [National Hospital of Yokohama (Japan)

1977-04-01

Discussion was made of the antitussive effects of Eprazinone hydrochloride (Resplen) on radiation-induced inflammation of the upper respiratory tract in 15 cases irradiated after an operation of breast cancer. Depth dose at 3 cm was 200 rads/day, and 5000 rad/25 times/5 weeks was irradiated with telecobalt. Mainly abnormal sensation and pain in the throat and cough appeared and patients complained of suffering from a common cold, because a part of irradiation field included the throat, trachea, and esophagus. At the same time as manifestation of symptoms, 120 mg/day of Eprazinone Dihydrochloride was administered. In 8 cases, other drugs were added to, or irradiation schedule was changed because the symptoms were not improved or were exaggerated. The symptoms disappeared up to 5000 rad irradiation in one case, up to 4000 to 5000 rad irradiation in 4 cases, and up to 4000 rad irradiation in 2 cases. It is impossible to decide effective rate of this drug because of shortage of clinical cases, but it is suggested that there is a significance to increase cases treated successively with this drug in future.

Descriptive study on parents' knowledge, attitudes and practices on antibiotic use and misuse in children with upper respiratory tract infections in Cyprus.

Science.gov (United States)

Rousounidis, Andreas; Papaevangelou, Vassiliki; Hadjipanayis, Adamos; Panagakou, Sotiria; Theodoridou, Maria; Syrogiannopoulos, George; Hadjichristodoulou, Christos

2011-08-01

Upper respiratory tract infections (URTIs) are common in children and represent a significant cause of antibiotic abuse which contributes to the development of antibiotic resistance. A survey was conducted in Cyprus in 2006 to assess parents' and pediatricians' Knowledge, Attitude and Practices (KAP) concerning the role of antibiotics in children with URTIs. A school-based stratified geographic clustering sampling was used and a pre-tested KAP questionnaire was distributed. A different questionnaire was distributed to paediatricians. Demographic factors associated with antibiotic misuse were identified by backward logistic regression analysis. The parental overall response rate was 69.3%. Parents (N = 1,462) follow pediatricians advice and rarely administer antibiotics acquired over the counter. Although a third expects an antibiotic prescription for URTI symptoms, most deny pressuring their doctors. Low parental education was the most important independent risk factor positively related to antibiotic misuse (OR = 2.88, 95%CI 2.02 to 4.12, p parental pressure but admit that parents ask for antibiotics and believe they expect antibiotic prescriptions even when not needed. In conclusion, Cypriotic parents trust their primary care providers. Although it appears that antibiotic misuse is not driven by parental pressure, the pediatricians' view differs.

Association between air pollution and general outpatient clinic consultations for upper respiratory tract infections in Hong Kong.

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Tam, Wilson W S; Wong, Tze Wai; Ng, Lorna; Wong, Samuel Y S; Kung, Kenny K L; Wong, Andromeda H S

2014-01-01

Many studies have shown the adverse effects of air pollution on respiratory health, but few have examined the effects of air pollution on service utilisation in the primary care setting. The aim of this study was to examine the association between air pollution and the daily number of consultations due to upper respiratory tract infections (URTIs) in general outpatient clinics (GOPCs) in Hong Kong. Daily data on the numbers of consultations due to URTIs in GOPCs, the concentrations of major air pollutants, and the mean values of metrological variables were retrospectively collected over a 3-year period (2008-2010, inclusive). Generalised additive models were constructed to examine the association between air pollution and the daily number of consultations, and to derive the relative risks and 95% confidence intervals (95% CI) of GOPC consultations for a unit increase in the concentrations of air pollutants. The mean daily consultations due to URTIs in GOPCs ranged from 68.4 to 253.0 over the study period. The summary relative risks (and 95% CI) of daily consultations in all GOPCs for the air pollutants PM10, NO2, O3, and SO2 were 1.005 (1.002, 1.009), 1.010 (1.006, 1.013), 1.009 (1.006, 1.012), and 1.004 (1.000, 1.008) respectively, per 10 µg/m(3) increase in the concentration of each pollutant. Significant associations were found between the daily number of consultations due to URTIs in GOPCs and the concentrations of air pollutants, implying that air pollution incurs a substantial morbidity and increases the burden of primary health care services.

Corrosive Injury of the Upper Gastrointestinal Tract: Review of Surgical Management and Outcome in 14 Adult Cases

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Mohammad Taghi Rajabi

2015-01-01

Full Text Available Introduction: Caustic ingestion is responsible for a spectrum of upper gastrointestinal tract injury from self-limited to perforation. This study conducted to evaluate clinical characteristics as well as surgical outcomes in patients with caustic ingestion.   Materials and Methods: Between Nov1993 to march 2011, 14 adults with a clinical evidence of corrosive ingestion were admitted into our institutions (Omid and Ghaem hospitals. Patients evaluated for etiology of erosion, location, type of surgery, morbidity and mortality after surgery.   Results: 14 patients (10men and 4 women with a age range between18-53 years were evaluated. In 6 patients, the injury was accidental and in 8 patients ingestion was a suicide attempt. Ingested agent included nitric acid in 4 patients, hydrochloric acid in 7 patients, sulfuric acid in 2 patients and strong alkali in one patient. The location and extent of lesion varied included esophagus in 13 cases, stomach in 7 cases and the pharynx in 3 cases. Acute abdomen was developed In 2 patients and a procedure of total gasterectomy and blunt esophagectomy was performed. In the remaining patients, substernal esophageal bypass in 2 patients, esophageal resection and replacement surgery in 9 patients and gastroenterostomy in one patient performed to relieve esophageal stricture. Two patients died of mediastinitis after esophageal replacement surgery. Postoperative strictures were developed in 2 survived patients with hypopharyngeal reconstruction that was managed by per oral bougienage in one patient and KTP Laser and stenting in the other patient.   Conclusion:  Esophageal resection with replacement was safe and good technique for severe corrosive esophageal stricture with low mortality and morbidity.

Thulium Laser Treatment of Upper Urinary Tract Carcinoma: A Multi-Institutional Analysis of Surgical and Oncological Outcomes.

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Musi, Gennaro; Mistretta, Francesco A; Marenghi, Carlo; Russo, Andrea; Catellani, Michele; Nazzani, Sebastiano; Conti, Andrea; Luzzago, Stefano; Ferro, Matteo; Matei, Deliu V; Carmignani, Luca; de Cobelli, Ottavio

2018-03-01

To evaluate the efficacy and safety of ureteroscopic thulium laser (TL) treatment of upper urinary tract carcinoma (UTUC). Forty-two consecutive patients underwent conservative TL treatment for UTUC at two referral institutions. All patients underwent preliminary biopsy and then laser vaporization. A 272 μm and 365 μm laser fibers were used with a flexible and semirigid scope, respectively. Ablation was carried out with a 10 to 20 W power. Mean age at surgery was 68 years (SD 10.7). Mean tumor size was 14.3 mm (range 2-30 mm). Preliminary biopsy revealed the presence of low-grade disease in 29 (69.1%) patients, high-grade disease in 4 (9.5%) and 1 carcinoma in situ 1 (2.4%), whereas it was not conclusive in 8 (19%) cases. Final stage was pTa and pTis in 41 (97.6%) and 1 (2.4%) patients, respectively. Thirty eight percent (16) experienced Clavien-Dindo grade I complication, 47.6% (20) grade II, and 2.4% (1) grade III. Five (12%) patients underwent a second-look procedure due to residual disease. Eight (19%) patients experienced clinical recurrence. The median estimated recurrence-free survival was 44 months (SE 3.68). Four patients (9.5%) underwent a nephroureterectomy. Final pathological stage was pTis, pT3 high grade, pTa low grade, and pT0. Median follow-up was 26.3 months (range 2-54 months), and no progression or upstaging of disease occurred. TL management of UTUC is a safe and efficacious conservative treatment. Our experience shows optimal vaporization and hemostatic control in the absence of major complications.

Antibiotic prescription patterns for upper respiratory tract infections in the outpatient Qatari population in the private sector.

Science.gov (United States)

Butt, Adeel Ajwad; Navasero, Cristina S; Thomas, Bright; Marri, Salih Al; Katheeri, Huda Al; Thani, Asmaa Al; Khal, Abdullatif Al; Khan, Tasnim; Abou-Samra, Abdul-Badi

2017-02-01

Antibiotics are often inappropriately prescribed for upper respiratory tract infections (URTIs) in developed countries. Data on the proportion of inappropriate prescriptions are lacking from the Middle East and other developing countries. Health insurance claims for all antibiotics prescribed for URTIs in the private sector in the State of Qatar between May 2014 and December 2015 were retrieved. During the study period, health insurance was limited to Qatari nationals. Topical antibiotics were excluded. Data on the prescriber's specialty, as listed with the licensing authority, were also retrieved. Diagnoses were classified as appropriate or inappropriate based on the likelihood of a bacterial etiology that may warrant antibiotic use. A total of 75 733 claims were made during the study period. Of these, 41 556 (55%) were for an appropriate indication, while 34 177 (45%) were for an inappropriate indication. The most common antibiotic classes prescribed were cephalosporins (43% of claims; 44% inappropriate), penicillins (28% of claims; 44% inappropriate), macrolides (19% of claims; 52% inappropriate), and fluoroquinolones (9% of claims; 40% inappropriate). Nearly 5% of antibiotics were prescribed in intravenous formulations. The most common prescribers were General/Family Practice physicians (53% of claims; 50% inappropriate), followed by Pediatrics (18.6% of claims; 36% inappropriate) and Internal Medicine (14.1% of claims; 44% inappropriate). There is a high rate of inappropriate antibiotic prescription for acute URTIs in the private health care sector in the State of Qatar. Further studies are needed to determine the population-based rates across the country. Interventions to decrease inappropriate use in such settings are urgently needed. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Psychological distress among women with newly diagnosed breast cancer

DEFF Research Database (Denmark)

Mertz, Birgitte; Bistrup, Pernille Envold; Johansen, Christoffer

2012-01-01

PURPOSE: Psychological distress is common in the cancer continuum. Our objectives were to determine the prevalence of distress and to investigate the related problems and the characteristics of women with breast cancer who experienced psychological distress at the time of diagnosis. METHODS: We...... thermometer' to measure psychological distress and the accompanying 'problem list' to identify related problems. Logistic regression models with 95% confidence intervals were used to estimate the associations between psychological distress, age, social support and domains on the problem list. RESULTS......: With a cut-off of 3 on the distress thermometer, 77% of women with breast cancer reported distress, whereas when the cut-off was 7, 43% were distressed. The mean distress score was 5.4 (SD, 3.1). The most frequently reported problems were worry (77%) and nervousness (71%). Distress was significantly...

Framing the issues: moral distress in health care.

Science.gov (United States)

Pauly, Bernadette M; Varcoe, Colleen; Storch, Jan

2012-03-01

Moral distress in health care has been identified as a growing concern and a focus of research in nursing and health care for almost three decades. Researchers and theorists have argued that moral distress has both short and long-term consequences. Moral distress has implications for satisfaction, recruitment and retention of health care providers and implications for the delivery of safe and competent quality patient care. In over a decade of research on ethical practice, registered nurses and other health care practitioners have repeatedly identified moral distress as a concern and called for action. However, research and action on moral distress has been constrained by lack of conceptual clarity and theoretical confusion as to the meaning and underpinnings of moral distress. To further examine these issues and foster action on moral distress, three members of the University of Victoria/University of British Columbia (UVIC/UVIC) nursing ethics research team initiated the development and delivery of a multi-faceted and interdisciplinary symposium on Moral Distress with international experts, researchers, and practitioners. The goal of the symposium was to develop an agenda for action on moral distress in health care. We sought to develop a plan of action that would encompass recommendations for education, practice, research and policy. The papers in this special issue of HEC Forum arose from that symposium. In this first paper, we provide an introduction to moral distress; make explicit some of the challenges associated with theoretical and conceptual constructions of moral distress; and discuss the barriers to the development of research, education, and policy that could, if addressed, foster action on moral distress in health care practice. The following three papers were written by key international experts on moral distress, who explore in-depth the issues in three arenas: education, practice, research. In the fifth and last paper in the series, we highlight

A Rare Cause of Upper Airway Obstruction in a Child

OpenAIRE

Ahmed, H.; Ndiaye, C.; Barry, M. W.; Thiongane, Aliou; Mbaye, A.; Zemene, Y.; Ndiaye, I. C.

2017-01-01

Ventricular band cyst is a rare condition in children but can result in severe upper airway obstruction with laryngeal dyspnea or death. The diagnosis should be considered in any stridor in children with previous history of intubation or respiratory infections. We report a case of a 4-year-old girl, received in an array of severe respiratory distress, emergency endoscopy was done, and a large ventricular tape band cyst obstructing the air way was found. Complete excision was made, and postope...

The cultural expression of spiritual distress in Israel.

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Schultz, Michael; Meged-Book, Tehilah; Mashiach, Tanya; Bar-Sela, Gil

2018-03-30

Although spiritual distress is present across cultures, the ways in which patients experience it vary between cultures. Our goal was to examine the cultural expression and key indicators of spiritual distress in Israel. We conducted a structured interview of 202 oncology outpatients in a cross-sectional study. Self-diagnosis of spiritual distress, which is a demonstrated gold standard for identifying its presence, was compared with the Facit-Sp-12 and a number of other items (from the Spiritual Injury Scale and newly developed Israeli items) hypothesized as Israeli cultural expressions of spiritual distress, demographic and medical data, and patient desire to receive spiritual care. Significant variation was found between Israeli cultural expression of spiritual distress and that found in studies from other countries. Key expressions of spiritual distress in this study included lack of inner peace, grief, and an inability to accept what is happening. Items related to faith were not significant, and loss of meaning showed mixed results. Patients requesting spiritual care were more likely to be in spiritual distress. No demographic or medical data correlated with spiritual distress. Specially designed interventions to reduce spiritual distress should address the expressions of the distress specific to that culture. Studies of the efficacy of spiritual care can examine the extent of spiritual distress in general or of its specific cultural expressions.

Distress intolerance and clinical functioning in persons with schizophrenia

Science.gov (United States)

Nugent, Katie L.; Chiappelli, Joshua; Rowland, Laura M.; Daughters, Stacey B.; Hong, L. Elliot

2014-01-01

Impaired tolerance to distress may help explain part of the cognitive and functional impairments in schizophrenia. This project investigated distress intolerance in schizophrenia patients (SZ) as compared to controls, and whether distress intolerance represented an independent domain in relationship to symptoms, cognition, and functional capacity. Healthy controls (n=43) and SZ (n=65) completed a psychological distress challenge experiment and their levels of intolerance to distress were estimated. SZ showed increased distress intolerance such that they were significantly more likely to terminate the distress challenge session early compared to controls. Greater distress intolerance was associated with reduced functional capacity and worse cognitive performance in SZ. Mediation analyses suggested that distress intolerance had an independent effect on functional capacity, while some of this effect was mediated by cognitive performance. Our results suggest that distress intolerance is a promising domain for treatment research, and functional capacity may be improved by targeting treatments towards SZ patient’s ability to tolerate distress. PMID:25107316

Maternal psychological distress and child decision-making.

Science.gov (United States)

Flouri, Eirini; Ioakeimidi, Sofia; Midouhas, Emily; Ploubidis, George B

2017-08-15

There is much research to suggest that maternal psychological distress is associated with many adverse outcomes in children. This study examined, for the first time, if it is related to children's affective decision-making. Using data from 12,080 families of the Millennium Cohort Study, we modelled the effect of trajectories of maternal psychological distress in early-to-middle childhood (3-11 years) on child affective decision-making, measured with a gambling task at age 11. Latent class analysis showed four longitudinal types of maternal psychological distress (chronically high, consistently low, moderate-accelerating and moderate-decelerating). Maternal distress typology predicted decision-making but only in girls. Specifically, compared to girls growing up in families with never-distressed mothers, those exposed to chronically high maternal psychological distress showed more risk-taking, bet more and exhibited poorer risk-adjustment, even after correction for confounding. Most of these effects on girls' decision-making were not robust to additional controls for concurrent internalising and externalising problems, but chronically high maternal psychological distress was associated positively with risk-taking even after this adjustment. Importantly, this association was similar for those who had reached puberty and those who had not. Given the study design, causality cannot be inferred. Therefore, we cannot propose that treating chronic maternal psychological distress will reduce decision-making pathology in young females. Our study suggests that young daughters of chronically distressed mothers tend to be particularly reckless decision-makers. Copyright © 2017. Published by Elsevier B.V.

Renal function study by sup(99m)Tc-DMSA renal scintigraphy in non-obstructive upper urinary tract infection

International Nuclear Information System (INIS)

Kawamura, Juichi; Itoh, Hitoshi; Wang, Pan-Chin; Hosokawa, Shinichi; Yoshida, Osamu

1979-01-01

Kidney function study was carried out in 90 patients with non-obstructive upper urinary tract infection using sup(99m)Tc-DMSA (dimercaptosuccinic acid) renal scintigraphy. sup(99m)Tc-DMSA renal scintigram demonstrated well pyelonephritic cortical lesions which were not easily visualized on IVP. A variety of sup(99m)Tc-DMSA renal uptake paralleled the grading of pyelonephritic changes in IVP, however, there was a discrepancy between some of grade II pyelonephritic changes in reflux kidneys and DMSA renal uptake. This may be partly attributed to hydrodynamic effects of VUR in addition to inflammatory changes. The severity of reflux and changes in pelviocaliceal system on VCG also paralleled DMSA renal uptake in reflux kidneys. A ratio of sup(99m)Tc-DMSA renal uptake in the healthy side to that in pathological side was observed in 23 cases with VUR before and after the anti-VUR operation was performed. In patients with more than 3.5 of preoperative DMSA uptake ratio, there were few increments postoperatively in kidney functions of the pathological side, while the contralateral healthy kidney showed a compensatory increase in kidney function. This DMSA renal uptake ratio between healthy and pathological side seems to be one of predictable determinants for postoperative recovery of the pathological side. Thus, by comparing the DMSA uptake between right and left kidney in the chronic course or pre- and postoperative periods, an effect of renal function in the pathological side on that in the healthy side was investigated from the point of renal counterbalance. (author)

Preoperative hydronephrosis is associated with less decline in renal function after radical nephroureterectomy for upper tract urothelial carcinoma.

Science.gov (United States)

Singla, Nirmish; Hutchinson, Ryan; Haddad, Ahmed; Sagalowsky, Arthur; Lotan, Yair; Margulis, Vitaly

2016-08-01

To compare renal function changes after radical nephroureterectomy (RNU) in patients with upper tract urothelial carcinoma (UTUC) based on the presence of preoperative hydronephrosis. Clinicopathologic data of 208 patients with UTUC treated surgically from 1998 to 2013 were compiled. Patients with bilateral disease, less than 1 month follow up, missing hydronephrosis data, or who underwent nephron-sparing approaches were excluded. Estimated glomerular filtration rate (eGFR) was calculated preoperatively, at first follow up (within 3 months) and at last follow up using the Modification of Diet in Renal Disease equation. Events were defined as new-onset stage III chronic kidney disease (CKD) or worsening of CKD stage in preexisting CKD. Kaplan-Meier event-free survival was assessed. Cox regression was performed to identify predictors of events. A total of 132 patients were analyzed, including 62 (47.0%) with hydronephrosis. Median follow up was 28.6 months. Patients with hydronephrosis had larger tumors (p = 0.045) and higher pathologic stage (p = 0.010) than those without hydronephrosis. Baseline eGFR was comparable between groups (p = 0.088). Patients without hydronephrosis experienced greater declines in eGFR following surgery (p hydronephrosis predicted lower event likelihood in the long term (univariate HR 0.54, p = 0.033), while ureteral tumor location predicted lower event likelihood in the short term (HR 0.52, p = 0.030). Patients with hydronephrosis undergoing RNU for UTUC experience less decline in renal function than those without hydronephrosis. Given the prevalence of renal dysfunction in patients with UTUC, our results may help inform preoperative counseling.

Outcome of index upper gastrointestinal endoscopy in patients presenting with dysphagia in a tertiary care hospital-A 10 years review

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Fielding John W

2007-11-01

Full Text Available Abstract Background Patients with malignant tumours of the upper gastrointestinal tract tumours exhibit important alarm symptoms such as dysphagia that warrant clinical investigations. An endoscopic examination of the upper gastrointestinal tract will be required in most cases. This study evaluates the diagnostic potential of index endoscopy in a random population of patients with dysphagia. Methods This is a retrospective analysis of prospectively collected data over 10 years. Patients with previous endoscopic evaluation or upper gastrointestinal pathology were excluded from the study. Data was analysed to see the number and frequency of abnormal findings in upper gastrointestinal tract, and their significance in relation to the presenting symptoms. Results Total number of index endoscopies was 13, 881. 913 patients were included in the study including 465 males (age range: 17–92 years, median: 55 years and 448 females (age range: 18–100, median: 59 years, with male to female ratio of 1.04: 1. Oesophagus was abnormal in 678 cases (74% and biopsies were taken in 428 patients (47%. Superficial oesophagitis, Barrett's oesophagus, oesophageal cancer, and oesophageal ulcer were main histological findings. Age more than 50 years and weight loss were significant predictors of oesophageal cancer (p Conclusion OGD is an effective initial investigation to assess patients with dysphagia, especially males above the age of 50 years. Patients may be started on treatment or referred for further investigations, for example, a barium meal in the absence of any anatomical abnormality.

The spiritual distress assessment tool: an instrument to assess spiritual distress in hospitalised elderly persons

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Martin Estelle

2010-12-01

Full Text Available Abstract Background Although spirituality is usually considered a positive resource for coping with illness, spiritual distress may have a negative influence on health outcomes. Tools are needed to identify spiritual distress in clinical practice and subsequently address identified needs. This study describes the first steps in the development of a clinically acceptable instrument to assess spiritual distress in hospitalized elderly patients. Methods A three-step process was used to develop the Spiritual Distress Assessment Tool (SDAT: 1 Conceptualisation by a multidisciplinary group of a model (Spiritual Needs Model to define the different dimensions characterizing a patient's spirituality and their corresponding needs; 2 Operationalisation of the Spiritual Needs Model within geriatric hospital care leading to a set of questions (SDAT investigating needs related to each of the defined dimensions; 3 Qualitative assessment of the instrument's acceptability and face validity in hospital chaplains. Results Four dimensions of spirituality (Meaning, Transcendence, Values, and Psychosocial Identity and their corresponding needs were defined. A formalised assessment procedure to both identify and subsequently score unmet spiritual needs and spiritual distress was developed. Face validity and acceptability in clinical practice were confirmed by chaplains involved in the focus groups. Conclusions The SDAT appears to be a clinically acceptable instrument to assess spiritual distress in elderly hospitalised persons. Studies are ongoing to investigate the psychometric properties of the instrument and to assess its potential to serve as a basis for integrating the spiritual dimension in the patient's plan of care.

47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

Science.gov (United States)

2010-10-01

... (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1115 Transmission...

How Does Distress Acquisition Incentivized by Government Purchases of Distressed Loans Affect Bank Default Risk?

Directory of Open Access Journals (Sweden)

Jyh-Jiuan Lin

2018-04-01

Full Text Available The topic of bank default risk in connection with government bailouts has recently attracted a great deal of attention. In this paper, the question of how a bank’s default risk is affected by a distress acquisition is investigated. Specifically, the government provides a bailout program of distressed loan purchases for a strong bank to acquire a bank in distress. The acquirer bank may likely refuse the acquisition with a bailout when the amount of distressed loan purchases is large or the knock-out value of the acquired bank is high. When the acquirer bank realizes acquisition gains, the default risk in the consolidated bank’s equity return is negatively related to loan purchases, but positively to the knock-out value of the acquired bank. The government bailout, as such, in large part contributes to banking stability.

Long-term, low-dose prophylaxis against urinary tract infections in young children.

Science.gov (United States)

Brandström, Per; Hansson, Sverker

2015-03-01

Urinary tract infection (UTI) affects about 2 % of boys and 8 % of girls during the first 6 years of life with Escherichia coli as the predominant pathogen. Symptomatic UTI causes discomfort and distress, and carries a risk of inducing renal damage. The strong correlation between febrile UTI, dilating vesicoureteral reflux (VUR), and renal scarring led to the introduction of antibiotic prophylaxis for children with VUR to reduce the rate of UTI recurrence. It became common practice to use prophylaxis for children with VUR and other urinary tract abnormalities. This policy has been challenged because of a lack of scientific support. Now, randomized controlled studies are available that compare prophylaxis to no treatment or placebo. They show that children with normal urinary tracts or non-dilating VUR do not benefit from prophylaxis. Dilating VUR may still be an indication for prophylaxis in young children. After the first year of life, boys have very few recurrences and do not benefit from prophylaxis. Girls with dilating VUR, on the other hand, are more prone to recurrences and benefit from prophylaxis. There has been a decline in the use of prophylaxis due to questioning of its efficacy, increasing bacterial resistance, and a propensity to low adherence to medication. Alternative measures to reduce UTI recurrences should be emphasized. However, in selected patients carefully followed, prophylaxis can protect from recurrent UTI and long-term sequelae. 1. There is a strong correlation between UTI, VUR, and renal scarring. 2. Children with normal urinary tracts or non-dilating VUR do not benefit from prophylaxis. 3. Young children, mainly girls, with dilating VUR are at risk of recurrent UTI and acquired renal scarring and seem to gain from antibiotic prophylaxis. 4. Increasing bacterial resistance and low adherence with prescribed medication is a major obstacle to successful antibiotic prophylaxis.

Partner personality in distressed relationships

NARCIS (Netherlands)

Barelds, D.P.H.; Barelds-Dijkstra, P.

2006-01-01

The present study examines the personality characteristics of partners receiving marital therapy. On the basis of previous research, we expected partners in distressed relationships to be more neurotic and more introverted and to have lower self-esteem than partners in non-distressed relationships.

Urinary Tract Health

Science.gov (United States)

... related to the urinary tract health of women: Urinary Tract Infections (UTIs) and Urinary Incontinence (UI). For information on a range of urinary tract health issues for women, men, and children, visit the National Kidney and Urologic Diseases Information ...

Distress During the Menopause Transition

Directory of Open Access Journals (Sweden)

Marcianna Nosek

2012-07-01

Full Text Available In 2010, nearly 400 million women worldwide were of menopause age (45-54. Although many women transition through menopause with ease, some experience distress and a subsequent decrease in quality of life. The purpose of this qualitative study was to examine the experiences of distress in women during the menopause transition. A narrative analysis methodology was used maintaining participants’ complete narratives when possible. In-person interviews of 15 midlife women were digitally audio recorded and transcribed verbatim. Women shared narratives of distress related to menstrual changes, emotional instability, vaginal dryness, and decreased libido affected by their relationships with self, partners, work, and family. Some experiences were presented against a backdrop of the past and influenced by concerns for the future. Detailed stories illuminated the effect that distressful symptoms had on quality of life and captured how intricately woven symptoms were with the women’s interpersonal and social lives.

Piracetam for fetal distress in labour.

Science.gov (United States)

Hofmeyr, G Justus; Kulier, Regina

2012-06-13

Piracetam is thought to promote the metabolism of brain cells when they are hypoxic. It has been used to prevent adverse effects of fetal distress. The objective of this review was to assess the effects of piracetam for suspected fetal distress in labour on method of delivery and perinatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 February 2012). Randomised trials of piracetam compared with placebo or no treatment for suspected fetal distress in labour. Both review authors assessed eligibility and trial quality. One study of 96 women was included. Piracetam compared with placebo was associated with a trend to reduced need for caesarean section (risk ratio 0.57, 95% confidence interval 0.32 to 1.03). There were no statistically significant differences between the piracetam and placebo group for neonatal morbidity (measured by neonatal respiratory distress) or Apgar score. There is not enough evidence to evaluate the use of piracetam for fetal distress in labour.

The Indirect Costs of Financial Distress in Indonesia

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Wijantini Wijantini

2007-06-01

Full Text Available This paper presents quantitative estimates of the indirect cost of financial distress and its determinants. In order to measure the cost, this study estimates the annualized changes in industry-adjusted operation profit and sales from a year before the onset of distress to the resolution year. Using those approaches, the median of indirect financial distress cost is estimated between three and 11 percent annually. To the extent that the direct cost of financial distress reduces reported operating income, the estimated costs are overstated. The simple regressions analysis suggest that the indirect cost of financial distress significantly increases with size, leverage, number of creditors, and poor industry performance, but is not related to degree of bank loan reliance. The findings provide a weak support for the financial distress theory which suggests that conflicts of interest render the costs of financial distress.

Distress risk and leverage puzzles: Evidence from Taiwan

Directory of Open Access Journals (Sweden)

Kung-Cheng Ho

2016-05-01

Full Text Available Financial distress has been invoked in the asset pricing literature to explain the anomalous patterns in the cross-section of stock returns. The risk of financial distress can be measured using indexes. George and Hwang (2010 suggest that leverage can explain the distress risk puzzle and that firms with high costs choose low leverage to reduce distress intensities and earn high returns. This study investigates whether this relationship exists in the Taiwan market. When examined separately, distress intensity is found to be negatively related to stock returns, but leverage is found to not be significantly related to stock returns. The results are the same when distress intensity and leverage are examined simultaneously. After assessing the robustness by using O-scores, distress risk puzzle is found to exist in the Taiwan market, but the leverage puzzle is not

The peculiarities of food allergies in accordance with the level of injury of respiratory tract in children of Eastern Siberia

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Irina V. Borisova

2013-08-01

Full Text Available Aim. To determine the course of food allergy in accordance with the level of respiratory tract injury in children of Eastern Siberia. Design of the research. We have examined 70 children aged 2–16, who have food sensibilization. We divided them into 2 groups: group I (n=32 with diseases of the upper and middle respiratory tract; and group II (n=38 with diseases of the lower respiratory tract. Methods. Allergological medical history, clinical laboratory examination and immunological examination, including the determination of IgA, IgM, IgG and IgE in blood serum. In cases where causal allergens were found, elimination diets were recommended. Results. Onset of upper respiratory tract injury in group I was more often registered in children aged 0–1; in group II, it was in the 3–7 age group. Isolated food sensibilization was more often marked in group I as compared to group II. Atopic mechanisms of respiratory tract injuries were more often registered in group II children. In the course of the elimination diet, we marked positive dynamics in 100% of group I and in 75% of group II. Conclusion. The most frequent allergens that cause respiratory forms of food allergy are hen eggs, cow milk, nutritive cereals, vegetables and fruit. Indices of a humoral link of immunity in the examined patients were more often registered as normal or their level is increased. Timely etiotropic therapy in the majority of cases allows for a stabilization of allergic inflammation.

Translating 'distress' and screening for emotional distress in multicultural cancer patients in Israel.

Science.gov (United States)

Cohen, Miri; Gagin, Roni; Cinamon, Tali; Stein, Tamar; Moscovitz, Marian; Kuten, Abraham

2012-05-01

The adaptability of the distress thermometer (DT) to multicultural groups has rarely been assessed. To assess DT adaptability to the Israeli population as a multicultural society. Participants were 496 cancer patients. They were recruited for 3 days a week in 2009-2010 (97% response rate). Participants completed the DT, a problem list, Hospital Anxiety and Depression Scale (HADS), and the Brief Symptom Inventory (BSI-18). Receiver-operating characteristic (ROC) curve analyses of DT scores yielded area under the curve (AUC) of 0.63 as against HADS and of 0.78 as against BSI-18. ROC analysis revealed that the optimal cutoff score was ≥ 3. It yielded sensitivity and specificity of 0.74 and 0.65, as against the HADS, and 0.64 and 0.64, as against the BSI-18. The Jewish participants reported higher distress than the Arab participants, and the ROC properties were markedly higher for the Jewish subgroup alone. The adapted DT was moderately efficient for detecting emotional distress in cancer patients in Israel. Cultural aspects related to distress should be taken into account for administration of the DT in multicultural societies.

47 CFR 80.1114 - False distress alerts.

Science.gov (United States)

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1114 False distress alerts. The provisions of §§ 80.334 and 80.335 apply to...

Assessment of a new algorithm in the management of acute respiratory tract infections in children

Directory of Open Access Journals (Sweden)

Seyed Ahmad Tabatabaei

2012-01-01

Full Text Available Objectives: To assess the practicability of a new algorithm in decreasing the rate of incorrect diagnoses and inappropriate antibiotic usage in pediatric Acute Respiratory Tract Infection (ARTI. Materials and Methods: Children between 1 month to15 years brought to outpatient clinics of a children′s hospital with acute respiratory symptoms were managed according to the steps recommended in the algorithm. Results: Upper Respiratory Tract Infection, Lower Respiratory Tract Infection, and undifferentiated ARTI accounted for 82%, 14.5%, and 3.5% of 1 209 cases, respectively. Antibiotics were prescribed in 33%; for: Common cold, 4.1%; Sinusitis, 85.7%; Otitis media, 96.9%; Pharyngotonsillitis, 63.3%; Croup, 6.5%; Bronchitis, 15.6%; Pertussis-like syndrome, 82.1%; Bronchiolitis, 4.1%; and Pneumonia, 50%. Conclusion: Implementation of the ARTIs algorithm is practicable and can help to reduce diagnostic errors and rate of antibiotic prescription in children with ARTIs.

Perceived organizational support and moral distress among nurses.

Science.gov (United States)

Robaee, Navideh; Atashzadeh-Shoorideh, Foroozan; Ashktorab, Tahereh; Baghestani, Ahmadreza; Barkhordari-Sharifabad, Maasoumeh

2018-01-01

Moral distress is prevalent in the health care environment at different levels. Nurses in all roles and positions are exposed to ethically challenging conditions. Development of supportive climates in organizations may drive nurses towards coping moral distress and other related factors. This study aimed at determining the level of perceived organizational support and moral distress among nurses and investigating the relationship between the two variables. This was a correlational-descriptive study. A total of 120 nurses were selected using random quota sampling method. A demographic questionnaire, Survey of Perceived Organizational Support, and Moral Distress Scale were used to collect the data which were analyzed using descriptive and analytical tests in SPSS20. The mean perceived organizational support was low (2.63 ± 0.79). The mean moral distress was 2.19 ± 0.58, which shows a high level of moral distress. Moreover, Statistical analysis showed no significant relationship between perceived organizational support and moral distress ( r  = 0.01, p  = 0.86). Given the low level of perceived organizational support and high moral distress among nurses in this study, it is necessary to provide a supportive environment in hospitals and to consider strategies for diminishing moral distress.

Marital Adjustment and Psychological Distress in Japan

Science.gov (United States)

Li, Angela; Robustelli, Briana L.; Whisman, Mark A.

2016-01-01

This study was conducted to examine the association between marital adjustment and psychological distress in a large, probability sample of married adults in Japan (N = 710) from the Midlife Development in Japan (MIDJA) study. Results indicate that positive and negative dimensions of marital adjustment were significantly associated with dimensional and categorical measures of psychological distress. Furthermore, the associations between marital adjustment and psychological distress remained significant when statistically controlling for neuroticism, quality of friend and family relationships, and demographic variables. These results demonstrate that the well-established association between marital adjustment and psychological distress found in European-American countries is also found in Japan. Findings support continued research on marital functioning and psychological distress in East Asian countries. PMID:28082761

An open-label, in-use study assessing the warming sensation accompanying IFF Flavour 316282 and the acceptability and local tolerability of a syrup containing paracetamol and pseudoephedrine for the short-term treatment of symptoms of an upper respiratory tract infection

Directory of Open Access Journals (Sweden)

Rowland Furcha

2015-03-01

Full Text Available Objective: The primary objective was to assess the warming sensation caused by IFF Flavour 316282 in a syrup used for short-term treatment by patients suffering from nasal congestion and mild to moderate body pain, headache, fever or sore throat associated with an upper respiratory tract infection. Methods: A single cohort, single treatment arm, open-label study. Subjects received one 30 mL dose of syrup containing IFF Flavour 316282, paracetamol and pseudoephedrine and recorded onset and disappearance of any warming sensation in the mouth/throat. Subjects’ assessments of strength and appeal of the sensation, taste, texture and acceptability of the product was investigated using questionnaires. Results: A total of 56 subjects were included; 53 (94.6% experienced a warming sensation. The median duration of the warming sensation was 114 s (95% confidence interval: 87–120 s. All subjects rated the syrup as excellent, good or fair for treating their symptoms; 100% and 94.6% of subjects respectively described texture and taste as excellent, good or fair. There were no safety concerns, and the syrup was well tolerated. Most subjects liked the warming sensation. Conclusions: IFF Flavour 316282 in a syrup for treatment of upper respiratory tract infection symptoms is associated with a warming sensation. The syrup is well tolerated, safe and palatable.

Perioperative respiratory adverse events in children with active upper respiratory tract infection who received general anesthesia through an orotracheal tube and inhalation agents.

Science.gov (United States)

Kim, So Yeon; Kim, Jeong Min; Lee, Jae Hoon; Kang, Young Ran; Jeong, Seung Ho; Koo, Bon-Nyeo

2013-08-01

Active upper respiratory tract infection (URI), orotracheal intubation and use of inhalation anesthetics are known risk factors for perioperative respiratory adverse events (RAE). This study investigated the risk factors of perioperative RAE in children with these risk factors. The records of 159 children who underwent general anesthesia with an orotracheal tube and inhalation were reviewed. These patients also had at least one of the following URI symptoms on the day of surgery: clear or green nasal secretion, dry or moist cough, nasal congestion, or fever. RAE such as laryngospasm, bronchospasm, oxygen desaturation and sustained cough were collected before induction, during intubation, during extubation, after extubation and in the postanesthesia care unit. Forty-five patients had RAE. The patients with RAE were younger than those without RAE. There were more passive smokers and a greater number of intubation attempts in patients with RAE than in those without RAE. The type of surgery and type of inhalation agents were not different between patients with and without RAE. Passive smoking was the only independent risk factor for RAE. In children with an active URI using orotracheal tube and inhalation anesthetics, passive smoking is an important risk factor for RAE.

Risk of upper aerodigestive tract cancer and type of alcoholic beverage: a European multicenter case-control study.

LENUS (Irish Health Repository)

Marron, Manuela

2012-07-01

The general relationship between cancers of the upper aerodigestive tract (UADT) and alcohol drinking is established. Nevertheless, it is uncertain whether different types of alcoholic beverages (wine, beer and liquor) carry different UADT cancer risks. Our study included 2,001 UADT cancer cases and 2,125 controls from 14 centres in 10 European countries. All cases were histologically or cytologically confirmed squamous cell carcinomas. Controls were frequency matched by sex, age and centre. Logistic regression models were used to estimate odds ratios (OR) and 95 % confidence intervals (95 %CI) adjusted for age, sex, centre, education level, vegetable and fruit intake, tobacco smoking and alcohol drinking, where appropriate. Risk of beverage-specific alcohol consumption were calculated among \\'pure drinker\\' who consumed one beverage type exclusively, among \\'predominant drinkers\\' who consumed one beverage type to more than 66 % and among \\'mixed drinkers\\' who consumed more than one beverage type to similar proportions. Compared to never drinkers and adjusted for cumulative alcohol consumption, the OR and 95 %CI for wine, beer and liquor drinking, respectively, were 1.24 (0.86, 1.78), 1.54 (1.05, 2.27) and 0.94 (0.53, 1.64) among \\'pure drinkers\\' (p value for heterogeneity across beverage types = 0.306), 1.05 (0.76,1.47), 1.25 (0.87,1.79) and 1.43 (0.95, 2.16) among \\'predominant drinkers\\' (p value = 0.456), and 1.09 (0.79, 1.50), 1.20 (0.88, 1.63) and 1.12 (0.82, 1.53) among \\'mixed drinkers\\' (p value = 0.889). Risk of UADT cancer increased with increasing consumption of all three alcohol beverage types. Our findings underscore the strong and comparable carcinogenic effect of ethanol in wine, beer and liquor on organs of the UADT.

IL-4-secreting eosinophils promote endometrial stromal cell proliferation and prevent Chlamydia-induced upper genital tract damage.

Science.gov (United States)

Vicetti Miguel, Rodolfo D; Quispe Calla, Nirk E; Dixon, Darlene; Foster, Robert A; Gambotto, Andrea; Pavelko, Stephen D; Hall-Stoodley, Luanne; Cherpes, Thomas L

2017-08-15

Genital Chlamydia trachomatis infections in women typically are asymptomatic and do not cause permanent upper genital tract (UGT) damage. Consistent with this presentation, type 2 innate and T H 2 adaptive immune responses associated with dampened inflammation and tissue repair are elicited in the UGT of Chlamydia -infected women. Primary C. trachomatis infection of mice also causes no genital pathology, but unlike women, does not generate Chlamydia -specific T H 2 immunity. Herein, we explored the significance of type 2 innate immunity for restricting UGT tissue damage in Chlamydia -infected mice, and in initial studies intravaginally infected wild-type, IL-10 -/- , IL-4 -/- , and IL-4Rα -/- mice with low-dose C. trachomatis inoculums. Whereas Chlamydia was comparably cleared in all groups, IL-4 -/- and IL-4Rα -/- mice displayed endometrial damage not seen in wild-type or IL-10 -/- mice. Congruent with the aberrant tissue repair in mice with deficient IL-4 signaling, we found that IL-4Rα and STAT6 signaling mediated IL-4-induced endometrial stromal cell (ESC) proliferation ex vivo, and that genital administration of an IL-4-expressing adenoviral vector greatly increased in vivo ESC proliferation. Studies with IL-4-IRES-eGFP (4get) reporter mice showed eosinophils were the main IL-4-producing endometrial leukocyte (constitutively and during Chlamydia infection), whereas studies with eosinophil-deficient mice identified this innate immune cell as essential for endometrial repair during Chlamydia infection. Together, our studies reveal IL-4-producing eosinophils stimulate ESC proliferation and prevent Chlamydia -induced endometrial damage. Based on these results, it seems possible that the robust type 2 immunity elicited by Chlamydia infection of human genital tissue may analogously promote repair processes that reduce phenotypic disease expression.

Homeopathy in the Age of Antimicrobial Resistance: Is It a Viable Treatment for Upper Respiratory Tract Infections?

Science.gov (United States)

Fixsen, Alison

2018-05-01

 Acute upper respiratory tract infections (URTIs) and their complications are the most frequent cause of antibiotic prescribing in primary care. With multi-resistant organisms proliferating, appropriate alternative treatments to these conditions are urgently required. Homeopathy presents one solution; however, there are many methods of homeopathic prescribing. This review of the literature considers firstly whether homeopathy offers a viable alternative therapeutic solution for acute URTIs and their complications, and secondly how such homeopathic intervention might take place.  Critical review of post 1994 clinical studies featuring homeopathic treatment of acute URTIs and their complications. Study design, treatment intervention, cohort group, measurement and outcome were considered. Discussion focused on the extent to which homeopathy is used to treat URTIs, rate of improvement and tolerability of the treatment, complications of URTIs, prophylactic and long-term effects, and the use of combination versus single homeopathic remedies.  Multiple peer-reviewed studies were found in which homeopathy had been used to treat URTIs and associated symptoms (cough, pharyngitis, tonsillitis, otitis media, acute sinusitis, etc.). Nine randomised controlled trials (RCTs) and 8 observational/cohort studies were analysed, 7 of which were paediatric studies. Seven RCTs used combination remedies with multiple constituents. Results for homeopathy treatment were positive overall, with faster resolution, reduced use of antibiotics and possible prophylactic and longer-term benefits.  Variations in size, location, cohort and outcome measures make comparisons and generalisations concerning homeopathic clinical trials for URTIs problematic. Nevertheless, study findings suggest at least equivalence between homeopathy and conventional treatment for uncomplicated URTI cases, with fewer adverse events and potentially broader therapeutic outcomes. The use of non

Comparing the meanings of living with advanced breast cancer between women resilient to distress and women with persistent distress: a qualitative study.

Science.gov (United States)

Lam, W W T; Yoon, S W; Sze, W K; Ng, A W Y; Soong, I; Kwong, A; Suen, D; Tsang, J; Yeo, W; Wong, K Y; Fielding, R

2017-02-01

Most women with advanced breast cancer (ABC) show little distress, but about one in ten show persistent distress over time. It remains unclear if meanings ascribed by patients to ABC differentiate these distress trajectories. This qualitative study (a) compared illness meanings of ABC between women with persistent psychological distress and those with low/transient distress, and (b) examined how illness meanings might influence coping strategies. The sample was drawn from a prior quantitative study exploring psychological distress trajectories following ABC diagnosis. Overall, 42 Cantonese- or Mandarin-speaking Chinese women diagnosed with locally advanced or metastatic ABC were recruited based on their distress trajectory status (low-stable, transient, or persistent distress). Interviews were recorded, transcribed, and analyzed following grounded theory approach using simultaneous analysis. Women with persistent distress viewed their diagnosis as another blow in life, the illness was global, permeating every aspect of their life. Maladaptive rumination and thought suppression were common responses to illness demands. These women had poor social support. A sense of demoralization stood out in their narratives. In contrast, women with transient/low-stable distress encapsulated the illness, with minimum impacts of their life. They did not evidence dysfunctional repetitive thoughts. Living in a supportive environment, they were able to accept and/or live in the present-moment. Rumination, thought suppression, social constraints, and pre-existing exposure to life stress may be potential risks for chronic distress in response to advanced breast cancer. Persistent and transient distress responses to cancer may have different underpinnings. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Maternal postpartum distress and childhood overweight

DEFF Research Database (Denmark)

Adeltoft, Teresa Ajslev; Andersen, Camilla S; Ingstrup, Katja Glejsted

2010-01-01

We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight.......We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight....

Psychological distress of adolescents exposed to Hurricane Hugo.

Science.gov (United States)

Hardin, S B; Weinrich, M; Weinrich, S; Hardin, T L; Garrison, C

1994-07-01

To ascertain the effects of a natural disaster on adolescents, 1482 South Carolina high school students who were exposed to Hurricane Hugo were surveyed 1 year after the disaster. Subjects completed a self-administered questionnaire measuring Hugo exposure, nonviolent and violent life events, social support, self-efficacy, and psychological distress. Results showed that the students reported minimal exposure to the hurricane and psychological distress variables approximated national norms. As exposure increased, adolescents reported increased symptoms of psychological distress; i.e., anger, depression, anxiety, and global mental distress. Females and white students experienced higher levels of distress. In most cases, other stressful life events were at least as strong a predictor of psychological distress as was exposure to the hurricane. Self-efficacy and social support were protective.

Transperitoneal laparoscopic pyeloplasty in children: does upper urinary tract anomalies affect surgical outcomes?

Science.gov (United States)

Brunhara, João Arthur; Moscardi, Paulo Renato Marcelo; Mello, Marcos Figueiredo; Andrade, Hiury Silva; Carvalho, Paulo Afonso; Cezarino, Bruno Nicolino; Dénes, Francisco Tibor; Lopes, Roberto Iglesias

2018-01-01

To assess the feasibility and outcomes of laparoscopic pyeloplasty in children with complex ureteropelvic junction obstruction (UPJO) and compare to children with iso-lated UPJO without associated urinary tract abnormalities. Medical records of 82 consecutive children submitted to transperitoneal laparoscopic pyeloplasty in a 12-year period were reviewed. Eleven cases were con-sidered complex, consisting of atypical anatomy including horseshoe kidneys in 6 patients, pelvic kidneys in 3 patients, and a duplex collecting system in 2 patients. Patients were di-vided into 2 groups: normal anatomy (group 1) and complex cases (group 2). Demographics, perioperative data, outcomes and complications were recorded and analyzed. Mean age was 8.9 years (0.5-17.9) for group 1 and 5.9 years (0.5-17.2) for group 2, p=0.08. The median operative time was 200 minutes (180-230) for group 1 and 203 minutes (120-300) for group 2, p=0.15. Major complications (Clavien ≥3) were 4 (5.6%) in group 1 and 1 (6.3%) in group 2, p=0.52. No deaths or early postoperative complications such as: urinoma or urinary leakage or bleeding, occurred. The success rate for radiologic improvement and flank pain improvement was comparable between the two groups. Re-garding hydronephrosis, significant improvement was present in 62 patients (93.4%) of group 1 and 10 cases (90.9%) of group 2, p=0.99. The median hospital stay was 4 days (IQR 3-4) for group 1 and 4.8 days (IQR 3-6) for group 2, p=0.27. Transperitoneal laparoscopic pyeloplasty is feasible and effective for the management of UPJO associated with renal or urinary tract anomalies. Copyright® by the International Brazilian Journal of Urology.

Intensity cut-points for the Respiratory Distress Observation Scale