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1

Thrombotic thrombocytopenic purpura in adult Still's disease.  

PubMed

We describe 2 patients with adult Still's disease who developed thrombotic thrombocytopenic purpura (TTP) and were successfully treated. Although TTP has been associated with autoimmune diseases, usually with systemic lupus erythematosus or various forms of vasculitis, it has rarely been observed in patients with adult Still's disease. This uncommon coexistence of 2 clinical entities may indicate similar pathogenetic mechanisms. PMID:8882053

Boki, K A; Tsirantonaki, M J; Markakis, K; Moutsopoulos, H M

1996-02-01

2

Economy class syndrome: still a recurrent complication of long journeys.  

PubMed

Economy class syndrome is a rare but still unavoidable complication of long haul flights, particularly in patients who carry various intrinsic risk factors. The tendency to affect even asymptomatic young people and the greater risk to fragment and propagate to the pulmonary circulation are the main characteristics of deep vein thrombosis of long-flight travelers. We report the clinical history of eight patients admitted to intensive care unit for confirmed or highly suspected economy class syndrome. Seven of them developed the syndrome within 72 h from a long return flight, one suffered from pulmonary embolism after a 12-h car trip. Two out of eight patients died, one because of extremely severe hemodynamic impairment, the other as a consequence of multiple organ failure caused by a concomitant myocardial infarction. Deep vein thrombosis and pulmonary embolism represent one of the main medical problems of air travel and cause almost 20% of deaths in people with no medical history. Although economy class syndrome occurs mostly in elderly, even the healthy young population can be affected and, in fact, three out of eight patients of our series were under 50 years of age. All our patients but one carried a well recognized risk factor for deep vein thrombosis. Clinical symptoms of deep vein thrombosis can sometimes be aspecific and confusing, so that a certain proportion of post-travel deep vein thrombosis, evolving favorably and not giving rise to pulmonary embolism, might effectively remain undiagnosed. Economy class syndrome is still quite difficult to deal with and controversial in terms of preventive strategies. PMID:17496687

Feltracco, Paolo; Barbieri, Stefania; Bertamini, Francesca; Michieletto, Elisa; Ori, Carlo

2007-04-01

3

Peyronie's Disease: Still a Surgical Disease  

PubMed Central

Peyronie's Disease (PD) remains a challenging and clinically significant morbid condition. Since its first description by François Gigot de la Peyronie, much of the treatment for PD remains nonstandardized. PD is characterized by the formation of fibrous plaques at the level of the tunica albuginea. Clinical manifestations include morphologic changes, such as curvatures and hourglass deformities. Here, we review the common surgical techniques for the management of patients with PD. PMID:22956943

Martinez, Daniel; Ercole, Cesar E.; Hakky, Tariq S.; Kramer, Andrew; Carrion, Rafael

2012-01-01

4

Elective operation after acute complicated diverticulitis: Is it still mandatory?  

PubMed Central

AIM: To investigate recurrence rates, patterns and complications after nonoperatively managed complicated diverticulitis (CD). METHODS: A retrospective study of patients treated for CD was performed. CD was defined on computed tomography by the presence of a localized abscess, pelvic abscess or extraluminal air. For follow-up, patients were contacted by telephone. Numbers of elective surgeries, recurrences and abdominal pain were analyzed. RESULTS: A total of 114 patients (median age 57 years (range 29-97)), were admitted for CD. Nine patients required surgical intervention for failure of conservative therapy (Hartmann’s procedure: n = 6; resection and colorectal anastomosis: n = 3). Of the 105 remaining patients, 24 (22.9%) underwent elective sigmoid resection. The 81 (71%) non-operated patients were all contacted after a median follow-up of 32 mo (4-63). Among them, six had developed a recurrent episode of diverticulitis at a median follow-up of 12 mo (6-36); however, no patient required hospitalization. Sixty-eight patients (84%) were asymptomatic and 13 (16%) had recurrent abdominal pain. CONCLUSION: Conservative policy is feasible and safe in 71% of cases, with a low medium-term recurrence risk. PMID:25009389

Bridoux, Valerie; Antor, Marlene; Schwarz, Lilian; Cahais, Julien; Khalil, Haitham; Michot, Francis; Tuech, Jean-Jacques

2014-01-01

5

Neurological complications of coeliac disease  

PubMed Central

A variety of neurological disorders have been reported in association with coeliac disease including epilepsy, ataxia, neuropathy, and myelopathy. The nature of this association is unclear and whether a specific neurological complication occurs in coeliac disease remains unproved. Malabsorption may lead to vitamin and trace element deficiencies. Therefore, patients who develop neurological dysfunction should be carefully screened for these. However, malabsorption does not satisfactorily explain the pathophysiology and clinical course of many of the associated neurological disorders. Other mechanisms proposed include altered autoimmunity, heredity, and gluten toxicity. This review attempts to summarise the literature and suggests directions for future research. PMID:12151653

Pengiran, T; Wills, A; Holmes, G

2002-01-01

6

[Therapy of complicated Crohn's disease].  

PubMed

During their disease course, the majority of Crohn's disease patients will develop a complicated disease which is characterized by the occurrence of fistulas and/or stenosis. Symptomatic, perianal fistulas should be surgically drained before anti-inflammatory therapy will be initiated. Antibiotics, such as metronidazole, improve disease symptomatic however, they are not sufficient to induce continuous fistula closure. For this purpose, azathioprine/6-mercaptopurine as well as anti-TNF antibodies are useful when administered continuously. Surgical options include seton drainage, fistula excision, fistula plugs and mucosa flaps. As ultima ratio, temporary ileostomy and proctectomy are to be discussed. Non-perianal fistulas often require surgical approaches. Symptomatic strictures or stenosis can be treated by anti-inflammatory medications (only if they are cause by inflammation), endoscopic balloon dilatation or surgery. PMID:24618311

Scharl, Michael; Barthel, Christiane; Rogler, Gerhard

2014-03-12

7

[Subacute sclerosing panencephalitis: a still existing disease].  

PubMed

Subacute sclerosing panencephalitis (SSPE) is a rare entity with an invariably fatal course that progressively affects the central nervous system. It is caused by persistent infection with the wild-type measles virus. While rare in industrial countries, it is not infrequent in developing countries, where there are still areas of endemic measles infection and immunization is not yet generalized. We describe an eight-year-old Spanish girl who presented rhythmic and symmetric myoclonus. She contracted measles at 13 months and required hospitalization. No cognitive deterioration was found. Neuroimaging and the initial electroencephalogram were normal. Oligoclonal bands and high titers of measles antibodies were found in serum and cerebrospinal fluid. She was treated with oral metisoprinol and intraventricular alpha-interferon (IFN-) and showed no further progression of her symptoms. The importance of including SSPE in the differential diagnosis of patients consulting for school failure, neurological deterioration or movement disorders is highlighted. Special attention should be paid to the immigrant population from countries where the incidence of SSPE is greater than in Spain. PMID:12781117

Lassaletta Atienza, A; Cebrero García, M; Martino Alba, R; González-Santiago, P; García-Frías, E

2003-06-01

8

[Adult onset Still's disease revealed by a myocarditis].  

PubMed

Adult onset Still's disease is an inflammatory disorder characterized by daily spiking high fevers, arthritis and an evanescent rash. It is a rare disease of unknown aetiology and can be life-threatening. We present a case of adult onset Still's disease associated with myocarditis requiring the use of invasive ventilation, in which the patient responded well to systemic steroids. PMID:23200908

Duburcq, T; Delannoy, P-Y; Sivova, N; Leroy, O

2013-01-01

9

Chronic Kidney Disease and Its Complications  

PubMed Central

Chronic kidney disease (CKD) is a complex disease impacting more than twenty million individuals in the United States. Progression of CKD is associated with a number of serious complications, including increased incidence of cardiovascular disease, hyperlipidemia, anemia and metabolic bone disease. CKD patients should be assessed for the presence of these complications and receive optimal treatment to reduce their morbidity and mortality. A multidisciplinary approach is required to accomplish this goal. PMID:18486718

Thomas, Robert; Kanso, Abbas; Sedor, John R.

2008-01-01

10

Cloak and dagger: the case for adult onset still disease and hemophagocytic lymphohistiocytosis  

Microsoft Academic Search

Adult onset Still’s disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. Systemic onset juvenile idiopathic\\u000a arthritis (SoJIA) is the preferred nomenclature of Still’s disease. Strong association with so-called macrophage activation\\u000a syndrome (MAS) may provide a clue to the understanding of the distinctive pathogenetic features of SoJIA. MAS is a severe,\\u000a potentially life-threatening complication characterized by the excessive

Francisco Hélder C. Félix; Luzia Kalyne A. M. Leal; Juvenia Bezerra Fontenele

2009-01-01

11

Cardiovascular complications of pediatric chronic kidney disease  

PubMed Central

Cardiovascular disease (CVD) mortality is a leading cause of death in adult chronic kidney disease (CKD), with exceptionally high rates in young adults, according to the Task Force on Cardiovascular Disease. Recent data indicate that cardiovascular complications are already present in children with CKD. This review summarizes the current literature on cardiac risk factors, mortality and morbidity in children with CKD. PMID:17120060

2006-01-01

12

Extraintestinal complications of inflammatory bowel disease  

Microsoft Academic Search

Opinion statement  \\u000a \\u000a \\u000a \\u000a \\u000a – \\u000a \\u000a Extraintestinal complications of inflammatory bowel disease (IBD) are often secondary to the underlying disease. Therefore,\\u000a the first priority is to get active IBD into remission with medications, since surgery for IBD is not indicated for the treatment\\u000a of extraintestinal complications.\\u000a \\u000a \\u000a \\u000a \\u000a – \\u000a \\u000a Symptoms of extraintestinal complications usually can be treated with simple agents; the treatment of patients with

Ad A. van Bodegraven; Ben A. C. Dijkmans; Paul Lips; Tom J. Stoof; A. Salvador Peña; Stephan G. M. Meuwissen

2001-01-01

13

Unusual imaging characteristics of complicated hydatid disease.  

PubMed

Hydatid disease, a worldwide zoonosis, is caused by the larval stage of the Echinococcus tapeworm. Although the liver and the lungs are the most frequently involved organs in the body, hydatid cysts of other organs are unusual. Radiologically, they usually demonstrate typical imaging findings, but unusual imaging characteristics of complicated cyst of hydatid disease, associated with high morbidity and mortality, are rarely described in the literature. The purpose of this study is to review the general features of hydatidosis and to discuss atypical imaging characteristics of the complicated hydatid disease in the human, with an emphasis on structure and rupture of the cystic lesion as well as ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI) features of the disease. In our study, the available literature and images of the cases with complicated hydatidosis involving liver, lung, brain, spine and orbit were reviewed retrospectively. In hydatid disease, there are many potential local and systemic complications due to secondary involvement in almost any anatomic location in humans. Radiologically, in addition to the presence of atypical findings such as perifocal edema, non-homogenous contrast enhancement, multiplicity or septations and calcification, various unusual manifestations due to rupture or infection of the cyst have been observed in our cases with complicated hydatid disease. To prevent subsequent acute catastrophic results and the development of recurrences in various organs, it should be kept in mind that complicated hydatid cysts can cause unusual USG, CT, and MRI findings, in addition to typical ones, in endemic areas. Therefore, familiarity with atypical radiological appearances of complicated hydatid disease may be valuable in making a correct diagnosis and treatment. PMID:17275238

Turgut, Ahmet Tuncay; Altin, Levent; Topçu, Salih; Kiliço?lu, Bülent; Aliinok, Tamer; Kaptano?lu, Erkan; Karademir, Alp; Ko?ar, U?ur

2007-07-01

14

Severe Complications of Inflammatory Bowel Disease  

Microsoft Academic Search

Patients who have inflammatory bowel disease (IBD) occasionally have severe complications or emergency situations that require expedited, expert medical care, including toxic colitis, fistulas, abdominal abscesses, malig- nancy, primary sclerosing cholangitis, and pouchitis. Morbidity and mortal- ity rates of Crohn's disease and ulcerative colitis (UC) are increased over the expected rates in the unaffected population. Knowledge of the presenting features,

Francisco Marrero; Mohammed A. Qadeer; Bret A. Lashner

15

Pulmonary hypertension complicating connective tissue disease.  

PubMed

Pulmonary hypertension (PH) may complicate connective tissue disease (CTD), particularly systemic sclerosis (SSc, scleroderma), and markedly increases mortality. More than 70% of cases of PH complicating CTD occur in SSc, which is the major focus of this article. Pulmonary complications (i.e., interstitial lung disease [ILD] and PH) are the leading causes of scleroderma-related deaths. "Isolated" PH (i.e., without ILD) complicates SSc in 7.5 to 20% of cases; secondary PH may also occur in patients with SSc-associated ILD. Several clinical markers and specific autoantibody profiles have been associated with PH in SSc. The role of PH-specific therapy is controversial, as prognosis and responsiveness to therapy are worse in SSc-associated PH compared with idiopathic pulmonary arterial hypertension. We discuss medical therapies for CTD-associated PH and the role of lung transplantation for patients failing medical therapy. PMID:24037627

Lynch, Joseph P; Belperio, John A; Saggar, Rajeev; Fishbein, Michael C; Saggar, Rajan

2013-10-01

16

Adult-Onset Still's Disease: From Pathophysiology to Targeted Therapies  

PubMed Central

Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder affecting primarily young individuals. The diagnosis is primarily clinical and necessitates the exclusion of a wide range of mimicking disorders. Given the lack of solid data in regard to the underlying pathogenetic mechanisms, treatment of AOSD has been for years largely empirical. Recent advances have revealed a pivotal role of several proinflammatory cytokines such as tumor necrosis factor-? (TNF-?), interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8), and interleukin-18 (IL-18) in disease pathogenesis, giving rise to the development of new targeted therapies aiming at optimal disease control. PMID:22792508

Mavragani, Clio P.; Spyridakis, Evangelos G.; Koutsilieris, Michael

2012-01-01

17

Psychological complications in sickle cell disease  

Microsoft Academic Search

Summary This review examines the evidence for some of the common psychological complications found across the life span of patients with sickle cell disease (SCD), which are likely to be encountered by haematologists responsible for their medical management. Electronic searches of medical and psychological databases were conducted with a focus on three main areas: psychological coping, quality of life and

Kofi A Anie

2005-01-01

18

Adult onset Still's disease and related renal amyloidosis.  

PubMed Central

A 57 year old woman presented with clinical and biological features of adult onset Still's disease. A kidney biopsy was performed at the onset of the condition and was found to be normal. Four years later, in view of a nephrotic syndrome, histopathological examination of a new kidney biopsy specimen was made and showed typical amyloid deposition. Renal amyloidosis was suspected in five previously reported cases but demonstrated by kidney biopsy in only two of them. In the present case renal amyloidosis was recorded after disease of four years' duration. The normality of the first renal biopsy specimen suggests the possibility of a direct relation between amyloidosis and adult onset Still's disease. Images PMID:2029209

Wendling, D; Humbert, P G; Billerey, C; Fest, T; Dupond, J L

1991-01-01

19

Complications of Therapy in Parkinson's Disease  

PubMed Central

Despite several more effective combinations, the incidence of disability and intractable complications from levodopa therapy for Parkinson's disease is unchanged. Many of these appear to be related to the development of denervation hypersensitivity as well as to drug tolerance and loss of effect. They include dyskinesia, `wearing off' phenomenon, `on-off' phenomenon, and various psychic changes. More current forms of therapy with bromocriptine and drug holidays are described, emphasizing methods of preventing and controlling the incapacitating complications associated with long term drug therapy. Some future therapeutic considerations are also described. PMID:21286582

Kofman, Oscar S.

1983-01-01

20

Giant aortic arch aneurysm complicating Kawasaki's disease  

PubMed Central

Kawasaki disease (KD) is a common acute vasculitis in pediatric population that usually involves small- and middle-sized arteries, commonly coronary arteries. Although the incidence and natural course of coronary aneurysms after KD are well documented in studies, related reports on peripheral arterial and aortic aneurysms are scarce. We report the occurrence of a giant aortic aneurysm involving the horizontal part of aortic arch in a 28-month-old boy diagnosed with KD. This complication was managed by steroids therapy in the beginning. Because of mechanical complication and potential risk of rupture, surgery was undertaken.

Hakim, Kaouthar; Boussada, Rafik; Chaker, Lilia; Ouarda, Fatma

2014-01-01

21

Perianal complications of pediatric Crohn's disease.  

PubMed

The management of perianal disease (PD) in children with Crohn's disease was reviewed. Of 325 patients (184 boys), 200 (62%) developed PD. The mean age at diagnosis of Crohn's disease was 11.2 years (range, 5 to 17 years). Skin tags were present in 114 (35%) patients, fissures in 165 (51%), fistulas in 41 (15%), and perirectal abscesses in 47 (13%). One hundred fifty-three patients had PD as one of the first symptoms; 71 of these had complete remission of PD and the remaining 82 had chronic symptoms. Forty-two patients were initially free of PD, only to develop it later. PD occurred in 50% of patients with gastroduodenal Crohn's disease, 57% with jejunal, 68% with ileal, 64% with ileocecal, 60% with ileocolic, and 51% with colonic. Local minor operation was necessary in 38 (12%) patients, fistulotomy in 12, and abscess drainage in 26. Four patients required either intestinal resection and/or enterostomy for progressive PD. Fifty-three patients received metronidazole, with amelioration in 38. It is concluded that PD is a common complication of Crohn's disease in children and adolescents. Its presentation may antedate that of the primary disease. Most PD follows a benign course. There is a limited role for operation, but a need for meticulous perineal care and a potential benefit with metronidazole therapy. We advocate conservatism in the management of perianal complications of Crohn's disease in pediatric patients. PMID:2061798

Palder, S B; Shandling, B; Bilik, R; Griffiths, A M; Sherman, P

1991-05-01

22

Adult onset Still's disease: clinical experience with 18 patients over 15 years in northern India.  

PubMed Central

Over a 15 year period 18 patients (eight men, 10 women), 16-50 years old, were diagnosed as having adult onset Still's disease. Fever and arthralgia were always present but prominent lymphadenopathy was uncommon and the serosa were rarely affected. The typical rash of this disease was observed in nine patients. Several complications, including deforming arthritis, amyloidosis, granulomatous hepatitis, uveitis, scleritis, cutaneous vasculitis, and cardiomyopathy, were observed during follow up. Two patients were affected by a nosocomial infection during immunosuppressive treatment for uncontrolled disease. There were no characteristic features at necropsy. Ten patients had a monocyclic course that responded well to aspirin and indomethacin, whereas eight had a polycyclic pattern which invariably required treatment with corticosteroids. Serious complications developed exclusively in the latter group. This group of patients requires early, intensive disease modifying treatment. PMID:1586255

Bambery, P; Thomas, R J; Malhotra, H S; Kaur, U; Bhusnurmath, S R; Deodhar, S D

1992-01-01

23

Pulmonary Complications of Sickle Cell Disease  

PubMed Central

Sickle cell disease (SCD) is a common monogenetic disorder with high associated morbidity and mortality. The pulmonary complications of SCD are of particular importance, as acute chest syndrome and pulmonary hypertension have the highest associated mortality rates within this population. This article reviews the pathophysiology, diagnosis, and treatment of clinically significant pulmonary manifestations of SCD, including acute chest syndrome, asthma, and pulmonary hypertension in adult and pediatric patients. Clinicians should be vigilant in screening and treating such comorbidities to improve patient outcomes. PMID:22447965

Miller, Andrew C.

2012-01-01

24

Q Fever: An Old but Still a Poorly Understood Disease  

PubMed Central

Q fever is a bacterial infection affecting mainly the lungs, liver, and heart. It is found around the world and is caused by the bacteria Coxiella burnetii. The bacteria affects sheep, goats, cattle, dogs, cats, birds, rodents, and ticks. Infected animals shed this bacteria in birth products, feces, milk, and urine. Humans usually get Q fever by breathing in contaminated droplets released by infected animals and drinking raw milk. People at highest risk for this infection are farmers, laboratory workers, sheep and dairy workers, and veterinarians. Chronic Q fever develops in people who have been infected for more than 6 months. It usually takes about 20 days after exposure to the bacteria for symptoms to occur. Most cases are mild, yet some severe cases have been reported. Symptoms of acute Q fever may include: chest pain with breathing, cough, fever, headache, jaundice, muscle pains, and shortness of breath. Symptoms of chronic Q fever may include chills, fatigue, night sweats, prolonged fever, and shortness of breath. Q fever is diagnosed with a blood antibody test. The main treatment for the disease is with antibiotics. For acute Q fever, doxycycline is recommended. For chronic Q fever, a combination of doxycycline and hydroxychloroquine is often used long term. Complications are cirrhosis, hepatitis, encephalitis, endocarditis, pericarditis, myocarditis, interstitial pulmonary fibrosis, meningitis, and pneumonia. People at risk should always: carefully dispose of animal products that may be infected, disinfect any contaminated areas, and thoroughly wash their hands. Pasteurizing milk can also help prevent Q fever. PMID:23213331

Honarmand, Hamidreza

2012-01-01

25

Adult-onset Still disease: a rare disorder with a potentially fatal outcome  

Microsoft Academic Search

Purpose  The aim of this study was to assess the clinical and laboratory features of a cohort of Italian patients with adult-onset\\u000a Still disease (AOSD) with particular attention on possible life-threatening complications.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The clinical charts of 41 consecutive Italian patients with AOSD referred to our rheumatological department over the last\\u000a 10 years were retrospectively examined. Data regarding clinical manifestations, laboratory features

Roberta Priori; Serena Colafrancesco; Angelica Gattamelata; Manuela Di Franco; Ugo Di Tondo; Guido Valesini

2010-01-01

26

Adamantiades-Behcet's disease-complicated gastroenteropathy.  

PubMed

Adamantiades-Behcet's disease (ABD) is a chronic, relapsing, systemic vasculitis of unknown etiology. It is more prevalent in populations along the ancient Silk Road from Eastern Asia to the Mediterranean Basin, and most frequently affects young adults between the second and fourth decades of life. ABD-complicated gastroenteropathy is a significant cause of morbidity and mortality, with abdominal pain as the most common symptom. The ileocecal region is affected predominantly, with ulcerations that may lead to penetration and/or perforation, whereas other parts of the gastrointestinal system including the esophagus and stomach can also be affected. Endoscopy is useful to locate the site and extent of the lesions, and tissue biopsy is often warranted to examine the histopathology that is often suggestive of underlying vasculitis of small veins/venules or, alternatively in some cases, nonspecific inflammation. Bowel wall thickening is the most common finding on computed tomography scan. Treatment is largely empirical since well-controlled studies are difficult to conduct due to the heterogeneity of the disease, and the unpredictable course with exacerbation and remission. Corticosteroids with or without other immunosuppressive drugs, such as cyclophosphamide, azathioprine, sulfasalazine, tumor necrosis factor ? antagonist or thalidomide should be applied before surgery, except in emergency. PMID:22363131

Wu, Qing-Jun; Zhang, Feng-Chun; Zhang, Xuan

2012-02-21

27

[Neurologic complications in inflammatory bowel diseases].  

PubMed

Some inflammatory diseases of the gastrointestinal system are associated with neurological symptoms which, in rare cases, may precede the onset of the gastrointestinal manifestation of the disease. Celiac sprue is characterized by an intolerance to the wheat protein gluten. The typical neurological manifestation of celiac sprue is cerebellar ataxia. The ataxia as well as the gastrointestinal symptoms can be treated with a strictly gluten-free diet. The neurological symptoms of Whipple's disease, a disorder caused by gram-positive bacilli, are variable. Typical symptoms of cerebral Whipple's disease include dementia, ophthalmoplegia, movement disorders, and signs of hypothalamic dysfunction. Nowadays, the diagnosis of cerebral Whipple's disease is made by PCR detection of the bacilli in the CSF. Crohn's disease and ulcerative colitis are associated with neurological symptoms to a similar proportion. Various forms of polyneuropathies have been observed. The CNS manifestations of inflammatory bowel diseases include thromboembolic stroke, cerebral venous thrombosis, and cerebral vasculitis. PMID:12242995

Töpper, R; Gartung, C; Block, F

2002-06-01

28

Adult-Onset Still's Disease Masquerading as Sepsis in an Asplenic Active Duty Soldier.  

PubMed

This is a case of a 26-year-old active duty male with a history of idiopathic thrombocytopenic purpura (ITP) and surgical asplenia who presented with a one-week history of fevers, myalgias, arthralgias, and rigors. His evaluation upon presentation was significant for a temperature of 103 degrees F, white blood cell count of 36?K with a granulocytic predominance, and elevated transaminases. He was treated empirically with broad-spectrum antibiotics with concern for a systemic infection with an encapsulated organism. During his stay, he developed four SIRS criteria and was transferred to the progressive care unit for suspected sepsis. He continued to have twice-daily fevers and a faint, salmon-colored centripetal rash was eventually observed during his febrile episodes. After a nondiagnostic microbiologic and serologic workup, he was diagnosed with adult-onset Still's Disease and started on intravenous methylprednisolone with brisk response. He was discharged on oral prednisone and was started on anakinra. Adult-onset Still's disease is a rare condition that presents with varying severity, and this is the first reported case, to our knowledge, of its diagnosis in an asplenic patient. Its management in the setting of asplenia is complicated by the need for antibiotic therapy with each episode of fever. PMID:23251171

Jaqua, Nathan T; Finger, David; Hawley, Joshua S

2012-01-01

29

Allertic complications of meningococcal disease. I. Clinical aspects.  

PubMed

Out of 717 patients with meningococcal disease 53 showed one or more of the three allergic complications: 47 (6.6%) developed arthritis, 12 (1.7%) developed cutaneous vasculitis, and 6 developed episcleritis. These complications, which were often multiple, occurred six to nine days after the beginning of the illness and three to six days after the start of successful antibiotic therapy. Those patients with severe systemic disease were prone to the complications.Histological and bacteriological study of the arthritis and vasculitis showed that these lesions were probably not due to persisting infection and suggested that they might be due to immune complex disease. PMID:4268766

Whittle, H C; Abdullahi, M T; Fakunle, F A; Greenwood, B M; Bryceson, A D; Parry, E H; Turk, J L

1973-06-30

30

Management of a Pregnancy Complicated by Pompe Disease  

PubMed Central

Background. As more women with metabolic muscle diseases reach reproductive age, knowledge of these diseases and their impact on pregnancy is necessary. Case. 23-year-old G1P0 with juvenile-onset Pompe disease (PD) delivered a viable infant by cesarean section at 32 weeks and 6 days. The pregnancy was complicated by worsening maternal pulmonary status, muscular strength, and mobility. Conclusion. The management of pregnancies complicated by Pompe disease requires a multidisciplinary approach, including expertise in neuromuscular disease, maternal-fetal medicine, biochemical genetics, pulmonology, anesthesia, and dietetics. PMID:23304582

Weida, Jennifer; Hainline, B. E.; Bodkin, C.; Williams, M. K.

2012-01-01

31

A complicated case of mitral valve disease.  

PubMed Central

A patient with rheumatic mitral stenosis and previous cerebral embolism had a myocardial infarction during cardiac catheterisation. She later developed severe mitral regurgitation one year after open valvotomy and at valve replacement was found to have a papillary tumour of the mitral valve. Unexplained low cardiac output occurred four days after operation. Postmortem examination showed thrombotic occlusion of the xenograft prosthesis, a complication not previously seen with tissue valves. Both of these rare events were suggested by the patient's clinical course and could have been diagnosed with cross sectional echocardiography. Images PMID:3970791

James, S E; McKay, R; Ross, D N

1985-01-01

32

Celiac disease: how complicated can it get?  

Microsoft Academic Search

In the small intestine of celiac disease patients, dietary wheat gluten and similar proteins in barley and rye trigger an\\u000a inflammatory response. While strict adherence to a gluten-free diet induces full recovery in most patients, a small percentage\\u000a of patients fail to recover. In a subset of these refractory celiac disease patients, an (aberrant) oligoclonal intraepithelial\\u000a lymphocyte population develops into

Jennifer May-Ling Tjon; Jeroen van Bergen; Frits Koning

2010-01-01

33

Allergic Complications of Meningococcal Disease I—Clinical Aspects  

Microsoft Academic Search

Out of 717 patients with meningococcal disease 53 showed one or more of the three allergic complications: 47 (6·6%) developed arthritis, 12 (1·7%) developed cutaneous vasculitis, and 6 developed episcleritis. These complications, which were often multiple, occurred six to nine days after the beginning of the illness and three to six days after the start of successful antibiotic therapy. Those

H. C. Whittle; M. T. Abdullahi; F. A. Fakunle; B. M. Greenwood; A. D. M. Bryceson; E. H. O. Parry; J. L. Turk

1973-01-01

34

Antacid Control of Complications from Acute Gastroduodenal Disease After Burns.  

National Technical Information Service (NTIS)

To determine the effectiveness of hydrogen ion neutralization in preventing the clinical complications (hemorrhage and perforation) of acute gastroduodenal disease after thermal injury, 48 patients with burns of greater than 35% total body surface were ev...

J. C. McAlhany, A. J. Czaja, B. A. Pruitt

1976-01-01

35

[Role of enterosorbents in treatment of complicated varicose disease].  

PubMed

Results of treatment of 43 patients, suffering varicose disease, complicated by trophic disorders, were analyzed. To the patients a complex was prescribed, including sorpents, angioprotectors, locally - ointments. There were operated 14 patients. PMID:25252553

Biliaieva, O O; Korzhyk, N P; Myronov, O M; Balins'ka, M I; Iemets', V V

2014-06-01

36

Pulmonary hypertension complicating interstitial lung disease and COPD.  

PubMed

Pulmonary hypertension (PH) may complicate parenchymal lung disease, specifically interstitial lung diseases and chronic obstructive pulmonary disease, and uniformly increases the mortality risk. The epidemiology and degree of PH is variable and unique to the underlying lung disease. The clinician should exercise a high index of suspicion for PH complicating parenchymal lung disease especially given the nonspecific symptomatology and the limitations of echocardiography in this patient population. In general, PH-specific therapies in this setting have been poorly studied, with concern for increased shunting and/or ventilation/perfusion (V/Q) mismatch and resultant hypoxemia. A better understanding of the mechanisms underlying PH related to parenchymal lung disease may lead to novel pharmacological targets to prevent or treat this serious complication. PMID:24037628

Shino, Michael Y; Lynch, Joseph P; Saggar, Rajeev; Abtin, Fereidoun; Belperio, John A; Saggar, Rajan

2013-10-01

37

Preventing infective complications in inflammatory bowel disease  

PubMed Central

Over the past decade there has been a dramatic change in the treatment of patients with Crohn’s disease and ulcerative colitis, which comprise the inflammatory bowel diseases (IBD). This is due to the increasing use of immunosuppressives and in particular the biological agents, which are being used earlier in the course of disease, and for longer durations, as these therapies result in better clinical outcomes for patients. This, however, has the potential to increase the risk of opportunistic and serious infections in these patients, most of which are preventable. Much like the risk for potential malignancy resulting from the use of these therapies long-term, a balance needs to be struck between medication use to control the disease with minimization of the risk of an opportunistic infection. This outcome is achieved by the physician’s tailored use of justified therapies, and the patients’ education and actions to minimize infection risk. The purpose of this review is to explore the evidence and guidelines available to all physicians managing patients with IBD using immunomodulating agents and to aid in the prevention of opportunistic infections. PMID:25110408

Mill, Justine; Lawrance, Ian C

2014-01-01

38

Ocular complications of childhood rheumatic diseases: Uveitis  

Microsoft Academic Search

Ocular involvement is common in pediatric rheumatologic diseases, supporting the concept that these conditions cannot be understood\\u000a simply as isolated entities, but rather as multisystem disorders. The reasons for the breach of the eye-brain barrier and\\u000a the targeting of the usually well-shielded eye during a pan-inflammatory process remains unclear. Pediatric rheumatologists\\u000a should become familiar with these ocular disorders, because as

Andreas Reiff

2006-01-01

39

Complications of treatment of Hodgkin's disease in children  

SciTech Connect

An analysis of complications of therapy requires long-term and frequent followup. Reported here is a review of 179 consecutive children with Hodgkin's disease from Stanford University Medical Center who were seen, treated, and followed over a 20-year period. Complications of treatment are related to the extent of disease and the aggressiveness of therapy. Severe complications from radiotherapy are associated with high-dose, extended-field treatment in preadolescent children. Severe chemotherapy-associated complications include immunosuppression, sterility, and secondary oncogenesis. As cure rates are increasingly optimistic among children with Hodgkin's disease, successful treatment with minimal morbidity remains our greatest challenge. Therapy programs require continual refinement utilizing assessment of short- and long-term side effects of treatment.

Donaldson, S.S.; Kaplan, H.S.

1982-04-01

40

The Evaluation of Pain Complicating Primary Disabling Disease  

Microsoft Academic Search

Pain syndromes complicate many diseases that cause disability. Not uncom- monly, more than one pain syndrome may follow a disease process: The literature describes somatic incisional pain, neurogenic phantom pain, and neurogenic neu- roma pain following amputation (1). Precisely defined, as well as generalized, pain syndromes exist: For example, thalamic, or central pain syndrome, charac- terized by burning hemibody pain

Donna Marie Bloodworth

41

Allergic Complications of Meningococcal Disease I—Clinical Aspects  

PubMed Central

Out of 717 patients with meningococcal disease 53 showed one or more of the three allergic complications: 47 (6·6%) developed arthritis, 12 (1·7%) developed cutaneous vasculitis, and 6 developed episcleritis. These complications, which were often multiple, occurred six to nine days after the beginning of the illness and three to six days after the start of successful antibiotic therapy. Those patients with severe systemic disease were prone to the complications. Histological and bacteriological study of the arthritis and vasculitis showed that these lesions were probably not due to persisting infection and suggested that they might be due to immune complex disease. ImagesFIG. 3FIG. 4FIG. 5FIG. 6 PMID:4268766

Whittle, H. C.; Abdullahi, M. T.; Fakunle, F. A.; Greenwood, B. M.; Bryceson, A. D. M.; Parry, E. H. O.; Turk, J. L.

1973-01-01

42

Paraneoplastic syndrome mimicking adult-onset Still's disease caused by advanced lung cancer: a case report  

PubMed Central

Background Paraneoplastic syndromes (PNSs) are common complications of lung cancer and often develop preceding the diagnosis of primary malignancy. Rheumatologic PNSs mimicking Adult-Onset Still' s Disease (AOSD) is a rare condition with only a limited number of cases reported in the literature, none of which was associated with lung cancer. It is often difficult to differentiate AOSD-like paraneoplasia from coincidental AOSD based on the clinical manifestations. Case presentation Here we present a 56-year-old man with advanced lung adenocarcinoma who developed a remittent fever together with pharyngodynia and joint pain after first cycle of chemotherapy with paclitaxel plus carboplatin. Although a leukocytosis was detected, no evidence of infection was acquired and empirical antibiotic treatment was ineffective. A temple skin rash, abnormal hepatic function and a remarkable elevated level of serum ferritin occurred later in this patient, which highly supported a potential diagnosis of AOSD. The patient was finally diagnosed as AOSD-like PNS considering the good and prompt response to a short-term administration of non-steroidal anti-inflammatory drug and subsequent cycles of effective chemotherapy with pemetrexed plus cisplatin. Discussion and conclusions Though rare, AOSD-like PNS can be one of the potential diagnoses in lung cancer patients with fever of undetermined origin, especially those having no response to antibiotic treatment. Management consists of control of the underlying malignancy and symptomatic treatment of the syndromes with non-steroidal anti-inflammatory drugs or corticosteroids. PMID:22085873

2011-01-01

43

No TV or Obesity, But Ancient People Still Had Heart Disease  

MedlinePLUS

... JavaScript. No TV or Obesity, But Ancient People Still Had Heart Disease Mummy study shows that, just ... that even when people managed to survive those ills, the body would be in a continual state ...

44

Extraintestinal manifestations and complications in inflammatory bowel diseases  

PubMed Central

Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) that often involve organs other than those of the gastrointestinal tract. These nonintestinal affections are termed extraintestinal symptoms. Differentiating the true extraintestinal manifestations of inflammatory bowel diseases from secondary extraintestinal complications, caused by malnutrition, chronic inflammation or side effects of therapy, may be difficult. This review concentrates on frequency, clinical presentation and therapeutic implications of extraintestinal symptoms in inflammatory bowel diseases. If possible, extraintestinal manifestations are differentiated from extraintestinal complications. Special attention is given to the more recently described sites of involvement; i.e. thromboembolic events, osteoporosis, pulmonary involvement and affection of the central nervous system. PMID:16937463

Rothfuss, Katja S; Stange, Eduard F; Herrlinger, Klaus R

2006-01-01

45

Ocular complications of childhood rheumatic diseases: Nonuveitic inflammatory eye diseases  

Microsoft Academic Search

Ocular involvement is common in pediatric rheumatologic diseases, supporting the concept that these conditions do not manifest\\u000a in isolation but are components of a multisystem inflammatory process. It remains unclear why the eye and its adjacent tissues\\u000a become a target during paninflammatory disease. Pediatric rheumatologists must recognize ocular disorders, as these conditions\\u000a significantly concern the treatment team managing serious cases

Andreas Reiff

2009-01-01

46

How I treat renal complications in sickle cell disease.  

PubMed

Renal disease is one of the most frequent and severe complications experienced by patients with sickle cell disease; its prevalence is likely to increase as the patient population ages. We recommend regular monitoring for early signs of renal involvement and a low threshold for the use of hydroxyurea as preventative measures for end-stage renal disease. Once renal complications are detected, a careful assessment of the patient is required to rule out other causes of renal disease. Proteinuria and hypertension should be managed aggressively and the patient referred to a specialist nephrology center when progressive decline in renal function is noted. For the few patients who develop advanced chronic kidney disease, timely planning for dialysis and transplantation can significantly improve outcome, and we recommend an exchange blood transfusion policy for all patients on the transplant waiting list and for those with a functioning graft. Alongside the invasive treatment regimes, it is important to remember that renal failure in conjunction with sickle cell disease does carry a significant burden of morbidity and that focusing on symptom control has to be central to good patient care. PMID:24764565

Sharpe, Claire C; Thein, Swee Lay

2014-06-12

47

Direct Hyperbilirubinemia Complicating ABO Hemolytic Disease of the Newborn  

Microsoft Academic Search

A retrospective study of the diagnostic implications of conjugated hyperbilirubinemia com plicating ABO hemolytic disease of the newborn (HDN) was done by studying the records of 264 infants with ABO-HDN. Direct hyperbilirubinemia was found to complicate ABO-HDN in 3 per cent of the infants, all being full term. Eighty-seven per cent were female and familial occurrence was noted in half

Yakov Sivan; Paul Merlob; Jacob Nutman; Salomon H. Reisner

1983-01-01

48

Chronic graft-versus-host disease complicated by nephrotic syndrome  

Microsoft Academic Search

Chronic graft-versus-host disease (cGVHD) is one of the most frequent and serious complications of allogeneic hematopoietic stem cell transplantation (HSCT). Nephrotic syndrome (NS) is an uncommon and underrecognized manifestation of cGVHD. We report a patient who developed NS 18 months after allogeneic bone marrow transplantation. The onset of NS was accompanied by active manifestations of cGVHD, and immunosuppressants had not

Hsin-Hui Wang; An-Hang Yang; Ling-Yu Yang; Giun-Yi Hung; Jei-Wen Chang; Chun-Kai Wang; Tzong-Yann Lee; Ren-Bin Tang

2011-01-01

49

The Still Divided Academy: How Competing Visions of Power, Politics, and Diversity Complicate the Mission of Higher Education  

ERIC Educational Resources Information Center

"The Still Divided Academy" is a wonderful examination of the academic community that shows their inner workings by addressing a broad range of issues including: academic politics, tenure, perceived and real political imbalance, academic freedom, and diversity. Administrators, professors, and students have very different priorities, values, and…

Rothman, Stanley; Kelly-Woessner, April; Woessner, Matthew

2011-01-01

50

Complications in the management of metastatic spinal disease  

PubMed Central

Metastatic spine disease accounts for 10% to 30% of new cancer diagnoses annually. The most frequent presentation is axial spinal pain. No treatment has been proven to increase the life expectancy of patients with spinal metastasis. The goals of therapy are pain control and functional preservation. The most important prognostic indicator for spinal metastases is the initial functional score. Treatment is multidisciplinary, and virtually all treatment is palliative. Management is guided by three key issues; neurologic compromise, spinal instability, and individual patient factors. Site-directed radiation, with or without chemotherapy is the most commonly used treatment modality for those patients presenting with spinal pain, causative by tumours which are not impinging on neural elements. Operative intervention has, until recently been advocated for establishing a tissue diagnosis, mechanical stabilization and for reduction of tumor burden but not for a curative approach. It is treatment of choice patients with diseaseadvancement despite radiotherapy and in those with known radiotherapy-resistant tumors. Vertebral resection and anterior stabilization with methacrylate or hardware (e.g., cages) has been advocated.Surgical decompression and stabilization, however, along with radiotherapy, may provide the most promising treatment. It stabilizes the metastatic deposited areaand allows ambulation with pain relief. In general, patients who are nonambulatory at diagnosis do poorly, as do patients in whom more than one vertebra is involved. Surgical intervention is indicated in patients with radiation-resistant tumors, spinal instability, spinal compression with bone or disk fragments, progressive neurologic deterioration, previous radiation exposure, and uncertain diagnosis that requires tissue diagnosis. The main goal in the management of spinal metastatic deposits is always palliative rather than curative, with the primary aim being pain relief and improved mobility. This however, does not come without complications, regardless of the surgical intervention technique used. These complication range from the general surgical complications of bleeding, infection, damage to surrounding structures and post operative DT/PE to spinal specific complications of persistent neurologic deficit and paralysis. PMID:22919567

Dunning, Eilis Catherine; Butler, Joseph Simon; Morris, Seamus

2012-01-01

51

Septic pylephlebitis as a rare complication of Crohn's disease.  

PubMed

Thrombophlebitis of the portal venous system (PVS) with superimposed bacterial infection (septic pylephlebitis) is an extremely rare complication of Crohn's disease (CD), and therefore diagnosis of septic pylephlebitis is difficult without high clinical suspicion. A 16-year old male patient who was diagnosed with CD 3 months earlier was admitted with recurrent fever and abdominal pain. CD activity had been well controlled with conventional medical treatment during a follow-up period. Abdominal contrast-enhanced computed tomography showed massive thrombosis in the PVS without evidence of intra-abdominal infection, and blood cultures were positive for Streptococcus viridians. There was no evidence of deep vein thrombosis or pulmonary thromboembolism, and all laboratory tests for thrombophilia were normal. Based on these findings, the patient was diagnosed with septic pylephlebitis complicated with CD, and was successfully treated with intravenous antibiotic therapy combined with anticoagulation. This case suggests that early comprehensive evaluation is crucial for immediate diagnosis and proper treatment of septic pylephlebitis in patients with CD who present with fever and abdominal pain of unknown origin, even with stable disease activity and absence of other intra-abdominal infections. PMID:23624737

Shin, A Ri; Lee, Chang Kyun; Kim, Hyo Jong; Shim, Jae-Jun; Jang, Jae Young; Dong, Seok Ho; Kim, Byung Ho; Chang, Young Woon

2013-04-01

52

Complications of HIV: lipodystrophy, anemia, renal, cardiovascular, and bone diseases.  

PubMed

Diagnosis of a human immunodeficiency virus (HIV) infection has long been associated with a short life expectancy, with care centered on the treatment and prevention of opportunistic infections and symptom management. As progress has been made through better understanding of the virus, and improved medications and treatments, persons with HIV are living longer, more productive lives. In addition to the scientific breakthroughs in treating the HIV-infected patient, more is also being learned about the long-term effects of the treatments and the virus, such as lipodystrophy syndrome. Comorbid diseases are also becoming more common in patients with HIV, such as anemia, bone disease, renal disease, and cardiac disease, which may be the result of metabolic complications or HIV itself. There is a vast array of comorbid diseases and adverse effects of medications in persons with HIV disease; and information regarding these issues is constantly changing as research continues to show more about their pathophysiology and treatment options. The most common comorbid disorders will be explored. A detailed explanation of the lipodystrophy syndrome and its common metabolic manifestations will be presented, including current research. In addition, the etiology, clinical findings, diagnosis, and treatment of the most common comorbid diseases associated with anemia and the bone, renal, and cardiovascular systems will be presented as they relate to the HIV-infected patient. All of the descriptions are designed for the primary care provider, who may be in contact with an HIV-infected patient whose differential diagnoses consist of one or more of these disorders. PMID:11889688

Balt, C A; Nixon, H

2001-12-01

53

Neurological Complications Following Endoluminal Repair of Thoracic Aortic Disease  

SciTech Connect

Open surgery for thoracic aortic disease is associated with significant morbidity and the reported rates for paraplegia and stroke are 3%-19% and 6%-11%, respectively. Spinal cord ischemia and stroke have also been reported following endoluminal repair. This study reviews the incidence of paraplegia and stroke in a series of 186 patients treated with thoracic stent grafts. From July 1997 to September 2006, 186 patients (125 men) underwent endoluminal repair of thoracic aortic pathology. Mean age was 71 years (range, 17-90 years). One hundred twenty-eight patients were treated electively and 58 patients had urgent procedures. Anesthesia was epidural in 131, general in 50, and local in 5 patients. Seven patients developed paraplegia (3.8%; two urgent and five elective). All occurred in-hospital apart from one associated with severe hypotension after a myocardial infarction at 3 weeks. Four of these recovered with cerebrospinal fluid (CSF) drainage. One patient with paraplegia died and two had permanent neurological deficit. The rate of permanent paraplegia and death was 1.6%. There were seven strokes (3.8%; four urgent and three elective). Three patients made a complete recovery, one had permanent expressive dysphasia, and three died. The rate of permanent stroke and death was 2.1%. Endoluminal treatment of thoracic aortic disease is an attractive alternative to open surgery; however, there is still a risk of paraplegia and stroke. Permanent neurological deficits and death occurred in 3.7% of the patients in this series. We conclude that prompt recognition of paraplegia and immediate insertion of a CSF drain can be an effective way of recovering spinal cord function and improving the prognosis.

Morales, J. P.; Taylor, P. R.; Bell, R. E.; Chan, Y. C. [Guy's and St. Thomas' Foundation Hospital NHS Trust, Department of Vascular Surgery (United Kingdom); Sabharwal, T. [Guy's and St. Thomas' Foundation Hospital NHS Trust, Department of Interventional Radiology (United Kingdom); Carrell, T. W. G. [Guy's and St. Thomas' Foundation Hospital NHS Trust, Department of Vascular Surgery (United Kingdom); Reidy, J. F. [Guy's and St. Thomas' Foundation Hospital NHS Trust, Department of Interventional Radiology (United Kingdom)], E-mail: John.Reidy@gstt.nhs.uk

2007-09-15

54

"Sickle Cell Disease in the Emergency Department: Atypical Complications and Management"  

PubMed Central

Sickle cell disease is the most common inherited blood disorder in the United States. This disorder of hemoglobin structure leads to a chronic hemolytic anemia and complex chronic disease manifested by sudden, severe, and life-threatening complications. These acute complications can occur in any organ system beginning in early childhood and lasting throughout life. The intermittent nature and acuity of these complications lend the emergency department to be an important site of care. The hallmark of sickle cell disease is the vasoocclusive painful event. Other more “typical” complications include fever, acute chest syndrome, priapism, and ischemic stroke. Children with sickle cell disease can also present with other “atypical” complications that can have devastating consequences if they are unrecognized. Detailed discussion of these “atypical” sickle cell disease complications, organized by organ system involved, will be the focus of this article. PMID:21927581

Brandow, Amanda M.; Liem, Robert

2011-01-01

55

Stevens-Johnson syndrome complicating adalimumab therapy in Crohn's disease  

PubMed Central

The anti-tumor necrosis factor (TNF)? medications demonstrate efficacy in the induction of remission and its maintenance in numerous chronic inflammatory conditions. With the increasing number of patients receiving anti-TNF? agents, however, less common adverse reactions will occur. Cutaneous eruptions complicating treatment with an anti-TNF? agent are not uncommon, occurring in around 20% of patients. Adalimumab, a fully humanized antibody against TNF?, may be expected to cause minimal immune-mediated skin reactions compared to the chimeric monoclonal antibody, infliximab. We, however, report a case of Stevens-Johnson syndrome that required hospitalization and cessation of adalimumab in a patient with Crohn’s disease (CD). In this case report, a 29-year-old male with colonic and perianal CD with associated erythema nodosum and large joint arthropathy developed severe mucositis, peripheral rash and desquamation, fevers and respiratory symptoms concomitant with a second dose of 40 mg adalimumab after a 2 mo break from adalimumab therapy. Skin biopsies of the abdominal wall confirmed erythema multiforme and the patient was on no other drugs and infective etiologies were excluded. The patient responded rapidly to IV hydrocortisone and was able to be commenced on infliximab without recurrence of the Stevens-Johnson syndrome. Desquamating skin reactions have now been described in three of the TNF? antagonists (infliximab, etanercept and adalimumab). These reactions can be serious and prescribers need to be aware of the potential mucocutaneous side effects of these agents, especially as Stevens-Johnson syndrome is associated with significant morbidity and mortality. PMID:19764100

Salama, Muna; Lawrance, Ian Craig

2009-01-01

56

Surgical intervention for complications of transcatheter dilation procedures in congenital heart disease  

Microsoft Academic Search

Background. Transcatheter interventions have assumed an important role in the management of many forms of congenital heart disease. While complications of transcatheter interventions are uncommon and usually minor, significant complications requiring operation do occur on occasion. The purpose of this report is to present our experiences with seven such complications, and to review the literature on this topic.Methods. Seven patients

Doff B McElhinney; V. Mohan Reddy; Phillip Moore; Michael M Brook; Frank L Hanley

2000-01-01

57

Surgical Intervention for Complications of Transcatheter Dilation Procedures in Congenital Heart Disease  

Microsoft Academic Search

Background. Transcatheter interventions have assumed an important role in the management of many forms of congenital heart disease. While complications of trans- catheter interventions are uncommon and usually minor, significant complications requiring operation do occur on occasion. The purpose of this report is to present our experiences with seven such complications, and to re- view the literature on this topic.

Doff B. McElhinney; V. Mohan Reddy; Phillip Moore; Michael M. Brook; Frank L. Hanley

2010-01-01

58

Post-infection immunocomplex glomerulonephritis and Legionnaires' disease in a patient with adult Still's disease during treatment with interleukin 1 receptor antagonist anakinra: a case report  

PubMed Central

Introduction Legionellosis is a systemic disease that primarily affects the lungs. However, dysfunction in many organ systems, including the kidneys, has also been described. There are only a few reported cases of renal dysfunction in patients with legionellosis. Case presentation A 27-year-old Caucasian woman with known adult Still's disease was admitted to our hospital for community-acquired pneumonia, due to Legionella infection, with acute renal failure. Although her respiratory symptoms responded well to antibiotic treatment, her renal function worsened, with severe proteinuria and edema. A renal biopsy showed extracapillary and endocapillary proliferative glomerulonephritis with accompanying chronic and acute interstitial nephritis. This was consistent with a post-infection immunocomplex glomerulonephritis. After initiation of steroid therapy, her renal function improved. Additionally, therapy with diuretics and an angiotensin-converting enzyme inhibitor was initiated because of persistent proteinuria. Under this treatment regimen, her severe edema and proteinuria disappeared. Conclusion To the best of our knowledge, there is only a handful of reported cases of post-infection glomerulonephritis with a nephrotic syndrome in a patient with legionellosis. Our findings suggest that, in patients with Legionnaires' disease with renal failure, post-infection immunocomplex glomerulonephritis should be considered and steroid therapy may be an effective modality to treat the renal complication. PMID:21740588

2011-01-01

59

Tumour necrosis factor ? blocking agents in refractory adult Still's disease: an observational study of 20 cases  

PubMed Central

Background: Consensus is lacking on treatment for corticosteroid resistant adult onset Still's disease (ASD). Objective: To assess anti-TNF? efficacy and tolerance in refractory ASD. Methods: All departments of rheumatology and internal medicine in France were contacted by mail to identify cases of refractory ASD for which anti-TNF? had been used. Medical information was collected using a standardised questionnaire. Results: Of 20 patients with mean age 40.7 years (range 18–74) at treatment start and mean disease duration 8.5 years (range 2–21), the clinical expression of ASD was predominantly systemic in five patients and polyarticular in 15. Response to corticosteroids and methotrexate had been considered inadequate in all patients. Infliximab was used to treat 15 patients, and etanercept used for 10; five had received both drugs consecutively. Steroids were concurrently used in 18 patients and an immunosuppressant in 17. At a mean (SD) follow up of 13 (14) months, complete remission had occurred in five cases (of 25 treatment sequences): one receiving etanercept and four infliximab. Partial response was observed in 16 cases (seven etanercept and nine infliximab). Treatment failed in four cases (two with each anti-TNF?). At the last visit, anti-TNF? therapy was discontinued in 17 cases, 11 times because of lack (or loss) of efficacy, four times because of a side effect, and twice for other reasons. Conclusion: Anti-TNF? therapy may be helpful for some patients with refractory ASD. However, most patients achieve only partial remission. Additional information is thus needed to evaluate more precisely the risk–benefit ratio of this treatment. PMID:15184196

Fautrel, B; Sibilia, J; Mariette, X; Combe, B; the, C

2005-01-01

60

Legionella (Legionnaires' Disease and Pontiac Fever): Treatment and Complications  

MedlinePLUS

... Search The CDC Cancel Submit Search The CDC Legionella (Legionnaires' Disease and Pontiac Fever) Note: Javascript is ... message, please visit this page: About CDC.gov . Legionella Home  About the Disease Causes & Transmission Signs & ...

61

Complications after endovascular stent-grafting of thoracic aortic diseases  

Microsoft Academic Search

BACKGROUND: To update our experience with thoracic aortic stent-graft treatment over a 5-year period, with special consideration for the occurrence and management of complications. METHODS: From December 2000 to June 2006, 52 patients with thoracic aortic pathologies underwent endovascular repair; there were 43 males (83%) and 9 females, mean age 63 ± 19 years (range 17–87). Fourteen patients (27%) were

Gabriele Piffaretti; Matteo Tozzi; Chiara Lomazzi; Nicola Rivolta; Roberto Caronno; Patrizio Castelli

2006-01-01

62

Thoracic irradiation in Hodgkin's disease: Disease control and long-term complications  

SciTech Connect

A total of 590 patients with Stage IA-IIIB Hodgkin's disease received mantle irradiation at the Joint Center for Radiation Therapy between April 1969 and December 1984 as part of their initial treatment. Recurrence patterns as well as pulmonary, cardiac and thyroid complications were analyzed. Pulmonary recurrence was more frequently seen in patients with large mediastinal adenopathy (LMA); 11% of patients with LMA recurred in the lung in contrast to 3.1% with small or no mediastinal disease, p = 0.003. Hilar involvement, when corrected for size of mediastinal involvement, was not predictive of lung relapse. Patients with LMA also had a high rate of nodal relapse above the diaphragm (40%) following radiation therapy (RT) alone as compared to similarly treated patients with small or no mediastinal adenopathy (6.5%), p less than 0.0001. This risk of nodal recurrence was greatly reduced (4.7%) for LMA patients receiving combined radiation therapy and chemotherapy (CMT), p less than 0.0001. Sixty-seven patients (11%) with hilar or large mediastinal involvement received prophylactic, low dose, whole lung irradiation. No decrease in the frequency of lung recurrence was seen with the use of whole lung irradiation. Radiation pneumonitis was seen in 3% of patients receiving radiation therapy alone. In contrast, the use of whole lung irradiation was associated with a 15% risk of pneumonitis, p = 0.006. The risk of pneumonitis was also significantly increased with the use of chemotherapy (11%), p = 0.0001. Cardiac complications were uncommon with pericarditis being the most common complication (2.2%). Thyroid dysfunction was seen in 25% of patients and appeared to be age-related. These data suggest that the long-term complications of mantle irradiation are uncommon with the use of modern radiotherapeutic techniques.

Tarbell, N.J.; Thompson, L.; Mauch, P. (Harvard Medical School, Boston, MA (USA))

1990-02-01

63

Herpes zoster meningoencephalitis complicated with peripheral vascular disease: An uncommon presentation of a common disease.  

PubMed

Abstract Herpes zoster is reactivation of the varicella zoster virus that has remained dormant in the dorsal root ganglia since an earlier episode of chickenpox. Herpes zoster has variable clinical presentations, but meningo-encephalitis is not frequently encountered. There is growing evidence of both large and small vessel involvement in immunocompetent and immunocompromised patients, in contrast with the previous opinion that immunocompetent patients have vasculopathy in the large vessels while immunosuppressed patients have vasculopathy in the small vessels. We present the case of a patient in whom herpes zoster meningoencephalitis was complicated with multifocal vasculopathy with peripheral vascular disease; this is an unusual co-occurrence. PMID:25019184

Srivastava, Trilochan; Nagpal, Kadam

2014-10-01

64

Managing complicated Crohn's disease in children and adolescents  

Microsoft Academic Search

The natural history of Crohn's disease is characterized by recurrent exacerbations. A small, but significant, number of pediatric patients with Crohn's disease are resistant to standard medical therapies. The goal of therapy in pediatric patients is not only to achieve and maintain clinical remission, but also to promote growth, development and improve quality of life. All of this needs to

Matjaz Homan; Petar Mamula; Robert N Baldassano

2005-01-01

65

Meningitis: a new vaccine but parents still ignorant about the disease.  

PubMed

The introduction of the pneumococcal vaccine will help protect against pneumococcal meningitis, but parents still need much more education about meningitis, its symptoms, dangers and the need for prevention. PMID:17139972

Smallpage, Sarah-Jane

2006-01-01

66

Therapy Insight: management of cardiovascular disease in patients with cancer and cardiac complications of cancer therapy  

Microsoft Academic Search

Cardiac disease in patients with cancer or caused by cancer therapy is a clinical problem of emerging importance. Optimum management of cardiovascular disease can mean that patients with cancer can successfully receive therapies to treat their malignancy and can reduce morbidity and mortality due to cardiovascular disease in cancer survivors. The presence of cancer and cancer-related morbidities substantially complicates the

Aarif Y Khakoo; Edward TH Yeh

2008-01-01

67

Pulmonary Complications Resulting from Genetic Cardiovascular Disease in Two Rat Models  

EPA Science Inventory

Underlying cardiovascular disease (CVD) has been considered a risk factor for exacerbation of air pollution health effects. Therefore, rodent models of CVD are increasingly used to examine mechanisms of variation in susceptibility. Pulmonary complications and altered iron homeost...

68

Complications of hyperbaric oxygen in the treatment of head and neck disease  

SciTech Connect

Hyperbaric oxygen has been advocated in the treatment of many head and neck diseases. Reports of such treatments have described eustachian tube dysfunction as the only complication. A review of patients receiving hyperbaric oxygen for head and neck diseases at The Mount Sinai Medical Center revealed serious complications, which included seizure, stroke, and myocardial infarction. In addition, follow-up study of these patients demonstrated that 11 patients treated for radiation-induced necrosis had an undiagnosed recurrence of cancer.

Giebfried, J.W.; Lawson, W.; Biller, H.F.

1986-04-01

69

Inflammatory bowel disease: An increased risk factor for neurologic complications  

PubMed Central

Only a very few systematic studies have investigated the frequency of neurologic disorders in patients with Crohn’s disease (CD) and ulcerative colitis (UC), which are the two main types of inflammatory bowel disease (IBD). Results have been inconsistent and variable, owing to differences in case-finding methods and evaluated outcomes in different studies. The most frequent neurologic manifestations reported in CD and UC populations are cerebrovascular disease (with either arterial or venous events), demyelinating central nervous system disease, and peripheral neuropathy (whether axonal or demyelinating); however, the literature describes numerous nervous system disorders as being associated with IBD. The pathogenesis of nervous system tissue involvement in IBD has yet to be elucidated, although it seems to be related to immune mechanisms or prothrombotic states. The recently-introduced tumor necrosis factor (TNF) inhibitors have proven successful in controlling moderate to severe IBD activity. However, severe neurologic disorders associated with TNF inhibitors have been reported, which therefore raises concerns regarding the effect of anti-TNF-? antibodies on the nervous system. Although neurological involvement associated with IBD is rarely reported, gastroenterologists should be aware of the neurologic manifestations of IBD in order to provide early treatment, which is crucial for preventing major neurologic morbidity. PMID:24574797

Moris, German

2014-01-01

70

The treatment and postoperative complications of Hirschsprung's disease  

Microsoft Academic Search

One hundred and ten patients with Hirschsprung's disease diagnosed and treated from 1981 to 1990 at the Royal Children's Hospital, Melbourne, were studied retrospectively. Eighty (72.7%) were treated by the Boley modification of the Soave procedure, 13 by the original Soave procedure, 13 had a Duhamel operation, and 4 had other procedures. Postoperative mortality was 2.7% (3 patients, 2 of

Kumiko Shono; John M. Hutson

1994-01-01

71

Modelling Gaucher disease progression: long-term enzyme replacement therapy reduces the incidence of splenectomy and bone complications.  

PubMed

Long-term complications and associated conditions of type 1 Gaucher Disease (GD) can include splenectomy, bone complications, pulmonary hypertension, Parkinson disease and malignancies. Enzyme replacement therapy (ERT) reverses cytopenia and reduces organomegaly. To study the effects of ERT on long-term complications and associated conditions, the course of Gaucher disease was modelled. PMID:25056340

van Dussen, Laura; Biegstraaten, Marieke; Dijkgraaf, Marcel Gw; Hollak, Carla Em

2014-01-01

72

Benign duodenocolic fistula as a complication of peptic ulcer disease  

PubMed Central

A 44-year-old man with upper abdominal pain, diarrhea and 25 kg weight loss since 3 months ago was admitted. He had a history of dyspepsia and peptic ulcer disease 4 months before admission. Gastroduodenal endoscopy and upper gastrointestinal series with barium study were done. Biopsies and CT-scan ruled out malignancies. Endoscopy and radiology studies revealed a duodenocolic fistula. He underwent right hemicolectomy, fistula en bloc excision, and distal gastrectomy surgery with gastrojejunostomy and ileocolic anastomosis. Radiologic modalities are necessary before surgery. Surgery is the only curative treatment in benign cases and reconstruction method is dependent on patient's situation.

Kamani, Fereshteh; Abrishami, Alireza

2014-01-01

73

Nephrectomy in Autosomal Dominant Polycystic Kidney Disease: A Patient with Exceptionally Large, Still Functioning Kidneys  

PubMed Central

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease. It is characterized by progressive cyst formation in both kidneys, often leading to end-stage kidney disease. Indications for surgical removal of an ADPKD kidney include intractable pain, hematuria, infection, or exceptional enlargement and small abdominal cavity hampering implantation of a donor kidney. We report the case of an extraordinarily large ADPKD kidney weighing 8.7 kg (19.3 lb) with a maximal length of 48 cm (19 inch), and with cysts filled with both clear and bloody fluid. PMID:25028584

Spithoven, Edwin M.; Casteleijn, Niek F.; Berger, Paul; Goldschmeding, Roel

2014-01-01

74

Does Dopamine Still Have a Leading Role in Advanced Parkinson’s Disease after Subthalamic Stimulation?  

Microsoft Academic Search

The role of endogenous dopamine in severe Parkinson’s disease is often underestimated. We report on a case of acute general motor worsening induced by the ingestion of fluphenazine in a parkinsonian patient successfully treated with STN DBS. Other etiologies were ruled out. Clinical improvement was gradual and fully reversible 4 days after discontinuation of the antidopaminergic drug. We suggest that

Mazen Jabre; George Nohra; Philippe Damier; Boulos-Paul Bejjani

2008-01-01

75

Segmental Colitis Associated with Diverticulosis: Complication of Diverticular Disease or Autonomous Entity?  

Microsoft Academic Search

Segmental colitis associated with diverticulosis (SCAD) is a disease that affects colon harboring diverticula, mostly located\\u000a in the sigmoid region. It has been considered a rare disease for many years, but new studies may contribute to easier recognition.\\u000a Although its pathogenesis is not yet well defined, in the past SCAD has been considered a complication of diverticular disease,\\u000a whilst new

Antonio Tursi

2011-01-01

76

Cardiovascular complications in patients with end stage renal disease on maintenance haemodialysis.  

PubMed

This cross-sectional study was carried out at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College Hospital (DMCH), National Institute of Kidney Diseases & Urology (NIKDU) and Kidney Foundation from July 2005 to June 2007 to find the cardiovascular complications in end stage renal disease (ESRD) patients on maintenance haemodialysis. Patients of both sexes with age ranging from 18-59 years and getting at least 8 hours of haemodialysis per week for the last 3 months were enrolled in the study. A total of 126 such patients were included in the study. Among 126 patients 77(61.1%) developed some types of cardiovascular complications. In terms of type of complications 63.6% of the patients had LVH, 23.4% had ischemic heart disease (IHD) and 10.4% had congestive heart failure (CCF) and 2.6% cardiomyopathy. Over 96% patients were hypertensive, followed by 46.8% diabetics and 42.1% smokers. Presence of hypertension, diabetes, family history of diabetes and hypertension were observed to be significantly higher in patients who developed cardiovascular complications (p<0.05). It is deserved that cardiovascular complications (CVC) are very common in ESRD patients on maintenance haemodialysis (MHD). Poor control of blood pressure, low Haemoglobin level and poor glycaemic control are higher in ESRD patients on MHD and are possibly related to the development of cardiovascular complications. PMID:24858162

Sweety, S A; Arzu, J; Rahman, M; Salim, M A; Mahmood, M

2014-04-01

77

Miller Fisher syndrome in adult onset Still's disease: case report and review of the literature of other neurological manifestations  

Microsoft Academic Search

Adult-onset Still's disease (AOSD) is a multi-system inflammatory disorder characterized by high spiking fevers, evanescent salmon-coloured rash, arthralgias or arthritis, hepatosplenomegaly, lymphadenopathy and sore throat. There is no specific test or combination of tests that can establish the diagnosis of AOSD and patients may present with other systemic involvement including neurological manifestations in 7-12% of cases. We present a complex

S. S. Desai; E. Allen; A. Deodhar

2002-01-01

78

Irritable bowel syndrome: a disease still searching for pathogenesis, diagnosis and therapy.  

PubMed

Irritable bowel syndrome (IBS) is the most frequently diagnosed functional gastrointestinal disorder in primary and secondary care. It is characterised by abdominal discomfort, pain and changes in bowel habits that can have a serious impact on the patient's quality of life. The pathophysiology of IBS is not yet completely clear. Genetic, immune, environmental, inflammatory, neurological and psychological factors, in addition to visceral hypersensitivity, can all play an important role, one that most likely involves the complex interactions between the gut and the brain (gut-brain axis). The diagnosis of IBS can only be made on the basis of the symptoms of the Rome III criteria. Because the probability of organic disease in patients fulfilling the IBS criteria is very low, a careful medical history is critical and should pay particular attention to the possible comorbidities. Nevertheless, the severity of the patient's symptoms or concerns sometimes compels the physician to perform useless and/or expensive diagnostic tests, transforming IBS into a diagnosis of exclusion. The presence of alarming symptoms (fever, weight loss, rectal bleeding, significant changes in blood chemistry), the presence of palpable abdominal masses, any recent onset of symptoms in patient aged over 50 years, the presence of symptoms at night, and a familial history of celiac disease, colorectal cancer and/or inflammatory bowel diseases all warrant investigation. Treatment strategies are based on the nature and severity of the symptoms, the degree of functional impairment of the bowel habits, and the presence of psychosocial disorders. This review examines and discusses the pathophysiological aspects and the diagnostic and therapeutic approaches available for patients with symptoms possibly related to IBS, pointing out controversial issues and the strengths and weaknesses of the current knowledge. PMID:25083055

Bellini, Massimo; Gambaccini, Dario; Stasi, Cristina; Urbano, Maria Teresa; Marchi, Santino; Usai-Satta, Paolo

2014-07-21

79

Beyond the Definitions of the Phenotypic Complications of Sickle Cell Disease: An Update on Management  

PubMed Central

The sickle hemoglobin is an abnormal hemoglobin due to point mutation (GAG ? GTG) in exon 1 of the ? globin gene resulting in the substitution of glutamic acid by valine at position 6 of the ? globin polypeptide chain. Although the molecular lesion is a single-point mutation, the sickle gene is pleiotropic in nature causing multiple phenotypic expressions that constitute the various complications of sickle cell disease in general and sickle cell anemia in particular. The disease itself is chronic in nature but many of its complications are acute such as the recurrent acute painful crises (its hallmark), acute chest syndrome, and priapism. These complications vary considerably among patients, in the same patient with time, among countries and with age and sex. To date, there is no well-established consensus among providers on the management of the complications of sickle cell disease due in part to lack of evidence and in part to differences in the experience of providers. It is the aim of this paper to review available current approaches to manage the major complications of sickle cell disease. We hope that this will establish another preliminary forum among providers that may eventually lead the way to better outcomes. PMID:22924029

Ballas, Samir K.; Kesen, Muge R.; Goldberg, Morton F.; Lutty, Gerard A.; Dampier, Carlton; Osunkwo, Ifeyinwa; Wang, Winfred C.; Hoppe, Carolyn; Hagar, Ward; Darbari, Deepika S.; Malik, Punam

2012-01-01

80

Vitamin C in human health and disease is still a mystery ? An overview  

PubMed Central

Ascorbic acid is one of the important water soluble vitamins. It is essential for collagen, carnitine and neurotransmitters biosynthesis. Most plants and animals synthesize ascorbic acid for their own requirement. However, apes and humans can not synthesize ascorbic acid due to lack of an enzyme gulonolactone oxidase. Hence, ascorbic acid has to be supplemented mainly through fruits, vegetables and tablets. The current US recommended daily allowance (RDA) for ascorbic acid ranges between 100–120 mg/per day for adults. Many health benefits have been attributed to ascorbic acid such as antioxidant, anti-atherogenic, anti-carcinogenic, immunomodulator and prevents cold etc. However, lately the health benefits of ascorbic acid has been the subject of debate and controversies viz., Danger of mega doses of ascorbic acid? Does ascorbic acid act as a antioxidant or pro-oxidant ? Does ascorbic acid cause cancer or may interfere with cancer therapy? However, the Panel on dietary antioxidants and related compounds stated that the in vivo data do not clearly show a relationship between excess ascorbic acid intake and kidney stone formation, pro-oxidant effects, excess iron absorption. A number of clinical and epidemiological studies on anti-carcinogenic effects of ascorbic acid in humans did not show any conclusive beneficial effects on various types of cancer except gastric cancer. Recently, a few derivatives of ascorbic acid were tested on cancer cells, among them ascorbic acid esters showed promising anticancer activity compared to ascorbic acid. Ascorbyl stearate was found to inhibit proliferation of human cancer cells by interfering with cell cycle progression, induced apoptosis by modulation of signal transduction pathways. However, more mechanistic and human in vivo studies are needed to understand and elucidate the molecular mechanism underlying the anti-carcinogenic property of ascorbic acid. Thus, though ascorbic acid was discovered in 17th century, the exact role of this vitamin/nutraceutical in human biology and health is still a mystery in view of many beneficial claims and controversies. PMID:14498993

Naidu, K Akhilender

2003-01-01

81

Mast Cells are Important Modifiers of Autoimmune Disease: With so Much Evidence, Why is There Still Controversy?  

PubMed Central

There is abundant evidence that mast cells are active participants in events that mediate tissue damage in autoimmune disease. Disease-associated increases in mast cell numbers accompanied by mast cell degranulation and elaboration of numerous mast cell mediators at sites of inflammation are commonly observed in many human autoimmune diseases including multiple sclerosis, rheumatoid arthritis, and bullous pemphigoid. In animal models, treatment with mast cell stabilizing drugs or mast cell ablation can result in diminished disease. A variety of receptors including those engaged by antibody, complement, pathogens, and intrinsic danger signals are implicated in mast cell activation in disease. Similar to their role as first responders in infection settings, mast cells likely orchestrate early recruitment of immune cells, including neutrophils, to the sites of autoimmune destruction. This co-localization promotes cellular crosstalk and activation and results in the amplification of the local inflammatory response thereby promoting and sustaining tissue damage. Despite the evidence, there is still a debate regarding the relative role of mast cells in these processes. However, by definition, mast cells can only act as accessory cells to the self-reactive T and/or antibody driven autoimmune responses. Thus, when evaluating mast cell involvement using existing and somewhat imperfect animal models of disease, their importance is sometimes obscured. However, these potent immune cells are undoubtedly major contributors to autoimmunity and should be considered as important targets for therapeutic disease intervention. PMID:22701454

Brown, Melissa A.; Hatfield, Julianne K.

2012-01-01

82

[Ways to prevent and treat disseminated inflammatory diseases of the maxillofacial area and their complications].  

PubMed

The authors analyze the results of diagnosis and treatment in 1062 patients with diffuse inflammatory diseases of the maxillofacial area and of complications of these diseases, such as mediastinitis, thrombosis of the cavernous sinus of the dura mater, meningoencephalitis. Improvement of the program of diagnosis and treatment helped improve the results: mortality from sepsis reduced from 50 to 26%. Approaches to prevention of progressive purulent infection are outlined. PMID:7770875

Robustova, T G; Gubin, M A; Tsarev, V N; Lebedev, K A; Ushakov, R V; Starodubtsev, V S; Fomichev, E V

1995-01-01

83

Therapy and Non-TherapyDependent Infectious Complications in Inflammatory Bowel Disease  

Microsoft Academic Search

Background: Patients with inflammatory bowel disease (IBD) are susceptible to infections. Results: Independently from immunomodulatory therapy, IBD predisposes to infectious complications. Thus, the incidence of Clostridium difficile infection is increased in IBD patients, and a significant proportion of these patients contracts C. difficile infection outside the hospital and without precedent antibiotic use. Cytomegalovirus infection has been reported in cortico- steroid-naive

Hans-Jörg Epple

2009-01-01

84

Physical exercise in the rehabilitation of patients with coronary heart disease complicated by cardiac arrhythmias  

Microsoft Academic Search

The response to a multimodal, therapeutic exercise program was studied in 184 patients with coronary heart disease (CHD) complicated with ventricular extrasystole and cardiac fibrillation. Therapeutic exercise comprised auto?genic relaxation practice, deep breathing, breath holding, and physical exercise promoting relaxation. Arrhythmias, myocardium and cardiac conductivity abnormalities, and anxiety and irritability of activated patients were all alleviated with minimum appropriate drug

S. V. Khruschev; V. A. Margazin; G. S. Kozlov; A. V. Britvenkov

1992-01-01

85

Adult Still's disease  

MedlinePLUS

... afternoon or evening. The skin rash is often salmon-pink colored and comes and goes with the ... Pa: Mosby Elsevier; 2012:chap 45. Pay S, Turkcapar N, Kalyoncu M, et al. A multicenter study of ...

86

Hemoglobin sickle cell disease complications: a clinical study of 179 cases  

PubMed Central

Background Hemoglobin sickle cell disease is one of the most frequent hemoglobinopathies. Surprisingly, few studies have been dedicated to this disease, currently considered to be a mild variant of homozygous sickle cell disease. The aim of this study was to update our knowledge about hemoglobin sickle cell disease. Design and Methods The study involved a single center series of 179 patients. Clinical and biological data were collected with special attention to the assessment of pulmonary arterial hypertension and nephropathy. Results Hemoglobin sickle cell diagnosis was delayed and performed in adulthood in 29% of cases. Prevalence of hospitalized painful vasoocclusive crisis, acute chest syndrome and priapism was 36%, 20% and 20%, respectively. The most common chronic organ complications were retinopathy and sensorineural otological disorders in 70% and 29% of cases. Indeed, prevalence of complications reported in homozygous sickle cell disease, such as nephropathy, suspicion of pulmonary hypertension, strokes and leg ulcers was rather low (13%, 4% and 1%, respectively). Phlebotomy performed in 36% of this population (baseline hemoglobin 11.5 g/dL) prevented recurrence of acute events in 71% of cases. Conclusions Our data suggest that hemoglobin sickle cell disease should not be considered as a mild form of sickle cell anemia but as a separate disease with a special emphasis on viscosity-associated otological and ophthalmological disorders, and with a low prevalence of vasculopathy (strokes, pulmonary hypertension, ulcers and nephropathy). Phlebotomy was useful in reducing acute events and a wider use of this procedure should be further investigated. PMID:22315500

Lionnet, Francois; Hammoudi, Nadjib; Stojanovic, Katia Stankovic; Avellino, Virginie; Grateau, Gilles; Girot, Robert; Haymann, Jean-Philippe

2012-01-01

87

Reduction of fatal complications from combined modality therapy in Hodgkin's disease  

SciTech Connect

A total of 464 pathologically staged IA through IIIB Hodgkin's disease patients were evaluated for the risk of developing acute nonlymphocytic leukemia, non-Hodgkin's lymphoma, or a fatal infection after treatment with radiation therapy (RT) alone, initial combined radiation therapy and chemotherapy (CMT), or RT with MOPP administered at relapse. Patients received a standard six cycles of MOPP, and additional maintenance chemotherapy was not administered. Patients receiving total nodal irradiation (TNI) and MOPP chemotherapy have an 11. 9% actuarial risk of developing a fatal complication at ten years, as compared to a 0.8% risk for lesser field irradiation and MOPP. The risk with RT alone is 0.6%. Patients 40 years of age or older have a greater risk for complications. These data report a low risk for fatal complication with CMT when less than TNI is administered and when maintenance chemotherapy is not used.

Mauch, P.M.; Canellos, G.P.; Rosenthal, D.S.; Hellman, S.

1985-04-01

88

Role of somatostatin and somatostatin analogues in the treatment of gastrointestinal diseases: prevention of complications after pancreatic surgery  

Microsoft Academic Search

Morbidity and mortality related to pancreatic surgery are still high: 30-40% and 3-10% respectively. As most complications are probably related to exocrine pancreatic secretion, its inhibition could improve the postoperative course. In 1979, Klempa saw a low complication rate after Whipple resection in a small number of patients treated with somatostatin, a powerful inhibitor of pancreatic exocrine secretion. The long

C Bassi; M Falconi; P Pederzoli

1994-01-01

89

Hepatobiliary Complications of Sickle Cell Disease among Children Admitted to Al Wahda Teaching Hospital, Aden, Yemen  

PubMed Central

Objectives: This study aimed to describe the pattern of hepatobiliary complications among patients with sickle cell disease (SCD) and to assess their correlation with age, gender and other risk factors. Methods: This cross-sectional study assessed 106 patients with SCD who were admitted to Al Wahda Teaching Hospital in Aden, Yemen, between January and June 2009. A full history, thorough examination, essential laboratory investigations (including a complete blood count, liver function test and viral markers test) and an abdominal ultrasound were performed on all patients. The clinicopathological characteristics of the hepatobiliary complications were analysed for their correlation to different risk factors such as age and gender. Results: It was found that 46.2% of the patients with SCD had hepatobiliary complications. Of these, 36.7% had viral hepatitis, 26.0% had cholecystitis and 20% had gallstones. A total of 60.4% of the affected patients were male. The mean levels of alanine aminotransferase (59.4 and 56.0 U/L) and aspartate transaminase (40.1 and 38.3 U/L) were significantly elevated in patients with viral hepatitis and cholecystitis, respectively. Hepatitis B virus surface antigen showed higher positivity (10.4%) than anti-hepatitis A and anti-hepatitis C antibodies. Hepatobiliary complications increased significantly with age and were notably higher among those who were often admitted to hospital and/or underwent frequent blood transfusions. Conclusion: This study suggests that hepatobiliary complications are common among SCD patients and the likelihood of developing such complications increases as patients age. Thus, regular clinical follow-ups, abdominal ultrasound studies and periodic liver function tests, as well as serological tests for viral hepatitis, are strongly recommended. These can help in the early detection of these complications and allow opportunities for their management and prevention. PMID:25364561

Qhalib, Hana A.; Zain, Gamal H.

2014-01-01

90

Early postoperative complications in patients with Crohn's disease given and not given preoperative total parenteral nutrition  

PubMed Central

Objective The effect of preoperative total parenteral nutrition (TPN) on the rate of early (within 30 days) postoperative complications in patients with moderate to severe Crohn's disease (CD) was examined. Material and methods A series of 15 consecutive patients with CD (mean CD activity index score, 270) given preoperative TPN for 18–90 days (mean, 46 days) and undergoing bowel resection and primary anastomosis was compared with matching controls (105 patients) consecutively selected from all CD patients operated in Stockholm County during a preceding 20-year period without preoperative TPN. Results During the preoperative TPN, all the patients studied displayed clinical remission of CD as reflected in improvement in their general well-being, relief of abdominal pain, and abatement of fever and diarrhea. There was no significant early postoperative complication in the TPN-treated group, whereas there were 29 patients with early postoperative complications in the control group, which means a significantly higher rate of postoperative complications when preoperative TPN was not provided. During the preoperative TPN, some crucial variables increased such as the body weight, the serum concentrations of albumin and triiodothyronine reflecting improved nutritional state, whereas the serum concentration of haptoglobin and the white cell count decreased reflecting decreased inflammatory activity. Conclusions This study shows that preoperative TPN for at least 18 days may be recommended to be given to patients with moderate to severe CD until clinical remission is achieved in order to minimize the risk of early postoperative complications. PMID:22242614

Jacobson, Stefan

2012-01-01

91

Postinfection immunocomplex glomerulonephritis and Legionnaires' disease in a patient with adult Still's disease during treatment with interleukin 1 receptor antagonist anakinra: a case report  

Microsoft Academic Search

Introduction  Legionellosis is a systemic disease that primarily affects the lungs. However, dysfunction in many organ systems, including\\u000a the kidneys, has also been described. There are only a few reported cases of renal dysfunction in patients with legionellosis.\\u000a \\u000a \\u000a \\u000a \\u000a Case presentation  A 27-year-old Caucasian woman with known adult Still's disease was admitted to our hospital for community-acquired pneumonia,\\u000a due to Legionella infection, with

Dieter Scholtze; Zsuzsanna Varga; Alexander Imhof

2011-01-01

92

Side-effects and complications of laser treatment in diabetic retinal disease.  

PubMed

ABSTRACT Laser treatment for diabetic retinopathy was the first intraocular treatment to provide a highly effective means for preventing visual loss in patients with diabetes. Although inherently destructive, laser treatment is remarkably effective in preventing visual loss and preserving vision long-term. This review will describe briefly the current techniques and discuss in detail the reported side-effects and potential complications of laser treatment of diabetic retinal disease. PMID:25325854

Deschler, Emily K; Sun, Jennifer K; Silva, Paolo S

2014-11-01

93

Neuropsychiatric Complications of Medical and Surgical Therapies for Parkinson’s Disease  

Microsoft Academic Search

This review deals with the range of neuropsychiatric problems that may arise from the use of medical and surgical therapies in the treatment of Parkinson’s disease. As new approaches emerge, these problems are diversifying. Well-recognized drug-related complications include hallucinations and psychosis and the so-called dopamine-dysregulation syndrome. The etiology of these problems has not been fully established and is not clearly

David J. Burn; Alexander I. Tröster

2004-01-01

94

The French Gaucher's disease registry: clinical characteristics, complications and treatment of 562 patients  

PubMed Central

Background Clinical features, complications and treatments of Gaucher’s disease (GD), a rare autosomal–recessive disorder due to a confirmed lysosomal enzyme (glucocerebrosidase) deficiency, are described. Methods All patients with known GD, living in France, with ?1 consultations (1980–2010), were included in the French GD registry, yielding the following 4 groups: the entire cohort, with clinical description; and its subgroups: patients with ?1 follow-up visits, to investigate complications; recently followed (2009–2010) patients; and patients treated during 2009–2010, to examine complications before and during treatment. Data are expressed as medians (range) for continuous variables and numbers (%) for categorical variables. Results Among the 562 registry patients, 265 (49.6%) were females; 454 (85.0%) had type 1, 22 (4.1%) type 2, 37 (6.9%) perinatal–lethal type and 21 (3.9%) type 3. Median ages at first GD symptoms and diagnosis, respectively, were 15 (0–77) and 22 (0–84) years for all types. The first symptom diagnosing GD was splenomegaly and/or thrombocytopenia (37.6% and 26.3%, respectively). Bone-marrow aspiration and/or biopsy yielded the diagnosis for 54.7% of the patients, with enzyme deficiency confirming GD for all patients. Birth incidence rate was estimated at 1/50,000 and prevalence at 1/136,000. For the 378 followed patients, median follow-up was 16.2 (0.1–67.6) years. Major clinical complications were bone events (BE; avascular necrosis, bone infarct or pathological fracture) for 109 patients, splenectomy for 104, and Parkinson’s disease for 14; 38 patients died (neurological complications for 15 type-2 and 3 type-3 patients, GD complications for 11 type-1 and another disease for 9 type-1 patients). Forty-six had monoclonal gammopathy. Among 283 recently followed patients, 36 were untreated and 247 had been treated during 2009–2010; 216 patients received treatment in December 2010 (126 with imiglucerase, 45 velaglucerase, 24 taliglucerase, 21 miglustat). BE occurred before (130 in 67 patients) and under treatment (60 in 41 patients) with respective estimated frequencies (95% CI) of first BE at 10 years of 20.3% (14.1%–26.5%) and 19.8% (13.5%–26.1%). Conclusion This registry enabled the epidemiological description of GD in France and showed that BE occur even during treatment. PMID:23046562

2012-01-01

95

Increased risk of cardiovascular complications in chronic kidney disease: a possible role of leptin.  

PubMed

Leptin is a small peptide hormone (16 kDa), a product of the obesity gene (Ob), and is mainly synthesized and secreted by adipocytes. It is removed from the blood by the kidneys. The kidney is not only a site of leptin clearance, but also a target organ for its action in different pathophysiological states. Several studies have documented a strong relationship between chronic kidney disease (CKD) and accelerated cardiovascular disease (CVD) defined as a cardiorenal syndrome. Patients with stage 3 and 4 CKD develop cardiovascular complications and are at increased risk of death from CVD. Renal dysfunction promotes several mechanisms responsible for exacerbation of cardiovascular disease. These include activation of the renin-angiotensin system, oxidative stress, elevated asymmetric dimethylarginine (ADMA), low-grade inflammation with increased circulating cytokines, and dyslipidemia. Recently, it has been observed that plasma leptin level is elevated in patients with cardiorenal syndrome. In obesity, hyperleptinemia combined with selective leptin resistance appear to have a critical role in the development and progression of kidney disease, CVD and metabolic syndrome. This has clinical implications for the treatment of obesity-related hypertension and kidney disease. In this paper the role of leptin in chronic kidney disease and accelerated cardiovascular disease is out lined. The link between hyperleptinemia and development and progression of morphologic changes that effect kidney in obese patients is also discussed. PMID:23688007

Korolczuk, Agnieszka; Dudka, Jaroslaw

2014-01-01

96

Early aggressive macrovascular disease and type 1 diabetes mellitus without chronic complications: a case report  

PubMed Central

Background Type 1 diabetes (T1DM) is considered to be one of the most significant risk factors for the development of coronary artery disease (CAD). However, the specific risk predictor models for T1DM are subject to many limitations. Case presentation We report the case of a 42-year-old Caucasian woman presenting with T1DM for 26 years. During her chronic hyperglycemic evolution (mean of HbA1c?>?3 percentage points above the superior limit) without microvascular complications, this patient presented with early and aggressive coronary artery disease, despite the lack of classical risk factors for CAD Conclusions The rapidly progressive macrovascular disease observed in this case demonstrates the different degrees of aggressiveness and unpredictable clinical evolution observed in some cases. It also confirms the need for a multi-factorial, early and optimized clinical management regime. PMID:23742649

2013-01-01

97

Medical status and complications in relation to periodontal disease experience in insulin-dependent diabetics.  

PubMed

The aim of this study was to define a population of diabetics exhibiting an increased risk of developing severe periodontitis by comparing the medical status of 2 groups of diabetics, 1 with no/minor periodontal disease and 1 with severe periodontal disease. The case-control study consisted of 2 parts, a baseline study and a follow-up study. 39 case-control pairs were selected. They were adult, long-duration, insulin-dependent diabetics matched according to sex, age and diabetes duration. One individual in each pair (the CASE) exhibited severe periodontal disease while the other (the CONTROL) exhibited gingivitis or only minor alveolar bone loss. The median age of the cases was 58 years (range 36 to 70 years) and of the controls 59 years (range 37 to 69 years). The median disease duration in cases and controls was 24 years and 25 years, respectively. The median follow-up time was 6 years. The medical variables analysed were weight, insulin dose, systolic and diastolic blood pressure, vibratory threshold, triglycerides, total-cholesterol, HDL-cholesterol, creatinine, HbA1, proteinuria, ECG, retinopathy, stroke, transient ischemic attacks (TIA), angina, myocardial infarct, heart failure, hypertension, intermittent claudication, foot ulcer, death, cause of death, and smoking habit. Biochemical analyses and clinical variables used as a routine in the monitoring of diabetics failed to differentiate between diabetics with severe and minor periodontal disease. In the follow-up study, significantly higher prevalences of proteinuria and cardiovascular complications such as stroke, TIA, angina, myocardial infarct and intermittent claudication were found in the case group. An association between renal disease, cardiovascular complications and severe periodontitis seems to exist. This indicates that a closer cooperation between the diabetologist and the dentist is necessary in monitoring the diabetic patient. PMID:8707978

Thorstensson, H; Kuylenstierna, J; Hugoson, A

1996-03-01

98

Desbaric air embolism during diving: an unusual complication of Osler-Weber-Rendu disease.  

PubMed

Cerebral manifestations of Osler-Weber-Rendu disease (OWRD, hereditary haemorrhagic telangiectasia) including telangiectases, venous malformations, and arteriovenous malformations, are usually under-recognised. The highest complication rate is observed in high flow cerebral arteriovenous malformations, which may present with headache, epilepsy, ischaemia, or haemorrhage. Cerebral air embolism during self-contained underwater breathing apparatus (scuba) diving as the first manifestation of pulmonary arteriovenous malformation (PAVM) in OWRD patients has never been reported before. Here we report a 31 year old male who presented desbaric air embolism as the first manifestation of PAVM. As far as we know, this is the first such case published in English medical literature. PMID:15273199

Hsu, Y-L; Wang, H-C; Yang, P-C

2004-08-01

99

Gastrointestinal complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.  

PubMed

A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval. The Multi-Societal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the gastrointestinal system. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases. Although serious gastrointestinal complications are relatively uncommon after congenital cardiac surgery, accurate estimates of the incidences of these complications are limited, in part due to lack of standardized reporting and the absence of universal nomenclature that defines organ-specific complications. The Multi-Societal Database Committee for Pediatric and Congenital Heart Disease has prepared and defined a list of gastrointestinal complications that may be temporally associated with congenital cardiac surgery. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of treatment. PMID:19063798

Ghanayem, Nancy S; Dearani, Joseph A; Welke, Karl F; Béland, Marie J; Shen, Irving; Ebels, Tjark

2008-12-01

100

Hold Still  

NSDL National Science Digital Library

Hold Still, from the American Physical Society's Physical Review Focus, describes how Stanford graduate student Adam Cohen built a feedback device to stop Brownian motion in its tracks and trap particles down to about 20 microns across. The article includes a color image that is an artistic rendition of the random walk of Brownian motion.

2008-04-24

101

Neurologic Complications Associated with Sj?gren's Disease: Case Reports and Modern Pathogenic Dilemma  

PubMed Central

Objectives. Sjögren's syndrome (SS) may be complicated by some neurological manifestations, generally sensory polyneuropathy. Furthermore, involvement of cranial nerves was described as rare complications of SS. Methods. We reported 2 cases: the first one was a 40-year-old woman who developed neuritis of the left optic nerve as presenting symptom few years before the diagnosis of SS; the second was a 54-year-old woman who presented a paralysis of the right phrenic nerve 7 years after the SS onset. An exhaustive review of the literature on patients with cranial or phrenic nerve involvements was also carried out. Results. To the best of our knowledge, our second case represents the first observation of SS-associated phrenic nerve mononeuritis, while optic neuritis represents the most frequent cranial nerve involvement detectable in this connective tissue disease. Trigeminal neuropathy is also frequently reported, whereas neuritis involving the other cranial nerves is quite rare. Conclusions. Cranial nerve injury is a harmful complication of SS, even if less commonly recorded compared to peripheral neuropathy. Neurological manifestations may precede the clinical onset of SS; therefore, in patients with apparently isolated cranial nerve involvement, a correct diagnosis of the underlying SS is often delayed or overlooked entirely; in these instances, standard clinicoserological assessment is recommendable. PMID:25161786

Colaci, Michele; Cassone, Giulia; Manfredi, Andreina; Sebastiani, Marco; Giuggioli, Dilia; Ferri, Clodoveo

2014-01-01

102

Immune complex associated complications in the subacute phase of meningococcal disease: incidence and literature review  

PubMed Central

Aim: To determine the incidence of immune complex associated complications (IAC) after severe meningococcal disease (SMD) in a group of Dutch children admitted to a paediatric intensive care unit (PICU). Methods: Retrospective chart analysis and follow up of 130 survivors of SMD admitted to PICU. Signs of IAC, inflammatory parameters, and temperature profile were reviewed. Results: Of 130 children with SMD, 20 (15.3%) showed one or more of the three manifestations of IAC: 18 (13.8%) developed arthritis (effusion, with or without erythema/arthralgia), 11 (8.4%) vasculitis, and five (3.8%) pleuritis. Eighteen of 20 (90%) patients with IAC had a secondary rise in temperature; in patients with no IAC this was 48 of 110 (43.6%). IAC was associated with leucocytosis in 82.3% versus 47.7% in patients without IAC, and with increased CRP in 86.6% versus 47.2% in patients without IAC. Leucocytes on admission were significantly lower in patients who would later develop IAC (mean 8.6 versus 13.8x109/l). Conclusion: IAC is a common complication of SMD, mainly occurring 4–10 days after systemic disease. IAC presents clinically as arthritis or vasculitis, mostly accompanied by secondary fever and raised inflammatory parameters. PMID:14500317

Goedvolk, C; von Rosenstiel, I A; Bos, A

2003-01-01

103

A multicentre case control study on complicated coeliac disease: two different patterns of natural history, two different prognoses  

PubMed Central

Background Coeliac disease is a common enteropathy characterized by an increased mortality mainly due to its complications. The natural history of complicated coeliac disease is characterised by two different types of course: patients with a new diagnosis of coeliac disease that do not improve despite a strict gluten-free diet (type A cases) and previously diagnosed coeliac patients that initially improved on a gluten-free diet but then relapsed despite a strict diet (type B cases). Our aim was to study the prognosis and survival of A and B cases. Methods Clinical and laboratory data from coeliac patients who later developed complications (A and B cases) and sex- and age-matched coeliac patients who normally responded to a gluten-free diet (controls) were collected among 11 Italian centres. Results 87 cases and 136 controls were enrolled. Complications tended to occur rapidly after the diagnosis of coeliac disease and cumulative survival dropped in the first months after diagnosis of complicated coeliac disease. Thirty-seven cases died (30/59 in group A, 7/28 in group B). Type B cases presented an increased survival rate compared to A cases. Conclusions Complicated coeliac disease is an extremely serious condition with a high mortality and a short survival. Survival depends on the type of natural history. PMID:25103857

2014-01-01

104

Crohn's disease complicated by multiple stenoses and internal fistulas clinically mimicking small bowel endometriosis  

PubMed Central

We report a 31-year-old woman with Crohn’s disease complicated by multiple stenoses and internal fistulas clinically misdiagnosed as small bowell endometriosis, due to the patient’s perimenstrual symptoms of mechanical subileus for 3 years; at first monthly, but later continuous, and gradually increasing in severity. We performed an exploratory laparotomy for small bowel obstruction, and found multiple ileal strictures and internal enteric fistulas. Because intraoperative findings were thought to indicate Crohn’s disease, a right hemicolectomy and partial distal ileum resection were performed for obstructive Crohn’s ileitis. Histopathology of the resected specimen revealed Crohn’s disease without endometrial tissue. The patient made an uneventful recovery from this procedure and was discharged home 10 d post-operatively. The differential diagnosis of Crohn’s diease with intestinal endometriosis may be difficult pre-operatively. The two entities share many overlapping clinical, radiological and pathological features. Nevertheless, when it is difficult to identify the cause of intestinal obstruction in a woman of child-bearing age with cyclical symptoms suggestive of small bowel endometriosis, Crohn’s disease should be included in the differential diagnosis. PMID:18176980

Teke, Zafer; Aytekin, Faruk Onder; Atalay, Ali Ozgur; Demirkan, Nese Calli

2008-01-01

105

[Medical significance of endothelial glycocalyx. Part 2: Its role in vascular diseases and in diabetic complications].  

PubMed

Endothelial glycocalyx is a layer composed by glycosaminoglycans, proteoglycans and glycoproteins attached to the vascular endothelial luminal surface. Shredding of glycocalyx appears as an essential initial step in the pathophysiology of atherosclerosis and microangiopathic complications of diabetes mellitus, as well as in chronic venous disease. Atherosclerosis risk factors, as hypercholesterolemia (LDL), hyperglycemia, inflammation, salt excess and altered shear stress can damage glycocalyx. This lead to endothelial dysfunction and allows LDL and leukocytes to filtrate to the subendothelial space initiating atheroma plaque formation. Degradation of glycocalyx in diabetes mellitus is mainly due to oxidative stress and enables protein filtration (albuminuria) and endothelial disorder of microangiopathy. Chronic venous hypertension brings to altered shears stress which results in shredded glycocalyx, this allows leukocytes to migrate into venous wall and initiate inflammation leading to morphologic and functional venous changes of the chronic venous disease. Treatment with glycosaminoglycans (sulodexide) prevents or recovers the damaged glycocalyx and several of its consequences. This drug improves chronic venous disease and promotes healing of chronic venous ulcers. It has also been useful in peripheral arterial obstructive disease and in diabetic nephropathy with albuminuria. PMID:24836779

Frati Munari, Alberto C

2014-01-01

106

Combination of Genetic and Quantitative Serological Immune Markers are Associated with Complicated Crohn’s Disease Behavior  

PubMed Central

Background Treatment of Crohn’s disease (CD) with biologics may alter disease progression, leading to fewer disease-related complications, but cost and adverse event profiles often limit their effective use. Tools identifying patients at high risk of complications, who would benefit the most from biologics, would be valuable. Previous studies suggest that biomarkers may aid in determining the course of CD. We aimed to determine if combined serologic immune responses and NOD2 genetic markers are associated with CD complications. Methods In this cross-sectional study, banked blood from well-characterized CD patients (n = 593; mean follow-up: 12 years) from tertiary and community centers was analyzed for six serological biomarkers (ASCA-IgA, ASCA-IgG, anti-OmpC, anti-CBir1, anti-I2, pANCA). In a patient subset (n = 385), NOD2 (SNP8, SNP12, SNP13) genotyping was performed. Complications included stricturing and penetrating disease behaviors. A logistic regression model for the risk of complications over time was constructed and evaluated by cross-validation. Results For each serologic marker, complication rates were stratified by quartile. Complication frequency was significantly different across quartiles for each marker (P trend ? 0.001). Patients with SNP13 NOD2 risk alleles experienced increased complications versus patients without NOD2 mutations (P ? 0.001). A calibration plot of modeled versus observed complication rates demonstrated good agreement (R = 0.973). Performance of the model integrating serologic and genetic markers was demonstrated by area under the receiver operating characteristic curve (AUC = 0.801; 95% confidence interval: 0.757–0.846). Conclusions This model combining serologic and NOD2 genetic markers may provide physicians with a tool to assess the probability of patients developing a complication over the course of CD. PMID:21391291

Lichtenstein, Gary R.; Targan, Stephan R.; Dubinsky, Marla C.; Rotter, Jerome I.; Barken, Derren M.; Princen, Fred; Carroll, Susan; Brown, Michelle; Stachelski, Jordan; Chuang, Emil; Landers, Carol J.; Stempak, Joanne M.; Singh, Sharat; Silverberg, Mark S.

2014-01-01

107

Renal complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.  

PubMed

A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval. The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the renal system. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases. Although renal dysfunction and renal failure are known risks of congenital heart surgery, accurate estimates of the incidences of these complications are limited. This lack of knowledge is in part due to the lack of uniform definitions of these postoperative complications. The purpose of this effort is to propose consensus definitions for renal complications following congenital cardiac surgery so that collection of such data can be standardized. Clinicians caring for patients with congenital heart disease will be able to use this list for databases, quality improvement initiatives, reporting of complications, and comparing strategies for treatment. PMID:19063795

Welke, Karl F; Dearani, Joseph A; Ghanayem, Nancy S; Beland, Marie J; Shen, Irving; Ebels, Tjark

2008-12-01

108

Pulmonary complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.  

PubMed

A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval. The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the pulmonary system. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases. As surgical survival in children with congenital cardiac disease has improved in recent years, focus has necessarily shifted to reducing the morbidity of congenital cardiac malformations and their treatment. A comprehensive list of pulmonary complications is presented. This list is a component of a systems-based compendium of complications that will standardize terminology and thereby allow the study and quantification of morbidity in patients with congenital cardiac malformations. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of treatment. PMID:19063794

Cooper, David S; Jacobs, Jeffrey P; Chai, Paul J; Jaggers, James; Barach, Paul; Beekman, Robert H; Krogmann, Otto; Manning, Peter

2008-12-01

109

Endocrinal complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.  

PubMed

A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval. The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the endocrine system. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases. As surgical survival in children with congenital cardiac disease has improved in recent years, focus has necessarily shifted to reducing the morbidity of congenital cardiac malformations and their treatment. A comprehensive list of endocrinal complications is presented. This list is a component of a systems-based compendium of complications that will standardize terminology and thereby allow the study and quantification of morbidity in patients with congenital cardiac malformations. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of treatment. PMID:19063800

Dickerson, Heather; Cooper, David S; Checchia, Paul A; Nelson, David P

2008-12-01

110

Modelling Gaucher disease progression: long-term enzyme replacement therapy reduces the incidence of splenectomy and bone complications  

PubMed Central

Long-term complications and associated conditions of type 1 Gaucher Disease (GD) can include splenectomy, bone complications, pulmonary hypertension, Parkinson disease and malignancies. Enzyme replacement therapy (ERT) reverses cytopenia and reduces organomegaly. To study the effects of ERT on long-term complications and associated conditions, the course of Gaucher disease was modelled. The cohort consisted of all diagnosed GD patients in the Netherlands. Mutually exclusive disease states were defined as ‘asymptomatic’, ‘signs/symptoms’, ‘recovery’, ‘splenectomy’, ‘bone complication’, ‘multiple complications’ and ‘malignancy’. A natural history (NH) cohort was delineated based upon historical data on Dutch patients before ERT was available. Cumulative incidence curves were composed for progression from each disease state to the next. Two scenarios were applied for the ERT cohort: time to complications was calculated from A. start of ERT; B. entering the previous disease state. Median time for the development of signs and/or symptoms was 30.1 years (N = 73). In the NH cohort (N = 42), 9% had developed a bone complication after 10 years in the signs/symptoms phase, while 21% had undergone a splenectomy. In the ERT cohort (N = 29 (A), N = 28 (B)), 12% (A) or 4% (B) had developed a bone complication after 10 years in this phase and no patient was splenectomized. No patients in the NH cohort recovered, compared to 50% in the ERT cohort after 3.6 years (N = 28 (A)) or 22.4 years (N = 27 (B)) of treatment. Median time from a first to a second complication was 11 years in the NH cohort (N = 31), whereas 16 respectively 14 percent had developed a second complication after 10 years in the ERT cohort (N = 17, scenario A/B). Fourteen percent (scenario A/B) developed an associated malignancy after 10 years in the phase ‘multiple complications’ (N = 23). Associated malignancies occurred almost exclusively in advanced disease stages, therefore it is suggested that ERT reduces their incidence Long-term ERT for GD can reduce the incidence of splenectomy and bone complications. As ERT prevents progression to more advanced stages of GD it will most likely result in a reduction of associated malignancies. PMID:25056340

2014-01-01

111

Skeletal Manifestations of Hydatid Disease in Serbia: Demographic Distribution, Site Involvement, Radiological Findings, and Complications  

PubMed Central

Although Serbia is recognized as an endemic country for echinococcosis, no information about precise incidence in humans has been available. The aim of this study was to investigate the skeletal manifestations of hydatid disease in Serbia. This retrospective study was conducted by reviewing the medical database of Institute for Pathology (Faculty of Medicine in Belgrade), a reference institution for bone pathology in Serbia. We reported a total of 41 patients with bone cystic echinococcosis (CE) during the study period. The mean age of 41 patients was 40.9±18.8 years. In 39% of patients, the fracture line was the only visible radiological sign, followed by cyst and tumefaction. The spine was the most commonly involved skeletal site (55.8%), followed by the femur (18.6%), pelvis (13.9%), humerus (7.0%), rib (2.3%), and tibia (2.3%). Pain was the symptom in 41.5% of patients, while some patients demonstrated complications such as paraplegia (22.0%), pathologic fracture (48.8%), and scoliosis (9.8%). The pathological fracture most frequently affected the spine (75.0%) followed by the femur (20.0%) and tibia (5.0%). However, 19.5% of patients didn't develop any complication or symptom. In this study, we showed that bone CE is not uncommon in Serbian population. As reported in the literature, therapy of bone CE is controversial and its results are poor. In order to improve the therapy outcome, early diagnosis, before symptoms and complications occur, can be contributive. PMID:24039289

Bracanovic, Djurdja; Sopta, Jelena; Djonic, Danijela; Lujic, Nenad

2013-01-01

112

Skeletal manifestations of hydatid disease in Serbia: demographic distribution, site involvement, radiological findings, and complications.  

PubMed

Although Serbia is recognized as an endemic country for echinococcosis, no information about precise incidence in humans has been available. The aim of this study was to investigate the skeletal manifestations of hydatid disease in Serbia. This retrospective study was conducted by reviewing the medical database of Institute for Pathology (Faculty of Medicine in Belgrade), a reference institution for bone pathology in Serbia. We reported a total of 41 patients with bone cystic echinococcosis (CE) during the study period. The mean age of 41 patients was 40.9±18.8 years. In 39% of patients, the fracture line was the only visible radiological sign, followed by cyst and tumefaction. The spine was the most commonly involved skeletal site (55.8%), followed by the femur (18.6%), pelvis (13.9%), humerus (7.0%), rib (2.3%), and tibia (2.3%). Pain was the symptom in 41.5% of patients, while some patients demonstrated complications such as paraplegia (22.0%), pathologic fracture (48.8%), and scoliosis (9.8%). The pathological fracture most frequently affected the spine (75.0%) followed by the femur (20.0%) and tibia (5.0%). However, 19.5% of patients didn't develop any complication or symptom. In this study, we showed that bone CE is not uncommon in Serbian population. As reported in the literature, therapy of bone CE is controversial and its results are poor. In order to improve the therapy outcome, early diagnosis, before symptoms and complications occur, can be contributive. PMID:24039289

Bracanovic, Djurdja; Djuric, Marija; Sopta, Jelena; Djonic, Danijela; Lujic, Nenad

2013-08-01

113

Introduction--databases and the assessment of complications associated with the treatment of patients with congenital cardiac disease.  

PubMed

The Multi-Societal Database Committee for Pediatric and Congenital Heart Disease was established in 2005 with the goal of providing the infrastructure, spanning geographical and subspecialty boundaries, for collaboration between health care professionals interested in the analysis of outcomes of treatments provided to patients with congenital cardiac disease, with the ultimate aim of improvement in the quality of care provided to these patients. The purpose of these collaborative efforts is to promote the highest quality comprehensive cardiac care to all patients with congenital heart disease, from the fetus to the adult, regardless of the patient's economic means, with an emphasis on excellence in teaching, research and community service. This manuscript provides the Introduction to the 2008 Supplement to Cardiology in the Young titled: "Databases and The Assessment of Complications associated with the Treatment of Patients with Congenital Cardiac Disease". This Supplement was prepared by The Multi-Societal Database Committee for Pediatric and Congenital Heart Disease. The Multi-Societal Database Committee for Pediatric and Congenital Heart Disease offers the following definition of the term "Complication": "A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval." The Multi-Societal Database Committee for Pediatric and Congenital Heart Disease offers the following definition of the term "Adverse Event": "An adverse event is a complication that is associated with a healthcare intervention and is associated with suboptimal outcome. Adverse events represent a subset of complications. Not all medical errors result in an adverse event; the administration of an incorrect dose of a medication is a medical error, but it does not always result in an adverse event. Similarly, not all adverse events are the result of medical error. A child may develop pneumonia after an atrial septal defect repair despite intra- and peri-operative management that is free of error. Complications of the underlying disease state, which are not related to a medical intervention, are not adverse events. For example, a patient who presents for medical care with metastatic lung cancer has already developed a complication (Metastatic spread) of the primary lung cancer without any healthcare intervention. Furthermore, complications not associated with suboptimal outcome or harm are not adverse events and are known as no harm events. The patient who receives an incorrect dose of a medication without harm has experienced a no harm event, but not an adverse event." Based on the above definitions, it is apparent that The Multi-Societal Database Committee for Pediatric and Congenital Heart Disease has taken an inclusive approach to defining the universe of complications. Complications may or may not be associated with healthcare intervention and may or may not be associated with suboptimal outcome. Meanwhile, adverse events must be associated with healthcare intervention and must be associated with suboptimal outcome. PMID:19063774

Jacobs, Jeffrey P

2008-12-01

114

Primary sclerosing cholangitis in patient with celiac disease complicated by cholecystic empyema and acute pancreatitis  

PubMed Central

Summary Background The association of celiac disease and sclerosing cholangitis is a well known, although unusual, pathologic feature of autoimmunity. Methods A 64 year old patient presenting with sub-acute cholangitis and pancreatitis, treated with cholecystectomy and endoscopic sphincterotomy. The post-operative course, complicated by cholestatic jaundice, and subsequent clinical complications are described, showing how the diagnosis of sclerosing cholangitis was outlined after the Endoscopic Retrograde Cholangio-Pancreatography (ERCP) and confirmed by liver biopsy. Long term treatment with Ursodeoxycholic acid has gradually normalized bilirubin values, while cholestasis enzymes are gradually decreasing. After 18 months bleeding from oesophageal varices ensued, which was controlled through endoscopic ligation. Conclusions The diagnosis of primary sclerosing cholangitis should be taken into account when cholangitis is associated with other immunity derangements and segmentary dilatations of the intra-hepatic bile ducts, but no dilatation of the main bile duct is noticed at imaging or endoscopy. Recovery of hepatic function should be always attempted before bringing the patient to surgery, in order to avoid postoperative hepatic decompensation. PMID:24629813

PICCOLBONI, D.; RAGONE, E.; INZIRILLO, A.; UTILI, R.

2013-01-01

115

The Genetics of Vascular Complications in Autosomal Dominant Polycystic Kidney Disease (ADPKD)  

PubMed Central

The most important extra-renal manifestation of autosomal dominant polycystic kidney disease (ADPKD) in terms of debilitating injury and premature death is the development of intracranial aneurysms (IAs) and other vascular complications, resulting in subarachnoid hemorrhage (SAH). IAs are found at a rate approximately five times higher in ADPKD patients than in the general population and in patients with a family history of SAH/IAs the frequency is elevated further three to five times, indicating the importance of genetic factors in its etiology. Expression of the ADPKD gene products, polycystin-1 (PKD1) and polycystin-2 (PKD2), in vascular smooth muscle and the endothelium, and evidence that reduced levels of these proteins leads to IA development in mouse models, suggests a direct role of these proteins in the vascular disease. PKD1 and PKD2 patients seem equally likely to develop IAs, while patients with mutations to the 5’ half of PKD1 may more likely have vascular complications. Genome wide association and candidate studies of multiplex families with IAs without ADPKD have identified a number of genes/proteins that may be risk factors for the development of IAs. These candidate proteins largely have roles in the maintenance and remodeling of the arterial wall of small brain arteries. The development of the genetic methodologies of massively parallel sequencing mean it is now possible to test these and other candidates in ADPKD families with multiplex and singleton IA cases. Identifying strong modifiers of this phenotype will be important for prioritizing patients for presymptomatic screening and interventions. PMID:23971643

Rossetti, Sandro; Harris, Peter C.

2014-01-01

116

Cardiac complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.  

PubMed

A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval. The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the cardiac system. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases.The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has prepared and defined a near-exhaustive list of cardiac complications, including intraoperative complications and cardiopulmonary bypass-related complications. These cardiac complications are presented in the following subgroups: 1) Cardiac (general), 2) Cardiac--Metabolic, 3) Cardiac--Residual and Recurrent cardiac lesions, 4) Arrhythmia, 5) Cardiopulmonary bypass and mechanical circulatory support, and 6) Operative/Procedural. Within each subgroup, complications are presented in alphabetical order. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, quality improvement initiatives, reporting of complications, and comparing strategies for treatment. PMID:19063791

Bacha, Emile Antoine; Cooper, David; Thiagarajan, Ravi; Franklin, Rodney C G; Krogmann, Otto; Deal, Barbara; Mavroudis, Constantine; Shukla, Avinash; Yeh, Thomas; Barach, Paul; Wessel, David; Stellin, Giovanni; Colan, Steven D

2008-12-01

117

Peliosis hepatis as a late and fatal complication of thorotrast liver disease. Report of five cases.  

PubMed

Five autopsy cases of peliosis hepatis occurring as a late complication of thorotrast (ThO2) liver disease are described. The liver contained many blood-filled cystic spaces of various sizes. Marked sinusoidal dilatation, disruption of cell cords and reticulin fiber framework, and cystic dilatation of sinusoids seem to represent the developmental stages of peliosis hepatis in sequence. Of the five cases, two had no other liver disease except for hepatic fibrosis, and the other three had associated neoplasms, such as angiosarcoma, hepatocellular carcinoma, cholangiocarcinoma, benign hemangioma, and their combinations. Peliosis hepatis seemed to have directly contributed to the patient's death in four cases. The most characteristic clinical feature was the fulminant terminal course with massive ascites, deep jaundice, and hepatic failure, often accompanied by hepatorenal syndrome and tendency to hemorrhage. Liver function study suggested progressive hepatic insufficiency with reduction in serum albumin, prothrombin and the clearance rate for test dyes, and increase in bilirubin. Clinical diagnosis was almost impossible without biopsy. PMID:7348756

Okuda, K; Omata, M; Itoh, Y; Ikezaki, H; Nakashima, T

1981-06-01

118

Obesity and Its Metabolic Complications: The Role of Adipokines and the Relationship between Obesity, Inflammation, Insulin Resistance, Dyslipidemia and Nonalcoholic Fatty Liver Disease  

PubMed Central

Accumulating evidence indicates that obesity is closely associated with an increased risk of metabolic diseases such as insulin resistance, type 2 diabetes, dyslipidemia and nonalcoholic fatty liver disease. Obesity results from an imbalance between food intake and energy expenditure, which leads to an excessive accumulation of adipose tissue. Adipose tissue is now recognized not only as a main site of storage of excess energy derived from food intake but also as an endocrine organ. The expansion of adipose tissue produces a number of bioactive substances, known as adipocytokines or adipokines, which trigger chronic low-grade inflammation and interact with a range of processes in many different organs. Although the precise mechanisms are still unclear, dysregulated production or secretion of these adipokines caused by excess adipose tissue and adipose tissue dysfunction can contribute to the development of obesity-related metabolic diseases. In this review, we focus on the role of several adipokines associated with obesity and the potential impact on obesity-related metabolic diseases. Multiple lines evidence provides valuable insights into the roles of adipokines in the development of obesity and its metabolic complications. Further research is still required to fully understand the mechanisms underlying the metabolic actions of a few newly identified adipokines. PMID:24733068

Jung, Un Ju; Choi, Myung-Sook

2014-01-01

119

[Ischemic heart disease complicated by heart failure: possibilities of surgical treatment].  

PubMed

Aim of the study was to assess remote results of surgical reconstruction of the left ventricle (LV) in patients with ischemic heart disease (IHD) and chronic heart failure (CHF). During 1996-2010 136 patients with IHD complicated by CHD were subjected to surgery. The patients were divided into 2 groups: with LV aneurism (group 1, n=70) and with ischemic cardiomyopathy (group 2, n=66). In all patients we performed coronary bypass surgery and Dor LV reconstruction. Moderate and high degree mitral regurgitation was corrected. Hospital mortality was 5.4% in group 2. There were no inhospital deaths in group 1. In all survivors we noted reduction of LV dimensions and sphericity of LV cavity, increase of LV ejection fraction. Ten year survival was 78 and 56,5% in groups 1 and 2, respectively. In 10 years after surgery 80.2 and 68% of patients, respectively, had no signs of high NYHA class (III-IV) CHF. Thus surgical intervention on all components of intracardiac pathology in patients with IHD with CHF allowed to achieve satisfactory long term results. PMID:23952996

Kuznetsov, D V; Khokhlunov, S M; Semagin, A P; Suslina, E A; Khokhlunov, M S; Poliakov, V P

2013-01-01

120

Management of diabetes across the course of disease: minimizing obesity-associated complications  

PubMed Central

Obesity increases the risk for developing type 2 diabetes mellitus (T2DM) and this in turn correlates with an elevated probability of long-term diabetes complications once diabetes is established. Interventions aimed at lowering weight via changes in diet and lifestyle have repeatedly been shown to improve glycemic control in patients with T2DM and even to reverse early disease. Weight gain, a potential side effect of treatment for patients with T2DM, is also an important concern, and it has been noted that weight increases associated with antidiabetes therapy may blunt cardiovascular risk reductions achieved by decreasing blood glucose. Among older agents, metformin and acarbose have the lowest risk for weight gain, while sulfonylureas, meglitinides, and thiazolidinediones are all associated with weight increases. Clinical trial results have also consistently demonstrated that treatment with glucagon-like peptide-1 receptor agonists and amylin lowers weight, and that dipeptidyl peptidase-4 inhibitors are weight neutral in patients with T2DM. Conventional human insulin formulations are known to increase weight in patients with T2DM. However, some insulin analogs, particularly insulin detemir, have lower liability for this adverse event. The use of both pharmacologic and surgical therapies aimed at treating obesity rather than lowering blood glucose have the potential to improve glycemic control and even resolve T2DM in some patients. PMID:22135499

Apovian, Caroline M

2011-01-01

121

What do adult patients with congenital heart disease know about their disease, treatment, and prevention of complications? A call for structured patient education  

Microsoft Academic Search

OBJECTIVETo assess how much adults with congenital heart disease understand about their heart defect, its treatment, and the preventive measures necessary to avoid complications.DESIGNDescriptive, cross sectional study.SETTINGAdult congenital heart disease programme in one tertiary care centre in Belgium.PATIENTS62 adults with congenital heart disease (47 men; 15 women), median age 23 years.MAIN OUTCOME MEASURESPatients' knowledge was assessed during an outpatient visit

P Moons; E De Volder; W Budts; S De Geest; J Elen; K Waeytens; M Gewillig

2001-01-01

122

Rare association of Hodgkin lymphoma, Graves’ disease and myasthenia gravis complicated by post-radiation neurofibrosarcoma: coincidence or genetic susceptibility?  

Microsoft Academic Search

With Hodgkin lymphoma (HL), other (autoimmune) diseases may occasionally occur or associate, whereas as a late treatment-complication,\\u000a second tumour may develop. In our patient HL was diagnosed in 1996 and consequently received COPP\\/ABV and mantle irradiation.\\u000a Due to the residual mediastinal tumour CRu was declared but later on no progression\\/relapse could be proved by PET. In 2000\\u000a Graves’s disease, in

Zsófia Simon; Zsuzsa Ress; József Toldi; Anita Trauninger; Zsófia Miltényi; Árpád Illés

2009-01-01

123

Psychiatric Disorders and Coronary Heart Disease in Women – A Still Neglected Topic: Review of the Literature from 1971 to 2000  

Microsoft Academic Search

Background: Coronary heart disease (CHD) is the leading cause of death in women aged over 40 years in the United States, for whom it conveys a worse prognosis than for men. Recently, psychosocial factors have been understood to represent significant risk factors for developing CHD, as well as having a worse outcome with established CHD. However, these factors are often

Bettina Bankier; Andrew B. Littman

2002-01-01

124

[Auto-immune diseases and cancers. Second part: Auto-immune diseases complicating cancers and their treatment].  

PubMed

Autoimmune diseases may reveal or occur during the course of a neoplasia or its treatment. Autoimmune cytopenia, especially haemolytic anaemia, is common in lymphoproliferative disorders such as chronic lymphoid leukemia. The link between cancer and myositis is well established. Dermatomyositis is associated with an increased relative risk of cancer of 3.4 to 4.4. A combination of detection of antibodies against p155 and TEP-computed tomography may be the best approach to ascertain the presence of occult malignancy in patients with dermatomyositis. A cutaneous or a systemic vascularitis may reveal a cancer, most often a haematological malignancy such as hairy cell leukemia. Paraneoplastic polyarthritis have been described in particular with adenocardinoma of the lungs. Underlying neoplasia should be considered in male smokers patients with new onset polyarthritis and poor health status. The prevalence of autoimmune conditions in myelodysplastic syndromes is 10 to 30%. Vasculitis and relapsing polychondritis are the most commonly reported manifestations. Immune manifestations can also be related to treatment. The most common treatment complications are autoimmune haemolytic anaemia with fludarabine and thyroiditis related to interferon and cervical radiotherapy. PMID:25106665

Pasquet, F; Pavic, M; Ninet, J; Hot, A

2014-10-01

125

Mechanic's hands revisited: is this sign still useful for diagnosis in patients with lung involvement of collagen vascular diseases?  

PubMed Central

Background The presence of “mechanic’s hands” is one of the clinical clues for collagen vascular diseases. However, the exact relevance of “mechanic’s hands” in collagen vascular diseases has not been well documented. The aim of this study was to clarify the relevance of “mechanic’s hands” to collagen vascular diseases including various skin lesions and interstitial pneumonia. Methods A retrospective review of the medical records of patients with “mechanic’s hands” at our hospital between April 2011 and December 2012 was conducted. A PubMed search was also conducted using the term “mechanic’s hands”. Results Four patients in our institution and 40 patients obtained from PubMed who had “mechanic’s hands” were identified. The most frequent diseases were DM/amyopathic DM (n = 24, 54.5%) and anti-ARS syndrome (n = 17, 38.6%). In these patients, the major skin lesions associated with “mechanic’s hands” were periungual erythema (n = 23, 52.3%), Gottron’s sign (n = 17, 38.6%), heliotrope rash (n = 10, 22.7%), Raynaud’s phenomenon (n = 9, 20.5%), and anti-ARS syndrome (n = 17, 38.6%). Six cases (2 DM, 4 anti-ARS syndrome) had only “mechanic’s hands”. Antibodies to anti-ARS (n = 24) were Jo-1 (n = 19), PL-7 (n = 3), OJ (n = 1), and PL-12 (n = 1). Conclusion The presence of “mechanic’s hands” together with diverse skin lesions could be a clinical clue to the diagnosis of lung involvement associated with collagen vascular diseases, especially in anti-ARS syndrome or DM/amyopathic DM. PMID:24886713

2014-01-01

126

Neurological complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.  

PubMed

A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval. The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrine systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the neurological system. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases. Although neurological injury and adverse neurodevelopmental outcome can follow procedures for congenital cardiac defects, much of the variability in neurological outcome is now recognized to be more related to patient specific factors rather than procedural factors. Additionally, the recognition of pre and postoperative neurological morbidity requires procedures and imaging modalities that can be resource-intensive to acquire and analyze, and little is known or described about variations in "sampling rate" from centre to centre. The purpose of this effort is to propose an initial set of consensus definitions for neurological complications following congenital cardiac surgery and intervention. Given the dramatic advances in understanding achieved to date, and those yet to occur, this effort is explicitly recognized as only the initial first step of a process that must remain iterative. This list is a component of a systems-based compendium of complications that may help standardize terminology and possibly enhance the study and quantification of morbidity in patients with congenital cardiac malformations. Clinicians caring for patients with congenital cardiac disease may be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of treatment. PMID:19063797

Bird, Geoffrey L; Jeffries, Howard E; Licht, Daniel J; Wernovsky, Gil; Weinberg, Paul M; Pizarro, Christian; Stellin, Giovanni

2008-12-01

127

Pregnancy Complications: Genital Herpes  

MedlinePLUS

... Home > Pregnancy > Pregnancy Complications > Genital herpes and pregnancy Pregnancy complications Pregnancy complications may need special medical care. ... been added to your dashboard . Genital herpes and pregnancy Genital herpes is a sexually transmitted disease (also ...

128

Effect of maternal chronic disease on obstetric complications in twin pregnancies in a U.S. cohort  

PubMed Central

Objective To evaluate the effect of maternal chronic disease on obstetric complications among twin pregnancies. Design Multicenter retrospective observational study. Setting The 12 Consortium on Safe Labor (CSL) clinical centers (19 hospitals). Patient(s) Twin pregnancies (n=4,821) delivered ? 23 weeks of gestation and classified by maternal chronic disease (either none or any of the following: asthma, depression, hypertension, diabetes, and heart, thyroid, gastrointestinal or renal disease). Intervention(s) None. Main Outcome Measure(s) Gestational age at delivery, gestational hypertension, preeclampsia, gestational diabetes, placental abruption, placenta previa, hemorrhage, chorioamnionitis, maternal postpartum fever, premature rupture of membranes, labor onset (spontaneous versus nonspontaneous), route of delivery, and maternal admission to intensive care unit. Result(s) Women with chronic disease delivered earlier (mean gestational length, 34.1 vs. 34.6 weeks, p<0.0001) and were less likely to have term birth (risk ratio (RR): 0.80; 95% confidence interval (95% CI): 0.70-0.90). Cesarean delivery after spontaneous labor (RR: 1.20; 95% CI: 1.05-1.37) was also increased with chronic disease. No statistically significant effects were observed for other complications studied. Women who used ART were more likely to hemorrhage, independent of chronic disease, but other findings were generally similar to the non-ART sample. Conclusion(s) Chronic disease was associated with additional risk of earlier delivery and cesarean section after spontaneous labor in a nationwide sample of US twin pregnancies. Capsule Among twin pregnancies, maternal chronic disease was associated with additional risk of earlier delivery and cesarean section after spontaneous labor, but not with other obstetric complications. PMID:23541402

Werder, Emily; Mendola, Pauline; Mannisto, Tuija; O'Loughlin, Jennifer; Laughon, S. Katherine

2013-01-01

129

Diabetes Care, Glycemic Control, Complications, and Concomitant Autoimmune Diseases in Children with Type 1 Diabetes in Turkey: A Multicenter Study  

PubMed Central

Objective: Epidemiologic and clinical features of type 1 diabetes mellitus (T1DM) may show substantial differences among countries. The primary goal in the management of T1DM is to prevent micro- and macrovascular complications by achieving good glycemic control. The present study aimed to assess metabolic control, presence of concomitant autoimmune diseases, and of acute and long-term complications in patients diagnosed with T1DM during childhood and adolescence. The study also aimed to be a first step in the development of a national registry system for T1DM, in Turkey. Methods: Based on hospital records, this cross-sectional, multicenter study included 1 032 patients with T1DM from 12 different centers in Turkey, in whom the diagnosis was established during childhood. Epidemiological and clinical characteristics of the patients were recorded. Metabolic control, diabetes care, complications, and concomitant autoimmune diseases were evaluated. Results: Mean age, diabetes duration, and hemoglobin A1c level were 12.5±4.1 years, 4.7±3.2 years, and 8.5±1.6%, respectively. Acute complications noted in the past year included ketoacidosis in 5.2% of the patients and severe hypoglycemia in 4.9%. Chronic lymphocytic thyroiditis was noted in 12%, Graves’ disease in 0.1%, and celiac disease in 4.3% of the patients. Chronic complications including neuropathy, retinopathy, and persistent microalbuminuria were present in 2.6%, 1.4%, and 5.4% of the patients, respectively. Diabetic nephropathy was not present in any of the patients. Mean diabetes duration and age of patients with neuropathy, retinopathy and microalbuminuria were significantly different from the patients without these long-term complications (p<0.01). A significant difference was found between pubertal and prepubertal children in terms of persistent microalbuminuria and neuropathy (p=0.02 and p<0.001, respectively). Of the patients, 4.4% (n:38) were obese and 5% had short stature; 17.4% of the patients had dyslipidemia, and 14% of the dyslipidemic patients were obese. Conclusions: Although the majority of the patients in the present study were using insulin analogues, poor glycemic control was common, and chronic complications were encountered. Conflict of interest:None declared. PMID:23419424

Simsek, Damla Goksen; Aycan, Zehra; Ozen, Samim; Cetinkaya, Semra; Kara, Cengiz; Abal?, Sayg?n; Demir, Korcan; Tunc, Ozgul; Ucakturk, Ahmet; Asar, Gulgun; Bas, Firdevs; Cetinkaya, Ergun; Ayd?n, Murat; Karaguzel, Gulay; Orbak, Zerrin; Orbak, Zerrin; S?klar, Zeynep; Alt?nc?k, Ayca; Okten, Aysenur; Ozkan, Behzat; Ocal, Gonul; Semiz, Serap; Arslanoglu, Ilknur; Evliyaoglu, Olcay; Bundak, Ruveyde; Darcan, Sukran

2013-01-01

130

Rare association of Hodgkin lymphoma, Graves' disease and myasthenia gravis complicated by post-radiation neurofibrosarcoma: coincidence or genetic susceptibility?  

PubMed

With Hodgkin lymphoma (HL), other (autoimmune) diseases may occasionally occur or associate, whereas as a late treatment-complication, second tumour may develop. In our patient HL was diagnosed in 1996 and consequently received COPP/ABV and mantle irradiation. Due to the residual mediastinal tumour CRu was declared but later on no progression/relapse could be proved by PET. In 2000 Graves's disease, in 2001 myasthenia gravis was diagnosed, which showed resistance for immunosuppressant drugs, thus plasmapheresis, intravenous immunoglobulin treatments were applied. In 2005, the residual mediastinal tumour started progressive growth, which leads to thoracotomy in which the tumour was removed, it was malignant peripheral nerve sheath tumour. The disease showed progression despite the chemotherapy applied and the patient died in 2007 due to respiratory failure. Not even the postmortem histopathologic examination revealed the relapse of HL. Association of Hodgkin lymphoma, and two antibody-mediated autoimmune diseases, Graves' disease and myasthenia gravis, is rare and has not yet been reported in the literature. The etiologic role of genetic predisposition and immune regulatory disorder must definitely be thought of, as the possibility of mere coincidence is extremely small. Malignant peripheral nerve sheath tumour is a rare complication of irradiation, which underlines the importance of the risk or/and response adapted therapy of HL. PMID:19381762

Simon, Zsófia; Ress, Zsuzsa; Toldi, József; Trauninger, Anita; Miltényi, Zsófia; Illés, Arpád

2009-05-01

131

Chronic pulmonary diseases are independent risk factors for complications after radical nephrectomy  

Microsoft Academic Search

Aim  We aimed to identify the prognostic factors and the new parameters such as Charlson’s comorbidity index (CCI) that might predict\\u000a postoperative complication rates in a radical nephrectomy cohort. We also evaluated the correlation of CCI with the Clavien\\u000a postoperative complication scale (CPCS).\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  Perioperative characteristics of 47 patients undergoing radical nephrectomy were recorded. Following items were assessed:\\u000a preoperative patient

Hüsnü Tokgöz; Bülent Akduman; ?lker Ünal; Bülent Erol; Ersöz Akyürek; Necmettin Aydin Mungan

132

Methicillin-resistant Staphylococcus aureus-related septic pulmonary embolism and sacroiliitis treated with long-term linezolid in a patient with adult-onset Still's disease.  

PubMed

We herein report the case of a 21-year-old woman with refractory adult-onset Still's disease who developed central venous catheter-related methicillin-resistant Staphylococcus aureus sepsis during aggressive immunosuppressive therapy. She subsequently experienced septic pulmonary embolism (SPE) and sacroiliitis during treatment with intravenous vancomycin and was successfully treated with long-term oral linezolid therapy. This case suggests that the occurrence of methicillin-resistant Staphylococcus aureus infection in immunosuppressive patients can trigger severe clinical manifestations such as SPE and septic sacroiliitis and that linezolid is suitable for treating such conditions. PMID:24785897

Horai, Yoshiro; Izumikawa, Koichi; Oka, Satoru; Nakashima, Yoshikazu; Suzuki, Takahisa; Nakajima, Hideki; Kawashiri, Shin-ya; Iwamoto, Naoki; Ichinose, Kunihiro; Tamai, Mami; Nakamura, Hideki; Origuchi, Tomoki; Kohno, Shigeru; Kawakami, Atsushi

2014-01-01

133

Circular Abscess Formation of the Inner Preputial Leaf as a Complication of a Penile Mondor's Disease: The First Case Report  

PubMed Central

Introduction. Mondor's disease of the penis is an uncommon condition characterized by thrombosis or thrombophlebitis involving the superficial dorsal veins. An accompanied lymphangitis is discussed. There is typical self-limiting clinical course. Case Presentation. This paper firstly reports a secondary abscess formation of the preputial leaf two weeks after penile Mondor's disease and subcutaneous lymphangitis as complication of excessive sexual intercourse of a 44-year-old man. Sexual transmitted diseases could be excluded. Lesions healed up completely under abscess drainage, antibiotic, and anti-inflammatory medication. Conclusion. Previous reports in the literature include several entities of the penile Mondor's disease. Our patient is very unusual in that he presented with a secondary preputial abscess formation due to superficial thrombophlebitis, subcutaneous lymphangitis, and local bacterial colonisation. Abscess drainage plus antiphlogistic and antibiotic medication is the treatment of choice. PMID:24868480

Wendler, Johann Jakob; Schindele, Daniel; Liehr, Uwe-Bernd; Porsch, Markus; Schostak, Martin

2014-01-01

134

Meta-Analysis of the Association between Transforming Growth Factor-Beta Polymorphisms and Complications of Coronary Heart Disease  

PubMed Central

Objective To investigate the association between common transforming growth factor beta (TGF-?) single nucleotide polymorphisms (SNP) and significant complications of coronary heart disease (CHD). Method We performed a meta-analysis of published case-control studies assessing the association of TGF-? SNPs with a range of CHD complications. A random effects model was used to calculate odds ratios and confidence intervals. Analyses were conducted for additive, dominant and recessive modes of inheritance. Results Six studies involving 5535 cases and 2970 controls examining the association of common SNPs in TGF-?1 with CHD were identified. Applying a dominant model of inheritance, three TGF-?1 SNPs were significantly associated with CHD complications: The T alleles of rs1800469 (OR?=?1.125, 95% CI 1.016–1.247, p?=?0.031) and rs1800470 (OR?=?1.146, 95% CI 1.026–1.279, p?=?0.021); and the C allele of rs1800471 (OR?=?1.207, 95% CI 1.037–1.406, p?=?0.021). Conclusion This meta-analysis suggests that common genetic polymorphisms in TGF-?1 are associated with complications of CHD. PMID:22662243

Morris, Dylan R.; Moxon, Joseph V.; Biros, Erik; Krishna, Smriti M.; Golledge, Jonathan

2012-01-01

135

LRRK2 and human disease: a complicated question or a question of complexes?  

PubMed

Leucine-rich repeat kinase 2 (LRRK2) is linked to various diseases, including Parkinson's disease, cancer, and leprosy. Data from LRRK2 knockout mice has highlighted a possible role for LRRK2 in regulating signaling pathways that are linked to the pathogenesis of Crohn's disease. Here, we examine how LRRK2's role as a signaling hub in the cell could lead to diverse pathologies. PMID:22253261

Lewis, Patrick A; Manzoni, Claudia

2012-01-17

136

A neonate with hand, foot, and mouth disease complicated with brainstem encephalitis and pulmonary edema:A complete recovery  

PubMed Central

Hand, foot, and mouth disease (HFMD) with serious complications and fatal cases have been reported over the last decade worldwide. The authors report a rare case of HFMD in a neonate complicated with brainstem encephalitis and pulmonary edema. She had fever, lethargy, dyspnea. Physical examination revealed shock signs, fine rales on both lungs, absent Moro reflex. The patient had a rapidly progressive course with seizures, coma, no spontaneous breathing, chemosis. There were some vesicles on left sole and red maculopapular rashes on perianal skin. She had a history of exposure to HFMD. Fecal sample was positive for EV71 RNA by real-time PCR. Chest X-rays showed bilateral pulmonary infiltrates. MRI of the brain showed significant hypointensity in the brainstem on T1WI and hyperintensity on T2WI. She recovered well. This case highlights severe HFMD in neonates is rare. Medical history and physical examination are important in making diagnosis. PMID:25097545

Guo, Shi-Jie; Wang, Dong-Xuan; Dai, Chun-Lai; Wu, Hui

2014-01-01

137

Impact of Preoperative Physiological Risk Profile on Postoperative Morbidity and Mortality After Emergency Operation of Complicated Peptic Ulcer Disease  

Microsoft Academic Search

Aim  The aim of this study was to evaluate the preoperative physiological risk profile for postoperative morbidity and mortality\\u000a after emergency treatment of complicated peptic ulcer disease (PUD).\\u000a \\u000a \\u000a \\u000a Methods  Operative notes and hospital files of 261 patients—111 female, 150 male; median age 67 years (range 17–100 years)—undergoing\\u000a an emergency operation from 1993 to 2005 were analyzed retrospectively. The physiologic subscore of the

Jan-Hendrik Egberts; Birte Summa; Ulrike Schulz; Clemens Schafmayer; Sebastian Hinz; Juergen Tepel

2007-01-01

138

Neonatal Outcomes and Birth Weight in Pregnancies Complicated by Maternal Thyroid Disease  

PubMed Central

Maternal hypothyroidism has previously been shown to increase risk for neonatal intensive care treatment, but otherwise the association between thyroid diseases and neonatal morbidity is understudied. The Consortium on Safe Labor, a retrospective cohort (2002–2008), included 223,512 singleton deliveries of which 0.2% had hyperthyroidism, 1.4% primary and 0.1% iatrogenic hypothyroidism, and 1.3% other/unspecified thyroid disease. Logistic regression with generalized estimating equations estimated adjusted odds ratios of adverse outcomes. Intensive care treatment was more common for neonates of women with thyroid disease. Hyperthyroidism and primary hypothyroidism were associated with sepsis, respiratory distress syndrome, transient tachypnea, and apnea. Iatrogenic hypothyroidism was associated with sepsis and neonatal anemia. Hyperthyroidism was also associated with rare outcomes (prevalence, <1%) including cardiomyopathy, retinopathy of prematurity, and neonatal thyroid diseases. Hyperthyroid non-Hispanic black women had higher odds of term infants that weighed <2,500 g, and hypothyroid non-Hispanic white women had higher odds of large-for-gestational-age infants. These analyses were stratified by race/ethnicity due to interaction. Associations were similar in analyses restricted to term infants. In conclusion, thyroid diseases were associated with increased neonatal morbidity. Although we lacked data on treatment during pregnancy, these nationwide data suggest a need for better thyroid disease management to reduce neonatal morbidity. PMID:23666815

Mannisto, Tuija; Mendola, Pauline; Reddy, Uma; Laughon, S. Katherine

2013-01-01

139

[Treatment and outcome of Crohn's disease without initial complications. Results of a retrospective, multicenter Tunisian study].  

PubMed

The purpose of this study was to estimate and achieve the factors that have an influence on the evolution of the Chron's disease. This study was done in 124 patients reaching the diagnosis of Chron's disease between 1988 and 1997. The evolution of this disease was achieved in 87 patients. The Chron's disease was inactive among 31 patients (35-6%)--with discontinous evolution in 42 patients (48.3%) and active chronic in 14 patients (16-1%). The active chronic form of Chron's disease was twice more frequent among the smokers and the patients with age above 40 years--but this difference has no statistical significance. The indication of surgical treatment was realised in 21 patients and it takes place as result of failure of medical treatment in 16 patients (76-2%)--an abcess in 2 patents (9-5%) and iatrogenic perforation in 1 patient (4-8%). The age-sexe-smoke--the intensity of the initial attack and the nature of the treatment had no influence in the need of the surgical interfference. The Chron's disease showed the less severe evolution in this study--the age above 40 years and the consumption of smoke increased the frequency of active chronic form. PMID:12416354

Cheikh, Imed; Ben Ammar, Ahmed; Essid, Mejda; Azzouz, Messadak; Ettahri, Nabil; Krichene, Mohamed; Bouzaidi, Slim; Ennajar, Taoufik

2002-04-01

140

Association of Serum Adiponectin, Leptin, and Resistin Concentrations with the Severity of Liver Dysfunction and the Disease Complications in Alcoholic Liver Disease  

PubMed Central

Background and aims. There is growing evidence that white adipose tissue is an important contributor in the pathogenesis of alcoholic liver disease (ALD). We investigated serum concentrations of total adiponectin (Acrp30), leptin, and resistin in patients with chronic alcohol abuse and different grades of liver dysfunction, as well as ALD complications. Materials and Methods. One hundred forty-seven consecutive inpatients with ALD were prospectively recruited. The evaluation of plasma adipokine levels was performed using immunoenzymatic ELISA tests. Multivariable logistic regression was applied in order to select independent predictors of advanced liver dysfunction and the disease complications. Results. Acrp30 and resistin levels were significantly higher in patients with ALD than in controls. Lower leptin levels in females with ALD compared to controls, but no significant differences in leptin concentrations in males, were found. High serum Acrp30 level revealed an independent association with advanced liver dysfunction, as well as the development of ALD complications, that is, ascites and hepatic encephalopathy. Conclusion. Gender-related differences in serum leptin concentrations may influence the ALD course, different in females compared with males. Serum Acrp30 level may serve as a potential prognostic indicator for patients with ALD. PMID:24259947

Surdacka, Agata; Smolen, Agata

2013-01-01

141

[Change of surgical treatment in benign thyroid gland diseases-- influence of surgical management on perioperative complications].  

PubMed

Since the beginning of 1994 standardized primary radical resection was performed in benign thyroid diseases at the surgical department, Barmherzige Brueder Hospital, Graz. In multinodular euthyroid goiter bilateral lobectomy or near total lobectomy respectively was done. In case of Graves' disease unilateral lobectomy and contralateral near total resection or "en bloc" thyroidectomy was performed. In accordance with literature a significant reduction of recurrent laryngeal nerve paralysis from approximately 9% to 1.2% occurred in our patients if this surgical procedure was performed consequently. Hypocalcemia rate after surgery needing treatment was approximately 1% at the time of demission. PMID:10812464

Hebenstreit, H; Papadi, H; Konrad, G; Seitinger, G; Reisenberger, F J; Kratochvil, A; Berger, A

2000-01-01

142

Percutaneous Transsplenic Access to the Portal Vein for Management of Vascular Complication in Patients with Chronic Liver Disease  

SciTech Connect

Purpose: To evaluate the safety and feasibility of percutaneous transsplenic access to the portal vein for management of vascular complication in patients with chronic liver diseases. Methods: Between Sept 2009 and April 2011, percutaneous transsplenic access to the portal vein was attempted in nine patients with chronic liver disease. Splenic vein puncture was performed under ultrasonographic guidance with a Chiba needle, followed by introduction of a 4 to 9F sheath. Four patients with hematemesis or hematochezia underwent variceal embolization. Another two patients underwent portosystemic shunt embolization in order to improve portal venous blood flow. Portal vein recanalization was attempted in three patients with a transplanted liver. The percutaneous transsplenic access site was closed using coils and glue. Results: Percutaneous transsplenic splenic vein catheterization was performed successfully in all patients. Gastric or jejunal varix embolization with glue and lipiodol mixture was performed successfully in four patients. In two patients with a massive portosystemic shunt, embolization of the shunting vessel with a vascular plug, microcoils, glue, and lipiodol mixture was achieved successfully. Portal vein recanalization was attempted in three patients with a transplanted liver; however, only one patient was treated successfully. Complete closure of the percutaneous transsplenic tract was achieved using coils and glue without bleeding complication in all patients. Conclusion: Percutaneous transsplenic access to the portal vein can be an alternative route for portography and further endovascular management in patients for whom conventional approaches are difficult or impossible.

Chu, Hee Ho; Kim, Hyo-Cheol, E-mail: angiointervention@gmail.com; Jae, Hwan Jun [Seoul National University College of Medicine, Seoul National University Medical Research Center, Seoul National University Hospital, Department of Radiology, Institute of Radiation Medicine, Clinical Research Institute (Korea, Republic of); Yi, Nam-Joon; Lee, Kwang-Woong; Suh, Kyung-Suk [Seoul National University College of Medicine and Seoul National University Hospital, Department of Surgery (Korea, Republic of); Chung, Jin Wook; Park, Jae Hyung [Seoul National University College of Medicine, Seoul National University Medical Research Center, Seoul National University Hospital, Department of Radiology, Institute of Radiation Medicine, Clinical Research Institute (Korea, Republic of)

2012-12-15

143

Complication Rate of Percutaneous Liver Biopsies among Persons with Advanced Chronic Liver Disease in the HALT-C Trial  

PubMed Central

Background & Aims Although percutaneous liver biopsy is a standard diagnostic procedure, it has drawbacks, including risk of serious complications. It is not known whether persons with advanced chronic liver disease have a greater risk of complications from liver biopsy than patients with more mild, chronic liver disease. The safety and complications of liver biopsy were examined in patients with hepatitis C-related bridging fibrosis or cirrhosis that were enrolled in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) Trial. Methods Standard case report forms from 2,740 liver biopsies performed at 10 study sites between 2000 and 2006 were reviewed for serious adverse events, along with information from questionnaires completed by investigators about details of biopsy techniques used at each hospital. Results There were 29 serious adverse events (1.1%); the most common was bleeding (16 cases, 0.6%). There were no biopsy-related deaths. The bleeding rate was higher among patients with platelet counts ?60,000/mm3 and among those with an international normalized ratio (INR) ?1.3, although none of the patients with an INR >1.5 bled. Excluding subjects with a platelet count ?60,000/mm3 would have reduced the bleeding rate by 25% (4/16), eliminating only 2.8% (77/2740) of biopsies. Operator experience, the type of needle used, or the performance of the biopsy under ultrasound guidance did not influence the frequencies of adverse events. Conclusions Approximately 0.5% of persons with hepatitis C and advanced fibrosis experienced potentially serious bleeding after liver biopsy; risk increased significantly in patients with platelet counts ?60,000/mm3.(K2). PMID:20362695

Seeff, Leonard B.; Everson, Gregory T.; Morgan, Timothy R.; Curto, Teresa M.; Lee, William M.; Ghany, Marc G.; Shiffman, Mitchell L.; Fontana, Robert J.; Di Bisceglie, Adrian M.; Bonkovsky, Herbert L.; Dienstag, Jules L.

2013-01-01

144

Radiation-induced chondrosarcoma of the clavicle complicating Hodgkin's disease. A case report  

SciTech Connect

Review of the literature reveals that postradiation chondrosarcoma is a rare secondary malignant bone tumor. This case report demonstrates a Grade 1 chondrosarcoma of the proximal right clavicle in a 17-year-old boy, eight years after extensive chemotherapy and radiation therapy for a Stage IIB Hodgkin's disease.

Aprin, H.; Calandra, J.; Mir, R.; Lee, J.Y.

1986-08-01

145

Humeral Lateral Epicondylitis Complicated by Hydroxyapatite Dihydrite Deposition Disease: A Case Report  

PubMed Central

Objective The aim of this case report is to differentiate the recovery timeline expected for patients with simple lateral epicondylitis from an abnormal recovery period, in which case an underlying condition should be suspected. Clinical features A 49-year-old woman presented to a chiropractic clinic with posterolateral right elbow pain. The history included chronic recurrent lateral elbow pain, followed by a traumatic event leading to sustained pain and disability. Intervention and outcomes Following a trial of conservative therapy including activity restrictions, soft tissue therapy, joint mobilizations, and therapeutic ultrasonography that led to no significant improvement, the patient was referred for diagnostic imaging that revealed hydroxyapatite dihydrite deposition disease. Conclusion This report describes a case for which lateral epicondylitis symptoms failed to resolve because of an underlying condition (hydroxyapatite dihydrite deposition disease). This case emphasizes that primary care practitioners treating lateral epicondylitis should consider referral for further investigations when positive results are not achieved. PMID:24711788

Marchand, Andree-Anne; O'Shaughnessy, Julie; Descarreaux, Martin

2014-01-01

146

Second malignancies in Hodgkin's disease: a complication of certain forms of treatment  

Microsoft Academic Search

A total of 764 patients with Hodgkin's disease treated with radiotherapy (RT) or chemotherapy or both were reviewed 3-186 months (median 43 months) after initial treatment to assess the incidence of second malignancies. Incidence of solid tumours and acute non-lymphoblastic leukaemia (ANLL) were calculated by a life-table method and percentages of patients affected derived from life-table plots. Within 10 years

P Valagussa; A Santoro; R Kenda; F Fossati Bellani; F Franchi; A Banfi; F Rilke; G Bonadonna

1980-01-01

147

Problems and complications associated with the nonsurgical management of intervertebral disc disease.  

PubMed

Intervertebral disc disease (IVDD) is a common problem encountered in veterinary practice. The primary goal in treating animals with IVDD should be to relieve nerve root and spinal cord compression, thereby retaining or regaining normal neurologic function. Methods of nonsurgical management include corticosteroid medication, nonsteroidal anti-inflammatory drugs, acupuncture therapy, and chemonucleolysis. Each one of these modalities have their own inherent advantages and disadvantages that should be considered before instituting therapy. PMID:2520123

Scavelli, T D; Schoen, A

1989-01-01

148

Second malignant neoplasms complicating Hodgkin's disease: the National Cancer Institute experience  

SciTech Connect

The medical records of all patients treated for Hodgkin's disease during the years 1964-1981 were reviewed. Four hundred seventy-three previously untreated patients were analyzed. Thirty-four subsequent second malignant neoplasms were observed in 33 patients among those treated for Hodgkin's disease. Eight cases of acute nonlymphocyctic leukemia, one case of chronic myeloid leukemia, three cases of non-Hodgkin's lymphoma, three cases of sarcoma, and 19 other tumors were identified. The ten-year estimated risk of leukemia by treatment was the following: radiotherapy only (0), chemotherapy only (0.02), initial combined radiotherapy-chemotherapy (0.06), and salvage combined radiotherapy-chemotherapy (0.09). The ten-year estimated risk of solid tumors was 0.07 overall, with all treatment groups associated with similar risks. Unlike some other reports, a greater risk of leukemia in patients who began treatment for Hodgkin's disease at age 40 or older was not found. However, a positive association was noted between increasing risk of solid tumors and increasing patient age.

Tester, W.J.; Kinsella, T.J.; Waller, B.; Makuch, R.W.; Kelley, P.A.; Glatstein, E.; DeVita, V.T.

1984-07-01

149

Complications related to the transplantation of thoracic organs: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.  

PubMed

A complication is an event or occurrence associated with a disease or a healthcare intervention, which constitutes a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after an intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval. The Multi-Societal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to patients who have received transplantation of the heart, heart and lung(s) or lung(s). These specific definitions and terms will be used to track morbidity associated with transplantation in a common language across many separate databases. The complications of transplantation are known risks of congenital cardiac surgery. The purpose of this effort is to propose consensus definitions for post-transplant complications following cardiac surgery so that collection of such data can be standardized. Clinicians caring for patients who have had transplantation of thoracic organs will be able to use this list for databases, quality improvement initiatives, reporting of complications, and comparing treatment strategies. PMID:19063801

Jeffries, Howard; Bird, Geoff; Law, Yuk; Wernovsky, Gil; Weinberg, Paul; Pizarro, Christian; Stellin, Giovanni

2008-12-01

150

Crohn's disease complicated by intestinal infection with methicillin-resistant Staphylococcus aureus.  

PubMed

We report on a 24-year-old male patient with history of bloody diarrhea, abdominal pain and vomiting. Endoscopy revealed massive ulcerative discontinuous proctosigmoiditis with deep, sharply demarcated epithelial denudations and enterotoxigenic methicillin-resistant Staphylococcus aureus (MRSA) was detected in mucosal biopsies. After treatment with linezolide and steroids, a significant amelioration of colitis was detected and testing for MRSA became negative. In face of the case presented here, we suggest that in patients with refractory inflammatory bowel disease (IBD), microbiological assessment should be performed to detect a possible Staphylococcus aureus infection in order to initiate an antimicrobial treatment in addition to IBD-specific treatment. PMID:23885156

Bettenworth, Dominik; Nowacki, Tobias M; Friedrich, Alexander; Becker, Karsten; Wessling, Johannes; Heidemann, Jan

2013-07-21

151

Crohn's disease complicated by intestinal infection with methicillin-resistant Staphylococcus aureus  

PubMed Central

We report on a 24-year-old male patient with history of bloody diarrhea, abdominal pain and vomiting. Endoscopy revealed massive ulcerative discontinuous proctosigmoiditis with deep, sharply demarcated epithelial denudations and enterotoxigenic methicillin-resistant Staphylococcus aureus (MRSA) was detected in mucosal biopsies. After treatment with linezolide and steroids, a significant amelioration of colitis was detected and testing for MRSA became negative. In face of the case presented here, we suggest that in patients with refractory inflammatory bowel disease (IBD), microbiological assessment should be performed to detect a possible Staphylococcus aureus infection in order to initiate an antimicrobial treatment in addition to IBD-specific treatment. PMID:23885156

Bettenworth, Dominik; Nowacki, Tobias M; Friedrich, Alexander; Becker, Karsten; Wessling, Johannes; Heidemann, Jan

2013-01-01

152

Severe conduction disturbances and ventricular arrhythmias complicating mediastinal irradiation for Hodgkin's disease: a case report  

SciTech Connect

A 27-year-old male had undergone mediastinal and retroperitoneal irradiation for stage IIIA Hodgkin's disease at age 19. When he was admitted to the hospital, because of lightheadedness and syncope, trifascicular bundle branch block was noted and the patient underwent a clinical electrophysiological investigation. AH and HV intervals were prolonged and ventricular fibrillation was induced during programmed right ventricular stimulation. Serial electrophysiological studies allowed us to prescribe effective antiarrhythmic drug therapy with no recurrence of symptoms during a follow-up period of 12 months.

Mary-Rabine, L.; Waleffe, A.; Kulbertus, H.E.

1980-09-01

153

[3.0T MRI with a high resolution protocol for the study of benign disease of the anus and rectum. Part 2: Anorectal inflammatory disease. Postsurgical anatomy and complications after treatment].  

PubMed

Benign anorectal disease comprises a broad group of processes with very diverse origins; these processes may be congenital or acquired as well as inflammatory or tumor related. However, benign anorectal disease has received less attention in the scientific literature than malignant disease. In this second part of this image-based review of benign anorectal disease, we describe the most common inflammatory and fistulous diseases, the postsurgical anatomy, and complications that can occur after surgical treatment or radiotherapy for anorectal disease. PMID:23102780

Herráiz Hidalgo, L; Cano Alonso, R; Carrascoso Arranz, J; Alvarez Moreno, E; Martínez de Vega Fernández, V

2014-01-01

154

Bilateral popliteal aneurysms complicating adult polycystic kidney disease in a patient with a marfanoid habitus.  

PubMed

A man born in 1944 presented with an episode of macroscopic haematuria during a urinary tract infection in 1988. He was unusually tall at 2 metres. An intravenous pyelogram and an abdominal ultrasound disclosed the presence of bilaterally enlarged polycystic kidneys and a polycystic liver. There was a family history of renal disease. Plasma creatinine (180 micro mol/l) and blood pressure (150/100 mm Hg) were both raised. Despite good blood pressure control his renal function declined progressively and he started renal dialysis treatment in 1995. He received a renal allograft in 1996. In 1994 he had noticed a painful swelling behind his left knee. Computed tomography with contrast showed a large popliteal aneurysm. This was replaced with a vein graft. The right popliteal artery showed milder changes, and this was repaired in 1999. Popliteal aneurysms develop most often in older vasculopaths with multiple risk factors; connective tissue disorders have rarely been associated with their presence in younger patients. Polycystic kidney disease has been associated with several aneurysms, most notably cerebral, but not popliteal. The patient's marfanoid habitus also may have played a part. This case emphasises the mixed aetiology of popliteal aneurysms. PMID:12954963

Al-Hakim, W; Goldsmith, D J A

2003-08-01

155

Clinical complications in pregnant women with sickle cell disease: prospective study of factors predicting maternal death or near miss  

PubMed Central

Objective To evaluate complications in pregnant women with sickle cell disease, especially those leading to maternal death or near miss (severe obstetric complications). Methods A prospective cohort of 104 pregnant women registered in the Blood Center of Belo Horizonte (Hemominas Foundation) was followed up at high-risk prenatal units. They belonged to Group I (51 hemoglobin SS and three hemoglobin S/?0-thalassemia) or Group II (49 hemoglobin SC and one hemoglobin S/?+-thalassemia). Both groups had similar median ages. Predictive factors for ‘near miss’ or maternal death with p-value ? 0.25 in the univariate analysis were included in a multivariate logistic model (significance set for p-value ? 0.05). Results Group I had more frequent episodes of vaso-occlusive crises, more transfusions in the antepartum and postpartum, and higher percentage of preterm deliveries than Group II. Infections and painful crises during the postpartum period were similar in both the groups. The mortality rate was 4.8%: three deaths in Group I and two in Group II. One-third of the women in both the groups experienced near miss. The most frequent event was pneumonia/acute chest syndrome. Alpha-thalassemia co-inheritance and ?-gene haplotypes were not associated with near miss or maternal death. In multivariate analysis predictors of near miss or death were parity above one and baseline red blood cell macrocytosis. In Group I, baseline hypoxemia (saturation < 94%) was also predictive of near miss or death. Conclusion One-third of pregnant women had near miss and 4.8% died. Both hemoglobin SS and SC pregnant women shared the same risk of death or of severe complications, especially pulmonary events. PMID:25031164

Resende Cardoso, Patricia Santos; Lopes Pessoa de Aguiar, Regina Amelia; Viana, Marcos Borato

2014-01-01

156

Haematological and infectious complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.  

PubMed

A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval.The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the haematological system and to infectious complications. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases.The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has prepared and defined a near-exhaustive list of haematological and infectious complications. Within each subgroup, complications are presented in alphabetical order. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, quality improvement initiatives, reporting of complications, and comparing strategies for treatment. PMID:19063796

Checchia, Paul A; Karamlou, Tara; Maruszewski, Bohdan; Ohye, Richard G; Bronicki, Ronald; Dodge-Khatami, Ali

2008-12-01

157

A case of primary biliary cirrhosis complicated by Behçet's disease and palmoplantar pustulosis.  

PubMed

A 46-year-old woman was diagnosed with palmoplantar pustulosis (PPP) at the Department of Dermatology, Fukushima Medical University Hospital in 2000, and was treated with ointment. However, because liver dysfunction developed in 2003, she was referred to our department, where primary biliary cirrhosis (PBC) was also diagnosed on the basis of clinical findings. One year later, at the age of 49, she developed manifestations of Behçet's disease (BD), including erythema nodosum in the lower extremities. Because she had a history of uveitis, recurrent oral ulceration was present, and the HLA typing was positive for B51, BD was additionally diagnosed. Liver function normalized within three months of the start of treatment with ursodesoxycholic acid (UDCA). This is the first case of PBC associated with BD and PPP. PMID:16610072

Iwadate, Haruyo; Ohira, Hiromasa; Saito, Hironobu; Takahashi, Atsushi; Rai, Tsuyoshi; Takiguchi, Junko; Sasajima, Tomomi; Kobayashi, Hiroko; Watanabe, Hiroshi; Sato, Yukio

2006-04-01

158

Pathophysiology and clinical basis of prevention and treatment of complications of chronic liver disease.  

PubMed

Chronic liver failure is characterized by the appearance of jaundice, ascites, encephalopathy and/or gastrointestinal bleeding. Acute episodes of hepatic decompensation are frequently precipitated by additional events, e.g. septicaemia, diuretic therapy or excessive protein intake. Identification, correction and treatment of these precipitating factors are first steps in the management of chronic liver failure. Nutritional support is important in the treatment of cirrhotic patients, because malnutrition is one of the major determinants of patient outcome. Management of encephalopathy reduces the appearance of gut-derived nitrogenous toxins and corrects imbalances in amino acid metabolism. Treatment of ascites is salt restriction supported by gentle and incremental administration of diuretics. Ursodesoxycholic acid has become a new and promising modality in the management of cholestatic liver diseases. If conservative therapy fails to recompensate liver function, liver transplantation may be indicated. PMID:2013971

Wagner, S; Lautz, H U; Müller, M J; Schmidt, F W

1991-02-01

159

A case of primary biliary cirrhosis complicated by Behçet’s disease and palmoplantar pustulosis  

PubMed Central

A 46-year-old woman was diagnosed with palmoplantar pustulosis (PPP) at the Department of Dermatology, Fukushima Medical University Hospital in 2000, and was treated with ointment. However, because liver dysfunction developed in 2003, she was referred to our department, where primary biliary cirrhosis (PBC) was also diagnosed on the basis of clinical findings. One year later, at the age of 49, she developed manifestations of Behçet’s disease (BD), including erythema nodosum in the lower extremities. Because she had a history of uveitis, recurrent oral ulceration was present, and the HLA typing was positive for B51, BD was additionally diagnosed. Liver function normalized within three months of the start of treatment with ursodesoxycholic acid (UDCA). This is the first case of PBC associated with BD and PPP. PMID:16610072

Iwadate, Haruyo; Ohira, Hiromasa; Saito, Hironobu; Takahashi, Atsushi; Rai, Tsuyoshi; Takiguchi, Junko; Sasajima, Tomomi; Kobayashi, Hiroko; Watanabe, Hiroshi; Sato, Yukio

2006-01-01

160

Second malignancies complicating Hodgkin's disease: a Southwest Oncology Group 10-year followup  

SciTech Connect

Thirty-two second malignancies (21 acute leukemias and 11 solid tumors) were identified among 659 patients with all stages of Hodgkin's disease treated by members of the Southwest Oncology Group. There were no leukemias and one solid tumor among 95 patients treated with radiotherapy alone. The actuarial risk of developing acute leukemia at 7 years was 6.2% for chemotherapy alone, 6.4% for combined modality, and 7.7% for salvage chemotherapy. The incidence of acute leukemia was higher (P . 0.002) among those whose treatment began at greater than or equal to 40 years of age. The actuarial risk of leukemia in that group was 20.7% at 7 years. These data are compatible with the hypothesis that chemotherapy alone, combined modality, and salvage chemotherapy have an equivalent oncogenic potential and that patients greater than or equal to 40 years of age have an enhanced susceptibility to these oncogenic stimuli.

Coltman, C.A. Jr.; Dixon, D.O.

1982-04-01

161

The impact of a regular erythrocytapheresis programme on the acute and chronic complications of sickle cell disease in adults.  

PubMed

Thirteen adult patients aged 22-63 (median 30) years with sickle cell disease (SCD) were enrolled in a regular erythrocytapheresis (ECP) programme at a single institution between December 1998 and November 2008. The indications for enrolment were recurrent painful crises (PC), acute chest syndrome (ACS), silent cortical ischaemia, pulmonary hypertension, multi-organ crises and pregnancy. Endpoints retrospectively evaluated included the incidence of SCD-related acute events requiring hospitalization following and prior to regular ECP, the development of new and progression of pre-existing related end-organ damage, the effectiveness in reducing HbS levels acutely and prior to the next exchange and the transfusion-related complications. Sixteen acute sickle-related events occurred in five patients in 846 months of patient follow-up. In all patients with reliable data available pre-ECP, the frequency of such events was reduced following commencing regular ECP. No patient experienced stroke, multi-organ crises or developed new and/or progression of end-organ dysfunction. Regular ECP reduced HbS levels to the target of <30% immediately post-exchange. Alloimmunization rates were comparable to the literature and ECP was effective in preventing progressive iron overload. Regular ECP was demonstrated to be an effective, well-tolerated therapy for both acute and chronic complications of SCD in adults. PMID:20346014

Kalff, Anna; Dowsing, Claire; Grigg, Andrew

2010-06-01

162

Dietary fats and cardiovascular disease: putting together the pieces of a complicated puzzle.  

PubMed

Dietary fatty acids play significant roles in the cause and prevention of cardiovascular disease (CVD). Trans fatty acids from partially hydrogenated vegetable oils have well-established adverse effects and should be eliminated from the human diet. CVD risk can be modestly reduced by decreasing saturated fatty acids (SFA) and replacing it by a combination of polyunsaturated fatty acids (PUFA) and monounsaturated fatty acids (MUFA). Although the ideal type of unsaturated fat for this replacement is unclear, the benefits of PUFA appear strongest. Both n-6 and n-3 PUFA are essential and reduce CVD risk. However, additional research is needed to better define the optimal amounts of both and to discern the patients and/or general population that would benefit from supplemental n-3 fatty acid intake. Furthermore, consumption of animal products, per se, is not necessarily associated with increased CVD risk, whereas nut and olive oil intake is associated with reduced CVD risk. In conclusion, the total matrix of a food is more important than just its fatty acid content in predicting the effect of a food on CVD risk, and a healthy diet should be the cornerstone of CVD prevention. PMID:24727233

Michas, George; Micha, Renata; Zampelas, Antonis

2014-06-01

163

[A patient with Parkinson's disease complicated by hypothyroidism who developed malignant syndrome after discontinuation of etizolam].  

PubMed

A 59-year-old man, who was diagnosed as having Parkinson's disease and depression seven years ago and was on oral antiparkinsonian agents, antianxiety agents, and antidepressants, developed a high fever, disturbed consciousness, and marked muscle rigidity after discontinuation of etizolam and amitriptyline. He was admitted to a nearby hospital. Hypothyroidism had been noted two months before admission. Marked muscle rigidity and increased serum CK were observed. Since discontinuation of benzodiazepine has been known to rarely trigger a neuroleptic malignant syndrome (NMS), he was diagnosed as having NMS. After receiving dantrolene and bromocriptine, these symptoms temporarily improved but he again developed consciousness disturbance, and convulsive seizures associated with an elevated serum CK. He was transferred to our hospital. On admission, the CK level was normal at 168 IU/l, while free T4 was 0.6 ng/dl (normal range, 0.9-2.3) and TSH was 108.7 mU/ml (normal range, 0.2-4.2) in serum, indicating the presence of primary hypothyroidism. As an increase in thyroid hormone dosage improved the thyroid function to normal level, his disturbed consciousness and muscle rigidity gradually improved. Convulsive seizure and recurrence of NMS in a short interval are unusual in neuroleptic malignant syndrome. In this patient, hypothyroidism may have contributed to the development of malignant syndrome through metabolic changes of the central dopaminergic system, and discontinuation of etizolam, a kind of benzodiazepine, may have triggered NMS, since there has not been reported that discontinuation of antidepressants including amitriptyline triggers NMS. PMID:12424963

Kawajiri, Masakazu; Ohyagi, Yasumasa; Furuya, Hirokazu; Araki, Takehisa; Inoue, Naohide; Esaki, Shigemitsu; Yamada, Takeshi; Kira, Junichi

2002-02-01

164

The Relationship between Hypomagnesemia, Metformin Therapy and Cardiovascular Disease Complicating Type 2 Diabetes: The Fremantle Diabetes Study  

PubMed Central

Background Low serum magnesium concentrations have been associated with cardiovascular disease risk and outcomes in some general population studies but there are no equivalent studies in diabetes. Metformin may have cardiovascular benefits beyond blood glucose lowering in type 2 diabetes but its association with hypomagnesemia appears paradoxical. The aim of this study was to examine relationships between metformin therapy, magnesium homoeostasis and cardiovascular disease in well-characterized type 2 patients from the community. Methods and Findings We studied 940 non-insulin-treated patients (mean±SD age 63.4±11.6 years, 49.0% males) from the longitudinal observational Fremantle Diabetes Study Phase I (FDS1) who were followed for 12.3±5.3 years. Baseline serum magnesium was measured using stored sera. Multivariate methods were used to determine associates of prevalent and incident coronary heart disease (CHD) and cerebrovascular disease (CVD) as ascertained from self-report and linked morbidity/mortality databases. 19% of patients were hypomagnesemic (serum magnesium <0.70 mmol/L). Patients on metformin, alone or combined with a sulfonylurea, had lower serum magnesium concentrations than those on diet alone (P<0.05). There were no independent associations between serum magnesium or metformin therapy and either CHD or CVD at baseline. Incident CVD, but not CHD, was independently and inversely associated with serum magnesium (hazard ratio (95% CI) 0.28 (0.11–0.74); P?=?0.010), but metformin therapy was not a significant variable in these models. Conclusions Since hypomagnesemia appears to be an independent risk factor for CVD complicating type 2 diabetes, the value of replacement therapy should be investigated further, especially in patients at high CVD risk. PMID:24019966

Peters, Kirsten E.; Chubb, S. A. Paul; Davis, Wendy A.; Davis, Timothy M. E.

2013-01-01

165

Peculiar Distribution of Tumorous Xanthomas in an Adult Case of Erdheim-Chester Disease Complicated by Atopic Dermatitis  

PubMed Central

Erdheim-Chester disease is a rare non-Langerhans form of histiocytosis with multiple organ involvement. Approximately 20% of patients have xanthoma-like lesions, usually on the eyelids. We report a case of Erdheim-Chester disease in a 32-year-old male who showed peculiar xanthomatous skin lesions and also had atopic dermatitis. His skin manifestations included ring-like yellowish tumors on his periorbital regions, rope necklace-like tumors on his neck, and spindle-shaped tumors on his right preauricular region and cubital fossas. He also had exophthalmos and diabetes insipidus. Chronic eczematous lesions were present on the flexor aspect of his extremities, and his serum eosinophil numbers and immunoglobulin E levels were elevated. A histological examination of his right neck tumor showed foamy macrophages and touton-type giant cells, which were positive for CD68 and CD163 and negative for S-100 and CD1a. We suggest that the complication of atopic dermatitis may have contributed to the uncommon clinical features in this case. PMID:21677888

Murakami, Yukako; Wataya-Kaneda, Mari; Terao, Mika; Azukizawa, Hiroaki; Murota, Hiroyuki; Nakata, Yukiko; Katayama, Ichiro

2011-01-01

166

Infliximab therapy for Crohn's-like disease in common variable immunodeficiency complicated by massive intestinal hemorrhage: a case report  

PubMed Central

Background Common variable immune deficiency is the most frequently encountered immunodeficiency in adults, which is characterized by low levels of serum immunoglobulins. Common variable immune deficiency can present with inflammatory bowel disease-like colitis because of the dysregulated immune system; paradoxically activated T cell receptor pathways are thought to be pivotal in pathogenesis of common variable immune deficiency-related colitis. Treatment for severe complications, such as gastrointestinal bleeding, is not established. We report a case of common variable immune deficiency-related Crohn’s-like disease presenting massive melena, which was successfully treated by short course infliximab therapy. Case presentation A 26-year-old Japanese man with history of common variable immune deficiency presented with diarrhea, abdominal pain, and fever. Venous administration of antibiotics did not improve his symptoms. Colonoscopy revealed multiple longitudinal ulcers as well as cobblestone-like change in the ileum end and the ascending colon. Histopathological examination of biopsy specimen showed erosion and infiltration of T lymphocytes with lack of B cells. Intravenous hyperalimentation, mesalazine, and steroid did not improve the symptoms and the patient subsequently presented with massive melena. Colonoscopy revealed a protuberant vessel on one of the ulcers in the ascending colon. Endoscopic clipping was repeatedly performed for hemostasis, which was only temporarily successful. In an attempt to manage the bleeding and colitis, a trial of infliximab was given on week 0, week 2 and week 6. Gastrointestinal hemorrhage from the ulcer halted immediately after the first infliximab injection. Colonoscopy performed after the third infliximab showed remarkable improvement in the ileocolitis. No evidence of increased susceptibility to infections was observed and the patient has been in clinical remission for 3 years. Conclusions We present this case together with review of literature to share our experience of encountering common variable immune deficiency complicating severe Crohn’s-like disease and to support that infliximab is a safe and effective treatment that can promptly manage life-threatening intestinal hemorrhage in common variable immune deficiency-related colitis. PMID:24952714

2014-01-01

167

Role of Innate Immune Response in Non-Alcoholic Fatty Liver Disease: Metabolic Complications and Therapeutic Tools  

PubMed Central

Non-alcoholic fatty liver disease (NAFLD) is currently the most common liver disease worldwide, both in adults and children. It is characterized by an aberrant lipid storage in hepatocytes, named hepatic steatosis. Simple steatosis remains a benign process in most affected patients, while some of them develop superimposed necroinflammatory activity with a non-specific inflammatory infiltrate and a progression to non-alcoholic steatohepatitis with or without fibrosis. Deep similarity and interconnections between innate immune cells and those of liver parenchyma have been highlighted and showed to play a key role in the development of chronic liver disease. The liver can be considered as an “immune organ” because it hosts non-lymphoid cells, such as macrophage Kupffer cells, stellate and dendritic cells, and lymphoid cells. Many of these cells are components of the classic innate immune system, enabling the liver to play a major role in response to pathogens. Although the liver provides a “tolerogenic” environment, aberrant activation of innate immune signaling may trigger “harmful” inflammation that contributes to tissue injury, fibrosis, and carcinogenesis. Pathogen recognition receptors, such as toll-like receptors and nucleotide oligomerization domain-like receptors, are responsible for the recognition of immunogenic signals, and represent the major conduit for sensing hepatic and non-hepatic noxious stimuli. A pivotal role in liver inflammation is also played by cytokines, which can initiate or have a part in immune response, triggering hepatic intracellular signaling pathways. The sum of inflammatory signals and deranged substrate handling induce most of the metabolic alteration traits: insulin resistance, obesity, diabetes, hyperlipidemia, and their compounded combined effects. In this review, we discuss the relevant role of innate immune cell activation in relation to NAFLD, the metabolic complications associated to this pathology, and the possible pharmacological tools. PMID:24795720

Meli, Rosaria; Mattace Raso, Giuseppina; Calignano, Antonio

2014-01-01

168

Site and still life  

E-print Network

This thesis uses the still life as a medium for investigating architecture and the city . An analogy is established between what the thesis defines as still life and an urban composition (a site in East Cambridge). Through ...

Willey, Guy Phillip

1993-01-01

169

Alcoholic liver disease complicated by deep bleeding into the muscles or retroperitoneum: report of three cases and a review of the literature.  

PubMed

We herein report three cases of alcoholic cirrhosis complicated by deep bleeding. In two of the three cases, intramuscular or retroperitoneal hematomas developed spontaneously. In contrast, in the remaining case, an intramuscular hematoma developed after trauma. In the former two patients, the intramuscular hematomas recurred at other sites during hospitalization. All three patients received conservative therapy, and one patient with a retroperitoneal hematoma underwent transcatheter arterial embolization. All of the patients eventually died of liver failure. The occurrence of severe alcoholic liver disease with deep bleeding has recently been reported with increasing frequency, and clinicians should bear this condition in mind as a life-threatening complication of alcoholic liver disease. PMID:25130107

Takamura, Masaaki; Watanabe, Jun; Sakamaki, Akira; Honda, Yutaka; Kamimura, Kenya; Tsuchiya, Atsunori; Yamagiwa, Satoshi; Suda, Takeshi; Matsuda, Yasunobu; Aoyagi, Yutaka

2014-01-01

170

Sudden cardiac death due to coronary artery involvement by IgG4-related disease: a rare, serious complication of a rare disease.  

PubMed

Immunoglobulin G4-related disease (IgG4-RD) is a systemic disorder characterized by multiorgan fibrosis with IgG4-producing plasma cells, increased IgG4 serum concentration, and responsiveness to steroid therapy. Involvement of the pancreas, salivary glands, orbit, aorta, and other sites has been well documented in the literature; however, there have been limited reports of cases involving the coronary arteries. We report the case of a 53-year-old Hispanic man who was brought to the emergency center and diagnosed with sudden cardiac death. Autopsy was subsequently performed, revealing multiorgan involvement by IgG4-RD, including involvement of the coronary arteries. The inflammation and fibrosis, in combination with concomitant atherosclerotic disease, resulted in severe stenosis of the coronary arteries. Two of the coronary arteries were further occluded by thrombosis. These factors led to cardiac hypoperfusion, myocardial infarction and, ultimately, sudden cardiac death. Fatal involvement of the coronary arteries has not been previously reported, raising a new concern for a severe complication of IgG4-RD. PMID:24878025

Patel, Nimesh R; Anzalone, Mary L; Buja, L Maximilian; Elghetany, M Tarek

2014-06-01

171

Solar still. Final report  

SciTech Connect

Passive solar heating was used in a still in which a packed column packed with popped popcorn separates the alcohol and water vapors. The still's performance was not satisfactory, and it is concluded that passive solar heating could have been better used to preheat makeup water for the fermentation process and to maintain proper fermentation temperatures during the winter. (LEW)

Adams, W.D.

1983-07-20

172

Pregnancy Complications  

MedlinePLUS

... Emergency Preparedness and Response Pregnant Women and Flu Pregnancy Complications On this Page Before Pregnancy During Pregnancy ... to decrease the risk of pregnancy complications. Before Pregnancy Make sure to talk to your doctor about ...

173

LASIK Complications  

Microsoft Academic Search

Laser in situ keratomileusis (LASIK) is a rapidly evolving ophthalmic surgical procedure. Several anatomic and refractive complications have been identified. Anatomic complications include corneal flap abnormalities, epithelial ingrowth, and corneal ectasia. Refractive complications include unexpected refractive outcomes, irregular astigmatism, decentration, visual aberrations, and loss of vision. Infectious keratitis, dry eyes, and diffuse lamellar keratitis may also occur following LASIK. By

Samir A Melki; Dimitri T Azar

2001-01-01

174

Still around and still dangerous: Giardia lamblia and Entamoeba histolytica.  

PubMed

The discovery of new infectious agents often overshadows the continuing impact and importance of well-established organisms. In the case of diarrheal disease, Entamoeba histolytica and its complications remain a major cause of morbidity and mortality in developing countries. Although it is also present in developing countries, Giardia lamblia is a primary cause of waterborne outbreaks of diarrhea in developed countries. Persons at risk of developing giardiasis in these countries include backpackers and campers who drink untreated stream water or persons who drink improperly treated municipal water containing infective cysts. Investigators have recently identified the mechanisms used by these organisms to colonize the intestinal tract and to cause disease. New methods of identification using immunologic principles have been added to the traditional microscopic methods of identification. PMID:10177206

Smith, L A

1997-01-01

175

Books Still Worth Reading.  

ERIC Educational Resources Information Center

The 10 major articles in this special journal issue deal with literary works designated by individual educators as "still worth reading." The works discussed are (1) "Madeline" by L. Bemelmans; (2) "The Assistant" by B. Malamud; (3) "The Pitfalls for Readers of Fiction" by H. Sample, the first of the pamphlet publications by the National Council…

McLeod, Alan M., Ed.

1983-01-01

176

The effect of excess weight gain with intensive diabetes treatment on cardiovascular disease risk factors and atherosclerosis in type 1 diabetes: Results from the Diabetes Control and Complications Trial / Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC) study  

PubMed Central

Rationale Intensive diabetes therapy of type 1 diabetes (T1DM) reduces diabetes complications but can be associated with excess weight gain, central obesity, and dyslipidemia. Objective The purpose of this study was to determine if excessive weight gain with diabetes therapy of T1DM is prospectively associated with atherosclerotic disease. Methods and Results Subjects with T1DM (97% Caucasian, 45% female, mean age 35 years) randomly assigned to intensive (INT) or conventional (CONV) diabetes treatment during the Diabetes Control and Complications Trial (DCCT) underwent intima-media thickness (IMT) (n=1015) and coronary artery calcium (CAC) score (n=925) measurements during follow-up in the Epidemiology of Diabetes Interventions and Complications (EDIC) Study. INT subjects were classified by quartile of BMI change during the DCCT. Excess gainers (4th quartile, including CONV subjects meeting this threshold) maintained greater BMI and waist circumference (WC), needed more insulin, had greater IMT (+5%, P<0.001 EDIC year 1, P=0.003 EDIC year 6), and trended towards greater CAC scores (OR 1.55, CI 0.97 – 2.49, P=0.07) than minimal gainers. DCCT subjects meeting metabolic syndrome criteria for WC and blood pressure had greater IMT in both EDIC years (P =0.02 to <0.001); those meeting HDL criteria had greater CAC scores (OR 1.6 and CI 1.1 – 2.4, P=0.01) during follow-up. Increasing frequency of a family history of diabetes, hypertension, and hyperlipidemia was associated with greater IMT thickness with INT but not CONV. Conclusions Excess weight gain in DCCT is associated with sustained increases in central obesity, insulin resistance, dyslipidemia and blood pressure, as well as more extensive atherosclerosis during EDIC. PMID:23212717

Purnell, Jonathan Q; Hokanson, John E.; Cleary, Patricia A.; Nathan, David M; Lachin, John M; Zinman, Bernard; Brunzell, John D.

2013-01-01

177

MRI characteristics and follow-up findings in patients with neurological complications of enterovirus 71-related hand, foot, and mouth disease  

PubMed Central

Objectives: This study aimed to investigate the magnetic resonance imaging (MRI) characteristics and clinical and MRI follow-up findings of patients with neurological complications of enterovirus 71-related hand, foot and mouth disease. Methods: Data were collected from 12 patients who developed neurological complications of enterovirus 71-related hand, foot, and mouth disease during an enterovirus-71 outbreak in Hainan Province, China, from May 2008 to October 2011. Patients were followed up for 2 years. Results: In the six patients with brainstem encephalitis, MRI showed posterior brainstem abnormalities with hyperintense areas on T2-weighted images and hypointense areas on T1-weighted images. In the four patients with acute flaccid paralysis but no brainstem encephalitis, sagittal MRI images showed linear hyperintense areas in the anterior spinal cord, transverse T2-weighted images showed hyperintense areas in the spinal cord, and contrast-enhanced axial T1-weighted images showed strong enhancement of the anterior horns or nerve roots. In the two patients with aseptic meningitis, MRI showed widening of the subarachnoid space and ventricles. The MRI and clinical signs of aseptic meningitis resolved within 4 weeks in both patients. Patients with isolated pontine abnormalities recovered faster than those with multiple brainstem abnormalities, patients with isolated brainstem encephalitis recovered faster than those with associated acute flaccid paralysis, patients with paralysis of one limb recovered faster than those with paralysis of multiple limbs, and patients with isolated thoracolumbar cord abnormalities recovered faster than those with cervical cord abnormalities. Conclusions: MRI is useful for assessment of the neurological complications of enterovirus 71-related hand, foot, and mouth disease. Patients who develop neurological complications characteristically have MRI abnormalities of the posterior brainstem or bilateral anterior horns of parts of the spinal cord. The MRI findings can help to predict prognosis. PMID:25356127

Chen, Feng; Liu, Tao; Li, Jianjun; Xing, Zengbao; Huang, Shixiong; Wen, Guoqiang

2014-01-01

178

Incident Chronic Kidney Disease and Newly Developed Complications Related to Renal Dysfunction in an Elderly Population during 5 Years: A Community-Based Elderly Population Cohort Study  

PubMed Central

Background Few studies have evaluated the association between incident chronic kidney disease (CKD) and related complications, especially in elderly population. We attempted to verify the association between GFR and concurrent CKD complications and elucidate the temporal relationship between incident CKD and new CKD complications in a community-based prospective elderly cohort. Method We analyzed the available data from 984 participants in the Korean Longitudinal Study on Health and Aging. Participants were categorized into 6 groups according to eGFR at baseline examination (?90, 75–89, 60–74, 45–59, 30–44, and <30 ml/min/1.73 m2). Result The mean age of study population was 76 ± 9.1 years and mean eGFR was 72.3 ± 17.0 ml/min/1.73 m2. Compared to eGFR group 1, the odds ratio (OR) for hypertension was 2.363 (95% CI, 1.299-4.298) in group 4, 5.191 (2.074-12.995) in group 5, and 13.675 (1.611-115.806) in group 6; for anemia, 7.842 (2.265-27.153) in group 5 and 13.019 (2.920-58.047) in group 6; for acidosis, 69.580 (6.770-715.147) in group 6; and for hyperkalemia, 19.177 (1.798-204.474) in group 6. Over a 5-year observational period, CKD developed in 34 (9.6%) among 354 participants with GFR ? 60 ml/min/1.73 m2 at basal examination. The estimated mean number of new complications according to analysis of co-variance was 0.52 (95% CI, 0.35–0.68) in subjects with incident CKD and 0.24 (0.19–0.29) in subjects without CKD (p = 0.002). Subjects with incident CKD had a 2.792-fold higher risk of developing new CKD complications. A GFR level of 52.4 ml/min/1.73 m2 (p = 0.032) predicted the development of a new CKD complication with a 90% sensitivity. Conclusion In an elderly prospective cohort, CKD diagnosed by current criteria is related to an increase in the number of concurrent CKD complications and the development of new CKD complications. PMID:24367663

Ahn, Shin Young; Ryu, Jiwon; Baek, Seon Ha; Kim, Sejoong; Na, Ki Young; Kim, Ki Woong; Chae, Dong-Wan; Chin, Ho Jun

2013-01-01

179

Digital Electronic Still Camera  

NASA Technical Reports Server (NTRS)

Digital electronic still camera part of electronic recording, processing, tansmitting, and displaying system. Removable hard-disk drive in camera serves as digital electronic equivalent of photographic film. Images viewed, analyzed, or transmitted quickly. Camera takes images of nearly photographic quality and stores them in digital form. Portable, hand-held, battery-powered unit designed for scientific use. Camera used in conjunction with playback unit also serving as transmitting unit if images sent to remote station. Remote station equipped to store, process, and display images. Digital image data encoded with error-correcting code at playback/transmitting unit for error-free transmission to remote station.

Holland, Samuel D.; Yeates, Herbert D.

1993-01-01

180

[Asbestosis still exists…].  

PubMed

A diagnosis of asbestosis, lung fibrosis due to asbestos exposure, was proposed in 2003 in a 64-year-old woman on the basis of the history, computed tomography appearances, lung function studies, and biometric data. This diagnosis was confirmed by the pathological examination of a lung lobe resected surgically for bronchial carcinoma in 2010. The diagnosis of asbestosis is now rarely made as a result of a substantial decrease in dust exposure over the past decades and mainly because of the interdiction of asbestos use in western countries. Currently, the most frequent thoracic manifestations of asbestos exposure are benign pleural lesions and mesothelioma. It has also become exceptional to have pathological confirmation of the diagnosis, obtained in this woman thanks to the surgical treatment of another complication of her occupational exposure. PMID:23200587

De Vuyst, P; Remmelink, M; Mekinda, Z; Thimpont, J; Dumortier, P; Gevenois, P-A

2012-11-01

181

Endometriosis still a challenge  

PubMed Central

Abstract Endometriosis is a debilitating disease with features of chronic inflammation. Endometriosis appears to be one of the most common benign gynecological proliferations in premenopausal women since it is estimated that 10–15% of reproductive aged women suffer from pelvic endometriosis. The biology of endometriosis is unclear. Despite its prevalence, this disease remains poorly understood and current studies prove that there is no relationship between the extent of the disease and its symptomatology. There is no blood test available for the diagnosis of endometriosis. Up to this point, there is no single very successful option for the treatment of endometriosis. Due to the relatively poor efficacy of hormonal therapy for endometriosis, several other experimental therapies are currently undergoing clinical trial.

Mehedintu, C; Plotogea, MN; Ionescu, S; Antonovici, M

2014-01-01

182

Is Gastroesophageal Reflux Disease Really a LifeLong Disease: Do Babies Who Regurgitate Grow up to Be Adults with GERD Complications?  

Microsoft Academic Search

There are a number of chronic digestive diseases in adults which have symptom and\\/or disease onset in childhood. Examples of childhood-onset chronic diseases include Helicobacter pylori-associated gastroduodenal disease and gastroesophageal reflux disease (GERD). Unfortunately, there is a paucity of well-designed longitudinal studies that characterize the natural history of each of these conditions and more importantly identify individuals (i.e., children) who

Benjamin D. Gold

2006-01-01

183

Ebola Outbreak Still Not Under Control: Officials  

MedlinePLUS

... on this page, please enable JavaScript. Ebola Outbreak Still Not Under Control: Officials World Health Organization says $ ... sweat, saliva or blood" -- of someone who is ill or has died of the disease. Coming into ...

184

Dance\\/movement therapy as a modality in the treatment of the psychosocial complications of heart disease  

Microsoft Academic Search

The problems accompanying cardiac illness are not purely physical in nature. Patients' negative feelings, anger-depression, and loss of self-esteem are a normal and predictable accompaniment of the disease. Once acknowledged, these feelings, like the disease itself, can be addressed and brought under control. Through the utilization of the dance therapist's skills and expertise, cardiac patients have an opportunity to deal

Marjorie R. Seides

1986-01-01

185

Gastrointestinal complications of oncologic therapy.  

PubMed

Gastrointestinal complications are common in patients undergoing various forms of cancer treatment, including chemotherapy, radiation therapy, and molecular-targeted therapies. Many of these complications are life-threatening and require prompt diagnosis and treatment. Complications of oncologic therapy can occur in the esophagus (esophagitis, strictures, bacterial, viral and fungal infections), upper gastrointestinal tract (mucositis, bleeding, nausea and vomiting), colon (diarrhea, graft-versus-host disease, colitis and constipation), liver (drug hepatotoxicity and graft-versus-host disease), and pancreas (pancreatitis). Treatment of the different gastrointestinal complications should be tailored to the individual patient and based on the underlying pathophysiology of the complication. PMID:18941434

Davila, Marta; Bresalier, Robert S

2008-12-01

186

[Type 2 diabetes complications].  

PubMed

People with type 2 diabetes are at increased risk of many complications, which are mainly due to complex and interconnected mechanisms such as hyperglycemia, insulino-resistance, low-grade inflammation and accelerated atherogenesis. Cardi-cerebrovascular disease are frequently associated to type 2 diabetes and may become life threatening, particularly coronaropathy, stroke and heart failure. Their clinical picture are sometimes atypical and silencious for a long time. Type 2 diabetes must be considered as an independent cardiovascular risk factor. Nephropathy is frequent in type 2 diabetes but has a mixed origin. Now it is the highest cause of end-stage renal disease. Better metabolic and blood pressure control and an improved management of microalbuminuria are able to slowdown the course of the disease. Retinopathy which is paradoxically slightly progressive must however be screened and treated in these rather old patients which are globally at high ophthalmologic risk. Diabetic foot is a severe complication secondary to microangiopathy, microangiopathy and neuropathy. It may be considered as a super-complication of several complications. Its screening must be done on a routine basis. Some cancer may be considered as an emerging complication of type 2 diabetes as well as cognitive decline, sleep apnea syndrome, mood disorders and bone metabolism impairments. Most of the type 2 diabetes complications may be prevented by a strategy combining a systematic screening and multi-interventional therapies. PMID:23528336

Schlienger, Jean-Louis

2013-05-01

187

Congenital cardiac surgical complications of the integument, vascular system, vascular-line(s), and wounds: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.  

PubMed

A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval. The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to a collection of loosely related topics that include the following groups of complications: 1) Complications of the Integument, 2) Complications of the Vascular System, 3) Complications of the Vascular-Line(s), 4) Complications of Wounds. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases. As surgical survival in children with congenital cardiac disease has improved in recent years, focus has necessarily shifted to reducing the morbidity of congenital cardiac malformations and their treatment. A comprehensive list of complications is presented. This list is a component of a systems-based compendium of complications that will standardize terminology and thereby allow the study and quantification of morbidity in patients with congenital cardiac malformations. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of treatment. PMID:19063799

Walters, Henry L; Jeffries, Howard E; Cohen, Gordon A; Klitzner, Thomas

2008-12-01

188

Hemorrhagic colitis with unusual colonoscopy features, complicated with chronic graft-versus-host disease after allogeneic bone marrow transplantation.  

PubMed

A 32-year-old man was admitted after bone marrow transplantation because of hematochezia. He had history of chronic graft-versus-host disease (GVHD) of the skin and the liver, and cytomegaloviral pneumonia. Barium enema and colonoscopy showed multiple colon ulcers in the ascending and transverse colon. This feature is very rare in chronic GVHD and resembles the feature in autoimmune disease such as periarteritis nodosa. Thus, this ulceration is thought to be caused by vasculitis due to an autoimmune reaction in chronic GVHD. PMID:7742748

Murayama, T; Nakagawa, T; Matsushita, K; Matozaki, S; Yasutake, K; Kizaki, T; Sashikata, T

1995-01-01

189

Hydatid Disease of the Liver: Spontaneous Rupture of the Portal Vein Into the Cyst Wall (A Rare Complication)  

Microsoft Academic Search

A 60-year-old man was admitted with a complaint of pain in the right upper quadrant of the abdomen together with itching. He had neither jaundice nor fever. He had not developed an anaphylactic reaction. On physical examination, maculopapular lesions and urticaria were observed. Eosinophilia was not defined. ELISA testing for hydatid disease was positive. The results of serologic tests for

Nusret AKYÜREK; Erdal KAYHAN; Mustafa KEREK

2000-01-01

190

Acquired aplastic anaemia: still a serious disease.  

PubMed Central

Over 15 years, 42 children aged 2-14 years were diagnosed as having acquired aplastic anaemia. Adequate clinical details were available for 38 children who were categorised as very severe (n = 13), severe (n = 16), or nonsevere (n = 9) by the modified Camitta criteria. Treatment varied over the study period. Seven children received a bone marrow allograft from a full match family donor and three a matched unrelated donor transplant after failed treatment with antilymphocyte globulin. The remainder were treated with antilymphocyte globulin (n = 11), antilymphocyte globulin and oxymetholone (n = 4), oxymetholone with or without prednisolone (n = 12), or supportive treatment alone (n = 1). With a minimum follow up of one year since treatment, the five year survival was 70% for bone marrow transplantation with a family donor, 30% for antilymphocyte globulin, and 25% for oxymetholone. All three children with a matched unrelated donor transplant died. The prognosis of acquired aplastic anaemia remains poor for most children and new approaches to treatment are urgently required. PMID:1863100

Webb, D K; Hann, I M; Chessells, J M

1991-01-01

191

Early respiratory complications after liver transplantation.  

PubMed

The poor clinical conditions associated with end-stage cirrhosis, pre-existing pulmonary abnormalities, and high comorbidity rates in patients with high Model for End-Stage Liver Disease scores are all well-recognized factors that increase the risk of pulmonary complications after orthotopic liver transplantation (OLT) surgery. Many intraoperative and postoperative events, such as fluid overload, massive transfusion of blood products, hemodynamic instability, unexpected coagulation abnormalities, renal dysfunction, and serious adverse effects of reperfusion syndrome, are other factors that predispose an individual to postoperative respiratory disorders. Despite advances in surgical techniques and anesthesiological management, the lung may still suffer throughout the perioperative period from various types of injury and ventilatory impairment, with different clinical outcomes. Pulmonary complications after OLT can be classified as infectious or non-infectious. Pleural effusion, atelectasis, pulmonary edema, respiratory distress syndrome, and pneumonia may contribute considerably to early morbidity and mortality in liver transplant patients. It is of paramount importance to accurately identify lung disorders because infectious pulmonary complications warrant speedy and aggressive treatment to prevent diffuse lung injury and the risk of evolution into multisystem organ failure. This review discusses the most common perioperative factors that predispose an individual to postoperative pulmonary complications and these complications' early clinical manifestations after OLT and influence on patient outcome. PMID:24409054

Feltracco, Paolo; Carollo, Cristiana; Barbieri, Stefania; Pettenuzzo, Tommaso; Ori, Carlo

2013-12-28

192

Early respiratory complications after liver transplantation  

PubMed Central

The poor clinical conditions associated with end-stage cirrhosis, pre-existing pulmonary abnormalities, and high comorbidity rates in patients with high Model for End-Stage Liver Disease scores are all well-recognized factors that increase the risk of pulmonary complications after orthotopic liver transplantation (OLT) surgery. Many intraoperative and postoperative events, such as fluid overload, massive transfusion of blood products, hemodynamic instability, unexpected coagulation abnormalities, renal dysfunction, and serious adverse effects of reperfusion syndrome, are other factors that predispose an individual to postoperative respiratory disorders. Despite advances in surgical techniques and anesthesiological management, the lung may still suffer throughout the perioperative period from various types of injury and ventilatory impairment, with different clinical outcomes. Pulmonary complications after OLT can be classified as infectious or non-infectious. Pleural effusion, atelectasis, pulmonary edema, respiratory distress syndrome, and pneumonia may contribute considerably to early morbidity and mortality in liver transplant patients. It is of paramount importance to accurately identify lung disorders because infectious pulmonary complications warrant speedy and aggressive treatment to prevent diffuse lung injury and the risk of evolution into multisystem organ failure. This review discusses the most common perioperative factors that predispose an individual to postoperative pulmonary complications and these complications’ early clinical manifestations after OLT and influence on patient outcome. PMID:24409054

Feltracco, Paolo; Carollo, Cristiana; Barbieri, Stefania; Pettenuzzo, Tommaso; Ori, Carlo

2013-01-01

193

Olestra? The Jury's Still Out  

NASA Astrophysics Data System (ADS)

Although it has been more than a year since the FDA approved the use of olestra in certain foods, this fat substitute, a mixture of sucrose polyesters, is still controversial. It would seem that a fat substitute that is heat stable and has an acceptable flavor and texture would be welcomed enthusiastically in a country where increasing numbers of people, young and old, exceed their ideal body weight. Obesity and diets containing high levels of fat have been linked to numerous health problems, including cardiovascular diseases, certain types of cancer, and adult-onset diabetes; they may also exacerbate some chronic problems such as arthritis in joints of the lower extremities. Nevertheless, some scientists and consumer groups question olestra's safety and usefulness.

Doyle, Ellin

1997-04-01

194

[Diabetes and cardiovascular complications].  

PubMed

The prevalence of obesity and diabetes is increasing dramatically. Currently, 800,000 patients are suffering from diabetes mellitus in Austria. Chronic hyperglycemia results in micro- and macrovascular complications, which reduce life expectancy up to 8 years. Furthermore, diabetes is among the most important risk factors for premature atherosclerosis and coronary artery disease. The incidence of coronary artery disease in diabetics is relatively high with about 146 cases per 10,000 patient years. Apart, it could be demonstrated that the presence of diabetes mellitus worsens the prognosis after an acute coronary syndrome. Considering ischemic stroke, the situation is nearly the same, as it is known that diabetes mellitus increases the risk for ischemic stroke events up to 5 times. Beside the macrovascular complications, microvascular complications like diabetic retinopathy, diabetic nephropathy and diabetic neuropathy also play a critical role. Retinopathy can be detected in nearly every patient after a diabetes duration of 20 years. Diabetic nephropathy, which is a major complication of diabetes mellitus, accounts for 19% of end stage renal disease. Microalbuminuria, which is an early marker of diabetic nephropathy, can be found in 30% of the patients after 10 years of diabetes. Due to the severity of the diabetic complications an early intensified antidiabetic treatment is highly important for the prevention of micro- and macrovascular events. PMID:20229155

Resl, Michael; Clodi, Martin

2010-01-01

195

Complications in subthalamic nucleus stimulation surgery for treatment of Parkinson’s disease. Review of 272 procedures  

Microsoft Academic Search

Summary  \\u000a Background. Deep brain stimulation (DBS) is a surgical technique used to alleviate symptoms in patients with advanced Parkinson’s disease\\u000a (PD). It is a reversible procedure and its effect is based on electrical modulation of the nervous system and has considerable\\u000a advantages in morbidity-mortality when compared to lesion techniques such as thalamotomy and\\/or pallidotomy. The objective\\u000a was to evaluate the

F. J. Seijo; M. A. Alvarez-Vega; J. C. Gutierrez; F. Fdez-Glez; B. Lozano

2007-01-01

196

Living Well with Lupus: Can I Still Plan a Pregnancy?  

MedlinePLUS

... well with lupus Can I still plan a pregnancy? Pregnancy is no longer considered an impossibility if ... History or presence of antiphospholipid antibodies Planning Your Pregnancy Although many lupus pregnancies will have no complications, ...

197

Tattoos: dermatological complications  

Microsoft Academic Search

From the Eskimo in Greenland to the tribes in Polynesia­the whole world knows the art of tattoo. Despite their wide popularity the relation between the skin diseases and the tattooed pictures aren't studied in depth. With the appearance of professional tattoo studios, the risk of infectious complications was reduced. Simultaneously, on a global scale there has been an increase in

Jana Kazandjieva; Nikolai Tsankov

2007-01-01

198

Pulmonary complications of hemoglobinopathies.  

PubMed

Hemoglobinopathies are diseases caused by genetic mutations that result in abnormal, dysfunctional hemoglobin molecules or lower levels of normal hemoglobin molecules. The most common hemoglobinopathies are sickle cell disease (SCD) and the thalassemias. In SCD, an abnormal hemoglobin alters the erythrocyte, causing a chronic hemolytic anemia, which can lead to pulmonary parenchymal damage and impaired vascular function. Pulmonary complications of SCD include the acute chest syndrome (ACS), reactive airways disease, pulmonary hypertension (PH), and pulmonary fibrosis. Episodes of ACS and the development of PH both increase the risk of death in patients with SCD. Both ? and ? thalassemia are characterized by impaired production of hemoglobin subunits, and severity of disease varies widely. Although screening studies suggest that PH is a common complication for patients with thalassemia, its impact on survival is unknown. Understanding the pathogenesis, diagnostic options, and prevention and treatment strategies for such complications is critical for clinicians who care for these patients. In this review, we discuss the mechanisms and clinical presentation of pulmonary complications associated with hemoglobinopathies, with a focus on recent advances in pathogenesis and treatment. PMID:20923801

Vij, Rekha; Machado, Roberto F

2010-10-01

199

Complications of sphenoid sinusitis  

Microsoft Academic Search

Regarding the skull base, no structure is as centrally located as the sphenoid sinus. It sits at the junction of the anterior and middle cranial fossae, and is surrounded by vital structures. Although relatively rare, complications of the inflammatory and infectious conditions of sphenoid sinusitis are the result of direct extension of disease to the surrounding tissues, or a propagated

Andrew Goldman

2003-01-01

200

Systemic Lupus Erythematosus (SLE) Complicated by Neuromyelitis Optica (NMO - Devic's Disease): Clinic-Pathological Report and Review of the Literature.  

PubMed

Neuromyelitis optica (NMO) is usually a relapsing demyelinating disease of the central nervous system associated with optic neuritis, transverse myelitis involving three or more contiguous spinal cord segments, and seropositivity for NMO-IgG antibody. NMO is often mistaken for multiple sclerosis and there are relatively sporadic publications about NMO and overlapping systemic or organ-specific autoimmune diseases, such as systemic lupus erythematosus (SLE). We described a unique case of a 25-year-old Arab young woman who was diagnosed with SLE, depending on clinical, laboratory investigations and after she had fulfilled the diagnostic criteria for SLE and had presented the following findings: constitutional findings (fatigue, fever, and arthralgia); dermatologic finding (photosensitivity and butterfly rash); chronic renal failure (proteinuria up to 400 mg in 24 hours); hematologic and antinuclear antibodies (positivity for antinuclear factor (ANF), anti-double-stranded DNA antibodies, direct Coombs, ANA and anti-DNA, low C4 and C3, aCL by IgG and IgM). Recently, she presented with several episodes of transverse myelitis and optic neuritis. Clinical, radiological, and laboratory findings especially seropositivity for NMO-IgG were compatible with NMO. Accurate diagnosis is critical to facilitate initiation of immunosuppressive therapy for attack prevention. This case illustrates that NMO may be associated with SLE. PMID:24948869

Adawi, Mohammad; Bisharat, Bishara; Bowirrat, Abdalla

2014-01-01

201

Reactive amyloidosis complicated by end-stage renal disease 28 years after liquid silicone injection in the buttocks.  

PubMed

Silicone ganulomas usually arise from the rupture of silicone implants. Until the 1980s, however, underground care providers used to inject liquid and unapproved silicone directly into human tissues, in the absence of a containing capsule. We report here the case of a man who ultimately developed end-stage renal disease (ESRD) because of a chronic glomerulosclerosis that was attributed to a glomerular AA amyloidosis diagnosed 28 years after a buttock injection of liquid silicone. To our knowledge, this is the first case of a silicone-induced AA amyloidosis irreversibly affecting the kidneys, and leading to ESRD. An interleukin 1 receptor antagonist was started to prevent the extension of amyloidosis, but to no avail as far as the kidneys are concerned. We want to draw the attention of health professionals about the risk of developing AA amyloidosis secondary to a long-lasting inflammation induced by silicone leakage, after a long latency period. PMID:23035166

d'Ythurbide, Geraldine; Kerrou, Khaldoun; Brocheriou, Isabelle; Hertig, Alexandre

2012-01-01

202

The aryl hydrocarbon receptor-activating effect of uremic toxins from tryptophan metabolism: a new concept to understand cardiovascular complications of chronic kidney disease.  

PubMed

Patients with chronic kidney disease (CKD) have a higher risk of cardiovascular diseases and suffer from accelerated atherosclerosis. CKD patients are permanently exposed to uremic toxins, making them good candidates as pathogenic agents. We focus here on uremic toxins from tryptophan metabolism because of their potential involvement in cardiovascular toxicity: indolic uremic toxins (indoxyl sulfate, indole-3 acetic acid, and indoxyl-?-d-glucuronide) and uremic toxins from the kynurenine pathway (kynurenine, kynurenic acid, anthranilic acid, 3-hydroxykynurenine, 3-hydroxyanthranilic acid, and quinolinic acid). Uremic toxins derived from tryptophan are endogenous ligands of the transcription factor aryl hydrocarbon receptor (AhR). AhR, also known as the dioxin receptor, interacts with various regulatory and signaling proteins, including protein kinases and phosphatases, and Nuclear Factor-Kappa-B. AhR activation by 2,3,7,8-tetrachlorodibenzo-p-dioxin and some polychlorinated biphenyls is associated with an increase in cardiovascular disease in humans and in mice. In addition, this AhR activation mediates cardiotoxicity, vascular inflammation, and a procoagulant and prooxidant phenotype of vascular cells. Uremic toxins derived from tryptophan have prooxidant, proinflammatory, procoagulant, and pro-apoptotic effects on cells involved in the cardiovascular system, and some of them are related with cardiovascular complications in CKD. We discuss here how the cardiovascular effects of these uremic toxins could be mediated by AhR activation, in a "dioxin-like" effect. PMID:24599232

Sallée, Marion; Dou, Laetitia; Cerini, Claire; Poitevin, Stéphane; Brunet, Philippe; Burtey, Stéphane

2014-03-01

203

The Aryl Hydrocarbon Receptor-Activating Effect of Uremic Toxins from Tryptophan Metabolism: A New Concept to Understand Cardiovascular Complications of Chronic Kidney Disease  

PubMed Central

Patients with chronic kidney disease (CKD) have a higher risk of cardiovascular diseases and suffer from accelerated atherosclerosis. CKD patients are permanently exposed to uremic toxins, making them good candidates as pathogenic agents. We focus here on uremic toxins from tryptophan metabolism because of their potential involvement in cardiovascular toxicity: indolic uremic toxins (indoxyl sulfate, indole-3 acetic acid, and indoxyl-?-d-glucuronide) and uremic toxins from the kynurenine pathway (kynurenine, kynurenic acid, anthranilic acid, 3-hydroxykynurenine, 3-hydroxyanthranilic acid, and quinolinic acid). Uremic toxins derived from tryptophan are endogenous ligands of the transcription factor aryl hydrocarbon receptor (AhR). AhR, also known as the dioxin receptor, interacts with various regulatory and signaling proteins, including protein kinases and phosphatases, and Nuclear Factor-Kappa-B. AhR activation by 2,3,7,8-tetrachlorodibenzo-p-dioxin and some polychlorinated biphenyls is associated with an increase in cardiovascular disease in humans and in mice. In addition, this AhR activation mediates cardiotoxicity, vascular inflammation, and a procoagulant and prooxidant phenotype of vascular cells. Uremic toxins derived from tryptophan have prooxidant, proinflammatory, procoagulant, and pro-apoptotic effects on cells involved in the cardiovascular system, and some of them are related with cardiovascular complications in CKD. We discuss here how the cardiovascular effects of these uremic toxins could be mediated by AhR activation, in a “dioxin-like” effect. PMID:24599232

Sallee, Marion; Dou, Laetitia; Cerini, Claire; Poitevin, Stephane; Brunet, Philippe; Burtey, Stephane

2014-01-01

204

Gonorrhea Complications  

MedlinePLUS

... related to gonorrhea on ClinicalTrials.gov. Related Links Sexually Transmitted Diseases National Library of ... untreated gonorrhea infections, the bacteria can spread up into the reproductive ...

205

Eye Complications  

MedlinePLUS

... the pupil (which is a hole in the iris, the colored part of the eye), and then through a lens that performs more ... will be successful. The best results occur when sight is still normal. In photocoagulation , the eye care professional makes tiny burns on the retina ...

206

Complicated necrotizing otitis externa.  

PubMed

Necrotizing (malignant) otitis externa (NOE) is a rare and invasive infection originating in the external acoustic meatus seen most commonly in diabetes and other immunocompromised states. After a protracted course, disease can smolder and extend into the mastoid, skull base, dural sinuses, and intracranially. We present a case of NOE complicated by mastoiditis, dural sinus thrombosis, and Bezold's abscess in an uncontrolled diabetic presenting with a prolonged course of facial nerve palsy. We stress the importance of maintaining a high index of clinical suspicion for NOE in diabetic patients and offering timely, aggressive treatment to mitigate its complications. PMID:23927998

Nawas, Mariam T; Daruwalla, Vistasp J; Spirer, David; Micco, Alan G; Nemeth, Alexander J

2013-01-01

207

Gastrointestinal complications of oncologic therapy  

Microsoft Academic Search

Gastrointestinal complications are common in patients undergoing various forms of cancer treatment, including chemotherapy, radiation therapy, and molecular-targeted therapies. Many of these complications are life-threatening and require prompt diagnosis and treatment. Complications of oncologic therapy can occur in the esophagus (esophagitis, strictures, bacterial, viral and fungal infections), upper gastrointestinal tract (mucositis, bleeding, nausea and vomiting), colon (diarrhea, graft–versus–host disease, colitis

Marta Davila; Robert S Bresalier

2008-01-01

208

Diphtheria Complications  

MedlinePLUS

... patients can die from the disease. Images and logos on this website which are trademarked/copyrighted or used with permission of the trademark/copyright or logo holder are not in the public domain. These ...

209

An unusual complication of a common endemic disease: clinical and laboratory aspects of patients with brucella epididymoorchitis in the north of Iran  

PubMed Central

Background Brucella epididymoorchitis(BEO) is a focal complication of human brucellosis and has been reported in 2-20% of patients with brucellosis. Brucellosis is an endemic disease in Iran. The incidence of the disease in this country is 34 per 100 000 per year. Methods In a retrospective study, we identified 30 cases of Brucella epididymoorchitis in two teaching hospitals in the north of Iran during 1997-2009. Findings Epididymoorchitis occurred in 11.1% of male patients with brucellosis. The average age was 25.5 ± 12.43 years. Pain and scrotal swelling (100%) and fever (96.7%) were the most common symptoms. Different treatment regimens were administered including doxycycline plus rifampin (60%), doxycycline plus rifampin plus aminoglycoside for the first two weeks (36.6%) and doxycycline plus cotrimoxazole(3.4%). Ten percent of the patients did not respond to antibiotic therapy and required surgical drainage or orchiectomy. Conclusions In brucellosis endemic areas, clinicians who encounter patients with epididymoorchitis should consider the likelihood of brucellosis. A careful history and physical examination and an immediate laboratory evaluation help to make a correct diagnosis. Generally, classical therapy of brucellosis is adequate for the treatment of epididymoorchitis. PMID:21834966

2011-01-01

210

Neurological Complications Comparing Endoscopically vs. Open Harvest of the Radial Artery  

ClinicalTrials.gov

Complications Due to Coronary Artery Bypass Graft; Coronary Artery Disease; Myocardial Ischemia; Coronary Disease; Heart Diseases; Cardiovascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Vascular Diseases

2013-06-24

211

Infectious Complications  

Microsoft Academic Search

Infections are strongly associated with Crohn’s disease (CD), both in their etiopathogenesis and in their clinical course\\u000a [1]. The hypothesis that infective agents are linked to the onset of CD is supported by several clinical and experimental observations,\\u000a although a direct causality remains to be demonstrated. In particular, bacteria such as Mycobacterium avium subsp. paratuberculosis (MAP), adherent invasive Escherichia coli

Nicola Petrosillo; Cecilia M. J. Drapeau

212

MEAT, POULTRY, Still contains ice  

E-print Network

MEAT, POULTRY, SEAFOOD Still contains ice crystals and feels as cold, there will be some texture and Clavor loss. Discard DAIRY Still contains ice crystals and feels Ice cream, frozen yogurt Discard Discard Cheese (soft and semi-soft) Refreeze. May

Liskiewicz, Maciej

213

Wild Beasts of Still Life  

ERIC Educational Resources Information Center

This article describes a project with a transformative approach to color theory and still life. Students' use of an arbitrary color scheme can open their eyes, push their creativity and produce exciting paintings. Ordinary still-life objects will be transformed into dramatic, vibrant visuals. The Fauve style of painting is a great art history…

Lott, Debra

2007-01-01

214

Hypoglycemia: The neglected complication  

PubMed Central

Hypoglycemia is an important complication of glucose-lowering therapy in patients with diabetes mellitus. Attempts made at intensive glycemic control invariably increases the risk of hypoglycemia. A six-fold increase in deaths due to diabetes has been attributed to patients experiencing severe hypoglycemia in comparison to those not experiencing severe hypoglycemia Repeated episodes of hypoglycemia can lead to impairment of the counter-regulatory system with the potential for development of hypoglycemia unawareness. The short- and long-term complications of diabetes related hypoglycemia include precipitation of acute cerebrovascular disease, myocardial infarction, neurocognitive dysfunction, retinal cell death and loss of vision in addition to health-related quality of life issues pertaining to sleep, driving, employment, recreational activities involving exercise and travel. There is an urgent need to examine the clinical spectrum and burden of hypoglycemia so that adequate control measures can be implemented against this neglected life-threatening complication. Early recognition of hypoglycemia risk factors, self-monitoring of blood glucose, selection of appropriate treatment regimens with minimal or no risk of hypoglycemia and appropriate educational programs for healthcare professionals and patients with diabetes are the major ways forward to maintain good glycemic control, minimize the risk of hypoglycemia and thereby prevent long-term complications. PMID:24083163

Kalra, Sanjay; Mukherjee, Jagat Jyoti; Venkataraman, Subramanium; Bantwal, Ganapathi; Shaikh, Shehla; Saboo, Banshi; Das, Ashok Kumar; Ramachandran, Ambady

2013-01-01

215

Neurological Complications of Transplantation  

PubMed Central

Hematopoietic cell transplantation (HCT) is the preferred treatment for an expanding range of neoplastic and nonmalignant conditions. Increasing numbers of solid organ transplantations (SOTs) add an additional population of immunosuppressed patients with multiple potential neurological problems. While the spectrum of neurological complications varies with conditioning procedure and hematopoietic cell or solid organ source, major neurological complications occur with all transplantation procedures. This 2 part review emphasizes a practical consultative approach to central and peripheral nervous system problems related to HCT or SOT with clinical and neuroimaging examples from the authors’ institutional experience with the following conditions: the diversity of manifestations of common infections such as varicella zoster virus, Aspergillus, and progressive multifocal leukoencephalopathy (PML), drug therapy-related complications, stroke mechanisms, the spectrum of graft versus host disease (GVHD), and neurologically important syndromes of immune reconstitution inflammatory syndrome (IRIS), posterior reversible encephalopathy syndrome (PRES), and posttransplantation lymphoproliferative disorder (PTLD). These complications preferentially occur at specific intervals after HCT and SOT, and neurological consultants must recognize an extensive spectrum of syndromes in order to effect timely diagnosis and expedite appropriate treatment. PMID:23983885

Pruitt, Amy A.; Graus, Francesc; Rosenfeld, Myrna R.

2013-01-01

216

Gastrointestinal complications of diabetes.  

PubMed

Gastrointestinal complications of diabetes include gastroparesis, intestinal enteropathy (which can cause diarrhea, constipation, and fecal incontinence), and nonalcoholic fatty liver disease. Patients with gastroparesis may present with early satiety, nausea, vomiting, bloating, postprandial fullness, or upper abdominal pain. The diagnosis of diabetic gastroparesis is made when other causes are excluded and postprandial gastric stasis is confirmed by gastric emptying scintigraphy. Whenever possible, patients should discontinue medications that exacerbate gastric dysmotility; control blood glucose levels; increase the liquid content of their diet; eat smaller meals more often; discontinue the use of tobacco products; and reduce the intake of insoluble dietary fiber, foods high in fat, and alcohol. Prokinetic agents (e.g., metoclopramide, erythromycin) may be helpful in controlling symptoms of gastroparesis. Treatment of diabetes-related constipation and diarrhea is aimed at supportive measures and symptom control. Nonalcoholic fatty liver disease is common in persons who are obese and who have diabetes. In persons with diabetes who have elevated hepatic transaminase levels, it is important to search for other causes of liver disease, including hepatitis and hemochromatosis. Gradual weight loss, control of blood glucose levels, and use of medications (e.g., pioglitazone, metformin) may normalize hepatic transaminase levels, but the clinical benefit of aggressively treating nonalcoholic fatty liver disease is unknown. Controlling blood glucose levels is important for managing most gastrointestinal complications. PMID:18619079

Shakil, Amer; Church, Robert J; Rao, Shobha S

2008-06-15

217

Fournier's Gangrene Complicating Hematologic Malignancies: a Case Report and Review of Licterature  

PubMed Central

Fournier’s gangrene (FG) is a rare but severe necrotizing fasciitis of the external genitalia that may complicate the clinical course of hematologic malignancies and sometimes may be the first sign of the disease. The clinical course of FG is very aggressive and the mortality is still high despite the improvement in its management. Early recognition of FG and prompt appropriate treatment with surgical debridement and administration of antibiotics are the cornerstone of the management of this very severe disease. A review of the scientific literature focusing on the topic of FG complicating hematologic disorders is reported PMID:24363882

D'Arena, Giovanni; Pietrantuono, Giuseppe; Buccino, Emilio; Pacifico, Giancarlo; Musto, Pellegrino

2013-01-01

218

Pregnancy Complications: Gonorrhea  

MedlinePLUS

... in the community. Home > Pregnancy > Pregnancy Complications > Gonorrhea Pregnancy complications Pregnancy complications may need special medical care. ... the United States. Can gonorrhea cause complications during pregnancy and for your baby? Yes. Gonorrhea can lead ...

219

Pregnancy Complications: Preeclampsia  

MedlinePLUS

... in the community. Home > Pregnancy > Pregnancy Complications > Preeclampsia Pregnancy complications Pregnancy complications may need special medical care. ... health care provider right away. What health and pregnancy complications can preeclampsia cause? Without treatment, preeclampsia can ...

220

Why Are Chimps Still Chimps?  

ERIC Educational Resources Information Center

Teachers may be posed with such questions as, "If we evolved from chimps, why are there still chimps?" We provide teachers with answers to this and related questions in the context of the latest genetic, fossil, and behavioral evidence. We also provide references they can use to further students' understanding of human evolution and evolution in…

Johnson, Norman A.; Smith, James J.; Pobiner, Briana; Schrein, Caitlin

2012-01-01

221

focusing on research still growing  

E-print Network

of pharmaceutical anD pharmacological sciences PSYCHOLOGY Department of philosophy, sociology, eDucation anD applieD49 focusing on research still growing SOCIAL SCIENCES AND HUMANITIES ECONOMICS AND STATISTICS Department of economics anD management Department of statistical sciences HISTORY, PHILOSOPHY AND PEDAGOGY

Cesare, Bernardo

222

A Beautiful Britto Still Life  

ERIC Educational Resources Information Center

Romero Britto is a wonderful artist for young students to study when learning the building blocks of art and design. Colorful, linear, and full of bold patterns, Britto's work blends a contemporary cubist style and pop art commercial appeal. Themes of this contemporary artist's work include animals, flowers, still life, and people in joyful…

Coy, Mary

2012-01-01

223

Prevention of Postoperative Complications following Pancreatic Surgery  

Microsoft Academic Search

Major pancreatic resection is still accompanied by considerable morbidity and even mortality. Complications which occur after pancreatic surgery are chiefly associated with exocrine pancreatic secretion, hence, the inhibition of exocrine pancreatic secretion perioperatively is a promising concept in the prevention of complications. The hormone somatostatin and its synthetic analogue octreotide have been shown to profoundly inhibit exocrine pancreatic secretion, particularly

M. Büchler; H. Friess

1993-01-01

224

Surgery for inflammatory bowel disease  

PubMed Central

Despite the new and ever expanding array of medications for the treatment of inflammatory bowel disease (IBD), there are still clear indications for operative management of IBD and its complications. We present an overview of indications, procedures, considerations, and controversies in the surgical therapy of IBD. PMID:18461653

Hwang, John M; Varma, Madhulika G

2008-01-01

225

Is Rheumatic Mitral Valve Repair Still a Feasible Alternative?  

PubMed Central

Rheumatic heart disease is still a major cause of mitral valve dysfunction in developing countries. We present our early results of rheumatic mitral valve repair. From August 2009 through July 2011, 60 patients (24 male and 36 female) with rheumatic disease underwent mitral repair. The mean age was 51.1 ± 13.8 years (range, 16–77 yr). Forty-nine patients were in New York Heart Association functional class III or IV. Repair procedures included chordal and papillary muscle splitting, secondary chordal division, mitral ring annuloplasty (n=58), commissurotomy (n=36), chordal replacement (n=9), posterior leaflet extension (n=4), annular decalcification (n=2), and quadrangular resection (n=2). Secondary procedures included tricuspid ring annuloplasty, left atrial ablation, obliteration of left atrial appendage, aortic valve replacement, and left atrial reduction. The early (30-d) mortality rate was 1.7%. The mean follow-up time was 14.9 ± 5 months (range, 4–26 mo). Follow-up echocardiography revealed trivial or no mitral regurgitation (MR) in 35.5% and mild (1+) MR in 49.1% of patients. Only 1 patient presented with severe (3+) MR. The mean MR grade decreased from 3.2 ± 0.9 to 0.3 ± 0.4 postoperatively (P=0.001). Left ventricular end-diastolic diameter and left atrial diameter significantly decreased postoperatively (P=0.006 and P=0.001, respectively). The mean gradient over the mitral valve decreased significantly from 11 ± 5.9 mmHg to 3.5 ± 1.8 mmHg (P=0.001). Because current techniques of mitral repair can effectively correct valve dysfunction in most patients with rheumatic disease, the number of repair procedures should be increased in developing countries to prevent complications of mechanical valve placement. PMID:23678214

Bakir, Ihsan; Onan, Burak; Onan, Ismihan Selen; Gul, Mehmet; Uslu, Nevzat

2013-01-01

226

Pregnancy Complications: Chlamydia  

MedlinePLUS

... in the community. Home > Pregnancy > Pregnancy Complications > Chlamydia Pregnancy complications Pregnancy complications may need special medical care. ... younger than 25. Can chlamydia cause problems during pregnancy? Yes. If you get it before or during ...

227

Pregnancy Complications: Syphilis  

MedlinePLUS

... in the community. Home > Pregnancy > Pregnancy Complications > Syphilis Pregnancy complications Pregnancy complications may need special medical care. ... syphilis each year. Can syphilis cause problems during pregnancy and for your baby? Yes. You can pass ...

228

Dengue encephalopathy - still an enigma?  

PubMed

Dengue encephalopathy or dengue hemorrhagic fever (DHF) with neurological involvement was once considered to be one of the rarer presentations of this infectious agent. In recent years, many such clinical cases have been reported, though they still remain isolated. We hereby report a case of confirmed dengue fever with features of encephalopathy with previously unreported cranial magnetic resonance imaging findings suggestive of extensive involvement of the bilateral cerebellar region, brainstem, and thalami along with peculiar rim enhancement but normal cerebrospinal fluid analysis. PMID:25116679

Malik, Rupali; Gogna, Arun; Meher, Jhasketan; Singh, Kumud Kumar; Sharma, Susheel Kumar

2014-08-01

229

[Orthostatic tremor: unsteadiness while standing still].  

PubMed

We present three patients with histories of the typical unsteady feeling in the legs while standing still which disappears when walking or sitting down. An orthostatic tremor is a disorder that is difficult to recognise because patients describe balance disturbances rather than tremors. Clinical findings include a fine tremor in the legs which may be invisible but can be heard on auscultation and felt on palpation of the leg muscles. The diagnosis is confirmed by EMG which reveals a pathognomonic tremor of 13-18 Hz while the patient is standing upright. Its pathophysiology is unknown but a disorder related to proprioceptive feedback has been suggested. The tremor can be associated with Parkinson's disease, Graves' disease, and cerebellar or pontine lesions which should be excluded by laboratory investigations and MRI. There is little evidence available on effective treatments, but clonazepam seems to be the first drug of choice, followed by gabapentin. Levodopa can be tried in patients with parkinsonism. PMID:22617068

Wiendels, Natalie J; Tromp, Selma C

2012-01-01

230

Complications of intraoperative radiation therapy  

SciTech Connect

The authors have studied the severe complications occurring after treatment with intraoperative radiation therapy (IORT) in patients with locally advanced carcinoma of the rectum. Four groups of patients were compared: Group 1 (80 patients) had treatment with surgery alone for mobile and resectable tumors; Group 2 (23 patients) had treatment with high dose preoperative irradiation followed by surgical resection for tumors which were fixed to adjacent structures and initially unresectable for cure; Group 3 (24 patients, primary disease) and Group 4 (17 patients, locally recurrent disease) had locally advance tumors as in Group 2 but were treated with IORT after preoperative irradiation and attempted surgical resection. All but 3 complications occurred within one year of therapy. Severe complications were seen in 16% of patients in Group 1, 35% in Group 2, 21% in Group 3 and 47% in Group 4 (32% in Groups 3 and 4 combined).

Tepper, J.E.; Gunderson, L.L.; Orlow, E.; Cohen, A.M.; Hedberg, S.E.; Shipley, W.U.; Blitzer, P.H.; Rich, T.

1984-10-01

231

The role of transjugular intrahepatic portosystemic shunt for treatment of portal hypertension and its complications: A conference sponsored by the National Digestive Diseases Advisory Board  

Microsoft Academic Search

TIPS is a new and exciting modality for treatment of portal hypertension and its complications. Indications for TIPS remain to be better defined in terms of efficacy and cost-benefit in relationship to other established modes of therapy of portal hypertension. Prospective, randomized controlled trials are needed for these comparisons. Until the role of TIPS in the routine management of the

Mitchell L. Shiffman; Lennox Jeffers; Jay H. Hoofnagle; Tommie Sue Tralka

1995-01-01

232

[Acute hepatic vascular complications].  

PubMed

Acute hepatic vascular complications are rare. Acute portal vein thrombosis (PVT) and the Budd-Chiari syndrome (BSC) are the leading causes. Coagulopathy and local factors are present in up to 80% of cases. Diagnosis is established by colour-coded Doppler sonography, contrast-enhanced computed tomography or magnetic resonance imaging. Patients with acute PVT present with abdominal pain and disturbed intestinal motility. In the absence of cirrhosis anticoagulation with heparin is established followed by oral anticoagulation. In severe cases, surgical thrombectomy or transjugular thrombolysis with stent shunt may be necessary. Acute or fulminant BCS may require emergency liver transplantation or a transjugular intrahepatic portosystemic stent shunt, if patients present with acute liver failure. Milder cases receive anticoagulation for thrombolysis of occluded hepatic veins. Sinusoidal obstruction syndrome (SOS) is diagnosed after total body irradiation or chemotherapy, the term SOS replacing the former veno-occlusive disease. The treatment of congenital vascular malformations, complications in the setting of OLTX as well as patients with hepatic involvement of hereditary hemorrhagic telangiectasia requires significant expertise in a multidisciplinary approach. PMID:21667100

Ochs, A

2011-07-01

233

Type 1 Diabetes, Cardiovascular Complications and Sesame (?? Zh? M?)  

PubMed Central

Diabetes is a major concern among medical practitioners, with the annual mortality rate increasing up to 26.9% in a person aged 65 years or older and 11.3% in the adult. There are many serious complications associated with diabetes, particularly cardiovascular complications due to microvascular diseases. A prerequisite to reduce the risk of microvascular and neurologic complications of type 1 diabetes is normoglycemia. Insulin therapy is the most common treatment used nowadays in type 1 diabetes. However, this method still has many disadvantages such as increased episode of severe hypoglycemia, hypoglycemia unawareness, increased weight gain, transient exacerbation of pre-existing retinopathy, etc. Using insulin pump (the insulin pump is a medical device used for continuous subcutaneous insulin infusion to manage the insulin level in the treatment of diabetes mellitus), is associated with known disadvantages including increased ketoacidosis, infection at the infusion site, and the treatment being less suitable in young children (less than 7 years of age). Therefore, alternative treatment for diabetes is still in great demand. We took the approach of traditional Chinese medicine to discuss this matter. Sesame (?? Zh? Má), a herb, has been used medicinally for thousands of years in almost all the countries in the world. The beneficial effects of sesame in remediating diabetes, such as hypoglycemic effects, antioxidant, anti-inflammatory, and hypolipidemic effects, improving fat metabolism, and reducing cholesterol, have been demonstrated in many studies,. However, reports on the effects of sesame in remediating cardiovascular complications in diabetic patients are limited, which necessitates further studies on the effects of sesame on cardiovascular complications. PMID:24872931

Lin, Yen-Chang; Thuy, Tran Duong; Wang, Shu-Yin; Huang, Pung-Ling

2014-01-01

234

The impact of mathematical modeling on the understanding of diabetes and related complications  

PubMed Central

Diabetes is a chronic and complex multifactorial disease caused by persistent hyperglycemia and for which underlying pathogenesis is still not completely understood. The mathematical modeling of glucose homeostasis, diabetic condition, and its associated complications is rapidly growing and provides new insights into the underlying mechanisms involved. Here, we discuss contributions to the diabetes modeling field over the past five decades, highlighting the areas where more focused research is required. PMID:23842097

Ajmera, I; Swat, M; Laibe, C; Novere, N Le; Chelliah, V

2013-01-01

235

Pregnancy Complications/Health Problems Complication Explanation  

E-print Network

1 Pregnancy Complications/Health Problems Complication Explanation Preterm Labor Labor that starts Premature Rupture of Membranes (PROM) Amniotic fluid bag surrounding baby ruptures or leaks before labor in pregnancy and goes away after delivery. Preeclampsia (hypertension) Pregnancy induced high blood pressure

Stromswold, Karin

236

Spongecake and eggroll: two hereditary diseases in Drosophila resemble patterns of human brain degeneration  

Microsoft Academic Search

Various neuronal degenerative diseases are characterized by late onset, relentless progression, and finally death. Many have a direct genetic basis; others are of still unknown etiological mechanisms [1,2]. The study of human neurodegenerative diseases is complicated by the difficulty of obtaining tissue samples at various stages of progression, especially early in the course of the disease. Since neurodegeneration occurs in

Kyung-Tai Min; Seymour Benzer

1997-01-01

237

Abnormal Bidirectional Plasticity-Like Effects in Parkinson's Disease  

ERIC Educational Resources Information Center

Levodopa-induced dyskinesia is a major complication of long-term dopamine replacement therapy for Parkinson's disease that becomes increasingly problematic in advanced Parkinson's disease. Although the cause of levodopa-induced dyskinesias is still unclear, recent work in animal models of the corticostriatal system has suggested that…

Huang, Ying-Zu; Rothwell, John C.; Lu, Chin-Song; Chuang, Wen-Li; Chen, Rou-Shayn

2011-01-01

238

Crohn's Disease: A Surgeon's Perspective  

PubMed Central

Crohn’s disease (CD) is known for wide anatomic distribution, different presentations, life-threatening complications, and multiple modalities of management. Its multiple implications are still unaddressed. Since all the patients do not show a good response to medical modalities of treatment, a significant percentage of these patients are referred to the surgeon for the palliation of complications or for the ultimate curative treatment. Since most surgeons come across such patients only rarely, it is sometimes difficult for them to choose the appropriate procedure at the time of need. Moreover, the various surgical modalities available for the different presentations and complications of the disease have not been adequately discussed. The aim of this review is to offer insight and a detailed account of the management of CD from a surgical perspective. This review offers an overview of the various surgical options available, their utility in context, and an approach to various scenarios of complicated CD. PMID:21196646

Parray, Fazl Q.; Wani, Mohd Lateef; Bijli, Akram H.; Thakur, Natasha; Irshad, Ifat; Nayeem-ul-Hassan

2011-01-01

239

Surgical Complications of Gynecologic Surgery  

PubMed Central

Complications of gynecological surgery are considerable and when reviewed in detail are almost frightening. There is no substitute for experience and intimate knowledge of the intricate pelvic structures in health and disease. Anyone who is active in the field is sooner or later going to experience some difficulty whether it be due to his miscalculation or to innate conditions in the patient which are beyond his/her control. It is the responsibility of the pelvic surgeon to recognize the complication and apply proper corrective measures. The patient should not be given false hopes of sure success nor should she be deprived of whatever hope for success does exist. PMID:572875

Weekes, Leroy R.; Gandhi, Shobhana Anil; Gandhi, Anil Krishnakumar

1977-01-01

240

Extracardiac complications of the Fontan circuit  

Microsoft Academic Search

The Fontan operation is the primary surgical procedure used in the palliation of patients with univentricular cardiac physiology.\\u000a With improved survival of children with congenital heart disease, long-term complications of the Fontan circuit are being\\u000a encountered more frequently. Radiologists are more likely to see both the cardiac and extracardiac complications of the Fontan\\u000a circuit. Awareness of the common extracardiac complications

Geetika Khanna; Sanjeev Bhalla; Rajesh Krishnamurthy; Charles Canter

241

Hemoperitoneum: a rare complication of hemorrhoid treatment.  

PubMed

Pile suturing has always been used by surgeons to treat hemorrhoidal disease. We report a case of hemoperitoneum complicating a pile suture. Ultrasonography and computed tomography scan indicated the need for an emergency laparoscopic procedure and conservative management. As other authors have pointed out, we do not know how to prevent this type of complication. This case suggests the possibility of life-threatening complications following treatment procedures for hemorrhoids and underlines the importance of conservative treatment when this is possible. PMID:22706732

Andreuccetti, J; Gaj, F; Crispino, P; Dassatti, M R; Negro, P

2014-04-01

242

Complications of orthotopic liver transplantation: imaging findings  

Microsoft Academic Search

Orthotopic liver transplantation has become the major treatment for end-stage chronic liver disease and for severe acute liver failure. Despite the improvement in survival due to advances in organ preservation, improved immunosuppressive therapy agents, and refinement of surgical techniques, there are significant complications after liver transplantation. These complications mainly include biliary strictures, stones, and leakage; arterial and venous stenoses and

P. Boraschi; F. Donati

2004-01-01

243

Osteogenesis imperfecta as a complication of pregnancy.  

PubMed

Osteogenesis imperfecta is a complex disorder that rarely complicates pregancy. The successful obstetric management of a patient with severe osteogensis imperfecta is presented along with a detailed review of maternal osteogenesis imperfecta in the recent English literature. A review of the disease process, its complications, and associated disorders is presented. PMID:619339

Key, T C; Horger, E O

1978-01-01

244

Endoscopic treatment of Crohn's complications.  

PubMed

The progression to fistula and strictures is part of the natural history of Crohn's disease (CD) and these complications negatively affect the quality of life of CD patients. Surgery is the traditional treatment of CD strictures. However, due the chronicity of the inflammatory process and the associated fibrosis, postoperative recurrence occurs frequently. The lack of specific drug to treat fibrotic strictures and their irreversible nature has drawn the attention to less invasive and bowel-sparing therapeutic modalities. Endoluminal therapies may provide effective option in relieving symptoms associated with CD complications and reduce the need for repeated surgery with substantial clinical benefit. This review will discuss the current use and efficacy of the endoscopic treatment of CD complications. New endoscopic modalities and recent advances will be also evaluated. PMID:24849124

Buda, Andrea; Okolo, Patrick I

2014-11-01

245

Unusual Development of Iatrogenic Complex, Mixed Biliary and Duodenal Fistulas Complicating Roux-en-Y Antrectomy for Stenotic Peptic Disease of the Supraampullary Duodenum Requiring Whipple Procedure: An Uncommon Clinical Dilemma.  

PubMed

Complex fistulas of the duodenum and biliary tree are severe complications of gastric surgery. The association of duodenal and major biliary fistulas occurs rarely and is a major challenge for treatment. They may occur during virtually any kind of operation, but they are more frequent in cases complicated by the presence of difficult duodenal ulcers or cancer, with a mortality rate of up to 35%. Options for treatment are many and range from simple drainage to extended resections and difficult reconstructions. Conservative treatment is the choice for well-drained fistulas, but some cases require reoperation. Very little is known about reoperation techniques and technical selection of the right patients. We present the case of a complex iatrogenic duodenal and biliary fistula. A 42-year-old Caucasian man with a diagnosis of postoperative peritonitis had been operated on 3 days earlier; an antrectomy with a Roux-en-Y reconstruction for stenotic peptic disease was performed. Conservative treatment was attempted with mixed results. Two more operations were required to achieve a definitive resolution of the fistula and related local complications. The decision was made to perform a pancreatoduodenectomy with subsequent reconstruction on a double jejunal loop. The patient did well and was discharged on postoperative day 17. In our experience pancreaticoduodenectomy may be an effective treatment of refractory and complex iatrogenic fistulas involving both the duodenum and the biliary tree. PMID:21103208

Polistina, Francesco A; Costantin, Giorgio; Settin, Alessandro; Lumachi, Franco; Ambrosino, Giovanni

2010-01-01

246

Acute polyradiculoneuropathy complicating systemic lupus erythematosus.  

PubMed Central

Two elderly patients with systemic lupus erythematosus (SLE) are presented. Both developed an acute polyradiculoneuropathy which is an unusual complication of this disease. Features of their presentation are discussed. PMID:3714625

Morgan, S. H.; Kennett, R. P.; Dudley, C.; Mackworth-Young, C.; Hull, R.; Hughes, G. R.

1986-01-01

247

Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors  

PubMed Central

Radiofrequency ablation (RFA) has become an important option in the therapy of primary and secondary hepatic tumors. Surgical resection is still the best treatment option, but only a few of these patients are candidates for surgery: multilobar disease, insufficient liver reserve that will lead to liver failure after resection, extra-hepatic disease, proximity to major bile ducts and vessels, and co-morbidities. RFA has a low mortality and morbidity rate and is considered to be safe. Thus, complications occur and vary widely in the literature. Complications are caused by thermal damage, direct needle injury, infection and the patient’s co-morbidities. Tumor type, type of approach, number of lesions, tumor localization, underlying hepatic disease, the physician’s experience, associated hepatic resection and lesion size have been described as factors significantly associated with complications. The physician in charge should promptly recognize high-risk patients more susceptible to complications, perform a close post procedure follow-up and manage them early and adequately if they occur. We aim to describe complications from RFA of hepatic tumors and their risk factors, as well as a few techniques to avoid them. This way, others can decrease their morbidity rates with better outcomes. PMID:24672640

Fonseca, Alexandre Zanchenko; Santin, Stephanie; Gomes, Luiz Guilherme Lisboa; Waisberg, Jaques; Ribeiro Jr., Marcelo Augusto Fontenelle

2014-01-01

248

Pulmonary complications after esophagectomy  

Microsoft Academic Search

Background. Pulmonary complications are common in patients who have undergone esophagectomy. There are no good predictive variables for these complications. In addition, the role that preoperative treatment with chemotherapy and radiation may play in postoperative complications remains unclear.Methods. We performed a retrospective review of all patients who underwent esophagectomy by a single surgeon at our institution over a 6-year period.

Christopher E Avendano; Patrick A Flume; Gerard A Silvestri; Lydia B King; Carolyn E Reed

2002-01-01

249

Transoesophageal Echocardiography Related Complications  

PubMed Central

Summary The application of transesophageal echocardiography (TEE) has been continuously increasing over past several decades. It is usually considered a very safe diagnostic and monitoring device. Though the complications are rare, but these complications must be known to the operators performing TEE. The goal of this article is to encapsulate the potential complications associated with TEE. The complications are primarily related to gastrointestinal, cardiovascular and respiratory systems along with some miscellaneous problems related to probe insertion, drugs and inexperience of the operator. Strategies for the prevention of these complications are also analyzed in order to avoid the risk. PMID:20640107

Mathur, S K; Singh, Pooja

2009-01-01

250

Radiological diagnosis of dialysis-associated complications.  

PubMed

In daily clinical practice, the radiologist in the context of diagnosis often faces dialysis-associated complications. The complications are numerous and range from infections, catheter dysfunctions, haematomas, cardiovascular diseases, digital ischaemia, and pseudoaneurysms to shunt stenosis. In this pictorial essay, we take a close look at the imaging diagnostics of the most common complications in dialysis patients. Teaching Points • The occurrence of venous stenosis in haemodialysis patients is up to 41 %. • Catheters usually have a fibrin sheath that can be rinsed but not aspirated. • The steal phenomenon occurs in 75-90 % of patients with a shunt system. • Arterial pseudoaneurysms can cause a number of complications. PMID:25095722

Zandieh, Shahin; Muin, Dina; Bernt, Reinhard; Krenn-List, Petra; Mirzaei, Siroos; Haller, Joerg

2014-10-01

251

Surgical management of complicated diverticulitis  

Microsoft Academic Search

One hundred forty patients who had complicated diverticular disease were identified in a retrospective review at the Lahey\\u000a Clinic between 1967 and 1982. Of these patients, 86 underwent resection with primary anastomosis with a 1 percent mortality\\u000a rate and an 18 percent morbidity rate; 13 had resection with anastomosis and creation of a proximal colostomy with no death\\u000a and a

Alan W. Hackford; David J. Schoetz; John A. Coller; Malcolm C. Veidenheimer

1985-01-01

252

Gastrointestinal complications of diabetes mellitus  

PubMed Central

Diabetes mellitus affects virtually every organ system in the body and the degree of organ involvement depends on the duration and severity of the disease, and other co-morbidities. Gastrointestinal (GI) involvement can present with esophageal dysmotility, gastro-esophageal reflux disease (GERD), gastroparesis, enteropathy, non alcoholic fatty liver disease (NAFLD) and glycogenic hepatopathy. Severity of GERD is inversely related to glycemic control and management is with prokinetics and proton pump inhibitors. Diabetic gastroparesis manifests as early satiety, bloating, vomiting, abdominal pain and erratic glycemic control. Gastric emptying scintigraphy is considered the gold standard test for diagnosis. Management includes dietary modifications, maintaining euglycemia, prokinetics, endoscopic and surgical treatments. Diabetic enteropathy is also common and management involves glycemic control and symptomatic measures. NAFLD is considered a hepatic manifestation of metabolic syndrome and treatment is mainly lifestyle measures, with diabetes and dyslipidemia management when coexistent. Glycogenic hepatopathy is a manifestation of poorly controlled type 1 diabetes and is managed by prompt insulin treatment. Though GI complications of diabetes are relatively common, awareness about its manifestations and treatment options are low among physicians. Optimal management of GI complications is important for appropriate metabolic control of diabetes and improvement in quality of life of the patient. This review is an update on the GI complications of diabetes, their pathophysiology, diagnostic evaluation and management. PMID:23772273

Krishnan, Babu; Babu, Shithu; Walker, Jessica; Walker, Adrian B; Pappachan, Joseph M

2013-01-01

253

Prediction of radiation-induced liver disease by Lyman normal-tissue complication probability model in three-dimensional conformal radiation therapy for primary liver carcinoma  

SciTech Connect

Purpose: To describe the probability of RILD by application of the Lyman-Kutcher-Burman normal-tissue complication (NTCP) model for primary liver carcinoma (PLC) treated with hypofractionated three-dimensional conformal radiotherapy (3D-CRT). Methods and Materials: A total of 109 PLC patients treated by 3D-CRT were followed for RILD. Of these patients, 93 were in liver cirrhosis of Child-Pugh Grade A, and 16 were in Child-Pugh Grade B. The Michigan NTCP model was used to predict the probability of RILD, and then the modified Lyman NTCP model was generated for Child-Pugh A and Child-Pugh B patients by maximum-likelihood analysis. Results: Of all patients, 17 developed RILD in which 8 were of Child-Pugh Grade A, and 9 were of Child-Pugh Grade B. The prediction of RILD by the Michigan model was underestimated for PLC patients. The modified n, m, TD{sub 5} (1) were 1.1, 0.28, and 40.5 Gy and 0.7, 0.43, and 23 Gy for patients with Child-Pugh A and B, respectively, which yielded better estimations of RILD probability. The hepatic tolerable doses (TD{sub 5}) would be MDTNL of 21 Gy and 6 Gy, respectively, for Child-Pugh A and B patients. Conclusions: The Michigan model was probably not fit to predict RILD in PLC patients. A modified Lyman NTCP model for RILD was recommended.

Xu ZhiYong [Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai (China); Department of Oncology, Shanghai Medical School, Fudan University, Shanghai (China); Liang Shixiong [Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai (China); Department of Radiation Oncology, Cancer Hospital, Guangxi Medical University, Nanning (China); Zhu Ji [Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai (China); Department of Oncology, Shanghai Medical School, Fudan University, Shanghai (China); Zhu Xiaodong [Department of Radiation Oncology, Cancer Hospital, Guangxi Medical University, Nanning (China); Zhao Jiandong [Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai (China); Department of Oncology, Shanghai Medical School, Fudan University, Shanghai (China); Lu Haijie [Department of Radiation Oncology, Cancer Hospital, Guangxi Medical University, Nanning (China); Yang Yunli [Department of Radiation Oncology, Cancer Hospital, Guangxi Medical University, Nanning (China); Chen Long [Department of Radiation Oncology, Cancer Hospital, Guangxi Medical University, Nanning (China); Wang Anyu [Department of Radiation Oncology, Cancer Hospital, Guangxi Medical University, Nanning (China); Fu Xiaolong [Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai (China); Department of Oncology, Shanghai Medical School, Fudan University, Shanghai (China); Jiang Guoliang [Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai (China) and Department of Oncology, Shanghai Medical School, Fudan University, Shanghai (China)]. E-mail: jianggl@21cn.com

2006-05-01

254

Life-threatening disseminated tuberculosis as a complication of treatment by infliximab for Crohn's disease: report of two cases, including cerebral tuberculomas and miliary tuberculosis.  

PubMed

Tumor necrosis factor ? antagonist therapies represent an increased risk of reactivation of tuberculosis. We report two cases of life-threatening disseminated tuberculosis in patients undergoing treatment with infliximab for Crohn's disease including one case of a patient with cerebral tuberculomas. We discuss the implication of tumor necrosis factor ? in the genesis of tuberculosis infection and the features of tuberculosis under infliximab. Tuberculosis screening and eventually preventive chemotherapy should become the standard of care for individual undergoing tumor necrosis factor ? antagonist therapies. PMID:22749231

Tissot, Claire; Couraud, Sébastien; Meng, Lun; Girard, Philippe; Avrillon, Virginie; Gérinière, Laurence; Perrot, Emilie; Souquet, Pierre-Jean

2012-10-01

255

Tattoo-associated complications.  

PubMed

Tattoo rates in the United States have been rising in recent years, with an expected concomitant rise in tattoo-associated complications. Tattoo complications range from cutaneous localized and generalized inflammatory eruptions, to local bacterial or viral infections, and finally to infectious endocarditis and hepatitis. Many complications may be avoided with proper counseling prior to tattoo placement, especially in high risk individuals. It is important for physicians to be able to recognize and diagnose complications from tattoos to avoid morbidity and possible mortality. PMID:23287600

Juhas, Elizabeth; English, Joseph C

2013-04-01

256

How to build a solar still  

Microsoft Academic Search

Directions for the construction of an inexpensive solar still for utilizing the sun's energy to convert salt water to fresh are presented. Information is given on the materials needed, directions for the use of the still, and expected production rates. This solar still can be built from materials available in most lumber yards, metal-supply houses, and plastic-supply stores. Illustrations are

L. Edson; H. McCracken; J. Weldy

1966-01-01

257

Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America.  

PubMed

Evidence-based guidelines for managing patients with intra-abdominal infection were prepared by an Expert Panel of the Surgical Infection Society and the Infectious Diseases Society of America. These updated guidelines replace those previously published in 2002 and 2003. The guidelines are intended for treating patients who either have these infections or may be at risk for them. New information, based on publications from the period 2003-2008, is incorporated into this guideline document. The panel has also added recommendations for managing intra-abdominal infection in children, particularly where such management differs from that of adults; for appendicitis in patients of all ages; and for necrotizing enterocolitis in neonates. PMID:20034345

Solomkin, Joseph S; Mazuski, John E; Bradley, John S; Rodvold, Keith A; Goldstein, Ellie J C; Baron, Ellen J; O'Neill, Patrick J; Chow, Anthony W; Dellinger, E Patchen; Eachempati, Soumitra R; Gorbach, Sherwood; Hilfiker, Mary; May, Addison K; Nathens, Avery B; Sawyer, Robert G; Bartlett, John G

2010-01-15

258

Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America.  

PubMed

Evidence-based guidelines for managing patients with intra-abdominal infection were prepared by an Expert Panel of the Surgical Infection Society and the Infectious Diseases Society of America. These updated guidelines replace those previously published in 2002 and 2003. The guidelines are intended for treating patients who either have these infections or may be at risk for them. New information, based on publications from the period 2003-2008, is incorporated into this guideline document. The panel has also added recommendations for managing intra-abdominal infection in children, particularly where such management differs from that of adults; for appendicitis in patients of all ages; and for necrotizing enterocolitis in neonates. PMID:20163262

Solomkin, Joseph S; Mazuski, John E; Bradley, John S; Rodvold, Keith A; Goldstein, Ellie J C; Baron, Ellen J; O'Neill, Patrick J; Chow, Anthony W; Dellinger, E Patchen; Eachempati, Soumitra R; Gorbach, Sherwood; Hilfiker, Mary; May, Addison K; Nathens, Avery B; Sawyer, Robert G; Bartlett, John G

2010-02-01

259

Deep brain stimulation in Parkinson's disease  

PubMed Central

For the last 50 years, levodopa has been the cornerstone of Parkinson’s disease management. However, a majority of patients develop motor complications a few years after therapy onset. Deep brain stimulation has been approved by the FDA as an adjunctive treatment in Parkinson disease, especially aimed at controlling these complications. However, the exact mechanism of action of deep brain stimulation, the best nucleus to target as well as the best timing for surgery are still debatable. We here provide an in-depth and critical review of the current literature on this topic. PMID:24245947

2013-01-01

260

Vascular complications of osteochondromas  

Microsoft Academic Search

Purpose: Osteochondromas are the most common benign tumor of the bone. They are sometimes responsible for vascular complications involving either veins or arteries, principally around the knee.Methods: We report six cases of such complications. An extensive review of literature through a computerized research was performed.Results: We found 97 cases that were previously reported in the English literature giving sufficient details

Marc-Antoine Vasseur; Oliver Fabre

2000-01-01

261

Neurologic complications of carcinoid.  

PubMed

We reviewed the records of all patients treated for carcinoid tumors at Memorial Sloan-Kettering Cancer Center from 1974 through 1984. Of 219 patients, 90 developed metastatic complications, and of these, 36 developed neurologic complications. Metastases, the most common neurologic complication, included epidural spinal cord compression (14 patients), intracranial metastases (13 patients), leptomeningeal metastases (1 patient), and peripheral nerve lesions (5 patients). Nonmetastatic complications were hepatic encephalopathy (six patients), herpes zoster infection (two patients), cerebral infarction due to septic emboli (one patient), superior sagittal sinus thrombosis (one patient), and carcinoid myopathy (one patient). The carcinoid syndrome was seen in eight patients (4%). Response of neurologic metastases to conventional radiation therapy was usually favorable. We conclude that (1) the frequency and type of neurologic complications associated with carcinoid tumors are similar to those seen with other systemic cancers; (2) CNS metastases are relatively common in patients with metastatic carcinoid (29%); and (3) the carcinoid syndrome is less common than CNS metastasis. PMID:3703281

Patchell, R A; Posner, J B

1986-06-01

262

Untreated Material Celiac Disease and Low Birth Weight Infants: A Systematic Review of the Literature  

Microsoft Academic Search

Background: Celiac Disease (CD) an autoimmune disease triggered by gluten is becoming more widespread. While there has been vast improvement in understanding the complications having CD, they are still not fully understood. There has been increasing research over the last decade looking at CD and undesirable pregnancy outcomes. The question of whether or not undiagnosed CD is associated with low

Elizabeth A Rupp

2011-01-01

263

The effect of febuxostat to prevent a further reduction in renal function of patients with hyperuricemia who have never had gout and are complicated by chronic kidney disease stage 3: study protocol for a multicenter randomized controlled study  

PubMed Central

Background Hyperuricemia is a risk factor for the onset of chronic kidney disease (CKD) and is significantly associated with the progression of CKD. However, there is no sufficient evidence by interventional research supporting a cause-effect relationship. Hyperuricemic patients without gouty arthritis, whose serum urate (SUA) concentration is ?8.0 mg/dL and who have a complication, are treated by pharmacotherapy in addition to lifestyle guidance. Nevertheless, there is no evidence that rationalizes pharmacotherapy for patients with hyperuricemia who have no complication and whose SUA concentration is below 9.0 mg/dL. Methods/Design The FEATHER (FEbuxostat versus placebo rAndomized controlled Trial regarding reduced renal function in patients with Hyperuricemia complicated by chRonic kidney disease stage 3) study is a prospective, multicenter, double-blind, randomized, placebo-controlled trial of febuxostat—a novel, nonpurine, selective, xanthine oxidase inhibitor. The present study will enroll, at 64 medical institutions in Japan, 400 Japanese patients aged 20 years or older who have hyperuricemia without gouty arthritis, who present CKD stage 3, and whose SUA concentration is 7.1-10.0 mg/dL. Patients are randomly assigned to either the febuxostat or the control group, in which febuxostat tablets and placebo are administered orally, respectively. The dosage of the study drugs should be one 10-mg tablet/day at weeks 1 to 4 after study initiation, increased to one 20-mg tablet/day at weeks 5 to 8, and elevated to one 40-mg tablet/day at week 9 and then maintained until week 108. The primary endpoint is estimated glomerular filtration rate (eGFR) slope. The secondary endpoints include the amount and percent rate of change in eGFR from baseline to week 108, the amount and percent rate of change in SUA concentration from baseline to week 108, the proportion of patients who achieved an SUA concentration ?6.0 mg/dL, and the incidence of renal function deterioration. Discussion The present study aims to examine whether febuxostat prevents a further reduction in renal function as assessed with eGFR in subjects and will (1) provide evidence to indicate the inverse association between a reduction in SUA concentration and an improvement in renal function and (2) rationalize pharmacotherapy for subjects and clarify its clinical relevance. Trial registration UMIN Identifier: UMIN000008343 PMID:24433285

2014-01-01

264

Tetanus is still present in the 21st century: case report and review of literature.  

PubMed

Tetanus is a very serious disease that can be fatal. Its incidence in the developed world has diminished considerably since the introduction of tetanus toxoid. More importantly, tetanus is one of the few infectious diseases that can be prevented. The recommendations for immunization are clear and readily available. In spite of the progress, we still see cases of tetanus in which the prognosis is poor. We present the case of a 67 year-old man that was admitted to our hospital with one of the most common manifestations of tetanus: trismus. Even though his treatment was established immediately, the hospital stay was long and made him susceptible to various medical complications and nosocomial infections. The incidence of tetanus in Puerto Rico is low but the mortality rate continues to be elevated in the high-risk group: patients older than 60 years of age. This is the reason for which we present this case. Our goal is to provide information with regards to epidemiology, pathogenesis, clinical manifestations, diagnosis and management of tetanus. In addition, it is equally essential to remind our colleagues the significance of adequate prevention of this potentially mortal and disabling disease. PMID:22111470

Otero-Maldonado, Mariely; Bosques-Rosado, Marisel; Soto-Malavé, Ruth; Deliz-Roldán, Brenda; Bertrán-Pasarell, Jorge; Vargas Otero, Pedro

2011-01-01

265

Encephalitis complicating smallpox vaccination.  

PubMed

A smallpox vaccination program has been initiated. The vaccine is a live virus that was used in the last century. Postvaccinal encephalitis is a complication of this vaccine. The clinical presentation, course, neuroimaging findings, and spinal fluid abnormalities are similar to a disorder that physicians are familiar with, acute disseminated encephalomyelitis. This complication can be prevented with the administration of antivaccinia gamma globulin at the time of vaccination. Antivaccinia gamma globulin is not efficacious once this complication occurs. Intravenous methylprednisolone is the recommended therapy, although intravenous immunoglobulin and plasmapheresis should be investigated in the treatment of postvaccinal encephalitis. PMID:12873847

Miravalle, Augusto; Roos, Karen L

2003-07-01

266

Helicobacter and disease: still more questions than answers  

PubMed Central

Since the causative role of Helicobacter pylori in peptic ulcer and gastritis was established, a number of advances have been made. Helicobacter virulence factors have been identified, the changes it causes in gastric acid secretion has been elucidated, and the entire genome of H. pylori has been mapped. Multiple lines of evidence indicate a strong link between the bacterium and noncardia gastric cancer. The infection can be confidently diagnosed by noninvasive serologic tests and the urea breath test. Triple therapy is almost always curative, and the infection almost never recurs in Canadian adults, but eradicating the bacteria in the absence of peptic ulcer only rarely leads to resolution of dyspepsia. New studies suggest that treating Helicobacter may increase the risk of peptic esophagitis and adenocarcinoma of the esophagus and cardia. PMID:11045091

Kandel, Gabor

2000-01-01

267

Ocular Complications of Chloroquine Therapy  

PubMed Central

Ocular complications of long-term chloroquine therapy were observed in 18 of 45 patients so treated. This therapy was used in patients with rheumatoid arthritis, lupus erythematosus, sarcoidosis, discoid lupus and other chronic “collagen disease”. Thirteen patients had reversible corneal opacifications, and seven had irreversible retinal changes, with visual loss and visual field defects. Pathological evidence of chloroquine retinopathy was obtained in one patient. Physicians are therefore warned to use this drug only after careful consideration. If it is used, repeated ocular examinations should include assessment of visual acuity, visual fields on a tangent screen and fundus examination through a dilated pupil. ImagesFig. 4Fig. 7Fig. 8 PMID:14275038

Lloyd, Lois A.; Hiltz, John W.

1965-01-01

268

Four patients with Sillence type I osteogenesis imperfecta and mild bone fragility, complicated by left ventricular cardiac valvular disease and cardiac tissue fragility caused by type I collagen mutations.  

PubMed

Osteogenesis imperfecta (OI) type I is a hereditary disorder of connective tissue (HDCT) characterized by blue or gray sclerae, variable short stature, dentinogenesis imperfecta, hearing loss, and recurrent fractures from infancy. We present four examples of OI type I complicated by valvular heart disease and associated with tissue fragility. The diagnosis of a type I collagen disorder was confirmed by abnormal COL1A1 or COL1A2 gene sequencing. One patient was investigated with electrophoresis of collagens from cultured skin fibroblasts, showing structurally abnormal collagen type I, skin biopsy showed unusual histology and abnormal collagen fibril ultra-structure at electron microscopy. The combined clinical, surgical, histological, ultra-structural, and molecular genetic data suggest the type I collagen defect as contributory to cardiac valvular disease. The degree of tissue fragility experienced at cardiac surgery in these individuals, also reported in a small number of similar case reports, suggests that patients with OI type I need careful pre-operative assessment and consideration of the risks and benefits of cardiac surgery. PMID:24311407

Vandersteen, Anthony M; Lund, Allan M; Ferguson, David J P; Sawle, Philip; Pollitt, Rebecca C; Holder, Susan E; Wakeling, Emma; Moat, Neil; Pope, F Michael

2014-02-01

269

[Neurological complications in uremia].  

PubMed

Neurological complications due to the uremic state or hemodialysis, contribute to the important cause of mortality in patients with uremia. Despite continuous advances in uremic treatment, many neurological complications of uremia, like uremic encephalopathy, peripheral neuropathy and myopathy fail to fully respond to hemodialysis. Moreover, hemodialysis or kidney transplantation may even induce neurological complications. Hemodialysis can directly or indirectly be associated with Wernicke's encephalopathy, dialytic dementia, dysequilibrium syndrome, cerebrovascular accidents, osmotic myelinolysis and mononeuropathy. Renal transplantation can give rise to rejection encephalopathy and acute femoral neuropathy. The use of immunosuppressive drugs after renal transplantation can cause reversible posterior leukoencephalopathy encephalopathy. The clinical, pathophysiological and therapeutical aspects of central nervous system, peripheral nervous system and myopathy complications in uremia are reviewed. PMID:18686653

Fong, Chin-Shih

2008-06-01

270

Complications of Circumcision  

PubMed Central

In the United States, circumcision is a commonly performed procedure. It is a relatively safe procedure with a low overall complication rate. Most complications are minor and can be managed easily. Though uncommon, complications of circumcision do represent a significant percentage of cases seen by pediatric urologists. Often they require surgical correction that results in a significant cost to the health care system. Severe complications are quite rare, but death has been reported as a result in some cases. A thorough and complete preoperative evaluation, focusing on bleeding history and birth history, is imperative. Proper selection of patients based on age and anatomic considerations as well as proper sterile surgical technique are critical to prevent future circumcision-related adverse events. PMID:22235177

Krill, Aaron J.; Palmer, Lane S.; Palmer, Jeffrey S.

2011-01-01

271

Pregnancy Complications: Shoulder Dystocia  

MedlinePLUS

... In the NICU Home after the NICU Your premature baby Birth Defects Loss and grief Pregnancy loss Newborn loss ... and the baby do well and have no permanent damage. But there may be some complications. For ...

272

Systemic Amyloidosis Complicating Dermatoses.  

National Technical Information Service (NTIS)

Certain dermatoses may be complicated by systemic amyloidosis. The underlying disorders in eight of 100 patients with secondary systemic amyloidosis studied at autopsy were: hidradenitis suppurativa, stasis ulcers, psoriatic arthritis, basal cell carcinom...

M. H. Brownstein, E. B. Helwig

1970-01-01

273

Tetanus: Symptoms and Complications  

MedlinePLUS

... of the muscles of the jaw, or "lockjaw". Tetanus symptoms include: Headache Jaw cramping Sudden, involuntary muscle ... sweating High blood pressure and fast heart rate Tetanus complications include: Uncontrolled/involuntary muscular contraction of the ...

274

Chickenpox (Varicella) Complications  

MedlinePLUS

... People at High Risk for Complications Interpreting Lab Tests Assessing Immunity Managing People at Risk for Severe Varicella Preventing Varicella in Healthcare Settings Monitoring the Impact of Varicella Vaccination Conducting Varicella Surveillance Laboratory Testing ...

275

Complications of circumcision  

Microsoft Academic Search

Circumcision remains the most common operation performed on males. Although, not technically difficult, it is accompanied\\u000a by a rate of morbidity and can result in complications ranging from trivial to tragic. The reported incidence of complications\\u000a varies from 0.1% to 35% the most common being infection, bleeding and failure to remove the appropriate amount of foreskin.\\u000a Forty patients suffering from

O. Latifoglu; R. Yavuzer; S. Ünal; A. Sari; S. Çenetoglu; N. K. Baran

1999-01-01

276

Hodgkin's Lymphoma: A Review of Neurologic Complications.  

PubMed

Hodgkin's lymphoma is a hematolymphoid neoplasm, primarily of B cell lineage, that has unique histologic, immunophenotypic, and clinical features. Neurologic complications of Hodgkin's Lymphoma can be separated into those that result directly from the disease, indirectly from the disease, or from its treatment. Direct neurologic dysfunction from Hodgkin's Lymphoma results from metastatic intracranial spinal disease, epidural metastases causing spinal cord/cauda equina compression, leptomeningeal metastases, or intradural intramedullary spinal cord metastases. Indirect neurologic dysfunction may be caused by paraneoplastic disorders (such as paraneoplastic cerebellar degeneration or limbic encephalitis) and primary angiitis of the central nervous system. Hodgkin's lymphoma treatment typically includes chemotherapy or radiotherapy with potential treatment-related complications affecting the nervous system. Neurologic complications resulting from mantle-field radiotherapy include the "dropped head syndrome," acute brachial plexopathy, and transient ischemic attacks/cerebral infarcts. Chemotherapy for Hodgkin's lymphoma may cause cerebral infarction (due to emboli from anthracycline-induced cardiomyopathy) and peripheral neuropathy. PMID:20975772

Grimm, Sean; Chamberlain, Marc

2011-01-01

277

Sedation-related complications in gastrointestinal endoscopy  

PubMed Central

Sedation practices for gastrointestinal endoscopic (GIE) procedures vary widely in different countries depending on health system regulations and local circumstances. The goal of procedural sedation is the safe and effective control of pain and anxiety, as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation-related complications in gastrointestinal endoscopy, once occurred, can lead to significant morbidity and occasional mortality in patients. The risk factors of these complications include the type, dose and mode of administration of sedative agents, as well as the patient’s age and underlying medical diseases. Complications attributed to moderate and deep sedation levels are more often associated with cardiovascular and respiratory systems. However, sedation-related complications during GIE procedures are commonly transient and of a mild degree. The risk for these complications while providing any level of sedation is greatest when caring for patients already medically compromised. Significant unwanted complications can generally be prevented by careful pre-procedure assessment and preparation, appropriate monitoring and support, as well as post-procedure management. Additionally, physicians must be prepared to manage these complications. This article will review sedation-related complications during moderate and deep sedation for GIE procedures and also address their appropriate management. PMID:24255744

Amornyotin, Somchai

2013-01-01

278

Qigong-Kurs Qigong -Bewegung und Stille  

E-print Network

Qigong-Kurs Datum 16.12.2011 Seite -2- Qigong - Bewegung und Stille Kursleiter: Peter Schwarz Theorie des QiGong. Praxisübungen bilden den Schwerpunkt. Qigong ­ vier Bahnen in die Stille Der Ausdruck Qigong, die �bungspraxis und die dahinterstehende Theorie stammen aus der chinesischen Tradition. Mit

Szmolyan, Peter

279

To Study the Level of Awareness About Complications of Chronic Suppurative Otitis Media (CSOM) in CSOM Patients  

PubMed Central

Introduction: Chronic Suppurative Otitis Media (CSOM) is one of the most common diseases in clinical practice. It affects large number of people. Disease causes disability and mortality because of its ability to cause complications. Patients develop complications because of lack of awareness about the disease, scarce availability of qualified otologists at peripheral areas and economical constraints. This study was conducted to study the awareness about CSOM and its complications. Materials and Methods: Patients suffering from CSOM attending outpatient department of Ear, Nose and Throat Department were included in this study. After taking proper history and examination to confirm the diagnosis patients were given structured questionnaire to assess their knowledge about CSOM and its complications. Results tabulated and compared with literature. Results: Majority of our patients (77.6%) were from low socio-economic status group. Maximum number of patients was from 3rd and 4th decade of life. Only 29.5% patients understood perforation in Tympanic Membrane (TM) as a cause for continued discharge. 94% patients did not differentiate between safe and unsafe CSOM. 52.2% had knowledge about entry of water in ear as cause for recurrence of discharge in CSOM. 44.7% said CSOM can be cured by surgery. Only 7.4% said infection can spread to brain, 23.3% knew about collection of pus around ear, 11.9% said it can cause vertigo, but none of them recognized facial nerve palsy as complication of CSOM. 38.8% took self medication and 16.4% consulted qualified ear nose throat (ENT) doctor. Conclusion: Although CSOM is a major disease affecting large number of people, awareness regarding disease and its complications is still poor. Mass education programs aimed at educating people about CSOM are need of the hour. PMID:24701483

S.H., Chandrashekharayya; M.M., Kavitha; Handi, Prakash; Khavasi, Prabhu; Doddmani, S.S.; Riyas, Mohmed

2014-01-01

280

Shingles Vaccine Still Effective After Chemotherapy  

MedlinePLUS

... sharing features on this page, please enable JavaScript. Shingles Vaccine Still Effective After Chemotherapy Study finds cancer ... August 8, 2014 Related MedlinePlus Pages Cancer Chemotherapy Shingles FRIDAY, Aug. 8, 2014 (HealthDay News) -- The shingles ...

281

Drinking Water: Health Hazards Still Not Resolved  

ERIC Educational Resources Information Center

Despite the suggested link between cancer deaths and drinking obtained from the Mississippi River, New Orleans still treats its water supply in the same manner as before the Environmental Defense Fund's epidemiological study. (BT)

Wade, Nicholas

1977-01-01

282

Complications of hysterectomy.  

PubMed

Hysterectomy is the most common gynecologic procedure performed in the United States, with more than 600,000 procedures performed each year. Complications of hysterectomy vary based on route of surgery and surgical technique. The objective of this article is to review risk factors associated with specific types of complications associated with benign hysterectomy, methods to prevent and recognize complications, and appropriate management of complications. The most common complications of hysterectomy can be categorized as infectious, venous thromboembolic, genitourinary (GU) and gastrointestinal (GI) tract injury, bleeding, nerve injury, and vaginal cuff dehiscence. Infectious complications after hysterectomy are most common, ranging from 10.5% for abdominal hysterectomy to 13.0% for vaginal hysterectomy and 9.0% for laparoscopic hysterectomy. Venous thromboembolism is less common, ranging from a clinical diagnosis rate of 1% to events detected by more sensitive laboratory methods of up to 12%. Injury to the GU tract is estimated to occur at a rate of 1-2% for all major gynecologic surgeries, with 75% of these injuries occurring during hysterectomy. Injury to the GI tract after hysterectomy is less common, with a range of 0.1-1%. Bleeding complications after hysterectomy also are rare, with a median range of estimated blood loss of 238-660.5 mL for abdominal hysterectomy, 156-568 mL for laparoscopic hysterectomy, and 215-287 mL for vaginal hysterectomy, with transfusion only being more likely after laparoscopic compared to vaginal hysterectomy (odds ratio 2.07, confidence interval 1.12-3.81). Neuropathy after hysterectomy is a rare but significant event, with a rate of 0.2-2% after major pelvic surgery. Vaginal cuff dehiscence is estimated at a rate of 0.39%, and it is more common after total laparoscopic hysterectomy (1.35%) compared with laparoscopic-assisted vaginal hysterectomy (0.28%), total abdominal hysterectomy (0.15%), and total vaginal hysterectomy (0.08%). With an emphasis on optimizing surgical technique, recognition of surgical complications, and timely management, we aim to minimize risk for women undergoing hysterectomy. PMID:23635631

Clarke-Pearson, Daniel L; Geller, Elizabeth J

2013-03-01

283

Neurologic complications of craniovertebral dislocation.  

PubMed

Craniovertebral dislocation is uncommon, but its diagnosis is important taking into account the potential severity of the neurologic complications. A number of causes are known; the most common are Down syndrome, rheumatoid arthritis, Paget's disease, other metabolic bone diseases, and craniocervical trauma. Down's syndrome is a relatively common clinical condition but craniovertebral subluxation is only observed in a small percentage of patients. About half of all cervical spine injuries affect the atlanto-occipital region and C2 vertebra. In rheumatoid arthritis, craniocervical dislocation occurs in up to 40% of patients with severe disease. In Paget's disease, involvement of the craniovertebral region occurs in about 30% of all cases. The clinical neurologic syndrome is characterized by local pain, features of upper spinal cord and medullary compression, positive Lhermitte phenomenon, syncope associated with neck flexion, vertebral artery obstruction or dissection leading to stroke, and asymmetrical lower cranial nerve palsies. Neuroimaging is essential to confirm the clinical diagnosis and to categorize severity. The treatment of this disorder is usually surgical, but traction and external immobilization is relevant in some cases. Specific conditions may require additional treatments such as radiotherapy, antibiotics, or chemotherapy. PMID:24365311

de Carvalho, Mamede; Swash, Michael

2014-01-01

284

Gastrointestinal Complications in Patients Undergoing Heart Operation  

PubMed Central

Introduction: Gastrointestinal (GI) complications following heart operation may be life-threatening. Systematic analysis of risk factors to allow early identification of patients at risk for GI complication may lead to the development of strategies to mitigate this complication as well as to optimize management after its occurrence. Methods: Of 8709 consecutive patients undergoing heart operation during 7 years (1997–2003), 46 (0.53%) developed GI complications requiring surgical consultation. Preoperative, intraoperative, and postoperative predictors of complication and death were identified and compared with a control group. Results: Significant (P < 0.05) preoperative predictors of complication were prior cerebrovascular accident (CVA), chronic obstructive pulmonary disease (COPD), type II heparin-induced thrombocytopenia, atrial fibrillation, prior myocardial infarction, renal insufficiency, hypertension, and need for intra-aortic balloon counter-pulsation. The most frequent serious GI complication was mesenteric ischemia, which developed in 31 (67%) patients. Twenty-two (71%) of these patients were explored, and 14 (64%) died within 2 days of heart operation. Of the 9 patients with mesenteric ischemia who were not explored, 7 (78%) died within 3 days of heart operation. Other complications included diverticulitis (5), pancreatitis (4), peptic ulcer disease (4), and cholecystitis (2). The mortality rate in this group of other diagnoses was lower (40%), and death occurred later (32 days) after heart operation (P = 0.03 compared with mesenteric ischemia). Predictors of death from GI complication included New York Heart Association (NYHA) class III and IV heart failure, smoking, chronic obstructive pulmonary disease, history of syncope, aspartate aminotransferase (AST) >600U/L, direct bilirubin >2.4mg/dL, pH < 7.30, and the need for >2 pressors. Conclusions: The most common catastrophic GI complication after cardiac surgery is mesenteric ischemia, which is frequently fatal. This complication may be a result of atheroembolization, heparin-induced thrombocytopenia, or hypoperfusion. Techniques to reduce the occurrence of and/or preemptively diagnosis postcardiotomy mesenteric ischemia are necessary to decrease its associated mortality. PMID:15912039

Mangi, Abeel A.; Christison-Lagay, Emily R.; Torchiana, David F.; Warshaw, Andrew L.; Berger, David L.

2005-01-01

285

[Complications after coronary angiography and balloon dilatation].  

PubMed

All major complications within four weeks after diagnostic cardiac catheterization (DCCA; n = 4,778) or percutaneous transluminal coronary angioplasty (PTCA; n = 3,073) were analysed prospectively in 7,851 patients (5,769 men, 2,082 women; mean age 59.4 [16-88] years). There were 116 such complications in 114 patients, 46 (0.9%) after DCCA, 70 (2.3%) after PTCA. 76% of all complications occurred during the first two days after the procedure: bleeding in 29 patients, false aneurysms in 15, arterial occlusions in 12, venous ones in three, cerebral ischaemia in 12, fulminant pulmonary emboli in three, cardiac complications in 27, and others in 15. There were five deaths in connection with a DCCA, 18 with PTCA. Complications were twice as common in women as in men (DCCA: 1.5% vs 0.7%, P < 0.05; PTCA: 4.2% vs 1.7%, P < 0.001). Complications after DCCA were more frequent in those aged over 55 years (1.2% vs 0.3%, P < 0.05); after PTCA they were more frequent in those aged over 65 years (4.1% vs 1.3%, P < 0.05). Other risk factors for complications were: peripheral arterial occlusive disease for arterial occlusion (P < 0.001), high heparin dosage with DCCA (P < 0.05), and additional venous puncture with DCCA (P < 0.01). PMID:8243238

Bach, R; Espinola-Klein, C; Ozbek, C; Jung, F; Schieffer, H

1993-11-19

286

Cirrhosis and its complications: Evidence based treatment  

PubMed Central

Cirrhosis results from progressive fibrosis and is the final outcome of all chronic liver disease. It is among the ten leading causes of death in United States. Cirrhosis can result in portal hypertension and/or hepatic dysfunction. Both of these either alone or in combination can lead to many complications, including ascites, varices, hepatic encephalopathy, hepatocellular carcinoma, hepatopulmonary syndrome, and coagulation disorders. Cirrhosis and its complications not only impair quality of life but also decrease survival. Managing patients with cirrhosis can be a challenge and requires an organized and systematic approach. Increasing physicians’ knowledge about prevention and treatment of these potential complications is important to improve patient outcomes. A literature search of the published data was performed to provide a comprehensive review regarding the management of cirrhosis and its complications. PMID:24833875

Nusrat, Salman; Khan, Muhammad S; Fazili, Javid; Madhoun, Mohammad F

2014-01-01

287

[Complications of experimental lung transplantations].  

PubMed

Experimental lung transplantations are burdened with a very high rate of complications even is there is a strict consideration of sterile precautions. These complications occur predominantly directly in connection with organ rejection. Extrathoracic complications are rare and predominantly attributed to arterial embolism. All untreated receivers of lung had thoracic complications in autopsy. Only 5% of immune suppressively treated receivers were free of complications. Most frequent complications are pleuropulmonary infections. Weighty complications are haemorrhagic infarcts of the transplant and insufficiency of the bronchus. Only without complications can survived about years the chronic rejection. PMID:7025481

Engelmann, C; Kaltwasser, K; Danzmann, E; Riesner, R; Schimmack, L; Reutgen, H; Voigt, H

1981-01-01

288

The Scientific Method: Is It Still Useful?  

ERIC Educational Resources Information Center

While the scientific method is a logical, orderly way to solve a problem or answer a question, it is not a magical formula that is too complicated for nonscientists to comprehend (Keeton and Gould 1986). The scientific method may include a variety of steps, processes, and definitions. It should not be seen as a single series of steps, with no…

Watson, Scott B.; James, Linda

2004-01-01

289

Treatment of complicated grief  

PubMed Central

Following the death of a loved one, a small group of grievers develop an abnormal grieving style, termed complicated or prolonged grief. In the effort to establish complicated grief as a disorder in DSM and ICD, several attempts have been made over the past two decades to establish symptom criteria for this form of grieving. Complicated grief is different from depression and PTSD yet often comorbid with other psychological disorders. Meta-analyses of grief interventions show small to medium effect sizes, with only few studies yielding large effect sizes. In this article, an integrative cognitive behavioral treatment manual for complicated grief disorder (CG-CBT) of 25 individual sessions is described. Three treatment phases, each entailing several treatment strategies, allow patients to stabilize, explore, and confront the most painful aspects of the loss, and finally to integrate and transform their grief. Core aspects are cognitive restructuring and confrontation. Special attention is given to practical exercises. This article includes the case report of a woman whose daughter committed suicide. PMID:22893810

Rosner, Rita; Pfoh, Gabriele; Kotoucova, Michaela

2011-01-01

290

Surgical complications of typhoid fever: Enteric perforation  

Microsoft Academic Search

Typhoid fever remains a prevalent disease in developing nations as the result of adverse socioeconomic factors. The most frequent complication, and principal cause of mortality, is perforation of the terminal ileum. This report presents our experience with 96 patients surgically treated at Cayetano Heredia University Hospital in Lima, Peru from 1972 to 1986. The clinical characteristics and the diverse surgical

Miguel Santillana

1991-01-01

291

Blepharoplasty complications: prevention and management.  

PubMed

This article presents common and rare complications following blepharoplasty, with discussion of avoidance of these complications through presurgical planning and review. Management of the complications is provided, with surgical details supported by images and advice for the best approaches. The complications discussed include hemorrhage, infection, corneal abrasion, ptosis, lacrimal gland injury, and residual excess skin. PMID:23186771

Whipple, Katherine M; Lim, Lee Hooi; Korn, Bobby S; Kikkawa, Don O

2013-01-01

292

Fistulas complicating diverticulitis  

Microsoft Academic Search

This study was undertaken to assess the appropriate management of patients with diverticulitis complicated by fistula formation.\\u000a A retrospective chart review was conducted on patients with symptoms of a fistula who presented between 1975 to 1995. There\\u000a were 42 patients (32 women, 76%; 10 men, 24%) who ranged in age from 46 to 89 years (mean 69.8±9.8). Six patients had

C.-A. Vasilevsky; P. Belliveau; J. L. Trudel; B. L. Stein; P. H. Gordon

1998-01-01

293

Neurologic Complications of Sarcoma  

Microsoft Academic Search

Sarcomas are a heterogeneous group of tumors that rarely involve the nervous system. Neurologic effects of sarcoma are more\\u000a often due to tumors outside of the central nervous system. However, as long-term survival rates in childhood sarcoma improves,\\u000a reports of late neurologic complications have increased. With recent advances in treating local sarcomas with targeted molecular\\u000a therapies, the incidence of late

Santosh Kesari; Lara J. Kunschner

294

Gender: Still a Useful Category of Analysis?  

Microsoft Academic Search

This paper traces the history of uses of the word “gender”. It suggests that though “gender” has been recuperated and become commonplace, many issues persist around the way “women” and “men”, and the power relations between them, are defined and are evolving. Provided it still allows us to question the meanings attached to the sexes, how they are established and

Joan Wallach Scott

2010-01-01

295

Still Foreign after All These Years  

ERIC Educational Resources Information Center

Paul Snowden's appointment as a dean to the School of International Liberal Studies at Waseda University was considered so unusual that he compared it to the first moonwalk. Snowden's new position was the highest position reached by a non-Japanese at Waseda, Japan's top private university. Waseda's embrace of foreigners is still considered an…

McNeill, David

2007-01-01

296

Humans 'still evolving' John von Radowitz  

E-print Network

Humans 'still evolving' John von Radowitz Tuesday 01 May 2012 Darwinian "survival scientists. A popular misconception is that humans stopped evolving when they took up farming and embraced-of-the-fittest" laws continue to shape human evolution in the modern age, research led by the University of Sheffield

Lummaa, Virpi

297

A Nation Still at Risk. ERIC Digest.  

ERIC Educational Resources Information Center

In 1983 the National Commission on Excellence in Education declared the United States "A Nation at Risk" because of inadequate education. A decade and a half later, the United States is still at risk because U.S. schools are failing children. Dropout rates have declined, and college attendance has risen, but student achievement has remained flat…

Thomas B. Fordham Foundation, Washington, DC.

298

Penile Calciphylaxis in End Stage Renal Disease  

PubMed Central

Calciphylaxis, better described as “Calcific uremic arteriolopathy” (CUA), involves about 1–4% of hemodialysis patients all around the world with high mortality rates. We describe a rare clinical case of CUA in peritoneal dialysis patient associated with urological disease. Penile calciphylaxis represents rare clinical complication, and an early diagnosis and multidisciplinary approach are requested. Pathogenesis is still unclear, and therapeutic approaches need more long-term clinical trials to test their efficacy and safety. PMID:23841013

Di Lullo, Luca; Otranto, Giovanni; Floccari, Fulvio; Malaguti, Moreno; Santoboni, Alberto

2013-01-01

299

Diabetes - Eye Complications  

MedlinePLUS

... diabetes helps prevent and delay these eye diseases. Management of diabetes consists of the following: • Controlling the blood sugar level • Eating healthy • Exercising • Keeping good hygiene • Learning about ...

300

Unusual Development of Iatrogenic Complex, Mixed Biliary and Duodenal Fistulas Complicating Roux-en-Y Antrectomy for Stenotic Peptic Disease of the Supraampullary Duodenum Requiring Whipple Procedure: An Uncommon Clinical Dilemma  

Microsoft Academic Search

Complex fistulas of the duodenum and biliary tree are severe complications of gastric surgery. The association of duodenal and major biliary fistulas occurs rarely and is a major challenge for treatment. They may occur during virtually any kind of operation, but they are more frequent in cases complicated by the presence of difficult duodenal ulcers or cancer, with a mortality

Francesco A. Polistina; Giorgio Costantin; Alessandro Settin; Franco Lumachi; Giovanni Ambrosino

2010-01-01

301

Diabetes mellitus complicating pregnancy  

Microsoft Academic Search

IABETES MELLITUS, the exact nature of which still eludes rus, was one of the first clinical conditions to be described. The Ebers Papyrus, found at Luxor in Egypt in 1872 and believed to date from 1500 B.C., contains a prescription for the treatment of polyuria. Aretaeus, writing in the second century, described it as--\\

M. I. Drury; M. I. DauRY

1961-01-01

302

Diabetic complications and dysregulated innate immunity  

PubMed Central

Diabetes mellitus is a metabolic disorder that leads to the development of a number of complications. The etiology of each diabetic complication is undoubtedly multifactorial. We will focus on one potential component that may be common in many diabetic complications, dysregulation of innate immunity associated with an increased inflammatory response. High glucose levels lead to shunting through the polyol pathway, an increase in diacylglycerol which activates protein kinase C, an increase in the release of electrons that react with oxygen molecules to form superoxides, and the non-enzymatic glycosylation of proteins that result in greater formation of advanced glycation end products. Each of these can lead to aberrant cell signalling that affects innate immunity for example, by activating the MAP kinase pathway or inducing activation of transcription factors such as NF-kappaB. This may be a common feature of several complications including periodontal disease, atherosclerosis, nephropathy, impaired healing and retinopathy. These complications are frequently associated with increased expression of inflammatory cytokines such as TNF-alpha, IL-1beta and IL-6 and enhanced generation of reactive oxygen species. Cause and effect relationship between dysregulation of key components of innate immunity and diabetic complications in many instances have been demonstrated with the use of cytokine blockers and antioxidants. PMID:17981625

Graves, Dana T; Kayal, Rayyan A

2011-01-01

303

Fabry disease  

PubMed Central

Fabry disease (FD) is a progressive, X-linked inherited disorder of glycosphingolipid metabolism due to deficient or absent lysosomal ?-galactosidase A activity. FD is pan-ethnic and the reported annual incidence of 1 in 100,000 may underestimate the true prevalence of the disease. Classically affected hemizygous males, with no residual ?-galactosidase A activity may display all the characteristic neurological (pain), cutaneous (angiokeratoma), renal (proteinuria, kidney failure), cardiovascular (cardiomyopathy, arrhythmia), cochleo-vestibular and cerebrovascular (transient ischemic attacks, strokes) signs of the disease while heterozygous females have symptoms ranging from very mild to severe. Deficient activity of lysosomal ?-galactosidase A results in progressive accumulation of globotriaosylceramide within lysosomes, believed to trigger a cascade of cellular events. Demonstration of marked ?-galactosidase A deficiency is the definitive method for the diagnosis of hemizygous males. Enzyme analysis may occasionnally help to detect heterozygotes but is often inconclusive due to random X-chromosomal inactivation so that molecular testing (genotyping) of females is mandatory. In childhood, other possible causes of pain such as rheumatoid arthritis and 'growing pains' must be ruled out. In adulthood, multiple sclerosis is sometimes considered. Prenatal diagnosis, available by determination of enzyme activity or DNA testing in chorionic villi or cultured amniotic cells is, for ethical reasons, only considered in male fetuses. Pre-implantation diagnosis is possible. The existence of atypical variants and the availability of a specific therapy singularly complicate genetic counseling. A disease-specific therapeutic option - enzyme replacement therapy using recombinant human ?-galactosidase A - has been recently introduced and its long term outcome is currently still being investigated. Conventional management consists of pain relief with analgesic drugs, nephroprotection (angiotensin converting enzyme inhibitors and angiotensin receptors blockers) and antiarrhythmic agents, whereas dialysis or renal transplantation are available for patients experiencing end-stage renal failure. With age, progressive damage to vital organ systems develops and at some point, organs may start to fail in functioning. End-stage renal disease and life-threatening cardiovascular or cerebrovascular complications limit life-expectancy of untreated males and females with reductions of 20 and 10 years, respectively, as compared to the general population. While there is increasing evidence that long-term enzyme therapy can halt disease progression, the importance of adjunctive therapies should be emphasized and the possibility of developing an oral therapy drives research forward into active site specific chaperones. PMID:21092187

2010-01-01

304

New oral anticoagulants: are coagulation units still required?  

PubMed Central

Chronic antithrombotic therapy involves the use of anticoagulants, antiplatelets given either as monotherapy or in combination for the prevention of thrombotic complications. The most feared and sometimes fatal complication with this therapy is bleeding. It should be considered a “golden rule” that a drug or combination of drugs that maximizes efficiency (decreased thromboembolic risk) will probably be less safe (increased risk of bleeding), and this holds true either for single therapy or during combined therapy. The chances of bleeding indicated by risk tables can be useful but show only a snapshot, and the biological, social, environmental, and drug changes and therapeutic adherence also determine changes in the risk of thrombosis and bleeding. Bleeding is an eventuality that occurs in places of “locus minoris resistentiae,” and the results of careful phase 3 studies thus cannot be completely predictive of outcomes when a medication is introduced on the pharmaceutical market. With the use of warfarin, the International Normalized Ratio (INR) that has been established to indicate adequately balanced therapy is between 2.0 and 3.0. With the new oral anticoagulants, the pharmaceutical companies emphasize that it is not necessary to monitor anticoagulant effects. In studies with different doses of new oral anticoagulants, however, incidence of clinically significant bleeding complications have been directly related to the doses. Therefore, therapeutic excesses can condition bleeding risk and therapeutic limitation can increase thrombotic risk, especially when short-acting drugs such as the new oral anticoagulants are used. Hence, it is imperative to establish an appropriate method for monitoring new oral anticoagulants, setting levels of safety and effectiveness through periodic dosage and monitoring of their anticoagulant effects. Therefore, we still recommend the use of anticoagulation units for monitoring during treatment with the new oral anticoagulants. PMID:24491189

2014-01-01

305

[Haematopoietic stem cell transplantation and oral complications].  

PubMed

New haematopoietic stem cell transplantation procedures make the treatment available to patients who previously did not qualify, such as the elderly. In addition, the spectrum of oral complications associated with haematopoietic stem cell transplantation has altered as a result of the recent developments. This article is a review of the main principles of haematopoietic stem cell transplantation and provides information on oral complications which may develop, such as mucositis, infections, bleeding, graft-versus-host disease, xerostomia, hyposalivation, altered taste, secondary tumors, osteoporosis, osteonecrosis and growing and developing disturbancies. Finally, the role of dental care providers in cases of haematopoietic stem cell transplantation is addressed. PMID:19585886

Raber-Durlacher, J E; von dem Borne, P A; Stokman, M A; Gortzak, R A Th

2009-06-01

306

Gastrointestinal complications of leukemia and its treatment  

SciTech Connect

Leukemia represents 4% of all cancer deaths and is the leading cause of death from malignancy for all patients under 30 years of age. Various rare, usually preterminal gastrointestinal complications of leukemia have been reported. These complications are becoming more common and no longer should be considered unusual. Their increasing incidence is the result of new, more aggressive treatment methods and increased patient lifespan. The authors describe the relative incidence and common radiographic presentations of leukemia-related gastrointestinal disease and emphasize that its prognosis is favorable with prompt diagnosis and treatment.

Hunter, T.B.; Bjelland, J.C.

1984-03-01

307

The JPEG still picture compression standard  

Microsoft Academic Search

For the past few years, a joint ISO\\/CCITT committee known as JPEG (Joint Photographic Experts Group) has been working to establish the first international compression standard for continuous-tone still images, both grayscale and color. JPEG's proposed standard aims to be generic, to support a wide variety of applications for continuous-tone images. To meet the differing needs of many applications, the

Gregory K. Wallace

1991-01-01

308

Non-infectious pulmonary complications after bone marrow transplantation  

PubMed Central

Bone marrow transplantation (BMT) is a successful and recognised treatment option for patients with a number of haematological and non-haematological malignant and non-malignant conditions. Pulmonary complications both infectious and non-infectious are common after BMT. Multiple factors are thought to contribute to pulmonary complications, including the type and duration of immunological defects produced by the underlying disease and treatment, the development of graft-versus-host disease (GVHD), and the conditioning regimens employed. These complications are classified as early or late, depending on whether they occur before or after 100 days from transplantation. Early non-infectious pulmonary complications typically include pulmonary oedema, upper airway complications, diffuse alveolar haemorrhage, cytolytic thrombi, and pleural effusion. Bronchiolitis obliterans, veno-occlusive disease, and secondary malignancies occur late after BMT. Idiopathic pneumonia syndrome, GVHD, and radiation induced lung injury can occur in early or late period after BMT. PMID:12151565

Khurshid, I; Anderson, L

2002-01-01

309

[Complications of hemorrhoids].  

PubMed

The most common and serious complications of haemorrhoids include perianal thrombosis and incarcerated prolapsed internal haemorrhoids with subsequent thrombosis. They are characterised by severe pain in the perianal region possibly with bleeding. In a short history of the perianal thrombosis, acute surgical incision or excision is indicated, which can result in rapid relief of the painful symptoms. In incarcerated prolapsed internal haemorrhoids, emergency haemorrhoidectomy may also be indicated. Segmental haemorrhoidectomy in the most affected quadrants followed by further elective surgery for haemorrhoids in the next stage is preferred. PMID:24881480

Slauf, P; Antoš, F; Marx, J

2014-04-01

310

SARS: Down But Still a Threat.  

National Technical Information Service (NTIS)

This Intelligence Community Assessment (ICA) highlights the evolution of Severe Acute Respiratory Syndrome (SARS) and the potential implications of the disease for the United States under future scenarios. Even though SARS has infected and killed far fewe...

K. Monaghan

2003-01-01

311

[Early gynecological complications as the result of legal abortion].  

PubMed

Gynecological complications occurring during the 7-day hospitalization following therapeutic abortion are studied on the basis of a series of 1234 patients treated between March 1965 and March 1969 in Berlin. There were 3 cases of complications due to preexistent disease (usually the indication for abortion) and 13 cases of nongenital complications (thrombophlebitis, thromboembolism, pneumonia, pyelitis). Gynecological complications included uterine perforation (13 cases), cervical tears (26 cases), uterine hemorrhage (18 cases), placental retention (12 cases), and inflammation (90 cases). Complications occurred less frequently with vacuum extraction (7.9%) than with classical instrumental methods (18.8%), and less frequently before the 12th week of pregnancy (14.7%) than thereafter (36.6%). To these complications must be added those which occur after the 1st postoperative week. The relatively high complication rate should be an incentive for the improvement of contraceptive services and technology. PMID:5555449

Lunow, E; Isbruch, E; Hamann, B

1971-01-01

312

Genital Herpes Complications  

MedlinePLUS

... ocular herpes. Ocular herpes is usually caused by herpes simplex virus (HSV)-1 but sometimes by HSV-2. It can occasionally result in serious eye disease, including blindness. Pregnancy and Babies A woman who has genital herpes ...

313

Laparoscopic surgery in the management of Crohn's disease.  

PubMed

Crohn's disease is a chronic inflammatory bowel disease with surgery still frequently necessary in its treatment. Since the 1990's, laparoscopic surgery has become increasingly common for primary resections in patients with Crohn's disease and has now become the standard of care. Studies have shown no difference in recurrence rates when compared to open surgery and benefits include shorter hospital stay, lower rates of wound infection and decreased time to bowel function. This review highlights studies comparing the laparoscopic approach to the open approach in specific situations, including cases of complicated Crohn's disease. PMID:25133022

Lim, James Y; Kim, Joseph; Nguyen, Scott Q

2014-08-15

314

Laparoscopic surgery in the management of Crohn's disease  

PubMed Central

Crohn’s disease is a chronic inflammatory bowel disease with surgery still frequently necessary in its treatment. Since the 1990’s, laparoscopic surgery has become increasingly common for primary resections in patients with Crohn’s disease and has now become the standard of care. Studies have shown no difference in recurrence rates when compared to open surgery and benefits include shorter hospital stay, lower rates of wound infection and decreased time to bowel function. This review highlights studies comparing the laparoscopic approach to the open approach in specific situations, including cases of complicated Crohn’s disease. PMID:25133022

Lim, James Y; Kim, Joseph; Nguyen, Scott Q

2014-01-01

315

Unilateral sacroiliitis as an unusual complication of acupuncture  

Microsoft Academic Search

Septic sacroiliitis in an uncommon disease and is rarely reported as a complication of acupuncture. We present a case of unilateral septic sarcoiliitis, which developed as a complication of acupuncture because of failure to sterilise the skin properly before treatment. Bone scan and computed tomography were positive for sacroiliitis. After a course of antibiotics with oxacillin for 6 weeks, the

Sheung-Mei Lau; Chung-Tei Chou; Chung-Ming Huang

1998-01-01

316

Acute pancreatitis - from cellular signalling to complicated clinical course  

PubMed Central

Acute pancreatitis (AP) is a common disease that has a mild to moderate course in most cases. During the last decade, a change in diagnostic facilities as well as improved intensive care have influenced both morbidity and mortality in AP. Still, however, a number of controversies and unresolved questions remain regarding AP. These include prognostic factors and how these may be used to improve outcome, diagnostic possibilities, their indications and optimal timing, and the systemic inflammatory reaction (systemic inflammatory response syndrome – SIRS) and its effect on the concomitant course of the disease and potential development of organ failure. The role of the gut has been suggested to be important in severe AP, but has recently been somewhat questioned. Despite extensive research, pharmacological and medical intervention of proven clinical value is scarce. Various aspects on surgical interventions, including endoscopic sphincterotomy, cholecystectomy and necrosectomy, as regards indications and timing, will be reviewed. Last, but not least, are the management of late complications and long-term outcome for patients with especially severe AP. PMID:18345287

Andersson, Bodil; Andersson, Ellen; Axelsson, Jakob; Eckerwall, Gunilla; Tingstedt, Bobby

2007-01-01

317

Biologic therapy for psoriasis - still searching for the best target.  

PubMed

Psoriasis is a chronic skin disease that results from the complex interaction between genetic and environmental factors. Over the last few decades, scientific evidence has redirected the focus of therapeutic studies to the immunologic pathways underlying its pathogenesis. This led to the biologic boom that we are currently experiencing, with the development and approval of targeted progressively more selective biological therapies and ongoing clinical trials of increasingly specific drugs, given their important implications for long-term efficacy and safety. Nevertheless, the search for the optimal biologic is still ongoing, and the best target has yet to be found. PMID:24770527

Pinto-Almeida, Teresa; Torres, Tiago

2014-01-01

318

Osteomyelitis complicating Streptococcus milleri endocarditis.  

PubMed Central

A patient with osteomyelitis of the spine complicating bacterial endocarditis due to Streptococcus milleri is discussed. To our knowledge, this is the first time this organism has been associated with this complication. Images Figure 1 PMID:2385559

Barham, N. J.; Flint, E. J.; Mifsud, R. P.

1990-01-01

319

Assessment of Complications After Pancreatic Surgery  

PubMed Central

Objective: To define a simple and reproducible classification of complications following pancreaticoduodenectomy (PD) based on a therapy-oriented severity grading system. Background: While mortality is rare after PD, morbidity rates remain high. The lack of standardization in evaluating morbidity after PD has severely hampered meaningful comparisons over time and among centers. We adapted a novel classification of complication to stratify morbidity by severity after PD, to test whether the incidence of pancreatic fistula has changed over time, and to identify risk factors in a single North American center. Methods: The classification was applied to a consecutive series of 633 patients undergoing PD between February 2003 and August 2005. Another series of 141 patients treated between 1987 and 1990 was also analyzed to identify changes in the incidence and severity of fistula. Univariate and multivariate analyses were performed to link respective complications with preoperative and intraoperative parameters, length of hospital stay, and long-term survival. Results: A total of 263 (41.5%) patients did not develop any complication, while 370 (58.5%) had at least one complication; 62 (10.0%) patients had only grade I complications (no need for specific intervention), 192 patients (30.0%) had grade II (need for drug therapy such as antibiotics), 85 patients (13.5%) had grade III (need for invasive therapy), and 19 patients (3.0%) had grade IV complications (organ dysfunction with ICU stay). Grade V (death) occurred in 12 patients (2.0%). A total of 57 patients (9.0%) developed pancreatic fistula, of which 33 (58.0%) were classified as grade II, 17 (30.0%) as grade III, 5 (9.0%) as grade IV, and 2 (3.5%) as grade V. Delayed gastric emptying was documented in 80 patients (12.7%); half of them were scored as grade II and the other half as grade III. A significant decrease in the incidence of fistula was observed between the 2 periods analyzed (14.0% vs. 9.0%, P < 0.001), mostly due to a decrease in grade II fistula. Cardiovascular disease was a risk factor for overall morbidity and complication severity, while texture of the gland and cardiovascular disease were risk factors for pancreatic fistula. Conclusion: This study demonstrates the applicability and utility of a new classification in grading complications following pancreatic surgery. This novel approach may provide a standardized, objective, and reproducible assessment of pancreas surgery enabling meaningful comparison among centers and over time. PMID:17122618

DeOliveira, Michelle L.; Winter, Jordan M.; Schafer, Markus; Cunningham, Steven C.; Cameron, John L.; Yeo, Charles J.; Clavien, Pierre-Alain

2006-01-01

320

The NASA Electronic Still Camera system  

NASA Technical Reports Server (NTRS)

The Electronic Still Camera (ESC) project has been implemented in its first form for space shuttle operations. The system is composed of three components: (1) a hand-held battery-operated fully digital and programmable high-resolution camera; (2) a laptop-computer-based playback/downlink unit for onboard image processing; and (3) a ground station capable of receiving shuttle data, processing images, producing hardcopies, and distributing the data and hardcopies to end users. The advantages of the ESC system over film and satellites are discussed, and system specifications are summarized.

Holland, S. D.

1992-01-01

321

Mosquito-Borne Chikungunya Virus Still a Concern for American Travelers  

MedlinePLUS

... sharing features on this page, please enable JavaScript. Mosquito-Borne Chikungunya Virus Still a Concern for American ... to be aware that an outbreak of the mosquito-borne disease chikungunya continues to spread in those ...

322

Complications of neuroimaging.  

PubMed

Modern imaging techniques with computed tomography (CT) and magnetic resonance imaging (MRI) have revolutionized neuroimaging. While eliminating the risks of invasive procedures, new risks must now be considered before ordering neuroimaging. Advanced imaging techniques with CT may pose a risk of significant radiation exposure. Contrast may pose a risk in patients with pre-existing renal failure. MR is associated with risks related to the static magnetic field, to risks associated with the magnetic field gradients, and to risk from contrast media. Neurointervenional techniques allow for nonoperative treatment of a variety of intracranial and spinal pathologies, but with associated risks of embolization, radiation exposure, bleeding complications at the access site and a potential for contrast-related nephropathy. PMID:24365444

Rosenblum, Jordan D; Pasternak, Olga; Mitchell, Myrosia M

2014-01-01

323

Gut microbiota-related complications in cirrhosis  

PubMed Central

Gut microbiota plays an important role in cirrhosis. The liver is constantly challenged with commensal bacteria and their products arriving through the portal vein in the so-called gut-liver axis. Bacterial translocation from the intestinal lumen through the intestinal wall and to mesenteric lymph nodes is facilitated by intestinal bacterial overgrowth, impairment in the permeability of the intestinal mucosal barrier, and deficiencies in local host immune defences. Deranged clearance of endogenous bacteria from portal and systemic circulation turns the gut into the major source of bacterial-related complications. Liver function may therefore be affected by alterations in the composition of the intestinal microbiota and a role for commensal flora has been evidenced in the pathogenesis of several complications arising in end-stage liver disease such as hepatic encephalopathy, splanchnic arterial vasodilatation and spontaneous bacterial peritonitis. The use of antibiotics is the main therapeutic pipeline in the management of these bacteria-related complications. However, other strategies aimed at preserving intestinal homeostasis through the use of pre-, pro- or symbiotic formulations are being studied in the last years. In this review, the role of intestinal microbiota in the development of the most frequent complications arising in cirrhosis and the different clinical and experimental studies conducted to prevent or improve these complications by modifying the gut microbiota composition are summarized.

Gomez-Hurtado, Isabel; Such, Jose; Sanz, Yolanda; Frances, Ruben

2014-01-01

324

Postoperative abdominal complications after cardiopulmonary bypass  

PubMed Central

Background To summarize the diagnostic and therapeutic experiences on the patients who suffered abdominal complications after cardiovascular surgery with cardiopulmonary bypass(CPB). Methods A total of 2349 consecutive patients submitted to cardiovascular surgery with CPB in our hospital from Jan 2004 to Dec 2010 were involved. The clinical data of any abdominal complication, including its incidence, characters, relative risks, diagnostic measures, medical or surgical management and mortality, was retrospectively analyzed. Results Of all the patients, 33(1.4%) developed abdominal complications postoperatively, including 11(33.3%) cases of paralytic ileus, 9(27.3%) of gastrointestinal haemorrhage, 2(6.1%) of gastroduodenal ulcer perforation, 2(6.1%) of acute calculus cholecystitis, 3(9.1%) of acute acalculus cholecystitis, 4(12.1%) of hepatic dysfunction and 2(6.1%) of ischemia bowel diseases. Of the 33 patients, 26 (78.8%) accepted medical treatment and 7 (21.2%) underwent subsequent surgical intervention. There were 5(15.2%) deaths in this series, which was significantly higher than the overall mortality (2.7%). Positive history of peptic ulcer, advanced ages, bad heart function, preoperative IABP support, prolonged CPB time, low cardiac output and prolonged mechanical ventilation are the risk factors of abdominal complications. Conclusions Abdominal complications after cardiovascular surgery with CPB have a low incidence but a higher mortality. Early detection and prompt appropriate intervention are essential for the outcome of the patients. PMID:23046511

2012-01-01

325

Electronic Still Camera Project on STS-48  

NASA Technical Reports Server (NTRS)

On behalf of NASA, the Office of Commercial Programs (OCP) has signed a Technical Exchange Agreement (TEA) with Autometric, Inc. (Autometric) of Alexandria, Virginia. The purpose of this agreement is to evaluate and analyze a high-resolution Electronic Still Camera (ESC) for potential commercial applications. During the mission, Autometric will provide unique photo analysis and hard-copy production. Once the mission is complete, Autometric will furnish NASA with an analysis of the ESC s capabilities. Electronic still photography is a developing technology providing the means by which a hand held camera electronically captures and produces a digital image with resolution approaching film quality. The digital image, stored on removable hard disks or small optical disks, can be converted to a format suitable for downlink transmission, or it can be enhanced using image processing software. The on-orbit ability to enhance or annotate high-resolution images and then downlink these images in real-time will greatly improve Space Shuttle and Space Station capabilities in Earth observations and on-board photo documentation.

1991-01-01

326

Chronic postsurgical pain: still a neglected topic?  

PubMed Central

Background Surgical injury can frequently lead to chronic pain. Despite the obvious importance of this problem, the first publications on chronic pain after surgery as a general topic appeared only a decade ago. This study tests the hypothesis that chronic postsurgical pain was, and still is, represented insufficiently. Methods We analyzed the presentation of this topic in journal articles covered by PubMed and in surgical textbooks. The following signs of insufficient representation in journal articles were used: (1) the lack of journal editorials on chronic pain after surgery, (2) the lack of journal articles with titles clearly indicating that they are devoted to chronic postsurgical pain, and (3) the insufficient representation of chronic postsurgical pain in the top surgical journals. Results It was demonstrated that insufficient representation of this topic existed in 1981–2000, especially in surgical journals and textbooks. Interest in this topic began to increase, however, mostly regarding one specific surgery: herniorrhaphy. It is important that the change in the attitude toward chronic postsurgical pain spreads to other groups of surgeries. Conclusion Chronic postsurgical pain is still a neglected topic, except for pain after herniorrhaphy. The change in the attitude toward chronic postsurgical pain is the important first step in the approach to this problem. PMID:23152698

Kissin, Igor; Gelman, Simon

2012-01-01

327

Pelvic Inflammatory Disease (PID)  

MedlinePLUS

... Pelvic Inflammatory Disease (PID) - CDC Fact Sheet Untreated sexually transmitted diseases (STDs) can cause pelvic inflammatory disease (PID), a serious ... It is a complication often caused by some STDs, like chlamydia and gonorrhea. Other infections that are ...

328

Rotator cuff injury: still a clinical controversy?  

Microsoft Academic Search

The rotator cuff mechanism is the primary stabiliser of the gleno-humeral joint and is vulnerable to considerable morbidity because of its anatomy and function. Both intrinsic and extrinsic factors are responsible for rotator cuff pathology, which is a disease spectrum ranging from inflammation to full thickness tears. The most notable extrinsic factors are impingement and demographic variables, whereas age-related degeneration

P. Hardy; S. Sanghavi

2009-01-01

329

Neurological Complications of Biologic Therapy in Psoriasis  

PubMed Central

Biologic agents have been a significant advancement in the management of psoriasis. Along with significant clinical improvement, there have been concerns for emerging side effects with the use of biologics. Reports have emerged showing the association between efalizumab and the development of progressive multifocal leukoencephalopathy and other demyelinating disorders. Tumor necrosis factor-alpha inhibitors have been associated with various demyelinating disorders. As such, it is imperative for dermatologists to be well informed regarding how to notify patients about the risks of biologic treatment. Dermatologists must be able to identify the signs and symptoms of neurological complications and recognize when to refer patients to neurologists for diagnostic workup, disease confirmation, and any necessary treatment. This review is a compilation of evidence showing the association between biologic therapy and neurological complications, as well as an overview of the clinical presentation and diagnosis of such diseases. PMID:20725577

Sanders, Catherine; Bechtel, Ann

2009-01-01

330

Multiple Myeloma: Cast Nephropathy, VTE, and Neurologic Complications  

PubMed Central

Multiple myeloma accounts for approximately 1% of neoplastic diseases and 13% of hematologic cancers. Complications often associated with MM include neurologic and hematologic issues, infections, renal insufficiency, and bone involvement. It is crucial for advanced practice professionals caring for myeloma patients to assess patients accurately, be keenly aware of possible associated complications, and be familiar with appropriate interventions to prevent further injury. This article will provide an overview of MM-related renal insufficiency, with a focus on cast nephropathy, venous thromboembolism, and neurologic complications along with various causes and treatment options; a future article will address additional complications associated with MM. PMID:25031979

Sullivan, Ellen; Smith, Lisa C.; Falco, Angela M.

2013-01-01

331

Transcatheter aortic valve implantation complicated by acute pericardial tamponade  

PubMed Central

Transcatheter aortic valve replacement (TAVR) is now an accepted standard of care for patients with symptomatic severe aortic stenosis who are not candidates for surgery or have high surgical risk. Despite its more widespread adoption as a treatment option and increasing experience of centers, TAVR is still associated with several complications. We therefore report a case of TAVR complicated by acute pericardial tamponade, one of the most severe potential complications of this procedure. We describe the way we approached the problem and we try to give a potential take-home message for others who might encounter such a situation in their own cath lab. PMID:24799924

Suwalski, Piotr; Pawlak, Agnieszka; Kulawik, Tomasz; Byczkowska, Katarzyna; Gil, Robert J.

2014-01-01

332

Skin Complications of IBD  

MedlinePLUS

... Crohn's & Colitis? What is Crohn's Disease What is Ulcerative Colitis Types of Medications What’s available to treat IBD ... about CCFA’s mission: to cure Crohn'sdisease and ulcerative colitis, and to improve the quality of life of ...

333

Eye Complications in IBD  

MedlinePLUS

... Crohn's & Colitis? What is Crohn's Disease What is Ulcerative Colitis Types of Medications What’s available to treat IBD ... about CCFA’s mission: to cure Crohn'sdisease and ulcerative colitis, and to improve the quality of life of ...

334

An experimental study of a new solar still - The wiping spherical still  

NASA Astrophysics Data System (ADS)

Theoretical and experimental results of the functioning of a spherical solar water distiller which includes a curved, turning glass wiper are presented. A review of past and present solar still apparatus is presented, along with an analytical examination of insolation characteristics. Numerical models are constructed of the performance of solar stills, noting the enhanced gain with less materials available by using spherically shaped plexiglass for the transparent upper surface. Attachment of a curved glass wiper, which extends from the top center of the dome to the collector tray and is made to revolve around the dome's inner surface by either an electric motor, or a wind-powered shaft, or by means of a motor driven by solar cells, is shown to keep the transparency higher and thus augment the efficiency of the still to 14 percent better performance than with a flat plate solar still.

Makki, A.

335

Risk of biliary complications in bariatric surgery.  

PubMed

Gallstones are commonly observed after rapid weight loss, particularly after bariatric surgery. Preventive measures of gallstone formation and potential related complications are still debated. This study aimed to propose a standardized strategy according to the results of the literature. Thus, preventive measures should be determined according to patient status (evaluated clinically and by routine ultrasound) and the type of bariatric surgery. Cholecystectomy should be performed in patients with symptomatic gallstones irrespective of the planned operation, or for asymptomatic gallstones during a gastric by-pass. In other settings, ursodesoxycholic acid should be given postoperatively for 6 months. PMID:20920904

Desbeaux, A; Hec, F; Andrieux, S; Fayard, A; Bresson, R; Pruvot, M-H; Mulliez, E

2010-08-01

336

Intentions make a difference: Infant responses to still-face and modified still-face conditions  

Microsoft Academic Search

In two studies, 3-, 6- and 9-month-old infants interacted with their mothers during natural, still-face, and modified still-face (i.e., mothers wearing a mask, or drinking from bottle) conditions. Infants were also presented with matching doll conditions to control for the possibility that their responses might be due to changes in superficial perceptual features. Regardless of age, infants displayed negative affect

Maria Legerstee; Gabriela Markova

2007-01-01

337

Is this (still) a man's world?  

PubMed

During the past 50 years, the participation of women in medicine has increased dramatically. However, this encouraging influx has not been accompanied by equality for male and female faculty in terms of rank attainment, leadership roles and salaries. There is considerable evidence that women are still under-represented in the higher echelons of academic medicine, either as heads of departments, authors of scientific papers or members of editorial boards. Participation in medical congresses is another important measure of medical achievement; this manuscript comments on the female representation in four of the largest international meetings in the field of intensive care medicine (ICM). It notes the scarcity of female faculty members and proposes several explanations for this phenomenon. The notable under-representation of women in the ICM congresses suggests the existence of a 'glass ceiling' in the field of intensive care medicine, a specialty that, up until today, hasn't been considered as traditionally 'male'. PMID:23360566

Metaxa, Victoria

2013-01-01

338

Why do Some Dwarf Novae Stand Still?  

NASA Technical Reports Server (NTRS)

The papers published through support of NASA. "Why do Some DwarfNovae Stand Still?" Preliminary results were published in the form of an abstract as part of Joint Discussion 5, at the IAU meeting in Sydney. The complete reference is: Hartley, L. E., Long, K. S., Froning, C.-S., & Drew, J. E. 2003, "The White Dwarf and Accretion Stream in Z Cam", presented as part of Joint Discussion 5, "White Dwarfs: Galactic and Cosmologic Probes, at 25th meeting of the MU, Joint Discussion 5 , 16-17 July 2003, Sydney, Australia Our final results were published in the Astrophysical Journal this year. Hartley, L. E., Long, K. S., Froning, C. S., & Drew, J. E. 2005, "The Far-Ultraviolet Spectrum of Z Camelopardalis in Quiescence and Standstill", ApJ, 623,425.

Sonneborn, George (Technical Monitor); Long, Knox

2005-01-01

339

[Regional conventions: still up-to-date?].  

PubMed

This article poses the question whether regional meetings are still contemporary for continuing medical education using the example of this year's joint meeting of the Vereingung der Mitteldeutschen Urologen e. V. and the Sächsischen Gesellschaft für Urologie e. V., which took place in Marburg from May 22nd - 24th , 2014. It gives an overview of the most important and interesting topics of the meeting and highlights the advantages of regional meetings in comparison to other kinds of medical education possibilities such as national conventions or internet-based courses. The authors conclude that in spite of a significant financial costs and organisational effort, regional meetings contain unique and favourable characteristics and hence should remain a permanent feature of the scientific landscape in Germany. PMID:25275689

Skrobek, L; Honacker, A; Hegele, A; Hofmann, R

2014-09-01

340

Solar 'hot spots' are still hot  

NASA Technical Reports Server (NTRS)

Longitude distributions of solar flares are not random but show evidence for active zones (or hot spots) where flares are concentrated. According to a previous study, two hot spots in the northern hemisphere, which rotate with a synodic period of about 26.72 days, produced the majority of major flares, during solar cycles 20 and 21. The more prominent of these two hot spots is found to be still active during the rising part of cycle 22, producing the majority of northern hemisphere major flares. The synodic rotation period of this hot spot is 26.727 + or - 0.007 days. There is also evidence for hot spots in the southern hemisphere. Two hot spots separated by 180 deg are found to rotate with a period of 29.407 days, with one of them having persisted in the same locations during cycles 19-22 and the other, during cycles 20-22.

Bai, Taeil

1990-01-01

341

Techniques, indications and complications of corneal debridement.  

PubMed

The cornea is the most exposed surface of the eye and, as such, is vulnerable to external trauma and the risk of infection. Many corneal diseases alter shape, surface, and transparency and thus result in reduced vision. The external position of the cornea, however, lends itself to diagnostic and therapeutic maneuvers that are commonly performed and readily done in the clinic. More sophisticated techniques require the use of complex equipment such as excimer and femtosecond laser. Complications that develop from poor healing and/or secondary infection are best avoided with appropriate technique, antisepsis, and modification of wound healing. We review corneal debridement in the management of corneal disease. PMID:24239444

McGrath, Lindsay A; Lee, Graham A

2014-01-01

342

Complications of laparoscopic antireflux surgery in childhood  

Microsoft Academic Search

Background: The aim of this study was to assess the complications associated with the laparoscopic treatment of gastroesophageal reflux\\u000a disease (GERD) in children.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a Methods: From March 1992 to March 1998, we used the laparoscopic approach to treat 289 children affected by gastroesophageal reflux\\u000a disease. The patients' ages ranged between 4 months and 17 years (median, 4.3 years), and their body

C. Esposito; P. Montupet; G. Amici; P. Desruelle

2000-01-01

343

Thoracic complications of illicit drug use: an organ system approach.  

PubMed

Illicit drug use constitutes a major health problem and may be associated with various thoracic complications. These complications vary depending on the specific drug used and the route of administration. Commonly abused drugs that may play a role in causing thoracic disease include cocaine, opiates, and methamphetamine derivatives. Intravenously abused oral medications may contain filler agents that may be responsible for disease. Thoracic complications may be categorized as pulmonary, pleural, mediastinal, cardiovascular, and chest wall complications. Pulmonary complications of drug abuse include pneumonia, cardiogenic edema, acute lung injury, pulmonary hemorrhage, and aspiration pneumonia. Filler agents such as talc may result in panacinar emphysema or high-attenuation upper-lobe conglomerate masses. The primary pleural complication of illicit drug use is pneumothorax. Mediastinal and cardiovascular complications of illicit drug use include pneumomediastinum, cardiomyopathy, myocardial infarction, aortic dissection, and injection-related pseudoaneurysms. Chest wall complications include diskitis and vertebral osteomyelitis, epidural abscess, necrotizing fasciitis, costochondritis, and septic arthritis. Categorization of thoracic complications of illicit drug use may facilitate understanding of these disorders and allow accurate diagnosis. PMID:12376606

Gotway, Michael B; Marder, Shelley R; Hanks, Douglas K; Leung, Jessica W T; Dawn, Samuel K; Gean, Alisa D; Reddy, Gautham P; Araoz, Philip A; Webb, W Richard

2002-10-01

344

Imaging findings of complications and unusual manifestations of ovarian teratomas.  

PubMed

Ovarian teratomas can be associated with various complications and demonstrate a wide spectrum of clinical and imaging features. The complications include torsion (16% of ovarian teratomas), rupture (1%-4%), malignant transformation (1%-2%), infection (1%), and autoimmune hemolytic anemia (<1%). These complications require different therapeutic strategies; therefore, timely and accurate diagnosis of these complications is important for optimal patient treatment. In cases of complicated ovarian teratomas, the clinical manifestations provide only limited information and often overlap with those of other diseases. Furthermore, ovarian teratomas may have unusual clinical and imaging manifestations, thereby leading to misdiagnosis. These unusual manifestations include immature teratomas, monodermal teratomas (struma ovarii), combination tumors and collision tumors containing teratomas, and mature cystic teratomas without demonstrable fat or with pure fatty components. To provide adequate treatment and prevent misdiagnosis, it is necessary to be familiar with the imaging findings of both the complications and the unusual manifestations of ovarian teratomas. PMID:18635624

Park, Sung Bin; Kim, Jeong Kon; Kim, Kyu-Rae; Cho, Kyoung-Sik

2008-01-01

345

Genital herpes complicating pregnancy.  

PubMed

Approximately 22% of pregnant women are infected with herpes simplex virus (HSV)-2, and 2% of women will acquire HSV during pregnancy. Remarkably, up to 90% of these women are undiagnosed because they are asymptomatic or have subtle symptoms attributed to other vulvovaginal disorders. Diagnosis of genital herpes relies on laboratory confirmation with culture or polymerase chain reaction assay of genital lesions and type-specific glycoprotein G-based serologic testing. Neonatal herpes is the most severe complication of genital HSV infection and is caused by contact with infected genital secretions at the time of labor. Maternal acquisition of HSV in the third trimester of pregnancy carries the highest risk of neonatal transmission. Despite advances in the diagnosis and treatment of neonatal herpes, little change in the incidence or serious sequelae from this infection has occurred. As such, prevention of the initial neonatal infection is critically important. Obstetricians are in a unique position to prevent vertical HSV transmission by identifying women with genital lesions at the time of labor for cesarean delivery, prescribing antiviral suppressive therapy as appropriate, and avoiding unnecessary invasive intrapartum procedures in women with genital herpes. Enhanced prevention strategies include identification of women at risk for HSV acquisition during pregnancy by testing women and possibly their partners for HSV antibodies and providing counseling to prevent transmission to women in late pregnancy. PMID:16199646

Brown, Zane A; Gardella, Carolyn; Wald, Anna; Morrow, Rhoda Ashley; Corey, Lawrence

2005-10-01

346

The baby killers are still at large.  

PubMed

This newspaper editorial reports that the UN Children's Fund's (UNICEF) executive director and recent US Presidential Medal of Freedom recipient believes that 1.5 million infants would survive annually if breast feeding declines worldwide were reversed. UNICEF adopted the International Code of Marketing of Breast Milk Substitutes in the World Health Assembly in 1981. The code restricts direct advertising, inadequate labels, saleswomen dressed as nurses, and promotion of free samples. The Baby Food Action Network is reported to have released a report which states that baby food companies are still donating free supplies of infant formula to hospitals. The UNICEF position is that provision of free supplies is the most important disincentive to breast feeding. 81 governments adopted the guidelines, but 41 countries have hospitals which accept free samples. 28 of these 41 countries adopted the ban. The Nestle Company, which was cited 20 years age for this practice, won the legal battle and today defies the guidelines in 22 countries, including China, Zimbabwe, and Bangladesh. A US company, Mead Johnson, uses advertising on its label that shows Beatrice Potter's Peter Rabbit being bottle fed. The International Code restricts idealization of bottle feeding. Nutrician, a large conglomerate ownership of US and European infant formula companies, brazenly advertises in the Peruvian daily newspapers with photos of baby milk boxes being donated to hospitals. Dr. Derek Jelliffe, an infant nutritionist, is credited with being the first to publicize the dangers of commercialized malnutrition 21 years ago. PMID:12319575

Power, J

1994-08-12

347

[Tuberculous pleurisy--still difficult diagnostic problem].  

PubMed

In years 1989-2000 in Lung Diseases Hospital in ?ód? tuberculous pleurisy TP was diagnosed in 271 patients; in 130 (48%) cases this diagnosis was confirmed by microbiological and histopathological examinations. Presence of tubercle bacilli in pleural fluid was discovered by smear and culture only in 13 cases, only by culture in 95 and in Bactec method in 7. During this period in 135 patients with pleural effusion of unknown etiology biopsy of the pleura (with Abrams needle) was performed and specific granuloma was found in 17 (13%) persons. In 15 (12%) patients it was the only method establishing diagnosis of TP (because in 2 remaining patients tubercle bacilli in pleural fluid were also found). Assessment of clinical symptoms indicates that onset of TP was insidious and course of the disease was subacute in about 30% of patients, manifested mainly by: fatigue, general weakness, night sweats. Radiological estimation of patients with TP disclosed (besides pleural effusion) lung infiltrations in 38 (28%) cases, including 13 (10%) with cavitation. Tuberculin induration with diameter 0 mm was found in 32% of patients with TP and with greater than 10 mm in 29% of patients. Because of low sensitivity of microbiological examinations of pleural fluid for tubercle bacilli biopsy of pleura should be method of choice in the diagnosis of TP in selected cases. PMID:11852805

Fija?kowski, M; Graczyk, J

2001-11-01

348

Androgen deprivation therapy complications.  

PubMed

Androgen deprivation therapy (ADT) is increasingly used to treat advanced prostate cancer and is also utilised as adjuvant or neo-adjuvant treatment for high-risk disease. The resulting suppression of endogenous testosterone production has deleterious effects on quality of life, including hot flushes, reduced mood and cognition and diminished sexual function. Cross-sectional and longitudinal studies show that ADT has adverse bone and cardio-metabolic effects. The rate of bone loss is accelerated, increasing the risk of osteoporosis and subsequent fracture. Fat mass is increased and lean mass reduced, and adverse effects on lipid levels and insulin resistance are observed, the latter increasing the risk of developing type 2 diabetes. ADT also appears to increase the risk of incident cardiovascular events, although whether it increases cardiovascular mortality is not certain from the observational evidence published to date. Until high-quality evidence is available to guide management, it is reasonable to consider men undergoing ADT to be at a higher risk of psychosexual dysfunction, osteoporotic fracture, diabetes and cardiovascular disease, especially when treated for extended periods of time and therefore subjected to profound and prolonged hypoandrogenism. Health professionals caring for men undergoing treatment for prostate cancer should be aware of the potential risks of ADT and ensure appropriate monitoring and clinical management. PMID:24872511

Allan, Carolyn A; Collins, Veronica R; Frydenberg, Mark; McLachlan, Robert I; Matthiesson, Kati L

2014-08-01

349

Complications of shoulder instability surgery.  

PubMed

Complications of shoulder instability surgery may results from errors made during the preoperative, intraoperative, or postoperative periods. Some complications are preventable whereas the risk of others can be reduced. A few complications remain unpreventable. Two sources of error in the preoperative period that can lead to complications are an incorrect diagnosis and failure to address a patient's expectations of treatment. These errors and their subsequent complications are preventable. Preventing complications during the intraoperative period begins with proper patient positioning and a thorough knowledge of shoulder anatomy. Understanding the indications and limitations of the various stabilization procedures, as well as applying proper surgical technique, is essential to avoid a surgical misadventure. Complications recognized in the postoperative period include recurrent instability, limitation of motion, inability to return to the previous level of sport, problems related to hardware, pain, development of osteoarthritis, and neurovascular injuries. Infection and hematoma formation may also occur; both need to be recognized and treated early to maximize outcome. A protocol for treating each complication that may occur often is helpful. Knowledge of the complications that can arise is paramount to preventing their occurrence. This knowledge comes through experience, study, and continued research. PMID:8582009

Wall, M S; Warren, R F

1995-10-01

350

Porcine Dermal Collagen Graft in Complicated Incisional Hernia  

Microsoft Academic Search

Several techniques for the repair of abdominal-wall defects and incisional hernia have been described. Primary repair, with\\u000a or without discharge incision on the rectus muscle sheath, and other closure techniques such as aponeurotic flap, myocutaneous\\u000a flap, skin or fascial graft, are still associated with high recurrence rates, especially in complicated incisional hernias.

Mariano Fortunato Armellino; Guglielmo De Stefano; Giovanni Bartone; Giovanni De Stefano

351

Neurologic complications of cardiac tests and procedures.  

PubMed

Arterial or central venous vascular access is the cornerstone of invasive cardiac diagnosis, monitoring, and therapeutics. Although procedural safety has significantly improved with protocols perfected over decades of use, their prevalence renders even the uncommon neurologic complication clinically relevant. Serious peripheral nerve complications result from direct or indirect nerve injuries in the setting of a hematoma or compartment syndrome. Functional outcome is dependent upon prompt diagnosis and early treatment, so proceduralists should be aware of the relevant anatomy and early signs of nerve injury. Ischemic stroke is the most common central nervous system complication of diagnostic and therapeutic cardiac catheterization, and is presumed to be due to embolization of atherosclerotic plaque or thrombus dislodged during guiding catheter manipulation, platelet-fibrin thrombus that forms on the catheters, or air that appears during catheter flushing. Acute neurologic deterioration after thrombolysis for acute myocardial infarction should be presumed to be an intracranial hemorrhage until proven otherwise. The ideal angiography suite of the future is patientcentric and multipurpose, coordinating diagnostic and therapeutic strategies for multivascular disease, allowing for multispecialty collaboration, and, in the event of a neurologic complication of a cardiac procedure, facilitating the various treating physicians to converge efficiently upon the patient. PMID:24365287

Sila, Cathy

2014-01-01

352

SPECT Molecular Imaging in Parkinson's Disease  

PubMed Central

Parkinson's disease (PD) is a common disorder, and the diagnosis of Parkinson's disease is clinical and relies on the presence of characteristic motor symptoms. The accuracy of the clinical diagnosis of PD is still limited. Functional neuroimaging using SPECT technique is helpful in patients with first signs of parkinsonism. The changes detected may reflect the disease process itself and/or compensatory responses to the disease, or they may arise in association with disease- and/or treatment-related complications. This paper addresses the value of SPECT in early differential diagnosis of PD and its potential as a sensitive tool to assess the pathophysiology and progression, as well as the therapeutic efficacy of PD. PMID:22529704

Wang, Ling; Zhang, Qi; Li, Huanbin; Zhang, Hong

2012-01-01

353

Clinicopathological and radiological study of Egyptian ?-thalassemia intermedia and ?-thalassemia major patients: relation to complications and response to therapy.  

PubMed

The clinico epidemiological characteristics, frequency of complications, and response to various therapeutic modalities in 80 Egyptian ?-thalassemia intermedia (?-TI) patients were compared with 70 ?-thalassemia major (?-TM) patients. ?-Thalassemia intermedia patients had a higher incidence of left atrium dilatation, right ventricular dilatation and pulmonary hypertension, whereas, ?-TM patients showed a higher incidence of left ventricular (LV) dilatation, restrictive LV filling and impaired LV contractility, with an overall higher incidence of heart disease (p <0.001). Short stature, delayed puberty, osteoporosis, bone fractures, diabetes mellitus and viral hepatitis was frequently observed in ?-TM patients compared with ?-TI patients (p <0.05). Administration of hydroxyurea (HU) alone was associated with significant improvement in hematological parameters and quality of life for ?-TI patients. In conclusion, the risk of complications still burdens the life of Egyptian thalassemia patients and their frequency varies between ?-TI and ?-TM. We provide evidence that calls for the use of HU in ?-TI patients. PMID:21797705

Mokhtar, Galila M; Tantawy, Azza A G; Adly, Amira A M; Ismail, Eman A R

2011-01-01

354

Where Does Human Plague Still Persist in Latin America?  

PubMed Central

Background Plague is an epidemic-prone disease with a potential impact on public health, international trade, and tourism. It may emerge and re-emerge after decades of epidemiological silence. Today, in Latin America, human cases and foci are present in Bolivia, Brazil, Ecuador, and Peru. Aims The objective of this study is to identify where cases of human plague still persist in Latin America and map areas that may be at risk for emergence or re-emergence. This analysis will provide evidence-based information for countries to prioritize areas for intervention. Methods Evidence of the presence of plague was demonstrated using existing official information from WHO, PAHO, and Ministries of Health. A geo-referenced database was created to map the historical presence of plague by country between the first registered case in 1899 and 2012. Areas where plague still persists were mapped at the second level of the political/administrative divisions (counties). Selected demographic, socioeconomic, and environmental variables were described. Results Plague was found to be present for one or more years in 14 out of 25 countries in Latin America (1899–2012). Foci persisted in six countries, two of which have no report of current cases. There is evidence that human cases of plague still persist in 18 counties. Demographic and poverty patterns were observed in 11/18 counties. Four types of biomes are most commonly found. 12/18 have an average altitude higher than 1,300 meters above sea level. Discussion Even though human plague cases are very localized, the risk is present, and unexpected outbreaks could occur. Countries need to make the final push to eliminate plague as a public health problem for the Americas. A further disaggregated risk evaluation is recommended, including identification of foci and possible interactions among areas where plague could emerge or re-emerge. A closer geographical approach and environmental characterization are suggested. PMID:24516682

Schneider, Maria Cristina; Najera, Patricia; Aldighieri, Sylvain; Galan, Deise I.; Bertherat, Eric; Ruiz, Alfonso; Dumit, Elsy; Gabastou, Jean Marc; Espinal, Marcos A.

2014-01-01

355

Complicated diverticulitis following renal transplantation  

Microsoft Academic Search

PURPOSE: Colonic perforations in renal transplant recipients have historically been associated with mortality rates as high as 50 to 100 percent. However, these previous series generally predate the use of cyclosporine-based immuno-suppressive protocols. METHODS: We retrospectively reviewed all patients who had undergone renal transplant from our institution and who developed complicated diverticulitis. Complicated diverticulitis was defined as diverticulitis involving free

Eric D. Lederman; David J. Conti; Neil Lempert; T. Paul Singh; Edward C. Lee

1998-01-01

356

Neurological complications of pertussis inoculation  

Microsoft Academic Search

Findings are presented in 36 children, seen in the past 11 years, who are believed to have suffered from neurological complications of pertussis inoculation (given as triple vaccine). The clustering of complications in the first 24 hours after inoculation suggests a causal rather than a coincidental relation. Possible contributory factors were present in one-third of patients studied and support the

M. Kulenkampff; J. S. Schwartzman; J. Wilson

1974-01-01

357

Clinical complications of osseointegrated implants  

Microsoft Academic Search

Statement of problem. There is no comprehensive review of the literature that identifies the complications reported in clinical dental implant studies. Purpose. This article attempted to determine the types of complications that have been reported and to provide data regarding their frequency. Methods. All available clinical studies from 1981 to 1997, published in English or with English abstract, that presented

Charles J. Goodacre; Joseph Y. K. Kan; Kitichai Rungcharassaeng

1999-01-01

358

Alimentary tract complications after renal transplantation.  

PubMed Central

A computer analysis of post renal transplantation gastrointestinal problems was performed to identify important associated clinical factors. Thirty-seven per cent of all transplant recipients developed one or more significant problems. Hemorrhage, nondiverticular intestinal perforation, and esophagitis occurred most frequently in hospitalized patients. Pancreatitis, diverticulitis, and gastroduodenal perforation occurred characteristically in long-term survivors with well functioning allografts. Eleven of 32 HLA identical recipients treated with maintenance corticosteroids during stable kidney function developed gastrointestinal disease while only one of 13 HLA identical recipients not given maintenance steroids developed a problem, which strongly suggests a causal role for steroids in the development of late complications. The association of preexisting peptic ulcer and diverticular disease with hemorrhage and perforation supports previous recommendations that documented peptic ulcer disease or diverticulitis should be corrected surgically prior to transplantation. Images Fig. 3. Fig. 5. PMID:384945

Meyers, W C; Harris, N; Stein, S; Brooks, M; Jones, R S; Thompson, W M; Stickel, D L; Seigler, H F

1979-01-01

359

Pathogenesis of diverticulitis complicating granulomatous colitis.  

PubMed

The involement of diverticula by granulomatous colitis may cause an increased incidence of diverticulitis. Of 21 patients with Crohn's disease and associated diverticulosis who underwent resection, sigmoid diverticulitis was pathologically confirmed in 10 (48%). The clinical recognition of the coexistence of the two diseases is often difficult. The radiological signs of peridiverticulitis complicating granulomatous colitis usually show clear evidence of the underlying pathological changes. They include localized diverticular performation, perhaps with multiple communications via a paracolonic sinus tract, mass pressure from the paracolicabscess, and occasionally some degree of communication with deep fissuring ulcers of Crohn's disease. Because diverticula breach the colonic wall, histological analysis confirm that their involvement by the transmural process of granulomatous colitis predisposes to peridiverticulitis and/or abscess formation. PMID:618429

Meyers, M A; Alonso, D R; Morson, B C; Bartram, C

1978-01-01

360

The ABC's of stroke complications.  

PubMed

Stroke is the third leading cause of death in the United States, with more than 140,000 deaths per year. Complications related to stroke resulting in morbidity and mortality are very common and may result from cerebral and extracerebral causes. Cerebral causes include cerebral edema, hemorrhagic conversion of an ischemic infarct, and progression of penumbra to infarction. Extracerebral complications include deep vein thrombosis and pulmonary embolism, urinary tract infection, and aspiration. Many of these complications are largely preventable and often tracked as "quality metrics" in institutions with a stroke center designation. The focus of the article is primarily on common poststroke complications, such as aspiration, DVT, decubitus ulcers, seizures, and urinary catheter infections. Knowledge about potential poststroke complications is critical to earlier diagnosis, proper preventive strategies, and management. PMID:21207342

Freeman, W David; Dawson, Steven B; Flemming, Kelly D

2010-11-01

361

Pancreatic sphincterotomy: Technique, indications, and complications  

PubMed Central

Pancreatic sphincterotomy serves as the cornerstone of endoscopic therapy of the pancreas. Historically, its indications have been less well-defined than those of endoscopic biliary sphincterotomy, yet it plays a definite and useful role in diseases such as chronic pancreatitis and pancreatic-type sphincter of Oddi dysfunction. In the appropriate setting, it may be used as a single therapeutic maneuver, or in conjunction with other endoscopic techniques such as pancreatic stone extraction or stent placement. The current standard of practice utilizes two different methods of performing pancreatic sphincterotomy: a pull-type sphincterotome technique without prior stent placement, and a needle-knife sphincterotome technique over an existing stent. The complications associated with pancreatic sphincterotomy are many, although acute pancreatitis appears to be the most common and the most serious of the early complications. As such, it continues to be reserved for those endoscopists who perform a relatively high-volume of therapeutic pancreaticobiliary endoscopic retrograde cholangio-pancreatography. PMID:17696223

Buscaglia, Jonathan M; Kalloo, Anthony N

2007-01-01

362

Blind loop: rare but important surgical complication  

PubMed Central

Background Surgical complications worldwide are dreaded by both patients and physicians alike. They represent significant and serious morbidity and mortality, and contribute substantially to increased costs of healthcare. Case presentation Our Case Report describes a 65yo Caucasian man with an extensive operative history for Crohn’s disease, including 4 laparotomies with small bowel resections to ameliorate small bowel obstructions. He presented with signs and symptoms of a chronic draining sinus, but was found to have a Blind Loop of bowel. This finding is believed to be the result of a surgical complication. Conclusion While the Case Reports discusses this particular patient presentation, the paper defines, describes and offers treatment strategies for Enterocutaneous Fistulas (ECF). We offer aim to add Blind Loop to the differential diagnosis when presented with a patient with signs and symptoms of ECF. PMID:25176257

2014-01-01

363

Myelofibrosis 2012: it's complicated  

PubMed Central

Major advances in myeloproliferative neoplasms in the last decade have cast light on their complexity. The identification of JAK2V617F briefly promised a unifying mechanism of pathogenesis with a single pathway that could be efficiently targeted. Instead, there have been major advances in understanding acquired and background genetic and epigenetic contributors to this group of disorders, with refined risk prediction models and experimental therapeutics that have provided a more nuanced model of disease. In aggregate these observations likely explain the heterogeneity of these disorders and their generally unpredictable response to therapy. Molecular studies, beginning with the identification of JAK2V617F, have led to a concept of MPN subtypes existing on a continuum, and additional discoveries such as TET2 and EZH2 mutations have provided the molecular underpinnings to begin to explain overlapping phenotypes in myeloid malignancies more generally. In many ways the pace of molecular discovery is outstripping our ability to integrate these observations into clinical care, both in terms of molecular diagnostics and medical decision making. This review will attempt to summarize, within a clinical context, our evolving understanding of myeloproliferative neoplasms. It focuses on biology, histopathology, prognostic scoring systems, stem cell transplantation as well as selected clinical/preclinical therapeutic observations. PMID:23556120

Hubbeling, Harper G.; Frank, Dale M.

2012-01-01

364

MEDIA ENCRYPTION FOR STILL VISUAL DATA MEDIA ENCRYPTION FOR STILL VISUAL DATA  

E-print Network

Dominik Engel Digitally signed by Dominik Engel DN: cn=Dominik Engel, o, ou, email=engel.dominik@gmail.com, c=AT Date: 2008.09.17 09:58:42 +02'00' #12;Dominik Engel: Media Encryption for Still Visual Data, Proceedings of SPIE, pages S ­ S , San Jose, CA, USA, Jan. a. SPIE. (Cited on pages , , , and .) D. E A. U

Uhl, Andreas

365

Gastrointestinal Complications Following Hematopoietic Stem Cell Transplantation in Children  

PubMed Central

Gastrointestinal system involvement is one of the principal complications seen in the recipients of hematopoietic stem cell transplantation (HSCT), and it is also a major cause of morbidity and death in these patients. The major gastrointestinal complications include typhlitis (neutropenic enterocolitis), pseudomembranous enterocolitis, viral enteritis, graft-versus-host disease, benign pneumatosis intestinalis, intestinal thrombotic microangiopathy, and post-transplantation lymphoproliferative disease. As these patients present with nonspecific abdominal symptoms, evaluation with using such imaging modalities as ultrasonography and CT is essential in order to assess the extent of gastrointestinal involvement and to diagnose these complications. We present here a pictorial review of the imaging features and other factors involved in the diagnosis of these gastrointestinal complications in pediatric HSCT recipients. PMID:18838855

Lee, Ji-Hye; Im, Soo Ah; Chung, Nak-Gyun; Hahn, Seung-Tae

2008-01-01

366

Kawasaki disease  

Microsoft Academic Search

Opinion statement  Kawasaki disease is an acute vasculitis of childhood, complicated by coronary artery aneurysms in up to 25% of affected children.\\u000a High-dose intravenous immunoglobulin (IVIG) administered in the acute phase of Kawasaki disease leads to a fivefold reduction\\u000a in the prevalence of coronary aneurysms. When fever persists, a second IVIG infusion should be administered. Rescue therapies\\u000a for IVIG-resistant Kawasaki disease

Jane W. Newburger; David R. Fulton

2007-01-01

367

[Complications after spinal cord injuries and their influence on the effectiveness of rehabilitation].  

PubMed

In this article, literature data on complications after spinal cord injuries and their influence on the efficiency of rehabilitation are analyzed. The spinal cord injury is associated with physical and psychological disorder that causes disability and requires intensive treatment. Authors in their articles indicate that many people after spinal cord injuries have complications. The most common complications are: skin breakdown, urinary tract infection, pulmonary complications, spasticity, pain, autonomic dysreflexia, cardiovascular disease, osteoporosis and fractures, heterotopic ossification, deep vein thrombosis. These complications make patients' rehabilitation more difficult and limit their self-care independence, and the treatment of such complications is very expensive. PMID:17172787

Drigotaite, Neringa; Krisci?nas, Aleksandras

2006-01-01

368

Complications of unilateral weight bearing.  

PubMed

The most common and significant complication of excessive unilateral weight bearing in adult horses is support limb laminitis. Young horses with unilateral lameness problems develop support limb laminitis infrequently compared with adult horses. PMID:19203705

Baxter, Gary M; Morrison, Scott

2008-12-01

369

Oral complications in radiation therapy.  

PubMed

The dentist is integral to managing care for patients with head and neck cancer. Oral complications may manifest during and/or following radiation therapy and can last for the lifetime of the individual. This article reviews a number of these complications as well as the resources available to dentists for managing care of radiation oncology patients and improving their quality of life. PMID:15055655

Harrison, Jody S; Dale, Robert A; Haveman, Carl W; Redding, Spencer W

2003-01-01

370

Prophylaxis of Complications after Pancreatic Surgery: Results of a Multicenter Trial in Germany  

Microsoft Academic Search

Major pancreatic resection still carries a considerable risk for morbidity and even mortality. Complications occurring after pancreatic surgery are chiefly linked with exocrine pancreatic secretion. Therefore to inhibit exocrine pancreatic secretion perioperatively seems to be a promising concept in the prevention of complications following pancreatic resection. The hormone somatostatin and its synthetic analogue octreotide have been demonstrated to inhibit exocrine

H. Friess; I. Klempa; P. Hermanek; U. Sulkowski; W. Uhl; H. G. Beger; M. W. Büchler

1994-01-01

371

Neurologic Complications in Percutaneous Nephrolithotomy  

PubMed Central

Purpose Percutaneous nephrolithotomy (PCNL) has been the preferred procedure for the removal of large renal stones in Iran since 1990. Recently, we encountered a series of devastating neurologic complications during PCNL, including paraplegia and hemiplegia. There are several reports of neurologic complications following PCNL owing to paradoxical air emboli, but there are no reports of paraplegia following PCNL. Materials and Methods We retrospectively reviewed the medical records of patients who had undergone PCNL in 13 different endourologic centers and retrieved data related to neurologic complications after PCNL, including coma, paraplegia, hemiplegia, and quadriplegia. Results The total number of PCNL procedures in these 13 centers was 30,666. Among these procedures, 11 cases were complicated by neurologic events, and four of these cases experienced paraplegia. All events happened with the patient in the prone position with the use of general anesthesia and in the presence of air injection. There were no reports of neurologic complications in PCNL procedures performed with the patient under general anesthesia and in the prone position and with contrast injection. Conclusions It can be assumed that using room air to opacify the collecting system played a major role in the occurrence of these complications. Likewise, the prone position and general anesthesia may predispose to these events in the presence of air injection. PMID:23526482

Basiri, Abbas; Soltani, Mohammad Hossein; Kamranmanesh, Mohammadreza; Tabibi, Ali; Mohsen Ziaee, Seyed Amir; Nouralizadeh, Akbar; Sharifiaghdas, Farzaneh; Poorzamani, Mahtab; Gharaei, Babak; Ozhand, Ardalan; Lashay, Alireza; Ahanian, Ali; Aminsharifi, Alireza; Sichani, Mehrdad Mohammadi; Asl-Zare, Mohammad; Ali Beigi, Faramarz Mohammad; Najjaran, Vahid; Abedinzadeh, Mehdi

2013-01-01

372

Ocular Complications of Leprosy in Yemen  

PubMed Central

Objectives: This study was conducted to identify the main ocular- and vision-threatening complications of leprosy in Yemen. Methods: This is a cross-sectional observational study which took place from February to July 2010. Leprosy patients attending the Skin and Venereal Diseases Hospital in the City of Light in Taiz, Yemen, who consented to participate in the study, were enrolled. Detailed demographic and medical histories were taken and clinical examination findings were recorded. A detailed eye examination, including visual acuity (VA), slit-lamp, and fundus examinations, was conducted on each patient by a qualified ophthalmologist. Results: A total of 192 patients (180 male, 12 female, with a male to female ratio of 15:1) were included in the study. The majority of the patients (157; 81.8%) were over 40 years. Over two-thirds of the patients (129; 67.2%) had had leprosy for more than 20 years. Ocular complications were found in 97% of cases; 150 (39.1%) of the patients’ eyes had at least one pathology. Eyelid involvement was the most common problem observed in 102 (26.5%) patients. Half of the eyes (192; 50%) had a VA of <6/60. The main cause of blindness among these patients was corneal opacity detected in 69 out of 192 patients (35.9%). Conclusion: Ocular complications are frequent among leprosy patients in Yemen. They are true vision-threatening lesions. It is important to prevent these lesions through early diagnosis and adequate treatment. PMID:23275842

Salem, Raga A. A.

2012-01-01

373

Enteral Nutrition within 48 Hours of Admission Improves Clinical Outcomes of Acute Pancreatitis by Reducing Complications: A Meta-Analysis  

PubMed Central

Background Enteral nutrition is increasingly advocated in the treatment of acute pancreatitis, but its timing is still controversial. The aim of this meta-analysis was to find out the feasibility of early enteral nutrition within 48 hours of admission and its possible advantages. Methods and Findings We searched PubMed, EMBASE Databases, Web of Science, the Cochrane library, and scholar.google.com for all the relevant articles about the effect of enteral nutrition initiated within 48 hours of admission on the clinical outcomes of acute pancreatitis from inception to December 2012. Eleven studies containing 775 patients with acute pancreatitis were analyzed. Results from a pooled analysis of all the studies demonstrated that early enteral nutrition was associated with significant reductions in all the infections as a whole (OR 0.38; 95%CI 0.21–0.68, P<0.05), in catheter-related septic complications (OR 0.26; 95%CI 0.11–0.58, P<0.05), in pancreatic infection (OR 0.49; 95%CI 0.31–0.78, P<0.05), in hyperglycemia (OR 0.24; 95%CI 0.11–0.52, P<0.05), in the length of hospitalization (mean difference ?2.18; 95%CI ?3.48?(?0.87); P<0.05), and in mortality (OR 0.31; 95%CI 0.14–0.71, P<0.05), but no difference was found in pulmonary complications (P>0.05). The stratified analysis based on the severity of disease revealed that, even in predicted severe or severe acute pancreatitis patients, early enteral nutrition still showed a protective power against all the infection complications as a whole, catheter-related septic complications, pancreatic infection complications, and organ failure that was only reported in the severe attack of the disease (all P<0.05). Conclusion Enteral nutrition within 48 hours of admission is feasible and improves the clinical outcomes in acute pancreatitis as well as in predicted severe or severe acute pancreatitis by reducing complications. PMID:23762266

Chen, Guang-Cheng; Yuan, Yu-Hong; Zhong, Wa; Zhao, Li-Na; Chen, Qi-Kui

2013-01-01

374

Living with Coronary Heart Disease  

MedlinePLUS

... from the NHLBI on Twitter. Living With Coronary Heart Disease Coronary heart disease (CHD) can cause serious complications. However, if you ... changes and medicines, go to "How Is Coronary Heart Disease Treated?" Work closely with your doctor to control ...

375

Heart transplantation in children: indications, complications, and management considerations.  

PubMed

Heart transplantation in children has increased in the last 5 years because of the availability of cyclosporine and improved surgical techniques. The primary indications for transplantation in children are dilated cardiomyopathy and complex congenital heart disease. The major complications affecting morbidity and mortality are infection and rejection. However, the development of accelerated coronary artery disease represents a serious complication limiting long-term survival. Successful rehabilitation and long-term survival depend on careful selection of potential recipients, application of stringent medical and psychosocial criteria, operative technique, comprehensive medical surveillance, and thorough and effective patient and family education. PMID:1556585

Muirhead, J

1992-04-01

376

Recognizing and managing comorbidities and complications in hidradenitis suppurativa.  

PubMed

The list of comorbidities associated with hidradenitis suppurativa (HS) is extensive, although these diseases do not necessarily share a common causality. Among the categories of comorbidities that are observed are obesity, other skin diseases, inflammatory conditions, and genetic disorders. Complications include scarring, restricted movement resulting from scarring and fibrosis in underlying tissue, conditions associated with obstructed lymph drainage, and psychosocial issues. Adverse effects on quality of life are common and may be severe, including unemployment, deterioration of family and other social relationships, and suicidal ideation. Clinical intervention for HS must include consideration and attention to these comorbidities and complications. PMID:25188459

Menter, Alan

2014-06-01

377

27 CFR 24.193 - Conversion into still wine.  

Code of Federal Regulations, 2010 CFR

... 2010-04-01 false Conversion into still wine. 24.193 Section 24.193 Alcohol, Tobacco...TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Production of Effervescent Wine § 24.193 Conversion into still wine....

2010-04-01

378

27 CFR 26.52 - Still wines containing carbon dioxide.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Still wines containing carbon dioxide. 26.52 Section...Products From Puerto Rico § 26.52 Still wines containing carbon dioxide. (a) General. Still wines may contain not more than 0.392 gram...

2010-04-01

379

27 CFR 26.222 - Still wines containing carbon dioxide.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Still wines containing carbon dioxide. 26.222 ...From the Virgin Islands § 26.222 Still wines containing carbon dioxide. (a) General. Still wines may contain not more than 0.392 gram...

2010-04-01

380

William Grant Still: A Voice High-Sounding.  

ERIC Educational Resources Information Center

William Grant Still died in 1978, but excerpts from a 1968 interview are now made available. Still discusses his life and work, especially his experiences as a Black composer in a still largely segregated America. He attempted to integrate his classical training with his roots in Black culture. (CS)

Headlee, Judith Anne Still

1984-01-01

381

Neurologic Complications in Infective Endocarditis  

PubMed Central

Neurologic complications of infective endocarditis (IE) are common and frequently life threatening. Neurologic events are not always obvious. The prediction and management of neurologic complications of IE are not easily approached algorithmically, and the impact they have on timing and ability to surgically repair or replace the affected valve often requires a painstaking evaluation and joint effort across multiple medical disciplines in order to achieve the best possible outcome. Although specific recommendations are always tailored to the individual patient, there are some guiding principles that can be used to help direct the decision-making process. Herein, we review the pathophysiology, epidemiology, manifestations, and diagnosis of neurological complications of IE and further consider the impact they have on clinical decision making. PMID:25360207

Morris, Nicholas A.; Matiello, Marcelo; Samuels, Martin A.

2014-01-01

382

Biliary complications after liver transplantation  

Microsoft Academic Search

Opinion statement  \\u000a \\u000a \\u000a \\u000a \\u000a – \\u000a \\u000a The incidence of biliary complications after liver transplant is estimated to be 8% to 20%. Post-liver transplant biliary\\u000a complications may lead to acute and chronic liver injury. The early recognition and prompt treatment of such complications\\u000a improves the long-term survival of the patient and graft.\\u000a \\u000a \\u000a \\u000a \\u000a – \\u000a \\u000a An understanding of the type of biliary reconstruction, the rationale for

Sanjay Jagannath; Anthony N. Kalloo

2002-01-01

383

Gastrointestinal complications after cardiac surgery.  

PubMed Central

Gastrointestinal complications after cardiac surgery are uncommon, but are associated with a high morbidity and mortality. Over 11 years 8559 procedures requiring cardiopulmonary bypass were performed in this unit and 35 patients were identified who developed gastrointestinal complications after surgery, an incidence of 0.41%. There were nine deaths in this group, a mortality of 25.7% compared with an overall mortality after cardiac surgery in Ireland ranging from 3.24% to 4.81%. These complications required surgery in 21 patients. The most common indication for surgical intervention was upper gastrointestinal bleeding in 10 patients, three patients had acute pancreatitis, two patients had perforated peptic ulcer; two patients had intestinal ischaemia, with five cases of colon pathology. The difficulties of making an early diagnosis are outlined and a low threshold to exploratory laparotomy is recommended. PMID:8422146

Egleston, C. V.; Wood, A. E.; Gorey, T. F.; McGovern, E. M.

1993-01-01

384

Tuberculous meningitis: more questions, still too few answers.  

PubMed

Tuberculous meningitis is especially common in young children and people with untreated HIV infection, and it kills or disables roughly half of everyone affected. Childhood disease can be prevented by vaccination and by giving prophylactic isoniazid to children exposed to infectious adults, although improvements in worldwide tuberculosis control would lead to more effective prevention. Diagnosis is difficult because clinical features are non-specific and laboratory tests are insensitive, and treatment delay is the strongest risk factor for death. Large doses of rifampicin and fluoroquinolones might improve outcome, and the beneficial effect of adjunctive corticosteroids on survival might be augmented by aspirin and could be predicted by screening for a polymorphism in LTA4H, which encodes an enzyme involved in eicosanoid synthesis. However, these advances are insufficient in the face of drug-resistant tuberculosis and HIV co-infection. Many questions remain about the best approaches to prevent, diagnose, and treat tuberculous meningitis, and there are still too few answers. PMID:23972913

Thwaites, Guy E; van Toorn, Ronald; Schoeman, Johan

2013-10-01

385

Complicated grief in late life  

PubMed Central

Complicated grief (CG) is a syndrome that affects 10% to 20% of grievers regardless of age, although proportionally more will face the death of loved ones in late life, CG is characterized by preoccupying and disabling symptoms that can persist for decades such as an inability to accept the death, intense yearning or avoidance, frequent reveries, deep sadness, crying, somatic distress, social withdrawal, and suicidal ideation. This syndrome is distinct from major depression and post-traumatic stress disorder, but CG maybe comorbid with each. This communication will focus on the impact of CG in late life (over age 60) and will include a case vignette for illustrating complicated grief therapy. PMID:22754292

Miller, Mark D.

2012-01-01

386

Caregiving, bereavement and complicated grief  

PubMed Central

Most deaths are preceded by chronic illness and disability and the provision of support by family caregivers. The purpose of this article is to describe how the caregiving experience affects bereavement, with an emphasis on the relationship between challenging caregiving situations and difficult grieving processes – often referred to as `complicated grief'. The article starts with a brief summary of the general literature on caregiving and bereavement. It then defines complicated grief and discusses why some caregivers may struggle with the death of their loved one. Finally, it offers practical suggestions for what professionals can do to help caregivers both before and after the death has occurred. PMID:20463850

Boerner, Kathrin; Schulz, Richard

2010-01-01

387

Complications from international surgery tourism.  

PubMed

Medical tourism is an increasing trend, particularly in cosmetic surgery. Complications resulting from these procedures can be quite disruptive to the healthcare industry in the United States since patients often seek treatment and have no compensation recourse from insurance. Despite the increasing number of plastic surgery patients seeking procedures abroad, there have been little reported data concerning outcomes, follow-up, or complication rates. Through a survey of American Society of Plastic Surgeons (ASPS) members, the authors provide data on trends to help define the scope of the problem. PMID:21813883

Melendez, Mark M; Alizadeh, Kaveh

2011-08-01

388

Plants Used in the Management of Diabetic Complications  

PubMed Central

Diabetes is a disease, which has assumed vital public health importance because of the complications associated with it. Various mechanisms including polyol pathway along with a complex integrating paradigm have been implicated in glucose-mediated complications. Though polyol pathway was established as a major mechanism, precise pathogenesis of these complications is not yet completely elucidated. Thus research focus was shifted towards key enzyme, aldose reductase in the pathway. Even though various compounds with aldose reductase inhibitory activity were synthesised, a very few compounds are under clinical use. However, studies on these compounds were always under conflicting results and an attempt has been made to review various natural substances with aldose reductase inhibitory activity and their role in management of diabetic complications. PMID:24843182

Dodda, D.; Ciddi, V.

2014-01-01

389

[Diagnosis of stroke due to cocaine and its complications].  

PubMed

INTRODUCTION. Cocaine is an independent cerebrovascular risk factor both for ischaemic and haemorrhagic events, above all among persons under 55 years of age. CASE REPORT. A case report of stroke due to the consumption of cocaine is used to review its pathophysiology and the complexity involved in the management and diagnosis of the associated complications. One of these complications reported in relation to the consumption of cocaine is vasospasm. This condition shares findings observed in ultrasound imaging studies with other conditions, such as early-onset post ischaemic hyperperfusion. Yet, there are important differences between the two as regards their treatment and prognosis. CONCLUSIONS. The consumption of cocaine is associated with cerebrovascular disease through a number of different mechanisms, which each give rise to different complications. By identifying these complications, correct management can be implemented. PMID:23884871

Larrosa-Campo, D; Ramon-Carbajo, C; Benavente-Fernandez, L; Alvarez-Escudero, R; Zeidan-Ramon, N; Calleja-Puerta, S; Pascual, J

2013-08-16

390

Neurologic complications of cardiac surgery: Current concepts and recent advances  

Microsoft Academic Search

Neurologic complications following cardiac surgery result in increased morbidity and mortality. The incidence of stroke is\\u000a 2% to 4%, but is substantially higher in patients with a prior history of stroke. The success of off-pump techniques in altering\\u000a this risk is controversial. The efficacy. and safety of simultaneous carotid endarterectomy and coronary artery bypass surgery\\u000a are still debated. Mechanical clot

David J. Bronster

2006-01-01

391

Infectious Complications Associated with Monoclonal Antibodies and Related Small Molecules  

PubMed Central

Summary: Biologics are increasingly becoming part of routine disease management. As more agents are developed, the challenge of keeping track of indications and side effects is growing. While biologics represent a milestone in targeted and specific therapy, they are not without drawbacks, and the judicious use of these “magic bullets” is essential if their full potential is to be realized. Infectious complications in particular are not an uncommon side effect of therapy, whether as a direct consequence of the agent or because of the underlying disease process. With this in mind, we have reviewed and summarized the risks of infection and the infectious disease-related complications for all FDA-approved monoclonal antibodies and some related small molecules, and we discuss the probable mechanisms involved in immunosuppression as well as recommendations for prophylaxis and treatment of specific disease entities. PMID:19366915

Salvana, Edsel Maurice T.; Salata, Robert A.

2009-01-01

392

Major Depression and Complicated Grief  

MedlinePLUS

... and bereavement Next Topic Coping with loss Major depression and complicated grief Depression It’s common for people to have sadness, pain, ... might be getting worse—going into a major depression. About 1 in 5 bereaved people will develop ...

393

The complication of pneumatic retinopexy.  

PubMed Central

There have been 26 published series with a total of 1274 detachments operated with pneumatic retinopexy. Eighty percent were reattached with a single procedure and 98% with reoperations. New breaks occurred in 13% and PVR in 4%. The complications published in 101 papers on pneumatic retinopexy in the last 5 years are analyzed as to frequency, prevention, management, and results. PMID:2095021

Hilton, G F; Tornambe, P E; Brinton, D A; Flood, T P; Green, S; Grizzard, W S; Hammer, M E; Leff, S R; Mascuilli, L; Morgan, C M

1990-01-01

394

Constraints complicate centrifugal compressor depressurization  

SciTech Connect

Blowdown of a centrifugal compressor is complicated by process constraints that might require slowing the depressurization rate and by mechanical constraints for which a faster rate might be preferred. The paper describes design constraints such as gas leaks; thrust-bearing overload; system constraints; flare extinguishing; heat levels; and pressure drop.

Key, B. (Hoover and Keith Inc., Houston, TX (United States)); Colbert, F.L. (Paragon Engineering Services Inc., Houston, TX (United States))

1993-05-10

395

Complicating the Concept of Culture  

ERIC Educational Resources Information Center

This essay argues against a simple, reified view of culture as a set of ideas and norms belonging to a group or nation, and considers the implications of a more complicated concept for discussion of world culture and the global/local nexus. Most anthropologists define culture as the making of meaning, with an emphasis on the process itself as…

Anderson-Levitt, Kathryn M.

2012-01-01

396

Permanent makeup: indications and complications  

Microsoft Academic Search

Cosmetic tattoos, simulating makeup, have become very popular in the last decades; the technique of micropigmentation consists of implantation of pigment into the skin using a tattoo pen. The procedure can also be used to camouflage vitiligo, to mask scars, and as an adjunct to reconstructive surgery. Risks and complications include infections, allergic reactions, scarring, fanning, fading, and dissatisfaction about

Christa De Cuyper

2008-01-01

397

Behavioral Complications of Early Pallidotomy  

Microsoft Academic Search

A review of stereotactic medial pallidotomy of the 1950s in five neurosurgical centers is presented. The surgical technique varied from one center to the other. The results of surgery, however, seemed to be quite equal, being positive in 70–90% of the patients. The surgical mortality ranged from 0 to 13%. Behavioral complications were adequately analyzed and reported from one center

Lauri V. Laitinen

2000-01-01

398

Imaging the Complications of Osteochondromas  

Microsoft Academic Search

Most osteochondromas are asymptomatic and incidental with typical radiographic characteristics. When symptomatic, complications due to space-occupying effects, mechanical deformity, or malignant transformation are usually the underlying causes. This article addresses the imaging strategy for their identification and evaluation. Lee, J. M.et al. (2002). Clinical Radiology57, 18–28.

K. C. Y. Lee; A. M. Davies; V. N. Cassar-Pullicino

2002-01-01

399

Complications of mediastinal neural tumours  

Microsoft Academic Search

Thirty-two mediastinal neural tumours were seen in the East Anglian Regional Thoracic Surgical Unit at Cambridge between October 1952 and July 1970. The descending order of frequency was neurofibroma, ganglioneuroma, neurilemmoma, neurofibrosarcoma, and neuroblastoma. The literature relating to these tumours is reviewed and the pathological and clinical complications encountered in this series and in the literature are described.

Christopher Parish

1971-01-01

400

Aortic complications after bariatric surgery  

Microsoft Academic Search

Obesity and its correlated comorbities are nowadays considered a public health concern. In the last few years a myriad of strategies searched an effective procedure to reduce weight and decreases related comorbities. Among these strategies, the bariatric procedures have been achieved a significantly increase, being able to promote an expressive and lasting weight reduction. Diverse early and late complications are

Diego Felipe GAIA; José Honório PALMA; João Nelson; Rodrigues BRANCO; Enio BUFFOLO

401

Anaesthetic complications in plastic surgery.  

PubMed

Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist's concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients' experience and surgical outcome. PMID:24501480

Nath, Soumya Sankar; Roy, Debashis; Ansari, Farrukh; Pawar, Sundeep T

2013-05-01

402

Manufacturing Complicated Shells And Liners  

NASA Technical Reports Server (NTRS)

Explosive forming, wax filling, and any one of welding, diffusion bonding, or brazing used in method of manufacturing large, complicated shell-and-liner vessels or structures. Method conceived for manufacture of film-cooled rocket nozzles but applicable to joining large coaxial shells and liners in general.

Sobol, Paul J.; Faucher, Joseph E.

1993-01-01

403

Gastrointestinal complications in renal transplantation  

Microsoft Academic Search

One wonders whether the use of cyclosporin, histamine receptor antagonists, low doses of steroids, and early diagnosis and treatment actually modify the incidence, morbidity, and mortality of gastrointestinal (GI) and pancreatic complications in renal transplantation. To find out, we reviewed 614 kidney transplant recipients between January 1984 and December 1988. One hundred patients (16.2%) were found to have GI and\\/or

G. Benoit; M. Moukarzel; G. Verdelli; C. Hiesse; C. Buffet; H. Bensadoun; B. Charpentier; A. Jardin; D. Fries

1993-01-01

404

Risks and complications in rhinoplasty  

PubMed Central

Rhinoplasty is regarded to be associated with many risks as the expectations of patient and physician are not always corresponding. Besides of postoperative deformities many other risks and complications have to be considered. Reduction-rhinoplasty e.g. can cause breathing disturbances which are reported in 70% of all revision-rhinoplasty-patients. One has to be aware however that scars and loss of mucosal-sensation can also give the feeling of a “blocked nose”. The main risks of autogenous transplants are dislocation and resorption, while alloplasts can cause infection and extrusion. In this respect silicone implants can have a complication rate between 5-20%. Less complications are reported with other materials like Gore-Tex. Complications of skin and soft tissues can be atrophy, fibrosis, numbness, cysts originating from displaced mucosa or subcutaneous granulomas caused by ointment material. Postoperative swelling depends mainly on the osteotomy technique. Percutaneous osteotomies cause less trauma, but may result in visible scars. Infections are rare but sometimes life-threatening (toxic-shock-syndrome). The risk is higher, when sinus surgery and rhinoplasty are combined. Osteotomies can also cause injuries of the orbital region. Necrosis of eye-lids by infections and blindness by central artery occlusion are known. There are reports on various other risks like rhinoliquorrhea, brain damage, fistulas between sinus-cavernosus and carotid artery, aneurysms and thrombosis of the cavernous sinus. Discoloration of incisors are possible by damage of vessels and nerves. Rhinoplasty can also become a court-case in dissatisfied patients, a situation that may be called a “typical complication of rhinoplasty”. It can be avoided by proper patient selection and consideration of psychological disturbances. Postoperative deformities are considered as main risks of rhinoplasty, causing revision surgery in 5% to 15% of the cases. The analysis of postoperative deformities allowes the identification of specific risks. The most frequent postoperative deformity is the “pollybeak” when a deep naso-frontal angle, cartilaginous hump and reduced tip projection are present preoperatively. The pollybeak is the indication in about 50% of all revision rhinoplasties. Other frequent postoperative deformities are a pendant and wide nasal tip, retractions of the columella base or irregularities of the nasal dorsum. These deformities are very often combined and caused by a loss of septal support. This is why the stability of the caudal septum in septorhinoplasty is the key for a predictable result. Maintaining the position of the tip and the columella is one of the main issues to avoid typical postoperative deformities. The risks for rhinoplasty-complications can be reduced with increasing experience. A prerequisite is continuing education and an earnest distinction between complication and mistake. PMID:22073084

Rettinger, Gerhard

2008-01-01

405

Lactic acidosis as a complication of ?-adrenergic aerosols.  

PubMed

Lactic acidosis is a marker of tissue hypoperfusion and impairs oxygen delivery. High lactate levels are associated with altered systemic hemodynamics, tissue hypoperfusion, and altered cellular metabolism. Increased lactate levels have also been reported as a complication of ?-adrenergic agents administered during asthma therapy. A 49-year-old woman with a prior diagnosis of asthma presented to the emergency department in respiratory distress. She immediately received, in 2 hours, 4 bronchodilator aerosols (ipratropium bromide 0.5 mg/2 mL and terbutaline 5 mg/2 mL) and methylprednisolone intravenous (120 mg). After these 4 aerosols, she was still dyspneic. First, arterial blood gases (pH 7.38; PCO2, 3.92 kPa; HCO3, 19.2 mmol/L) and arterial lactate (lactate, 7.96 mmol/L) were performed with a second series of 4 aerosols. Second, arterial blood gases (pH 7.29; PCO2, 4.01 kPa; HCO3, 15.4 mmol/L) and arterial lactate (lactate, 10.47 mmol/L) were performed at the end of the second series of aerosols. There was no hypoxemia, no inadequate cardiac output state, no anemia, no sepsis, and no use of biguanides. Previous studies have suggested that administration of ? agonists can lead to lactic acidemia in the absence of hypoxia or shock, but it is the highest level of lactate that we found in the literature. In sepsis and shock, lactic acidosis is used as a marker of disease severity. In this case, it is not necessarily the sign of an immediate gravity. PMID:21802882

Claret, Pierre-Géraud; Bobbia, Xavier; Boutin, Caroline; Rougier, Marion; de la Coussaye, Jean-Emmanuel

2012-09-01

406

Lymphatic complications after vascular interventions  

PubMed Central

Introduction Lymphorrhea due to classical and mini-invasive surgical interventions on femoral and popliteal arteries is a serious hindrance to patient treatment. Depending on the experience of a particular center, the incidence and frequency of this type of complication may constitute a serious clinical problem. While the level of lymphorrhea intensity and its duration result in certain foreseeable consequences, their treatment can be a time-consuming and multistep procedure. Aim To compare different types of vascular interventions with lymphorrhea occurrence. Material and methods The authors conducted a retrospective analysis of lymphatic complications based on the material collected between 2005 and 2012 at the Department of Vascular and Endovascular Surgery of the Military Institute of Medicine in Warsaw and in the Department of Interventional Cardiology and Angiology of the Institute of Cardiology in Anin, Warsaw, in 2009–2012. Results Maintaining due thoroughness when dissecting tissues and treating the cutting line in this area with ligatures and tissue puncture are the most reliable methods of minimizing the risk of lymphatic leakage after surgical procedures performed in a classical way. The lymphatic complication under analysis is far less likely to occur when procedures are performed as planned and an endovascular technique is used – statistical significance p < 0.05. Minimally invasive and fully percutaneous procedures performed via needle puncture, including the use of the fascial closure technique to close the femoral artery, eliminate the likelihood of the occurrence of this vascular complication – statistical significance was found with p value less than 0.05. Conclusions We concluded that in every case by minimizing the vascular approach we protected the patient against lymphatic complications. PMID:25337168

Obara, Andrzej; Maruszynski, Marek; Witkowski, Adam; Dabrowski, Maciej; Chmielak, Zbigniew

2014-01-01

407

Abdominal complications in pediatric bone marrow transplant recipients.  

PubMed

Abdominal problems and catastrophes often complicate the clinical course after bone marrow transplantation (BMT) in children. These complications can be grouped into categories of infection, chemotherapy and radiation toxicity, graft-versus-host disease (GVHD), recurrent or de novo malignancy, and miscellaneous complications and can involve the hepatobiliary system, pancreas, spleen, gastrointestinal tract, and urinary tract. Infection is common after BMT: the causative organism depends on the changing immunologic state of the recipient and even on environmental factors such as recent construction, humidity, and antibiotic use. Chemotherapy and radiation therapy can cause hepatic veno-occlusive disease, pancreatitis, nephritis, and hemorrhagic cystitis. GVHD is a process in which donor lymphoid cells produce damage to recipient target organs, especially skin, liver, and intestinal mucosa. Recurrent or de novo disease or malignancies, particularly B-cell lymphomas, may develop in chronically immunocompromised children. Other problems include stone disease, splenic and renal infarction, and complications of hyperalimentation therapy. Abdominal imaging, including plain radiography, contrast material-enhanced studies of the bowel, real-time and duplex sonography, and computed tomography, is essential in diagnosing these problems and evaluating response to therapy. PMID:8210593

Day, D L; Carpenter, B L

1993-09-01

408

Mining Diabetes Complication and Treatment Patterns for Clinical Decision Support  

E-print Network

Mining Diabetes Complication and Treatment Patterns for Clinical Decision Support Lu Liu , Jie Tang to utilize the heterogeneous medical records to aid the clinical treatments of diabetes mellitus. Diabetes mellitus, simply diabetes, is a group of metabolic diseases, which is often accompa- nied with many

409

Review of Readmissions Due to Complications from Uterine Fibroid Embolization  

Microsoft Academic Search

AIM: To determine the frequency, nature and outcome of complications resulting in readmission to hospital following uterine artery embolization (UAE). MATERIAL AND METHODS: A retrospective review of the medical notes and available imaging of 42 consecutive patients who had undergone elective uterine artery embolization for the treatment of fibroid disease was performed. RESULTS: The mean age of the patients was

H Mehta; C Sandhu; M Matson; A.-M Belli

2002-01-01

410

Septic Mesenteric Venous Thrombophlebitis: A Rare Complication of Acute Appendicitis  

PubMed Central

Mesenteric venous thrombophlebitis represents a very rare complication of acute appendicitis. Based on the findings of a 45-year-old patient with mesenteric venous thrombophlebitis due to acute appendicitis, we herein describe the diagnostic difficulties and therapeutic options in this uncommon disease. The treatment in our case consisted of simple appendectomy and perioperative anticoagulation therapy. PMID:22162705

Kykalos, Stylianos; Sotiropoulos, Georgios C.; Vernadakis, Spiridon

2011-01-01

411

Laparoscopic reoperations after failed and complicated antireflux operations  

Microsoft Academic Search

Nineteen patients underwent laparoscopic reoperations for failed or complicated antireflux operations from a total of 248 patients with gastroesophageal reflux disease who had been operated on by this approach. Sixteen had been submitted to open surgery and three to laparoscopic surgery over a period ranging from 5 days to 31 years before the study. Three patients had been submitted to

A. L. DePaula; K. Hashiba; M. Bafutto; C. A. Machado

1995-01-01

412

Calciphylaxis as a Catastrophic Complication in a Patient with POEMS Syndrome  

PubMed Central

Calciphylaxis is a vascular calcification-cutaneous necrosis syndrome, usually seen in patients with end-stage renal disease and secondary hyperparathyroidism. We report a 57-year-old polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome patient complicated with extensive skin ulcers due to calciphylaxis. He first noted a painful cutaneous ulcer on his left thigh, and then skin lesions rapidly worsened, resulting in multiple intractable ulcers with gangrene on his legs and trunk in a few months. Serum vascular endothelial growth factor (VEGF) was markedly elevated. Biopsy samples from his skin ulcers showed the deposition of calcium in the medial layer of cutaneous vessels, this finding being compatible with calciphylaxis. This is the second reported case with POEMS syndrome complicated with calciphylaxis. Both patients had no evidence of renal failure, hyperparathyroidism, or clotting disorders. The pathogenic link between POEMS syndrome and calciphylaxis is still unclear, but VEGF is known to regulate vascular calcification, in cooperation with bone morphogenetic proteins. Further, corticosteroid and several proinflammatory cytokines activate nuclear factor-?B pathway, known as the final common pathway leading to vascular calcification. Taken together, we consider that POEMS syndrome can be an independent risk condition for calciphylaxis. PMID:20847836

Hineno, Akiyo; Kinoshita, Tomomi; Kinoshita, Michiaki; Arakura, Fuyuko; Naito, Ko-suke; Shimojima, Yasuhiro; Matsuda, Masayuki; Yoshida, Kunihiro; Ikeda, Shu-ichi

2009-01-01

413

Complications associated with laparoscopic sleeve gastrectomy for morbid obesity: a surgeon's guide.  

PubMed

Obesity is a common disease affecting adults and children. The incidence of obesity in Canada is increasing. Laparoscopic sleeve gastrectomy (LSG) is a relatively new and effective procedure for weight loss. Owing to an increase in the number of bariatric surgical procedures, general surgeons should have an understanding of the complications associated with LSG and an approach for dealing with them. Early postoperative complications following LSG that need to be identified urgently include bleeding, staple line leak and development of an abscess. Delayed complications include strictures, nutritional deficiencies and gastresophageal reflux disease. We discuss the principles involved in the management of each complication. PMID:24067520

Sarkhosh, Kourosh; Birch, Daniel W; Sharma, Arya; Karmali, Shahzeer

2013-10-01

414

Complications associated with laparoscopic sleeve gastrectomy for morbid obesity: a surgeon's guide  

PubMed Central

Obesity is a common disease affecting adults and children. The incidence of obesity in Canada is increasing. Laparoscopic sleeve gastrectomy (LSG) is a relatively new and effective procedure for weight loss. Owing to an increase in the number of bariatric surgical procedures, general surgeons should have an understanding of the complications associated with LSG and an approach for dealing with them. Early postoperative complications following LSG that need to be identified urgently include bleeding, staple line leak and development of an abscess. Delayed complications include strictures, nutritional deficiencies and gastresophageal reflux disease. We discuss the principles involved in the management of each complication. PMID:24067520

Sarkhosh, Kourosh; Birch, Daniel W.; Sharma, Arya; Karmali, Shahzeer

2013-01-01

415

Colostomy closure: how to avoid complications  

PubMed Central

Purpose Colostomy is an operation frequently performed in pediatric surgery. Despite its benefits, it can produce significant morbidity. In a previous publication we presented our experience with the errors and complications that occurred during cases of colostomy creation. We now have focused in the morbidity related to the colostomy closure. The technical details that might have contributed to the minimal morbidity we experienced are described. Methods The medical records of 649 patients who underwent colostomy closure over a 28-year period were retrospectively reviewed looking for complications following these procedures. Our perioperative protocol for colostomy closure consisted in: clear fluids by mouth and repeated proximal stoma irrigations 24 h prior to the operation. Administration of IV antibiotics during anesthesia induction and continued for 48 h. Meticulous surgical technique that included: packing of the proximal stoma, plastic drape to immobilize the surgical field, careful hemostasis, emphasis in avoiding contamination, cleaning the edge of the stomas to allow a good 2-layer, end-to-end anastomosis with separated long-term absorbable sutures, generous irrigation of the peritoneal cavity and subsequent layers with saline solution, closure by layers to avoid dead space, and avoidance of hematomas. No drains and no nasogastric tubes were used. Oral fluids were started the day after surgery and patients were discharged 48–72 h after the operation. Results The original diagnoses of the patients were: anorectal malformation (583), Hirschsprung’s disease (53), and others (13). 10 patients (1.5%) had complications: 6 had intestinal obstruction (5 due to small bowel adhesions, 1 had temporary delay of the function of the anastomosis due to a severe size discrepancy between proximal and distal stoma with a distal microcolon) and 4 incisional hernias. There were no anastomotic dehiscences or wound infection. There was no bleeding, no anastomotic stricture and no mortality. Conclusion Based on this experience we believe that colostomy closure can be performed with minimal morbidity provided a meticulous technique is observed. PMID:20714731

Levitt, Marc A.; Lawal, Taiwo A.; Pena, Alberto

2010-01-01

416

Azathiopine-steroid combination therapy for pulmonary arterial aneurysms in Behçet's disease.  

PubMed

Vasculitis is the primary pathological feature of Behçet's disease and in which pulmonary arterial aneurysm formations are rare but serious complications representing poor prognosis. There is no agreement on how to treat major venous and arterial disease. The use of steroids alone or corticosteroid treatment supplemented with cyclophosphamide or azathioprine is still controversial. We present three young male patients with Behçet's disease with aneurysms in the pulmonary arteries. In two of them, cyclophosphamide was the first choice of treatment, but this was ceased due to side effects. All three patients were then treated with azathioprine (2 mg/kg per day) and methylprednisolone (1.5 mg/kg per day). All three showed clinical improvement. Regression was observed radiologically in two (one minimal and the other complete). No complication related to therapy was encountered. Steroid therapy supplemented with azathioprine may be a good choice for treatment of pulmonary arterial aneurysms in Behçet's disease. PMID:11411965

Acican, T; Gürkan, O U

2001-05-01

417

Prevention of the Musculoskeletal Complications of Hemophilia  

PubMed Central

Hemophilia is an inherited disorder of clotting factor deficiencies resulting in musculoskeletal bleeding, including hemarthroses, leading to musculoskeletal complications. The articular problems of hemophiliac patients begin in infancy. These include: recurrent hemarthroses, chronic synovitis, flexion deformities, hypertrophy of the growth epiphyses, damage to the articular cartilage, and hemophilic arthropathy. The most commonly affected joints are the ankle, the knee, and the elbow. Hematologic prophylactic treatment from ages 2 to 18 years could avoid the development of hemophilic arthropathy if the concentration of the patient's deficient factor is prevented from falling below 1% of normal. Hemarthroses can be prevented by the administration of clotting factor concentrates (prophylaxis). However, high costs and the need for venous access devices in younger children continue to complicate recommendations for universal prophylaxis. Prevention of joint arthropathy needs to focus on prevention of hemarthroses through prophylaxis, identifying early joint disease through the optimal use of cost-effective imaging modalities and the validation of serological markers of joint arthropathy. Screening for effects on bone health and optimal management of pain to improve quality of life are, likewise, important issues. Major hemarthrosis and chronic hemophilic synovitis should be treated aggressively to prevent hemophilic arthropathy. PMID:22778972

Rodriguez-Merchan, E. C.

2012-01-01

418

Retinal complications after bungee jumping.  

PubMed

Bungee jumping is becoming a popular sport in the Western world with some cases of ophthalmic complications being reported in recent literature. The authors reported a case of a 23-year-old healthy female who presented retinal complications following a bungee jumping. Her fundi showed superficial retinal hemorrhages in the right eye and a sub-internal limiting membrane hemorrhage affecting the left eye. A general examination, including a full neurological examination, was normal and laboratorial investigations were all within normal values. More studies are necessary to identify risk factors and the true incidence of related ocular lesions, but until then, we think this sport activity should be desencouraged, especially to those that are not psychological and physically fit. PMID:7642337

Filipe, J A; Pinto, A M; Rosas, V; Castro-Correia, J

419

Suicide bereavement and complicated grief  

PubMed Central

Losing a loved to suicide is one is one of life's most painful experiences. The feelings of loss, sadness, and loneliness experienced after any death of a loved one are often magnified in suicide survivors by feelings of quilt, confusion, rejection, shame, anger, and the effects of stigma and trauma. Furthermore, survivors of suicide loss are at higher risk of developing major depression, post-traumatic stress disorder, and suicidal behaviors, as well as a prolonged form of grief called complicated grief. Added to the burden is the substantial stigma, which can keep survivors away from much needed support and healing resources. Thus, survivors may require unique supportive measures and targeted treatment to cope with their loss. After a brief description of the epidemiology and circumstances of suicide, we review the current state of research on suicide bereavement, complicated grief in suicide survivors, and grief treatment for survivors of suicide. PMID:22754290

Tal Young, Ilanit; Iglewicz, Alana; Glorioso, Danielle; Lanouette, Nicole; Seay, Kathryn; Ilapakurti, Manjusha; Zisook, Sidney

2012-01-01

420

Imaging of hidradenitis suppurativa and its complications.  

PubMed

We present a 56-year-old man with known diabetes mellitus and a 10-year history of hidradenitis suppurativa (HS) and highlight, through MR imaging findings, the relentless natural progression of the disease, characterized by recurrent exacerbations of abscesses and fistulae and complications of perianal fistulae and sacral osteomyelitis. We also demonstrate the appearance of this condition on PET-CT with F-18 FDG, which was performed for staging after postexcision tissue specimen revealed well-differentiated squamous cell carcinoma. The association of arthritis and possible dactylitis was also manifested in our patient. Discussion of HS in the radiology literature is limited and, to our knowledge, there has been no case report describing these imaging findings in the same patient. PMID:25221681

Poh, Feng; Wong, Siew Kune

2014-01-01

421

Imaging of Hidradenitis Suppurativa and Its Complications  

PubMed Central

We present a 56-year-old man with known diabetes mellitus and a 10-year history of hidradenitis suppurativa (HS) and highlight, through MR imaging findings, the relentless natural progression of the disease, characterized by recurrent exacerbations of abscesses and fistulae and complications of perianal fistulae and sacral osteomyelitis. We also demonstrate the appearance of this condition on PET-CT with F-18 FDG, which was performed for staging after postexcision tissue specimen revealed well-differentiated squamous cell carcinoma. The association of arthritis and possible dactylitis was also manifested in our patient. Discussion of HS in the radiology literature is limited and, to our knowledge, there has been no case report describing these imaging findings in the same patient.

2014-01-01

422

Cavitary alveolar sarcoidosis complicated by an aspergilloma.  

PubMed

Cavitation in pulmonary sarcoidosis is rather unusual and even rarer in the alveolar form of the disease. A review of the literature revealed only 13 documented patients with cavitating alveolar sarcoidosis. Of the 13 patients, clinical information was available in only eight cases. Aspergilloma complicating cavitary alveolar sarcoidosis has been documented only once before. A 38-year-old woman with progressive dyspnoea for 3?years presented owing to a bout of haemoptysis. Imaging prior to presentation demonstrated mediastinal lymphadenopathy and coalescent parenchymal alveolar opacities along with air bronchograms, suggestive of alveolar sarcoidosis. On presentation, cavitations were visible in both lungs within the consolidation along with an intracavitary mass in the left upper lobe, which on evaluation was recognised as an aspergilloma. Bronchoscopy disclosed non-caseating granulomas on histopathology confirming pulmonary sarcoidosis. Cavitary alveolar sarcoidosis with aspergilloma formation can result in a diagnostic dilemma, especially in endemic tuberculous areas. PMID:25326564

Gera, Kamal; Panjabi, Chandramani; Dash, Devijyoti; Shah, Ashok

2014-01-01

423

Steroids: Pharmacology, Complications, and Practice Delivery Issues  

PubMed Central

Background Since their identification nearly 80 years ago, steroids have played a prominent role in the treatment of many disease states. Many of the clinical roles of steroids are related to their potent antiinflammatory and immune-modulating properties. Methods This review summarizes the basic pharmacology, complications, and practice delivery issues regarding steroids. Results Clinically relevant side effects of steroids are common and problematic. Side effects can occur at a wide range of doses and vary depending on the route of administration. The full spectrum of side effects can be present even in patients taking low doses. Conclusions Practitioners must be aware that these drugs might exacerbate a preexisting condition or present a new medical condition. Knowledge of the clinical implications of prescribing these agents is critical. PMID:24940130

Ericson-Neilsen, William; Kaye, Alan David

2014-01-01

424

Does antiviral therapy reduce complications of cirrhosis?  

PubMed Central

Chronic hepatitis B infection is associated with the development of cirrhosis, hepatocellular carcinoma, and finally liver-related mortality. Each year, approximately, 2%-5% of patients with hepatitis B virus (HBV)-related compensated cirrhosis develop decompensation, with additional clinical manifestations, such as ascites, jaundice, hepatic encephalopathy, and gastrointestinal bleeding. The outcome of decompensated HBV-related cirrhosis is poor, with a 5-year survival of 14%-35% compared to 84% in patients with compensated cirrhosis. Because the risk of disease progression is closely linked to a patient’s serum HBV DNA level, antiviral therapy may suppress viral replication, stabilize liver function and improve survival. This article briefly reviews the role that antiviral therapy plays in cirrhosis complications, particularly, in decompensation and acute-on-chronic liver failure. PMID:24966601

Chung, Goh Eun; Lee, Jeong-Hoon; Kim, Yoon Jun

2014-01-01

425

Recognizing asthma mimics and asthma complications.  

PubMed

Asthma is a chronic inflammatory disorder of the airways characterized by airflow obstruction, bronchial hyperreactivity, and underlying inflammation. Two common reasons asthmatics fail standard therapy are incorrect diagnosis and failure to recognize underlying contributing factors. A correct diagnosis of asthma is of great importance to military practitioners since misdiagnosis or uncontrolled asthma affects an individual's operational readiness or determines whether one can receive a medical waiver to enlist in military service. This article presents four cases of patients with dyspnea that have conditions which mimic asthma or complicate asthma management: vocal cord dysfunction misdiagnosed as asthma, respiratory bronchiolitis interstitial lung disease mistaken as asthma, difficult-to-control asthma because of bronchiectasis and allergic bronchopulmonary aspergillosis, and difficult and fatal asthma. Asthma is contrasted to other respiratory disorders, and an outlined approach to asthma diagnosis and management is presented using the Global Initiative for Asthma guidelines. PMID:22128653

Amundson, Dennis; Seda, Gilbert; Daheshia, Massoud

2011-10-01

426

Neurologic Complications of Lung Cancer  

Microsoft Academic Search

Lung cancer frequently causes neurological complications from direct and indirect effects. Brain metastases occur in 41% of\\u000a patients with non-small cell lung cancer and 35% with small cell lung cancer at autopsy. Presenting symptoms can be quite\\u000a protean. MRI continues to be the gold standard of detecting metastases. Biopsy or resection should be considered for patients\\u000a with a single lesion,

Suriya A. Jeyapalan; Anand Mahadevan

427

Complications following Acute Ischemic Stroke  

Microsoft Academic Search

The objective of this study was to assess typical early-onset complications following ischemic stroke in a large, hospital-based cohort to provide clinical data for future randomized trials and quality standards in clinical routine. 3,866 patients with acute ischemic stroke were prospectively documented in 14 Neurology Departments with an acute stroke unit. Within the first week after admission, increased intracranial pressure

Christian Weimar; Michael P. Roth; Gesine Zillessen; Jörg Glahn; Martin L. J. Wimmer; Otto Busse; Roman L. Haberl; Hans-Christoph Diener

2002-01-01

428

[Respiratory complications in compressive goiters].  

PubMed

Authors' experience in respiratory complications of compressive goiter is reviewed. Three cases with typical symptoms, relative therapy and outcome are reported. Appearance of respiratory distress should urge to avoid delay in elective surgery performing. In case of acute respiratory failure, immediate emergency tracheostomy is mandatory, subsequently followed by elective intervention. In case of malignancy, if radical surgery is not possible, tracheostomy is the short and medium-term palliative surgical treatment of choice. PMID:1751337

De Toma, G; Sgarzini, G; Gabriele, R; Campli, M; Adami, E A; De Cesare, E

1991-01-01

429

Genetic hypofibrinolysis in complicated pregnancies  

Microsoft Academic Search

Objective: To assess the hypofibrinolytic 4G\\/4G mutation of the plasminogen activator inhibitor (PAI-1) gene as a possible factor contributing to severe preeclampsia, abruptio placentae, fetal growth restriction, and stillbirth.Methods: We compared 94 women from a previous report who had obstetric complications to 95 controls with normal pregnancies matched for ethnic background and age. We collected blood and extracted DNA after

Charles J Glueck; Michael J Kupferminc; Robert N Fontaine; Ping Wang; Babette B Weksler; Amiram Eldor

2001-01-01

430

Bacterial endocarditis complicating body art.  

PubMed

Increasing numbers of patients are living with congenital heart disease at a time when body art is growing in popularity. We present a case of subacute bacterial endocarditis following repeated tattooing in a patient with known valvular heart disease. This case highlights the importance of education of patients with structural heart disease to the potential risks of such procedures, particularly at a time when endocarditis prophylaxis protocols are being revised. PMID:18180055

Tse, Donald; Khan, Sadia; Clarke, Sarah

2009-03-20

431

Role of endoscopic retrograde cholangiopancreatography in the management of hepatic hydatid disease  

PubMed Central

Most cases of hepatic hydatid disease exhibit uncomplicated clinical course and management. However, the diagnosis and management of complicated hepatic hydatid disease is a special issue. One of the most common and serious complications of hepatic hydatid disease is the rupture of the cyst into intrahepatic bile ducts. The clinical appearance of intrabiliary rupture can range from asymptomatic to jaundice, cholecystitis, cholangitis, liver abscess, pancreatitis and septicemia. Current treatments for major ruptures can result in high morbidity and mortality rates. Furthermore, ruptures that cannot be diagnosed preoperatively can induce complications such as biliary fistulae, biloma, cavitary infection and obstructive jaundice. In the past, these complications were diagnosed and treated by surgical methods. Currently, complications in both the pre- and postoperative periods are diagnosed and treated by non-invasive or minimally invasive methods. In clinical practice, endoscopic retrograde cholangiopancreatography (ERCP) is indicated for patients with preoperative frank intrabiliary rupture in which hydatid elements are clearly seen in the bile ducts, or for biliary adverse events after surgery, including persistent biliary fistulae and jaundice. However, controversy concerning routine preoperative ERCP and prophylactic endoscopic sphincterotomy in patients suspected of having minor cystobiliary communications still remains. In this article, the role of ERCP in the diagnosis and management of hepatic hydatid disease during the pre- and postoperative periods is reviewed. PMID:25386073

Dolay, Kemal; Akbulut, Sami

2014-01-01

432

Management of complicated duodenal diverticula.  

PubMed

The duodenum is the second most common location of intestinal diverticula after the colon. Duodenal diverticulum (DD) is usually located in the second portion of the duodenum (D2), close to the papilla. Most duodenal diverticula are extraluminal and acquired rather than congenital; more rare is the congenital, intraluminal diverticulum. DD is usually asymptomatic and discovered incidentally, but can become symptomatic in 1% to 5% of cases when complicated by gastroduodenal, biliary and/or pancreatic obstruction, by perforation or by hemorrhage. Endoscopic treatment is the most common first-line treatment for biliopancreatic complications caused by juxtapapillary diverticula and also for bleeding. Conservative treatment of perforated DD based on fasting and broad-spectrum antibiotics may be offered in some selected cases when diagnosis is made early in stable patients, or in elderly patients with comorbidities who are poor operative candidates. Surgical treatment is currently reserved for failure of endoscopic or conservative treatment. The main postoperative complication of diverticulectomy is duodenal leak or fistula, which carries up to a 30% mortality rate. PMID:23810155

Oukachbi, N; Brouzes, S

2013-06-01

433

Complications of acute otitis media in children  

Microsoft Academic Search

The clinical picture and the treatment of acute otitis media (AOM) and its complications have changed during the past decades.\\u000a The availability of antibiotics has decreased the incidence of complications of AOM significantly. The treatment of complications\\u000a of AOM is conservative in most cases. Mastoidectomy is needed when abscess-forming mastoiditis or intracranial complications\\u000a develop. Although intratemporal and intracranial complications of

Kimmo Leskinen

2005-01-01

434

27 CFR 24.301 - Bulk still wine record.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Bulk still wine record. 24.301 Section 24.301 Alcohol...BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Records and Reports § 24.301 Bulk still wine record. A proprietor who produces or...

2010-04-01

435

[Young people still have a classic perception of old age].  

PubMed

Young people still have a classic perception of old age. Wisdom and experience, dependency and bereavement undoubtedly characterise old age. A survey of student nurses in Grenoble, confirms this view. It also highlights the fact that our representations are determined as much by advertising as by famous people who, despite being old, are still perceived as seductive and charming. PMID:24600951

Sifaoui, Brigitte

2014-01-01

436

Teaching Guide for Still Photographic Technician Aide Occupations.  

ERIC Educational Resources Information Center

This teaching guide for still photographic technician aide is one of a series of five performance-based secondary level guides for vocational education. Part 1 provides tools, resources, and a process to be used at the local level to develop a still photographic technician aide training curriculum. It includes a comprehensive overview of the…

Kempton, Robert F.