These are representative sample records from Science.gov related to your search topic.
For comprehensive and current results, perform a real-time search at Science.gov.
1

A Case of Adult-Onset Still's Disease Complicated with Diffuse Alveolar Hemorrhage  

PubMed Central

Adult-onset Still's disease (AOSD) is an inflammatory disease that presents with a variety of clinical symptoms. Pulmonary involvement is well-known in AOSD and is seen in up to 53% of AOSD cases, with the most common pulmonary diseases being pleural effusion and transient pulmonary infiltrates. We present the first case of chronic AOSD complicated with diffuse alveolar hemorrhage during the acute flare of the disease. PMID:19270830

Sari, Ismail; Birlik, Merih; Binicier, Omer; Akar, Servet; Yilmaz, Erkan; Onen, Fatos

2009-01-01

2

Aseptic meningitis in adult onset Still’s disease  

Microsoft Academic Search

Adult onset Still’s disease (AOSD) is a systemic inflammatory disease characterized by high-fevers, articular involvement,\\u000a maculopapular rash, hepatosplenomegaly, lymphadenopathy, and a neutrophilic leukocytosis. Though systemic complications of\\u000a AOSD or its treatment are well described in the literature, CNS involvement in AOSD is exceedingly rare and can have protean\\u000a manifestations. We present a patient with AOSD who developed chronic meningitis and

Bharath Manu Akkara Veetil; Alan H. Yee; Kenneth J. Warrington; Allen J. Aksamit; Thomas G. Mason

3

Neurological Complications of Lyme Disease  

MedlinePLUS

NINDS Neurological Complications of Lyme Disease Information Page Synonym(s): Lyme Disease - Neurological Complications Table of Contents (click to jump to sections) What are Neurological Complications of ...

4

[Complications of celiac disease].  

PubMed

Numerous complications can occur in celiac disease, nutritional (growth failure in children, malnutrition, vitamin deficiencies), hematologic (anaemia), bone disease (osteoporosis, fracture), gynaecologic (hypo fertility), cardiovascular (coronaropathy, venous thrombosis), neurological (peripheral neuropathy), hepatic (cytolysis, cirrhosis). Celiac disease is associated with an increased risk of autoimmune diseases (type 1 diabetes, thyroiditis), and cancer (upper digestive tract, hepatocellular carcinoma, lymphoma). The main digestive complications are microscopic colitis and refractory sprue, which are resistant to gluten-free diet. It can be associated with a monoclonal proliferation of intraepithelial lymphocytes (type 2 refractory sprue), which may be considered as a cryptic lymphoma and can lead to invasive T lymphoma, which occurs in one celiac patient in 1000. Gluten-free diet protects from the occurrence of most complications and correct the over-mortality related to these complications. PMID:21621350

Cosnes, J; Nion-Larmurier, I

2013-04-01

5

Pelvic Inflammatory Disease: Complications  

MedlinePLUS

... JavaScript on. Read more information on enabling JavaScript. Pelvic Inflammatory Disease Skip Content Marketing Share this: Main Content Area ... and appropriate treatment can help prevent complications of PID. Without treatment, PID can cause permanent damage to ...

6

Nonmotor complications in Parkinson's disease  

Microsoft Academic Search

Parkinson's disease (PD) is most often considered a disorder of movement. Whereas bradykinesia, rigidity, tremor, and postural instability result in disability, nonmotor complications in PD may be of equal or greater significance in some patients. This review will discuss many of the nonmotor complications in PD, Although the majority of problems for Parkinson's disease patients are thought to be motor

Charles H. Adler

2005-01-01

7

Hemophagocytic syndrome secondary to adult-onset still’s disease but very similar to lymphoma  

PubMed Central

Hemophagocytic syndrome (HPS) is a clinicopathologic entity characterized by increased proliferation and activation of benign macrophages with hemophagocytosis throughout the reticuloendothelial system. HPS may be primary, or secondary to malignancy, infections, auto-immune diseases and pharmacotherapy. In patients with adult-onset Still’s disease (AOSD), HPS is a rare but life-threatening complication. Herein, we described a female patient with HPS secondary to AOSD. During the therapy, giant gastric ulcer similar to lymphoma developed after treatment with corticosteroid and nonsteroidal anti-inflammatory drugs. PMID:22670185

Zhang, Xin-Hua; Han, Yong-Mei; Wang, Wen-Wen; Cheng, Hao; Zhu, Ke-Jian

2012-01-01

8

Peyronie's Disease: Still a Surgical Disease.  

PubMed

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

9

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

10

Treatment of adult-onset Still’s disease: a review  

PubMed Central

Adult-onset Still’s disease (AOSD) is a rare inflammatory disorder that has been recently classified as a polygenic autoinflammatory disorder. The former classification, based on the disease course, seems to be quite dated. Indeed, there is accumulating evidence that AOSD can be divided into two distinct phenotypes based on cytokine profile, clinical presentation, and outcome, ie, a “systemic” pattern and an “articular” pattern. The first part of this review deals with the treatments that are currently available for AOSD. We then present the different strategies based on the characteristics of the disease according to clinical presentation. To do so, we focus on the two subsets of the disease. Finally, we discuss the management of life-threatening complications of AOSD, along with the therapeutic options during pregnancy. PMID:25653531

Jamilloux, Yvan; Gerfaud-Valentin, Mathieu; Henry, Thomas; Sève, Pascal

2015-01-01

11

Complications of diverticular disease: surgical laparoscopic treatment  

PubMed Central

Surgical treatment of complicated colonic diverticular disease is still debatable. The aim of our study was to evaluate the outcome of laparoscopic colon resection in patients with diverticulitis and with complications like colon-vescical fistula, peridiverticular abscess, perforation or stricture. All patients underwent laparoscopic colectomy within 8 years period. Main data recorded were age, sex, return of bowel function, operation time, duration of hospital stay, ASA score, body mass index (BMI), early and late complications. During the study period, 33 colon resections were performed for diverticulitis and complications of diverticulitis. We performed 5 associated procedures. We had 2 postoperative complications; 1 of these required a redo operation with laparotomy for anastomotic leak and 3 patients required conversion from laparoscopic to open colectomy. The most common reasons for conversion were related to the inflammatory process with a severe adhesion syndrome. Mean operative time was 229 minutes, and average postoperative hospital stay was 9,8 days. Laparoscopic surgery for complications of diverticular disease is safe, effective and feasible. Laparoscopic colectomy has replaced open resection as standard surgery for recurrent and complicated diverticulitis in our institution. PMID:24979103

ANANIA, G.; VEDANA, L.; SANTINI, M.; SCAGLIARINI, L.; GIACCARI, S.; RESTA, G.; CAVALLESCO, G.

2014-01-01

12

Encephalic large arteries narrowness and peripheral neuropathy in a patient with adult-onset Still’s disease  

Microsoft Academic Search

Adult-onset Still’s disease (AOSD) is a rare, systemic inflammatory disorder, characterized by spiking high fever, fever-associated\\u000a evanescent rash, arthritis, myalgia, serositis and hepatosplenomegaly. White blood cell count, neutrophilic cell count, and\\u000a serum ferritin level are markedly elevated in the active stage of the disease. Neurological complications of AOSD commonly\\u000a were cranial nerve palsies, seizures, aseptic meningoencephalitis, peripheral neuropathy and Miller–Fisher

Hong Zhao; Yun Yuan; Yue Li; Chong-Wen Si; Geng-Shan Tian; Gui-Qiang Wang; Xue-Dong Yang

2008-01-01

13

[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

14

Pulmonary Vascular Complications of Liver Disease  

PubMed Central

Hepatopulmonary syndrome and portopulmonary hypertension are two pulmonary vascular complications of liver disease. The pathophysiology underlying each disorder is distinct, but patients with either condition may be limited by dyspnea. A careful evaluation of concomitant symptoms, the physical examination, pulmonary function testing and arterial blood gas analysis, and echocardiographic, imaging, and hemodynamic studies is crucial to establishing (and distinguishing) these diagnoses. Our understanding of the pathobiology, natural history, and treatment of these disorders has advanced considerably over the past decade; however, the presence of either still increases the risk of morbidity and mortality in patients with underlying liver disease. There is no effective medical treatment for hepatopulmonary syndrome. Although liver transplantation can resolve hepatopulmonary syndrome, there appears to be worse survival even with transplantation. Liver transplantation poses a very high risk of death in those with significant portopulmonary hypertension, where targeted medical therapies may improve functional status and allow successful transplantation in a small number of select patients. PMID:23155142

Fritz, Jason S.; Fallon, Michael B.

2013-01-01

15

Adult Celiac Disease and Its Malignant Complications  

PubMed Central

Adult celiac disease is a chronic intestinal disorder that has been estimated to affect up to 1-2% of the population in some nations. Awareness of the disease has increased, but still it remains markedly underdiagnosed. Celiac disease is a pathologically defined condition with several characteristic clinical scenarios that should lead the clinician to suspect its presence. Critical to diagnosis is a documented responsiveness to a gluten-free diet. After diagnosis and treatment, symptoms and biopsy-proven changes may recur and appear refractory to a gluten-free diet. Recurrent symptoms are most often due to poor diet compliance, a ubiquitous and unrecognized gluten source, an initially incorrect diagnosis, or an associated disease or complication of celiac disease. Some patients with persistent symptoms and biopsy-proven changes may not have celiac disease at all, instead suffering from a sprue-like intestinal disease, so-called unclassified sprue, which is a specific entity that does not appear to respond to a gluten-free diet. Some of these patients eventually prove to have an underlying malignant cause, particularly lymphoma. The risk of developing lymphoma and other malignancies is increased in celiac disease, especially if initially diagnosed in the elderly, or late in the clinical course of the disease. However, recent studies suggest that the risk of gastric and colon cancer is low. This has led to the hypothesis that untreated celiac disease may be protective, possibly due to impaired absorption and more rapid excretion of fat or fat-soluble agents, including hydrocarbons and other putative cocarcinogens, which are implicated in the pathogenesis of colorectal cancer. PMID:20431755

2009-01-01

16

Pleural complications of hydatid disease  

Microsoft Academic Search

Objective: The aim of this retrospective study was to review pleural and pericardial complications of patients with hydatid cysts and to analyze the management of therapy for these patients. Methods: Between 1991 and 2001, 43 (29.7%) of 145 patients presented with pleural and pericardial complications. These patients had spontaneous pneumothorax (6.2%), empyema (7.6%), pleural thickening (10.3%), hepatopleural fistula (2.8%), pericarditis

Olgun Kadir Aribas; Fikret Kanat; Niyazi Gormus; Emel Turk

2002-01-01

17

Iron hypothesis of cardiovascular disease: still controversial.  

PubMed

Iron hypothesis has been a controversial subject for over 30 years as many studies support its role as a risk factor for cardiovascular disease, while other studies found no evidence to support it. The conflicting results are accounted for by the non-homogeneity of trial design in terms of population inclusion criteria and different endpoints, non-uniform use of parameters for assessing iron role, and incomplete understanding of the mechanisms of action. The nature of iron is dual, being of crucial importance for the human body, but also toxic as "free iron" induces oxidative stress. Under physiological conditions, there are efficient and complex mechanisms against iron-induced oxidative stress, which could be reproduced for creating new, intelligent antioxidants. Iron depletion improves the cardiovascular prognosis only if serum concentration is at the lowest limit of normal ranges. However, low iron levels and the type of dietary iron intake correlate with atherosclerotic cardiovascular disease, influence the ischemic endpoints in the elderly, and exert negative impact on heart failure prognosis. So far, the causal relation and involved mechanisms are not fully elucidated. Iron overload is a difficult and frequent condition, involving the cardiovascular system by specific pathogenic pathways, therefore determining a particular form of restrictive cardiomyopathy and vaso-occlusive arterial damage. PMID:25581946

Aursulesei, Viviana; Cozma, A; Krasniqi, A

2014-01-01

18

Complications of chronic liver disease.  

PubMed

Children with chronic liver disease (CLD) need a head to toe approach and an early suspicion of multi organ involvement. Nutritional assessment and management is the cornerstone of management. Consider immune dysfunction in everyday treatment decisions. Consider early heart-lung-brain involvement in transplant evaluation. PMID:22521556

Tsouka, Alexandra; McLin, Valérie A

2012-06-01

19

Late complications of Hodgkin's disease management  

SciTech Connect

In the past several decades, Hodgkin's disease has been transformed from a uniformly fatal illness to one that can be treated with the expectation of long-term remission or cure in the majority of patients. Because patients now survive for long periods after curative intervention, various complications have been identified. The spectrum of complications following curative therapy is quite diverse and includes immunologic, cardiovascular, pulmonary, thyroid, and gonadal dysfunction. In addition, second malignant neoplasms in the form of acute leukemia as well as secondary solid tumors have now been documented to occur with increased frequency in patients cured of Hodgkin's disease. 80 references.

Young, R.C.; Bookman, M.A.; Longo, D.L. (Fox Chase Cancer Center, Philadelphia, PA (USA))

1990-01-01

20

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

21

Pathogenesis of diabetic cerebral vascular disease complication.  

PubMed

Diabetes mellitus is one of the most potent independent risk factors for the development of diabetic cerebral vascular disease (CVD). Many evidences suggested that hyperglycemia caused excess free fatty acids, the loss of endothelium-derived nitric oxide, insulin resistance, the prothrombotic state, endothelial dysfunction, the abnormal release of endothelial vasoactivators, vascular smooth muscle dysfunction, oxidative stress, and the downregulation of miRs participated in vessel generation and recovery as well as the balance of endotheliocytes. In turn, these abnormalities, mainly via phosphatidylinositol 3 kinase, mitogen-activated protein kinase, polyol, hexosamine, protein kinase C activation, and increased generation of advanced glycosylation end products pathway, play an important role in inducing diabetic CVD complication. A deeper comprehension of pathogenesis producing diabetic CVD could offer base for developing new therapeutic ways preventing diabetic CVD complications, therefore, in the paper we mainly reviewed present information about the possible pathogenesis of diabetic CVD complication. PMID:25685278

Xu, Ren-Shi

2015-02-15

22

Pathogenesis of diabetic cerebral vascular disease complication  

PubMed Central

Diabetes mellitus is one of the most potent independent risk factors for the development of diabetic cerebral vascular disease (CVD). Many evidences suggested that hyperglycemia caused excess free fatty acids, the loss of endothelium-derived nitric oxide, insulin resistance, the prothrombotic state, endothelial dysfunction, the abnormal release of endothelial vasoactivators, vascular smooth muscle dysfunction, oxidative stress, and the downregulation of miRs participated in vessel generation and recovery as well as the balance of endotheliocytes. In turn, these abnormalities, mainly via phosphatidylinositol 3 kinase, mitogen-activated protein kinase, polyol, hexosamine, protein kinase C activation, and increased generation of advanced glycosylation end products pathway, play an important role in inducing diabetic CVD complication. A deeper comprehension of pathogenesis producing diabetic CVD could offer base for developing new therapeutic ways preventing diabetic CVD complications, therefore, in the paper we mainly reviewed present information about the possible pathogenesis of diabetic CVD complication.

Xu, Ren-Shi

2015-01-01

23

Gaucher disease: haematological presentations and complications.  

PubMed

Gaucher disease (GD) is an autosomal recessive lysosomal storage disease, caused by deficiency of the enzyme glucocerebrosidase, required for the degradation of glycosphingolipids. Clinical manifestations include hepatosplenomegaly, thrombocytopenia, bone disease and a bleeding diathesis, frequently resulting in presentation to haematologists. Historically managed by splenectomy, transfusions and orthopaedic surgery, the development of specific therapy in the form of intravenous enzyme replacement therapy in the 1990s has resulted in dramatic improvements in haematological and visceral disease. Recognition of complications, including multiple myeloma and Parkinson disease, has challenged the traditional macrophage-centric view of the pathophysiology of this disorder. The pathways by which enzyme deficiency results in the clinical manifestations of this disorder are poorly understood; altered inflammatory cytokine profiles, bioactive sphingolipid derivatives and alterations in the bone marrow microenvironment have been implicated. Further elucidating these pathways will serve to advance our understanding not only of GD, but of associated disorders. PMID:24588457

Thomas, Alison S; Mehta, Atul; Hughes, Derralynn A

2014-05-01

24

Adult-onset Still's disease associated to toxoplasma gondii infection  

Microsoft Academic Search

Summary Adult-onset Still's disease is characterized by high spiking fever, evanescent maculopapular rash and arthritis. Several recent reports have associated its development with a variety of infectious agents. We describe the case of a 25-year old woman presenting high fever, maculopapular rash and seronegative polyarthritis associated with lymphoadenopathy, splenomegaly and neutrophil leucocytosis together with acute acquired toxoplasmosis. Other causes of

E. Balleari; M. Cutolo; S. Accardo

1991-01-01

25

Complications of HIV Disease and Antiretroviral Therapy  

PubMed Central

There is growing interest in the pathogenesis, treatment, and prevention of long-term complications of HIV disease and its therapies. Specifically, studies focused on cardiovascular, renal, bone, and fat abnormalities were prominent at the 17th Conference on Retroviruses and Opportunistic Infections. Although enthusiasm about the effectiveness of current antiretroviral therapy remains strong, collectively, the ongoing work in the area of HIV disease and treatment complications appears to reflect concerns that these clinical problems will continue to remain important and possibly increase over time in the current therapeutic era. This year’s conference also highlighted important data on prevention and optimal treatment of common coinfections that occur in HIV-infected individuals, including tuberculosis, influenza, and viral hepatitis. PMID:20516525

Luetkemeyer, Anne F.; Havlir, Diane V.; Currier, Judith S.

2011-01-01

26

Postpandemic Influenza A/H1N1pdm09 is still Causing Severe Perinatal Complications  

PubMed Central

Although influenza A/H1N1pdm09 is not causing a pandemic anymore, we recently observed two critically ill pregnant women infected by this virus. We present these cases to illustrate the possible severe complications of an – at that moment – seasonal influenza in pregnancy. We discuss the epidemiological differences between the pandemic and post pandemic phase and try to explain the high virulence of influenza A/H1N1pdm09 -infections in pregnancy by discussing insights in immunology during pregnancy. We conclude that although influenza A/H1N1pdm09 is in the post pandemic phase, infection by this influenza virus still needs to be considered in pregnant women with progressive respiratory dysfunction. PMID:25574366

Bogers, Hein; Bos, Dominique; Schoenmakers, Sam; Duvekot, Johannes J

2015-01-01

27

Chronic Anemia and Thrombocytosis as the Initial Presentation of Still’s Disease in an Elderly Patient  

Microsoft Academic Search

Still’s disease is very rare in elderly patients. We report a case of Still’s disease in an elderly patient that had an atypical initial presentation. A 76-year-old woman developed unexplained chronic anemia and thrombocytosis. Three years later she had acute onset of high fever, arthritis, maculopapular rash, pleuritic chest pain, abdominal pain, lymphadenopathy and elevated erythrocyte sedimentation rate. Rheumatoid factor

Luis M. Vilá; María J. Molina

2007-01-01

28

The Hyperferritinemic Syndrome: macrophage activation syndrome, Still’s disease, septic shock and catastrophic antiphospholipid syndrome  

PubMed Central

Background Over the last few years, accumulating data have implicated a role for ferritin as a signaling molecule and direct mediator of the immune system. Hyperferritinemia is associated with a multitude of clinical conditions and with worse prognosis in critically ill patients. Discussion There are four uncommon medical conditions characterized by high levels of ferritin, namely the macrophage activation syndrome (MAS), adult onset Still’s disease (AOSD), catastrophic antiphospholipid syndrome (cAPS) and septic shock, that share a similar clinical and laboratory features, and also respond to similar treatments, suggesting a common pathogenic mechanism. Ferritin is known to be a pro-inflammatory mediator inducing expression of pro-inflammatory molecules, yet it has opposing actions as a pro-inflammatory and as an immunosuppressant. We propose that the exceptionally high ferritin levels observed in these uncommon clinical conditions are not just the product of the inflammation but rather may contribute to the development of a cytokine storm. Summary Here we review and compare four clinical conditions and the role of ferritin as an immunomodulator. We would like to propose including these four conditions under a common syndrome entity termed “Hyperferritinemic Syndrome”. PMID:23968282

2013-01-01

29

Celiac disease: how complicated can it get?  

PubMed

In the small intestine of celiac disease patients, dietary wheat gluten and similar proteins in barley and rye trigger an inflammatory response. While strict adherence to a gluten-free diet induces full recovery in most patients, a small percentage of patients fail to recover. In a subset of these refractory celiac disease patients, an (aberrant) oligoclonal intraepithelial lymphocyte population develops into overt lymphoma. Celiac disease is strongly associated with HLA-DQ2 and/or HLA-DQ8, as both genotypes predispose for disease development. This association can be explained by the fact that gluten peptides can be presented in HLA-DQ2 and HLA-DQ8 molecules on antigen presenting cells. Gluten-specific CD4(+) T cells in the lamina propria respond to these peptides, and this likely enhances cytotoxicity of intraepithelial lymphocytes against the intestinal epithelium. We propose a threshold model for the development of celiac disease, in which the efficiency of gluten presentation to CD4(+) T cells determines the likelihood of developing celiac disease and its complications. Key factors that influence the efficiency of gluten presentation include: (1) the level of gluten intake, (2) the enzyme tissue transglutaminase 2 which modifies gluten into high affinity binding peptides for HLA-DQ2 and HLA-DQ8, (3) the HLA-DQ type, as HLA-DQ2 binds a wider range of gluten peptides than HLA-DQ8, (4) the gene dose of HLA-DQ2 and HLA-DQ8, and finally,(5) additional genetic polymorphisms that may influence T cell reactivity. This threshold model might also help to understand the development of refractory celiac disease and lymphoma. PMID:20661732

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

2010-10-01

30

Celiac disease: how complicated can it get?  

PubMed Central

In the small intestine of celiac disease patients, dietary wheat gluten and similar proteins in barley and rye trigger an inflammatory response. While strict adherence to a gluten-free diet induces full recovery in most patients, a small percentage of patients fail to recover. In a subset of these refractory celiac disease patients, an (aberrant) oligoclonal intraepithelial lymphocyte population develops into overt lymphoma. Celiac disease is strongly associated with HLA-DQ2 and/or HLA-DQ8, as both genotypes predispose for disease development. This association can be explained by the fact that gluten peptides can be presented in HLA-DQ2 and HLA-DQ8 molecules on antigen presenting cells. Gluten-specific CD4+ T cells in the lamina propria respond to these peptides, and this likely enhances cytotoxicity of intraepithelial lymphocytes against the intestinal epithelium. We propose a threshold model for the development of celiac disease, in which the efficiency of gluten presentation to CD4+ T cells determines the likelihood of developing celiac disease and its complications. Key factors that influence the efficiency of gluten presentation include: (1) the level of gluten intake, (2) the enzyme tissue transglutaminase 2 which modifies gluten into high affinity binding peptides for HLA-DQ2 and HLA-DQ8, (3) the HLA-DQ type, as HLA-DQ2 binds a wider range of gluten peptides than HLA-DQ8, (4) the gene dose of HLA-DQ2 and HLA-DQ8, and finally,(5) additional genetic polymorphisms that may influence T cell reactivity. This threshold model might also help to understand the development of refractory celiac disease and lymphoma. PMID:20661732

van Bergen, Jeroen; Koning, Frits

2010-01-01

31

Iron: Protector or Risk Factor for Cardiovascular Disease? Still Controversial  

PubMed Central

Iron is the second most abundant metal in the Earth’s crust. Despite being present in trace amounts, it is an essential trace element for the human body, although it can also be toxic due to oxidative stress generation by the Fenton reaction, causing organic biomolecule oxidation. This process is the basis of numerous pathologies, including cardiovascular diseases (CVD). The relationship between iron and cardiovascular disease was proposed in 1981 by Jerome Sullivan. Since then, numerous epidemiological studies have been conducted to test this hypothesis. The aim of this review is to present the main findings of the chief epidemiological studies published during the last 32 years, since Sullivan formulated his iron hypothesis, suggesting that this element might act as a risk factor for cardiovascular disease. We have analyzed 55 studies, of which 27 supported the iron hypothesis, 20 found no evidence to support it and eight were contrary to the iron hypothesis. Our results suggest that there is not a high level of evidence which supports the hypothesis that the iron may be associated with CVD. Despite the large number of studies published to date, the role of iron in cardiovascular disease still generates a fair amount of debate, due to a marked disparity in results. PMID:23857219

Muñoz-Bravo, Carlos; Gutiérrez-Bedmar, Mario; Gómez-Aracena, Jorge; García-Rodríguez, Antonio; Fernández-Crehuet Navajas, Joaquín

2013-01-01

32

Neurological complications of Anderson-Fabry disease.  

PubMed

Characteristic clinical manifestations of AFD such as acroparesthesias, angiokeratoma, corneal opacity, hypo/ and anhidrosis, gastrointestinal symptoms, renal and cardiac dysfunctions can occur in male and female patients, although heterozygous females with AFD usually seem to be less severely affected. The most prominent CNS manifestations consist of cerebrovascular events such as transient ischaemic attacks (TIAs) and (recurrent) strokes. For the most part, CNS complications in AFD have been attributed to cerebral vasculopathy, including anatomical abnormalities. The natural history of Fabry patients includes transitory cerebral ischaemia and strokes, even in very young persons of both genders. The mechanism is partly due to vascular endothelial accumulation of Gb-3. White matter lesions (WML) on occur MRI. Both males and females can be safely treated with enzyme replacement; and thus screening for Fabry disease of young stroke populations should be considered. There are, however, no hard data of treatment effect on mortality and morbidity. Stroke in Anderson-Fabry disease study of 721 patients with cryptogenic stroke, aged 18-55 years, showed a high prevalence of Fabry disease in this group: 5% (21/432) of men and 3% (7/289) of women. Combining results of both sexes showed that 4% of young patients with stroke of previously unknown cause had Fabry disease, corresponding to about 1-2% of the general population of young stroke patients. Cerebral micro- and macro-vasculopathy have been described in Fabry disease. Neuronal globotriaosylceramide accumulation in selective cortical and brain stem areas including the hippocampus has been reported by autopsy studies in FD, but clinical surrogates as well as the clinical relevance of these findings have not been investigated so far. Another Neurologic hallmark of Fabry disease (FD) includes small fiber neuropathy as well as cerebral micro- and macroangiopathy with premature stroke. Cranial MRI shows progressive white matter lesions (WML) at an early age, increased signal intensity in the pulvinar, and tortuosity and dilatation of the larger vessels. Conventional MRI shows a progressive load of white matter lesions (WMLs) due to cerebral vasculopathy in the course of FD. Another study has been conducted to quantify brain structural changes in clinically affected male and female patients with FD. The peripheral neuropathy in Fabry disease manifests as neuropathic pain, reduced cold and warm sensation and possibly gastrointestinal disturbances. Patients with Fabry disease begin having pain towards the end of the first decade of life or during puberty. Children as young as 6 years of age have complained of pain often associated with febrile illnesses with reduced heat and exercise tolerance. The patients describe the pain as burning that is often associated with deep ache or paresthesiae. Some patients also have joint pain. A high proportion of patients with Fabry disease is at increased risk of developing neuropsychiatric symptoms, such as depression and neuropsychological deficits. Due to both somatic and psychological impairment, health-related quality of life (QoL) is considerably reduced in patients with Fabry disease. Targeted screening for Fabry disease among young individuals with stroke seems to disclose unrecognized cases and may therefore very well be recommended as routine in the future. Furthermore, ischemic stroke is related to inflammation and arterial stiffness and no study had addressed this relationship in patients with AF disease and cerebrovascular disease, so this topic could represent a possible future research line. PMID:23448452

Tuttolomondo, Antonino; Pecoraro, Rosaria; Simonetta, Irene; Miceli, Salvatore; Arnao, Valentina; Licata, Giuseppe; Pinto, Antonio

2013-01-01

33

Coagulopathy in liver diseases: complication or therapy?  

PubMed

Coagulopathy in cirrhosis is a composite condition where liver synthetic deficit rebalances coagulation to a parallel reduction of both pro- and anticoagulant factors. Cirrhosis is therefore no longer considered a hypocoagulable state but rather a more unstable hemostatic balance with a lower threshold for tipping toward thrombosis or bleeding. Tendency to bleeding in cirrhosis is due to the reduction in the synthesis of procoagulants and a low platelet count as well as hyperfibrinolysis. Variceal hemorrhage is a frequent bleeding complication in decompensated cirrhosis. However, the possible contribution of coagulopathy as a precipitant or an aggravating factor is poorly documented and further data are required to clarify its real contributing role. Moreover, apart from the gastrointestinal tract, the occurrence of spontaneous and procedure-related bleeding elsewhere in the body, whilst not uncommon, is less than would be expected. By contrast, a large-scale population-based study has shown the propensity towards venous thrombosis in patients with liver diseases. Portal vein thrombosis (PVT) is a critical but frequent event occurring in up to 40% of patients with liver cirrhosis. PVT causes deterioration of the clinical course, the complications of portal hypertension and an increase in post-transplant mortality. The pathogenesis of PVT includes both local alterations, like blood flow reduction and endothelial activation, and systemic derangement. Systemic prohemostatic alterations include high von Willebrand factor, low ADAMTS-13, low levels of anticoagulants (antithrombin, proteins C and S) and increases in procoagulants like factor VIII. Low-molecular-weight heparin such as enoxaparin has proven to be safe and effective in both the treatment and prevention of PVT. In addition, patients in prophylaxis with enoxaparin showed a lower rate of decompensation and a better survival without bleeding complications. In such patients, circulating bacterial DNA, endotoxemia and markers of inflammation were attenuated compared to controls. These results therefore suggest a possible connection between enoxaparin, decrease of endotoxemia and reduction of portal hypertension. The approach to the coagulopathy in patients with liver diseases is changing: while the main goal for clinicians so far has been to reduce the risk of bleeding, the results of these new studies highlight the importance of preventing or treating thrombophilic disorders like PVT to avoid microcirculatory damage and eventually liver decompensation. PMID:25034295

Bianchini, Marcello; De Pietri, Lesley; Villa, Erica

2014-01-01

34

Adult-Onset Still’s Disease Associated with Thyroid Dysfunction: Case Report and Review of the Literature  

PubMed Central

To our knowledge, the possible unveiled interaction between adult-onset Still’s disease (AOSD) with autoimmune thyroid disease (AITD) has never been reported although it is well established that systemic autoimmune disease may usually occur in relation to AITD. As increasingly clear links of AITD with other autoimmune disease such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and primary Sjögren’s syndrome (pSS) have been reported, and the incidence of AOSD concurrent AITD draws our attention rapidly. In this study, we searched relevant literatures published in the past 30 years to explore that condition. PMID:25067964

Hu, Yingchun; Wang, Han; Deng, Juelin

2014-01-01

35

Pathophysiology and management of some medical complications of Crohn's disease.  

PubMed Central

The pathophysiology of various metabolic and other medical disorders that may complicate Crohn's disease is outlined. Measures that may help to prevent or mitigate these complications are discussed. PMID:7065595

Turnberg, L. A.

1982-01-01

36

Histological healing in inflammatory bowel disease: A still unfulfilled promise  

PubMed Central

Treatment of inflammatory bowel disease (IBD) is traditionally based on several drugs, including salicylates, corticosteroids, and antibiotics; in addition, the therapeutic armamentarium has considerably evolved with the advent of newer, effective therapeutic measures (such as the biological agents) that are able to improve in a considerable manner both the clinical and endoscopic variables. Thus, mucosal healing, at least considered from an endoscopic point of view, is today regarded as the ultimate endpoint for treatment of these conditions. However, it is also increasingly clear that endoscopic healing is not necessarily paralleled by histological healing; There are few doubts that the latter should be considered as a true, objective healing and the ultimate goal to reach when treating patients with IBD. Unfortunately, and surprisingly, only a few, incomplete, and somewhat conflicting data exist on this topic, especially because there is still the need to standardize both histological assessment and the severity grading of these disorders; Issues that have not been yet been resolved for clinical practice and therapeutic trials. Hopefully, with the help of an increased awareness on the clinical researchers’ side, and the availability of dedicated pathologists on the other side, this matter will be effectively faced and resolved in the near future. PMID:23467585

Villanacci, Vincenzo; Antonelli, Elisabetta; Geboes, Karel; Casella, Giovanni; Bassotti, Gabrio

2013-01-01

37

Adult-onset Still's disease presenting as myopericarditis.  

PubMed

A 24-year-old man presented to the emergency department with fever, maculopapular rash, myalgia and polyarthralgia, thoracic pain and dry cough, which had been present for 24?h. At the time of observation he had high fever (39°C), maculopapular rash on the torso, arms and legs proximally, axillary adenopathies and pharyngitis. Laboratorial data showed elevated inflammation markers (leukocytosis, C reactive protein of 44?mg/dL, erythrocyte sedimentation rate of 120?mm), elevated transaminases, lactate dehydrogenase, ferritin levels (>2000?ng/mL) and rising troponin. ECG had sinus rhythm and ST elevation in leads V1-V5. Thoracic radiography revealed bilateral interstitial infiltrate confirmed by CT scan. Echocardiographic findings included diffuse hypokinesia of the left ventricle and impaired systolic function. After the investigation of an infectious or autoimmune aetiology was negative, the diagnosis of adult-onset Still's disease was considered. The patient was put on a 60?mg/day prednisolone regimen with remission of symptoms and normalisation of systolic function and ECG. PMID:24898998

Gonzalez, Filipe André; Beirão, Pedro; Adrião, Joana; Coelho, Margarida Lopes

2014-01-01

38

Successful Surgical Treatment of Cardiac Complication of Graves Disease  

PubMed Central

Cardiac complications such as arrhythmia and heart failure are common in Graves disease. Early detection and proper treatment of hyperthyroidism are important because cardiac complications are reported to be reversible if the thyroid function is normalized by medical treatment. We report here a case of cardiac complication of Graves disease that was too late to reverse with medical treatment and required surgical treatment. PMID:25207231

Min, Jooncheol; Kim, Woong-Han; Jang, Woo Sung; Choi, Eun Seok; Cho, Sungkyu; Choi, Kwang Ho

2014-01-01

39

Haemophilus influenzae Disease (Including Hib) Complications  

MedlinePLUS

... given to prevent complications. Learn more about using antibiotics for respiratory infections . Related Links Global Hib Vaccination Hib Vaccination Meningitis Pneumonia File Formats Help: How do I view different file formats (PDF, DOC, PPT, MPEG) on ...

40

[Neurological complications of inflammatory bowel diseases].  

PubMed

Inflammatory bowel diseases, such as Crohn's disease, ulcerative colitis, autoantibody driven celiac disease and infectious Whipple's disease can all be associated with neurological symptoms. The neurological manifestation may occur even before the gastrointestinal symptoms or the enteropathic symptoms can even be absent as in celiac disease. These diseases can be caused by malresorption and lack of vitamins due to enteral inflammation as well as (auto-)immunological mechanisms and drug-associated side effects. Thus, inflammatory bowel diseases have to be considered in the differential diagnosis. In this review the most common neurological manifestations of these diseases will be described as well as the diagnostic approach. PMID:23392266

Cieplik, N; Stangel, M; Bachmann, O

2013-02-01

41

Recognition and management of neuropsychiatric complications in Parkinson's disease.  

PubMed

Parkinson's disease is primarily considered a motor disease characterized by rest tremor, rigidity, bradykinesia and postural disturbances. However, neuropsychiatric complications, including mood and anxiety disorders, fatigue, apathy, psychosis, cognitive impairment, dementia, sleep disorders and addictions, frequently complicate the course of the illness. The pathophysiologic features of these complications are multifaceted and include neuropathophysiologic changes of a degenerative disease, exposure to antiparkinsonian treatments and emotional reactions to having a disabling chronic illness. Changes in mental status have profound implications for the well-being of patients with Parkinson's disease and of their caregivers. Treatment is often efficacious but becomes a challenge in advanced stages of Parkinson's disease. In this article, we review the key clinical features of neuropsychiatric complications in Parkinson's disease as well as what is known about their epidemiologic characteristics, risk factors, pathophysiologic features and management. PMID:17146092

Ferreri, Florian; Agbokou, Catherine; Gauthier, Serge

2006-12-01

42

Diabetic myonecrosis: uncommon complications in common diseases.  

PubMed

We report a case of sudden thigh pain from spontaneous quadriceps necrosis, also known as diabetic myonecrosis, in a 28-year-old patient with poorly controlled diabetes mellitus. Diabetic muscle infarction is a rare end-organ complication seen in patients with poor glycemic control and advanced chronic microvascular complications. Proposed mechanisms involve atherosclerotic microvascular occlusion, ischemia-reperfusion related injury, vasculitis with microthrombi formation, and an acquired antiphospholipid syndrome. Diabetic myonecrosis most commonly presents as sudden thigh pain with swelling and should be considered in any patient who has poorly controlled diabetes mellitus. PMID:24716004

Sran, Sisira; Sran, Manpreet; Ferguson, Nicole; Anand, Prachi

2014-01-01

43

Diabetic Myonecrosis: Uncommon Complications in Common Diseases  

PubMed Central

We report a case of sudden thigh pain from spontaneous quadriceps necrosis, also known as diabetic myonecrosis, in a 28-year-old patient with poorly controlled diabetes mellitus. Diabetic muscle infarction is a rare end-organ complication seen in patients with poor glycemic control and advanced chronic microvascular complications. Proposed mechanisms involve atherosclerotic microvascular occlusion, ischemia-reperfusion related injury, vasculitis with microthrombi formation, and an acquired antiphospholipid syndrome. Diabetic myonecrosis most commonly presents as sudden thigh pain with swelling and should be considered in any patient who has poorly controlled diabetes mellitus. PMID:24716004

Sran, Manpreet; Ferguson, Nicole

2014-01-01

44

Vaccination and Rheumatic Diseases: Is There Still a Dilemma?  

Microsoft Academic Search

The development of rheumatic diseases after immunization has been reported in the medical literature but a causal relationship has not been established. Infections remain an important cause of morbidity and mortality in patients with rheumatic diseases who may be immunodepressed for immunological dysfunctions or immunosuppressed due to the pharmacologic therapy. Although vaccines against infectious diseases are considered the standard way

Fabrizio Conti; Soheila Rezai; Guido Valesini

2007-01-01

45

Cardiovascular complications in chronic kidney disease  

Microsoft Academic Search

The risk for cardiovascular disease (CVD) morbidity and mortality remains alarmingly high in all stages of chronic kidney disease (CKD). CVD often begins before end-stage renal disease (ESRD), and patients with reduced kidney function are more likely to die of CVD than to develop ESRD. Three pathological forms of CVD should be considered in patients with CKD: alterations in cardiac

Mark J. Sarnak

2003-01-01

46

Complications of Gamma Knife Surgery for Parkinson Disease  

Microsoft Academic Search

Background: Many medical centers throughout the world offer radiosurgery with the gamma knife (GK) for pal- lidotomy and thalamotomy as a safe and effective alterna- tive to radiofrequency ablative surgery and deep brain stimu- lation for Parkinson disease (PD). The reported incidence of significant complications varies considerably, and the long-term complication rate remains unknown. Design: We describe 8 patients seen

Michael S. Okun; Natividad P. Stover; Thyagarajan Subramanian; Marla Gearing; Bruce H. Wainer; Chad A. Holder; Ray L. Watts; Jorge L. Juncos; Alan Freeman; Marian L. Evatt; Stephan U. Schuele; Jerrold L. Vitek; Mahlon R. DeLong

2001-01-01

47

[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

48

Wilson disease: what is still unclear in pediatric patients?  

PubMed

Since Wilson disease (WD) may not be present with evident clinical symptoms of liver injury and neurological presentation is rare in children, establishing a diagnosis is often challenging, especially in childhood. Increased transaminases can be the only abnormality found in early course of WD. In clinical practice, high suspicion is crucial for early diagnosis and timely treatment to ensure better outcomes. Conventional diagnostic criteria established for adults are commonly agreed for children but may not always be appropriate in very young age. Currently, the best therapeutic approach for each specific presentation of the disease remains controversial and there are no clear indications about how to treat pediatric WD patients with a mild liver disease. PMID:24745882

Ranucci, Giusy; Socha, Piotr; Iorio, Raffaele

2014-06-01

49

Successful management of severe acute liver disease related with adult-onset Still's disease in a pregnant patient.  

PubMed

Adult-onset Still's disease is a rare systemic inflammatory disease, which is characterized by varying degrees of liver involvement. Herein we present a rare case of pregnancy onset adult onset Still's disease with severe acute liver disease which worsened after labor. The patient was successfully managed with medical treatment preventing acute liver failure, and is currently in remission from adult onset Still's disease with liver tests that have returned to normal. PMID:23794346

Harmanci, Özgür; Kav, Taylan; Sökmensüer, Cenk; Çalgüner?, Meral; Bayraktar, Yusuf

2013-01-01

50

The spectrum of opportunistic diseases complicating sarcoidosis.  

PubMed

Sarcoidosis is an inflammatory disease marked by a paradoxical immune status. The anergic state, which results from various immune defects, contrasts with the inflammatory formation of granulomas. Sarcoidosis patients may be at risk for opportunistic infections (OIs) and a substantial number of cases have been reported, even in untreated sarcoidosis. It is not clear how OIs in patients with sarcoidosis are different from other groups at risk. In this review, we discuss the most common OIs: mycobacterial infection (including tuberculosis), cryptococcosis, progressive multifocal leukoencephalopathy, and aspergillosis. Unlike peripheral lymphocytopenia, corticosteroids are a major risk factor for OIs but the occurrence of Ols in untreated patients suggests more complex predisposing mechanisms. Opportunistic infections presenting with extrapulmonary features are often misdiagnosed as new localizations of sarcoidosis. Aspergillomas mostly develop on fibrocystic lungs. Overall, physicians should be aware of the possible occurrence of OIs during sarcoidosis, even in untreated patients. PMID:25305373

Jamilloux, Ivan; Valeyre, Dominique; Lortholary, Olivier; Bernard, Claire; Kerever, Sébastien; Lelievre, Lucie; Neel, Antoine; Broussolle, Christiane; Seve, Pascal

2015-01-01

51

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

52

A FORGOTTEN DISEASE REMINDS ITSELF WITH A RARE COMPLICATION  

PubMed Central

Diagnosed cases of sexually transmitted diseases (STD) represent tip of the iceberg and Donovanosis in one of them. Donovanosis, in most cases is obvious clinically, but rely for its confirmation on the demonstration of donovan bodies in histological sections and cytological preparation. In an extremely rare setting, this disease may get complicated by the development of squamous cell carcinoma. We report this occurrence in an 18-year-old girl to review the currently forgotten status of donovanosis amongst the STDs and the poor outcome of the disease if left untreated. PMID:21965857

Agrawal, Meetu; Arora, S K; Agarwal, Asha

2011-01-01

53

Potential benefit of paracetamol administration in adult-onset Still's disease.  

PubMed

Still's disease is a rare, systemic inflammatory disease of unknown etiology, characterized by daily high fever, transient rash, arthritis, and organ involvement including lymphadenopathy, hepatosplenomegaly, pleuritis or pericarditis. The diagnosis of the disease is based on clinical signs and symptoms, and requires exclusion of infectious, neoplastic, and other autoimmune diseases. Treatment options include non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, sometimes in combination with immunosuppressive agents. We report the case of a 21-year-old man with a recent diagnosis of Still's disease. The fever, resistant to NSAIDs, resolved after treatment with paracetamol and the patient's general condition also improved. The present case has been the first to demonstrate that paracetamol may be an effective agent in adult-onset Still's disease. PMID:19776706

Kedzia, Agnieszka; Bo?dys, Aleksandra; Krysiak, Robert; Szkróbka, Witold; Okopie?, Bogus?aw

2009-09-01

54

Kawasaki disease complicated with reversible splenial lesion and acute myocarditis.  

PubMed

Kawasaki disease, a systemic vasculitis of unknown etiology, develops frequently in infants and demonstrates a variety of clinical symptoms during the disease course. The most important complication, coronary artery lesions, is found in 15-25% of untreated patients. Meanwhile, acute myocarditis, another complication that can occur during the acute phase of severe systemic vasculitis, has been found in more than 50% of affected individuals when asymptomatic cases are included. However, cases that require treatment are rare as reported by Yoshikawa et al. (Circ J 70:202-205, 2006). As for neural complications, aseptic meningitis is well known, but it is extremely rare for these patients to develop encephalitis or encephalopathy as reported by Imai et al. (Jpn Soc Emerg Pediatr 8:50-55, 2009). Recently reported magnetic resonance images (MRIs) have shown reversible lesions in the median splenium of patients complicated with encephalitis or encephalopathy. Reversible lesions have also been observed after the administration of an antiepileptic agent, drastic weight loss, and development of metabolic abnormalities as reported by Massimo et al. (Neuroradiology 49:541-544, 2007) and Tada et al. (Neurology 63:1854-1858, 2004). Aggressive therapy for such lesions is not considered necessary because most disappear without neurologic aftereffects. However, the clinical significance and pathogenesis of the condition remain largely unknown. We present the first known report of a Kawasaki disease case complicated with acute myocarditis and mild encephalitis/encephalopathy with a reversible splenial lesion (MERS). These findings may be valuable for the diagnosis and treatment of affected patients. PMID:21380714

Itamura, Shinji; Kamada, Masahiro; Nakagawa, Naomi

2011-06-01

55

Celiac disease causing severe osteomalacia: an association still present in Morocco!  

PubMed Central

Celiac disease (CD), a malabsorption syndrome caused by hypersensitivity to gliadin fraction of gluten. CD can manifest with classic symptoms; however, significant myopathy and multiple fractures are rarely the predominant presentation of untreated celiac disease. Osteomalacia complicating celiac disease had become more and more rare. We describe here a case of osteomalacia secondary to a longstanding untreated celiac disease. This patient complained about progressive bone and muscular pain, weakness, fractures and skeletal deformities. Radiological and laboratory findings were all in favor of severe osteomalacia. Improvement of patient's weakness and laboratory abnormalities was obvious after treatment with gluten free diet, vitamin D, calcium and iron. This case affirms that chronic untreated celiac disease, can lead to an important bone loss and irreversible complications like skeletal deformities.

Tahiri, Latifa; Azzouzi, Hamida; Squalli, Ghita; Abourazzak, Fatimazahra; Harzy, Taoufik

2014-01-01

56

Complications and concurrent disease associated with diabetes mellitus.  

PubMed

Many animals with diabetes mellitus are severely ill on clinical presentation. The spectrum of disease is quite variable and includes diabetic ketoacidosis (DKA), ketosis without acidosis, hyperosmolar nonketotic syndrome (HNKS), and other nonketotic variants (negative urine ketones, serum osmolality < 340 mOsm/kg with or without acidosis). These more severe forms of diabetes are often precipitated by concurrent diseases such as pyelonephritis, pancreatitis, pyometra, hyperadrenocorticism, renal failure, and heart failure. To make matters worse, in-hospital treatment of diabetic dogs and cats is commonly associated with serious complications, including hypoglycemia, hypokalemia, and hypophosphatemia. PMID:10889875

Nichols, R

1997-11-01

57

Adult onset Still's disease diagnosed concomitantly with occult papillary thyroid cancer: paraneoplastic manifestation or coincidence?  

Microsoft Academic Search

Adult onset Still's disease (AOSD) is an inflammatory disease of unknown etiology, characterized by spiking fever, evanescent\\u000a salmon pink maculopapular rash, arthritis, and leukocytosis with neutrophilia. Malignant lymphoma is one of the most important\\u000a differential diagnoses of AOSD. AOSD has been reported as one of paraneoplastic syndromes associated with breast cancer. We\\u000a report a rare case of occult papillary thyroid

Joong Kyong Ahn; Ji-Min Oh; Jaejoon Lee; Sun Wook Kim; Hoon-Suk Cha; Eun-Mi Koh

2010-01-01

58

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

59

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

60

Orbital complications in children: differential diagnosis of a challenging disease.  

PubMed

Orbital swelling in children presents diagnostic and therapeutic challenges. Most are associated with acute sinusitis with complicating factors possibly including: amaurosis, meningitis, intracranial abscess or even cavernous sinus thrombosis. However not all acute orbital swelling is associated with acute sinusitis. A careful evaluation is critical prior to initiating therapy. Clinical records of 49 children (27 girls, 22 boys, with an average age of 11.8 years) were retrospectively reviewed. Historical data evaluated included all available information from parents and previous treating physicians. All patients underwent intensive pediatric, ophthalmologic, and otorhinolaryngologic examinations. Computed tomography (CT scans) were additionally performed in 40 % of children. The results of any examinations were also evaluated. Eighteen of the 49 patients had an orbital complication due to acute sinusitis. All 18 had elevated body temperature, C-Reactive Protein (CRP) values and white blood cell counts. Endoscopy of the nose revealed pus in the middle meatus in each case. According to Chandlers' classification, ten children presented with a preseptal, and eight children had a postseptal orbital cellulitis. All patients were admitted to the hospital and treated with intravenous antibiotics. CT scans further demonstrated signs of subperiostal abscess in four children. Functional endoscopic sinus surgery (FESS) was required in six children, including all patients with subperiostal abscess. Twenty children experienced orbital swelling unrelated to acute sinusitis, i.e. atheroma, inflammed insect stings, dental related abscess, conjunctivitis, and Herpes simplex associated superinfection. In three children, acute orbital swelling was caused by an orbital tumor. Orbital complications of an acute sinusitis occur often in the pediatric patient group, and most of these patients can be treated conservative with intravenous antibiotics. Indications for FESS include failure to improve or worsening of clinical symptoms during 24 h of therapy, signs for subperiostal abscess in CT scan, and/or vision loss. Patients with infectous orbital complications had fever, elevated CRP and white blood cell counts. This symptom complex is key in making the correct diagnosis. Interestingly, 61 % of patients in this study demonstrated non-sinusitis related diseases leading to acute orbital swelling, which also required prompt recognition and appropriate therapy. PMID:25056021

Welkoborsky, Hans-J; Graß, Sylvia; Deichmüller, Cordula; Bertram, Oliver; Hinni, Michael L

2014-07-24

61

Fever of unknown origin: a review of 20 patients with Adult-onset Still's disease  

Microsoft Academic Search

In this study we aimed to investigate the findings in patients with adult-onset Still's disease (AOSD) admitted with fever\\u000a of unknown origin (FUO) during the last 18 years in our unit, in order to discover the ratio of such patients to all patients\\u000a with FUO during the same period, and to determine the clinical features of AOSD in FUO. The

A. Mert; R. Ozaras; F. Tabak; M. Bilir; R. Ozturk; H. Ozdogan; Y. Aktuglu

2003-01-01

62

Adult onset Still's disease (AOSD) in the era of biologic therapies: Dichotomous view for cytokine and clinical expressions.  

PubMed

Adult onset Still's disease (AOSD) is a rare inflammatory disorder characterized by hectic spiking fever, evanescent rash and joint involvement. Prognosis is highly variable upon disease course and specific involvements, ranging from benign and limited outcome to chronic destructive polyarthritis and/or life-threatening events in case of visceral complications or reactive hemophagocytic lymphohistiocytosis (RHL). AOSD remains a debatable entity at the frontiers of autoimmune diseases and autoinflammatory disorders. The pivotal role of macrophage cell activation leading to a typical Th1 cytokine storm is now well established in AOSD, and confirmed by the benefits using treatments targeting TNF-?, IL-1? or IL-6 in refractory patients. However, it remains difficult to determine predictive factors of outcome and to draw guidelines for patient management. Herein, reviewing literature and relying on our experience in a series of 8 refractory AOSD patients, we question nosology and postulate that different cytokine patterns could underlie contrasting clinical expressions, as well as responses to targeted therapies. We therefore propose to dichotomize AOSD according to its clinical presentation. On the one hand, 'systemic AOSD' patients, exhibiting the highest inflammation process driven by excessive IL-18, IL-1? and IL-6 production, would be at risk of life-threatening complications (such as multivisceral involvements and RHL), and would preferentially respond to IL-1? and IL-6 antagonists. On the other hand, 'rheumatic AOSD' patients, exhibiting pre-eminence of joint involvement driven by IL-8 and IFN-? production, would be at risk of articular destructions, and would preferentially respond to TNF-? blockers. PMID:25183244

Maria, Alexandre Thibault Jacques; Le Quellec, Alain; Jorgensen, Christian; Touitou, Isabelle; Rivière, Sophie; Guilpain, Philippe

2014-11-01

63

Pathogenesis of adult-onset Still's disease: new insights from the juvenile counterpart.  

PubMed

Adult-onset Still's disease (AOSD) is a rare inflammatory disease characterized by the classical triad of daily fever, arthritis, and typical salmon-colored rash. Recent accumulation of knowledge, mostly arising from hereditary autoinflammatory diseases and from the systemic-onset juvenile idiopathic arthritis (sJIA), has given raise to new hypotheses on the pathophysiology of AOSD. In this review, we first discuss on the continuum between AOSD and sJIA. Then, we summarize current hypotheses on the underlying pathogenesis: (1) an infectious hypothesis; (2) an autoinflammatory hypothesis; (3) a lymphohistiocytic hypothesis; and (4) a hyperferritinemic hypothesis. Finally, we present the recent data suggesting that patients with AOSD fall into two distinct subgroups with different courses, one with prominent systemic features and one with chronic arthritis. PMID:25388963

Jamilloux, Yvan; Gerfaud-Valentin, Mathieu; Martinon, Fabio; Belot, Alexandre; Henry, Thomas; Sève, Pascal

2015-02-01

64

Adult-onset Still's disease: can recent advances in our understanding of its pathogenesis lead to targeted therapy?  

Microsoft Academic Search

Adult-onset Still's disease is a rare systemic inflammatory disease of unknown etiology, characterized by daily high, spiking fevers, evanescent rash, and arthritis. There is no single diagnostic test for adult-onset Still's disease; rather, the diagnosis is based on clinical criteria and necessitates the exclusion of infectious, neoplastic, and other 'autoimmune' diseases. Proinflammatory cytokines such as interleukin (IL)-1, IL-6, and IL-18,

Apostolos Kontzias; Carla M Ward; Neeta S Ogden; Petros Efthimiou

2007-01-01

65

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

66

Maple Syrup Urine Disease Complicated with Kyphoscoliosis and Myelopathy.  

PubMed

Maple syrup urine disease (MSUD) is an autosomal recessive aminoacidopathy secondary to an enzyme defect in the catabolic pathway of the branched-chain amino acids (BCAAs: leucine, isoleucine, and valine). Accumulation of their corresponding keto-acids leads to encephalopathy if not treated in time. A newborn male patient was suspected to have MSUD after tandem mass study when he presented symptoms and signs suggestive neonatal sepsis, anemia, and diarrhea. Food restriction of BCAAs was started; however, acrodermatitis enteropathica-like skin eruptions occurred at age 2 months. The skin rashes resolved after adding BCAAs and adjusting the infant formula. At age 7 months, he suffered from recurrent skin lesions, zinc deficiency, osteoporosis, and kyphosis of the thoracic spine with acute angulation over the T11-T12 level associated with spinal compression and myelopathy. After supplementation of zinc products and pamidronate, skin lesions and osteopenia improved gradually. Direct sequencing of the DBT gene showed a compound heterozygous mutation [4.7 kb deletion and c.650-651insT (L217F or L217fsX223)]. It is unusual that neurodegeneration still developed in this patient despite diet restriction. Additionally, brain and spinal magnetic resonance imaging, bone mineral density study, and monitoring of zinc status are suggested in MSUD patients. PMID:24486081

Hou, Jia-Woei

2014-01-29

67

Association Between Genetics of Diabetes, Coronary Artery Disease, and Macrovascular Complications: Exploring a Common Ground Hypothesis  

PubMed Central

Type 2 diabetes and coronary artery disease (CAD) are conditions that cause a substantial public health burden. Since both conditions often coexist in the same individual, it has been hypothesized that they have a common effector. Insulin and hyperglycemia are assumed to play critical roles in this scenario. In recent years, many genetic risk factors for both diabetes and CAD have been discovered, mainly through genome-wide association studies. Genetic aspects of diabetes, diabetic macrovascular complications, and CAD are assumed to have intersections leading to the common effector hypothesis. However, only a few genetic risk factors could be identified that modulate the risk for both conditions. Polymorphisms in TCF7L2 and near the CDKN2A/B genes seem to be of great importance in this regard since they appear to modulate both conditions, and they are not necessarily related to insulinism, or hyperglycemia, for CAD development. Other issues related to this hypothesis, such as the problems of phenotype heterogeneity, are also of interest. Recent studies have contributed to a better understanding of the complex genetics of diabetic macrovascular complications. Much effort is still needed to clarify the associations in the genetics of diabetes, and cardiovascular disease. At present, there is little genetic evidence to support a common effector hypothesis, other than insulin or hyperglycemia, for the association between these conditions. PMID:22189546

Sousa, André G.; Selvatici, Lívia; Krieger, José E.; Pereira, Alexandre C.

2011-01-01

68

Usefulness of tacrolimus for refractory adult-onset still's disease: Report of six cases.  

PubMed

Six patients with refractory adult-onset Still's disease (AOSD) were treated with tacrolimus (TAC). Patient 1 was pregnant, for whom high-dose corticosteroid (CS) monotherapy did not achieve clinical remission, whereas TAC concomitant with CS was successful, and her baby had no apparent abnormalities. Patient 2 had hemophagocytic syndrome (HPS), for whom high-dose CS monotherapy did not achieve clinical remission, whereas TAC improved HPS, and a complete clinical remission was achieved with concomitant administration of TAC and methotrexate (MTX) with CS. Cases 3-5 could not have reduced CS doses due to repeated recurrences and other disease-modifying antirheumatic drugs, including MTX, Cyclosporine A, and tumor necrosis factor alpha inhibitors, did not control disease activity. TAC administration allowed for reduced CS doses. Case 6 experienced adverse effects, and TAC was discontinued due to elevated serum creatinine and potassium levels. TAC was useful for five of six patients, which suggests it as an option for refractory AOSD. PMID:25036233

Nakamura, Hiroyuki; Odani, Toshio; Shimizu, Yuka; Takeda, Tsuyoshi; Kikuchi, Hideaki

2014-07-18

69

Supradiaphragmatic early stage Hodgkin's disease: does mantle radiation therapy still have a role?  

PubMed

Extended field radiation therapy represents the main therapeutic option in early stage Hodgkin's disease with favorable prognostic features. Its role however has recently been criticized, mainly due to the high incidence of late complications in irradiated tissues. Furthermore, surgical staging, which in the opinion of many is mandatory for proper selection of patients for radiotherapy alone, has a well-known morbidity, and splenectomy has been associated with a high risk of secondary leukemias. Lastly, the failure rate after radiotherapy only is not negligible and second-line treatment is not always successful. A review of our experience and of the recent literature has allowed us to refute these objections. The results of radiotherapy, when properly performed, are highly reliable and have been reproducible in many Institutions. Chemotherapy alone cannot yet be regarded as an alternative to radiotherapy in these patients since data reported on this issue are conflicting. Present knowledge regarding the relationship between clinical features and the risk of occult subdiaphragmatic spread allows patients with localized disease to be selected without surgical staging; the results of radiotherapy in clinically staged patients confirm this statement. Concern for the late effects in irradiated tissues is justified, and future efforts should be directed at reducing the toxicity of this treatment. Associating a short chemotherapy course with low-dose radiotherapy to involved sites could help to achieve this goal. PMID:8641642

Frezza, G; Barbieri, E; Zinzani, P L; Babini, L; Tura, S

1996-01-01

70

A Case of Adult Onset Still's Disease Misdiagnosed as Septic Arthritis  

PubMed Central

We present a case of adult onset Still's disease (AOSD) that was misdiagnosed as septic arthritis of the shoulder and knee. A forty-nine-year-old woman was admitted for pain in the left knee. The patient's medical history showed that she had undergone arthroscopic irrigation twice and an open debridement under the diagnosis of septic shoulder at another hospital. The laboratory and joint fluid analysis findings led us to suspect septic knee. Arthroscopic irrigation and antibiotics treatment were performed. At five weeks after discharge, she presented with pain in the same joint, fever, and rash. The symptoms were consistent with Yamaguchi's criteria for AOSD. We started corticosteroid therapy, and clinical remission was achieved. In conclusion, we suggest that AOSD should be considered as a diagnosis of exclusion to avoid misdiagnosis with septic arthritis. PMID:22570830

Song, Sang Jun; Noh, Jung Ho; Seo, Geon Wook; Nam, Dong Cheol

2011-01-01

71

Co-occurrence of Kikuchi-Fujimoto's disease and Still's disease: case report and review of previously reported cases.  

PubMed

Kikuchi-Fujimoto's disease (KFD) and adult-onset Still's disease (AOSD) are rare inflammatory conditions with some overlapping features. We encountered a 22-year-old male patient who presented with daily fevers, neck discomfort, and sore throat and subsequently developed rash, arthritis, and cervical lymphadenopathy. Biopsy of the skin rash was consistent with KFD skin involvement. Given that the patient also met criteria for AOSD, a final diagnosis of KFD/AOSD co-occurrence was made. Anti-IL-1? therapy with anakinra resulted in rapid resolution of all symptoms. A literature search identified eight more cases of KFD/AOSD. Fever, rash, arthritis, and lymphadenopathy were present in all patients. No case report demonstrated an association of rash eruption clearly associated with fever spikes. Duration of symptoms ranged from 3 weeks to 10 years. Seven patients had leukocytosis, six had anemia, and five demonstrated elevated ferritin and/or decreased glycosylated ferritin. Seven patients had elevated erythrocyte sedimentation rate (ESR), and seven had transaminitis. Eight of nine patients had no evidence of infectious disease. Autoantibodies were absent from all patients. KFD and AOSD are very rare diseases, yet they may overlap. The two conditions not only share several clinical and laboratory characteristics but also differ in characteristic ways. Given the rapid response observed with anakinra in the index patient, IL-1? likely plays a role in both diseases. PMID:25098416

Toribio, Karen A; Kamino, Hideko; Hu, Stephanie; Pomeranz, Miriam; Pillinger, Michael H

2014-08-01

72

An Unusual Case of Adult-Onset Still's Disease with Hemophagocytic Syndrome, Necrotic Leukoencephalopathy and Disseminated Intravascular Coagulation  

PubMed Central

Case. A 34-year-old African-American female with a history of adult-onset Still's disease presented to an outside hospital with oligoarthritis. She experienced a generalized tonic-clonic seizure en route via ambulance, was intubated upon arrival, and transferred to the intensive care unit for treatment of suspected pneumonia and sepsis. She subsequently developed generalized cutaneous desquamation that progressed despite the cessation of antibiotics and other potential offending drugs which required transfer to our hospital's burn unit. She was suspected to have reactive hemophagocytic syndrome based on her clinical presentation of fever, rash, polyarthritis, elevated liver enzymes, coagulopathy, splenomegaly, normocytic anemia, thrombocytopenia, hypertriglyceridemia, hyperferritinemia, and hemophagocytosis visualized in bone marrow biopsy specimen. Magnetic resonance imaging demonstrated necrotic demyelination of the deep white matter and corona radiata. The patient developed multiorgan dysfunction and DIC without any other attributable etiology. Despite aggressive broad spectrum therapy and high dose of steroids she progressively deteriorated and eventually expired. Conclusion. Previous publications have highlighted the prevalence of necrotic leukoencephalopathy in children with familial hemophagocytic syndrome. Our patient demonstrated some uncommon features complicating her HLH including DIC and necrotic leukoencephalopathy, which are very rare entities in AOSD. PMID:24707428

Nannapaneni, Naveen; Altinok, Gulcin; Levine, Miriam; Dhar, J. Patricia

2014-01-01

73

GB Virus C/Hepatitis G Virus (GBV-C/HGV): still looking for a disease  

PubMed Central

GB Virus C and Hepatitis G Virus (GBV-C/HGV) are positive, single-stranded flaviviruses. GBV-C and HGV are independent isolates of the same virus. Transmission via the blood-borne route is the commonest mode, although vertical and sexual transmission is well documented. GBV-C/HGV is distributed globally; its prevalence in the general population is 10 fold higher in African countries than in non-African countries. High prevalences of GBV-C/HGV have been found in subjects with frequent parenteral exposure and in groups at high risk of exposure to blood and blood products. The clinical significance of human infection with GBV-C/HGV is currently unclear. The virus can establish both acute and chronic infection and appears to be sensitive to interferon. Only some 12–15% of chronic Non-A, B, C hepatitis cases are infected with GBV-C/HGV. A direct association with liver pathology is still lacking and it is not yet clear as to whether GBV-C/HGV is indeed a hepatotropic virus. Current evidence suggests that the spectrum of association of GBV-C/HGV infection with extrahepatic diseases ranges from haematalogical diseases, aplastic anaemia, human immunodeficiency virus (HIV)-positive idiopathic thrombocytopenia and thalassemia, through to common variable immune deficiency and cryoglobunemia. PMID:11168678

Sathar, M A; Soni, P N; York, D

2000-01-01

74

Lumpy Skin Disease in Jordan: Disease Emergence, Clinical Signs, Complications and Preliminary-associated Economic Losses.  

PubMed

The objectives of this study are to report the emergence of lumpy skin disease (LSD) in Jordan and associated clinical signs, complications and preliminary economic losses. In mid-April, 2013, two adult dairy cattle developed clinical signs suggestive of LSD and were confirmed as positive by PCR. The two cases were in Bani Kenanah district, Irbid governorate, on the Jordanian border of Israel and Syria. The disease spread rapidly to all the districts of Irbid governorate. During the month following the emergence of the disease, data were collected related to the epidemiology of the disease and the numbers of affected cattle on the premises. Forty-one dairy cattle holdings were surveyed. The morbidity rate ranged from 3% to 100%, (Mean = 35.1%, SD ±28.5%). The mortality rate ranged from 0% to 20%, (Mean = 1.3%, SD ±4.4%). The case fatality rate ranged from 0% to 100%, (Mean = 6.2%, SD ±22%). The overall morbidity rate was 26%, mortality rate 1.9% and case fatality rate 7.5%. Skin nodules, anorexia, decreased milk production and decreased body weight were common clinical signs, while mastitis and myiasis were seen as complications in a few affected animals. Decreased body weight ranged from 0% to 80%, (Mean = 23.1%, SD ±15.7%). Decreased milk production ranged from 0% to 100%, (Mean = 51.5%, SD ±22.2%). Affected cattle were treated mainly with broad-spectrum antibiotics and anti-inflammatory drugs. The cost of treatment ranged from 0 to 84.3 British Pound/animal, (Mean = 27.9 GBP, SD ±22.5 GBP). LSD continues to spread through the Middle East region and poses a serious threat to the rest of Asia and Europe. International collaboration and communication is warranted to prevent the further spread of the disease to the rest of Asia and Europe. PMID:24148185

Abutarbush, S M; Ababneh, M M; Al Zoubi, I G; Al Sheyab, O M; Al Zoubi, M G; Alekish, M O; Al Gharabat, R J

2013-10-21

75

Spinal epidural abscess – a rare complication of inflammatory bowel disease  

PubMed Central

Spinal epidural abscess is an uncommon but highly morbid illness. While it usually afflicts older, immunocompromised patients, this condition has been reported as a result of intestinal perforation in the setting of inflammatory bowel disease. Two cases of spinal epidural abscess in patients with inflammatory bowel disease are reported: one in a patient with Crohn’s disease and one in a patient with ulcerative colitis after restorative proctocolectomy. PMID:18299737

Brown, Carl J; Jaffer, Hussein; Jaffer, Nasir; Burul, Claude; McLeod, Robin S

2008-01-01

76

Is routine antenatal venereal disease research laboratory test still justified? Nigerian experience  

PubMed Central

Objective To determine the seroreactivity of pregnant women to syphilis in order to justify the need for routine antenatal syphilis screening. Methods A multicenter retrospective analysis of routine antenatal venereal disease research laboratory (VDRL) test results between 1 September 2010 and 31 August 2012 at three specialist care hospitals in south-east Nigeria was done. A reactive VDRL result is subjected for confirmation using Treponema pallidum hemagglutination assay test. Analysis was by Epi Info 2008 version 3.5.1 and Stata/IC version 10. Results Adequate records were available regarding 2,156 patients and were thus reviewed. The mean age of the women was 27.4 years (±3.34), and mean gestational age was 26.4 weeks (±6.36). Only 15 cases (0.70%) were seropositive to VDRL. Confirmatory T. pallidum hemagglutination assay was positive in 4 of the 15 cases, giving an overall prevalence of 0.19% and a false-positive rate of 73.3%. There was no significant difference in the prevalence of syphilis in relation to maternal age and parity (P>0.05). Conclusion While the prevalence of syphilis is extremely low in the antenatal care population at the three specialist care hospitals in south-east Nigeria, false-positive rate is high and prevalence did not significantly vary with maternal age or parity. Because syphilis is still a serious but preventable and curable disease, screening with VDRL alone, without confirmatory tests may not be justified. Because of the increase in the demand for evidence-based medicine and litigation encountered in medical practice, we may advocate that confirmatory test for syphilis is introduced in routine antenatal testing to reduce the problem of false positives. The government should increase the health budget that will include free routine antenatal testing including the T. pallidum hemagglutination assay. PMID:25610000

Nwosu, Betrand O; Eleje, George U; Obi-Nwosu, Amaka L; Ahiarakwem, Ita F; Akujobi, Comfort N; Egwuatu, Chukwudi C; Onyiuke, Chukwudumebi O C

2015-01-01

77

Optimal phosphate control: still an unmet need in chronic kidney disease patients.  

PubMed

Reduction of phosphate levels has traditionally been considered a mainstay treatment for patients with chronic kidney disease (CKD). Unfortunately, the treatment of hyperphosphatemia is far from being satisfactory. Available phosphate binders have limited efficacy, forcing the consumption of many tablets in order to achieve mild-to-moderate effect or low tolerability. Moreover, even if calcium-free phosphate binders, such as sevelamer and lanthanum carbonate, decrease serum phosphate levels without affecting serum calcium concentration, they do not significantly reduce circulating parathyroid hormone (PTH). The higher phosphate-binding efficacy of lanthanum carbonate should be balanced with the accumulation in bones and the lack of pleiotropic effects on lipid metabolism and inflammation. However, the fact that lanthanum carbonate seems to decrease the rate of development of vascular calcifications more or less similar to sevelamer suggests that phosphate control could actually be the key factor to improve patient outcome. New iron-based phosphate binders are undergoing clinical development. In addition to phosphate binding, they can be useful to treat anemia, and are undergoing Phase II clinical development for this indication. This could be of clinical importance particularly in CKD patients not on dialysis, avoiding the need for extra oral iron administration, and favoring compliance. In conclusion, the control of phosphate retention should still be considered an unmet medical need for CKD patients. PMID:24283572

Locatelli, Francesco; Del Vecchio, Lucia

2014-02-01

78

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...

79

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

80

Infectious complications of immunosuppressive therapy in patients with rheumatic diseases.  

PubMed

Infection continues to be a significant cause of morbidity and mortality in patients with rheumatic diseases, and, consequently, early diagnosis and treatment of infection is critical to the successful medical management of these patients. The intensity of immunosuppressive therapy is the dominant risk factor for infection in this patient population. Because the manifestations of infection in patients with rheumatic diseases are highly variable, the clinician must always be vigilant about the possibility of infection even if the clinical presentation is highly suggestive of an exacerbation of the underlying disease. We have stressed a systematic and individualized approach in the diagnostic evaluation of suspected infection in these patients. The first part of the evaluation involves forming a list of the most likely pathogens based on a detailed history and physical examination and the intensity and type of immunosuppressive therapy the patient is receiving. The physician must then formulate a plan designed to establish a diagnosis expeditiously and with the least morbidity. PMID:9156390

Segal, B H; Sneller, M C

1997-05-01

81

Musculoskeletal complications of Crohn's disease: the role of computed tomography in diagnosis and patient management.  

PubMed

The delayed diagnosis of musculoskeletal complications of Crohn's disease may produce major morbidity in patients. This study compared abdominal and pelvic computed tomography (CT) with conventional radiography in the diagnosis of musculoskeletal complications in 23 of 552 patients with Crohn's disease examined by CT over a 7-year period. Surgical confirmation was available in 15 of 21 patients. The clinical features of psoas/gluteal abscesses, abdominal wall fistulae, and sacral osteomyelitis are described. Because the clinical manifestations of these musculoskeletal complications are often nonspecific, CT is often useful in diagnosing and directing therapeutic interventions. PMID:11103962

Brenner, H I; Fishman, E K; Harris, M L; Bayless, T M

2000-11-01

82

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

Morís, Germán

2014-01-01

83

POTASSIUM, MAGNESIUM, AND ELECTROLYTE IMBALANCE AND COMPLICATIONS IN DISEASE MANAGEMENT  

Technology Transfer Automated Retrieval System (TEKTRAN)

Electrolyte balance is a critical issue in managing comorbid conditions in both diseased and elderly patients. Patients with hypertension and diabetes need careful regulation of their calcium and magnesium levels, whereas in patients with congestive heart failure, sodium and potassium levels also ar...

84

Transabdominal bowel sonography for the detection of intestinal complications in Crohn's disease  

PubMed Central

Background—The course of Crohn's disease is characterised by the occurrence of intestinal complications such as strictures, intra-abdominal fistulas, or abscesses. Standard diagnostic procedures may fail to show these complications, in particular fistulas. ?Aims—To test the value of transabdominal bowel sonography (TABS) for the detection of intestinal complications in Crohn's disease. ?Methods—TABS was prospectively performed in 213 patients with Crohn's disease in a university based inflammatory bowel disease referral centre. Thirty three underwent resective bowel surgery and were included in this study. The accuracy of TABS to detect strictures, intra-abdominal fistulas, or abscesses was compared with surgical and pathological findings. ?Results—TABS was able to identify strictures in 22/22 patients and to exclude it in 10/11 patients (100% sensitivity, 91% specificity). Fistulas were correctly identified in 20/23 patients and excluded in 9/10 patients (87% sensitivity, 90% specificity). Intra-abdominal abscesses were correctly detected in 9/9 patients and excluded in 22/24 patients (100% sensitivity, 92% specificity). ?Conclusions—In experienced hands TABS is an accurate method for the detection of intestinal complications in Crohn's disease. TABS is thus recommended as a primary investigative method for evaluation of severe Crohn's disease. ?? Keywords: Crohn's disease complications; fistula; stricture; abscess; bowel sonography PMID:9862836

Gasche, C; Moser, G; Turetschek, K; Schober, E; Moeschl, P; Oberhuber, G

1999-01-01

85

The modern pre-levodopa era of Parkinson's disease: insights into motor complications from sub-Saharan Africa.  

PubMed

During the past decade, a number of large drug trials suggested that the initiation of levodopa therapy should be delayed to reduce the risk of motor complications in patients with Parkinson's disease. However, the relative contribution of the cumulative exposure to levodopa and of disease progression to the pathophysiology of motor fluctuations and dyskinesias is still poorly understood. In this 4-year multicentre study, we investigated a large cohort of patients with Parkinson's disease in a sub-Saharan African country (Ghana), where access to medication is limited and the initiation of levodopa therapy often occurs many years after onset. The primary objective was to investigate whether the occurrence of motor complications is primarily related to the duration of levodopa therapy or to disease-related factors. Study design included a cross-sectional case-control analysis of data collected between December 2008 and November 2012, and a prospective study of patients followed-up for at least 6 months after the initiation of levodopa therapy. Ninety-one patients fulfilled criteria for clinical diagnosis of idiopathic Parkinson's disease (58 males, mean age at onset 60.6 ± 11.3 years). Demographic data were compared to those of 2282 consecutive Italian patients recruited during the same period, whereas nested matched subgroups were used to compare clinical variables. Demographic features, frequency and severity of motor and non-motor symptoms were comparable between the two populations, with the only exception of more frequent tremor-dominant presentation in Ghana. At baseline, the proportion of Ghanaian patients with motor fluctuations and dyskinesias was 56% and 14%, respectively. Although levodopa therapy was introduced later in Ghana (mean disease duration 4.2 ± 2.8 versus 2.4 ± 2.1 years, P < 0.001), disease duration at the occurrence of motor fluctuations and dyskinesias was similar in the two populations. In multivariate analysis, disease duration and levodopa daily dose (mg/kg of body weight) were associated with motor complications, while the disease duration at the initiation of levodopa was not. Prospective follow-up for a mean of 2.6 ± 1.3 years of a subgroup of 21 patients who were drug-naïve at baseline [median disease duration 4.5 (interquartile range, 2.3-5) years] revealed that the median time to development of motor fluctuations and dyskinesias after initiation of levodopa therapy was 6 months. We conclude that motor fluctuations and dyskinesias are not associated with the duration of levodopa therapy, but rather with longer disease duration and higher levodopa daily dose. Hence, the practice to withhold levodopa therapy with the objective of delaying the occurrence of motor complications is not justified. PMID:25034897

Cilia, Roberto; Akpalu, Albert; Sarfo, Fred Stephen; Cham, Momodou; Amboni, Marianna; Cereda, Emanuele; Fabbri, Margherita; Adjei, Patrick; Akassi, John; Bonetti, Alba; Pezzoli, Gianni

2014-10-01

86

Rare Manifestation of a Rare Disease, Acute Liver Failure in Adult Onset Still's Disease: Dramatic Response to Methylprednisolone Pulse Therapy—A Case Report and Review  

PubMed Central

Adult onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. It is characterized by daily fevers, arthralgias or arthritis, typical skin rash, and leukocytosis. Hepatic involvement is frequently observed in the course of AOSD with mildly elevated transaminases and/or hepatomegaly. Fulminant hepatic failure, occasionally requiring urgent liver transplantation, is a rare manifestation of AOSD. Here, we present a case of 22-year-old woman with no significant medical history who initially came with fever, arthralgias, myalgias, generalized weakness, and sore throat. Laboratory data showed mildly elevated transaminases and markedly elevated ferritin levels. She was diagnosed with AOSD based on Yamaguchi diagnostic criteria and was started on prednisone. Three months later, while she was on tapering dose of steroid, she presented with fever, abdominal pain, jaundice, and markedly elevated transaminases. Extensive workup excluded all potential causes of liver failure. She was diagnosed with AOSD associated acute liver failure (ALF). Intravenous (IV) methylprednisolone pulse therapy was started, with dramatic improvement in liver function. Our case demonstrated that ALF can present as a complication of AOSD and IV mega dose pulse methylprednisolone therapy can be employed as a first-line treatment in AOSD associated ALF with favorable outcome. PMID:24991218

Valluru, Nalini; Tammana, Venkata S.; Windham, Michael; Mekonen, Eyasu; Begum, Rehana; Sanderson, Andrew

2014-01-01

87

Spontaneous pneumopericardium in a dog with bronchopulmonary disease complicated by pyothorax and pneumothorax.  

PubMed

Spontaneous pneumopericardium is a rare condition consisting of pericardial gas in the absence of iatrogenic or traumatic causes; it has been described secondary to pneumonia, lung abscess, and bronchopulmonary disease. This report describes a case of spontaneous pneumopericardium in a dog presenting with dyspnea secondary to pyopneumothorax complicating a bronchopulmonary disease. PMID:25477548

Borgonovo, Simone; Rocchi, Paola M; Raiano, Vera; Diana, Daniela; Greci, Valentina

2014-12-01

88

Diabetes Complications  

MedlinePLUS

... the potential complications of type 1 diabetes are: Cardiovascular disease Cardiovascular disease, a range of blood vessel system diseases that ... with diabetes. The two most common types of cardiovascular disease are coronary heart disease, caused by fatty deposits ...

89

Treatment of Wilson's disease motor complications with deep brain stimulation.  

PubMed

A considerable proportion of patients with Wilson's disease (WD) experience neurologic symptoms that are functionally disabling. The most common neurologic problems in advanced WD include dystonia and tremor. Medically refractory idiopathic dystonia and essential tremor (ET) have been successfully treated with deep brain stimulation (DBS), functional surgical therapy targeting the globus pallidus pars interna (GPi), or the ventral intermediate (Vim) thalamic nucleus. Even though the pathophysiology of tremor is different in WD and ET, available experience supports DBS targeting the Vim for WD patients. Dystonia associated with WD is classified as secondary dystonia and GPi stimulation has yielded mixed results in these patients. The presence of structural changes in the basal ganglia may limit the therapeutic success of DBS for WD dystonia compared with idiopathic dystonia. In spite of these limitations, DBS in WD may be an effective approach to treat medically refractory residual neurologic symptoms in carefully selected patients. PMID:24547944

Hedera, Peter

2014-05-01

90

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

91

Knocked-out and still walking: prion protein-deficient cattle are resistant to prion disease  

Technology Transfer Automated Retrieval System (TEKTRAN)

Background: Transmissible spongiform encephalopathies (TSEs) or prion diseases are caused by the propagation of a misfolded form (PrP**d) of the normal cellular prion protein, PrP**c. Disruption of PrP**c expression in the mouse results in resistance to PrP-propagation and disease. However, the impa...

92

Care of the injured worldwide: trauma still the neglected disease of modern society  

PubMed Central

Traditionally, surgical diseases including emergency and injury care have garnered less attention and support internationally when compared to other medical specialties. Over the past decade however, healthcare professionals have increasingly advocated for the need to address the global burden of non-communicable diseases. Surgical disease, including traumatic injury, is among the top causes of death and disability worldwide and the subsequent economic burden is substantial, falling disproportionately on low- and middle-income countries (LMICs). The future of global health in these regions depends on a redirection of attention to diseases managed within surgical, anesthesia and emergency specialties. Increasing awareness of these disparities, as well as increasing focus in the realms of policy and advocacy, is crucial. While the barriers to providing quality trauma and emergency care worldwide are not insurmountable, we must work together across disciplines and across boundaries in order to negotiate change and reduce the global burden of surgical disease. PMID:22980446

2012-01-01

93

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

94

Enteropathy-Associated T Cell Lymphoma as a Complication of Silent Celiac Disease  

PubMed Central

Celiac disease is an autoimmune disorder in which a genetic predisposition and the ingestion of wheat gluten triggers a deleterious immune response. This response is complex and may lead to manifestations other than enteropathyha: hepatitis, dermatitis and neuropathy. There is higher risk for neoplasia. We observed an atypical case, corresponding to a 69-year old female presenting with complicated celiac disease. The patient was referred following the histological examination of an enterectomy specimen, which unexpectedly revealed an enteropathy-associated T cell lymphoma in a background of celiac disease. Patient’s previous medical history comprised several abdominal surgical procedures, without other prior symptoms suggestive of celiac disease. Indeed, the patient was obese and no signs of malabsortion were apparent. This case draws our attention to clinically silent celiac disease, which represents a diagnostic challenge. Thus, this should be kept in mind whenever a patient presents with abdominal relapsing complications, otherwise unexplained. PMID:25568762

Brito, Margarida Dantas; Martins, Ângelo; Henrique, Rui; Mariz, José

2014-01-01

95

Haff disease complicated by multiple organ failure after crayfish consumption: a case study  

PubMed Central

Haff disease is a syndrome consisting of unexplained rhabdomyolysis. Patients suffering from Haff disease report having eaten fish within 24 hours before the onset of illness. Most patients survive and recover quickly. The present study is the first report of Haff disease complicated by multiple organ failure after crayfish consumption. A 66-year-old Chinese man ate cooked crayfish on the night of June 23, 2013. He arrived at our hospital 2 days later and was admitted to the intensive care unit. After admission, the patient was diagnosed with Haff disease complicated by multiple organ failure. Despite supportive and symptomatic treatments, the condition of the patient deteriorated, and he died due to his illness. Haff disease is a rare clinical syndrome that is sometimes misdiagnosed. Early diagnosis and proper treatment are essential to prevent progression to multiple organ failure. PMID:25607271

Feng, Gang; Luo, Qiancheng; Zhuang, Ping; Guo, Enwei; Yao, Yulan; Gao, Zhongyu

2014-01-01

96

Transcatheter aortic valve replacement for patients with aortic valve stenosis complicated with moyamoya disease.  

PubMed

Moyamoya disease (MMD) is a rare disease characterized by occlusive intracranial arteriopathy with formation of abnormal cerebrovascular collateral networks. Conventional cardiovascular surgical procedures using cardiopulmonary bypass for patients with MMD is challenging because low cerebral perfusion pressure and nonpulsatile (continuous) flow during cardiopulmonary bypass can cause severe cerebral ischemia. We successfully performed transcatheter aortic valve replacement in 3 women with severe aortic valve stenosis complicated with MMD. Transcatheter aortic valve replacement may be useful for patients with severe aortic valve stenosis complicated with severe cerebral ischemia, including MMD. PMID:25282207

Maeda, Koichi; Kuratani, Toru; Torikai, Kei; Mizote, Isamu; Iritakenishi, Takeshi; Takeda, Yasuharu; Nakatani, Satoshi; Nanto, Shinsuke; Toda, Koichi; Sawa, Yoshiki

2014-10-01

97

Giant aortic arch aneurysm complicating Kawasaki disease: an original case report  

PubMed Central

Summary 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, related reports on peripheral arterial and aortic aneurysms are scarce. We report an original case of a giant aortic aneurysm involving the horizontal part of aortic arch in a 28 months- old patient diagnosed with Kawasaki Disease. This complication was managed by steroids therapy in the beginning than surgery was indicated because of mechanical complication and risk of rupture.

Kaouthar, Hakim; Rafik, Boussaada; Jihen, Ayari; Imen, Hamdi; Lilia, Chaker; Fatma, Ouarda; Hela, Msaad

2014-01-01

98

Complications of pulmonary AVMs in a patient with Rendu-Osler-Weber disease.  

PubMed

Rendu-Osler-Weber disease, also called hereditary hemorrhagic telangiectasia (HHT), is a rare, genetically determined complex disease with a spectrum of associated manifestations which extend beyond the typical pathology of arteriovenosus malformations (AVMs). Our subject, a 54-year-old male patient with a long history of HHT has a typical mucocutaneous telangiectasias and bleeding from the nose, but the most important manifestations of the disease are those related to pulmonary AVMs. A variety of complications, such as hypoxemia, polycythemia, cyanosis, clubbing fingers and brain abscesses, have developed over time as a consequence of a-v shunt in the pulmonary AVMs. A large pulmonary AVM necessitated a surgical intervention when the patient was in his thirties, and two more surgeries followed later, due to brain abscesses. Despite intensive manifestations of the disease and episodes of life threatening complications, the patient has adjusted well to his chronic medical condition and lives a near-normal life. PMID:25507382

Skrinjari?-Cincar, Sanda; Petrovi?, Gordana; Fuštar Bosanac, Vanja; Fija?ko, Vladimir; He?imovi?, Ivan

2014-09-01

99

Complications of pulmonary AVMs in a patient with Rendu-Osler-Weber disease.  

PubMed

Rendu-Osler-Weber disease, also called hereditary hemorrhagic telangiectasia (HHT), is a rare, genetically determined complex disease with a spectrum of associated manifestations which extend beyond the typical pathology of arteriovenosus malformations (AVMs). Our subject, a 54-year-old male patient with a long history of HHT has a typical mucocutaneous telangiectasias and bleeding from the nose, but the most important manifestations of the disease are those related to pulmonary AVMs. A variety of complications, such as hypoxemia, polycythemia, cyanosis, clubbing fingers and brain abscesses, have developed over time as a consequence of a-v shunt in the pulmonary AVMs. A large pulmonary AVM necessitated a surgical intervention when the patient was in his thirties, and two more surgeries followed later, due to brain abscesses. Despite intensive manifestations of the disease and episodes of life threatening complications, the patient has adjusted well to his chronic medical condition and lives a near-normal life. PMID:25420398

Skrinjari?-Cincar, Sanda; Petrovi?, Gordana; Fuštar Bosanac, Vanja; Fija?ko, Vladimir; He?imovi?, Ivan

2014-09-01

100

[Scurvy, an old disease still in the news: Two case reports].  

PubMed

Scurvy is the clinical manifestation of a deficiency in vitamin C, which is present in fresh fruits and vegetables. It is historically linked to the era of great maritime expeditions. Manifestations are misleading in children, in contrast with adults: bone disease and hemorrhagic syndrome are the earliest and most frequent manifestations due to a collagen biosynthesis defect. Scurvy is an old, potentially fatal disease but is easily curable with ascorbic acid. It can be prevented with vitamin C treatment in pediatric populations with unusual eating habits. We describe two cases of pediatric scurvy in two 7-year-old boys who had dietary restrictions stemming from developmental disorders. PMID:25455083

Pailhous, S; Lamoureux, S; Caietta, E; Bosdure, E; Chambost, H; Chabrol, B; Bresson, V

2015-01-01

101

[Treatment of thoracic aortic disease using endovascular stent-grafts: from therapeutic indications to possible complications].  

PubMed

Thoracic endovascular aortic repair (TEVAR) is a minimally invasive technique which is increasingly used in different thoracic aortic pathologies such as aortic aneurysm, complicated type B aortic dissection, aortic trauma, intramural hematoma and penetrating aortic ulcer. In this paper we discuss the main indications for endovascular stent-grafts in the treatment of thoracic aortic disease, based on three cases in which this procedure was used for three different conditions: degenerative aneurysm, complicated type B dissection and post-traumatic injury. These case reports add to the evidence that TEVAR is a safe and feasible therapeutic alternative in selected patients with thoracic aortic disease, improving aortic remodeling, with relatively low morbidity and mortality. The main complications and difficulties related to the procedure are also discussed. PMID:22285176

Fontes-Carvalho, Ricardo; Braga, Pedro; Rodrigues, Alberto; Bettencourt, Nuno; Santos, Lino; Melica, Bruno; Rocha, João; Gonçalves, Manuel; Ribeiro, Vasco Gama

2012-03-01

102

[Management of complications related to intraduodenal infusion of levodopa/carbidopa in patients with Parkinson's disease].  

PubMed

Continuous infusion of intraduodenal levodopa/carbidopa is an effective treatment that improves the motor complications and the quality of life of patients in the advanced stages of Parkinson's disease. However, it is not free of complications. These may present in the post-operative period following surgery (gastrostomy) or in the long-term during the follow-up period and can be related with the medication (levodopa/carbidopa), the stoma, the gastrostomy or the device (pump, enteral tube, parts of the FREKA system). The aim of this review is to report on the management of the complications that can be observed in patients with advanced Parkinson's disease treated with continuous infusion of intraduodenal levodopa/carbidopa. PMID:24861226

Santos-Garcia, Diego; de Deus, Teresa; Lopez-Pazos, Elina; Macias-Arribi, Mercedes; Llaneza-Gonzalez, Miguel A; Echarri-Piudo, Ana; Carpintero, Pedro; de la Fuente-Fernandez, Raúl

2014-06-01

103

Clinical significance of 18 F-fluoro-dexoxyglucose positron emission tomography in patients with adult-onset Still’s disease: report of two cases and review of literatures  

Microsoft Academic Search

Adult-onset Still’s disease (AOSD) is a multi-systemic inflammatory disease that usually presents with high fever and variable\\u000a systemic features. The pathogenesis and etiology of AOSD have not yet been clearly determined. In addition, there is no diagnostic\\u000a test for AOSD. Even though some useful diagnostic criteria or laboratory findings, such as serum ferritin levels, have been\\u000a proposed, useful imaging studies

Jung-Yoon Choe; Duck Soo Chung; Sung-Hoon Park; Hyun-Hee Kwon; Seong-Kyu Kim

2010-01-01

104

Natural History, Prognosis, Clinical Features and Complications of Metastatic Bone Disease  

Microsoft Academic Search

The survival and prognosis of patients with metastatic bone disease varies widely and depends on many factors including the\\u000a histologic type and grade of the primary tumor, performance status and age of patients, presence of extraosseus metastases,\\u000a level of tumor markers and extend of skeletal disease. Bone metastases are inevitably associated with considerable morbidity\\u000a and suffering, and severe complications such

Vassilios Vassiliou; Edward Chow; Dimitrios Kardamakis

105

Severe Metabolic Bone Disease as a Long-Term Complication of Obesity Surgery  

Microsoft Academic Search

Background: Metabolic bone disease is a well-documented long-term complication of obesity surgery. It is often undiagnosed,\\u000a or misdiagnosed, because of lack of physician and patient awareness. Abnormalities in calcium and vitamin D metabolism begin\\u000a shortly after gastrointestinal bypass operations; however, clinical and biochemical evidence of metabolic bone disease may\\u000a not be detected until many years later. Case Report: A 57-year-old

Whitney S. Goldner; Thomas M. O'Dorisio; Joseph S. Dillon; Edward E. Mason

2002-01-01

106

SPECIAL FEATURES OF THE COURSE IN INJURIES AND BURNS OF THE EYE, COMPLICATED BY RADIATION DISEASE  

Microsoft Academic Search

It was experimentally proved that healing of wounds in radiated animals ; is complicated by the development of a wound infection, especially during the ; climax period, i.e., 2 to 3 weeks after infection. This fact raised the question ; whether radiation disease influences also the healing process of wounds and burns ; ot the eye. Based on experiments on

Polyak

1958-01-01

107

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

108

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

109

Increased Immune Reactivity Predicts Aggressive Complicating Crohn’s disease in Children  

PubMed Central

Background and Aim The ability to identify children with Crohn’s disease who are at highest risk for rapid progression from uncomplicated to complicated phenotypes would be invaluable in guiding initial therapy. Aim: To determine whether immune responses and/or CARD15 variants are associated with complicated disease phenotypes and predict disease progression. Methods Sera were collected from 796 pediatric CD cases and tested for anti-Cbir1 (flagellin), anti-outer membrane protein C (anti-OmpC), anti-Saccharomyces-cerevisiae (ASCA) and perinuclear anti-neutrophil cytoplasmic antibody (pANCA) using ELISA. Genotyping (TaqmanMGB) was performed for 3 CARD15 variants (SNPs 8, 12, 13). Associations between immune responses (antibody sum (AS) and quartile sum score (QSS), CARD15, and clinical phenotype were evaluated. Results 32% of patients developed at least one disease complication within a median of 32 months and 18% underwent surgery. The frequency of internal penetrating (IP), stricturing (S) and surgery significantly increased (p trend < 0.0001 for all 3 outcomes) with increasing AS and QSS. 9% of seropositive groups had IP/S vs. 2.9% in the seronegative group (p=0.01). 12% of seropositive groups underwent surgery vs. 2% in the seronegative group (p=0.0001). The highest AS group (3) and QSS group (4) demonstrated the most rapid disease progression (p < 0.0001). Increased hazard ratio was observed for AS group 3 (7.8 [2.2–28.7] p < 0.002 and QSS group 4 (11.0 [1.5,83.0] p < 0.02). Conclusions The rate of complicated CD increases in children as the number and magnitude of immune reactivity increases. Disease progression is significantly faster in children expressing immune reactivity. PMID:18619921

Dubinsky, Marla C; Kugathasan, Subra; Mei, Ling; Picornell, Yoana; Nebel, Justin; Wrobel, Iwona; Quiros, Antonio; Silber, Gary; Wahbeh, Ghassan; Katzir, Lirona; Vasiliauskas, Eric; Bahar, Ron; Otley, Anthony; Mack, David; Evans, Jonathan; Rosh, Joel; Hemker, Maria Oliva; Leleiko, Neal; Crandall, Wallace; Langton, Christine; Landers, Carol; Taylor, Kent D.; Targan, Stephan R; Rotter, Jerome I; Markowitz, James; Hyams, Jeffrey

2009-01-01

110

Unstable moyamoya disease: clinical features and impact on perioperative ischemic complications.  

PubMed

OBJECT Unstable moyamoya disease, reasonably defined as cases exhibiting either rapid disease progression or repeated ischemic stroke, represents a challenge in the treatment of moyamoya disease. Despite its overall efficacy, direct bypass for such unstable disease remains controversial in terms of safety. This study aims to reveal factors associated with unstable disease and to assess its impact on postoperative silent or symptomatic ischemic lesions. METHODS This retrospective cohort study included both pediatric and adult patients with moyamoya disease who had undergone 140 consecutive direct bypass procedures at Kyoto University Hospital. "Unstable moyamoya disease" was defined as either the rapid progression of a steno-occlusive lesion or repeat ischemic stroke, either occurring within 6 months of surgery. The extent of progression was determined through a comparison of the findings between 2 different MR angiography sessions performed before surgery. The clinical variables of the stable and unstable disease groups were compared, and the association between unstable disease and postoperative diffusion-weighted imaging (DWI)-detected lesion was assessed through univariate and multivariate analyses with generalized estimating equations. RESULTS Of 134 direct bypass procedures performed after patients had undergone at least 2 sessions of MR angiography, 24 (17.9%) were classified as cases of unstable disease. Age younger than 3 years (p = 0.029), underlying disease causing moyamoya syndrome (p = 0.049), and radiographic evidence of infarction (p = 0.030) were identified as factors associated with unstable disease. Postoperative DWI-defined lesions were detected after 13 of 140 procedures (9.3%), although only 4 lesions (2.9%) could be classified as a permanent complication. The incidence of postoperative DWI-detected lesions in the unstable group was notable at 33.3% (8 of 24). Univariate analysis revealed that unstable disease (p < 0.001), underlying disease (p = 0.028), and recent stroke (p = 0.012) were factors associated with DWI-detected lesions. Unstable disease remained statistically significant after adjustment for covariates in both the primary and sensitivity analyses (primary analysis: OR 6.62 [95% CI 1.79-24.5]; sensitivity analysis: OR 5.36 [95% CI 1.47-19.6]). CONCLUSIONS Unstable moyamoya disease, more prevalent in younger patients and those with underlying disease, is a possible risk factor for perioperative ischemic complications. Recognition of unstable moyamoya disease may contribute to an improved surgical result through focused perioperative management based on appropriate surgical risk stratification. PMID:25423271

Funaki, Takeshi; Takahashi, Jun C; Takagi, Yasushi; Kikuchi, Takayuki; Yoshida, Kazumichi; Mitsuhara, Takafumi; Kataoka, Hiroharu; Okada, Tomohisa; Fushimi, Yasutaka; Miyamoto, Susumu

2015-02-01

111

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

112

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

113

Adult Still's disease  

MedlinePLUS

... and goes with the fever. Additional symptoms include: Abdominal pain and swelling Pain with a deep breath (pleurisy) Sore throat Swollen lymph nodes (glands) Weight loss The spleen or liver may ...

114

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

115

Small bowel transplantation complicated by cytomegalovirus tissue invasive disease without viremia.  

PubMed

We report on a small bowel transplant patient, donor/recipient seropositive (D+/R+) for cytomegalovirus (CMV), with a clinical course complicated by CMV disease. Anti-CMV prophylaxis was given for 100 days. Immunosuppression consisted of alemtuzumab, tacrolimus, mycophenolate mofetil and prednisolone. Five months posttransplant, CMV tissue invasive disease of the upper gastrointestinal tract was evident without the presence of viremia, tested by quantitative polymerase chain reaction (PCR). Complete viral load suppression was achieved with intravenous ganciclovir, followed by valganciclovir for secondary prophylaxis. Mycophenolate mofetil and prednisolone were discontinued. Shortly thereafter the patient presented with recurrent CMV and candida esophagitis. While on ganciclovir and caspofungin, the patient developed CMV tissue invasive disease of the ileal graft, with persistent absence of viremia. Foscarnet and CMV immunoglobulin were added. Viral load declined to undetectable levels; however, clinical improvement did not occur due to occurrence of graft rejection. Despite infliximab and high dose prednisolone, graft rejection was progressive, requiring surgical explantation of the graft. This case highlights the importance of additional diagnostic tools such as endoscopy including PCR analysis of tissue samples. Extension of primary antiviral prophylaxis interval up to 6 months and prolonged retreatment for recurrent CMV disease may be useful to avoid severe CMV-related complications. PMID:24703746

Avsar, Yesim; Cicinnati, Vito R; Kabar, Iyad; Wolters, Heiner; Anthoni, Christoph; Schmidt, Hartmut H J; Beckebaum, Susanne

2014-06-01

116

Treatment of hepatic hydatid disease complications using endoscopic retrograde cholangiopancreatography procedures  

PubMed Central

Background Liver hydatidosis may lead to serious morbidity due to biliary complications, the management for which endoscopic sphincterotomy (ES) and biliary drainage are very efficient. We evaluated the effectiveness of endoscopic treatment for complications of hepatic hydatid disease. Methods We retrospectively reviewed endoscopic retrograde cholangiopancreatography (ERCP) procedures performed between January 2000 and December 2009 and compared laboratory findings, localization of the lesions and ERCP procedures applied between patients with and without jaundice. Results In all, 70 ERCP procedures were performed in 54 patients (24 men, 30 women). Of the 70 procedures, 24 were performed to treat jaundice. All patients with biliary fistulas and jaundice were managed with endoscopic procedures. The 70 ERCP procedures included sphincterotomy only (n = 40); sphincterotomy and stent placement (n = 7); stent placement only (n = 4); sphincterotomy and membrane extraction (n = 9); sphincterotomy, membrane extraction and pus drainage (n = 5); and sphincterotomy and pus drainage (n = 5). Laboratory results improved in 3–7 days, and bile leakage ceased in 2–21 days. Conclusion Endoscopic retrograde cholangiopancreatography is a safe and effective way to manage biliary complications of hepatic echinococcal disease. In most patients, ES is the most efficient treatment of postoperative external biliary fistulas, jaundice and accompanying cholangitis, as it enables clearing the bile ducts of hydatid remnants; ES should be performed since it accelerates the healing process by decreasing pressure in the choledochus. PMID:22617539

Akaydin, Murat; Erozgen, Fazilet; Ersoy, Yeliz E.; Birol, Selim; Kaplan, Rafet

2012-01-01

117

Increased serum HO-1 in hemophagocytic syndrome and adult-onset Still's disease: use in the differential diagnosis of hyperferritinemia  

PubMed Central

Heme oxygenase-1 (HO-1), an inducible heme-degrading enzyme, is expressed by macrophages and endothelial cells in response to various stresses. Because ferritin synthesis is stimulated by Fe2+, which is a product of heme degradation, we examined the relation between HO-1 and ferritin levels in the serum of patients with hemophagocytic syndrome (HPS), adult-onset Still's disease (ASD), and other diseases that may cause hyperferritinemia. Seven patients with HPS, 10 with ASD, 73 with other rheumatic diseases, 20 with liver diseases, 10 recipients of repeated blood transfusion because of hematological disorders, and 22 healthy volunteers were enrolled. Serum HO-1 and ferritin levels were determined by ELISA. Expression of HO-1 mRNA and protein by peripheral blood mononuclear cells (PBMCs) was determined by real-time PCR and immunocytochemical techniques, respectively. Serum levels of HO-1 were significantly higher in patients with active HPS and ASD than in the other groups (P < 0.01). HO-1 levels were not elevated in patients with other causes of hyperferritinemia but were moderately elevated in patients with dermatomyositis/polymyositis. Among patients with HPS and ASD, serum HO-1 levels correlated closely with serum ferritin levels, and the levels of both returned to normal after therapy had induced remission. Increased expression of HO-1 mRNA was confirmed in PBMCs from some patients with HPS and ASD. Hyperferritinemia correlated closely with increased serum HO-1 in patients with HPS and ASD but not other conditions, indicating that measurement of serum HO-1 and ferritin levels would be useful in the differential diagnosis of hyperferritinemia and perhaps also in monitoring disease activity in HPS and ASD. PMID:15899048

Kirino, Yohei; Takeno, Mitsuhiro; Iwasaki, Mika; Ueda, Atsuhisa; Ohno, Shigeru; Shirai, Akira; Kanamori, Heiwa; Tanaka, Katsuaki; Ishigatsubo, Yoshiaki

2005-01-01

118

Complicated pancreatic inflammatory disease: Diagnostic and therapeutic role of interventional radiology  

SciTech Connect

Diagnostic and therapeutic interventional radiology techniques in 41 patients with complications of pancreatic inflammatory disease are described. Computed tomography or ultrasound-guided aspiration or percutaneous pancreatic ductography enabled specific diagnoses in 43 of 45 patients (96%). Single-step needle aspiration of noninfected pseudocysts was successful in only three of ten patients (30%). Catheter drainage cured six of seven noninfected pseudocysts (85.7%) and seven of nine infected pseudocysts (77.7%). Pancreatic abscesses were drained successfully in nine of 13 patients (69.2%); temporizing benefit was achieved in the other four who eventually underwent surgery in improved condition. Early diagnosis of the complications of pancreatitis may be established almost uniformly, and at least 70% of patients with infected or noninfected pseudocysts and pancreatic abscesses may be cured by nonoperative drainage.

vanSonnenberg, E.; Wittich, G.R.; Casola, G.; Stauffer, A.E.; Polansky, A.D.; Coons, H.G.; Cabrera, O.A.; Gerver, P.S.

1985-05-01

119

Short-term central venous catheter complications in patients with sickle cell disease who undergo apheresis.  

PubMed

Patients with sickle cell disease (SCD) are prone to develop thrombosis and infection due to their inflammatory and immune deficiency state. These patients require red cell exchange therapy for treatment or prevention of hemoglobin S associated complications. Owing to vascular access problems, adult patients need central venous catheterization (CVC) for exchange procedures. Procedure related complications have been reported for long-term CVCs in pediatric patients. However, short-term CVC complications in adult patients are not clear. This report represents the results of documented complications of short-term CVCs in patients with SCD who undergo apheresis. A total of 142 non-tunneled catheters with average median diameter of 9 F (range 8-16 F) were implanted for apheresis. The catheters were mainly inserted through the right internal jugular vein (66.2 %). Total days of catheter were 412. Results were reported as a complication rate and event according to 1,000 catheter days and compared to a control group including 37 healthy stem cell donors. In the patient group, 1 (1 %) hematoma and 1 (1 %) infection were observed for internal jugular vein catheterization (3.7 hemorrhages and 3.7 infections according to 1,000 catheter days), whereas four (8.9 %) cases of thrombosis and 1 (2.2 %) infection (27 and 6.9 according to 1,000 catheter days) developed in femoral vein. There was a significant difference in terms of thrombosis (P = 0.009). In the control group, only individual developed thrombosis in internal jugular vein. Short-term CVC inserted through to the internal jugular vein seems to be safer than femoral vein in patients with SCD. PMID:23504572

Yeral, Mahmut; Boga, Can; Oguzkurt, Levent; Asma, Suheyl; Kasar, Mutlu; Kozanoglu, Ilknur

2014-01-01

120

Behçet's Disease Complicated with Thrombosis: A Report of 93 Chinese Cases.  

PubMed

To investigate the clinical features of Behçet's disease (BD) complicated with thrombosis.Medical records of patients with BD at Peking Union Medical College Hospital from 1993 to 2013 were reviewed to identify thrombosis.Of the 766 patients with BD, 93 patients (16 female and 77 male) developed thrombosis. The most common thrombosis was extremity vein thrombosis (86.0%), including deep vein thrombosis (n?=?78) and superficial thrombophlebitis (n?=?4). The other thrombosis types associated with BD in descending frequency of order were: vena cava thrombosis (30.1%), pulmonary thromboembolism (15.1%), cerebral venous thrombosis (CVT) (12.9%), intracardiac thrombosis (8.6%), Budd-Chiari syndrome (7.5%), and renal vein thrombosis (4.3%), etc. Venous thrombosis is more frequent than arterial thrombosis, and most of patients (94.6%) experienced multiple thrombosis. A male predominance of extremity vein thrombosis and positive pathergy test, and a female predominance of CVT and genital ulcers were noted. All of these patients exhibited active disease during the emergence of thrombotic events. After treating with glucocorticosteroids, immunosuppressants, and/or anticoagulants, the thrombosis resolved in 89 patients. Three patients died from aneurysm rupture, myocardial infarction and Budd-Chiari syndrome, respectively. One patient with septic shock discontinued therapy during follow-up.Thrombosis in BD patients is male predominance, mainly multiple and venous thrombosis is more common. Active disease patients are prone to thrombosis, which suggest the key role of immunosuppressive therapy for the complication. PMID:25526452

Wu, Xiuhua; Li, Guohua; Huang, Xinxiang; Wang, Li; Liu, Wanli; Zhao, Yan; Zheng, Wenjie

2014-12-01

121

The Frequency of Complications and the Etiology of Disease in Patients with Liver Cirrhosis in Erzurum  

PubMed Central

Objective: This study included 100 patients diagnosed with liver cirrhosis who presented at Atatürk University Faculty of Medicine Gastroenterology clinic and polyclinic. Materials and Methods: The etiology of liver cirrhosis and the incidence of its complications have been investigated. Results: The etiological classification of liver cirrhosis in our patients was as follows: 47 hepatitis B virus hepatitis, 11 hepatitis C virus hepatitis, 5 HBV+HDV hepatitis, 4 Budd Chiari syndrome, 2 chronic alcohol abuse, 2 ischemic heart disease, 1 autoimmune hepatitis, 1 sclerosing cholangitis, 1 hydatid cyst. In 26 patients we could not find any etiological condition. These patients were called cryptogenic cirrhosis patients.When we examined the complications of liver cirrhosis, it appeared that there were ascites in 83 patient. In 56 patients, esophageal variceal bleeding occurred. There was spontaneous bacterial peritonitis in 42 patients. Hepatorenal syndrome occurred in 26 patients. Finally, in 3 patients we detected hepatorenal syndrome. Conclusion: The most common causes in the etiology of liver cirrhosis are viral, especially HBV. Many of the patients were in decompensated phase when diagnosed. We found that there was a close relation between the frequency of complications and mortality in liver cirrhosis. PMID:25610308

Topdagi, Omer; Okcu, Nihat; Bilen, Nurhan

2014-01-01

122

An aortoduodenal fistula as a complication of immunoglobulin G4-related disease  

PubMed Central

Most primary aortoduodenal fistulas occur in the presence of an aortic aneurysm, which can be part of immunoglobulin G4 (IgG4)-related sclerosing disease. We present a case who underwent endovascular grafting of an aortoduodenal fistula associated with a high serum IgG4 level. A 56-year-old male underwent urgent endovascular reconstruction of an aortoduodenal fistula. The patient received antibiotics and other supportive therapy, and the postoperative course was uneventful, however, elevated levels of serum IgG, IgG4 and C-reactive protein were noted, which normalized after the introduction of steroid therapy. Control computed tomography angiography showed no endoleaks. The primary aortoduodenal fistula may have been associated with IgG4-related sclerosing disease as a possible complication of IgG4-related inflammatory aortic aneurysm. Endovascular grafting of a primary aortoduodenal fistula is an effective and minimally invasive alternative to standard surgical repair. PMID:23155348

Sarac, Momir; Marjanovic, Ivan; Bezmarevic, Mihailo; Zoranovic, Uros; Petrovic, Stanko; Mihajlovic, Miodrag

2012-01-01

123

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

124

Interleukin 1 inhibition with anakinra in adult-onset Still disease: a meta-analysis of its efficacy and safety  

PubMed Central

Background Anakinra is the first interleukin-1 inhibitor to be used in clinical practice, and recent evidence showed that interleukin-1 plays a pivotal role in the pathogenesis of adult-onset Still disease (AoSD). However, data concerning efficacy with anakinra use in different clinical trials has not been evaluated, and the overall remission of AoSD with anakinra treatment has not been well defined. Methods We conducted a search on Embase, PubMed, and the Cochrane Library for relevant trials. Statistical analyses were conducted to calculate the overall remission rates, odds ratios (OR), and 95% confidence intervals (CI), by using either random effects or fixed effect models according to the heterogeneity. Results Of the 273 articles that were identified, 265 were excluded. Eight studies were eligible for inclusion. The overall remission rate and complete remission rate of anakinra in AoSD patients were 81.66% (95% CI: 69.51%–89.69%) and 66.75% (95% CI: 59.94%–75.3%), respectively. Compared with the controls, the use of anakinra was associated with a significant remission in AoSD, with an OR of 0.16 (95% CI: 0.06–0.44, P=0.0005). There were also significant reductions of the dosage of corticosteroid (mean difference =21.19) (95% CI: 13.2–29.18, P<0.0001) from anakinra onset to the latest follow up time. Clinical and laboratory parameters were all improved, and anakinra was well tolerated in patients with AoSD. No evidence of publication bias was observed. Conclusion Our study has shown that anakinra is effective in remitting the manifestations of AoSD, with reduction of the dose of corticosteroid in patients with AoSD. Further, anakinra therapy was not associated with increased risk of adverse events, and it was well tolerated in patients with AoSD. Further research is still recommended to investigate these findings. PMID:25473268

Hong, Dongsheng; Yang, Zhihai; Han, Shuyin; Liang, Xingguang; Ma, Kuifen; Zhang, Xingguo

2014-01-01

125

Angiogenesis-Related Biomarkers in Patients with Alcoholic Liver Disease: Their Association with Liver Disease Complications and Outcome  

PubMed Central

Angiogenesis is believed to be implicated in the pathogenesis of alcoholic liver disease (ALD). We aimed to explore the usefulness and accuracy of plasma angiogenic biomarkers for noninvasive evaluation of the severity of liver failure and ALD outcome. One hundred and forty-seven patients with ALD were prospectively enrolled and assessed based on their (1) gender, (2) age, (3) severity of liver dysfunction according to the Child-Turcotte-Pugh and MELD scores, and (4) the presence of ALD complications. Plasma levels of vascular endothelial growth factor (VEGF-A) and angiopoietins 1 and 2 (Ang1 and Ang2) were investigated using ELISAs. Multivariable logistic regression was applied in order to select independent predictors of advanced liver dysfunction and the disease complications. Significantly higher concentrations of Ang2 and VEGF-A in ALD patients as compared to controls were found. There was no difference in Ang1 levels in both groups. A positive correlation of Ang2 levels with INR (Rho 0.66; P < 0.0001) and its inverse correlation with plasma albumin levels (Rho –0.62; P < 0.0001) were found. High Ang2 concentrations turned out to be an independent predictor of severe liver dysfunction, as well as hepatic encephalopathy and renal impairment. Ang2 possessed the highest diagnostic and prognostic potential among three studied angiogenesis-related molecules. PMID:24959006

Cichoz-Lach, Halina

2014-01-01

126

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

127

Soy Allergy Complicating Disease Management in a Child With Coeliac Disease.  

PubMed

Food allergy is an immune-mediated reaction that occurs reproducibly on exposure to a certain food or food component (most commonly a protein) and is distinct from other conditions causing adverse responses to food, including digestive/absorptive processes, toxic reactions and autoimmune disorders [1]. Coeliac disease (CD) is an autoimmune condition which typically presents with gastrointestinal symptoms and failure to thrive within the first years of life and is caused by an abnormal immunological response to ingested gluten, in genetically predisposed individuals [2,3]. Its diagnosis is primarily based on the presence of characteristic duodenal biopsy findings (villous atrophy, crypt hyperplasia and intraepithelial lymphocytosis) along with documentation of clinical or histological response to a gluten-free diet (GFD) [4]. This article is protected by copyright. All rights reserved. PMID:25376325

Syrigou, Ekaterini; Angelakopoulou, Aspasia; Merikas, Emmanouil; Syrigos, Konstantinos

2014-11-01

128

Orbital socket contracture: a complication of inflammatory orbital disease in patients with Wegener’s granulomatosis  

PubMed Central

Aim: To describe the clinical characteristics of orbital socket contracture in patients with Wegener’s granulomatosis (WG). Methods: A retrospective cohort study The medical records of 256 patients with WG examined at the National Institutes of Health from 1967 to 2004 were reviewed to identify patients with orbital socket contracture. Details of the orbital disease including Hertel exophthalmometry readings, radiological findings, and results of eye examinations were recorded. Orbital socket contracture was defined as orbital inflammation with proptosis followed by the development of enophthalmos and radiographic evidence of residual fibrotic changes in the orbit. To examine for risk factors in the development of a contracted orbit, patients with orbital socket contracture were compared to patients without contracture with respect to multiple variables including history of orbital surgery, orbital disease severity, and major organ system involvement. The main outcome measures were the clinical characteristics of orbital socket contracture associated with inflammatory orbital disease in patients with WG. Results: Inflammatory orbital disease occurred in 34 of 256 (13%) patients and detailed clinical data on 18 patients were available and examined. Orbital socket contracture occurred during the clinical course in six patients; the features included restrictive ophthalmopathy (five), chronic orbital pain (three), and ischaemic optic nerve disease (two) resulting in blindness (no light perception) in one patient. The orbital socket contracture occurred within 3 months of treatment with immunosuppressive medications for inflammatory orbital disease in five patients and was not responsive to immunosuppressive medications. The median degree of enophthalmos in the contracted orbit compared with the fellow eye was 2.8 mm (range 1.5–3.5 mm) by Hertel exophthalmometry. There were no risk factors that predicted development of orbital socket contracture. Conclusions: In six patients with WG and active inflammatory orbital disease, orbital socket contracture occurred during the treatment course with systemic immunosuppressive medications. The orbital socket contracture, presumably caused by orbital fibrosis, led to enophthalmos, restrictive ophthalmopathy, chronic orbital pain, and optic nerve disease and was not responsive to immunosuppressive therapy. Orbital socket contracture has not been previously reported as a complication of inflammatory orbital disease associated with WG and was an important cause of visual morbidity in our cohort of patients. PMID:15774931

Talar-Williams, C; Sneller, M C; Langford, C A; Smith, J A; Cox, T A; Robinson, M R

2005-01-01

129

Complicated Whipple’s disease and endocarditis following tumor necrosis factor inhibitors  

PubMed Central

AIM: To test whether treatment with tumor necrosis factor inhibitors (TNFI) is associated with complications of Tropheryma whipplei (T. whipplei) infection. METHODS: Because unexplained arthritis is often the first Whipple’s disease (WD) symptom, patients may undergo treatment with TNFI before diagnosis. This may influence the course of infection with T. whipplei, which causes WD, because host immune defects contribute to the pathogenesis of WD. A literature search and cross referencing identified 19 reports of TNFI treatment prior to WD diagnosis. This case-control study compared clinical data in patients receiving TNFI therapy (group?I, n = 41) with patients not receiving TNFI therapy (group II, n = 61). Patients from large reviews served as controls (group III, n = 1059). RESULTS: The rate of endocarditis in patient group?I?was significantly higher than in patient group II (12.2% in group?I vs 1.6% in group II, P < 0.05), and group III (12.2% in group?I?vs 0.16% in group III, P < 0.01). Other, severe systemic or local WD complications such as pericarditis, fever or specific organ manifestations were increased also in group?I?as compared to the other patient groups. However, diarrhea and weight loss were somewhat less frequent in patient group?I. WD is typically diagnosed with duodenal biopsy and periodic acid Schiff (PAS) staining. PAS-stain as standard diagnostic test had a very high percentage of false negative results (diagnostic failure in 63.6% of cases) in group I. Polymerase chain reaction (PCR) for T. whipplei was more accurate than PAS-stainings (diagnostic accuracy, rate of true positive tests 90.9% for PCR vs 36.4% for PAS, P < 0.01). CONCLUSION: TNFI trigger severe WD complications, particularly endocarditis, and lead to false-negative PAS-tests. In case of TNFI treatment failure, infection with T. whipplei should be considered. PMID:25548618

Marth, Thomas

2014-01-01

130

Disseminated kidney tuberculosis complicating autosomal dominant polycystic kidney disease: a case report.  

PubMed

Mycobacterium tuberculosis infection in patients with autosomal dominant polycystic kidney disease (ADPKD) is rare, and its diagnosis and treatment are difficult because numerous cysts are exposed to infection and antibiotics do not easily penetrate infected cysts. Here, we report the case of a 43-year-old Japanese man with disseminated urogenital tuberculosis (TB) and ADPKD without human immunodeficiency virus (HIV) infection. Delayed diagnosis and ineffective anti-TB chemotherapy worsened his condition. Finally, he underwent bilateral nephrectomy but experienced postoperative complications. In conclusion, kidney TB should be recognized as a cause of renal infection in ADPKD, and surgical treatment should be instituted without delay. The importance of early diagnosis and treatment cannot be overemphasized to prevent kidney TB deterioration. PMID:22377257

Takeshita, Hideki; Amemiya, Morimasa; Chiba, Koji; Urushibara, Masayasu; Satoh, Jun-Ichi; Noro, Akira

2012-03-01

131

A study of medial pallidotomy for Parkinson's disease: clinical outcome, MRI location and complications.  

PubMed

We have studied the effects of unilateral ventral medial pallidotomy in 26 patients with medically intractable Parkinson's disease with marked drug-induced dyskinesias. Preoperatively, all patients were assessed during one 5-day admission according to the Core Assessment Programme for Intracerebral Transplantation (CAPIT) protocol, including rating in the 'practically defined off' and 'best on' states before and during a single-dose levodopa challenge. Motor performance was assessed with subset categories of the Unified Parkinson's Disease Rating Scale (UPDRS), timed motor tests and a standard dyskinesia rating scale. Pallidotomy was performed under stereotaxic CT guidance with intra-operative extracellular microelectrode recording made from the basal ganglia. All patients were re-assessed 3 months postoperatively and a subgroup (n = 9) have so far also been re-assessed after 1 year. Pre- and postoperative performance scores were compared in order to determine which categories of performance improved postoperatively. Significance was accepted at P < 0.005 in order to take into account the multiple number of comparisons performed. Patient medication was compared pre- and postoperatively and the morbidity associated with surgery was also recorded. The most significant improvement postoperatively was the diminution of 'on' dyskinesias contralaterally (67%, P = 0.0001); however, ipsilateral (45%, P = 0.0006) and axial (50%, P = 0.0008) dyskinesias also improved. Contralateral to pallidotomy, the median 'off' motor UPDRS score improved by 27% (P = 0.001) and a significant improvement was also observed in contralateral rigidity by 25% (P = 0.001). There were trends towards improvement in contralateral tremor (33%, P = 0.016) and bradykinesia (24%, P = 0.013) scores. Ipsilateral rigidity improved by 22% (P = 0.005), but other ipsilateral motor scores did not alter significantly. The 'off' gait/postural instability score and 'off' walking time showed marginally significant improvements by 7% (P = 0.007) and 29% (P = 0.014), respectively. On medication, no significant postoperative improvements in parkinsonism were detected. Anti-parkinsonian medication increased by 11% postoperatively. In the subgroup who were available for assessment 1 year postoperatively, responses were generally maintained. Two (7.7%) of the 26 patients had fatal complications (one cerebral haemorrhage and one haemorrhagic infarct) directly related to surgery. Among the remaining 24 patients, four (15.4% of the total 26) had major complications (two persisting and two transient). Ten patients (38.5%) had minor complications. The majority of the complications (major and minor) occurred in the earlier operated patients and the complication rate subsequently declined with increasing operative experience. The remaining 10 patients (38.5%) had no significant side-effects. One of these 10 patients died from an incidental malignant glioma 6 months postoperatively. These findings confirm that levodopa-induced dyskinesias are dramatically reduced following ventral medial pallidotomy and constitute the principal indication for pallidotomy. Improvements in underlying parkinsonism were of smaller magnitude. Pallidotomy may also offer some patients an opportunity to increase antiparkinsonian medication. Patient selection for medial pallidotomy should, therefore, be based largely on anticipated improvements in levodopa-induced dyskinesias, but this must be balanced against the associated morbidity and mortality. PMID:9549488

Samuel, M; Caputo, E; Brooks, D J; Schrag, A; Scaravilli, T; Branston, N M; Rothwell, J C; Marsden, C D; Thomas, D G; Lees, A J; Quinn, N P

1998-01-01

132

[The role of biologic therapy in the treatment of extraintestinal manifestations and complications of inflammatory bowel disease].  

PubMed

Extraintestinal manifestations occur in about 35% of patients with inflammatory bowel diseases (IBD). Most frequently affected are bones and joints, skin, eyes, liver and biliary ducts. Extraintestinal manifestations of IBD are divided in two groups: reactive manifestations which depend on activity of IBD--peripheral arthritis, erythema nodosum, aphthous stomatitis, episcleritis and other manifestations which are independent on activity of IBD--pyoderma gangrenosum, uveitis, axial arthropathy, primary sclerosing cholangitis (PSC). Most affected are bones and joints. Symptoms vary from mild arthralgia to severe arthritis with painful swallowing of joints. They occur in about 5-10% of patients with ulcerative colitis (UC) and in 10-20% of patients with Crohn's disease (CD). Both peripheral and axial joints can be affected. According to available data, most patients with active IBD and concomitant arthritis have benefit from infliximab therapy. Infliximab is also effective in maintenance of remission in group of patients with spondyloarthropathy. Adalimumab showed similar efficacy in treatment of ankylosing spondylitis, but there are still no data about efficacy of adalimumab in treatment of patients with IBD and concomitant arthritis. Primary sclerosing cholangitis, autoimmune hepatitis, cholestasis, cholelithiasis and elevation of aminotransferase are also considered to be extraintestinal manifestations of IBD. Most frequent is PSC which affects usually patients with UC (7.5% of patients). Course of liver disease is completely independent on activity of IBD, and destruction of biliary ducts is usually irreversible and refractory on treatment and most of the patients need liver transplantation. Anti-TNF therapy is also ineffective in treatment of PSC and has no impact on disease course and outcome. However, there is no contraindication for anti-TNF therapy of concomitant active IBD in this group of patients. Erythema nodosum (EN) and pyoderma gangrenosum (PG) are usual skin manifestations of IBD. Erythema nodosum occurs in about 3-20%, and pyoderma gangrenosum in about 0.5-20% of patients with IBD. Infliximab is proven to be effective in treatment of PG, but there is still not enough evidence on efficacy of anti-TNF drugs in treatment of EN and other rare skin manifestations of IBD. About 2-5% of patients with IBD have also some ophthalmological disorder. Symptoms vary from mild conjunctivitis to severe inflammation of eye membranes--iritis, episcleritis, scleritis and uveitis. It seems that infliximab and adalimumab can diminish uveitis and scleritis in patients with different autoimmune disorders and IBD. According to guidelines of American Gastroenterology Association (AGA), in group of patients with CD, infliximab is indicated in treatment of spondyloarthropathies, arthritis, arthralgia, pyoderma gangrenosum, erythema nodosum, uveitis and other ophthalmological manifestations of IBD except optical neuritis which can worse or be consequence of anti-TNF treatment. Similar indications exist for use of adalimumab except in case of erythema nodosum. In group of patients with extraintestinal manifestations of UC, infliximab is indicated in treatment of spondyloarthropathies and pyoderma gangrenosum. Complications of IBD are fistulas (perianal and non-perianal), stenosis and strictures, abscesses, bowel perforations, gastrointestinal bleeding and development of different malignomas. Anti-TNF drugs are proven to be effective and indicated only for treatment of perianal fistulas in patients with Crohn's disease. In group of patients with UC, there are only few case reports on beneficial effect of infliximab in treating chronic pouchitis and infliximab in treatment of these patients still cannot be recommended. PMID:24471303

Kujundzi?, Milan

2013-04-01

133

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

134

THAOS: Gastrointestinal manifestations of transthyretin amyloidosis - common complications of a rare disease  

PubMed Central

Background Transthyretin amyloidosis is a systemic disorder caused by amyloid deposits formed by misfolded transthyretin monomers. Two main forms exist: hereditary and wild-type transthyretin amyloidosis, the former associated with transthyretin gene mutations. There are several disease manifestations; however, gastrointestinal complications are common in the hereditary form. The aim of this study was to explore the prevalence and distribution of gastrointestinal manifestations in transthyretin amyloidosis and to evaluate their impact on the patients’ nutritional status and health-related quality of life (HRQoL). Methods The Transthyretin Amyloidosis Outcomes Survey (THAOS) is the first global, multicenter, longitudinal, observational survey that collects data on patients with transthyretin amyloidosis and the registry is sponsored by Pfizer Inc. This study presents baseline data from patients enrolled in THAOS as of June 2013. The modified body mass index (mBMI), in which BMI is multiplied with serum albumin, was used to assess the nutritional status and the EQ-5D Index was used to assess HRQoL. Results Data from 1579 patients with hereditary transthyretin amyloidosis and 160 patients with wild-type transthyretin amyloidosis were analyzed. Sixty-three percent of those with the hereditary form and 15% of those with the wild-type form reported gastrointestinal symptoms at enrollment. Unintentional weight loss and early satiety were the most frequent symptoms, reported by 32% and 26% of those with transthyretin gene mutations, respectively. Early-onset patients (<50 years) reported gastrointestinal complaints more frequently than those with a late onset (p?complications, the prevalence of gastrointestinal manifestations was not evidently higher than that expected in the general population. Both upper and lower gastrointestinal symptoms were significant negative predictors of mBMI and the EQ-5D Index Score (p?complications did not show an increased prevalence of gastrointestinal disturbances. PMID:24767411

2014-01-01

135

Airway complications after lung transplantation.  

PubMed

Airway complications after lung transplantation present a formidable challenge to the lung transplant team, ranging from mere unusual images to fatal events. The exact incidence of complications is wide-ranging depending on the type of event, and there is still evolution of a universal characterization of the airway findings. Management is also wide-ranging. Simple observation or simple balloon bronchoplasty is sufficient in many cases, but vigilance following more severe necrosis is required for late development of both anastomotic and nonanastomotic airway strictures. Furthermore, the impact of coexisting infection, rejection, and medical disease associated with high-level immunosuppression further complicates care. PMID:25430430

Machuzak, Michael; Santacruz, Jose F; Gildea, Thomas; Murthy, Sudish C

2015-01-01

136

Comprehensive MRI diagnosis of sacral osteomyelitis and multiple muscle abscesses as a rare complication of fistulizing Crohn's disease.  

PubMed

Pelvic osteomyelitis is a very uncommon complication of Crohn's disease, usually clinically unsuspected in the setting of acute Crohn's disease relapses. The case of a 21-year old patient is reported, in whom ileo-cecal inflammatory disease was complicated by fistulization to the presacral space and sacral osteomyelitis, plus multiple abscesses involving the iliopsoas, posterior paravertebral and gluteal muscles. As confirmed by surgical and pathological findings, MRI provided comprehensive imaging diagnosis by demonstrating both the pathogenesis and the full extent of the complex, deep pelvic inflammatory process. Low back pain in patients with Crohn's disease should not be underestimated since its differential diagnosis includes serious and potentially life-threatening causes such as osteomyelitis, so prompt assessment with cross sectional imaging, particularly MRI, is necessary. PMID:21939924

Tonolini, Massimo; Ravelli, Anna; Campari, Alessandro; Bianco, Roberto

2011-10-01

137

Modified activin receptor IIB ligand trap mitigates ineffective erythropoiesis and disease complications in murine ?-thalassemia  

PubMed Central

In ?-thalassemia, unequal production of ?- and ?-globin chains in erythroid precursors causes apoptosis and inhibition of late-stage erythroid differentiation, leading to anemia, ineffective erythropoiesis (IE), and dysregulated iron homeostasis. Here we used a murine model of ?-thalassemia intermedia (Hbbth1/th1 mice) to investigate effects of a modified activin receptor type IIB (ActRIIB) ligand trap (RAP-536) that inhibits Smad2/3 signaling. In Hbbth1/th1 mice, treatment with RAP-536 reduced overactivation of Smad2/3 in splenic erythroid precursors. In addition, treatment of Hbbth1/th1 mice with RAP-536 reduced ?-globin aggregates in peripheral red cells, decreased the elevated reactive oxygen species present in erythroid precursors and peripheral red cells, and alleviated anemia by promoting differentiation of late-stage erythroid precursors and reducing hemolysis. Notably, RAP-536 treatment mitigated disease complications of IE, including iron overload, splenomegaly, and bone pathology, while reducing erythropoietin levels, improving erythrocyte morphology, and extending erythrocyte life span. These results implicate signaling by the transforming growth factor-? superfamily in late-stage erythropoiesis and reveal potential of a modified ActRIIB ligand trap as a novel therapeutic agent for thalassemia syndrome and other red cell disorders characterized by IE. PMID:24795345

Suragani, Rajasekhar N. V. S.; Cawley, Sharon M.; Li, Robert; Wallner, Samantha; Alexander, Mark J.; Mulivor, Aaron W.; Gardenghi, Sara; Rivella, Stefano; Grinberg, Asya V.; Pearsall, R. Scott

2014-01-01

138

Evaluating the Efficacy of Primary Treatment for Graves' Disease Complicated by Thyrotoxic Periodic Paralysis  

PubMed Central

Objective. Thyrotoxic periodic paralysis (TPP) is a potentially life-threatening complication of Graves' disease (GD). The present study compared the long-term efficacy of antithyroid drugs (ATD), radioactive iodine (RAI), and surgery in GD/TPP. Methods. Sixteen patients with GD/TPP were followed over a 14-year period. ATD was generally prescribed upfront for 12–18 months before RAI or surgery was considered. Outcomes such as thyrotoxic or TPP relapses were compared between the three modalities. Results. Eight (50.0%) patients had ATD alone, 4 (25.0%) had RAI, and 4 (25.0%) had surgery as primary treatment. Despite being able to withdraw ATD in all 8 patients for 37.5 (22–247) months, all subsequently developed thyrotoxic relapses and 4 (50.0%) had ?1 TPP relapses. Of the four patients who had RAI, two (50%) developed thyrotoxic relapse after 12 and 29 months, respectively, and two (50.0%) became hypothyroid. The median required RAI dose to render hypothyroidism was 550 (350–700) MBq. Of the 4 patients who underwent surgery, none developed relapses but all became hypothyroid. Conclusion. To minimize future relapses, more definitive primary treatment such as RAI or surgery is preferred over ATD alone. If RAI is chosen over surgery, a higher dose (>550?MBq) is recommended. PMID:25147568

Chang, Rita Yuk-Kwan; Lang, Brian Hung-Hin; Chan, Ai Chen; Wong, Kai Pun

2014-01-01

139

[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

140

Still the Heart of Darkness: The Ebola Virus and the Meta-Narrative of Disease in The Hot Zone  

Microsoft Academic Search

Still the Heart of Darkness” analyzes Richard Preston's best-selling account of an Ebola virus outbreak in Reston, Virginia in 1989. Through a textual examination of The Hot Zone, this essay demonstrates how Preston grounds his narrative about the threat of rare emerging viruses from the third world in terms of the colonialist discourse about Africa as “the white man's grave,”

Douglas M. Haynes

2002-01-01

141

Clinical features of patients with IgG4-related disease complicated with perivascular lesions.  

PubMed

Abstract Objective. To define the clinical features of IgG4-related disease (IgG4-RD) complicated with perivascular lesions. Methods. The clinical features of seven patients with IgG4-RD and perivascular lesions diagnosed at the University of Tsukuba Hospital between October 2008 and October 2013, were analyzed, including clinical background, results of imaging studies, satisfaction of the 2011 comprehensive diagnostic criteria (CDC) for IgG4-RD, laboratory data, distribution of perivascular lesions, involvement of other organs, and response to steroid therapy. Results. We studied six men and one woman with a mean age of 66.9 ± 6.7 years (± SD). Six of seven patients were diagnosed as definite IgG4-RD, while the seventh was considered possible IgG4-RD, based on the CDC for IgG4-RD. Serum IgG4 levels at diagnosis were higher than 135 mg/dl in all seven patients (mean, 933 ± 527). Serum C-reactive protein (CRP) levels were elevated in two only (mean, 1.42 ± 3.56 mg/dl). The perivascular lesions were located in the pulmonary artery (n = 1), thoracic aorta (n = 2), abdominal aorta (n = 6), coronary (n = 1), celiac (n = 1), superior mesenteric (n = 1), renal (n = 2), inferior mesenteric (n = 5), and iliac (n = 3) arteries. In addition to perivascular lesions, six patients showed involvement of other organs. All seven patients were treated with prednisolone (0.6 mg/kg/day), which rapidly improved the perivascular and other organ lesions in six patients (the other one patient have not yet been evaluated due to the short follow-up). Conclusion. Perivascular lesions show wide distribution in patients with IgG4-RD. Serum CRP levels are not necessarily elevated in these patients. Steroid therapy is effective in IgG4-RD and results in resolution of lesions. PMID:24754274

Ebe, Hiroshi; Tsuboi, Hiroto; Hagiya, Chihiro; Takahashi, Hiroyuki; Yokosawa, Masahiro; Hagiwara, Shinya; Hirota, Tomoya; Kurashima, Yuko; Takai, Chinatsu; Miki, Haruka; Asashima, Hiromitsu; Umeda, Naoto; Kondo, Yuya; Ogishima, Hiroshi; Suzuki, Takeshi; Chino, Yusuke; Matsumoto, Isao; Sumida, Takayuki

2015-01-01

142

Hemophagocytic Lymphohistiocytosis: an Unusual Complication of Orientia tsutsugamushi Disease (Scrub Typhus)  

PubMed Central

Background Hemophagocytic lymphohistiocytosis (HLH) is an uncommon, potentially fatal, hyperinflammatory syndrome that may rarely complicate the clinical course of Orientia tsutsugamushi disease (scrub typhus). Methods Here we describe the clinicopathological features, laboratory parameters, management, and outcome of three adult patients (1 female, 2 males) with scrub typhus associated HLH from a tertiary center. A brief and concise review of international literature on the topic was also added. Results All three patients satisfied the HLH-2004 diagnostic criteria; one had multi-organ dysfunction with very high ferritin level (>30,000 ng/ml), and all had a dramatic recovery following doxycyclin therapy. Literature review from January 1990 to March 2014 revealed that scrub typhus associated HLH were reported in 21 patients, mostly from the scrub endemic countries of the world. These included 11 females and 10 males with a mean age of 35 years (range; 8 months to 81 years). Fifteen of 17 patients (where data were available) had a favorable outcome following early serological diagnosis and initiation of definitive antibiotic therapy with (N=6) or without (N=9) immunosuppressive/immunomodulator therapy. Mutation analysis for primary HLH was performed in one patient only, and HLH-2004 protocol was used in two patients. Conclusion We suggest that HLH should be considered in severe cases of scrub typhus especially if associated with cytopenia (s), liver dysfunction, and coagulation abnormalities. Further studies are required to understand whether an immunosuppressive and/or immunomodulator therapy could be beneficial in those patients who remain unresponsive to definitive antibiotic therapy. PMID:25574367

Basheer, Aneesh; Padhi, Somanath; Boopathy, Vinoth; Mallick, Saumyaranjan; Nair, Shashikala; Varghese, Renu G’Boy; Kanungo, Reba

2015-01-01

143

Nonalcoholic fatty liver disease and microvascular complications in type 2 diabetes  

PubMed Central

AIM: To evaluate the correlation between nonalcoholic fatty liver disease (NAFLD) and microvascular complications in type 2 diabetes mellitus (T2DM). METHODS: Data were obtained from 1217 inpatients with T2DM (757 females, 460 males; aged 63.39 ± 12.28 years). NAFLD was diagnosed by hepatic ultrasonography. Diabetic nephropathy (DN), diabetic peripheral neuropathy (DPN), and diabetic retinopathy (DR) were diagnosed according to their respective criteria. The prevalence of NAFLD and the independent correlations of clinical characteristics with NAFLD were determined by cross-tabulation and logistic regression, respectively. RESULTS: Approximately 61% of inpatients with T2DM in Qingdao, China had NAFLD, which decreased significantly with increase in age and prolonged course of diabetes. The prevalence of NAFLD in patients presenting with DN, DPN and DR was 49.4%, 57.2% and 54.9%, respectively. These rates were significantly lower than those of patients without DN, DPN and DR (65.9%, 65.6% and 66.1%, respectively, P < 0.05). Participants with NAFLD had greater body weight, waist circumference (WC), body mass index (BMI), fasting blood glucose (FBG), hemoglobin A1c, alanine aminotransferase, aspartate aminotransferase, ?-glutamyltransferase, blood pressure, as well as triglyceride (TG) levels and lower high-density lipoprotein (HDL) concentration than those without NAFLD (P < 0.05). NAFLD was positively correlated with BMI, WC, TG, FBG, diastolic blood pressure, and systolic blood pressure but negatively correlated with the duration of diabetes, DR, DPN, DN, and HDL. CONCLUSION: Despite the benign nature of NAFLD, efforts should be directed toward early diagnosis, intensive blood glucose and blood pressure control, and effective dyslipidemia correction. PMID:23716995

Lv, Wen-Shan; Sun, Rui-Xia; Gao, Yan-Yan; Wen, Jun-Ping; Pan, Rong-Fang; Li, Li; Wang, Jing; Xian, Yu-Xin; Cao, Cai-Xia; Zheng, Ming

2013-01-01

144

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

145

Risk Factors for Neurologic Complications of Hand, Foot and Mouth Disease in the Republic of Korea, 2009  

PubMed Central

In 2009, the first outbreak of hand, foot and mouth disease (HFMD) or herpangina (HP) caused by enterovirus 71 occurred in the Republic of Korea. This study inquired into risk factors associated with complications of HFMD or HP. A retrospective medical records review was conducted on HFMD or HP patients for whom etiologic viruses had been verified in 2009. One hundred sixty-eight patients were examined for this investigation. Eighty patients were without complications while 88 were accompanied by complications, and 2 had expired. Enterovirus 71 subgenotype C4a was the most prevalent in number with 67 cases (54.9%). In the univariate analysis, the disease patterns of HFMD rather than HP, fever longer than 4 days, peak body temperature over 39?, vomiting, headache, neurologic signs, serum glucose over 100 mg/dL, and having an enterovirus 71 as a causative virus were significant risk factors of the complications. After multiple logistic analysis, headache (Odds ratio [OR], 10.75; P < 0.001) and neurologic signs (OR, 42.76; P < 0.001) were found to be the most significant factors. Early detection and proper management of patients with aforementioned risk factors would be necessary in order to attain a better clinical outcome. PMID:23341722

Kim, Seong Joon; Kang, Jin-Han; Kim, Dong Soo; Kim, Ki Hwan; Kim, Kyung-Hyo; Kim, Young-Hoon; Chung, Ju-Young; Bin, Joong Hyun; Jung, Da Eun; Kim, Ji Hong; Kim, Hwang Min; Cheon, Doo-Sung; Kang, Byung Hak; Seo, Soon Young

2013-01-01

146

Pulmonary co-infection with Nocardia and Aspergillus in a patient with adult-onset Still's disease receiving steroids and tacrolimus.  

PubMed

Patients on immunosuppression are at risk of unusual infections. We present a man diagnosed to have adult-onset Still's disease who, on high-dose oral steroid and tacrolimus, developed a cavitating pneumonia due to co-infection with Aspergillus flavus and Nocardia. Timely diagnosis and institution of appropriate therapy resulted in a favourable clinical outcome. Such co-infection in a patient receiving tacrolimus is rare in the published literature. This case serves to emphasise the need to be vigilant for unusual infections in patients who are immunosuppressed, either due to drugs or underlying disease condition. PMID:25398925

Misra, Durga Prasanna; Parida, Jyoti Ranjan; Chowdhury, Abhra Chandra; Agarwal, Vikas

2014-01-01

147

Use of Memantine (akatinol) for the Correction of Cognitive Impairments in Parkinson’s Disease Complicated by Dementia  

Microsoft Academic Search

This study addresses the effects of 52 weeks of treatment with the NMDA glutamate receptor antagonist memantine on motor,\\u000a cognitive, and mental disorders in patients with Parkinson’s disease complicated by dementia, as compared with a control group\\u000a of patients not treated with memantine. Patients of the experimental group (32 subjects) received memantine (20 mg\\/day), while\\u000a patients in the control group

I. V. Litvinenko; M. M. Odinak; V. I. Mogil’naya; S. V. Perstnev

2010-01-01

148

Surgical Approach to Complicated Intestinal Failure for Benign Disease in Adult Patients: Transplantation or Surgical Rehabilitation?  

Microsoft Academic Search

Surgical approaches to complicated benign intestinal failure are gaining acceptance, especially in the pediatric population. Less international experience has been obtained in adult patients, who are usually treated with total parenteral nutrition (TPN). An intestinal rehabilitation program was started in our institution with comprehensive medical rehabilitation, surgical bowel rescue, and transplantation. Among 38 adult patients referred by our gastroenterologists for

A. Lauro; C. Zanfi; A. Dazzi; L. Golfieri; A. Amaduzzi; G. Ercolani; M. Cescon; A. Siniscalchi; G. L. Grazi; M. Vivarelli; G. Varotti; M. Ravaioli; M. Del Gaudio; F. Di Benedetto; A. Cucchetti; G. La Barba; G. Vetrone; M. Zanello; L. Pironi; S. Faenza; A. D. Pinna

2006-01-01

149

Oral complications during treatment of malignant diseases in childhood: effects of tooth brushing  

Microsoft Academic Search

During anticancer treatment, oral lesions considerably aggravate the child’s clinical condition and increase the risk of infection. This prospective study evaluated the incidence, nature and chronology of oral complications arising during the first 6 weeks of chemotherapy. 131 children were included in this study, and their oral and dental health evaluated on enrolment. Each child was observed once a week,

M Bonnaure-Mallet; L Bunetel; S Tricot-Doleux; J Guérin; C Bergeron; E LeGall

1998-01-01

150

MTHFR polymorphic variant C677T is associated to vascular complications in sickle-cell disease.  

PubMed

Vaso-occlusion is a determinant for most signs and symptoms of sickle-cell anemia (SCA). The mechanisms involved in the pathogenesis of vascular complications in SCA remain unclear. It is known that genetic polymorphisms associated with thrombophilia may be potential modifiers of clinical features of SCA. The genetic polymorphisms C677T and A1298C relating to the enzyme methylenetetrahydrofolate reductase (MTHFR), a clotting Factor V Leiden mutation (1691G?A substitution of Factor V Leiden), and the mutant prothrombin 20210A allele were analyzed in this study. The aim was to find possible correlations with vascular complications and thrombophilia markers in a group of SCA patients in Pernambuco, Brazil. The study included 277 SCA patients, divided into two groups: one consisting of 177 nonconsanguineous SCA patients who presented vascular manifestations of stroke, avascular necrosis, leg ulcers, priapism, and acute chest syndrome (group 1); and the other consisting of 100 SCA patients without any reported vascular complication (group 2). Molecular tests were done using either polymerase chain reaction (PCR) restriction fragment length polymorphism or allele-specific PCR techniques. Comparisons between the groups were made using the ?(2) test. The 677 CT and TT genotypes showed a significant risk of vascular complications (p=0.015). No significant associations between the groups were found when samples were analyzed for the MTHFR A1298C allele (p=0.913), Factor V G1691 (p=0.555), or prothrombin G20210A mutation (p=1.000). The polymorphism MTHFR C677T seemed to be possibly predictive for the development of some vascular complications in SCA patients among this population. PMID:22924497

Hatzlhofer, Betânia L D; Bezerra, Marcos André C; Santos, Magnun N N; Albuquerque, Dulcinéia M; Freitas, Elizabete M; Costa, Fernando F; Araújo, Aderson S; Muniz, Maria Tereza C

2012-09-01

151

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

PubMed

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

2014-07-01

152

LRRK2 and Human Disease: A Complicated Question or a Question of Complexes?  

NSDL National Science Digital Library

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.

Patrick A. Lewis (University College London; UCL Institute of Neurology REV)

2012-01-17

153

Role of Neurohormonal Activation in the Pathogenesis of Cardiovascular Complications in Chronic Kidney Disease  

Microsoft Academic Search

\\u000a Cardiovascular disease (CVD) is the leading cause of mortality in patients with end-stage renal disease. Combined cardiac\\u000a and renal dysfunction amplifies disease progression in both organs and increases the incidence of morbidity and mortality\\u000a it these patients. This clinical condition is defined as cardiorenal syndrome, which was recently classified into five subtypes\\u000a defined according to pathophysiology, time frame, and nature

Andrea Stella; Giovanna Castoldi

154

Spontaneous mesenteric hematoma complicating an exacerbation of Crohn’s disease: report of a case  

PubMed Central

Case Presentation Spontaneous mesenteric haematoma is a rare condition that occurs due to localized bleeding in the mesenteric vascular tree of a bowel segment in the absence of an identifiable cause. Here we report a case of spontaneous mesenteric haematoma during an inflammatory exacerbation of Crohn’s disease. The patient underwent surgical management for small bowel obstruction secondary to Crohn’s disease, however the concurrent presence of a spontaneous mesenteric haematoma in the mid-jejunal mesentery was successfully managed conservatively. Conclusion This case identifies the first association of spontaneous mesenteric haematoma with an exacerbation of Crohn’s disease and highlights the need to consider rare differential diagnoses such as SMH when performing radiological assessment of unexplained symptoms in inflammatory bowel disease patients. PMID:24894713

2014-01-01

155

Patellar tendon avulsion as a complication of Osgood-Schlatter's disease  

Microsoft Academic Search

The etiology of Osgood-Schlatter's disease remains a topic for debate. Previous studies by Ogden and Southwick (Osgood-Schlatter's disease and tibial tu bercle development. Clin Orthop 116: 180-189, 1976) strongly support the concept of multiple mi croavulsions of the anterior surface of the developing ossification center of the tibial tubercle as the under lying cause.Orthopaedic literature fails to associate Osgood- Schlatter's

K. Douglas Bowers

1981-01-01

156

[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

157

[Risks and complications of thyroid surgery].  

PubMed

Despite technical improvements, complications may still occur after thyroid surgery, mostly after total thyroidectomy, removal of diving or suffocating goiters for Graves' disease or carcinoma, and in reoperations. Hypoparathyreosis or unilateral recurrent laryngeal nerve palsy are observed in 10% of the patients but persist in only 1% of the cases managed by orthophony or vitaminocalcic supply. Two early complications are severe respiratory obstruction by bilateral nerve palsy and suffocating haematoma. Claude-Bernard Horner syndrome, lymphorrhea, abscess or disgraciods scar are rarely observed. The prevention of these complications requires adequate surgical indications performed by specialized endocrine surgeons. PMID:8978191

Chapuis, Y

1996-12-01

158

Chronic granulomatous disease: a review of the infectious and inflammatory complications  

PubMed Central

Chronic Granulomatous Disease is the most commonly encountered immunodeficiency involving the phagocyte, and is characterized by repeated infections with bacterial and fungal pathogens, as well as the formation of granulomas in tissue. The disease is the result of a disorder of the NADPH oxidase system, culminating in an inability of the phagocyte to generate superoxide, leading to the defective killing of pathogenic organisms. This can lead to infections with Staphylococcus aureus, Psedomonas species, Nocardia species, and fungi (such as Aspergillus species and Candida albicans). Involvement of vital or large organs can contribute to morbidity and/or mortality in the affected patients. Major advances have occurred in the diagnosis and treatment of this disease, with the potential for gene therapy or stem cell transplantation looming on the horizon. PMID:21624140

2011-01-01

159

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

160

Long-term outcome of enzyme-replacement therapy in advanced Fabry disease: evidence for disease progression towards serious complications  

PubMed Central

Objective The long-term effects of enzyme-replacement therapy (ERT) in Fabry disease are unknown. Thus, the aim of this study was to determine whether ERT in patients with advanced Fabry disease affects progression towards ‘hard’ clinical end-points in comparison with the natural course of the disease. Methods A total of 40 patients with genetically proven Fabry disease (mean age 40 ± 9 years; n = 9 women) were treated prospectively with ERT for 6 years. In addition, 40 subjects from the Fabry Registry, matched for age, sex, chronic kidney disease stage and previous transient ischaemic attack (TIA), served as a comparison group. The main outcome was a composite of stroke, end-stage renal disease (ESRD) and death. Secondary outcomes included changes in myocardial left ventricular (LV) wall thickness and replacement fibrosis, change in glomerular filtration rate (GFR), new TIA and change in neuropathic pain. Results During a median follow-up of 6.0 years (bottom and top quartiles: 5.1, 7.2), 15 events occurred in 13 patients (n = 7 deaths, n = 4 cases of ESRD and n = 4 strokes). Sudden death occurred (n = 6) only in patients with documented ventricular tachycardia and myocardial replacement fibrosis. The annual progression of myocardial LV fibrosis in the entire cohort was 0.6 ± 0.7%. As a result, posterior end-diastolic wall thinning was observed (baseline, 13.2 ± 2.0 mm; follow-up, 11.4 ± 2.1 mm; P < 0.01). GFR decreased by 2.3 ± 4.6 mL min?1 per year. Three patients experienced a TIA. The major clinical symptom was neuropathic pain (n = 37), and this symptom improved in 25 patients. The event rate was not different between the ERT group and the untreated (natural history) group of the Fabry Registry. Conclusion Despite ERT, clinically meaningful events including sudden cardiac death continue to develop in patients with advanced Fabry disease. PMID:23586858

Weidemann, F; Niemann, M; Störk, S; Breunig, F; Beer, M; Sommer, C; Herrmann, S; Ertl, G; Wanner, C

2013-01-01

161

Recurrent buccal space abscessesA complication of Crohn’s disease  

Microsoft Academic Search

Oral features of Crohn’s disease include ulcerations, lip fissuring, cobblestone plaques, and mucosal tags. We report the case of a 16-year old male patient with a 3-month history of abdominal pain, diarrhea, and oral ulceration. Clinical examinations revealed established intestinal lesions, a marked cobblestone appearance in the oral cavity, and an unusual pattern of presentation not previously reported in the

O. K. Gagoh; R. M. Qureshi; M. T. Hendrickse

1999-01-01

162

Orbital socket contracture: a complication of inflammatory orbital disease in patients with Wegener’s granulomatosis  

Microsoft Academic Search

Aim: To describe the clinical characteristics of orbital socket contracture in patients with Wegener’s granulomatosis (WG).Methods: A retrospective cohort study The medical records of 256 patients with WG examined at the National Institutes of Health from 1967 to 2004 were reviewed to identify patients with orbital socket contracture. Details of the orbital disease including Hertel exophthalmometry readings, radiological findings, and

C Talar-Williams; M C Sneller; C A Langford; J A Smith; T A Cox; M R Robinson

2005-01-01

163

[Celiac disease revealed by hypocalcemia complicating total thyroidectomy: a case report].  

PubMed

In order to illustrate a particular circumstance of diagnosis of celiac disease, we report the case of 54-year-old women with a history of thyroid enlargement with normal thyroid function and positive anti-peroxidase antibodies. Immediately after total thyroidectomy with preservation of the parathyroid glands, she developed tetany with total serum calcium level at 50mg/l. Intravenous calcium infusion increased the calcium level and led to resolution of hypocalcemia-induced signs but there was no result when calcium and vitamin D were taken orally. The diagnosis of malabsorption was very probable in light of the family history of celiac disease, the anemia and the hypoalbuminemia. The diagnosis was confirmed by antibodies assay and endoscopy. The PTH level was less than 1 pg/l and radiography showed signs of hyperparathyroidism. Gluten-free diet, calcium and vitamin D led to an improvement of serum calcium. PMID:17072243

Harzallah, F; Daoud, I; Bouzid, C; Oueslati, A; Kanoun, F; Slimane, H

2006-09-01

164

When children with Kawasaki disease grow up: Myocardial and vascular complications in adulthood  

PubMed Central

Kawaski disease (KD) is an acute, self-limited vasculitis that typically occurs in young children and was first described by Japanese pediatrician Tomisaku Kawasaki in 1967. Although originally thought to be a rare condition, KD has become the most common cause of acquired heart disease in the pediatric age group in developed countries. The majority of patients with KD appear to have a benign prognosis but a subset of patients with coronary artery aneurysms are at risk for ischemic events and require lifelong treatment. In the four decades that have passed since the initial recognition of KD, the number of patients reaching adulthood has continued to grow. Adult cardiologists will be increasingly involved in the management these patients. Currently, there are no established guidelines for the evaluation and treatment of adult patients who have had KD. We review here the current literature that may be helpful to clinicians who care for adults who suffered from KD in childhood. PMID:19909870

Gordon, John B.; Kahn, Andrew M.; Burns, Jane C.

2010-01-01

165

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, Andrée-Anne; O’Shaughnessy, Julie; Descarreaux, Martin

2014-01-01

166

Post partum haemorrhage secondary to uterine atony, complicated by platelet storage pool disease and partial placenta diffusa: a case report  

PubMed Central

Introduction Uterine atony is the most common cause of primary post partum haemorrhage. We report a case where this was complicated by two rare conditions, platelet storage pool disease and placenta diffusa. Platelet storage pool disease is a platelet aggregation disorder associated with mild to moderate bleeding diathesis. There are limited cases reported in pregnancy. Placenta diffusa is a rare anomaly where all or part of the fetal membranes remain covered by chorionic villi, and is associated with post partum haemorrhage. Case presentation A 37-year-old woman was referred to the obstetric haematology clinic for prenatal counselling with a history of three severe post partum haemorrhages, two of which were complicated by placental retention. Platelet aggregation studies confirmed a diagnosis of platelet storage pool disease. She was counselled regarding her risk of a recurrent haemorrhage and a planned delivery was discussed. She subsequently presented at 15 weeks' gestation. Following an uneventful pregnancy, she was covered with prophylactic desmopressin and tranexamic acid before a planned induction of labour. She had a normal delivery but placenta was retained. In theatre, an uncomplicated manual removal was followed by massive haemorrhage secondary to uterine atony. Aggressive medical management and B lynch sutures at laparotomy failed to contract the uterus. Hysterectomy was therefore performed. Placental histology later showed evidence of partial placenta diffusa. Conclusion Post partum haemorrhage continues to be a leading cause of maternal morbidity and mortality. In this patient, despite identification and attempts at correction of an identified clotting disorder, major obstetric haemorrhage was not avoided. An additional rare placental abnormality was later found. This case highlights the need for medical staff to be aware and alert to unusual risk factors. However, these factors may be unavoidable and early surgical intervention as per local protocol is recommended to minimise maternal morbidity. PMID:19077291

Rahman, Shimma S; Myers, Jenny E; Gillham, Joanna C; Fitzmaurice, Richard; Johnston, Tracey A

2008-01-01

167

Septicemia caused by salmonella infection: An overlooked complication of sickle cell disease  

Microsoft Academic Search

Objectives: To describe the characteristics of salmonella infections in sickle cell disease and to compare the features of osteomyelitis and those with bacteremia\\/septicemia without obvious bone changes. To search for risk factors for osteomyelitis, and to draw attention to the frequency and significance of salmonella bacteremia\\/septicemia.Study design: A retrospective review of all salmonella isolations from the blood, pus, or aspirates

Jonathan Wright; Peter Thomas; Graham R. Serjeant

1997-01-01

168

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

169

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, Patrícia Santos; Lopes Pessoa de Aguiar, Regina Amélia; Viana, Marcos Borato

2014-01-01

170

Clinical efficacy of Xinkeshu Pian on coronary heart disease and mood disorder complications after PCI  

PubMed Central

Aim: To assess the efficacy and safety of combining Xinkeshu tablet treatment with routine Western medicine treatment for patients with coronary heart disease (CHD) and mood disorders after PCI postoperative period. Method: 100 patients were randomly divided into treatment group of 50 cases, and control group of 50 cases. The control group was given routine Western medical treatment, whereas the treatment group was given routine Western medical treatment in combination with Xinkeshu tablets. Eight weeks after treatment, the patients underwent SF-36 life quality evaluation, self-rating depression scale (SDS) evaluation, and self-rating anxiety scale (SAS) evaluation. Result: After the eight-week treatment, the SF-36 life quality scores, SAS scores, SDS score, as well as the reduction in heart creatinine levels of the two groups were compared. The results show statistical significance (P<0.05). Conclusion: Xinkeshu can effectively address the PCI postoperative mood disorders in patients with coronary heart disease and improve the quality of life. PMID:25126196

Li, Chun-Jie; Zhang, Guanwei; Zhang, Yingyi; Cong, Hongliang; Zhang, Bo-Li

2014-01-01

171

Acute Inflammatory Bowel Disease Complicating Chronic Alcoholism and Mimicking Carcinoid Syndrome  

PubMed Central

We report the case of a woman with a history of chronic alcohol abuse who was hospitalized with diarrhea, severe hypokalemia refractory to potassium infusion, nausea, vomiting, abdominal pain, alternations of high blood pressure with phases of hypotension, irritability and increased urinary 5-hydroxyindoleacetic acid and cortisol. Although carcinoid syndrome was hypothesized, abdominal computed tomography and colonoscopy showed non-specific inflammatory bowel disease with severe colic wall thickening, and multiple colic biopsies confirmed non-specific inflammation with no evidence of carcinoid cells. During the following days diarrhea slowly decreased and the patient's condition progressively improved. One year after stopping alcohol consumption, the patient was asymptomatic and serum potassium was normal. Chronic alcohol exposure is known to have several deleterious effects on the intestinal mucosa and can favor and sustain local inflammation. Chronic alcohol intake may also be associated with high blood pressure, behavior disorders, abnormalities in blood pressure regulation with episodes of hypotension during hospitalization due to impaired baroreflex sensitivity in the context of an alcohol withdrawal syndrome, increased urinary 5-hydroxyindoleacetic acid as a result of malabsorption syndrome, and increased urinary cortisol as a result of hypothalamic-pituitary-adrenal axis dysregulation. These considerations, together with the regression of symptoms and normalization of potassium levels after stopping alcohol consumption, suggest the intriguing possibility of a alcohol-related acute inflammatory bowel disease mimicking carcinoid syndrome. PMID:22949895

Ballo, Piercarlo; Dattolo, Pietro; Mangialavori, Giuseppe; Ferro, Giuseppe; Fusco, Francesca; Consalvo, Matteo; Chiodi, Leandro; Pizzarelli, Francesco; Zuppiroli, Alfredo

2012-01-01

172

Transplantation of an eight-organ multivisceral graft in a patient with frozen abdomen after complicated Crohn’s disease  

PubMed Central

To report an extended multivisceral transplantation (MVTx) including right kidney and ascending colon in a patient with complicated Crohn's disease (CD). A 36-year old female suffering from short bowel syndrome and frozen abdomen due to fistulizing CD after multiple abdominal operations underwent MVTx of eight organs including stomach, pancreatoduodenal complex, liver, intestine, ascending colon, right kidney, right adrenal gland, and greater omentum in November 2003. Immunosuppression consisted of alemtuzumab, tacrolimus and steroids. The patient was off parenteral nutrition by postoperative wk 3. She experienced one episode of pneumonia. The patient recovered completely and discharged 2.5 mo and was doing well 30 mo after MVTx. This is one of the very rare cases in which a complete mulitivisceral graft of eight abdominal organs was transplanted orthotopically. PMID:16865793

Pascher, Andreas; Klupp, Jochen; Kohler, Sven; Langrehr, Jan M; Neuhaus, Peter

2006-01-01

173

Aging and antihypertensive medication-related complications in the chronic kidney disease patient  

PubMed Central

Purpose of review We have reviewed the recent literature to describe the potential medication errors and adverse drug events (ADEs) associated with antihypertensives among older adults with chronic kidney disease (CKD). Recent findings Overall, few studies have been published describing ADEs in older adults with CKD. Several examined hyperkalemia associated with angiotensin-converting enzyme (ACE)-inhibitor/angiotensin II receptor blocker (ARB), diuretic (potassium-sparing), and ?-blocker use. Additional studies described acute kidney injury (AKI) most commonly with ACE-inhibitor/ARB therapy. Finally, orthostatic hypotension was evaluated in those taking ACE-inhibitor/ARB, ?-blocker, or calcium-channel blocker therapy. In the absence of robust literature examining these events in this understudied population, one must consider age-related antihypertensive pharmacokinetic/pharmacodynamic profiles concomitantly with the patient’s comorbidities and other medications in order to minimize the risk for potential medication errors, drug–drug interactions, and ADEs. Summary Some of the most common ADEs associated with antihypertensive use in older adults with CKD include hyperkalemia, AKI, and orthostatic hypotension. Diligent monitoring of laboratory data, vital signs, and potential drug–drug interactions may mitigate serious ADEs caused by antihypertensives in this high-risk patient population. PMID:21670671

Marcum, Zachary A.; Fried, Linda F.

2012-01-01

174

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

175

Complications of surgical treatment of Rosai–Dorfman disease: A case report and review  

PubMed Central

Background: Rosai–Dorfman disease (RDD) was first described in 1969 as an idiopathic histiocytic proliferative disorder. It commonly presents as a massive and painless adenopathy. Until 1990, extranodal involvement of the central nervous system (CNS) was rare and reported in less than 5% of the total number of patients with extranodal RDD. Complete removal of CNS RDD has been achieved in many cases. Case Description: We report a case of an isolated intracranial RDD in a 53-year-old man. The patient had an episode of generalized seizures. Imaging studies of the brain were compatible with a meningioma en plaque. The mass was exposed by a right frontotemporal craniotomy. The tumor was adhered tightly to the adjacent cerebral cortex and was permeated by pial arteries of the brain surface. The sacrificing of these arteries was inevitable in order to achieve the total removal of the tumor. The patient had incomplete left hemiparesis after the surgery. Brain computed tomography (CT) imaging revealed a postoperative hemorrhage and a low-density lesion in the right frontal lobe. The patient was postoperatively diagnosed with isolated central nervous system RDD. Conclusion: Although the complete removal of dural-based lesions without any neurological deficits has been performed in many cases, the treatment of cases with high risks, such as the present case, indicates conservative excisions and adjuvant radiotherapy with or without chemotherapy. PMID:22347671

Tomio, Ryosuke; Katayama, Makoto; Takenaka, Nobuo; Imanishi, Tomoyuki

2012-01-01

176

[Depression in chronic heart failure: complication, risk factor or autonomous disease?].  

PubMed

A major depressive episode is diagnosed based on several well-defined criteria as the presence of depressed mood and loss of interest. According to a large meta-analysis the prevalence of major depression in patients with chronic heart failure is more than 20%. Etiological factors include individual (genetic) disposition and social environment as well as psychosocial stress and biological risk factors related to the chronic cardiac illness. As in coronary artery disease, mortality rates are increased in patients suffering from heart failure and comorbid depression. Possible mechanisms mediating this relationship include both biological (e.g. severity of chronic heart failure, autonomic and immunological dysregulation, multiple comorbidities) and behavioral factors (health behavior, compliance with pharmacological and non-pharmacological therapy). Shared pathophysiological mechanisms as well as a common genetic disposition are also discussed. Simple screening instruments and effective treatment options (psychotherapy, selective serotonin re-uptake inhibitors) are available. However, at present evidence is lacking that beyond improvement of depression these strategies impact favorably on morbidity and mortality. PMID:18301872

Faller, H; Angermann, C E

2008-04-01

177

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

178

Internal haemorrhagic pachymeningiosis: specific disease or complication of chronic subdural hematoma? Report of five cases surgically treated and literature review  

PubMed Central

Background Internal haemorrhagic pachymeningiosis (IHP) is a rare disease characterized by a fibrous thickening and inflammatory infiltration in dural space mimicking chronic subdural hematoma. The pathogenesis of IHP is not entirely clear yet and treatment is still controversial. Objective We want to emphasize the importance of differentiating pachymeningiosis from chronic subdural hematoma as distinct pathological entities. Patients and methods The records of five selected cases of IHP histologically confirmed were reviewed, focusing onset, neuroimaging, surgery and outcomes. Conclusions IHP is most likely underestimated. Only through multidisciplinary approach it is possible to plane the proper therapeutic strategy. The diagnosis of IHP is confirmed by definitive histology but in some cases is possible with intraoperative frozen section. PMID:25174295

CARANGELO, B.; LAVALLE, L.; MUSCAS, G.; PERI, G.; TIEZZI, G.; BRANCO, D.; TACCHINI, D.; COSTANTINO, G.; MARIOTTINI, A.; MATURO, A.

2014-01-01

179

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

180

[Transient paraplegia of the legs after sigmoid resection--late complication after implantation of an aortic bifurcation prosthesis in arterial occlusive disease?].  

PubMed

Ischemic spinal lesions following graft replacement of an infrarenal aortic aneurysm are rare complications. Even more rare is the development of this complication in case of aortoiliac occlusive disease. We report one further case who developed transient paraplegia following sigma resection six years after implantation of an aortobifemoral bifurcation graft because of aortoiliac occlusive disease. The abdominal vessel and the collateral situation of this site of the caudal aorta is discussed and the possibility of late ischemic spinal lesions is pointed out. PMID:8036839

Graupe, F; Badke, A; Taleb, N; Mackrodt, H G; Stock, W

1994-01-01

181

Long-term follow-up in two cases of intracranial Rosai–Dorfman Disease complicated by incomplete resection and recurrence  

PubMed Central

Background: Although intracranial Rosai–Dorfman disease is a principally benign lymphohistiocytosis, some patients run a relapsing or progressive course. However, reports about long-term follow-up are extremely rare. Case Description: In two patients, initial tumor resection was incomplete or followed by recurrences over 3 years, which finally subsided after application of chemotherapy, and patients remained tumor-free for more than 7 years thereafter. Conclusion: Up to now there is no agreement on how to treat complicated cases of intracranial Rosai–Dorfman disease; our good experience with adjuvant chemotherapy and long-term follow-up will contribute to treatment planning in complicated cases. PMID:24778918

Rivera, Diones; Pérez-Castillo, Miguelina; Fernández, Belkis; Stoeter, Peter

2014-01-01

182

Total hip replacement infected with Mycobacterium tuberculosis complicated by Addison disease and psoas muscle abscess: a case report  

PubMed Central

Introduction Prosthetic joint infection due to Mycobacterium tuberculosis is occasionally encountered in clinical practice. To the best of our knowledge, this is the first report of a prosthetic joint infection due to Mycobacterium tuberculosis complicated by psoas abscesses and secondary Addison disease. Case presentation A 67-year-old immunocompetent Caucasian woman underwent total left hip arthroplasty because of osteoarthritis. After 18 months, she underwent arthroplasty revision for a possible prosthetic infection. Periprosthetic tissue specimens for bacteria were negative, and empirical antibiotic therapy was unsuccessful. She was then admitted to our department because of complications arising 22 months after arthroplasty. A physical examination revealed a sinus tract overlying her left hip and skin and mucosal pigmentation. Her levels of C-reactive protein, basal cortisol, adrenocorticotropic hormone, and sodium were out of normal range. Results of the tuberculin skin test and QuantiFERON-TB Gold test were positive. Computed tomography revealed a periprosthetic abscess and the inclusion of the left psoas muscle. Results of microbiological tests were negative, but polymerase chain reaction of a specimen taken from the hip fistula was positive for Mycobacterium tuberculosis. Our patient's condition was diagnosed as prosthetic joint infection and muscle psoas abscess due to Mycobacterium tuberculosis and secondary Addison disease. She underwent standard treatment with rifampicin, ethambutol, isoniazid, and pyrazinamide associated with hydrocortisone and fludrocortisone. At 15 months from the beginning of therapy, she was in good clinical condition and free of symptoms. Conclusions Prosthetic joint infection with Mycobacterium tuberculosis is uncommon. A differential diagnosis of tuberculosis should be considered when dealing with prosthetic joint infection, especially when repeated smears and histology examination from infected joints are negative. Clinical outcomes of prosthetic joint infection by Mycobacterium tuberculosis are unpredictable, especially given the limited literature in this field and the uncertainty of whether medical treatment alone can eradicate the infection without prosthesis removal. Furthermore, this case report raises interesting issues such as the necessity of a follow-up evaluation after treatment based on clinical conditions, the utility of a more standardized length of treatment for periprosthetic tuberculous infection, and the importance of a high diffusion capacity of anti-mycobacterial agents in order to eradicate the infection. PMID:22233936

2012-01-01

183

Rain Machine (Solar Still)  

NSDL National Science Digital Library

In this activity, learners work in groups to build simple solar stills filled with salt water. After the stills are complete, learners observe what happens when they place the stills in the sun. Learners taste the water they collect and discuss what has happened in their stills.

2012-07-03

184

Complications of the intrauterine device in nulliparous and parous women  

Microsoft Academic Search

OBJECTIVES: The intrauterine device (IUD) is still related to pelvic inflammatory disease (PID), pregnancy, expulsion, perforation and menstrual problems, particularly in nulliparous women. We aimed to study the complications and symptoms of the intrauterine device in general practice, particularly in nulliparous women. METHODS: We used a retrospective cohort study in four general practices participating in the Nijmegen Continuous Morbidity Registration.

H. M. Veldhuis; A. G. Vos; A. L. M. Lagro-Janssen

2004-01-01

185

Complications of Measles (Rubeola)  

MedlinePLUS

... Travelers Lab Tools Serology Specimens for Detection by RT-PCR or Virus Isolation Measles Lab Manual Vero/ ... Measles chapter of the Epidemiology and Prevention of Vaccine Preventable Diseases (Pink Book) describes measles complications in ...

186

Pertussis (Whooping Cough) Complications  

MedlinePLUS

... The CDC Cancel Submit Search The CDC Pertussis (Whooping Cough) Note: Javascript is disabled or is not supported ... Kid-friendly Fact Sheet Pertussis Vaccination Pregnancy and Whooping Cough Clinicians Disease Specifics Treatment Clinical Features Clinical Complications ...

187

Subthalamic nucleus-deep brain stimulation for early motor complications in Parkinson's disease-the EARLYSTIM trial: early is not always better.  

PubMed

Subthalamic nucleus deep brain stimulation (STN-DBS) has revolutionized the management of disabling motor complications in Parkinson's disease. The EARLYSTIM trial applied this treatment to patients who had been experiencing motor complications for less than three years. STN-DBS significantly improved all primary and secondary outcome measures while best medical therapy failed to provide any improvement at the two-year follow-up time point. On face value these results strongly favor the application of STN-DBS far earlier than is currently applied, when patients are just beginning to experience problems with motor complications. Here we review the application of early DBS and the EARLYSTIM trial from the perspectives of clinical issues, health economics and study design and patient expectation of benefit. We conclude that the most relevant issue is not when to operate but on whom and that early is not always better. © 2014 International Parkinson and Movement Disorder Society. PMID:25227325

Mestre, Tiago A; Espay, Alberto J; Marras, Connie; Eckman, Mark H; Pollak, Pierre; Lang, Anthony E

2014-12-01

188

Clinical application of transient elastography in prediction of portal hypertension related complication in patients with chronic liver diseases.  

PubMed

Liver cirrhosis (LC) is the final evaluative stage of chronic liver diseases with dynamic progressive process to multiple complications especially splenomegaly and esophageal varices(EV). Efforts have been made to develop non-invasive predictive models that may correlate with LC and EV. The role of liver stiffness measurement (LSM)- and spleen stiffness measurement (SSM) by transient elastography (TE) in the diagnosis of LC and prediction of EV was studied on 90 subjects selected from the outpatient clinics of Bakhash Hospitals. They were classified into three groups: GI included 10 healthy volunteers as a control group, GII included 20 chronic hepatitis (CH) patients and GIII included 60 cirrhotic patients. Patients in GIII were further subdivided equally into two subgroups A & B according to presence or absence of EV. GIII patients were evaluated by gastroscope for screening and grading of EV. All groups were subjected to complete blood picture, liver and kidney function testes and abdominal ultrasonography as well as LSM (right lobe) and SSM by using fibroscan. LS were significantly higher in LC patients as compared with CH patients and controls. At a cutoff value of 9.8 kPa, sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) for LC were 90%, 73%, 55% &78% respectively. At a cutoff value of 17.75 kPa (no varices vs. varices at any grade), sensitivity, specificity, PPV & NPV for prediction of EV were 92%, 46.2%, 73% & 67.2% respectively. LS at cut off values of 14.4 KPa predicted the splenomegaly. SSM at 50.4 KPa being the best cut-off value for prediction of varices with sensitivity, specificity, PPV, NPV & accuracy were 81.2%, 73.2%, 88.7%, 48.8% & 79.4% respectively. Combination of LS >17 KPa & SS > 52, predicted EV with 87.6% diagnostic accuracy. As regard EV prediction, combination of LSM & SSM had a highest diagnostic accuracy than PSR (76.9% vs. 87.6). PMID:22662598

Al-Dahshan, Magdy

2012-04-01

189

[Complications in pediatric anesthesia].  

PubMed

As in adult anesthesia, morbidity and mortality could be significantly reduced in pediatric anesthesia in recent decades. This fact cannot conceal the fact that the incidence of anesthetic complications in children is still much more common than in adults and sometimes with a severe outcome. Newborns and infants in particular but also children with emergency interventions and severe comorbidities are at increased risk of potential complications. Typical complications in pediatric anesthesia are respiratory problems, medication errors, difficulties with the intravenous puncture and pulmonal aspiration. In the postoperative setting, nausea and vomiting, pain, and emergence delirium can be mentioned as typical complications. In addition to the systematic prevention of complications in pediatric anesthesia, it is important to quickly recognize disturbances of homeostasis and treat them promptly and appropriately. In addition to the expertise of the performing anesthesia team, the institutional structure in particular can improve quality and safety in pediatric anesthesia. PMID:25004872

Becke, K

2014-07-01

190

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

191

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

192

Hematologic Complications of Pregnancy  

PubMed Central

Pregnancy induces a number of physiologic changes that affect the hematologic indices, either directly or indirectly. Recognizing and treating hematologic disorders that occur during pregnancy is difficult owing to the paucity of evidence available to guide consultants. This paper specifically reviews the diagnosis and management of benign hematologic disorders occurring during pregnancy. Anemia secondary to iron deficiency is the most frequent hematologic complication and is easily treated with oral iron formulations,; however care must be taken not to miss other causes of anemia, such as sickle cell disease. Thrombocytopenia is also a common reason for consulting the hematologist and distinguishing gestational thrombocytopenia from immune thrombocytopenia (ITP), preeclampsia, HELLP syndrome, or thrombotic thrombocytopenic purpura (TTP) is essential since the treatment differs widely. Occasionally the management of mother and infant involves the expeditious recognition of neonatal alloimmune thrombocytopenia (NAIT), a condition that is responsible for severe life-threatening bleeding of the newborn. Additionally, inherited and acquired bleeding disorders affect pregnant women disproportionately and often require careful monitoring of coagulation parameters in order to prevent bleeding in the puerperium. Finally, venous thromboembolism (VTE) during pregnancy is still largely responsible for mortality during pregnancy and the diagnosis, treatment options and guidelines for prevention of VTE during pregnancy are explored. PMID:23953339

Townsley, Danielle M.

2013-01-01

193

Should We Still be Performing Vasectomies?  

PubMed Central

Longterm safety of vasectomy has been questioned, based on the possibility of sperm antigens causing an antibody response. The point at which the antigens enter the circulation is unknown. Animal experiments have shown atherosclerosis as a result of antibody production, but evidence in man is still equivocal. Nonetheless, the family physician is obliged to inform patients of possible postoperative complications, but to avoid overinterpretation of a still controversial problem. PMID:20469361

Smith, R. K. L. Percival

1981-01-01

194

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

195

Ocular complications of diabetes mellitus  

PubMed Central

Diabetes mellitus (DM) is a important health problem that induces ernestful complications and it causes significant morbidity owing to specific microvascular complications such as, retinopathy, nephropathy and neuropathy, and macrovascular complications such as, ischaemic heart disease, and peripheral vasculopathy. It can affect children, young people and adults and is becoming more common. Ocular complications associated with DM are progressive and rapidly becoming the world’s most significant cause of morbidity and are preventable with early detection and timely treatment. This review provides an overview of five main ocular complications associated with DM, diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases.

Sayin, Nihat; Kara, Necip; Pekel, Gökhan

2015-01-01

196

Ocular complications of diabetes mellitus.  

PubMed

Diabetes mellitus (DM) is a important health problem that induces ernestful complications and it causes significant morbidity owing to specific microvascular complications such as, retinopathy, nephropathy and neuropathy, and macrovascular complications such as, ischaemic heart disease, and peripheral vasculopathy. It can affect children, young people and adults and is becoming more common. Ocular complications associated with DM are progressive and rapidly becoming the world's most significant cause of morbidity and are preventable with early detection and timely treatment. This review provides an overview of five main ocular complications associated with DM, diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases. PMID:25685281

Sayin, Nihat; Kara, Necip; Pekel, Gökhan

2015-02-15

197

Report from The International Society for Nomenclature of Paediatric and Congenital Heart Disease: cardiovascular catheterisation for congenital and paediatric cardiac disease (Part 2 - Nomenclature of complications associated with interventional cardiology).  

PubMed

Interventional cardiology for paediatric and congenital cardiac disease is a relatively young and rapidly evolving field. As the profession begins to establish multi-institutional databases, a universal system of nomenclature is necessary for the field of interventional cardiology for paediatric and congenital cardiac disease. The purpose of this paper is to present the results of the efforts of The International Society for Nomenclature of Paediatric and Congenital Heart Disease to establish a system of nomenclature for cardiovascular catheterisation for congenital and paediatric cardiac disease, focusing both on procedural nomenclature and the nomenclature of complications associated with interventional cardiology. This system of nomenclature for cardiovascular catheterisation for congenital and paediatric cardiac disease is a component of The International Paediatric and Congenital Cardiac Code. This manuscript is the second part of the two-part series. Part 1 covered the procedural nomenclature associated with interventional cardiology as treatment for paediatric and congenital cardiac disease. Part 2 will cover the nomenclature of complications associated with interventional cardiology as treatment for paediatric and congenital cardiac disease. PMID:21310094

Bergersen, Lisa; Giroud, Jorge Manuel; Jacobs, Jeffrey Phillip; Franklin, Rodney Cyril George; Béland, Marie Josée; Krogmann, Otto Nils; Aiello, Vera Demarchi; Colan, Steven D; Elliott, Martin J; Gaynor, J William; Kurosawa, Hiromi; Maruszewski, Bohdan; Stellin, Giovanni; Tchervenkov, Christo I; Walters, Henry Lane; Weinberg, Paul; Everett, Allen Dale

2011-06-01

198

Challenging complications of treatment – human herpes virus 6 encephalitis and pneumonitis in a patient undergoing autologous stem cell transplantation for relapsed Hodgkin's disease: a case report  

PubMed Central

Background Reactivation of human herpesvirus 6 (HHV-6) occurs frequently in patients after allogeneic stem cell transplantation and is associated with bone-marrow suppression, enteritis, pneumonitis, pericarditis and also encephalitis. After autologous stem cell transplantation or intensive polychemotherapy HHV-6 reactivation is rarely reported. Case report This case demonstrates a severe symptomatic HHV-6 infection with encephalitis and pneumonitis after autologous stem cell transplantation of a patient with relapsed Hodgkin's disease. Conclusion Careful diagnostic work up in patients with severe complications after autologous stem cell transplantation is mandatory to identify uncommon infections. PMID:19619326

Bommer, Martin; Pauls, Sandra; Greiner, Jochen

2009-01-01

199

Encaustic Still Life.  

ERIC Educational Resources Information Center

Presents an art lesson used in an advanced high school art class where students used the encaustic painting technique by melting wax and combining various pigments. Explains that the students painted a still-life of flowers in the style of Vincent van Gogh. (CMK)

Mathes, Len

2002-01-01

200

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

201

Still Flying Fusion Edition  

E-print Network

's why we're still flyin'... Filk - Firefly Musi c! Based on Survivor's "Eye of the Tiger" (from Rocky III), written by Frankie Sullivan/Jim Peterik, 1982 Dedicated by Cyby and Ying to Kerry Pearson (Lux Lucre), 1963-2004, whose spirit...

2013-11-27

202

Turnaround Momentum Still Fragile  

ERIC Educational Resources Information Center

The federal program providing billions of dollars to help states and districts close or remake some of their worst-performing schools remains a work in progress after two years, with more than 1,200 turnaround efforts under way but still no definitive verdict on its effectiveness. The School Improvement Grant (SIG) program, supercharged by a…

Klein, Alyson

2012-01-01

203

Is Information Still Relevant?  

ERIC Educational Resources Information Center

Introduction: The term "information" in information science does not share the characteristics of those of a nomenclature: it does not bear a generally accepted definition and it does not serve as the bases and assumptions for research studies. As the data deluge has arrived, is the concept of information still relevant for information…

Ma, Lia

2013-01-01

204

Medical complications of obesity.  

PubMed Central

Obesity leads to several complications that affect many body systems. This paper focuses mainly on the cardiovascular complications, which include coronary heart disease, cerebrovascular disease and stroke, and congestive heart failure; the last may be secondary not only to advanced coronary atherosclerosis, but also to other pathogenetic factors. The increased frequency of coronary heart disease in the obese is largely attributable to the commonly associated hypertension, diabetes mellitus and lipoprotein abnormalities, rather than the adiposity. The lipoprotein disorders that have a role in atherogenesis are decreased plasma concentrations of high-density lipoproteins and elevated plasma concentrations of low-density lipoproteins. Abnormalities in cholesterol metabolism are responsible for the increased frequency of cholelithiasis in obese persons. The factors that mediate the development of cardiovascular and gallbladder complications are correctable by an appropriate program of meal planning and physical activity. PMID:737618

Angel, A.; Roncari, D. A.

1978-01-01

205

Outbreaks of hand, foot, and mouth disease by enterovirus 71. High incidence of complication disorders of central nervous system  

Microsoft Academic Search

In Japan we have had two outbreaks of hand, foot, and mouth disease associated with disorders of the central nervous system, one in 1973 and the other in 1978. The isolated virus in both outbreaks was enterovirus 71. Central nervous system disorders were present in 24% of patients in 1973 and in 8% of patients in 1978. These disorders were

Y Ishimaru; S Nakano; K Yamaoka; S Takami

1980-01-01

206

Beneficial Effect of Intravenous Dexamethasone in Children With Mild to Moderately Severe Acute Chest Syndrome Complicating Sickle Cell Disease  

Microsoft Academic Search

Acute chest syndrome (ACS) in patients with sickle cell disease (SCD) has historically been managed with oxygen, antibiotics, and blood transfusions. Recently high-dose corti- costeroid therapy was shown to reduce the duration of hospitalization in children with SCD and vaso-occlusive crisis. Therefore, we chose to assess the use of glucocorti- coids in ACS. We conducted a randomized, double-blind placebo-controlled trial

Juan Carlos Bernini; Zora R. Rogers; Eric S. Sandler; Joan S. Reisch; Charles T. Quinn; George R. Buchanan

207

Low Mannan-Binding Lectin Serum Levels Are Associated With Complicated Crohn's Disease and Reactivity to Oligomannan (ASCA)  

Microsoft Academic Search

OBJECTIVES:Mannan-binding lectin (MBL) acts as a pattern-recognition molecule directed against oligomannan, which is part of the cell wall of yeasts and various bacteria. We have previously shown an association between MBL deficiency and anti-Saccharomyces cerevisiae mannan antibody (ASCA) positivity. This study aims at evaluating whether MBL deficiency is associated with distinct Crohn's disease (CD) phenotypes.METHODS:Serum concentrations of MBL and ASCA

Alain M Schoepfer; Beatrice Flogerzi; Beatrice Seibold-Schmid; Thomas Schaffer; Jürgen F J Kun; Valerie Pittet; Stefan Mueller; Frank Seibold

2009-01-01

208

Behavioral complications of dementia  

Microsoft Academic Search

BEHAVIORAL COMPLICATIONS of dementia, a major source of morbidity associated with diseases marked by cognitive impairment, are usually very distressing to both demented patients and their caregivers, v3 Since general internists often manage these debilitating problems, we have structured this overview for the primary care physician. The existing literature in this new area of study is not yet sufficient for

Timothy Howell; David T. Watts

1990-01-01

209

Old is still gold  

PubMed Central

Common bile duct injury is infrequent but a serious complication of cholecystectomy. Variable biliary anatomy has an increased risk of iatrogenic injury. Intraoperative cholangiogram can be performed to provide a clearer picture of biliary anatomy. We report a case of a 71-year-old lady who underwent cholecystectomy for symptomatic gallstones. Anatomy initially was misinterpreted at laparoscopy when common bile duct was identified as a cystic duct, and a hole in what appeared to be Hartmann's pouch was in fact in common hepatic duct. If continued laparoscopically, further misconception could have led to the complete excision of the biliary system. Instead, procedure was converted to an open and intraoperative cholangiogram performed, which confirmed a diagnosis of Mirizzi syndrome. Following the identification of structures, subtotal cholecystectomy was completed. The patient made an uneventful recovery. This case highlights the limitations of laparoscopy and the importance of an intraoperative cholangiogram. Despite advances in surgical techniques, we continue to advocate a low threshold for its use during cholecystectomy as a useful tool in evaluating and minimising the extent of biliary injury. PMID:23378548

Keens, Keta L; Pursnani, Kishore G; Ward, Jeremy B; Date, Ravindra S

2013-01-01

210

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

211

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

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

2014-01-01

212

Sarcoidosis: still a mystery?  

PubMed Central

Sarcoidosis is a systemic granulomatous disease of unknown etiology. It has diverse clinical manifestations, most frequently including pulmonary disorders. It is associated with immunological abnormalities, the intricacies of which have yet to be clearly delineated. In the immunologically susceptible individual, genetic, environmental, nutritional, and socioeconomic factors may play a governing role in its development. Sarcoidosis is a diagnosis of exclusion established by clinical manifestations, radiologic findings, and histologic evidence of noncaseating epithelioid-cell granulomas in >1 organ. We will discuss parameters that are helpful in making this diagnosis. PMID:16369580

2001-01-01

213

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

214

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, ...

215

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

216

Ulcerative Ileitis after Proctocolectomy in Children: A Complication of Ulcerative Colitis or a Disease in Itself after Ileoanal Pullthrough?  

PubMed

Ulcerative ileitis (UI) after restorative proctocolectomy (RPC) and ileoanal pullthrough procedure (IAPP) is a rare condition described as inflammation of the terminal ileum proximal to the anastomosis. It is mostly observed in ulcerative colitis (UC) and is designated as prepouch ileitis; sometimes with pouchitis, but not necessarily all the time. Its incidence in adults is less than 5%, but the information in children is limited. Pathogenesis is unknown, it has been considered as a disease by itself, independently on the underlying disease. It involves additional morbidity and impacts negatively on quality of life because there is no effective treatment so far. This study aims to review the cases of UI in our institution and to summarize their clinical features and management. A descriptive retrospective study of UI patients between 1990 and 2013 was conducted. Children with RPC and IAPP with clinical and pathological diagnosis of UI were included. Sociodemographic and clinical data, diagnostic, and therapeutic procedures were collected through medical records. UI was diagnosed in eight patients (six males) after RCP; four had UC, two had total colonic aganglionosis (TCA), and two had complex anorectal malformations (one cloacal exstrophy and one omphalopagus twin with bladder exstrophy). Different surgical techniques were used in each case: UC patients underwent IAPP, 50% with J-reservoir and 50% without it; posterior sagittal pullthrough was performed in those with anorectal malformations; one Soave and one Swenson procedure in those with TCA. In summary, three patients had reservoir and five did not. The median age at the IAPP and ostomy closure was 6 years (range 2 months-8 years) and 7 years (range 6 months-9 years), respectively. UI was found after a median of 23 months (range 1-48 months), all of them after digestive tract continuity was reestablished. The leading symptom was lower GI or gastrointestinal, both of them bleeding with abdominal pain, followed by abdominopelvic abscesses and malabsorption with weight loss. Pathology showed nonspecific inflammatory changes. Treatment included antibiotics, corticosteroids and/or immunosuppressive agents with variable response, requiring a new ileostomy in five cases. Ileitis disappeared after diversion. In our experience, UI after colectomy is not an exclusive feature of UC as has been previously described. Although it appears with pouchitis, the presence of a reservoir is not a must, suggesting that this is a different entity. No medical treatment has been really effective in our patients and diversion above this level stopped the process. Further studies on its pathogenesis and treatment strategies are necessary. PMID:25144351

Galán, Alba Sánchez; Moreno, Ane M Andres; Caamaño, Beatriz Fernández; Sánchez, Alejandra Vilanova; Dominguez, Eva; Ortiz, Ruben; Prieto, Gerardo; Santamaria, Manuel Lopez; Tovar, J A

2014-08-21

217

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

218

Hand, foot and mouth disease complicated with central nervous system involvement in Taiwan in 1980-1981.  

PubMed

Sixteen cases from the 1980-1981 Taiwan outbreak of hand, foot and mouth disease (HFMD) associated with central nervous system involvement were identified: nine had polio-like syndrome, four had encephalitis or encephalomyelitis, one had cerebellitis, and two had aseptic meningitis. They all had fever, five (31%) had documented myoclonic jerk, and 15 (93%) had HFMD. Their mean blood leukocyte count was 12,490/microL, and five (31%) had leukocytosis (> 15,000/microL); mean cerebrospinal fluid (CSF) leukocyte count was 156/microL, CSF protein was 57 mg/dL and CSF glucose was 57 mg/dL. Two patients with HFMD plus encephalitis died within 1 day of hospitalization, and one of them had acute cardiopulmonary failure mimicking myocarditis. Twenty years later, at least one male patient had sequelae of polio-like syndrome and was therefore exempted from military service. Clinical severity was comparable to the 1998 EV71 epidemic. PMID:17339164

Chang, Luan-Yin; Lee, Chin-Yun; Kao, Chuan-Liang; Fang, Tsui-Yen; Lu, Chun-Yi; Lee, Ping-Ing; Huang, Li-Min

2007-02-01

219

The impact of omega-3 polyunsaturated fatty acid supplementation on the incidence of cardiovascular events and complications in peripheral arterial disease: a systematic review and meta-analysis  

PubMed Central

Background Individuals with peripheral arterial disease are at higher risk for cardiovascular events than the general population. While supplementation with omega-3 polyunsaturated fatty acids (PUFA) has been shown to improve vascular function, it remains unclear if supplementation decreases serious clinical outcomes. We conducted a systematic review and meta-analysis to determine whether omega-3 PUFA supplementation reduces the incidence of cardiovascular events and complications in adults with peripheral arterial disease. Methods We searched five electronic databases (MEDLINE, EMBASE, CENTRAL, Scopus and the International Clinical Trials Registry Platform) from inception to 6 December 2013 to identify randomized trials of omega-3 PUFA supplementation (from fish or plant oils) that lasted ?12 weeks in adults with peripheral arterial disease. No language filters were applied. Data on trial design, population characteristics, and health outcomes were extracted. The primary outcome was major adverse cardiac events; secondary outcomes included myocardial infarction, cardiovascular death, stroke, angina, amputation, revascularization procedures, maximum and pain-free walking distance, adverse effects of the intervention, and quality of life. Trial quality was assessed using the Cochrane Risk of Bias tool. Results Of 741 citations reviewed, we included five trials enrolling 396 individuals. All included trials were of unclear or high risk of bias. There was no evidence of a protective association of omega-3 PUFA supplementation against major adverse cardiac events (pooled risk ratio 0.73, 95% CI 0.22 to 2.41, I 2 75%, 2 trials, 288 individuals) or other serious clinical outcomes. Adverse events and compliance were poorly reported. Conclusions Our results showed that insufficient evidence exists to suggest a beneficial effect of omega-3 PUFA supplementation in adults with peripheral arterial disease with regard to cardiovascular events and other serious clinical outcomes. PMID:24885361

2014-01-01

220

Subcutaneous emphysema as the first relevant clinical sign of complicated tubercular lymph node disease in a child  

PubMed Central

Background Children make up a significant proportion of the global tuberculosis (TB) caseload, and experience considerable TB-related morbidity and mortality. Unfortunately, it is not easy to diagnose TB in the first years of life because of the diversity of its clinical presentation and the non-specific nature of most of its symptoms. Case presentation A 26-month-old male child was admitted to hospital because of the sudden onset of rapidly increasing swelling of the neck, face and upper trunk a few hours before. Upon admission, his temperature was 36.5°C, pulse rate 120/min, respiratory rate 36/min, and O2 saturation 97% in air. Palpation revealed subcutaneous emphysema (SE) over the swollen skin areas, and an examination of the respiratory system revealed crepitations in the left part of the chest without any significant suggestion of mediastinal shift. Chest radiography showed enlargement of the left lung hilum with pneumomediastinum and diffuse SE. Bronchoscopy was carried out because of the suspicion that the SE may have been due to the inhalation of a peanut. This excluded the presence of a foreign body but showed that the left main bronchus was partially obstructed with caseous material and showed significant signs of granulomatous inflammation on the wall. Contrast-enhanced computed tomography of the lungs confirmed the SE and pneumomediastinum, and revealed bilateral hilum lymph node disease with infiltration of the adjacent anatomical structure and a considerable breach in the left primary bronchus wall conditioning the passage of air in the mediastinum and subcutaneous tissue. As a tuberculin skin test and polymerase chain reaction for Mycobacterium tuberculosis on bronchial material and gastric aspirate were positive, a diagnosis of TB was made and oral anti-TB therapy was started, which led to the elimination of M. tuberculosis and a positive clinical outcome. Conclusions This is the first case in which SE was the first relevant clinical manifestation of TB and arose from infiltration of the bronchial wall secondary to caseous necrosis of the hilum lymph nodes. Physicians should be aware of the fact that SE is one of the possible initial signs and symptoms of early TB infection, and act accordingly. PMID:24094042

2013-01-01

221

Eczema: Complications  

MedlinePLUS

... Diseases Asthma Food Allergy Immune System Methicillin-Resistant Staphylococcus Aureus (MRSA) Sinusitis Javascript Error Your browser JavaScript is ... atopic dermatitis. Bacterial Infections Scanning electron micrograph of Staphylococcus aureus bacteria. Credit: NIAID A major health risk associated ...

222

Complications in colorectal surgery: risk factors and preventive strategies  

PubMed Central

Backround Open or laparoscopic colorectal surgery comprises of many different types of procedures for various diseases. Depending upon the operation and modifiable and non-modifiable risk factors the intra- and postoperative morbidity and mortality rate vary. In general, surgical complications can be divided into intraoperative and postoperative complications and usually occur while the patient is still in the hospital. Methods A literature search (1980-2009) was carried out, using MEDLINE, PubMed and the Cochrane library. Results This review provides an overview how to identify and minimize intra- and postoperative complications. The improvement of different treatment strategies and technical inventions in the recent decade has been enormous. This is mainly attributable to the increase in the laparoscopic approach, which is now well accepted for many procedures. Training of the surgeon, hospital volume and learning curves are becoming increasingly more important to maximize patient safety, surgeon expertise and cost effectiveness. In addition, standardization of perioperative care is essential to minimize postoperative complications. Conclusion This review summarizes the main perioperative complications of colorectal surgery and influencable and non-influencable risk factors which are important to the general surgeon and the relevant specialist as well. In order to minimize or even avoid complications it is crucial to know these risk factors and strategies to prevent, treat or reduce intra- and postoperative complications. PMID:20338045

2010-01-01

223

An overview of international literature from cystic fibrosis registries. Part 3. Disease incidence, genotype/phenotype correlation, microbiology, pregnancy, clinical complications, lung transplantation, and miscellanea.  

PubMed

This is the third article related to a review of the literature based on data from national cystic fibrosis (CF) patient registries up to June 2008 and covering a total of 115 published studies. It focuses on several topics: CF incidence, genotype/phenotype correlation, microbiology, pregnancy/paternity, clinical complications, lung transplantation, and others. Seventy seven papers meeting the inclusion criteria were found to be related to the topics listed above. Another seven studies, already evaluated in previous papers of this series, were recalled for specific topics. Incidence is described by several studies, results being quite different from one country to another and quite inhomogeneous among regions within the same country. Studies on genetics address the genotype/phenotype correlation and look for a predictive value of CFTR mutations in terms of clinical outcome, with controversial results. Papers on microbiology describe the clinical relevance of different pathogens and their role in the progress of CF lung disease. A few articles give information on the features of CF women undergoing a pregnancy and try to identify the ones associated with a better outcome. Studies on clinical complications discuss prevalence and the role of haemoptysis, pneumothorax, CF related diabetes, ABPA and cancer. Papers on lung transplantation focus on models able to improve the selection criteria for transplantation candidates and the factors linked to post transplantation survival. Finally, several studies deal with a number of interesting topics related to CF epidemiology: clinical trial methodology, quality of care comparison among countries and centers, relationship between diagnosis and age/gender, and evaluation of pharmacological therapy. On the whole, CF Registries have already contributed to important advances in the knowledge of the natural history of CF, establishing the foundations for future improvement in CF research and care. PMID:21257352

Salvatore, Donatello; Buzzetti, Roberto; Baldo, Ermanno; Forneris, Maria Pia; Lucidi, Vincenzina; Manunza, Daniela; Marinelli, Italo; Messore, Barbara; Neri, Anna Silvia; Raia, Valeria; Furnari, Maria Lucia; Mastella, Gianni

2011-03-01

224

Oral Complications of HIV Disease  

PubMed Central

Oral lesions are among the early signs of HIV infection and can predict its progression to acquired immunodeficiency syndrome (AIDS). A better understanding of the oral manifestations of AIDS in both adults and children has implications for all health care professionals. The knowledge of such alterations would allow for early recognition of HIV-infected patients. The present paper reviews epidemiology, relevant aspects of HIV infection related to the mouth in both adults and children, as well as current trends in antiretroviral therapy and its connection with orofacial manifestations related to AIDS. PMID:19488613

Leao, Jair C.; Ribeiro, Camila M. B.; Carvalho, Alessandra A. T.; Frezzini, Cristina; Porter, Stephen

2009-01-01

225

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

226

The Burden of Cardiovascular Disease in Patients with Chronic Kidney Disease and in End-Stage Renal Disease  

Microsoft Academic Search

Patients who reach the end-stage phase of renal disease (ESRD) display an exceedingly high risk for cardiovascular (CV) complications. However it is still unclear whether in patients with chronic kidney disease (CKD) a critical glomerular filtration rate (GFR) threshold exists below which CV risk starts to rise. Analyses based on a medical database indicate that starting from the lower limit

C. Zoccali

2008-01-01

227

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

228

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

229

Respiratory complications of relapsing polychondritis  

Microsoft Academic Search

Gibson, G. J. and Davis, P. (1974).Thorax, 29, 726-731. Respiratory complications of relapsing polychondritis. The respiratory function of a patient with relapsing polychondritis is described. He had severe airflow obstruction due to disease of both the extra and intrathoracic large airways. Evidence of small airways disease was lacking. The airflow obstruction was probably due to a combination of structural narrowing

G. J. Gibson; P. Davis

1974-01-01

230

Perineal wound complications after abdominoperineal resection.  

PubMed

Perineal wound complications following abdominoperineal resection (APR) is a common occurrence. Risk factors such as operative technique, preoperative radiation therapy, and indication for surgery (i.e., rectal cancer, anal cancer, or inflammatory bowel disease [IBD]) are strong predictors of these complications. Patient risk factors include diabetes, obesity, and smoking. Intraoperative perineal wound management has evolved from open wound packing to primary closure with closed suctioned transabdominal pelvic drains. Wide excision is used to gain local control in cancer patients, and coupled with the increased use of pelvic radiation therapy, we have experienced increased challenges with primary closure of the perineal wound. Tissue transfer techniques such as omental pedicle flaps, and vertical rectus abdominis and gracilis muscle or myocutaneous flaps are being used to reconstruct large perineal defects and decrease the incidence of perineal wound complications. Wound failure is frequently managed by wet to dry dressing changes, but can result in prolonged hospital stay, hospital readmission, home nursing wound care needs, and the expenditure of significant medical costs. Adjuvant therapies to conservative wound care have been suggested, but evidence is still lacking. The use of the vacuum-assisted closure device has shown promise in chronic soft tissue wounds; however, experience is lacking, and is likely due to the difficulty in application techniques. PMID:20011400

Wiatrek, Rebecca L; Thomas, J Scott; Papaconstantinou, Harry T

2008-02-01

231

The Effects of Ranitidine and Hydrocortisone on the Complications of Femoral Artery Obstruction Treated by Streptokinase Following Cardiac Catheterization in Pediatric Patients with Congenital Heart Diseases  

PubMed Central

Background: The most important complication following cardiac catheterization required urgent therapeutic management is vessel obstruction and arterial thrombosis. The morbidity following this complication can be decreased by surgery intervention and/or thrombolytic drugs. Objectives: In this study we evaluated the effects of ranitidine and hydrocortisone on pediatric patients with congenital heart diseases who suffered from femoral artery obstruction following cardiac catheterization on decreasing the events after streptokinase administration. Materials and Methods: This semi experimental study was conducted on 47 patients among 600 cases who underwent cardiac catheterization from April 2002 to December 2011.The patients suffered from distal vessel obstruction following cardiac catheterization with no response to surgery intervention, were enrolled and divided in two groups. Streptokinase was administrated in both groups. Patients in group 2 (25 cases), received ranitidine and hydrocortisone before streptokinase administration. In group 1 (22 cases), the loading dose of streptokinase was 2000IU/kg/ in 20-30 minutes/ infusion and thereafter streptokinase was administrated 1000 IU /kg/hour. In group 2, the loading dose was 3000IU/kg in 20-30 minutes /infusion and 1500 IU/kg/hour as maintenance dose. The infusion dose of streptokinase was decreased and then terminated in 2-3 hours by the time arterial pulse was detected by pulse oximetry. Results: There were 13 (59, 1%) male and 9 (40.9%) female patients in group 1. In group 2, there were 15 (60%) male and 10 (40%) female cases (P = 0.949). Patients in both groups were matched well regarding age, body weight, height and the duration of streptokinase infusion (P < 0.05). The incidence of hematoma was higher in group 1 than group 2 (P = 0.032). the patients of Group 1 required more blood transfusion than group 2 because the incidence of bleeding was more in the first group (P = 0.042). 12 patients in group 1 required fresh frozen plasma transfusion versus 4 patients in group 2 (P = 0.049). Local oozing was detected more in group 1 (P = 0.042). Significant bleeding was occurred in 6 cases in group 1; however this event did not occurrin any patients in group 2 (P = 0.007). Although 4 patients in group 1 suffered from anaphylactic shock after streptokinase administration but no patients in group 2 did. (P = 0.041). Conclusions: Based on the results of this study, we concluded that streptokinase was able to remove the vessel thrombosis at the site of cardiac catheterization and ranitidine and hydrocortisone administration before streptokinase may be effective in order to reduce the complications related to thrombolytic drugs; however the experience of the performer is an issue of concern in this matter. PMID:24693416

Noori, Noormohammad; Miri Aliabad, Ghasem; Mohammadi, Mehdi; Mahjoubifard, Maziar; Jahangiri Fard, Alireza

2013-01-01

232

Pregnancy Complications: Gonorrhea  

MedlinePLUS

... is running out: 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 ...

233

Complications of gastroesophageal reflux disease. Role of the lower esophageal sphincter, esophageal acid and acid/alkaline exposure, and duodenogastric reflux.  

PubMed Central

The factors contributing to the development of esophageal mucosal injury in gastroesophageal reflux disease (GERD) are unclear. The lower esophageal sphincter, esophageal acid and acid/alkaline exposure, and the presence of excessive duodenogastric reflux (DGR) was evaluated in 205 consecutive patients with GERD and various degrees of mucosal injury (no mucosal injury, n = 92; esophagitis, n = 66; stricture, n = 19; Barrett's esophagus, n = 28). Manometry and 24-hour esophageal pH monitoring showed that the prevalence and severity of esophageal mucosal injury was higher in patients with a mechanically defective lower esophageal sphincter (p less than 0.01) or increased esophageal acid/alkaline exposure (p less than 0.01) as compared with those with a normal sphincter or only increased esophageal acid exposure. Complications of GERD were particularly frequent and severe in patients who had a combination of a defective sphincter and increased esophageal acid/alkaline exposure (p less than 0.01). Combined esophageal and gastric pH monitoring showed that esophageal alkaline exposure was increased only in GERD patients with DGR (p less than 0.05) and that DGR was more frequent in GERD patients with a stricture or Barrett's esophagus. A mechanically defective lower esophageal sphincter and reflux of acid gastric juice contaminated with duodenal contents therefore appear to be the most important determinants for the development of mucosal injury in GERD. This explains why some patients fail medical therapy and supports the surgical reconstruction of the defective sphincter as the most effective therapy. PMID:1632700

Stein, H J; Barlow, A P; DeMeester, T R; Hinder, R A

1992-01-01

234

Oral Manifestations and Complications of Diabetes Mellitus  

PubMed Central

Diabetes mellitus is a chronic disease affecting all age groups. It is one of the leading causes of mortality and morbidity worldwide. Many chronic macrovascular and microvascular complications of diabetes have been reported in the literature with few reports about oral complications. This article aims to review and increase the awareness of oral manifestations and complications of diabetes mellitus and to stimulate research on the subject. It treats in depth some of the complications such as periodontal disease, fungal infection and salivary dysfunction while other complications are mentioned briefly. PMID:21969888

Al-Maskari, Awatif Y.; Al-Maskari, Masoud Y.; Al-Sudairy, Salem

2011-01-01

235

Higher Still in European Perspective.  

ERIC Educational Resources Information Center

In 1999, Scotland's "Higher Still" will incorporate all upper-secondary academic and vocational courses in a unified curriculum and assessment system for postcompulsory education. Higher Still's objectives, strategies, and "system architecture" are compared to those of Austria, England, Finland, France, Germany, Norway, and Sweden, studied by the…

Raffe, David

1997-01-01

236

[Pulmonary complications in chemotherapy].  

PubMed

Many chemotherapeutic agents have a direct or indirect toxic effect on the lungs and airways which can lead to potentially fatal complications. It is a diagnostic challenge to identify such changes by imaging early as they are often unspecific and can be misinterpreted as pulmonary edema, infections, radiation pneumonitis or progression of an underlying disease. In this review the morphological changes of the lungs and airways are summarized according to anatomical location and some of the most commonly used chemotherapeutic agents and their adverse effects are listed. PMID:25316105

Becker, A; Frauenfelder, T

2014-10-01

237

[Long-term complications of sulfur mustard exposure: a therapeutic update].  

PubMed

Sulfur mustard (SM) is an alkylating chemical warfare agent with high military significance due to its high toxicity, resistance and availability. SM was widely used in military conflicts, the last being the Iran-Iraq war with more than 100,000 Iranians exposed, one-third of whom are still suffering from late effects. The intensity of the delayed complications correlates to the extent, the area and the route of exposure. The clinical manifestations most commonly involve respiratory, ocular and dermal effects. Respiratory complications include dyspnea, cough and expectorations and various obstructive and restrictive lung diseases. Dermal complications are itching, burning sensation, blisters, dry skin, dermatitis and pigmentary changes. Ocular complications include photophobia, red eye, tearing, corneal ulcers and blindness. Although the picture remains incomplete the major mechanisms responsible for the clinical and pathological effects of SM are: DNA alkylation and cross-linking, protein modification and membrane damage in addition to induction of inflammatory mediators in the target tissues causing extensive necrosis, apoptosis and loss of tissue structure. The current report reviews long-term complications of SM exposure, focusing on new treatments tested in clinical trials conducted on humans. Such treatments include: N-acetyl cysteine, bronchodilators, corticosteroids, Interferon-gamma, furosemide and morphine for the respiratory complications. Ocular complications may entail: Invasive procedures treating corneal complication, limbal ischemia and stem cell deficiency. Treatment for dermatological complications include: anti-depressants, pimercrolimus, Unna's boot, capsaicin, phenol and menthol, Aloe vera and olive oil, curcumin and Interferon-gamma. PMID:24791566

Shiyovich, Arthur; Rosman, Yossi; Krivoy, Amir; Statlender, Liran; Kassirer, Michael; Shrot, Shai

2014-01-01

238

[Complications of ileal lymphoma].  

PubMed

Non-Hodgkin lymphoma of the ileum accounts for some 3% of all extranodal onset lymphoma and 20% of gastrointestinal lymphoma given that the ileum is more frequently affected than the jejunum and duodenum. The large majority of primary extranodal lymphomas present a diffuse histological structure and in particular involve the cervico-fascial and gastrointestinal regions. Moreover, it is not uncommon to find an association between gastroenteric involvement and Waldeyer's ring (cervico-fascial region). Primary intestinal involvement may not present specific symptoms and remain silent for some time. It is manifested by the onset of complications caused by occlusion and perforation. Two cases of ileal lymphoma were treated at the Institute of Emergency Surgery of Catania University between 1992 and 1993. They were complicated by intestinal perforation and occlusion respectively. Both patients underwent emergency intestinal resection. Surgery represents the elective treatment for primary forms, followed by polychemotherapy and radiotherapy. Prognosis depends on the spread of disease and the hystotype. The administration of NTP and somatopstatin resulted in a shorter postoperative period with fewer surgical complications. PMID:8710149

Vadalà, G; Salice, M; L'Anfusa, G; Caragliano, P; Vadalà, F; Mangiameli, A

1995-11-01

239

Pleuropulmonary complications of pancreatitis  

PubMed Central

Pancreatitis, in common with many other upper abdominal diseases, often leads to pleuropulmonary complications. Radiological evidence of pleuropulmonary abnormality was found in 55% of 58 cases examined retrospectively. The majority of such abnormalities are not specific for pancreatitis; but a particular category of pleural effusions, rich in pancreatic enzymes, is a notable exception. A patient with this type of effusion, complicated by a spontaneous bronchopleural fistula and then by an empyema, is reported. The literature relating to pancreatic enzyme-rich pleural effusions (pathognomonic of pancreatitis) is reviewed. Of several possible mechanisms involved in pathogenesis, transdiaphragmatic lymphatic transfer of pancreatic enzymes, intrapleural rupture of mediastinal extensions of pseudocysts, and diaphragmatic perforation are the most important. The measurement of pleural fluid amylase, at present little employed in this country, has considerable diagnostic value. Enzyme-rich effusions are more commonly left-sided, are often blood-stained, are frequently associated with pancreatic pseudocysts, and—if long standing—may be complicated by a bronchopleural fistula. Images PMID:4872925

Kaye, Michael D.

1968-01-01

240

MicroRNAs: Potential Mediators and Biomarkers of Diabetic Complications  

PubMed Central

The incidence of diabetes is escalating worldwide and consequently, this has become a major healthcare problem. Moreover, both type 1 and type 2 diabetes are associated with significantly accelerated rates of microvascular complications including retinopathy, nephropathy and neuropathy, as well as macrovascular complications such as atherosclerotic cardiovascular and hypertensive diseases. Key factors have been implicated in leading to these complications including hyperglycemia, insulin resistance, dyslipidemia, advanced glycation end products, growth factors, inflammatory cytokines/chemokines and related increases in cellular oxidant stress (including mitochondrial) and endoplasmic reticulum stress. However, the molecular mechanisms underlying the high incidence of diabetic complications, which often progress despite glycemic control, are still not fully understood. MicroRNAs (miRNAs) are short non-coding RNAs that have elicited immense interest in recent years. They repress target gene expression via post-transcriptional mechanisms and have diverse cellular and biological functions. Herein, we have discussed the role of miRNAs in the pathobiology of various diabetic complications, their involvement in oxidant stress, and also the potential use of differentially expressed miRNAs as novel diagnostic biomarkers and therapeutic targets. PMID:23770198

Kato, Mitsuo; Castro, Nancy E.; Natarajan, Rama

2013-01-01

241

MEAT, POULTRY, Still contains ice  

E-print Network

MEAT, POULTRY, SEAFOOD Still contains ice crystals and feels as cold, and ground meats Refreeze Discard Poultry and ground poultry Refreeze Discard Variety meats, entree, specialty items (pizza, sausage and biscuit, meat pie,convenience foods

Liskiewicz, Maciej

242

Solar Still Part II: Juice  

NSDL National Science Digital Library

In this video segment, adapted from a ZOOM television broadcast, cast members repeat an experiment designed to separate fresh water from a liquid solution, this time using colored sugar water in one solar still and orange juice in another. The basic still design they employ traps water vapor that is created when the Sun's heat causes water to evaporate. As the vapor cools, it condenses and trickles down to a collection container. The segment is three minutes fifty-five seconds in length.

243

Study of Pulmonary Complications in Pediatric Patients With Storage Disorders Undergoing Allogeneic Hematopoietic Stem Cell Transplantation  

ClinicalTrials.gov

I Cell Disease; Fucosidosis; Globoid Cell Leukodystrophy; Adrenoleukodystrophy; Mannosidosis; Niemann-Pick Disease; Pulmonary Complications; Mucopolysaccharidosis I; Mucopolysaccharidosis VI; Metachromatic Leukodystrophy; Gaucher's Disease; Wolman Disease

2005-06-23

244

Pregnancy Complications: Chlamydia  

MedlinePLUS

... is running out: 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 ...

245

Maternal complications in diabetic pregnancy.  

PubMed

Pregnant women with diabetes have to manage both the effect of pregnancy on glucose control and its effect on pre-existing diabetic complications. Most women experience hypoglycaemia as a consequence of tightened glycaemic control and this impacts on daily living. Less commonly, diabetic ketoacidosis, a serious metabolic decompensation of diabetic control and a medical emergency, can cause foetal and maternal mortality. Microvascular complications of diabetes include retinopathy and nephropathy. Retinopathy can deteriorate during pregnancy; hence, regular routine examination is required and, if indicated, ophthalmological input. Diabetic nephropathy significantly increases the risk of obstetric complications and impacts on foetal outcomes. Pregnancy outcome is closely related to pre-pregnancy renal function. Diabetic pregnancy is contraindicated if the maternal complications of ischaemic heart disease or diabetic gastropathy are known to be present before pregnancy as there is a significant maternal mortality associated with both of these conditions. PMID:21130689

Hawthorne, Gillian

2011-02-01

246

Otolaryngologic complications of acute porphyria.  

PubMed

The porphyrias are a group of diseases which may be complicated by acute neurological crises having serious morbidity and a high rate of mortality. We report a case of acute porphyria in which an acute neurological crisis, resulting in loss of laryngeal function, precipitated life-threatening aspiration pneumonia. PMID:6834975

Lewis, M; Kallenbach, J; Hockman, M; Zaltzman, M; Zwi, S

1983-04-01

247

Video-assisted thoracic surgery complications  

PubMed Central

Video-assisted thoracic surgery (VATS) is a miniinvasive technique commonly applied worldwide. Indications for VATS are very broad and include the diagnosis of mediastinal, lung and pleural diseases, as well as large resection procedures such as pneumonectomy. The most frequent complication is prolonged postoperative air leak. The other significant complications are bleeding, infections, postoperative pain and recurrence at the port site. Different complications of VATS procedures can occur with variable frequency in various diseases. Despite the large number of their types, such complications are rare and can be avoided through the proper selection of patients and an appropriate surgical technique.

Kozak, Józef

2014-01-01

248

Video-assisted thoracic surgery complications.  

PubMed

Video-assisted thoracic surgery (VATS) is a miniinvasive technique commonly applied worldwide. Indications for VATS are very broad and include the diagnosis of mediastinal, lung and pleural diseases, as well as large resection procedures such as pneumonectomy. The most frequent complication is prolonged postoperative air leak. The other significant complications are bleeding, infections, postoperative pain and recurrence at the port site. Different complications of VATS procedures can occur with variable frequency in various diseases. Despite the large number of their types, such complications are rare and can be avoided through the proper selection of patients and an appropriate surgical technique. PMID:25561984

?ochowski, Mariusz P; Kozak, Józef

2014-12-01

249

Noninfectious lung complications are closely associated with chronic graft-versus-host disease: a single center study of incidence, risk factors and outcome  

Microsoft Academic Search

Non-infectious lung complications (NILC) are frequent, influencing morbidity and mortality of patients after allogeneic BMT. Although the term NILC encompasses a number of different entities, an association with GVHD has been noted for almost all of them. Our study was directed towards assessing the incidence and risk factors for developing NILC, as well as the response to treatment and long-term

C Duncker; D Dohr; S von Harsdorf; J Duyster; M Stefanic; C Martini; M Treiber; B Hertenstein; J Novotny; R Arnold; H Heimpel; L Bergmann; D Bunjes

2000-01-01

250

Value-Able Still Life  

ERIC Educational Resources Information Center

In this article, the author discusses how she made a major improvement to her fifth-grade lesson plan by providing a hands-on Internet experience before students worked on their own oil pastel still life. It was a success with beautiful finished products and highly motivated, engaged students. Details of this lesson are described in this article.

Gardner, Susan

2005-01-01

251

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

252

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

253

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

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; Thùy, Tr?n D??ng; Wang, Shu-Yin; Huang, Pung-Ling

2014-01-01

254

Type 1 diabetes, cardiovascular complications and sesame ( zh? má).  

PubMed

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; Thùy, Tr?n D Ng; Wang, Shu-Yin; Huang, Pung-Ling

2014-01-01

255

Complications of colostomy  

Microsoft Academic Search

Summary  A review of 200 colostomies showed that the incidence of complications was 11 per cent. Prolapse was the most common complication.\\u000a Indications for colostomy and factors resulting in complications are mentioned. Technics that may prevent or reduce the incidence\\u000a of complications are briefly discussed.

Sibu Pada Saha; Narasihma Rao; Sam E. Stephenson

1973-01-01

256

[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

257

Complications of Endovascular Repair of Abdominal Aortic Aneurysms: A Review  

SciTech Connect

The endovascular procedure for repair of abdominal aortic aneurysms has had an enormous impact on the treatment of this challenging disease. Complications, however, do occur and it is important to have a thorough understanding of the array of complications and appropriate management strategies. In this review of endovascular complications, we describe early and late complications paying particular attention to preventive, treatment and surveillance strategies.

Katzen, Barry T. [Baptist Cardiac and Vascular Institute, Baptist Health Systems, Department of Interventional Radiology, Florida (United States)], E-mail: barryk@baptisthealth.net; MacLean, Alexandra A. [New York Hospital-Queens, Department of Surgery (United States)

2006-12-15

258

Why Descriptive Science Still Matters  

E-print Network

- finements, of course) that were estab- lished by Carolus Linnaeus in 1758 for biological classifications, by William Smith in 1815 for the geological timescale, and by Dmitri Mendeleev in 1869 for the periodic table of the elements. More recent architects... emotions. His Origin of Species succeeded so well because it assembled and explained vast descriptive evidence. Few people are as insightful as Darwin, Mendeleev, Wegener, Hennig, or William Smith, but we lesser souls can still create enduring science...

Grimaldi, David A.; Engel, Michael S.

2007-09-01

259

Neonatal Meningitis: Risk Factors, Causes, and Neurologic Complications  

PubMed Central

Objective Neonates are at greater risk for sepsis and meningitis than other ages and in spite of rapid diagnoses of pathogens and treatments, they still contribute to complications and mortality. This study determines risk factors, causes, and neurologic complications of neonatal meningitis in hospitalized neonates. Material & Methods In this descriptive, cross sectional study, we evaluated 415 neonates with sepsis and meningitis admitted to the neonatal intensive care unit at our center between 2008 and 2012. The data that was recorded was age, sex, birth weight, prenatal risk factors, clinical features, blood and cerebrospinal fluid analysis, and brain sonographic findings and outcomes. Results Twenty patients had meningitis. Eleven cases (55%) were male. The mean age was 8. 41 days and mean birth weight was 2891.5±766 grams. Poor feeding, seizures, and tachypnea were detected in 12 (60%), 11 (55%), and 6 (30%) patients, respectively. Prenatal risk factors were prolonged rupture of membranes, maternal vaginitis, asymptomatic bacteriuria, prematurity, low birth weights, and asphyxia. Four patients had positive cerebrospinal fluid cultures with klebsiella pneumoniae 2 (50%), Enterococcus spp. 1 (25%), and Group B streptococcus 1 (25%) cases, respectively. Two cases had positive blood cultures with klebsiella pneumoniae. Neurologic complications were brain edema, subdural effusion, and brain abscesses with hydrocephaly. One neonate (5%) died. Conclusion Our study provides some information about risk factors, pathogens, and neurologic complications for neonatal meningitis. Prenatal assessments help to diagnose and reduce risk factors of this hazardous disease.

KHALESSI, Nasrin; AFSHARKHAS, Ladan

2014-01-01

260

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

261

A newborn case with perinatal-lethal Gaucher disease due to R463H homozygosity complicated by C677T homozygosity in the MTHFR gene.  

PubMed

Perinatal-lethal Gaucher disease is very rare and is considered a variant of type 2 Gaucher disease that occurs in the neonatal period. The most distinct features of perinatal-lethal Gaucher disease are non-immune hydrops fetalis, in utero fetal demise and neonatal distress. In some cases without hydrops, neurological signs occur in the first week of life and lead to death within 3 months. Less common signs of the disease are hepatosplenomegaly, ichthyosis, arthrogryposis and facial dysmorphy. We describe a preterm neonate with Gaucher disease homozygous for R463H mutation in GBA gene who showed severe neurologic signs in addition to refractory thrombocytopenia, hepatosplenomagaly, direct hyperbilirubinemia, facial dysmorphy and ichthyosiform skin abnormalities in addition to having thrombosis in portal and splenic veins possibly due to homozygosity for C677T mutation in MTHFR gene. To the best of our knowledge, this is the first case homozygous for the GBA R463H mutation resulting in Gaucher disease with a concomitant homozygous MTHFR C677T mutation. PMID:21823541

Akdag, Arzu; O?uz, Serife Suna; Ezgü, Fatih; Erdeve, Omer; Ura?, Nurdan; Dilmen, U?ur

2011-01-01

262

Long-Term Complications of Diabetes (For Parents)  

MedlinePLUS

... schedule prescribed by the doctor. Continue Kidney Disease (Diabetic Nephropathy) High blood sugar can damage the blood ... complications and health problems. Back Continue Nerve Damage (Diabetic Neuropathy) Another complication that people who have had ...

263

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 Central

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

264

Thoracic complications of peritoneal dialysis.  

PubMed

Approximately 20% of the 100,000 patients in the United States currently undergoing dialysis therapy for end-stage renal disease use the technique of peritoneal dialysis. We present a patient on peritoneal dialysis who developed a large posterior mediastinal mass, which on surgical exploration was found to be a paraesophageal hernia sac filled with omentum and dialysis fluid. We use this case as an introduction to review the thoracic complications of peritoneal dialysis. PMID:10355457

Hughes, G C; Ketchersid, T L; Lenzen, J M; Lowe, J E

1999-05-01

265

Infectious complications in patients with liver cirrhosis.  

PubMed

Liver cirrhosis is the end stage of any chronic liver disease. Complications occurring in patients with liver cirrhosis may be specific to this pathology and to gastroenterology (upper gastrointestinal bleeding, hepatic encephalopathy) or may interfere with other specialties (hepatorenal syndrome, spontaneous bacterial peritonitis, and other localized infectious complications). Over the past few decades, major efforts have been made to increase survival in patients with cirrhosis, but unfortunately, few therapeutic methods have been proven effective. Bacterial infections are frequent and serious complications of liver cirrhosis, resulting in high morbidity and mortality, especially in hospitalized patients, despite significant progress in health care for those with advanced liver disease. PMID:25341269

Preda, Sînziana; Trifan, Anca; Gîrleanu, Irina; Stanciu, C; Cojocariu, Camelia

2014-01-01

266

Complications of ascending phlebography of the leg.  

PubMed Central

Forty patients were studied prospectively for complications of ascending phlebography. The commonest immediate complication was pain at the site of injection and the commonest delayed complication pain in the foot or calf. Out of 30 patients with pain in the foot and calf, 15 had venous thrombosis. Review of 200 case notes disclosed only one recorded complication--namely, necrosis of the dorsal skin of the foot. Complications of the procedure reported by referring clinicians over 10 years comprised four cases of necrosis of the dorsum of the foot and two of gangrene of the foot, in one of which the gangrene spread to the leg. Major complications of ascending phlebography are rare, though when they occur may cause serious morbidity. If a scrupulous technique is used contrast phlebography remains the most accurate method of diagnosing venous disease of the leg. PMID:687897

Thomas, M L; MacDonald, L M

1978-01-01

267

Crohn's disease of the small bowel, complicated by primary biliary cirrhosis, Hashimoto thyroiditis, and Raynaud's phenomenon: favorable response of all disorders to adalimumab treatment  

PubMed Central

We describe the case of a male patient suffering from long-lasting Crohn's disease of the small bowel who developed thyroiditis Hassimoto, Raynaud's phenomenon, and primary biliary cirrhosis, during the course of the underlying bowel disease. It is not clear whether these co-morbidities appeared coincidentally, or because they share some common immunopathogenetic mechanisms. In this patient, Crohn's disease favorably responded to the treatment with an anti-TNF-? agent (adalimumab). The serum titers of antimitochondrial antibodyies and cholestatic enzymes considerably reduced during the 3-year treatment with the biologic agent. Raynaud's phenomenon, also, completely disappeared. Bearing in mind the possible involvement of TNF-? in the pathogenesis of primary biliary cirrhosis, it could be argued that the clinical and laboratory improvement of liver disease, as well as the reduction in serum titers of antimitochondrial antibodies, might be due to the anti-TNF-? action of adalimumab. We suggest that it would be worth further investigating the role of biologic agents in the treatment of patients with primary biliary cirrhosis. PMID:24834253

Durakis, Spyros; Merikas, Emmanuel

2013-01-01

268

Aspergillus osteomyelitis of the lumbar spine complicated with orbital apex syndrome: A potential role of the Batson's plexus in disease propagation  

PubMed Central

We report a rare case of orbital apex syndrome following epidural steroid injections of the lumbar spine in an immunocompetent individual with osteomyelitis and discitis caused by Aspergillus fumigatus. We suspect that the craniospinal venous system, also known as the Batson's plexus, was the main route for steroid-facilitated disease propagation from the spine to intracranial structures. PMID:24371725

Camargo, Jose F.; Seriburi, Vimon; Tenner, Michael; El Khoury, Marc Y.

2012-01-01

269

Fournier's gangrene: still highly lethal.  

PubMed

Five patients with necrotizing soft tissue infections of the perineum and scrotum are presented. There were one female and four male patients, aged from 35 to 70 years. Portals of entry were perirectal abscesses in four cases and a scrotal abscess in one case. All patients required extensive surgical debridement and intravenous broad-spectrum antibiotics. Operative debridement involved the scrotum, the perineal and inguinal area, the upper thighs and the anterior abdominal wall. One patient required transverse loop colostomy and one loop sigmoidostomy. One patient was reoperated on after inadequate drainage of a perirectal abscess. Three patients were referred to our unit after some delay, while one patient did not seek medical care until after being febrile for 2 weeks. Despite aggressive debridement, this last patient died of fulminant sepsis. Fournier's gangrene, which is not so rare as in generally considered, is still associated with a high mortality, which can be reduced only by improving medical awareness and early treatment both of the primary cause and of necrotizing fasciitis. PMID:9049954

Papachristodoulou, A J; Zografos, G N; Papastratis, G; Papavassiliou, V; Markopoulos, C J; Mandrekas, D; Gogas, J G

1997-01-01

270

Disease burden evaluation of fall-related events in the elderly due to hypoglycemia and other diabetic complications: a clinical review.  

PubMed

A hypoglycemia-induced fall is common in older persons with diabetes. The etiology of falls in this population is usually multifactorial, and includes microvascular and macrovascular complications and age-related comorbidities, with hypoglycemia being one of the major precipitating causes. In this review, we systematically searched the literature that was available up to March 31, 2014 from MEDLINE/PubMed, Embase, and Google Scholar using the following terms: hypoglycemia; insulin; diabetic complications; and falls in elderly. Hypoglycemia, defined as blood glucose <4.0 mmol/L (70 mg/dL) requiring external assistance, occurs in one-third of elderly diabetics on glucose-lowering therapies. It represents a major barrier to the treatment of diabetes, particularly in the elderly population. Patients who experience hypoglycemia are at a high risk for adverse outcomes, including falls leading to bone fracture, seizures, cognitive dysfunction, and prolonged hospital stays. An increase in mortality has been observed in patients who experience any one of these events. Paradoxically, rational insulin therapy, dosed according to a patient's clinical status and the results of home blood glucose monitoring, so as to achieve and maintain recommended glycemic goals, can be an effective method for the prevention of hypoglycemia and falls in the elderly. Contingencies, such as clinician-directed hypoglycemia treatment protocols that guide the immediate treatment of hypoglycemia, help to limit both the duration and severity of the event. Older diabetic patients with or without underlying renal insufficiency or other severe illnesses represent groups that are at high risk for hypoglycemia-induced falls and, therefore, require lower insulin dosages. In this review, the risk factors of falls associated with hypoglycemia in elderly diabetics were highlighted and management plans were suggested. A target hemoglobin A1c level between 7% and 8% seems to be more appropriate for this population. In addition, the first-choice drugs should have good safety profiles and have the lowest probability of causing hypoglycemia - such as metformin (in the absence of significant renal impairment) and incretin enhancers - while other therapies that may cause more frequent hypoglycemia should be avoided. PMID:25152631

Malabu, Usman H; Vangaveti, Venkat N; Kennedy, Richard Lee

2014-01-01

271

Clinical indications for the albumin use: still a controversial issue.  

PubMed

Human serum albumin (HSA) is the most abundant circulating protein and accounts for about 70% of the plasma colloid osmotic pressure. Beside the well known capacity to act as plasma-expander, HSA is provided of many other properties which are unrelated to the regulation of fluid compartmentalization, including binding and transport of many endogenous and exogenous substances, antioxidant function, immuno-modulation, anti-inflammatory activity, and endothelial stabilization. Treatment (hepatorenal syndrome) or prevention (renal failure after spontaneous bacterial peritonitis and post-paracentesis circulatory dysfunction after large volume paracentesis) of severe clinical complications in patients with cirrhosis and fluid resuscitation in critically ill patients, when crystalloids and non-proteic colloids are not effective or contra-indicated, represents the major evidence-based clinical indications for HSA administration. However, a large proportion of HSA prescription is inappropriate. Despite the existence of solid data against a real benefit, HSA is still given for nutritional interventions or for correcting hypoalbuminemia per se (without hypovolemia). Other clinical uses for HSA administration not supported by definitive scientific evidence are long-term treatment of ascites, nephrotic syndrome, pancreatitis, abdominal surgery, acute distress respiratory syndrome, cerebral ischemia, and enteric diseases. HSA prescription should be not uncritically restricted. Enforcement of clinical practice recommendations has been shown to allow a more liberal use for indications supported by strong scientific data and to avoid the futile administration in settings where there is a lack of clinical evidence of efficacy. As a result, a more appropriate HSA use can be achieved maintaining the health care expenditure under control. PMID:23790570

Caraceni, Paolo; Domenicali, Marco; Tovoli, Alessandra; Napoli, Lucia; Ricci, Carmen Serena; Tufoni, Manuel; Bernardi, Mauro

2013-12-01

272

Still Watching, from the Edge of Extinction  

NSDL National Science Digital Library

Today, human behavior drives many extinctions and preserves some species. To help understand such behavior, we published a book in 1999 that viewed selected endangered species through the eyes of those who have watched them decline and, in some cases, vanish from the wild. Here we revisit those stories to document what has happened in the interim 10 years, a period that is very short in evolutionary time but that has proven decisive for some endangered species. One species is now extinct in the wild; others have been devastated or scattered; several are on âÂÂlife support.â Some things have not changed: Too many people consume too much, and disagreements among conservationists still impede progress. Some issues have become more prominent, such as emerging diseases and global economic crises. Although there have been some striking successes, it is very clear that more species now depend on human support for their survival than may be sustainable.

Beverly Peterson Stearns (freelance writer;); Stephen Stearns (Yale University;Ecology and Evolutionary Biology)

2010-02-01

273

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

274

Dermatological complications of obesity.  

PubMed

Obesity is a health problem of considerable magnitude in the Western world. Dermatological changes have been reported in patients with obesity, including: acanthosis nigricans and skin tags (due to insulin resistance); hyperandrogenism; striae due to over extension; stasis pigmentation due to peripheral vascular disease; lymphedema; pathologies associated with augmented folds; morphologic changes in the foot anatomy due to excess load; and complications that may arise from hospitalization. Acanthosis nigricans plaques can be managed by improved control of hyperinsulinemia; the vitamin D3 analog calcipitriol has also been shown to be effective. Skin tags can be removed by snipping with curved scissors, by cryotherapy or by electrodesiccation. Hyperandrogenism, a result of increased production of endogenous androgens due to increased volumes of adipose tissue (which synthesizes testosterone) and hyperinsulinemia (which increases the production of ovarian androgens) needs to be carefully assessed to ensure disorders such as virilizing tumors and congenital adrenal hyperplasia are treated appropriately. Treatment of hyperandrogenism should be centred on controlling insulin levels; weight loss, oral contraceptive and antiandrogenic therapies are also possible treatment options. The etiology of striae distensae, also known as stretch marks, is yet to be defined and treatment options are unsatisfactory at present; striae rubra and alba have been treated with a pulsed dye laser with marginal success. The relationship between obesity and varicose veins is controversial; symptoms are best prevented by the use of elastic stockings. Itching and inflammation associated with stasis pigmentation, the result of red blood cells escaping into the tissues, can be treated with corticosteroids. Lymphedema is associated with dilatation of tissue channels, reduced tissue oxygenation and provides a culture medium for bacterial growth. Lymphedema treatment is directed towards reducing the limb girth and weight, and the prevention of infection. Intertrigo is caused by friction between skin surfaces, combined with moisture and warmth, resulting in infection. This infection, most commonly candidiasis, is best treated with topical antifungal agents; systemic antifungal therapy may be required in some patients. Excess load on the feet can result in morphological changes that require careful diagnosis; insoles may offer some symptom relief while control of obesity is achieved. Obesity-related dermatoses associated with hospitalization, such as pressure ulcers, diminished wound healing, dermatoses secondary to respiratory conditions, and incontinence, must all be carefully managed with an emphasis on prevention where possible. Recognition and control of the dermatological complications of obesity play an important role in diminishing the morbidity of obesity. PMID:12180897

García Hidalgo, Linda

2002-01-01

275

World J Urol. Author manuscript Analysis of complications from 600 retroperitoneoscopic procedures of  

E-print Network

; adverse effects ; Postoperative Complications ; Retroperitoneal Space ; surgery ; Urologic Diseases ; surgery ; Urologic Surgical Procedures ; adverse effects Author Keywords Nephrectomy ; complicationsWorld J Urol. Author manuscript Page /1 10 Analysis of complications from 600 retroperitoneoscopic

Paris-Sud XI, Université de

276

Neurologic complications after liver transplantation  

PubMed Central

Neurologic complications are relatively common after solid organ transplantation and affect 15%-30% of liver transplant recipients. Etiology is often related to immunosuppressant neurotoxicity and opportunistic infections. Most common complications include seizures and encephalopathy, and occurrence of central pontine myelinolysis is relatively specific for liver transplant recipients. Delayed allograft function may precipitate hepatic encephalopathy and neurotoxicity of calcineurin inhibitors typically manifests with tremor, headaches and encephalopathy. Reduction of neurotoxic immunosuppressants or conversion to an alternative medication usually result in clinical improvement. Standard preventive and diagnostic protocols have helped to reduce the prevalence of opportunistic central nervous system (CNS) infections, but viral and fungal CNS infections still affect 1% of liver transplant recipients, and the morbidity and mortality in the affected patients remain fairly high. Critical illness myopathy may also affect up to 7% of liver transplant recipients. Liver insufficiency is also associated with various neurologic disorders which may improve or resolve after successful liver transplantation. Accurate diagnosis and timely intervention are essential to improve outcomes, while advances in clinical management and extended post-transplant survival are increasingly shifting the focus to chronic post-transplant complications which are often encountered in a community hospital and an outpatient setting. PMID:24023979

Živkovi?, Saša A

2013-01-01

277

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

PubMed Central

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

278

Bilateral Empyema Caused by Adult-Onset Still’s Disease  

Microsoft Academic Search

Empyemas are usually of infectious origin. Noninfectious causes of empyema may be a considerable diagnostic challenge, as exemplified in the present case report. A 21-year-old male presented with high fever, sore throat and myalgias of 1 week duration. In the following days, bilateral pleural effusions developed, with cellular counts in the pleural fluid up to 117 × 109\\/liter (98% neutrophils).

M. Mattiuzzo; M. Del Forno; B. Branca; V. Moretti; M. Pirisi

2001-01-01

279

Feline infectious peritonitis: still an enigma?  

PubMed

Feline infectious peritonitis (FIP) is one of the most important fatal infectious diseases of cats, the pathogenesis of which has not yet been fully revealed. The present review focuses on the biology of feline coronavirus (FCoV) infection and the pathogenesis and pathological features of FIP. Recent studies have revealed functions of many viral proteins, differing receptor specificity for type I and type II FCoV, and genomic differences between feline enteric coronaviruses (FECVs) and FIP viruses (FIPVs). FECV and FIP also exhibit functional differences, since FECVs replicate mainly in intestinal epithelium and are shed in feces, and FIPVs replicate efficiently in monocytes and induce systemic disease. Thus, key events in the pathogenesis of FIP are systemic infection with FIPV, effective and sustainable viral replication in monocytes, and activation of infected monocytes. The host's genetics and immune system also play important roles. It is the activation of monocytes and macrophages that directly leads to the pathologic features of FIP, including vasculitis, body cavity effusions, and fibrinous and granulomatous inflammatory lesions. Advances have been made in the clinical diagnosis of FIP, based on the clinical pathologic findings, serologic testing, and detection of virus using molecular (polymerase chain reaction) or antibody-based methods. Nevertheless, the clinical diagnosis remains challenging in particular in the dry form of FIP, which is partly due to the incomplete understanding of infection biology and pathogenesis in FIP. So, while much progress has been made, many aspects of FIP pathogenesis still remain an enigma. PMID:24569616

Kipar, A; Meli, M L

2014-03-01

280

The KID Study V: the natural history of type 2 diabetes in younger patients still practising a profession. Heterogeneity of basal and reactive C-peptide levels in relation to BMI, duration of disease, age and HbA1.  

PubMed

In a detailed evaluation of the data accumulated for 493 type 2 diabetics who participated in the KID Study, pre- and postprandial C-peptide was correlated with blood glucose level, HbA1, body mass index (BMI), duration of disease and age. As described earlier the KID-Study examined a younger cohort of type 2 diabetics predominately practising a profession. Our investigations demonstrate a significant increase of pre- as well as postprandial C-peptide levels with increasing obesity. However, delta C-peptide, as an indicator at the reaction capacity of pancreatic secretion, decreases significantly and continuously. Pre- as well as postprandial C-peptide levels decrease significantly with up to 15-20 years duration of disease. The preprandial pancreatic secretion is usually even at a high normal level at such a late stage whereas the secretory reserve of normal or mildly overweight as well as of obese type 2 diabetics is more impaired. In contrast to patients with a BMI < 30, obese patients with a BMI > 30 will also develop impairment of basal insulin secretion over decades. The patient's age did not influence the pre- or postprandial insulin secretion. The quality of metabolic control as measured by the HbA1 has nearly exclusive impact on the secretory reserve capacity. Correlation with increasing HbA1 concentrations, the postprandial but not the preprandial C-peptide levels decreased significantly and continuously. Predictive factors for a deterioration in pancreatic function are in order of importance: the extent of obesity, the quality of metabolic control and only last the duration of diabetes. Fortunately, consistent diabetic care can have an impact on the first two. PMID:10433062

Haupt, E; Haupt, A; Herrmann, R; Benecke-Timp, A; Vogel, H; Walter, C

1999-01-01

281

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

282

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

283

Complications of colostomy  

Microsoft Academic Search

Summary  In a series of 307 colostomies established in 296 patients, there were complications in 53 patients (16 per cent), of whom\\u000a 41 had reoperations to correct the complications. One patient died of sepsis following operation for a perforation caused\\u000a by an irrigating catheter.

Francis J. Burns; SainZ Louis

1970-01-01

284

Managing complications I: leaks, strictures, emptying, reflux, chylothorax.  

PubMed

Esophagectomy can be used to treat several esophageal diseases; it is most commonly used for treatment of esophageal cancer. Esophagectomy is a major procedure that may result in various complications. This article reviews only the important complications resulting from esophageal resection, which are anastomotic complications after esophageal reconstruction (leakage and stricture), delayed emptying or dumping syndrome, reflux, and chylothorax. PMID:24876942

Chen, Ke-Neng

2014-05-01

285

Medical complications of achondroplasia: a multicentre patient review  

Microsoft Academic Search

Achondroplasia is the most prevalent chondrodysplasia and numerous authors have documented the varied social and medical complications that may compromise a full and productive life. Complications include cervicomedullary compression, spinal stenosis, restrictive and obstructive lung disease, otitis media, and tibial bowing, among others. These known complications have led to recommendations for the anticipatory management of such patients. There are relatively

A G Hunter; A Bankier; J G Rogers; D Sillence; C I Scott

1998-01-01

286

[Hyponatremia - carbamazepine medication complications].  

PubMed

Hyponatremia can be defined like the low sodium concentration, lower that 135 mmol/l. It becomes really serious when the concentration is lower than 120 mmol/l. The most frequent causes of hyponatremia are: the extrarenal loss (GIT, skin, bleeding, sequestration), the renal loss (diuretics, nephritis with the salt loss, osmotical diuresis, the Addison disease), hypothyroidism, the lack of glucocorticoids, emotional stress, pain, pseudohyponatremia (incorrect taking, dyslipoproteinemia). There is fatigue, exhaustion, headache and vertigoes dominating in the clinical record file. By the deficit increasing a patient becomes delirious, comatose even with the shock development. It is necessary to separate sufficient supply of sodium from much more often reason, which is loss of sodium which can be caused by: excessive sweating, vomitting with the metabolical alkalosis development, diarrhoea with the metabolical acidosis development, renal losses (a phase of renal failure). Treatment of hyponatremia: intensive treatment starts at the level of plasmatic concentration of sodium under 120 mmol/l or when neurological symptoms of brain oedema are present. In the therapy it is necessary to avoid fast infusions of hypertonic saline solutions (3-5% NaCl solutions) because of the danger of the development of serious CNS complications (intracranial bleeding, etc.). It is recommended to adjust the plasmatic concentration of sodium up to 120 mmol/l during the first four hours and a subsequent correction should not be higher than 2 mmol per an hour. Treatment of the basic illness is very important. We present 2 case histories: a 74-year old female patient and a 69-year old female patient both with the hyponatremia caused by taking of carbamazepine. We want to inform and warn about not only a well known side effect during long-term treatment but about hyponatremia that arose within 48 hours after the start of taking medicine as well. PMID:22448705

Dedinská, I; Ma?ka, V; Ságová, I; Klimentová, A; Makovický, P; Polko, J; Sadlo?ová, J; Moká?, M

2012-01-01

287

Clinical spectrum of levodopa-induced complications.  

PubMed

The first years of Parkinson disease (PD) treatment are marked by good and sustained responses to dopaminergic therapy. With disease progression and longer exposure to levodopa (l-dopa), patients develop a range of l-dopa-induced complications that include motor and non-motor symptoms. Motor complications include motor fluctuations, characterized by periods of reduced benefit from the medication, and l-dopa-induced dyskinesia, characterized by emergence of hyperkinetic involuntary movements. Dyskinesia can occur at peak effect of l-dopa, at the beginning and end of dose, or between doses. These motor complications are often associated with fluctuations in non-motor symptoms, particularly fluctuations in neuropsychiatric, autonomic, and sensory symptoms. Recognizing such complications and understanding their relationship with the timing of l-dopa doses is essential for adequate diagnosis and management. © 2014 International Parkinson and Movement Disorder Society. PMID:25488260

Aquino, Camila Catherine; Fox, Susan H

2014-12-01

288

Hemodiafiltration in infants with complications during peritoneal dialysis.  

PubMed

End-stage renal disease (ESRD) in neonates still has a high mortality, particularly in the first year of life. We present the combination of peritoneal dialysis (PD) with intermittent hemodiafiltration (iHDF) in neonates with ESRD. Four infants younger than 28 days were treated with PD and iHDF. Renal diagnoses leading to ESRD were cortical necrosis, prune belly syndrome, neonatal hemolytic uremic syndrome, and autosomal recessive polycystic kidney disease. Initially, three patients were on iHDF until PD was started. At the time when complications occurred during PD, patients were switched back to iHDF. iHDF was used five times as a bridge to PD in case of abdominal surgery. Two of the four patients were switched to iHDF because of peritoneal ultrafiltration failure due to recurrent peritoneal leaks. Once, iHDF became necessary due to refractory peritonitis. All four patients survived the first year of life. Two patients were transplanted successfully at an age of 35 and 22 months, respectively. The others are on renal replacement therapy, one on PD at the age of 28 months and one on iHDF at the age of 25 months, respectively. In case of PD complications, iHDF may be an appropriate bridge to achieve long-term survival until kidney transplantation. PMID:22428733

Rödl, Siegfried; Marschitz, Ingrid; Mache, Christoph J; Nagel, Bert; Koestenberger, Martin; Zobel, Gerfried

2012-07-01

289

Complications of Corneal Collagen Cross-Linking  

PubMed Central

Cross-linking of corneal collagen (CXL) is a promising approach for the treatment of keratoconus and secondary ectasia. Several long-term and short-term complications of CXL have been studied and documented. The possibility of a secondary infection after the procedure exists because the patient is subjected to epithelial debridement and the application of a soft contact lens. Formation of temporary corneal haze, permanent scars, endothelial damage, treatment failure, sterile infiltrates, and herpes reactivation are the other reported complications of this procedure. Cross-linking is a low-invasive procedure with low complication and failure rate but it may have direct or primary complications due to incorrect technique application or incorrect patient's inclusion and indirect or secondary complications related to therapeutic soft contact lens, patient's poor hygiene, and undiagnosed concomitant ocular surface diseases. PMID:22254130

Dhawan, Shikha; Rao, Kavita; Natrajan, Sundaram

2011-01-01

290

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

291

Neurological Complications of Hematopoietic Stem Cell Transplantation  

Microsoft Academic Search

Complications following hematopoietic stem cell transplantation have long been recognized. The causes are numerous, including\\u000a chemoradiotoxicity, medication toxicity, metabolic abnormalities, organ failure, graft versus host disease, infection, pancytopenia,\\u000a and platelet dysfunction. This chapter summarizes the disorders affecting the nervous system associated with hematopoietic\\u000a stem cell transplantation. As the number of transplants performed annually increases, potential neurologic complications are\\u000a being seen

Eudocia Quant; Patrick Y. Wen

292

Pleural space complications associated with lung transplantation.  

PubMed

Lung transplantation represents a life-saving option for some end-stage lung diseases. Despite the magnitude of anatomic manipulation and the fragility of the patient population, the procedures have become progressively safer. Perioperative morbidity, however, remains high. Pleural space complications are particularly common. This article discusses hemothorax, chylothorax, air leak or pneumothorax, recurrent effusion, empyema, trapped lung, and chronic pleural complications. PMID:25430432

Arndt, Andrew; Boffa, Daniel J

2015-01-01

293

Tuberculosis complications after BCG treatment for urinary bladder cancer.  

PubMed

Bacillus Calmette-Guérin (BCG) is an attenuated strain of Mycobacterium bovis that has been effectively used in the treatment of non-muscle invasive bladder carcinoma. The complications of this treatment are uncommon, and the causes of dissemination are still discussed. We report a case of disseminated tuberculosis in a 66-year-old smoking man without a history of pulmonary diseases, who underwent immunotherapy with BCG after the initial surgical treatment of bladder cancer. After the last BCG instillation, he developed a fever. The diagnosis of sepsis was not confirmed, and miliary pulmonary tuberculosis was suspected. The diagnosis was confirmed by clinical manifestation, computed tomography of the lungs, and histological examination. PMID:23455890

Naudži?nas, Albinas; Juškait?, R?ta; Žiaugryt?, Indr?; Unikauskas, Alvydas; Varanauskien?, Egl?; Mašanauskien?, Edita

2012-01-01

294

Complications in late pregnancy.  

PubMed

Complications of late pregnancy are managed infrequently in the emergency department and, thus, can pose a challenge when the emergency physician encounters acute presentations. An expert understanding of the anatomic and physiologic changes and possible complications of late pregnancy is vital to ensure proper evaluation and care for both mother and fetus. This article focuses on the late pregnancy issues that the emergency physician will face, from the bleeding and instability of abruptio placentae to the wide spectrum of complications and management strategies encountered with preterm labor. PMID:23137403

Meguerdichian, David

2012-11-01

295

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

296

Infection and Other Complications  

MedlinePLUS

... and improve your overall health. Other Complications of Lymphedema The sudden onset of swelling anywhere in the ... can block lymphatic flow, causing a worsening of lymphedema or other forms of swelling. Patients with a ...

297

Pregnancy Complications: Genital Herpes  

MedlinePLUS

... page It's been added to your dashboard . Genital herpes and pregnancy Genital herpes is a sexually transmitted ... the United States has genital herpes. Can genital herpes cause complications during pregnancy? Yes. Genital herpes can ...

298

[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

299

Complications of colostomy closure  

Microsoft Academic Search

A series of 126 colostomy closures was analyzed to evaluate factors contributing to morbidity. There were no deaths, but there\\u000a was a 33 percent complication rate. Patients with penetrating abdominal trauma and foreign-body rectal perforations had fewer\\u000a serious complications following colostomy closures than patients with diverticulitis or cancer. No significant difference\\u000a was found in the anastomotic leak rate, length of

Donna M. Pittman; Lee E. Smith

1985-01-01

300

Complications of auricular correction  

PubMed Central

The risk of complications of auricular correction is underestimated. There is around a 5% risk of early complications (haematoma, infection, fistulae caused by stitches and granulomae, allergic reactions, pressure ulcers, feelings of pain and asymmetry in side comparison) and a 20% risk of late complications (recurrences, telehone ear, excessive edge formation, auricle fitting too closely, narrowing of the auditory canal, keloids and complete collapse of the ear). Deformities are evaluated less critically by patients than by the surgeons, providing they do not concern how the ear is positioned. The causes of complications and deformities are, in the vast majority of cases, incorrect diagnosis and wrong choice of operating procedure. The choice of operating procedure must be adapted to suit the individual ear morphology. Bandaging technique and inspections and, if necessary, early revision are of great importance for the occurence and progress of early complications, in addition to operation techniques. In cases of late complications such as keloids and auricles that are too closely fitting, unfixed full-thickness skin flaps have proved to be the most successful. Large deformities can often only be corrected to a limited degree of satisfaction. PMID:22073079

Staindl, Otto; Siedek, Vanessa

2008-01-01

301

Impact of high preoperative steroid doses on postoperative complications among patients on prolonged preoperative steroid therapy.  

PubMed

Corticosteroids are essential to maintain the organic homeostasis. Steroid, glucocorticoid or its synthetic analog is widely used for inflammatory and autoimmune diseases. Prolonged steroid therapy is reported to cause the susceptibility to infection, impaired wound healing and psychoneurosis, however whether the quantity of taking the preoperative steroid is associated the postoperative complication is still unknown. The aim of this study was to elucidate whether the steroid dose in patients on prolonged preoperative steroid therapy is associated postoperative morbidity and mortality. Twenty-five patients taking steroid for various illnesses and underwent the surgery under general anesthesia were selected in this study. The mean +/- standard deviation and the median of the steroid dose converted into hydrocortisone (mg/day) were 39.2 +/- 31.0 and 20, respectively. Of 25 cases, postoperative complications were seen in 10 cases. The postoperative complication was severe based on the grade of Clavien and Dindo by ANOVA as the doses of taking steroid increased (p = 0.0171). The grave postoperative complication classified as Clavien and Dindo grade III occurred with 100% sensitivity and 87% specificity for the steroid dose converted into hydrocortisone > 80 mg/day. Preoperative taking the large amount of steroid (> 80 mg/day) could cause a grave complication. More careful selection of the operative procedure might improve the mobidity rate. PMID:24693677

Iguchi, Tomohiro; Shirabe, Ken; Inoue, Kentaro; Ito, Shuhei; Ohga, Takefumi; Nozoe, Tadahiro; Ezaki, Takahiro; Yoshizumi, Tomoharu; Uchiyama, Hideaki; Soejima, Yuji; Ikegami, Toru; Yamashita, Yo-Ichi; Kawanaka, Hirofumi; Ikeda, Tetsuo; Saeki, Hiroshi; Morita, Masaru; Maehara, Yoshihiko

2013-12-01

302

Study design and rationale of 'Influence of Cilostazol-based triple anti-platelet therapy on ischemic complication after drug-eluting stent implantation (CILON-T)' study: A multicenter randomized trial evaluating the efficacy of Cilostazol on ischemic vascular complications after drug-eluting stent implantation for coronary heart disease  

PubMed Central

Background Current guidelines recommend dual anti-platelet therapy, aspirin and clopidogrel, for patients treated with drug-eluting stent for coronary heart disease. In a few small trials, addition of cilostazol on dual anti-platelet therapy (triple anti-platelet therapy) showed better late luminal loss. In the real-world unselected patients with coronary heart disease, however, the effect of cilostazol on platelet reactivity and ischemic vascular events after drug-eluting stent implantation has not been tested. It is also controversial whether there is a significant interaction between lipophilic statin and clopidogrel. Methods/Design CILON-T trial was a prospective, randomized, open-label, multi-center, near-all-comer trial to demonstrate the superiority of triple anti-platelet therapy to dual anti-platelet therapy in reducing 6 months' major adverse cardiovascular/cerebrovascular events, composite of cardiac death, nonfatal myocardial infarction, target lesion revascularization and ischemic stroke. It also tested whether triple anti-platelet therapy is superior to dual anti-platelet therapy in inhibiting platelet reactivity in patients receiving percutaneous coronary intervention with drug-eluting stent. Total 960 patients were randomized to receive either dual anti-platelet therapy or triple anti-platelet therapy for 6 months and also, randomly stratified to either lipophilic statin (atorvastatin) or non-lipophilic statin (rosuvastatin) indefinitely. Secondary endpoints included all components of major adverse cardiovascular/cerebrovascular events, platelet reactivity as assessed by VerifyNow P2Y12 assay, effect of statin on major adverse cardiovascular/cerebrovascular events, bleeding complications, and albumin-to-creatinine ratio to test the nephroprotective effect of cilostazol. Major adverse cardiovascular/cerebrovascular events will also be checked at 1, 2, and 3 years to test the 'legacy' effect of triple anti-platelet therapy that was prescribed for only 6 months after percutaneous coronary intervention. Discussion CILON-T trial will give powerful insight into whether triple anti-platelet therapy is superior to dual anti-platelet therapy in reducing ischemic events and platelet reactivity in the real-world unselected patients treated with drug-eluting stent for coronary heart disease. Also, it will verify the laboratory and clinical significance of drug interaction between lipophilic statin and clopidogrel. Trial Registration National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier# NCT00776828). PMID:20735821

2010-01-01

303

Complications of body piercing.  

PubMed

The trend of body piercing at sites other than the earlobe has grown in popularity in the past decade. The tongue, lips, nose, eyebrows, nipples, navel, and genitals may be pierced. Complications of body piercing include local and systemic infections, poor cosmesis, and foreign body rejection. Swelling and tooth fracture are common problems after tongue piercing. Minor infections, allergic contact dermatitis, keloid formation, and traumatic tearing may occur after piercing of the earlobe. "High" ear piercing through the ear cartilage is associated with more serious infections and disfigurement. Fluoroquinolone antibiotics are advised for treatment of auricular perichondritis because of their antipseudomonal activity. Many complications from piercing are body-site-specific or related to the piercing technique used. Navel, nipple, and genital piercings often have prolonged healing times. Family physicians should be prepared to address complications of body piercing and provide accurate information to patients. PMID:16342832

Meltzer, Donna I

2005-11-15

304

[Varicella complicated by pericarditis and pneumonia].  

PubMed

Varicella is a highly infectious disease mainly affecting young children under 14 years of age, and being generally mild. In adults immunodeficient children and neonates exposed in utero, the illness tends to be more severe with higher incidence of complications. The type of complication is linked to the age: in children, bacterial infection of skin lesions and acute cerebellar ataxia are more frequent while lower respiratory tract infection, Reye syndrome and encephalitis are less common. Varicella pneumonia is found typically in adult patients and diffuse encephalitis which course is worse than children could be less frequently. Acute pericarditis is an exceptional complication with a benign course, but only if myocarditis or pericardial effusion are not concurrent. It usually appears in teenagers and young adults; only a few times, it has been linked to other complications as pneumonia or arthritis. We report a varicella case in an adult patient who suffered from pneumonia and pericarditis, both of them were benign. PMID:8679843

Rivera Cívico, F; Omar, M; Aliaga Martínez, L; Mendoza, J; Jiménez-Alonso, J

1996-03-01

305

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

306

Pregnancy Complications and Later Development of Hypertension.  

PubMed

Pregnancy complications such as preeclampsia and diabetes affect approximately 5 to 10 % of all pregnancies and compromise maternal and fetal health during gestation. Complications during pregnancy may also contribute to the development of hypertension and future cardiovascular risk in the mother. Moreover, fetal exposure to hypertension and diabetes during pregnancy can program hypertension and cardiovascular disease in the offspring. Transgenerational transmission of programmed cardiovascular risk highlights the importance of understanding the mechanisms that link complications during pregnancy with later hypertension in her offspring and subsequent generations. However, experimental studies are needed to investigate the cause and effect of increased blood pressure in the mother following a complicated pregnancy and provide insight into the development of preventative measures that may improve the long-term cardiovascular health of women and their offspring. PMID:23914279

Intapad, Suttira; Alexander, Barbara T

2013-06-01

307

Vasectomy without complication.  

PubMed

In a four-year period 500 outpatient vasectomies were performed by the author. Bilateral scrotal incisions were used in all cases as were metal clips to occlude the vas deferens. Operating time rarely exceeded fifteen minutes. No failures and no sperm granulomas were encountered. Complications were rare and included a single scrotal hematoma and six minor infections. Unilateral absence of the vas deferens was noted in 2 patients. The technique to be described is a simple, complication-free method of vasectomy. PMID:1246787

Bennett, A H

1976-02-01

308

Review article Pasteurella haemolytica complicated respiratory  

E-print Network

Review article Pasteurella haemolytica complicated respiratory infections in sheep and goats Kim A. Brogden Howard D. Lehmkuhl. Randall C. Cutlip Respiratory and Neurologic Disease Research Unit, National (Received 15 September 1997; accepted l2 December 1997) Abstract - Respiratory infections which commonly

Paris-Sud XI, Université de

309

Long-term complications of chemotherapy  

Microsoft Academic Search

Patients with cancer are living longer and, therefore, are not only at risk for recurrence of the disease but also for long-term side effects of treatment. For patients treated with chemotherapy, secondary malignancies are a special concern, with acute nonlymphocytic leukemia being the most common. Although typically associated with alkylating agents, this complication is now being seen with use of

Mark A. Morgan; Stephen C. Rubin

1998-01-01

310

Squamous cell carcinoma complicating perianal hidradenitis suppurativa  

Microsoft Academic Search

Hidradenitis suppurativa or Verneuil's disease is usually a chronic, recurrent, suppurative and cicatricial disorder. It most often affects the skin of the axillae, groins and perineum, and less commonly the buttocks and upper thighs. A squamous cell carcinoma located in the hidradenitis-affected area is a rare complication. We present a review of the twenty-six published cases adding one of our

D. Pérez-Diaz; M. Calvo-Serrano; E. Mártinez-Hijosa; L. Fuenmayor-Valera; F. Muñoz-Jiménez; F. Turégano-Fuentes; E. Valle

1995-01-01

311

Neurological Complications of AIDS  

MedlinePLUS

... of certain brain structures involved in learning and information processing. Other nervous system complications that occur as a result of the ... resistant to drug combination therapy0 in the nervous system. Where can I get more information? For more information on neurological disorders or research ...

312

Complications of Ventricular Shunts  

Microsoft Academic Search

Ventricular shunting is the most widely accepted form of treatment of hydrocephalus. The placement of cerebrospinal fluid shunts has become on eo f the most common procedures in modern neurologic surgery. Despite significant improve- ments in shunt procedures, shunt complications remain common. These troubles are associated with significant adverse consequences, both medical and economic. At- tempts to limit their incidence

Bradley E. Weprin; Dale M. Swift

2002-01-01

313

Apprentice Still Photographic Specialist (AFSC 23132).  

ERIC Educational Resources Information Center

This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for apprentice still photographic specialists. Covered in the individual volumes are general subjects (career ladder progression, security, photographic safety, and photographic laboratory administration); still photographic…

Air Univ., Gunter AFS, Ala. Extension Course Inst.

314

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

315

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

316

Complications of Microsurgery of Vestibular Schwannoma  

PubMed Central

Background. The aim of this study was to analyze complications of vestibular schwannoma (VS) microsurgery. Material and Methods. A retrospective study was performed in 333 patients with unilateral vestibular schwannoma indicated for surgical treatment between January 1997 and December 2012. Postoperative complications were assessed immediately after VS surgery as well as during outpatient followup. Results. In all 333 patients microsurgical vestibular schwannoma (Koos grade 1: 12, grade 2: 34, grade 3: 62, and grade 4: 225) removal was performed. The main neurological complication was facial nerve dysfunction. The intermediate and poor function (HB III–VI) was observed in 124 cases (45%) immediately after surgery and in 104 cases (33%) on the last followup. We encountered disordered vestibular compensation in 13%, permanent trigeminal nerve dysfunction in 1%, and transient lower cranial nerves (IX–XI) deficit in 6%. Nonneurological complications included CSF leakage in 63% (lateral/medial variant: 99/1%), headache in 9%, and intracerebral hemorrhage in 5%. We did not encounter any case of meningitis. Conclusions. Our study demonstrates that despite the benefits of advanced high-tech equipment, refined microsurgical instruments, and highly developed neuroimaging technologies, there are still various and significant complications associated with vestibular schwannomas microsurgery. PMID:24987677

Zv??ina, Eduard; Balogová, Zuzana; Sk?ivan, Ji?í; Kraus, Josef; Syka, Josef; Chovanec, Martin

2014-01-01

317

Atovaquone ameliorate gastrointestinal Toxoplasmosis complications in a pregnancy model  

PubMed Central

Summary Background Toxoplasma is an important source of foodborne hospitalization with no safe and effective therapy against chronic or congenital Toxopalsmosis. Atovaquone is a drug of choice but not approved for use in congenital Toxoplasmosis. We hypothesized atovaquone to be safe and effective against feto-maternal Toxoplasmosis. Material/Methods Programmed pregnant mice were i.p. infected with 50–2400 Tachyzoites from Type II strain (clone PTG). Dams were treated daily with atovaquone or sham and monitored for pain, and complications. Results Dams developed pain related abdominal hypersensitivity (allodynia) to mechanical stimuli in a Tachyzoites dose dependent manner. Infected dams were anemic and exhibited ascities and severe hepatitis (score 3.6±0.01 on scale 0 – normal to 4 – severe) with influx of inflammatory and plasma cells, multinucleated dysplastic hepatocytes and necrosis. In addition, dams expressed mild to severe pancreatitis with mononuclear cell invasion, loss of islets and necrosis. This was consistent with splenomegaly (X3 Fold), and massive infiltration of epithelioid cells and loss of germinal structure. Colon became significantly shortened in length (p<0.01) with semi-normal content. Pathological manifestation included, shortening of crypts with numerous microabscess formations, infiltration of lymphocytes, and macrophages. The severe clinical complications led to abortion (50%), early birth (25%) or still birth (25%) consistent with the high dose of Tachyzoites inoculation. Atovaquone treatment partially but significantly protected the dams from the severity of hepatitis, splenomegaly, colitis, myocarditis, and pain related responses as well as fetal demise. Conclusions This is a valuable model for therapeutic evaluation of feto-maternal Toxoplasmosis and gastrointestinal complications. Atovaquone protects dams and their fetuses against some infectious/inflammatory aspects of the disease. PMID:22936182

Oz, Helieh S.; Tobin, Thomas

2012-01-01

318

Bereavement and Complicated Grief  

PubMed Central

Bereavement is a common experience in adults age 60 and older. Loss of a loved one usually leads to acute grief characterized by yearning and longing, decreased interest in ongoing activities, and frequent thoughts of the deceased. For most, acute grief naturally evolves into a state of integrated grief, where the bereaved is able to reengage with everyday activities and find interest or pleasure. About 7% of bereaved older adults, however, will develop the mental health condition of Complicated Grief (CG). In CG, the movement from acute to integrated grief is derailed, and grief symptoms remain severe and impairing. This article reviews recent publications on the diagnosis of CG, risk factors for the condition, and evidenced-based treatments for CG. Greater attention to complicated grief detection and treatment in older adults is needed. PMID:24068457

Ghesquiere, Angela; Glickman, Kim

2013-01-01

319

Diabetic complications and dysregulated innate immunity.  

PubMed

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

2008-01-01

320

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

321

Complications following cava catheterization.  

PubMed

The employment of cava catheterization in intensive care and emergency-treatment has dramatically increased. On the basis of our patients in the Surgical Clinics of the RWTH Aachen risks and complications of the central venous catheterization are explained. Six hundred and eighty-four cases have been examined--categorized according to the method of insertion and according to the technique. In a small randomized study, 60 cava catheters were individually examined bacteriologically. PMID:899567

Raguse, T; Lynen, F K; Schröder, W

1977-01-01

322

Multiple gastrointestinal complications of crack cocaine abuse.  

PubMed

Cocaine and its alkaloid free base "crack-cocaine" have long since been substances of abuse. Drug abuse of cocaine via oral, inhalation, intravenous, and intranasal intake has famously been associated with a number of medical complications. Intestinal ischemia and perforation remain the most common manifestations of cocaine associated gastrointestinal disease and have historically been associated with oral intake of cocaine. Here we find a rare case of two relatively uncommon gastrointestinal complications of hemorrhage and pancreatitis presenting within a single admission in a chronic crack cocaine abuser. PMID:24839446

Carlin, Neal; Nguyen, Nhat; DePasquale, Joseph R

2014-01-01

323

Multiple Gastrointestinal Complications of Crack Cocaine Abuse  

PubMed Central

Cocaine and its alkaloid free base “crack-cocaine” have long since been substances of abuse. Drug abuse of cocaine via oral, inhalation, intravenous, and intranasal intake has famously been associated with a number of medical complications. Intestinal ischemia and perforation remain the most common manifestations of cocaine associated gastrointestinal disease and have historically been associated with oral intake of cocaine. Here we find a rare case of two relatively uncommon gastrointestinal complications of hemorrhage and pancreatitis presenting within a single admission in a chronic crack cocaine abuser. PMID:24839446

Carlin, Neal; Nguyen, Nhat; DePasquale, Joseph R.

2014-01-01

324

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

325

590?A Case of Chronic Urticaria Complicated by Raoultella Ornithinolytica Urinary Tract Infection, Bronchospasm and Angioedema  

PubMed Central

Background Raoultella ornithinolytica (formerly Klebsiella ornithinolytica) has been recovered from water, soil, plants and occasionally mammalian mucosae. It is one of the organisms that cause histamine fish poisoning by converting histidine to histamine as it possesses the enzyme histidine decarboxylase. Methods We report a case of a 51 year old woman with a history of rheumatic heart disease, allergy to aspirin and penicillin, reflux oesophagitis, atopic dermatitis, stress incontinence and a cystocele attributed to chronic obstructive pulmonary disease. She presented to the emergency unit with a 5 years history of urticaria of unknown cause, complicated by symptoms of a urinary tract infection and 3 episodes of angioedema in the preceding 10 days. She was not on regular medication but on intermittent prednisone, promethazine and was recently treated with omeprazole and sucralfate for reflux oesophagitis. She denied previous use of angiotensin converting enzyme inhibitors. Urine culture grew Raoultella ornithinolitica (>100 000 CFU/mL) after 3 days. Results The angioedema resolved on treatment of the UTI with oral ciprofloxacin. She was lost to follow-up and when seen 3 years later she still had intermittent flares of urticaria, but had had no episodes of angioedema. Conclusions R ornithinolytica, most commonly described as a causative agent of histamine fish poisoning in humans, possesses histidine decarboxylase, an enzyme that converts histidine into histamine. The resulting elevated levels of histamine usually do not cause severe disease but complications can arise in people with chronic histamine mediated diseases.

Lehloenya, Rannakoe; Christians, Sean

2012-01-01

326

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

327

About Alzheimer's Disease: Alzheimer's Basics  

MedlinePLUS

... with Alzheimer's disease? What is dementia? What is Alzheimer's disease? Alzheimer’s disease is an irreversible, progressive brain disease ... devastating disease. What happens to the brain in Alzheimer's disease? Although we still don’t know how the ...

328

Traditional phytotherapy remedies used in Southern Rwanda for the treatment of liver diseases  

Microsoft Academic Search

Ethnopharmacological relevanceLiver diseases represent a major health problem due to their complications and limited treatment possibilities. In Rwanda, given low accessibility to modern treatments, most people still rely on traditional medicinal plants. The symptomatology of many hepatic troubles (icterus) is evident for traditional healers who have a high probability of selecting efficient herbal medicines.

Marie-Jeanne Mukazayire; Védaste Minani; Christopher K. Ruffo; Elias Bizuru; Caroline Stévigny; Pierre Duez

329

Managing esthetic implant complications.  

PubMed

Dental implant success today is judged not only by osseointegration but also by esthetic results. Cosmetic predictability can often be difficult to attain, and esthetic implant failures can be multifactorial. Once esthetic implant failures occur, many cannot be fully corrected. Some complications must be addressed by an interdisciplinary dental team. In this summary of case reports, surgical considerations are provided, including cases of facial asymmetry/recession due to facial implant placement or bone loss resulting from technique/treatment failures, as well as papillary deficiencies. Restorative considerations for correcting failures are also discussed. PMID:22908600

Butler, Bobby; Kinzer, Greggory A

2012-01-01

330

Complications of Bryan cervical disc replacement.  

PubMed

The primary goals of cervical disc replacement are to avoid fusion in the affected segment, maintain the mobility and function of the involved cervical segments, allow patients to quickly return to routine activities and reduce or eliminate adjacent-segment disease. A large number of patients have already undergone, and more and more patients will in the future undergo, cervical disc replacement. The cervical device which best preserves movement, and has therefore been the device of choice, has been the Bryan cervical disc. Although a safe surgical technique has been demonstrated and favorable results of using the Bryan disc reported, some complications have also accompanied this arthroplasty. Complications of Bryan cervical disc replacement include those related to the operative approach and decompression process, loosening and failure of the device, postoperative kyphosis, heterotopic ossification, and loss of movement due to spontaneous fusion. In order to avoid these complications, strict patient selection criteria and a meticulous knowledge of anatomy are necessary. PMID:22009921

Cao, Jun-ming; Zhang, Ying-ze; Shen, Yong; Ding, Wen-yuan

2010-05-01

331

Pregnancy Complications: Syphilis  

MedlinePLUS

... this page It's been added to your dashboard . Syphilis Syphilis is a sexually transmitted disease (also called ... women are diagnosed with syphilis each year. Can syphilis cause problems during pregnancy and for your baby? ...

332

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

333

Gastrointestinal complications of gastrocystoplasty.  

PubMed Central

The cases are reported of five children with chronic renal failure who underwent gastrocystoplasty for a variety of urological disorders. Gastrocystoplasty comprises the transplantation of a vascularised segment of stomach to the bladder to form an augmented neobladder. The patients had gastrointestinal complications after the operation, including considerable weight loss in all five patients, accompanied by marked failure to thrive in four of the five patients, and food aversion, feeding intolerance, dumping syndrome, delayed gastric emptying, and oesophagitis in two patients. Three of the five patients developed severe abdominal pain and haemorrhagic cystitis secondary to gastric acid secretion in the neobladder from the transplanted gastric pedicle. Nutritional and pharmacological interventions were used to manage the gastrointestinal problems. Explanations are offered for the pathophysiology of the observed complications of gastrocystoplasty. It is believed that the use of this procedure in infants and children, particularly those with chronic renal failure and uraemia, warrants caution until successful long term follow up and experience with this procedure have been reported. PMID:1444527

Gold, B D; Bhoopalam, P S; Reifen, R M; Harvey, E; Marcon, M A

1992-01-01

334

Complications in periocular rejuvenation.  

PubMed

Thorough preoperative evaluation with meticulous surgical planning to achieve facial aesthetic balance between the forehead, eyelids, and midface is imperative to avoid or decrease potential functional and/or cosmetic complications in cosmetic periocular surgery. Before performing surgery, the physician should be aware of the patient's history of dry eyes, previous facial trauma, previous injection of Botox Cosmetic, history of previous laser-assisted in situ keratomileusis, and past facial surgery. A full evaluation should be performed on the upper eyelid/brow region to assess for the presence of brow ptosis, brow/eyelid asymmetry, dermatochalasis/pseudodermatochalasis, eyelid ptosis, and deep superior sulcus. On the lower eyelid/cheek examination, special attention should be directed to the diagnosis of underlying negative vector, dry eyes, prominent eyes, lower lid retraction, ectropion, lateral canthal dystopia, lower eyelid laxity, scleral show, and lagophthalmos, with a rejuvenation goal that focuses on obtaining a youthful fullness through repositioning and reinforcing efforts to avoid the negative effects of hollowness. Intraoperative and postoperative medical and surgical management of cosmetic periocular surgery complications focus on decreasing the risk of postoperative ptosis, lagophthalmos, lid retraction, and lid asymmetry, with special attention to limiting the risk of visual loss secondary to orbital hemorrhage. PMID:20659676

Mack, William P

2010-08-01

335

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. PMID:25400446

Gómez-Hurtado, Isabel; Such, José; Sanz, Yolanda; Francés, Rubén

2014-01-01

336

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

337

Complications of Targeted Drug Therapies for Solid Malignancies: Manifestations and Mechanisms  

PubMed Central

OBJECTIVE This article reviews important complications of targeted drug therapies for solid malignancies that can be identified on diagnostic imaging. Wherever possible, known or proposed mechanistic explanations for drug complications are emphasized. CONCLUSION Familiarity with the toxicity profiles of different targeted cancer therapies is important for identifying drug-related complications and for differentiating drug effects from disease progression. A mechanistic understanding may be useful for associating individual drugs with their complications and for predicting the complications of emerging agents. PMID:23436834

Abramson, Richard G.; Abramson, Vandana G.; Chan, Emily; Horn, Leora; Keedy, Vicki L.; Pao, William; Sosman, Jeffrey A.

2013-01-01

338

Stillness in Motion The Essence of Symmetry  

E-print Network

Stillness in Motion The Essence of Symmetry Carl Lee University of Kentucky Chellgren Presentation -- October 2014 Carl Lee Symmetry October 2014 1 / 39 #12;Key Idea #1 An object is symmetrical if it "remains or transformation. Carl Lee Symmetry October 2014 2 / 39 #12;Product Design (Hubcap) Carl Lee Symmetry October 2014

Lee, Carl

339

Solar Still Part I: Salt Water  

NSDL National Science Digital Library

The water cycle is the process that moves water around Earth. In this video segment, adapted from a ZOOM television broadcast, cast members use a homemade solar still to mimic the natural processes of evaporation and condensation, separating pure water from a saltwater mixture. The segment is three minutes thirty-two seconds in length.

340

32 CFR 705.10 - Still photography.  

Code of Federal Regulations, 2013 CFR

... (a) Policy and procedures on taking photos by the general public, given in § 705...Basic policy and procedures for still photos are set forth in the Manual of Naval...photographed. In such cases, all unclassified photos will be returned promptly to the...

2013-07-01

341

32 CFR 705.10 - Still photography.  

Code of Federal Regulations, 2014 CFR

... (a) Policy and procedures on taking photos by the general public, given in § 705...Basic policy and procedures for still photos are set forth in the Manual of Naval...photographed. In such cases, all unclassified photos will be returned promptly to the...

2014-07-01

342

32 CFR 705.10 - Still photography.  

Code of Federal Regulations, 2010 CFR

... (a) Policy and procedures on taking photos by the general public, given in § 705...Basic policy and procedures for still photos are set forth in the Manual of Naval...photographed. In such cases, all unclassified photos will be returned promptly to the...

2010-07-01

343

32 CFR 705.10 - Still photography.  

Code of Federal Regulations, 2012 CFR

... (a) Policy and procedures on taking photos by the general public, given in § 705...Basic policy and procedures for still photos are set forth in the Manual of Naval...photographed. In such cases, all unclassified photos will be returned promptly to the...

2012-07-01

344

32 CFR 705.10 - Still photography.  

Code of Federal Regulations, 2011 CFR

... (a) Policy and procedures on taking photos by the general public, given in § 705...Basic policy and procedures for still photos are set forth in the Manual of Naval...photographed. In such cases, all unclassified photos will be returned promptly to the...

2011-07-01

345

Mathematics from Still and Moving Images  

ERIC Educational Resources Information Center

Digital photos and digital movies offer an excellent way of bringing real world situations into the mathematics classroom. The technologies surveyed here are feasible for everyday classroom use and inexpensive. Examples are drawn from the teaching of Cartesian coordinates, linear functions, ratio and Pythagoras' theorem using still images, and…

Pierce, Robyn; Stacey, Kaye; Ball, Lynda

2005-01-01

346

Salient video stills: content and context preserved  

Microsoft Academic Search

A new class of images called salient stills is demonstrated and a software development platform for their creation is discussed. These images do not represent one discrete moment of time, as do a photograph or single video frame. Rather, one image reflects the aggregate of the temporal changes that occur in a moving image sequence with the salient features preserved.

Laura Teodosio; Walter Bender

1993-01-01

347

Instructor Gallery. Still Life in Bloom.  

ERIC Educational Resources Information Center

The article presents ideas for using Van Gogh's painting, "Irises," to teach elementary students about floral still lifes and the use of space, light, and other aspects of composition. It includes a poster of "Irises" along with suggestions and activities for using it to explore the elements of art. (SM)

Darst, Diane W.

1992-01-01

348

Face Detection in Still Gray Images  

Microsoft Academic Search

We present a trainable system for detecting frontal and near-frontal viewsof faces in still gray images using Support Vector Machines (SVMs). Werst consider the problem of detecting the whole face pattern by a singleSVM classier. In this context we compare dierent types of imagefeatures, present and evaluate a new method for reducing the numberfeatures and discuss practical issues concerning the

Bernd Heisele; Tomaso Poggio

2000-01-01

349

Postoperative pulmonary complications updating.  

PubMed

Postoperative pulmonary complications (PPCs) are a major contributor to the overall risk of surgery. PPCs affect the length of hospital stay and are associated with a higher in-hospital mortality. PPCs are even the leading cause of death either in cardiothoracic surgery but also in non-cardiothoracic surgery. Thus, reliable PPCs risk stratification tools are the key issue of clinical decision making in the perioperative period. When the risk is clearly identified related to the patient according the ARISCAT score and/or the type of surgery (mainly thoracic and abdominal), low-cost preemptive interventions improve outcomes and new strategies can be developed to prevent this risk. The EuSOS, PERISCOPE and IMPROVE studies demonstrated this care optimization by risk identification first, then risk stratification and new care (multifaceted) strategies implementation allowing a decrease in PPCs mortality by optimizing the clinical path of the patient and the care resources. PMID:25168300

Langeron, O; Carreira, S; le Saché, F; Raux, M

2014-01-01

350

Locus minoris resistentiae: An old but still valid way of thinking in medicine.  

PubMed

Locus minoris resistentiae (lmr) refers to a body region more vulnerable than others. This ancient concept, which is also present in Achilles' and Siegfried's old epic myths, weaves through many fields of medicine. In any internal organ or external body region with a congenital or acquired altered defense capacity, a disease process may occur more easily than elsewhere. Illustrative instances are the appearance of hepatocarcinoma on a cirrhotic liver, the onset of lung carcinoma in a tuberculosis scar, cases of osteosarcoma arising in chronic osteomyelitis, and carcinoma complicating chronic cholelithiasis, just to name a few. In dermatology there are countless reports of privileged localization of cutaneous lesions on injured skin which, therefore, represents a typical condition of lmr. The Köbner phenomenon itself features the oldest, simplest, and most common example of lmr, because it denotes the appearance of new lesions pertaining to a previously present skin disorder at the sites of trauma or other insult. The modern transposition of this old but still valid way of thinking in medicine is the reading key of this issue, devoted to lmr in dermatology. PMID:25160095

Lo Schiavo, Ada; Ruocco, Eleonora; Russo, Teresa; Brancaccio, Gabriella

2014-01-01

351

Do ketoanalogues still have a role in delaying dialysis initiation in CKD predialysis patients?  

PubMed

Early versus later start of dialysis is still a matter of debate. Low-protein diets have been used for many decades to delay dialysis initiation. Protein-restricted diets (0.3-0.6 g protein/kg/day) supplemented with essential amino acids and ketoanalogues (sVLPD) can be offered, in association with pharmacological treatment, to motivated stage 4-5 chronic kidney disease (CKD) patients not having severe comorbid conditions; they probably represent 30-40% of the concerned population. A satisfactory adherence to such dietary prescription is observed in approximately 50% of the patients. While the results of the studies on the effects of this diet on the rate of progression of renal failure remain inconclusive, they are highly significant when initiation of dialysis is the primary outcome. The correction of uremic symptoms allows for initiation of dialysis treatment at a level of residual renal function lower than that usually recommended. Most of the CKD-associated complications of cardiovascular and metabolic origin, which hamper both lifespan and quality of life, are positively influenced by the diet. Lastly, with regular monitoring jointly assumed by physicians and dietitians, nutritional status is well preserved as confirmed by a very low mortality rate and by the absence of detrimental effect on the long-term outcome of patients once renal replacement therapy is initiated. On account of its feasibility, efficacy and safety, sVLPD deserves a place in the management of selected patients to safely delay the time needed for dialysis. PMID:24016150

Aparicio, Michel; Bellizzi, Vincenzo; Chauveau, Philippe; Cupisti, Adamasco; Ecder, Tevfik; Fouque, Denis; Garneata, Liliana; Lin, Shanyan; Mitch, William; Teplan, Vladimir; Yu, Xueqing; Zakar, Gabor

2013-01-01

352

Management of Cardiopulmonary Complications of Cirrhosis  

PubMed Central

Advanced portal hypertension accompanying end-stage liver disease results in an altered milieu due to inadequate detoxification of blood from splanchnic circulation by the failing liver. The portosystemic shunts with hepatic dysfunction result in an increased absorption and impaired neutralisation of the gastrointestinal bacteria and endotoxins leads to altered homeostasis with multiorgan dysfunction. The important cardiopulmonary complications are cirrhotic cardiomyopathy, hepatopulmonary syndrome, portopulmonary hypertension, and right-sided hydrothorax. PMID:21994850

Sawant, Prabha; Vashishtha, C.; Nasa, M.

2011-01-01

353

Management of cardiopulmonary complications of cirrhosis.  

PubMed

Advanced portal hypertension accompanying end-stage liver disease results in an altered milieu due to inadequate detoxification of blood from splanchnic circulation by the failing liver. The portosystemic shunts with hepatic dysfunction result in an increased absorption and impaired neutralisation of the gastrointestinal bacteria and endotoxins leads to altered homeostasis with multiorgan dysfunction. The important cardiopulmonary complications are cirrhotic cardiomyopathy, hepatopulmonary syndrome, portopulmonary hypertension, and right-sided hydrothorax. PMID:21994850

Sawant, Prabha; Vashishtha, C; Nasa, M

2011-01-01

354

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

355

Gastrointestinal complications after ischemic stroke.  

PubMed

Ischemic stroke is an important cause of morbidity and mortality, and currently the leading cause of adult disability in developed countries. Stroke is associated with various non-neurological medical complications, including infections and thrombosis. Gastrointestinal complications after stroke are also common, with over half of all stroke patients presenting with dysphagia, constipation, fecal incontinence or gastrointestinal bleeding. These complications are associated with increased hospital length of stay, the development of further complications and even increased mortality. In this article we review the epidemiology, pathophysiology, diagnosis, management and prevention of the most common gastrointestinal complications associated with ischemic stroke. PMID:25214444

Camara-Lemarroy, Carlos R; Ibarra-Yruegas, Beatriz E; Gongora-Rivera, Fernando

2014-11-15

356

Vascular Complications of Pancreatitis: Imaging and Intervention  

SciTech Connect

The objective of this study was to highlight technical challenges and potential pitfalls of diagnostic imaging, intervention, and postintervention follow-up of vascular complications of pancreatitis. Diagnostic and interventional radiology imaging from patients with pancreatitis from 2002 to 2006 was reviewed. We conclude that biphasic CT is the diagnostic modality of choice. Catheter angiography may (still) be required to diagnose small pseudoaneurysms. Endovascular coiling is the treatment of choice for pseudoaneurysms. Close clinical follow-up is required, as patients may rebleed/develop aneurysms elsewhere.

Kirby, John M., E-mail: johnkirby@ireland.com; Vora, Parag; Midia, Mehran; Rawlinson, John [McMaster University Medical Center (Canada)

2008-09-15

357

Complications of transrectal ultrasound-guided systematic sextant biopsies of the prostate: evaluation of complication rates and risk factors within a population-based screening program  

Microsoft Academic Search

Objectives. Screening for prostate cancer to reduce the mortality and morbidity from this disease has become an important issue in recent years. Of all procedures used to diagnose prostate cancer, biopsy of the prostate is the cause of most complications. To evaluate the safety of the screening procedure, we have studied the complications and risk factors for complications within the

John B. W. Rietbergen; Arto E. Boeken Kruger; Ries Kranse; Fritz H. Schröder

1997-01-01

358

Pancreatitis in scrub typhus: a rare complication.  

PubMed

Scrub typhus is a zoonosis transmitted by a trombiculid mite which introduces bacteria of Orientia tsutsugamushi by its bite. The acute febrile illness is characterised by eschar at the site of the bite with maculopapular rashes and local and/or generalised lymphadenopathy. The disease is endemic in the tsutsugamushi triangle. Sikkim, a small Himalayan north-eastern state, is also not unaffected where outbreaks of the disease have been reported. The clinical spectrum of the disease ranges from mild to fatal depending on the virulence of the bacterial strain, susceptibility of the host and promptness of the treatment. In severe cases, there can be multiple organ involvement. Pancreatitis is a serious and unusual complication of this disease, which was seen in our presentation. A 22-year-old man, diagnosed to have scrub typhus, developed pancreatitis in the second week of the illness and responded well to medical treatment. PMID:24692372

Dhakal, Mona; Dhakal, Om Prakash; Bhandari, Dhurba

2014-01-01

359

Neurologists Say Jury Still Out on Medical Marijuana's Use for Brain Disorders  

MedlinePLUS

... JavaScript. Neurologists Say Jury Still Out on Medical Marijuana's Use for Brain Disorders Easing federal restrictions on ... 2015) Wednesday, December 17, 2014 Related MedlinePlus Pages Marijuana Neurologic Diseases WEDNESDAY, Dec. 17, 2014 (HealthDay News) -- ...

360

Instructor: Susanne Still sstill@hawaii.edu  

E-print Network

Instructor: Susanne Still sstill@hawaii.edu www2.hawaii.edu/~sstill/ ICS 435 Machine Learning Fundamentals Friday 1.30pm-4.10pm. KUY 303. Course website: www2.hawaii.edu/~sstill/ICS435.html From Synapses, applicable to many fields. Auditors and non-ICS majors are welcome! www2.hawaii.edu/~sstill/ICS435.html www2

Still, Susanna

361

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

362

Complications of colostomies  

Microsoft Academic Search

One hundred twenty-six patients underwent 130 end colostomies, 44 for benign and 86 for malignant disease, and were followed\\u000a for an average of 35 months. The left or sigmoid colon was used in 99 and the transverse colon in 31. Stomas were made electively\\u000a in 98 patients and urgently in 32. Seventy-six stomas were brought out through the incision and

J. A. Porter; E. P. Salvati; R. J. Rubin; T. E. Eisenstat

1989-01-01

363

Orbital myositis complicating sinusitis  

PubMed Central

Orbital myositis is a common cause of extraocular muscle enlargement. It is characterized by nonspecific inflammation of one or more extraocular muscles. Although often idiopathic in origin, orbital myositis has been associated with various noninfectious diseases. Several cases have also been reported as occurring after upper respiratory tract infections. The present report describes a case of orbital myositis together with subclinical sinusitis and its rapid resolution after antibiotic treatment. The literature on this clinical entity is also reviewed. PMID:18159317

Dylewski, Joe S; Drummond, Robert; Townsend, Tiffany

2001-01-01

364

DELAITRE, LAPTEV, SIVIC: RECOGNIZING HUMAN ACTIONS IN STILL IMAGES. 1 Recognizing human actions in still images  

E-print Network

DELAITRE, LAPTEV, SIVIC: RECOGNIZING HUMAN ACTIONS IN STILL IMAGES. 1 Recognizing human actions.delaitre@ens-lyon.org Ivan Laptev2 ivan.laptev@inria.fr Josef Sivic2 josef.sivic@ens.fr 1 �cole Normale Supérieure de Lyon 2 or electronic forms. #12;2 DELAITRE, LAPTEV, SIVIC: RECOGNIZING HUMAN ACTIONS IN STILL IMAGES. Interacting

365

Helicobacter pylori: why it still matters in 2005.  

PubMed

Despite falling prevalence rates in the developed world, H pylori is still present in the United States and is particularly prevalent among racial minorities and recent immigrants. H pylori infection is clearly associated with an increased risk of peptic ulcer disease, gastric cancer, and MALT lymphoma, and it is associated with some cases of uninvestigated dyspepsia. Identification and eradication of H pylori improves outcomes in patients with peptic ulcer disease and causes tumor regression in patients with MALT lymphoma. It is uncertain whether H pylori eradication will improve outcomes in patients with gastric cancer. Decision analytic models suggest that a test-and-treat strategy for H pylori is rational and cost-effective for patients with uninvestigated dyspepsia. PMID:15931849

Fennerty, M Brian

2005-05-01

366

Unusual complications of gallstones.  

PubMed

Extrinsic compression of the bile duct from gallstone disease is associated with bilio-biliary fistulization, requiring biliary-enteric reconstruction. Biliary-enteric fistulas are associated with intestinal obstruction at various levels. The primary goal of therapy is relief of intestinal obstruction; definitive repair is performed for selected patients. Hemobilia from gallstone-related pseudoaneurysms is preferentially controlled by selective arterial embolization. Rapidly increasing jaundice with relatively normal liver enzymes is a diagnostic hallmark of bilhemia. Acquired thoraco-biliary fistulas are primarily treated by percutaneous and endoscopic interventions. PMID:24679427

Luu, Minh B; Deziel, Daniel J

2014-04-01

367

Colostomy for anorectal anomalies: High incidence of complications  

Microsoft Academic Search

Purpose: The aim of this study was to characterize the type and incidence of complications related to colostomy formation in newborn infants with anorectal anomalies. Methods: The authors reviewed a 5-year (1994 to 1999) experience of a single institution in the management of neonates with high and intermediate anorectal anomalies who required colostomy at birth. Patients with colostomy still in

N. Patwardhan; E. M. Kiely; D. P. Drake; L. Spitz; A. Pierro

2001-01-01

368

[Medical complications of extracorporeal lithotripsy].  

PubMed

Extracorporeal shock wave lithotripsy (ESWL) is one of the most frequently applied procedures for the treatment of urolithiasis. ESWL breaks and splits stones by the means of repeated acoustic shock waves. Despite its non invasive nature, ESWL has been intuitively associated with potential complications, mostly related to residual stone fragments. While non stone-related complications are rare (< 1 %), awareness and identification of these complications could help clinicians to prevent and manage them safely and effectively. The current study reviews the pathophysiology, predicting factors and possible preventive measures of non stone-related medical complications after ESWL. PMID:23951856

Legrand, F; Idrissi Kaitouni, M; Roumeguère, T

2013-01-01

369

Complications in Ankle Fracture Surgery.  

E-print Network

??Mikko Ovaska. Complications in Ankle Fracture Surgery. Helsinki Bone and Joint Research Group, Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, University of Helsinki,… (more)

Ovaska, Mikko

2014-01-01

370

Building Your Resume While Still in School  

NSDL National Science Digital Library

The ATETV project delivers web-based videos to connect students to careers in advanced technology. This episode of ATETV focuses on "some of the many ways students can build their resume while still in school and graduate ready to enter a high-paying, high-demand job of the future." The episode can be watched in full or through the two segments: Growing Your Own Workforce and Creating an Energy Efficient Future. Running time for the full episode of this streaming video is 7:39.

371

Varicella Zoster Complications  

PubMed Central

Opinion statement Varicella zoster virus (VZV) is an exclusively human neurotropic alphaherpesvirus. Primary infection causes varicella (chickenpox), after which virus becomes latent in ganglionic neurons along the entire neuraxis. With advancing age or immunosuppression, cell-mediated immunity to VZV declines and virus reactivates to cause zoster (shingles), which can occur anywhere on the body. Skin lesions resolve within 1-2 weeks, while complete cessation of pain usually takes 4-6 weeks. Zoster can be followed by chronic pain (postherpetic neuralgia), cranial nerve palsies, zoster paresis, meningoencephalitis, cerebellitis, myelopathy, multiple ocular disorders and vasculopathy that can mimic giant cell arteritis. All of the neurological and ocular disorders listed above may also develop without rash. Diagnosis of VZV-induced neurological disease may require examination of CSF, serum and/ or ocular fluids. In the absence of rash in a patient with neurological disease potentially due to VZV, CSF should be examined for VZV DNA by PCR and for anti-VZV IgG and IGM. Detection of VZV IgG antibody in CSF is superior to detection of VZV DNA in CSF to diagnose vasculopathy, recurrent myelopathy, and brainstem encephalitis. Oral antiviral drugs speed healing of rash and shorten acute pain. Immunocompromised patients require intravenous acyclovir. First-line treatments for post-herpetic neuralgia include tricyclic antidepressants gabapentin, pregabalin, and topical lidocaine patches. VZV vasculopathy, meningoencephalitis, and myelitis are all treated with intravenous acyclovir. PMID:23794213

Nagel, Maria A.; Gilden, Don

2013-01-01

372

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

373

Thrombocytopenia and hemostatic disorders in chronic graft versus host disease  

Microsoft Academic Search

Chronic graft versus host disease (cGVHD) is a major and frequent late complication in allogeneic stem cell transplantation recipients. Although thrombocytopenia in cGVHD patients is among the most consistent and strongest predictors of poor survival across many cGVHD studies, such correlation is still neither clearly explained nor well understood. Low platelet counts in the setting of cGVHD are associated with

D Pulanic; J N Lozier; S Z Pavletic

2009-01-01

374

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

375

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

376

[Cardiopulmonary complications in sickle cell anemia].  

PubMed

Sickle cell anemia, considered the most prevalent genetic disease among African Americans, is a disease with autosomal recessive inheritance pattern, characterized by the production of hemoglobin S. This abnormal protein polymerizes and facilitates the formation of fibrillar aggregates that alters the erythrocyte morphology. The stiffness of the red blood cells hinders the adequate transit across microcirculation, leading to hemolysis and increased blood viscosity, which ease thrombogenesis and vascular occlusion, resulting in tissue ischemia and microinfarcts. This disease has a high rate of morbidity and mortality, especially in the first three years of life, when a rapid diagnosis and appropriate treatment are essential. Cardiovascular complications such as heart failure and pulmonary hypertension may develop independently, and each one contributes to increased mortality, being the combination of both risk factors, an important aggravating factor for prognosis and a determinant indicator of mortality. PMID:24215682

Rojas-Jiménez, Sara; Lopera-Valle, Johan; Yabur-Espítia, Mirna

2013-01-01

377

Prevention of complications in neck dissection  

PubMed Central

Background The neck dissection has remained a pivotal aspect of head and neck cancer management for over a century. During this time its role has expanded from a purely therapeutic option into an elective setting, in part promoted by efforts to reduce its morbidity. Objectives This review will consider the potential complications of neck dissection and on the basis of the available evidence describe both their management and prevention. Conclusion Although the neck dissection continues to provide clinicians with a method of addressing cervical disease, its reliability and safety can only be assured if surgeons remain cognisant of the potential complications and aim to minimise such morbidity by appropriate management in the peri-operative period. PMID:19822010

Kerawala, Cyrus J; Heliotos, Manolis

2009-01-01

378

Proarrhythmia, a serious complication of antiarrhythmic drugs.  

PubMed

Aggravation of arrhythmia with antiarrhythmic drugs is not an infrequent side effect associated with antiarrhythmic drugs. Defined as the provocation of a new arrhythmia or a significant increase in the frequency of a preexisting arrhythmia, it occurs with all antiarrhythmic agents, although the incidence varies from 6% to 23% with the different drugs. In general, arrhythmia aggravation is an early event, occurring within the first several days of initiating drugs therapy. It has been found, however, that this complication can also occur as a late event, particularly in patients who have evidence of ongoing ischemia that may be overt or silent. Although there is no good way to predict the patient who is likely to experience this complication, it has been observed that there several predictors of an increased risk for experiencing arrhythmia aggravation including significant underlying heart disease, congestive heart failure, evidence of active or potentially active ischemia, and electrolyte abnormalities, particularly hypokalemia. PMID:10980856

Podrid, P J

1999-11-01

379

Radiological imaging in pediatric rheumatic diseases.  

PubMed

Radiological imaging plays a fundamental role in the diagnosis and monitoring of rheumatic diseases. The basic method of imaging is a classic X-ray picture, which for many years has been used as a single method for the recognition and evaluation of the effects of disease management. In today's modern day treatment of rheumatic diseases, ultrasonography and magnetic resonance are more commonly performed for early detection of inflammatory changes in the region of soft tissue, subchondral bone and bone marrow. In spite of their usefulness and fundamental role in the diagnosis, X-ray still remains an essential tool in the diagnosis of rheumatoid arthritis in children and is complementary to today's methods of imaging diagnostics. In clinical practice, X-ray imaging is still an important examination performed not only to recognize the disorders, but also to provide a differential diagnosis. It helps estimate disease progression and is used to monitor the effects of treatment and the development of possible complications. Differential diagnosis of rheumatic diseases is performed on the basis of localization and type of radiographic changes. The surrounding periarticular soft tissues, bone structures, joint space, with special attention to articular bone surfaces and epiphyses, are analyzed. The aim of this work is to describe characteristic inflammatory changes present on X-ray imaging typical for the most commonly diagnosed rheumatic diseases in children, such as juvenile idiopathic arthritis, systemic lupus erythematosus, systemic scleroderma, mixed connective tissue disease, juvenile dermatomyositis, juvenile spondyloarthropathy and systemic vascular disease. PMID:24669280

Matuszewska, Genowefa; Zaniewicz-Kaniewska, Katarzyna; W?odkowska-Korytkowska, Monika; Smorawi?ska, Patrycja; Saied, Fadhil; Kunisz, Wojciech; Sudo?-Szopi?ska, Iwona

2014-01-01

380

Medical complications of bulimia nervosa  

Microsoft Academic Search

Bulimia nervosa (BN) is a prevalent illness. There are multiple different medical complications that impact the overall treatment plan and prognosis of these patients. Practitioners should be alert for medical complications that are a direct result of the mode of purging behavior utilized by the bulimic patient. The treatment will proceed most smoothly if the primary care physician and the

Laura M. Lasater; Philip S. Mehler

2001-01-01

381

Major Depression and Complicated Grief  

MedlinePLUS

... SEE A LIST » Grief, mourning, and bereavement Major depression and complicated grief Coping with loss Helping someone who is grieving Grief ... Previous Topic Grief, mourning, and bereavement Next Topic Coping with loss Major depression and complicated grief Depression It’s common for people ...

382

[Complications caused by intravenous therapy].  

PubMed

Nursing professionals must know everything related to complications caused by intravenous therapy including the ways to prevent and solve these complications. We need not forget that nurses are the ones mainly responsible for the insertion, manipulation, removal and care of catheters. PMID:16363113

Quirós Luque, José María; Gago Fornells, Manuel

2005-11-01

383

Study design and rationale of 'Influence of Cilostazol-based triple anti-platelet therapy on ischemic complication after drug-eluting stent implantation (CILON-T)' study: A multicenter randomized trial evaluating the efficacy of Cilostazol on ischemic vascular complications after drug-eluting stent implantation for coronary heart disease  

Microsoft Academic Search

BACKGROUND: Current guidelines recommend dual anti-platelet therapy, aspirin and clopidogrel, for patients treated with drug-eluting stent for coronary heart disease. In a few small trials, addition of cilostazol on dual anti-platelet therapy (triple anti-platelet therapy) showed better late luminal loss. In the real-world unselected patients with coronary heart disease, however, the effect of cilostazol on platelet reactivity and ischemic vascular

Seung-Pyo Lee; Jung-Won Suh; Kyung Woo Park; Hae-Young Lee; Hyun-Jae Kang; Bon-Kwon Koo; In-Ho Chae; Dong-Ju Choi; Seung-Woon Rha; Jang-Whan Bae; Myeong-Chan Cho; Taek-Geun Kwon; Jang-Ho Bae; Hyo-Soo Kim

2010-01-01

384

Vinyl chloride: still a cause for concern.  

PubMed Central

Vinyl chloride (VC) is both a known carcinogen and a regulated chemical, and its production capacity has almost doubled over the last 20 years, currently 27 million tons/year worldwide. According to recent reports it is still a cause for concern. VC has been found as a degradation product of chloroethylene solvents (perchloroethylene and trichloroethylene) and in landfill gas and groundwater at concentrations up to 200 mg/m(3) and 10 mg/L, respectively. Worldwide occupational exposure to VC still seems to be high in some countries (e.g., averages of approximately 1,300 mg/m(3) until 1987 in one factory), and exposure may also be high in others where VC is not regulated. By combining the most relevant epidemiologic studies from several countries, we observed a 5-fold excess of liver cancer, primarily because of a 45-fold excess risk from angiosarcoma of the liver (ASL). The number of ASL cases reported up to the end of 1998 was 197 worldwide. The average latency for ASL is 22 years. Some studies show a small excess risk for hepatocellular carcinoma, and others suggest a possible risk of brain tumors among highly exposed workers. Lung cancer, lymphomas, or leukemia do not seem to be related to VC exposure according to recent results. The mutation spectra observed in rat and human liver tumors (ASL and/or hepatocellular carcinoma) that are associated with exposure to VC are clearly distinct from those observed in sporadic liver tumors or hepatic tumors that are associated with other exposures. In rats, the substitution mutations found at A:T base pairs in the ras and p53 genes are consistent with the promutagenic properties of the DNA adduct 1,N(6)-ethenoadenine formed from VC metabolites. Risk assessments derived from animal studies seem to overestimate the actual risk of cancer when comparing estimated and reported cases of ASL. Images Figure 1 Figure 2 PMID:10905993

Kielhorn, J; Melber, C; Wahnschaffe, U; Aitio, A; Mangelsdorf, I

2000-01-01

385

Neurocysticercosis is still prevalent in Mexico.  

PubMed

In this work, we report the published cases of human and porcine cysticercosis, as well as Taenia solium taeniasis diagnosed in Mexico during the last 10 years. Numerical data allow us to state that this disease remains as a public health problem in our country. Whereas efficient tools have been developed for the diagnosis and prevention of cysticercosis, we strongly recommend further measures allowing the control and eventual eradication of this parasite in Mexico. PMID:23318900

Fleury, Agnès; Sciutto, Edda; Larralde, Carlos

2012-01-01

386

Is Aortic Valve Replacement with Bileaflet Prostheses Still Contraindicated in the Elderly?  

Microsoft Academic Search

Background: Prolonged survival in the Western world has increased the number of elderly patients referred for open-heart surgery during the last decade. Aortic valve disease is the most common heart valve disease in aged patients. Which aortic valve substitute is best employed in the elderly is still a debated matter. The main concern is about the thromboembolic and hemorrhagic risks

Marisa De Feo; Attilio Renzulli; Mariano Vicchio; Alessandro Della Corte; Francesco Onorati; Maurizio Cotrufo

2002-01-01

387

Translational research efforts in biomarkers and biology of early transplant-related complications.  

PubMed

In the time since the first allogeneic hematopoietic stem cell transplantation (HSCT) was performed over 40 years ago, this life-saving procedure has been used increasingly for patients with hematologic, metabolic, and malignant diseases. Despite major advances in our understanding of the immunologic processes (both beneficial and injurious) that are associated with HSCT and improvements in supportive and critical care medicine, successful outcomes are still limited by several serious complications. As such, the establishment of effective therapeutic strategies for these complications will be crucial as increasing numbers of high-risk transplants are performed each year. The development of such approaches is fundamentally dependent upon a basic understanding of pathophysiologic mechanisms of disease and also on our ability to successfully translate these insights back to the bedside. This brief review will highlight breakthroughs in translational research endeavors that have paved the way for the development of novel strategies intended to change the standard of care and optimize outcomes for patients in whom allogeneic HSCT offers the only hope for a cure. PMID:21195297

Paczesny, Sophie; Diaz-Ricart, Maribel; Carreras, Enric; Carerras, Enrique; Cooke, Kenneth R

2011-01-01

388

The use of monoclonal antibodies in the treatment of autoimmune complications of chronic lymphocytic leukemia.  

PubMed

Autoimmune cytopenias are a frequent complication in CLL, occurring in approximately 5-10% of the patients. The most common manifestation is autoimmune haemolytic anaemia, followed by immune thrombocytopenia and only rarely pure red blood cell aplasia or autoimmune granulocytopenia. Initial treatment is as for the idiopathic autoimmune cytopenias, with most patients responding to conventional corticosteroid therapy. Patients, who do not respond to conventional therapy after 4-6 weeks, should be considered for alternative immunosuppression, monoclonal antibody therapy or splenectomy. While randomized trials demonstrating the benefit of rituximab in CLL-related autoimmune diseases are still lacking, there are considerable data in the literature that provide evidence for its effectiveness. The monoclonal antibody alemtuzumab also displays considerable activity against both the malignant disease and the autoimmune complication in patients with CLL, although at the expense of greater toxicity. A number of new monoclonal antibodies, such as ofatumumab, GA-101, lumiliximab, TRU-016, epratuzumab, and galiximab, are currently investigated in CLL and their activity in CLL-related autoimmune cytopenias should be evaluated in future studies. PMID:23667725

Laurenti, Luca; Vannata, Barbara; Innocenti, Idanna; Autore, Francesco; Santini, Francesco; Sica, Simona; Efremov, Dimitar G

2013-01-01

389

Splenectomy in patients with myeloproliferative neoplasms: efficacy, complications and impact on survival and transformation.  

PubMed

Splenectomy may be an effective therapeutic option for treating massive splenomegaly in patients with myeloproliferative neoplasms (MPNs). There are still limited data on its short- and long-term benefits and risks. Efficacy and short-term complications were analyzed in 94 patients with different MPNs who underwent splenectomy at M. D. Anderson Cancer Center. The long-term impact of splenectomy on overall survival (OS) and transformation free survival (TFS) was evaluated in 461 patients with myelofibrosis (MF) seen at M. D. Anderson, including 50 who underwent splenectomy during disease evolution. Splenectomy improved anemia and thrombocytopenia in 47% and 66% of patients, respectively. The most common complications were leukocytosis (76%), thrombocytosis (43%) and venous thromboembolism (16%). Post-operative mortality was 5%. Among patients with MF, splenectomy during disease evolution was associated with decreased OS (hazard ratio [HR] = 2.17, p < 0.0001) and TFS (HR = 2.17, p < 0.0001). This effect was independent of the Dynamic International Prognostic Scoring System. Splenectomy is a possible therapeutic option for patients with MF and other MPNs, and its greatest benefits are related to improvement in spleen pain and discomfort, anemia and thrombocytopenia. However, in patients with MF it appears to be associated with increased mortality. PMID:23573823

Santos, Fabio P S; Tam, Constantine S; Kantarjian, Hagop; Cortes, Jorge; Thomas, Deborah; Pollock, Raphael; Verstovsek, Srdan

2014-01-01

390

Splenectomy in patients with Myeloproliferative Neoplasms: efficacy, complications and impact on survival and transformation  

PubMed Central

Background Splenectomy may be an effective therapeutic option for treating massive splenomegaly in patients with myeloproliferative neoplasms (MPNs). There is still limited data on its short- and long-term benefits and risks. Methods Efficacy and short-term complications were analyzed in 94 patients with different MPNs who underwent splenectomy at MD Anderson. The long-term impact of splenectomy on overall survival (OS) and transformation free survival (TFS) was evaluated in 461 patients with myelofibrosis (MF) seen at MD Anderson including 50 who underwent splenectomy during disease evolution. Results Splenectomy improved anemia and thrombocytopenia in 47% and 66% of patients, respectively. Most common complications were leukocytosis (76%), thrombocytosis (43%), and venous thromboembolism (16%). Post-operative mortality was 5%. Among patients with MF, splenectomy during disease evolution was associated with decreased OS (Hazard Ratio [HR] =2.17, p<0.0001) and TFS (HR=2.17, p<0.0001). This effect was independent of the Dynamic International Prognostic Scoring System. Conclusions Splenectomy is a possible therapeutic option for patients with MF and other MPNs, and its greatest benefits are related to improvement in spleen pain and discomfort, anemia and thrombocytopenia. However, in patients with MF it appears to be associated with increased mortality. PMID:23573823

Santos, Fabio P S; Tam, Constantine S; Kantarjian, Hagop; Cortes, Jorge; Thomas, Deborah; Pollock, Raphael; Verstovsek, Srdan

2013-01-01

391

The Use of Monoclonal Antibodies in the Treatment of Autoimmune Complications of Chronic Lymphocytic Leukemia  

PubMed Central

Autoimmune cytopenias are a frequent complication in CLL, occurring in approximately 5–10% of the patients. The most common manifestation is autoimmune haemolytic anaemia, followed by immune thrombocytopenia and only rarely pure red blood cell aplasia or autoimmune granulocytopenia. Initial treatment is as for the idiopathic autoimmune cytopenias, with most patients responding to conventional corticosteroid therapy. Patients, who do not respond to conventional therapy after 4–6 weeks, should be considered for alternative immunosuppression, monoclonal antibody therapy or splenectomy. While randomized trials demonstrating the benefit of rituximab in CLL-related autoimmune diseases are still lacking, there are considerable data in the literature that provide evidence for its effectiveness. The monoclonal antibody alemtuzumab also displays considerable activity against both the malignant disease and the autoimmune complication in patients with CLL, although at the expense of greater toxicity. A number of new monoclonal antibodies, such as ofatumumab, GA-101, lumiliximab, TRU-016, epratuzumab, and galiximab, are currently investigated in CLL and their activity in CLL-related autoimmune cytopenias should be evaluated in future studies. PMID:23667725

Laurenti, Luca; Vannata, Barbara; Innocenti, Idanna; Autore, Francesco; Santini, Francesco; Sica, Simona; Efremov, Dimitar G.

2013-01-01

392

Vision-threatening complications of nasal T\\/NK lymphoma  

Microsoft Academic Search

PURPOSE: Nasal T\\/NK lineage lymphoma, previously known as lethal midline granuloma, is common among Oriental, Native-American, and Hispanic patients and is invariably associated with Epstein-Barr virus. Nasal localization, local necrosis, angioinvasion, and aggressive behavior are hallmarks of the disease. Ophthalmologic symptoms and signs may precede lymphoma diagnosis or complicate its disease course. We aim to define the incidence and disease

Charmaine Hon; Alvin K. H Kwok; Tony W. H Shek; James C. S Chim; Wing Y Au

2002-01-01

393

Complications of digital intravenous angiography: experience in 2488 cervicocranial examinations  

SciTech Connect

All complications were recorded from the initial 2488 cases studied with digital intravenous angiography (DIVA) at New York University Medical Center. Mechanisms of producing these reactions were categorized into procedure-related, contrast-medium-related, or disease-related. The complications included extravasation of contrast material into the arm (11 patients) and mediastinum (two), acute pulmonary edema(four), hypotension (23), thrombophlebitis (two), and grand mal seizure (one). Recommendations are made that would allow DIVA to be performed more safely.

Pinto, R.S.; Manuell, M.; Kricheff, I.I.

1984-12-01

394

Smallpox: can we still learn from the journey to eradication?  

PubMed Central

One of the most celebrated achievements of immunology and modern medicine is the eradication of the dreaded plague smallpox. From the introduction of smallpox vaccination by Edward Jenner, to its popularization by Louis Pasteur, to the eradication effort led by Donald Henderson, this story has many lessons for us today, including the characteristics of the disease and vaccine that permitted its eradication, and the obviousness of the vaccine as a vector for other intractable Infectious diseases. The disease itself, interpreted in the light of modern molecular immunology, is an obvious immunopathological disease, which occurs after a latent interval of 1-2 weeks, and manifests as a systemic cell-mediated delayed type hypersensitivity (DTH) syndrome. The vaccine that slayed this dragon was given the name vaccinia, and was thought to have evolved from cowpox virus, but is now known to be most closely related to a poxvirus isolated from a horse. Of interest is the fact that of the various isolates of orthopox viruses, only variola, vaccinia and monkeypox viruses can infect humans. In contrast to the systemic disease of variola, vaccinia only replicates locally at the site of inoculation, and causes a localized DTH response that usually peaks after 7-10 days. This difference in the pathogenicity of variola vs. vaccinia is thought to be due to the capacity of variola to circumvent innate immunity, which allows it to disseminate widely before the adaptive immune response occurs. Thus, the fact that vaccinia virus is attenuated compared to variola, but is still replication competent, makes for its remarkable efficacy as a vaccine, as the localized infection activates all of the cells and molecules of both innate and adaptive immunity. Accordingly vaccinia itself, and not modified replication incompetent vaccina, is the hope for use as a vector in the eradication of additional pathogenic microbes from the globe. PMID:23760373

Smith, Kendall A.

2013-01-01

395

Smallpox: can we still learn from the journey to eradication?  

PubMed

One of the most celebrated achievements of immunology and modern medicine is the eradication of the dreaded plague smallpox. From the introduction of smallpox vaccination by Edward Jenner, to its popularization by Louis Pasteur, to the eradication effort led by Donald Henderson, this story has many lessons for us today, including the characteristics of the disease and vaccine that permitted its eradication, and the obviousness of the vaccine as a vector for other intractable Infectious diseases. The disease itself, interpreted in the light of modern molecular immunology, is an obvious immunopathological disease, which occurs after a latent interval of 1-2 weeks, and manifests as a systemic cell-mediated delayed type hypersensitivity (DTH) syndrome. The vaccine that slayed this dragon was given the name vaccinia, and was thought to have evolved from cowpox virus, but is now known to be most closely related to a poxvirus isolated from a horse. Of interest is the fact that of the various isolates of orthopox viruses, only variola, vaccinia and monkeypox viruses can infect humans. In contrast to the systemic disease of variola, vaccinia only replicates locally at the site of inoculation, and causes a localized DTH response that usually peaks after 7-10 days. This difference in the pathogenicity of variola vs. vaccinia is thought to be due to the capacity of variola to circumvent innate immunity, which allows it to disseminate widely before the adaptive immune response occurs. Thus, the fact that vaccinia virus is attenuated compared to variola, but is still replication competent, makes for its remarkable efficacy as a vaccine, as the localized infection activates all of the cells and molecules of both innate and adaptive immunity. Accordingly vaccinia itself, and not modified replication incompetent vaccina, is the hope for use as a vector in the eradication of additional pathogenic microbes from the globe. PMID:23760373

Smith, Kendall A

2013-05-01

396

Prevention of pelvic radiation disease  

PubMed Central

Pelvic cancers are among the most frequently diagnosed cancers worldwide. Treatment of patients requires a multidisciplinary approach that frequently includes radiotherapy. Gastrointestinal (GI) radiation-induced toxicity is a major complication and the transient or long-term problems, ranging from mild to very severe, arising in non-cancerous tissues resulting from radiation treatment to a tumor of pelvic origin, are actually called as pelvic radiation disease. The incidence of pelvic radiation disease changes according to the radiation technique, the length of follow up, the assessment method, the type and stage of cancer and several other variables. Notably, even with the most recent radiation techniques, i.e., intensity-modulated radiotherapy, the incidence of radiation-induced GI side effects is overall reduced but still not negligible. In addition, radiation-induced GI side effects can develop even after several decades; therefore, the improvement of patient life expectancy will unavoidably increase the risk of developing radiation-induced complications. Once developed, the management of pelvic radiation disease may be challenging. Therefore, the prevention of radiation-induced toxicity represents a reasonable way to avoid a dramatic drop of the quality of life of these patients. In the current manuscript we provide an updated and practical review on the best available evidences in the field of the prevention of pelvic radiation disease. PMID:25664197

Fuccio, Lorenzo; Frazzoni, Leonardo; Guido, Alessandra

2015-01-01

397

Prevention of pelvic radiation disease.  

PubMed

Pelvic cancers are among the most frequently diagnosed cancers worldwide. Treatment of patients requires a multidisciplinary approach that frequently includes radiotherapy. Gastrointestinal (GI) radiation-induced toxicity is a major complication and the transient or long-term problems, ranging from mild to very severe, arising in non-cancerous tissues resulting from radiation treatment to a tumor of pelvic origin, are actually called as pelvic radiation disease. The incidence of pelvic radiation disease changes according to the radiation technique, the length of follow up, the assessment method, the type and stage of cancer and several other variables. Notably, even with the most recent radiation techniques, i.e., intensity-modulated radiotherapy, the incidence of radiation-induced GI side effects is overall reduced but still not negligible. In addition, radiation-induced GI side effects can develop even after several decades; therefore, the improvement of patient life expectancy will unavoidably increase the risk of developing radiation-induced complications. Once developed, the management of pelvic radiation disease may be challenging. Therefore, the prevention of radiation-induced toxicity represents a reasonable way to avoid a dramatic drop of the quality of life of these patients. In the current manuscript we provide an updated and practical review on the best available evidences in the field of the prevention of pelvic radiation disease. PMID:25664197

Fuccio, Lorenzo; Frazzoni, Leonardo; Guido, Alessandra

2015-02-01

398

Urological surgery in elderly patients: results and complications  

PubMed Central

Purpose Owing to the large aging population, a growing number of elderly patients are undergoing surgical treatment. Surgical procedures in elderly patients are associated with a higher risk of complications. The aim of this study was to evaluate the efficacy and safety of urological surgeries in old patients. Methods The authors carried out a retrospective study, evaluating results and early postoperative complications in patients aged 75 years and older. The cohort of patients included 221 patients who underwent surgical procedures in the department of urology between January 2011 and December 2012. The average age of patients was 78. The results and complications were categorized based on the type of surgery performed, and the Dindo–Clavien scale. Results The median follow-up was 18 months. All surgeries for malignant tumors were performed successfully with no residual disease. Totally, 48 (22%) complications were recorded. The most serious were as follows: one patient (<0.5%) died; and four (<2%) patients underwent reoperation. The most common complications involved infection, mainly sepsis and surgical site infections. Other complications included mild respiratory insufficiency, delirium, bleeding, etc. Conclusion Surgeries in elderly patients were effective and safe. The cornerstone of safety is careful preparation and treatment of comorbidities. Complications occurred mainly as a result of emergency procedures during emergency procedures and in major surgeries such as cystectomy and nephrectomy. The standard use of low molecular-weight heparin caused no incidence of thromboembolic disease. PMID:25673978

Brodak, Milos; Tomasek, Jan; Pacovsky, Jaroslav; Holub, Lukas; Husek, Petr

2015-01-01

399

Retroperitoneoscopic renal biopsy: still a good indication!  

PubMed

The histological evaluation of the renal parenchyma is often essential in cases of several renal diseases and provides useful information in determining the prognosis and guiding treatment. In patients with contraindications to percutaneous kidney biopsy, retroperitoneal laparoendoscopic single-site surgery (LESS) is to be preferred as a minimally invasive technique. However, there are cases in which the LESS technique is difficult to perform, especially given that the learning curve is not optimal. We present a case of a Jehovah's Witness patient with severe obesity, in whom conventional retroperitoneal laparoscopic renal biopsy was preferred to the LESS technique. PMID:25198939

Micali, Salvatore; Dandrea, Matteo; De Carne, Cosimo; Martorana, Eugenio; De Stefani, Stefano; Cappelli, Gianni; Bianchi, Giampaolo

2014-12-23

400

Chronic Kidney Diseases  

MedlinePLUS

... pressure at a healthy level. Continue Kinds of Kidney Diseases Like any complicated machine, not all kidneys work ... passed down through a person's genes. How Are Kidney Diseases Diagnosed? Kidney problems are often not noticed at ...

401

[Urologic complications after radical hysterectomy].  

PubMed

From 1981-1984, in cases of the carcinoma of the cervix uteri, 174 radical abdominal and 29 radical vaginal hysterectomies were performed. Prior the surgery, there were 6.4% of pathologic urograms in the patients. After it, applying the Wertheim method, temporary hydronephrosis was recorded in 32.5%, lasting hydronephrosis in 9.8%, and fistulas in 2.5% of patients. Lasting complications developed also several year following the treatment. Subsequent surgery due to urologic complications included 19 patients having been treated by a combined therapy, surgery and radiation. More complications were observed after combined therapy applied in 58.6% of cases. PMID:2640270

Lukanovic, A; Rakar, S

1989-01-01

402

Surgical Complications After Implant Placement.  

PubMed

Placement of dental implants in the maxillofacial region is routine and considered safe. However, as with any surgical procedure, complications occur. Many issues that arise at surgery can be traced to the preoperative evaluation of the patient and assessment of the underlying anatomy. In this article, the authors review some common and uncommon complications that can occur during and shortly after implant placement. The emphasis of each section is on the management and prevention of complications that may occur during implant placement. PMID:25434559

Camargo, Igor Batista; Van Sickels, Joseph E

2015-01-01

403

[On prevention of oncological involutory complications].  

PubMed

Actual issues of modem medicine meeting basic directions of reformation of national public health system and enhancement of preventive services to female patients of various age groups are considered. Actual information on development of oncological gynecological diseases in women with complicated involutional period is included. Possibility in getting new data on risk factors in women with involutional period for the purpose of health promotion in women of reproductive age and of enhancement of life quality during involutional period is surmised. Prospective and effective pattern of primary prevention of oncological gynecological involutional pathology is proposed to be implemented in practice of public health cervices as standardized normative document. PMID:17004375

Kulikova, N G; Minaev, A B; Simonova, L P

2006-01-01

404

Low light performance of digital still cameras  

NASA Astrophysics Data System (ADS)

The major difference between a dSLR camera, a consumer camera, and a camera in a mobile device is the sensor size. The sensor size is also related to the over all system size including the lens. With the sensors getting smaller the individual light sensitive areas are also getting smaller leaving less light falling onto each of the pixels. This effect requires higher signal amplification that leads to higher noise levels or other problems that may occur due to denoising algorithms. These Problems become more visible at low light conditions because of the lower signal levels. The fact that the sensitivity of cameras decreases makes customers ask for a standardized way to measure low light performance of cameras. The CEA (Consumer Electronics Association) together with ANSI has addressed this for camcorders in the CEA-639 [1] standard. The ISO technical committee 42 (photography) is currently also thinking about a potential standard on this topic for still picture cameras. This paper is part of the preparation work for this standardization activity and addresses the differences compared to camcorders and also potential additional problems with noise reduction that have occurred over the past few years. The result of this paper is a proposed test procedure with a few open questions that have to be answered in future work.

Wueller, Dietmar

2013-03-01

405

The still obscure attributes of cryptococcal glucuronoxylomannan  

PubMed Central

Glucuronoxylomannan (GXM) is the major capsular polysaccharide of Cryptococcus neoformans. It is essential for fungal virulence and causes a number of deleterious effects to host cells. During the last decades, most of the experimental models designed to study the roles of GXM during cryptococcal infection were based on the stimulation of animal cells. This most commonly involved macrophages or other effector cells, with polysaccharide fractions obtained by precipitation with cationic detergents. More recently, it has been demonstrated that GXM interferes with the physiological state of other target cells, such as the epithelium. In addition, recent studies indicate that the structure of the polysaccharide and, consequently, its functions vary according with the method used for its purification. This raises questions as to what is native GXM and the significance of prior studies. In this paper, we discuss some of the aspects of GXM that are still poorly explored in the current literature, including the relevance of the polysaccharide in the interaction of cryptococci with non-phagocytic cells and the relationship between its structure and biological activity. PMID:19343609

RODRIGUES, MARCIO L.; FONSECA, FERNANDA L.; FRASES, SUSANA; CASADEVALL, ARTURO; NIMRICHTER, LEONARDO

2015-01-01

406

Cardiovascular Complications in CKD Patients: Role of Oxidative Stress  

PubMed Central

Starting with the early stages, patients with chronic kidney disease (CKD) experience higher burden of cardiovascular disease (CVD). Moreover, CVD complications are the major cause of mortality in CKD patients as compared with complications from chronic kidney failure. While traditional CVD risk factors, including diabetes, hypertension, hyperlipidemia, obesity, physical inactivity, may be more prevalent among CKD patients, these factors seem to underestimate the accelerated cardiovascular disease in the CKD population. Search for additional biomarkers that could explain the enhanced CVD risk in CKD patients has gained increasing importance. Although it is unlikely that any single nontraditional risk factor would fully account for the increased CVD risk in individuals with CKD, oxidative stress appears to play a central role in the development and progression of CVD and its complications. We will review the data that support the contribution of oxidative stress in the pathogenesis of CVD in patients with chronic kidney failure. PMID:21253517

Gosmanova, Elvira O.; Le, Ngoc-Anh

2011-01-01

407

Diabetes and associated complications in the South Asian population.  

PubMed

The rising prevalence of diabetes in South Asians has significant health and economic implications. South Asians are predisposed to the development of diabetes due to biologic causes which are exacerbated by lifestyle and environmental factors. Furthermore, they experience significant morbidity and mortality from complications of diabetes, most notably coronary artery disease, cerebrovascular disease, and chronic kidney disease. Therefore, understanding the pathophysiology and genetics of diabetes risk factors and its associated complications in South Asians is paramount to curbing the diabetes epidemic. With this understanding, the appropriate screening, preventative and therapeutic strategies can be implemented and further developed. In this review, we discuss in detail the biologic and lifestyle factors that predispose South Asians to diabetes and review the epidemiology and pathophysiology of microvascular and macrovascular complications of diabetes in South Asians. We also review the ongoing and completed diabetes prevention and management studies in South Asians. PMID:24643902

Shah, Arti; Kanaya, Alka M

2014-05-01

408

Left ventricular assist device implantation: short and long-term surgical complications  

Microsoft Academic Search

Long-term implanted left ventricular assist devices (LVADs) have significantly improved the care of patients awaiting heart transplantation and will provide an alternative therapy to select patients with heart failure. However, although the technology and clinical results continue to improve, LVAD implantation is still associated with a significant level of complications. Left ventricular assist device–associated complications can be broadly divided by

William Piccione

2000-01-01

409

Hypertrophic Osteoarthropathy in Patient with Crohn's Disease: A Case Report  

PubMed Central

Numerous causes of hypertrophic osteoarthropathy (HOA) have been reported. Commonly, secondary osteoarthropathy accompanies pulmonary diseases such as carcinoma of the lung, pleural tumors, lung abscesses, and bronchiectasis. However, HOA in inflammatory bowel disease is a rare complication. There are only a few reports of secondary HOA with Crohn's disease. Our purpose was to report another case of HOA in Crohn's disease. We describe a case of a 27-year-old man with underlying Crohn's disease presenting with 2 years of pain in multiple joints. Radiographic findings suggested HOA in extremities. We performed a conservative treatment including medication and rehabilitations. The patient's symptoms were much improved at the latest follow-up. Although numerous studies on HOA have been published, the pathogenesis of HOA is still unclear. Various treatment modalities were recommended but further studies to uncover the pathogenesis of HOA with Crohn's disease and to establish a treatment modality are needed. PMID:25025001

Rhee, Sung-Min; Park, Ki Jeong

2014-01-01

410

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

411

Current and future HCV therapy: do we still need other anti-HCV drugs?  

PubMed

Eradication of hepatitis C virus (HCV) infection, at least in compensated patients, can help improve the outcomes of liver disease such as cirrhosis, hepatocellular carcinoma (HCC) and liver transplantation, as well as perhaps extra-hepatic complications such as diabetes and cardiovascular risk. In the past few years, the landscape of antiviral therapy has evolved at a breathtaking pace from pegylated interferon (PEG-IFN) plus ribavirin (RBV) (PEG-IFN/RBV) to IFN-based strategies combining direct acting antivirals (DDAs) with PEG-IFN/RBV and finally IFN-free combinations of DAAs. In particular with these most recent developments, treatment regimens have become shorter, safer and even more effective, with a wide range of indications. Nevertheless, research continues and newer antiviral drugs are still under development. At a point when a >90% sustained virological response (SVR) is being claimed with all new available regimens, pharmacological and clinical research should be addressing unresolved areas, such as cases of suboptimal SVR or to increase effectiveness rather than pursuing the development of new 'me-too' drugs. The issues which should be given priority for further development include the following: Improving the results of IFN-free regimens in patients with genotype 3 (HCV-3) infection. Identifying the indications for the treatment in patients with compensated and decompensated cirrhosis. Identifying standardized or personalized backup strategies in patients who do not respond to IFN-free regimens. Finally, because of financial constraints, the high cost of IFN-free strategies prevents their universal use in CHC patients and coverage by national healthcare systems. Thus, efforts must be made to document cost-effectiveness in all clinical scenarios and to develop more affordable IFN-free regimens. PMID:25529081

Petta, Salvatore; Craxì, Antonio

2015-01-01

412

Advanced Glycation End Products and Diabetic Complications  

PubMed Central

During long standing hyperglycaemic state in diabetes mellitus, glucose forms covalent adducts with the plasma proteins through a non-enzymatic process known as glycation. Protein glycation and formation of advanced glycation end products (AGEs) play an important role in the pathogenesis of diabetic complications like retinopathy, nephropathy, neuropathy, cardiomyopathy along with some other diseases such as rheumatoid arthritis, osteoporosis and aging. Glycation of proteins interferes with their normal functions by disrupting molecular conformation, altering enzymatic activity, and interfering with receptor functioning. AGEs form intra- and extracellular cross linking not only with proteins, but with some other endogenous key molecules including lipids and nucleic acids to contribute in the development of diabetic complications. Recent studies suggest that AGEs interact with plasma membrane localized receptors for AGEs (RAGE) to alter intracellular signaling, gene expression, release of pro-inflammatory molecules and free radicals. The present review discusses the glycation of plasma proteins such as albumin, fibrinogen, globulins and collagen to form different types of AGEs. Furthermore, the role of AGEs in the pathogenesis of diabetic complications including retinopathy, cataract, neuropathy, nephropathy and cardiomyopathy is also discussed. PMID:24634591

Singh, Varun Parkash; Bali, Anjana; Singh, Nirmal

2014-01-01

413

Underwater terrain mapping of dam stilling basins  

NASA Astrophysics Data System (ADS)

The high-resolution acoustic mapping (HRAM) system was developed in response to a stated need by the United States Army Corps of Engineers to evaluate the floor of a navigation lock that could not be dewatered. Navigation Lock #26 on the Mississippi River was constructed on piles and mats over a sandy bottom. Over the years the footings had shifted, probably damaging the floor. The lock could not be dewatered because of leakage around the lock-wall footings. Based on our work in ultrasonic inspection; using B-scan, C-scan and holographic imaging to display hidden faults in metal; we were asked to propose a solution to the navigation-lock imaging problem. The C-scan ultrasonic method employs a single ultrasonic transducer stepped over a regularly spaced grid to collect a set of data that can be displayed on an oscilloscope screen to evaluate the material being inspected. It is well suited for the inspection of large flat areas. We proposed to build in essence a large C-scan system. A boat supporting several ultrasonic transducers would move in a regular X-Y pattern over the floor of the lock. The data from the scan would be computer processed to provide a plot of the surface of the floor. We called this a 3D plot since it would be a nearly three-dimensional view of the inspected surface. I should point out that this work was proposed in 1975 and conducted in 1976, when small high-powered computers were still well in the future. The results of the program were spectacular. The 3D plot of the Lock 26 floor showed that individual concrete slabs had broken, some slabs had been tilted, the entire river side of the lock floor had settled nearly two meters, and piles of silt had built up in front of the lock gates.

Price, Ted O.

1995-05-01

414

Why women still die from cervical cancer.  

PubMed

Cervicovaginal cytology, known as Pap smear, is the most effective screening test in medical oncology. Introduced by Dr. George Papanicolaou in 1940, the Pap smear is now being recognized as a major contributor to the remarkable decrease in cervical cancer morbidity and mortality among women throughout the world. However, there are still significant numbers of women who lose their lives to cervical cancer every day. To overcome this major problem, first, we must search for the reasons for these lost lives and then take appropriate measures to resolve the existing issues. There is now substantial evidence that emphasizes the importance of an effective screening program. This program must integrate education and accessibility to health care for all women regardless of age, race, ethnic background and socioeconomic status. The public, the media, the government and health care providers must also become acutely aware of the inherent difficulties involved in providing a high-quality Pap smear. Compounded by medicolegal pressures and reimbursement issues, the Pap smear has become one of the more difficult tests to perform. Current reimbursement mechanisms are not appropriate for the cost of providing the service and cannot guarantee the resources necessary for a high-quality Pap smear. Congress should consider mandating direct billing to the patient for the service, so that cervicovaginal cytology could be reimbursed on a level commensurate with the requirements of providing quality service. A concerted effort should also be made to enhance the level of public knowledge about the issues surrounding Pap smear. This could be achieved by fostering the idea of designating a "Cervical Cancer Awareness Month," and by encouraging the spirit of community networking. PMID:9379163

Masood, S

1997-01-01

415

Unusual Complications of Quinalphos Poisoning  

PubMed Central

This 40-year-old man was treated for suicidal quinalphos 25%EC consumption. He developed intermediate syndrome with normal response to repetitive nerve stimulation, pancreatitis with high enzyme elevations, and normal computed tomography and excreted black, brown, and orange urine sequentially over the first nine days of hospitalization. The last complication has not been previously reported with any organophosphate compound. He finally succumbed to complication of ventilator associated pneumonia related septic shock and ventricular tachycardia. PMID:23762661

Viswanathan, Stalin

2013-01-01

416

The management of complicated glaucoma  

PubMed Central

Complicated glaucomas present considerable diagnostic and management challenges. Response to treatment can be unpredictable or reduced compared with other glaucomas. However, target intraocular pressure and preservation of vision may be achieved with selected medical, laser and surgical treatment. The evidence for such treatment is expanding and consequently affords clinicians a better understanding of established and novel techniques. Herein we review the mechanisms involved in the development of complicated glaucoma and the current evidence supporting its management. PMID:21150026

Clement, C I; Goldberg, Ivan

2011-01-01

417

Death in pediatric Cushing syndrome is uncommon but still occurs.  

PubMed

Cushing syndrome (CS) in children is rare. Delayed diagnosis and treatment of CS may be associated with increased morbidity and, unfortunately, mortality. We performed a retrospective review of all patients with CS under the age of 18 years referred to the National Institutes of Health (NIH) from 1998 to 2013 in order to describe deceased patients among cases of pediatric CS referred to the National Institutes of Health (NIH). The deaths of four children (three females and one male), aged 7.5-15.5 years (mean age 11.2 years) with length of disease 2-4 years, were recorded among 160 (2.5 %) children seen at or referred to the NIH over the last 15 years. All died at different institutions, prior to coming to the NIH (two) or after leaving NIH (two). Presenting symptoms included increasing weight and decreasing height gain, facial plethora, dorsocervical fat pad (webbed neck), striae, headache, vision disturbances, and depression and other mood or behavior changes; there were no differences between how these patients presented and the others in our cohort. The causes of CS in the deceased patients were also not different, in fact, they spanned the entire spectrum of CS: pituitary disease (one), ectopic corticotropin production (one), and primary adrenal hyperplasia (one). In one patient, the cause of CS could not be verified. Three died of sepsis and one due to residual disease and complications of the primary tumor. Conclusions: Despite the advances in early diagnosis and treatment of pediatric CS, a 2.5 % mortality rate was identified in a large cohort of patients with this condition referred to an experienced, tertiary care referral center (although these deaths occurred elsewhere). Pediatricians need to recognize the possibility of death, primarily due to sepsis, in a patient with pediatric CS and treat accordingly. PMID:25241829

Gkourogianni, Alexandra; Lodish, Maya B; Zilbermint, Mihail; Lyssikatos, Charalampos; Belyavskaya, Elena; Keil, Margaret F; Stratakis, Constantine A

2014-09-23

418

Linking uric acid metabolism to diabetic complications  

PubMed Central

Hyperuricemia have been thought to be caused by the ingestion of large amounts of purines, and prevention or treatment of hyperuricemia has intended to prevent gout. Xanthine dehydrogenase/xanthine oxidase (XDH/XO) is rate-limiting enzyme of uric acid generation, and allopurinol was developed as a uric acid (UA) generation inhibitor in the 1950s and has been routinely used for gout prevention since then. Serum UA levels are an important risk factor of disease progression for various diseases, including those related to lifestyle. Recently, other UA generation inhibitors such as febuxostat and topiroxostat were launched. The emergence of these novel medications has promoted new research in the field. Lifestyle-related diseases, such as metabolic syndrome or type 2 diabetes mellitus, often have a common pathological foundation. As such, hyperuricemia is often present among these patients. Many in vitro and animal studies have implicated inflammation and oxidative stress in UA metabolism and vascular injury because XDH/XO act as one of the major source of reactive oxygen species Many studies on UA levels and associated diseases implicate involvement of UA generation in disease onset and/or progression. Interventional studies for UA generation, not UA excretion revealed XDH/XO can be the therapeutic target for vascular injury and renal dysfunction. In this review, the relationship between UA metabolism and diabetic complications is highlighted. PMID:25512781

Kushiyama, Akifumi; Tanaka, Kentaro; Hara, Shigeko; Kawazu, Shoji

2014-01-01

419

Linking uric acid metabolism to diabetic complications.  

PubMed

Hyperuricemia have been thought to be caused by the ingestion of large amounts of purines, and prevention or treatment of hyperuricemia has intended to prevent gout. Xanthine dehydrogenase/xanthine oxidase (XDH/XO) is rate-limiting enzyme of uric acid generation, and allopurinol was developed as a uric acid (UA) generation inhibitor in the 1950s and has been routinely used for gout prevention since then. Serum UA levels are an important risk factor of disease progression for various diseases, including those related to lifestyle. Recently, other UA generation inhibitors such as febuxostat and topiroxostat were launched. The emergence of these novel medications has promoted new research in the field. Lifestyle-related diseases, such as metabolic syndrome or type 2 diabetes mellitus, often have a common pathological foundation. As such, hyperuricemia is often present among these patients. Many in vitro and animal studies have implicated inflammation and oxidative stress in UA metabolism and vascular injury because XDH/XO act as one of the major source of reactive oxygen species Many studies on UA levels and associated diseases implicate involvement of UA generation in disease onset and/or progression. Interventional studies for UA generation, not UA excretion revealed XDH/XO can be the therapeutic target for vascular injury and renal dysfunction. In this review, the relationship between UA metabolism and diabetic complications is highlighted. PMID:25512781

Kushiyama, Akifumi; Tanaka, Kentaro; Hara, Shigeko; Kawazu, Shoji

2014-12-15

420

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

421

Pneumomediastinum is a possible acute complication of severe occupational asthma.  

PubMed

Occupational asthma has been reported to be the most common chronic respiratory occupational disease in many developed countries, and as with other occupational lung diseases, occupational asthma is potentially preventable. We report the case of a 24-year-old baker who experienced pneumomediastinum as a consequence of workplace exposure. This is the first report of pneumomediastinum as an acute complication of occupational asthma, and it exemplarily shows that the lack of medical surveillance at the workplace may lead to an acute, although unusual, complication. PMID:22427480

Pala, Gianni; Pignatti, Patrizia; Moscato, Gianna

2012-03-01

422

Patient factors may predict anastomotic complications after rectal cancer surgery  

PubMed Central

Purpose Anastomotic complications following rectal cancer surgery occur with varying frequency. Preoperative radiation, BMI, and low anastomoses have been implicated as predictors in previous studies, but their definitive role is still under review. The objective of our study was to identify patient and operative factors that may be predictive of anastomotic complications. Methods A retrospective review was performed on patients who had sphincter-preservation surgery performed for rectal cancer at a tertiary medical center between 2005 and 2011. Results 123 patients were included in this study, mean age was 59 (26–86), 58% were male. There were 33 complications in 32 patients (27%). Stenosis was the most frequent complication (24 of 33). 11 patients required mechanical dilatation, and 4 had operative revision of the anastomosis. Leak or pelvic abscess were present in 9 patients (7.3%); 4 were explored, 2 were drained and 3 were managed conservatively. 4 patients had permanent colostomy created due to anastomotic complications. Laparoscopy approach, BMI, age, smoking and tumor distance from anal verge were not significantly associated with anastomotic complications. After a multivariate analysis chemoradiation was significantly associated with overall anastomotic complications (Wall = 0.35, p = 0.05), and hemoglobin levels were associated with anastomotic leak (Wald = 4.09, p = 0.04). Conclusion Our study identifies preoperative anemia as possible risk factor for anastomotic leak and neoadjuvant chemoradiation may lead to increased risk of complications overall. Further prospective studies will help to elucidate these findings as well as identify amenable factors that may decrease risk of anastomotic complications after rectal cancer surgery.

Hayden, Dana M.; Mora Pinzon, Maria C.; Francescatti, Amanda B.; Saclarides, Theodore J.

2014-01-01

423

Infrared Thermal Imaging for Automated Detection of Diabetic Foot Complications  

PubMed Central

Background Although thermal imaging can be a valuable technology in the prevention and management of diabetic foot disease, it is not yet widely used in clinical practice. Technological advancement in infrared imaging increases its application range. The aim was to explore the first steps in the applicability of high-resolution infrared thermal imaging for noninvasive automated detection of signs of diabetic foot disease. Methods The plantar foot surfaces of 15 diabetes patients were imaged with an infrared camera (resolution, 1.2 mm/pixel): 5 patients had no visible signs of foot complications, 5 patients had local complications (e.g., abundant callus or neuropathic ulcer), and 5 patients had diffuse complications (e.g., Charcot foot, infected ulcer, or critical ischemia). Foot temperature was calculated as mean temperature across pixels for the whole foot and for specified regions of interest (ROIs). Results No differences in mean temperature >1.5 °C between the ipsilateral and the contralateral foot were found in patients without complications. In patients with local complications, mean temperatures of the ipsilateral and the contralateral foot were similar, but temperature at the ROI was >2 °C higher compared with the corresponding region in the contralateral foot and to the mean of the whole ipsilateral foot. In patients with diffuse complications, mean temperature differences of >3 °C between ipsilateral and contralateral foot were found. Conclusions With an algorithm based on parameters that can be captured and analyzed with a high-resolution infrared camera and a computer, it is possible to detect signs of diabetic foot disease and to discriminate between no, local, or diffuse diabetic foot complications. As such, an intelligent telemedicine monitoring system for noninvasive automated detection of signs of diabetic foot disease is one step closer. Future studies are essential to confirm and extend these promising early findings. PMID:24124937

van Netten, Jaap J.; van Baal, Jeff G.; Liu, Chanjuan; van der Heijden, Ferdi; Bus, Sicco A.

2013-01-01

424

Off-pump coronary artery surgery in a patient with essential thrombocythaemia: two life-threatening complications in the same patient  

PubMed Central

Essential thrombocythaemia (ET) is a rare chronic myeloproliferative disease characterised by persistent thrombocytosis. Cerebral, myocardial and peripheral thrombosis are frequently seen complications, but bleeding and venous thrombosis are more rare. Here, a case of essential thrombocythaemia complicated by cerebral and myocardial thrombosis is presented. The patient’s platelet count was 680×109/litre on admission. Electrocardiogram showed a slight ST elevation in leads V1 to V4. A coronary angiography was performed and it revealed a severe stenosis of the left anterior descending artery. The patient had a successful off-pump coronary artery bypass grafting surgery. After the operation the platelet count was 390×109/litre. The patient received hydroxyurea and aspirin treatment preoperatively and continued postoperatively. ET is a rare myeloproliferative disease; its complications are also rare, but the occurrence of two life-threatening complications in the same patient is rarer still. Further investigations are needed to determine the risk stratification for patients with ET undergoing cardiac surgery. PMID:21866237

Kaya, Kaan; Cavolli, Raif; Telli, Alpaslan; Tasoz, Refik

2009-01-01

425

Off-pump coronary artery surgery in a patient with essential thrombocythaemia: two life-threatening complications in the same patient.  

PubMed

Essential thrombocythaemia (ET) is a rare chronic myeloproliferative disease characterised by persistent thrombocytosis. Cerebral, myocardial and peripheral thrombosis are frequently seen complications, but bleeding and venous thrombosis are more rare. Here, a case of essential thrombocythaemia complicated by cerebral and myocardial thrombosis is presented. The patient's platelet count was 680×10(9)/litre on admission. Electrocardiogram showed a slight ST elevation in leads V1 to V4. A coronary angiography was performed and it revealed a severe stenosis of the left anterior descending artery. The patient had a successful off-pump coronary artery bypass grafting surgery. After the operation the platelet count was 390×10(9)/litre. The patient received hydroxyurea and aspirin treatment preoperatively and continued postoperatively. ET is a rare myeloproliferative disease; its complications are also rare, but the occurrence of two life-threatening complications in the same patient is rarer still. Further investigations are needed to determine the risk stratification for patients with ET undergoing cardiac surgery. PMID:21866237

Kaya, Kaan; Cavolli, Raif; Telli, Alpaslan; Tasoz, Refik

2009-01-01

426

Imbalance of angiogenesis in diabetic complications: the mechanisms.  

PubMed

Type 2 diabetes mellitus is a complex disease and a chronic health-care problem. Nowadays, because of alteration of lifestyle such as lack of exercise, intake of high fat diet subsequently obesity and aging population, the prevalence of diabetes mellitus is increasing quickly in around the world. The international diabetes federation estimated in 2008, that 246 million adults in worldwide suffered from diabetes mellitus and the prevalence of disease is expected to reach to 380 million by 2025. Although, mainly in management of diabetes focused on hyperglycemia, however, it is documented that abnormalities of angiogenesis may contribute in the pathogenesis of diabetes complications. Angiogenesis is the generation of new blood vessels from pre-existing ones. Normal angiogenesis depends on the intricate balance between angiogenic factors (such as VEGF, FGF(2), TGF-?, angiopoietins) and angiostatic factors (angiostatin, endostatin, thrombospondins). Vascular abnormalities in different tissues including retina and kidney can play a role in pathogenesis of micro-vascular complications of diabetes; also vascular impairment contributes in macrovascular complications e.g., diabetic neuropathy and impaired formation of coronary collaterals. Therefore, identifying of different mechanisms of the diabetic complications can give us an opportunity to prevent and/or treat the following complications and improves quality of life for patients and society. In this review, we studied the mechanisms of angiogenesis in micro-vascular and macro-vascular complications of diabetes mellitus. PMID:23272281

Tahergorabi, Zoya; Khazaei, Majid

2012-12-01

427

Graves' disease as an uncommon cause of acute pericarditis.  

PubMed

Acute pericarditis is either dry, fibrinous or effusive, independent of its aetiology. A case is presented involving a 44-year-old man with acute pericarditis. The cause was established to be an aggravation of Graves' disease due to non-compliance with treatment. Pericarditis is an uncommon cardiac complication of Graves' disease and is associated with more recurrent episodes when not detected. Pharmacological treatment should include anti-inflammatory drugs in combination with treatment for hyperthyroidism. The specific pathophysiological link between the two conditions is still to be elucidated. PMID:24769665

Kortekaas, Kirsten A; Kortekaas, Kirsten; van der Lienden, Bas; Jong, Simone; Riezebos, Robert

2014-01-01

428

Subglottic stenosis as a complication of Wegener's granulomatosis.  

PubMed

Wegener's granulomatosis (WG) is a relatively uncommon collagen vascular disease that can lead to both upper and lower airway disease. Subglottic stenosis is one manifestation of the airway disease and can occur even during the quiescent phase of the disease, independent of an active inflammatory response. A high index of suspicion is necessary for this complication in patients with known WG who complain of dyspnoea, and WG should be high on the differential diagnosis in those found to have "idiopathic" subglottic stenosis. We report the case of a patient who presented with this problem, and we review the prevalence, diagnosis, symptoms, and treatment. PMID:18253680

Blaivas, Allen J; Strauss, Walter; Yudd, Michael

2008-06-01

429

The Orion Nebula: Still Full of Surprises  

NASA Astrophysics Data System (ADS)

This ethereal-looking image of the Orion Nebula was captured using the Wide Field Imager on the MPG/ESO 2.2-metre telescope at the La Silla Observatory, Chile. This nebula is much more than just a pretty face, offering astronomers a close-up view of a massive star-forming region to help advance our understanding of stellar birth and evolution. The data used for this image were selected by Igor Chekalin (Russia), who participated in ESO's Hidden Treasures 2010 astrophotography competition. Igor's composition of the Orion Nebula was the seventh highest ranked entry in the competition, although another of Igor's images was the eventual overall winner. The Orion Nebula, also known as Messier 42, is one of the most easily recognisable and best-studied celestial objects. It is a huge complex of gas and dust where massive stars are forming and is the closest such region to the Earth. The glowing gas is so bright that it can be seen with the unaided eye and is a fascinating sight through a telescope. Despite its familiarity and closeness there is still much to learn about this stellar nursery. It was only in 2007, for instance, that the nebula was shown to be closer to us than previously thought: 1350 light-years, rather than about 1500 light-years. Astronomers have used the Wide Field Imager on the MPG/ESO 2.2-metre telescope at ESO's La Silla Observatory in Chile to observe the stars within Messier 42. They found that the faint red dwarfs in the star cluster associated with the glowing gas radiate much more light than had previously been thought, giving us further insights into this famous object and the stars that it hosts. The data collected for this science project, with no original intention to make a colour image, have now been reused to create the richly detailed picture of Messier 42 shown here. The image is a composite of several exposures taken through a total of five different filters. Light that passed through a red filter as well as light from a filter that shows the glowing hydrogen gas, were coloured red. Light in the yellow-green part of the spectrum is coloured green, blue light is coloured blue and light that passed through an ultraviolet filter has been coloured purple. The exposure times were about 52 minutes through each filter. This image was processed by ESO using the observational data found by Igor Chekalin (Russia) [1], who participated in E