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Predisposing Factors (predisposing + factor)
Kinds of Predisposing Factors Selected AbstractsAcute pseudo-obstruction of the colon (Ogilvie's syndrome) following instrumental vaginal deliveryINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 10 2006A. KAKARLA Summary Acute pseudo-obstruction of the colon (Ogilvie's syndrome) is an adynamic ileus without mechanical obstruction of the bowel. Predisposing factors include: abdominal and pelvic surgery, or trauma, or severe pre-existing systemic illness. In obstetrics, many cases have been reported after caesarean delivery, but none following a vaginal delivery. Conservative and pharmacological therapies are effective in many patients, but surgical intervention may be required. Early diagnosis and appropriate treatment is imperative to avoid caecal rupture, faecal peritonitis and the associated high maternal mortality. High index of clinical suspicion and proper assessment of the gastrointestinal system in the post-surgical patient are vital to the management of this uncommon but potentially serious condition met with in obstetrics practice. [source] Correlates of specific childhood feeding problemsJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2003D Field Objective: The correlates of specific childhood feeding problems are described to further examine possible predisposing factors for feeding problems. We report our experience with 349 participants evaluated by an interdisciplinary feeding team. Methods: A review of records was conducted and each participant was identified as having one or more of five functionally defined feeding problems: food refusal, food selectivity by type, food selectivity by texture, oral motor delays, or dysphagia. The prevalence of predisposing factors for these feeding problems was examined. Predisposing factors included developmental disabilities, gastrointestinal problems, cardiopulmonary problems, neurological problems, renal disease and anatomical anomalies. Results: The frequencies of predisposing factors varied by feeding problem. Differences were found in the prevalence of the five feeding problems among children with three different developmental disabilities: autism, Down syndrome and cerebral palsy. Gastro-oesophageal reflux was the most prevalent condition found among all children in the sample and was the factor most often associated with food refusal. Neurological conditions and anatomical anomalies were highly associated with skill deficits, such as oral motor delays and dysphagia. Conclusions: Specific medical conditions and developmental disabilities are often associated with certain feeding problems. Information concerning predisposing factors of feeding problems can help providers employ appropriate primary, secondary and tertiary prevention measures to decrease the frequency or severity of some feeding problems. [source] Predisposing factors to phlebitis in patients with peripheral intravenous catheters: A descriptive studyJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 4 2008Esin Uslusoy BSN, MS (Research Assistant) Abstract Purpose: The purpose of this study was to investigate the predisposing factors in the development of phlebitis in peripheral intravenous (IV) catheterization sites in patients treated with a variety of IV infusion solutions and drugs. Data sources: Systematic observation of 568 IV sites inserted for fluid infusion and drug administration in 355 patients in the Department of General Surgery of a University Hospital in Turkey. A data collection tool was based on standards established by the Infusion Nurses Society. Patients' infusion sites were monitored every 24 h during treatment and for 48 h after discontinuation of the IV. Conclusions: In contrast to the usual findings in the literature, the authors found that infusion through an infusion pump and insertion of catheters in the veins around the elbow increased the risk of phlebitis. Also, the number of times infusions were started led to an increased rate of phlebitis. However, conflicting results were obtained about the relation between phlebitis, gender, and catheter size. Implications for practice: Phlebitis causes sepsis, pain, additional diagnostic investigations, and treatments, and may lead to increased duration of hospitalization, patient's stress level, and financial burden, as well as increasing staff workload. Advanced practice nurses need to be aware of the factors that increase the likelihood of phlebitis and take appropriate measures to prevent it. [source] Predisposing factors in delayed sleep phase syndromePSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2000Yasuro Takahashi MD Abstract We classified 64 patients with chronic delayed sleep phase syndrome (DSPS) into the primary (n = 53) and secondary (n = 11) group according to presence or absence of such signs as difficulty in waking up which appeared much earlier than the onset of DSPS. The age at the onset of the early signs concentrated in adolescence. The familial occurrence of DSPS was noted in 11 patients of the primary group. In human leukocyte antigen (HLA) typing, the incidence of DR1 positivity alone was significantly higher in DSPS patients than in healthy subjects. Minnesota Multiphasic Personality Inventory revealed high scores on depression, psychoasthenia and hypochondriasis. We suggest that a predisposition to DSPS includes biological, genetic, social and psychological factors, various combinations of which may lead to DSPS. [source] Risk Factors and Long-Term Outcome of Transplant Renal Artery Stenosis in Adult Recipients After Treatment by Percutaneous Transluminal AngioplastyAMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2006V. Audard Transplant renal artery stenosis (TRAS) is a common complication of kidney transplantation but attempts to identify predisposing risk factors for TRAS have yielded conflicting results. In order to determine the predisposing factors for transplant (TRAS), we retrospectively reviewed the records of 29 renal allograft recipients with TRAS treated with percutaneous transluminal angioplasty (PTA). The TRAS group was compared with a case-control group of 58 patients. Predisposing factors for TRAS included CMV infection (41.4% vs. 12.1% p = 0.0018) and initial delayed graft function (DGF) (48.3% vs. 15.5% p = 0.0018), respectively in the TRAS and the control group. Acute rejection occurred more frequently in patients from the TRAS group (48.3%) compared with the control group (27.6%), although the difference was not significant (p = 0.06). In a multivariate analysis, only CMV infection (p = 0.005) and DGF (p = 0.009) appear to be significantly and independently associated with TRAS. The long-term graft survival was significantly higher in the control group, compared with the TRAS group (p = 0.03). Our study suggests that CMV infection and DGF are two reliable risk factors for TRAS. Despite treatment by PTA with primary successful results, TRAS significantly affects long-term graft outcome. [source] Onychomycosis in clinical practice: factors contributing to recurrenceBRITISH JOURNAL OF DERMATOLOGY, Issue 2003R.K. Scher Summary The treatment of onychomycosis has improved in recent years and many patients can now expect a complete and lasting cure. However, for up to 25% of patients, persistent disease remains a problem, thus presenting a particular challenge to the clinician. For these patients, it is obviously important to ensure that a correct diagnosis of onychomycosis has been made, as misdiagnosis will inevitably jeopardize the perception of therapeutic effectiveness. Although onychomycosis accounts for about 50% of all nail diseases seen by physicians, nonfungal causes of similar symptoms include repeated trauma, psoriasis, lichen planus, local tumours vascular disorders and inflammatory diseases. Predisposing factors that contribute to a poor response to topical and/or oral therapy include the presence of a very thick nail, extensive involvement of the entire nail unit, lateral nail disease and yellow spikes. However, poor penetration of systemic agents to the centre of infection, or the inability of topical agents to diffuse between the surface of the nail plate and the active disease below, probably contributes to this. Other factors contributing to recurrence may be related to the patient's family history, occupation, lifestyle or underlying physiology. In addition, patients with concomitant disease (e.g. peripheral vascular disease, diabetes) or patients who are immunosuppressed (e.g. those with human immunodeficiency virus/acquired immunodeficiency syndrome) are more susceptible to onychomycosis. In the elderly, the prevalence of onychomycosis may be as high as 60%, and increases with age; in this population, physical trauma plays a major role in precipitating recurrence, especially in patients with faulty biomechanics due to underlying arthritis and bone abnormalities. It is also possible that recurrence in some cases is due to early termination of treatment or use of an inappropriate dose, and these possibilities should be eliminated before further investigations are undertaken. ,There is good evidence to suggest that a combination of oral and topical therapies, when given at the same time, yield excellent clinical outcomes, although there remains a need for more effective topical agents with greater nail penetration and more effective oral antifungal agents. [source] Brain abscess in children , epidemiology, predisposing factors and management in the modern medicine eraACTA PAEDIATRICA, Issue 8 2010Y Shachor-Meyouhas Abstract Aims:, Brain abscess is rare in children. Predisposing factors are found in almost 85% of cases. Overall, 25% of brain abscesses develop in children, mostly in the 4,7 years age group. Our study aimed to characterize children with brain abscesses treated in our hospital, identify risk factors, pathogens and short-term outcome. Methods:, A retrospective cohort of 20 years period, (1989,2009) included 27children (0,18 years). Medical records were analysed for age, gender, presenting symptoms and signs, predisposing factors, laboratory tests, imaging, microbiology results, treatment and outcome. Results:, Of all the children, 63% (17/27) were male patients; mean age was 7.9 years and 52% were referred from other hospitals. Predisposing factors were identified in 81%, congenital heart disease and otitis were rare and sinusitis was found in 22% of the children. Main symptoms and signs included headaches, fever, neurological signs convulsions, (41%, 81%, 78% and 41% respectively). In 30% of cases, cultures were sterile. All patients were operated in addition to antibiotic treatment. Outcome was good with low mortality rate (3.7%). Conclusions:, Manifestations of brain abscess may be subtle. A high index of suspicion and early imaging are warranted, different predisposing factors may reflect early intervention for congenital heart diseases. Mortality is rare in the modern medicine era. [source] Potential role of colour-Doppler cystosonography with echocontrast in the screening and follow-up of vesicoureteral refluxACTA PAEDIATRICA, Issue 11 2000G Ascenti Primary vesicoureteral reflux is a predisposing factor for urinary tract infections in children. The first-choice technique for the diagnosis of vesicoureteral reflux is voiding cystourethrography, followed by cystoscintigraphy; cystoscintigraphy, however, has the advantage of only minor irradiation of the patient, but it does not allow the morphological evaluation of bladder and vesicoureteral reflux grading. Colour-Doppler cystosonography with echocontrast is a recently introduced method for imaging vesicoureteral reflux. The aim of our study is to evaluate the role of colour-Doppler cystosonography with echocontrast in the diagnosis of vesicoureteral reflux. Twenty children (11M, 9F) aged between 0.4 and 4.9 y underwent colour-Doppler cystosonography using a diluted solution of Levovist® (Schering, Germany), after filling up the bladder with saline. In all patients, vesicoureteral reflux diagnosis and grading had been performed previously by voiding cystourethrography within 5 d from ultrasonography. Our data showed high accuracy in the detection of medium to severe vesicoureteral reflux (grades III-V), confirmed by radiological features in 9/9 patients. Conversely, in the 11 patients with mild vesicoureteral reflux (grades I-II), this technique showed extremely low sensitivity, allowing diagnosis in only four cases. Conclusions: Colour-Doppler cystosonography, because of the absence of ionizing radiations, has great advantages, particularly in patients needing prolonged monitoring. Despite experiences reported in the literature, this technique has a role in the diagnosis of vesicoureteral reflux. Our group chooses colour-Doppler cystosonography for the follow-up of medium-severe grade vesicoureteral reflux already diagnosed by radiology and/or scintigraphy. Cystoscintigraphy is employed only to confirm cases resulting negative at ultrasonography. [source] Depressive symptoms predispose females to metabolic syndrome: a 7-year follow-up studyACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2009M. Vanhala Objective:, To evaluate the risk for developing metabolic syndrome when having depressive symptoms. Method:, The prevalence of depressive symptoms and metabolic syndrome at baseline, and after a 7-year follow-up as measured with Beck depression inventory (BDI), and using the modified National Cholesterol Education Program , Adult Treatment Panel III criteria for metabolic syndrome (MetS) were studied in a middle-aged population-based sample (n = 1294). Results:, The logistic regression analysis showed a 2.5-fold risk (95% CI: 1.2,5.2) for the females with depressive symptoms (BDI ,10) at baseline to have MetS at the end of the follow-up. The risk was highest in the subgroup with more melancholic symptoms evaluated with a summary score of the melancholic items in BDI (OR 6.81, 95% CI: 2.09,22.20). In men, there was no risk difference. Conclusion:, The higher risks for MetS in females with depressive symptoms at baseline suggest that depression may be an important predisposing factor for the development of MetS. [source] Epileptic Seizures Superimposed on Catatonic StuporEPILEPSIA, Issue 4 2006Kazumasa Suzuki Summary:,Purpose: Some patients with nonconvulsive status epilepticus are known to exhibit catatonic stupor. Thus it is necessary to rule out ictal catatonia by electroencephalography in patients with catatonic stupor. However, few reports are available on epileptic seizures superimposed on catatonic stupor. Methods: We report three cases of epileptic seizures superimposed on psychiatric catatonic stupor without a prominent predisposing factor, including high fever or encephalitis. None of the patients had a personal or family history of neurologic disease, including epilepsy. Results: In all three patients, catatonic stupor persisted after resolution of the epileptic seizures with administration of phenytoin. In two of the three patients, catatonic stupor resolved with electroconvulsive therapy, which caused no marked adverse effects. Conclusions: Because it is possible that catatonic stupor itself predisposes patients to the development of epileptic seizures, electroencephalographic examinations in patients with catatonic stupor are indispensable for early recognition not only of nonconvulsive status epilepticus but also of epileptic seizures superimposed on catatonic stupor. Electroconvulsive therapy deserves consideration when catatonic stupor persists after resolution of epileptic seizures. [source] Severe hypertriglyceridaemia in clinically ill horses: diagnosis, treatment and outcomeEQUINE VETERINARY JOURNAL, Issue 6 2003B. DUNKEL Summary Reasons for performing study: Sporadic measurement of serum triglycerides in depressed and inappetant clinically ill horses revealed severe hypertriglyceridaemia without visible evidence of lipaemia on several occasions, leading to the inclusion of serum triglyceride concentrations in the routine serum biochemistry evaluation of our hospital. Since then, more cases have been identified and treated for hypertriglyceridaemia, raising questions about the prevalence, predisposing factors and significance of these findings. Hypotheses: 1) Severe hypertriglyceridaemia without visible opacity of the serum occurs more commonly in clinically ill and inappetant horses than previously described and 2) appropriate treatment using i.v. dextrose and/or partial parenteral nutrition would decrease serum triglycerides to normal limits and might result in improved appetite and attitude of the patient. Methods: The laboratory computer database from 2000 and 2001 was searched for increased serum triglycerides (>5.65 mmol/l) in any horse breed, ponies and miniature breeds excluded. Data analysed included subject details, diagnosis, clinical and laboratory parameters, treatment, response to treatment and outcome. Results: Severe hypertriglyceridaemia was identified in 13 horses, with serum triglyceride concentrations 6.17,18.29 mmol/l, while none showed visible lipaemia. All horses had clinical and laboratory findings consistent with systemic inflammatory response syndrome and all but one had an increased serum creatinine concentration. Treatment with i.v. dextrose and/or partial parenteral nutrition resulted in decrease of the serum triglycerides to normal limits. Conclusions: Severe hypertriglyceridaemia occurs in inappetant and clinically ill horses without evidence of serum opacity more commonly than previously described. The presence of systemic inflammatory response syndrome might predispose horses to hypertriglyceridaemia, while the increased creatinine concentration might be a predisposing factor or result of the condition. Horses identified in our study readily responded to treatment and appetite and attitude improved coincident with decrease of the serum triglycerides to normal limits. Potential relevance: Hypertriglyceridaemia could perpetuate inappetance and depression in clinically ill horses and potentially predispose to fatty infiltration of the liver and other organ systems. [source] Early diagnosis of rhinocerebral mucormycosis by cerebrospinal fluid analysis and determination of 16s rRNA gene sequenceEUROPEAN JOURNAL OF NEUROLOGY, Issue 9 2007D. Bengel A 40-year-old diabetic woman was diagnosed with rhinocerebral mucormycosis. Cerebral mucormycosis is an acute life-threatening disease, which is caused by fungi of the class Phycomycetae. Clinical suspicion and detection of the fungal hyphae in cerebrospinal fluid (CSF) led to early diagnosis, subsequently confirmed by immunohistochemistry and molecular analysis of fungal RNA. Early infiltration of the infectious agent into the central nervous system resulted in septic thrombosis of the cavernous sinus, mycotic meningoencephalitis, brain infarctions as well as intracerebral and subarachnoidal hemorrhages. Despite immediate high-dose antimycotic treatment, surgical debridement of necrotic tissue, and control of diabetes as a predisposing factor, the woman died 2 weeks after admission. Although fungal organisms are rarely detectable in CSF specimens from patients with mycotic infections of the central nervous system, comprehensive CSF examination is beneficial in the diagnosis of rhinocerebral mucormycosis. Furthermore, a concerted team approach, systemic antifungal agents and early surgical intervention seem to be crucial for preventing rapid disease progression. [source] Pine mistletoe (Viscum album ssp. austriacum) contributes to Scots pine (Pinus sylvestris) mortality in the Rhone valley of SwitzerlandFOREST PATHOLOGY, Issue 5 2006M. Dobbertin Summary In recent years unusual high mortality of Scots pine (Pinus sylvestris) has been observed in the Swiss Rhone Valley. The exact causes, however, are not known. At a 2-ha monitoring plot, tree mortality and crown condition have been monitored since 1996. Between 1996 and 2004, 59% of the Scots pines died, most of them following the drought periods 1996,1998 and 2003,2004, while only 15% of the deciduous trees died. Crown transparency, needle discolouration, dead branch percentage, mistletoe (Viscum album ssp. austriacum) rating, Tomicus sp. shoot feeding, male flowering effect, tree stem diameter, crown shading and social tree class assessed in 1998 were used in a logistic regression model to predict tree mortality. Crown transparency, mistletoe rating and percentage of dead branches were found significant in the model and the probability of tree mortality increased with increasing rankings of these parameters. Needle discolouration could be used to substitute ,dead branch percentage' as predictor. While crown transparency increased with mistletoe rating, for trees in the same transparency class, trees with medium and heavy mistletoe infection were two to four times more likely to die than trees with no or only low mistletoe infection. For the surviving trees we found that trees with mistletoes showed a significantly higher increase in transparency in the year following a drought than trees without, while in a drought year the opposite was true. At the beginning of the observations no significant differences in transparency had been found between the trees with and without mistletoe. However, by the end of the observation period trees with mistletoe had significantly higher crown transparency. We conclude that mistletoe infection can be considered as both a predisposing factor for tree death, by increasing needle loss following drought and a contributing factor by increasing water stress during drought. Résumé Une forte mortalité des pins sylvestres (Pinus sylvestris) a été observée ces dernières années dans la vallée du Rhône en Suisse. Les causes exactes n'en sont pas connues. La mortalité des arbres et l'état des houppiers ont été suivis depuis 1996 dans une parcelle de 2 ha. Entre 1996 et 2004, 59% des pins sylvestres sont morts, la plupart après les périodes de sécheresse de 1996,98 et 2003,2004, comparéà 15% pour les feuillus. La transparence des houppiers, le jaunissement des aiguilles, le pourcentage de mortalité de branches, une note d'importance du gui (Viscum album ssp. austriacum), les attaques d'alimentation sur pousses par Tomicus sp., la floraison mâle, le diamètre du tronc, l'ombrage du houppier et le statut social des arbres, mesurés en 1998, ont été utilisés dans un modèle de régression logistique pour prédire la mortalité des arbres. La transparence des houppiers, le taux de gui et le pourcentage de branches mortes sont des variables significatives, dont l'augmentation est associée à une augmentation de la probabilité de mortalité des arbres. Le jaunissement des aiguilles pourrait être substituée à la mortalité des branches comme variable prédictrice. Tandis que la transparence des houppiers augmente avec le taux de gui, au sein de la même classe de transparence, les arbres avec une infestation de gui moyenne à forte ont une probabilité de mortalité 2 à 4 fois plus élevée que les arbres à infestation faible ou nulle. Chez les arbres survivants, on observe que les arbres porteurs de gui ont une augmentation plus forte de la transparence du houppier l'année suivant une sécheresse que les arbres sans gui, l'inverse étant vrai pendant une année sèche. La différence de transparence des houppiers entre arbres porteurs de gui et arbres sans gui n'était pas significative au début des observations, alors qu'à la fin de la période, les arbres avec gui ont une transparence plus forte. Nous concluons que l'infestation par le gui peut être considérée à la fois comme un facteur prédisposant à la mortalité, en augmentant la perte d'aiguilles après sécheresse, et un facteur contribuant, en augmentant le stress hydrique pendant la sécheresse. Zusammenfassung Seit einigen Jahren werden im Schweizer Rhonetal hohe Absterberaten der gemeinen Kiefer (Pinus sylvestris L.) beobachtet. Die genauen Ursachen sind bis jetzt unbekannt. Auf der zwei Hektar grossen langfristigen Waldökosystemfläche (LWF) Visp werden seit 1996 jährlich Absterberaten, Kronenverlichtung, Mistelbefall (Viscum album ssp. austriacum) und andere Symptome aufgenommen. Zwischen 1996 und 2004 sind 59% aller Föhren auf der Fläche abgestorben, die meisten nach den Trockenperioden 1996,98 und 2003,2004. Dagegen starben nur 15% der Laubbäume ab. Kronenverlichtung, Nadelverfärbung, Totast- und Totzweiganteil (als Indikatoren der Vitalität des Baumes), Mistelbefallsklasse, Triebabwurf durch Waldgärtner, männliche Blütenbildung, Stammdurchmesser, Kronenkonkurrenz und soziale Stellung, alle im Jahr 1998 erhoben, wurden in einer logistischen Regression zur Bestimmung der Absterbewahrscheinlichkeit auf Signifikanz getestet. Kronenverlichtung, Mistelbefallsklasse und Totastanteil waren in dem Model signifikant. Die Wahrscheinlichkeit des Absterbens stieg dabei mit ansteigender Kronenverlichtung, ansteigendem Mistelbefall und ansteigendem Totastanteil. Der Totastanteil konnte im Model durch die Nadelverfärbung ersetzt werden. Die Kronenverlichtung stieg mit dem Mistelbefall an. Bei gleicher Verlichtung starben jedoch Bäume mit mittlerem und starkem Mistelbefall zwei- bis viermal häufiger ab als Bäume ohne oder mit leichtem Mistelbefall. Von den überlebenden Bäumen zeigten solche mit Mistelbefall einen deutlichen Anstieg der Transparenz im Jahr nach Beginn der Trockenheit im Vergleich zu den Bäumen ohne Misteln, während im Jahr der Trockenheit das Umgekehrte der Fall war. Zu Beginn der Beobachtung ergaben sich keine signifikanten Unterschiede in der Kronentransparenz der überlebenden Bäume mit und ohne Misteln. Am Ende der Beobachtungsperiode wiesen jedoch die Bäume mit Misteln signifikant höhere Kronenverlichtungen auf. Wir schliessen daraus, dass die Misteln auf der einen Seite den Baum langfristig schwächen, indem sie zur Reduzierung der Nadelmasse führen und sie auf der anderen Seite während Trockenheit durch erhöhten Wasserstress zum vorzeitigen Absterben beitragen. [source] Genomic analysis of Barrett's esophagus after ablative therapy: Persistence of genetic alterations at tumor suppressor lociINTERNATIONAL JOURNAL OF CANCER, Issue 1 2006Mariska Hage Abstract Barrett's esophagus (BE) is a major predisposing factor for the development of esophageal adenocarcinoma. Current strategies for treatment of BE, both dysplastic and nondysplastic, include photodynamic therapy (PDT) and argon plasma coagulation (APC). However, the effect of ablative therapy at the genetic level is unclear. We performed loss of heterozygosity (LOH) analysis of BE in baseline and follow-up biopsy specimens from 21 patients with BE (17 male, 4 female) treated with PDT and/or APC. At baseline, 14 patients had intestinal metaplasia without dysplasia (MET), 4 low-grade dysplasia (LGD) and 3 high-grade dysplasia (HGD). LOH was assessed using a panel of 9 polymorphic markers for evaluation of the P53 gene on 17p, P16 on 9p, DCC and SMAD4 on 18q and the APC gene on 5q. The tissue specimens obtained at baseline (t = 0) were analysed, as well as the first (t = 1; mean interval: 4 months) and last (t = 2; mean interval: 8 months) available biopsy with residual or recurrent BE after ablation. At t = 0, allelic loss was detected of 5q in 27%, 9p in 56%, 17p in 31% and 18q in 6% of informative cases. At t = 1 (18 patients with persistent MET and 3 with LGD) and at t = 2 (8 MET, 2 LGD), the LOH patterns were not statistically different from t = 0. Further, multiple genetic lineages before and after therapy were detected in 15 cases illustrating the multiclonal nature of BE. We conclude that recurrent and/or persistent BE after ablative therapy still contains genetic alterations associated with malignant progression to cancer. Therefore, the goal of treatment should be the complete elimination of Barrett's mucosa. © 2005 Wiley-Liss, Inc. [source] Palaeopathological and palaeogenetic study of 13 cases of developmental dysplasia of the hip with dislocation in a historical population from southern FranceINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 1 2007B. Mafart Abstract Dislocation of the hip can be consecutive to developmental dysplasia of the hip that is linked to a complex set of genetic and mechanical factors. The purpose of this report is to describe 13 cases of complete dysplastic hip dislocation observed in the skeletal remains of nine women exhumed from an historical gravesite dating from the 5th to 17th centuries in southern France. Despite the size of this palaeopathological series, which is the largest study published to date, findings indicate that the prevalence of hip dislocation in this historical sample was still lower than in some French areas at the beginning of the 20th century. Mitochondrial DNA sequencing demonstrated possible kinship only between two women, i.e. one who died in the period from the 11th to 13th centuries and another who died in the period from the 16th to 17th centuries. It is suggested that the tight swaddling of young infants in France up to the end of the 19th century could have been a predisposing factor for this highly debilitating disorder. Copyright © 2006 John Wiley & Sons, Ltd. [source] Does the capacity for energy utilization affect the survival of post-smolt Atlantic salmon, Salmo salar L., during natural outbreaks of infectious pancreatic necrosis?JOURNAL OF FISH DISEASES, Issue 7 2007K-A Rørvik Abstract If osmotic stress and reduced seawater tolerance are predisposing factors for infectious pancreatic necrosis (IPN) outbreaks in farmed Atlantic salmon, increased survival by enhancing access to energy would be expected. The aim of the present study was, therefore, to increase energy access in 1-year old Atlantic salmon after sea transfer by increasing the level of dietary fat, by exchanging some of the dietary oil with more easily oxidized medium chain triacylglycerols, or by dietary supplementation of potentially energy enhancing additives such as clofibrate and tetradecylthioacetic acid (TTA). A natural outbreak of IPN occurred 8 weeks after sea transfer, and a significant dietary effect explaining 76% of the variation in mortality was observed. Relative percentage survival for the fish fed TTA in sea water was 70% when compared with the unsupplemented control, reducing mortality from 7.8 to 2.3%. Muscle fat content and plasma chloride were related to IPN mortality, suggesting that reduced hypoosmoregulatory capacity might be a predisposing factor to the onset of an IPN outbreak. Based on the observation of a threefold increase in white muscle mitochondrial fatty acid oxidizing activity by TTA, it is suggested that TTA has resulted in a re-allocation of dietary fatty acids from storage to energy producing oxidation. [source] Clinical characteristics of perforated pyometra and impending perforation: Specific issues in gynecological emergencyJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 3 2010Yu-Che Ou Abstract Objective:, To evaluate the clinical characteristics of pyometra and the differences between perforated pyometra and early-drained pyometra in order to prevent morbidity. Material and Methods:, Retrospective study of 14 patients diagnosed between 1998 and 2008 with early-drainage pyometra and six patients with perforated pyometra were included. In addition, a review of the literature yielded another 30 perforated pyometra cases for comparison. Results:, Of 20 women with pyometra, the main presented symptoms at admission were abdominal pain (80%), fever (45%) and vaginal discharge (25%). The majority of organisms isolated were Bacteroides fragilis (seven cases), Streptococcus species (six cases) and Escherichia coli (five cases). Of the 36 cases with spontaneous uterine perforation to date, 35 cases (97%) had abdominal pain, 11 cases (31%) had fever, and 10 cases (27%) had vomiting. Hypoalbuminemia was found in seven patients (five cases in the perforation group and two cases in the drainage group). Conclusion:, Early diagnosis of pyometra before perforation can avoid surgical exploration and decrease morbidity and mortality. Perforated pyometra should be considered as a differential diagnosis in women with pneumoperitoneum and fever. Hypoalbuminemia should be considered as a predisposing factor for pyometra perforation. [source] A fatal case of cutaneous zygomycosis in a patient with severe metabolic acidosisMYCOSES, Issue 4 2009C. Kosmidis Summary We present a case of cutaneous zygomycosis in a patient with an ureteroileostomy and severe metabolic acidosis, but without diabetes. The patient died despite multiple aggressive surgical interventions and antifungal therapy with liposomal amphotericin B. Ureteroileostomy-related acidosis can be a predisposing factor for zygomycosis. Metabolic acidosis can have a role in the severity of cutaneous disease. [source] Differential diagnosis of denture-induced stomatitis, Candida, and their variations in patients using complete denture: a clinical and mycological studyMYCOSES, Issue 3 2009Saadettin Da, istan Summary Denture-induced stomatitis usually occurs in persons who wear a complete or a partial denture. Among the many aetiological and predisposing factors, Candida spp. are believed to play an important role in the initiation and progression of the infection. Seventy cases who attended the clinics of the Dental Faculty, University of Atatürk, Turkey were investigated from the viewpoint of denture-induced stomatitis. After questioning the patients for their personal information, they were examined clinically and smears were obtained from lesions of the palatal mucosa and the contiguous denture surface by calcium aliginate swabs, and inoculated onto Sabouraud dextrose agar supplemented with 1% chloramphenicol, and CHROMagar Candida. Individual yeast species were identified by a germ tube test, development of blastospores, chlamydospores and pseudohyphae and assimilation tests employing the commercial kit API 20C AUX system. According to the results obtained, 70% of the cases had denture-induced stomatitis, and in 68% of them mycological culture results were positive. Candida albicans was the most frequently isolated fungus (68.75%). On the other hand, fungal growth was much more pronounced in the cultures made from the inner surface of the dentures. In conclusion, this study showed that candidal infections are not the predisposing factor in the occurrence of denture-induced stomatitis, but they play a major role, as also some other factors, especially those related with dentures. [source] Is there an experimental basis for the development of ischaemic colitis as a result of 5-HT3 antagonist treatment?NEUROGASTROENTEROLOGY & MOTILITY, Issue 2 2007M. Camilleri Abstract, 5-HT3 antagonists are effective treatments for chemotherapy-induced emesis and diarrhoea and urgency and pain associated with irritable bowel syndrome. Reports of ischaemic colitis led to restricted use of the approved drug, alosetron. This article briefly reviews the controversial information from epidemiology and adverse reaction reports and addresses the experimental basis for the development of ischaemic colitis as a result of 5-HT3 antagonist treatment. The author reviews the potential factors based involved in the ischaemic colitis and ways in which this class of compound may influence those factors based on experimental evidence, including the literature on any vascular effects of these agents. Finally, the article addresses the theoretical basis for the constipation as a predisposing factor for the development of ischaemic colitis. The evidence reviewed suggests that further studies are needed to explore the principles to prove or disprove the association. [source] Biology, clinical characteristics, and management of adrenocortical tumors in childrenPEDIATRIC BLOOD & CANCER, Issue 3 2005Carlos Rodriguez-Galindo MD Abstract Childhood adrenocortical tumors (ACT) are very aggressive endocrine neoplasms whose incidence is quite low. Little is known about their pathogenesis, clinical presentation, and optimal treatment. In recent years, however, new information has been derived from the International Pediatric Adrenocortical Tumor Registry (IPACTR), and new clues to its pathogenesis have emerged. To provide an overview of the available data that may apply to pediatric ACT, we reviewed the epidemiology, pathogenesis, and treatment of ACT in adults and in children. Germline TP53 mutation is almost always the predisposing factor in childhood ACT. A unique germline mutation (TP53,R337H) has been described in Southern Brazil, where the incidence of ACT is 10,15 times the general incidence. Childhood ACT typically present during the first 5 years of life and has female predominance. Hormone hyperproduction is almost universal, and most patients present with virilization. Two-thirds of patients have resectable tumors. Surgery is the definitive treatment for ACT, and a curative complete resection should always be attempted. Cisplatin-based chemotherapy with mitotane is indicated for unresectable or metastatic disease, although its impact on overall outcome is slight. In childhood ACT, age, tumor size, and tumor resectability are the most important prognostic indicators. Outcome is stage-dependent; patients with small, resectable tumors have survival rates in excess of 80%, whereas the outcome for patients with unresectable disease is dismal. Patients with large, resectable tumors have an intermediate outcome. Childhood ACT are rare, but their unique epidemiology appear to implicate novel oncogenic pathways that are unique to the pediatric population. Multi-institutional and prospective studies are necessary to further our understanding of the pathogenesis and to improve outcomes. © 2005 Wiley-Liss, Inc. [source] ORIGINAL ARTICLE: PTPN22 C1858T Polymorphism in Women with EndometriosisAMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 3 2010Fabiane M. C. S. Gomes Citation Gomes FMCS, Bianco B, Teles JS, Christofolini DM, de Souza AMB, Guedes AD, Barbosa CP. PTPN22 C1858T polymorphismin women with endometriosis. Am J Reprod Immunol 2010; 63: 227,232 Problem, Endometriosis has been suggested to be an autoimmune disease and recently, an allelic variation of the PTPN22 (C1858T) gene was revealed to be associated with the development of autoimmunity. The aim of the study was to determine the frequency of the PTPN22 (C1858T) polymorphism in Brazilian women with endometriosis as compared with controls. Method of study, Case,control study included 140 women with endometriosis and a control group consisting of 180 healthy fertile women without a history of endometriosis and/or autoimmune diseases from the ABC School of Medicine. The PTPN22 (C1858T) polymorphism was studied by restriction fragment length polymorphism polymerase chain reaction (RFLP-PCR). Results, Genotypes CC, CT and TT of PTPN22 polymorphism presented frequencies of 67.9, 30.0 and 2.1% in the women with endometriosis (P = 0.008); 76.2, 19.0 and 4.8% in women with minimal/mild endometriosis (P = 0.173); 61.0, 39.0 and 0.0% in women with moderate/severe endometriosis (P , 0.001) and 82.8, 16.1 and 1.1% in control group. Allele C and T were present in 82.9 and 17.1%; 85.7 and 14.3%; 80.5 and 19.5%; and 90.8 and 9.2% respectively, in women with endometriosis (P = 0.004), women with minimal/mild endometriosis (P = 0.148), women with moderate/severe endometriosis (P = 0.002) and control group. Conclusion, The data suggest that in Brazilian women polymorphism PTPN22 (C1858T) may be an important genetic predisposing factor for endometriosis, especially, in advanced disease. [source] The 423Q polymorphism of the X-linked inhibitor of apoptosis gene influences monocyte function and is associated with periodic feverARTHRITIS & RHEUMATISM, Issue 11 2009Massimo Ferretti Objective Hereditary periodic fever syndromes (HPFs) develop as a result of uncontrolled activation of the inflammatory response, with a substantial contribution from interleukin-1, or tumor necrosis factor , (TNF,). The HPFs include familial Mediterranean fever (FMF), hyperimmunoglobulinemia D with periodic fever syndrome (HIDS), TNF receptor,associated syndrome (TRAPS), and cryopyrinopathies, which are attributable to mutations of the MEFV, MVK, TNFRSF1A, and CIAS1 genes, respectively. However, in many patients, the mutated gene has not been determined; therefore, the condition in these patients with an HPF-like clinical picture is referred to as idiopathic periodic fever (IPF). The aim of this study was to assess involvement of X-linked inhibitor of apoptosis (XIAP), which plays a role in caspase inhibition and NF-,B signaling, both of which are processes that influence the development of inflammatory cells. Methods The XIAP gene (X-linked) was sequenced in 87 patients with IPF, 46 patients with HPF (13 with HIDS, 17 with TRAPS, and 16 with FMF), and 182 healthy control subjects. The expression of different alleles was evaluated by sequencing XIAP -specific complementary DNA mini-libraries and by real-time polymerase chain reaction and Western blot analyses. The functional effect of XIAP on caspase 9 activity was assessed by a fluorimetric assay, and cytokine secretion was evaluated by enzyme-linked immunosorbent assay. Results Sequencing disclosed a 1268A>C variation that caused a Q423P amino acid substitution. The frequency of 423Q-homozygous female patients and 423Q-hemizygous male patients was significantly higher in the IPF group than in the control group (69% versus 51%; odds ratio 2.17, 95% confidence interval 1.23,3.87, P = 0.007), whereas no significant difference was detected in the HPF group (59%) compared with controls. In primary lymphocytes and transfected cell lines, 423Q, as compared with 423P, was associated with higher XIAP protein and messenger RNA expression and lower caspase 9 activation. In lipopolysaccharide-activated monocytes, 423Q was associated with higher secretion of TNF,. Conclusion These results suggest that 423Q is a predisposing factor for IPF development, possibly through its influence on monocyte function. [source] Single-institution experience with primary tumours of the male urethraBJU INTERNATIONAL, Issue 8 2008Rolf Gillitzer OBJECTIVE To assess primary tumours of the urethra in males. PATIENTS AND METHODS We retrospectively reviewed our database from 1986 to 2006 for primary tumours of the male urethra; nine patients with primary tumours of the urethra were analysed and follow-up information was obtained. RESULTS Three patients had tumours of the prostatic urethra, two of which had proliferating focal inflammation and one a low-grade, superficial urothelial cancer. All patients were treated successfully with transurethral resection. Six patients had carcinoma of the bulbar or penile urethra, including two with previous local percutaneous radiotherapy for prostate cancer. All had primary surgical excision that was adapted to tumour location and extension. One patient had adjuvant chemotherapy after surgery. All but one patient remain recurrence-free after a median follow-up of 20 months. CONCLUSION Primary carcinoma of the male urethra is a rare entity. Previous radiotherapy might be a predisposing factor. Local surgical tumour control is essential for long-term survival, but the extent of surgery depends on tumour location and stage. Multimodal therapy might be required to obtain an optimum oncological outcome. [source] Meningothelial Hyperplasia: A Detailed Clinicopathologic, Immunohistochemical and Genetic Study of 11 CasesBRAIN PATHOLOGY, Issue 2 2005Arie Perry MD Meningothelial hyperplasia is a poorly characterized entity, often associated with advanced age, chronic renal failure, trauma, hemorrhage, and neoplasia. In order to elucidate the nature of this lesion, 11 cases defined by the presence of nests of 10 or more cell layers thick, were compared with normal arachnoidal cap cells and meningiomas. Immunohistochemistry and FISH were performed to determine NF2 (merlin), protein 4.1 B, EMA, progesterone receptor (PR), EGFR, survivin, VEGF, PDGF-BB, PDGFR,, E-cadherin, and cathepsin D status. All cases had at least one putative predisposing factor, including hemorrhage (7), chronic renal disease (5), old age (5), trauma (1), and an adjacent optic nerve pilocytic astrocytoma (1). There was typically a discontinuous growth pattern, with no invasion of surrounding normal tissue. No gene deletions were found, though scattered polyploid cells were seen in 2 cases. The immunoprofile was similar to normal cap cells with one exception; whereas normal cells were uniformly negative for PR, nuclear positivity was seen in 64% of hyperplasias, a frequency similar to that of benign meningiomas. Our data suggest that meningothelial hyperplasia is a reactive process that is usually distinguishable from meningioma based on clinicopathologic and genetic features. It may be preneoplastic in some, though further studies are needed to test this hypothesis. SUMMARY Based on our data and that of others, we conclude that meningothelial hyperplasia is a reactive process characterized by a proliferation of arachnoidal cap cells that is often non-invasive, multicentric, and at least focally reaches a thickness of 10 or more cell layers. Florid examples are often difficult to distinguish from meningioma. However, they are commonly associated with inciting factors, such as chronic renal disease, hemorrhage, trauma, intracranial hypotension, and neoplasia, particularly optic pathway gliomas. Although meningothelial hyperplasia shares many immunohistochemical and genetic features with normal cap cells, it differs in terms of its frequent PR immunoreactivity and occasional polyploid cells. In contrast to classic meningiomas, there is no evidence for either NF2 or 4.1 B gene deletions by FISH or merlin or protein 4.1 B losses of expression by immunohistochemistry. The data suggest that meningothelial hyperplasia may represent a preneoplastic lesion in some cases, although additional studies are needed to rigorously test this hypothesis. [source] Stress, norepinephrine and depressionACTA NEUROPSYCHIATRICA, Issue 4 2002Brian E. Leonard Experimental and clinical evidence implicates stress as a major predisposing factor in depression and other severe psychiatric disorders. In this review, evidence is presented to show how the impact of stress on the central sympathetic system leads to changes in the endocrine, immune and neurotransmitter axes which underlie the main clinical symptoms of depression. Thus it can be shown that the noradrenergic system is dysfunctional in depression, a situation which reflects the chronic hypersecretion of glucocorticoids and inflammatory mediators within the brain in addition to an enhanced activity of the locus ceruleus. With regard to the actions of antidepressants in modulating the stress response and alleviating depression it is now evident that, irrespective of the presumed specificity of the antidepressants for the noradrenergic or serotonergic systems, they all normalize noradrenergic function. This action is due partly to the regulation of tyrosine hydroxylase activity in the locus ceruleus but also enhances neuronal sprouting which counteracts the neurodegenerative effects of chronic stress. [source] Contact lens induced keratitis associated with contact lens wearACTA OPHTHALMOLOGICA, Issue 5 2001Irene Dejaco-Ruhswurm ABSTRACT. Purpose: To evaluate clinical characteristics, risk factors, management and outcome of contact lens induced keratitis (CLIK) associated with contact lens wear. Methods: The study comprised all consecutive patients presenting with contact lens related presumed microbial keratitis during a 12-month period at our department. Detailed demographic data, type of contact lens, duration of lens wear, wearing schedule and lens hygiene were derived from a self-administered questionnaire. Severity of ulcer, corneal scrapings, treatment and final outcome were evaluated. Results: 27 patients with CLIK, some of which may have been sterile peripheral infiltrates, due to contact lens wear were detected. In the majority of the cases patients had used disposable soft contact lenses (89%) and most of them had a daily wearing schedule (78%). 51.8% patients cleaned their lenses regularly. 6 (22%) applied no disinfection since their lenses were disposable on removal. In 3 of our cases with CLIK, penetrating keratoplasty had to be performed. Conclusion: Disposable contact lenses seem to have been a predisposing factor for contact lens induced keratitis also when used on a daily wear schedule. Insufficient contact lens care products and/or manufacturing characteristics may be responsible for CLIK, which is also observed in otherwise compliant contact lens users. In 3 of our patients with CLIK keratoplasty became necessary, indicating that contact lens induced keratitis may result in severe corneal complications. [source] Desloratadine partially inhibits the augmented bacterial responses in the sinuses of allergic and infected miceCLINICAL & EXPERIMENTAL ALLERGY, Issue 10 2004V. Kirtsreesakul Summary Background Allergic rhinitis (AR) is considered a major predisposing factor for the development of acute bacterial rhinosinusitis. How AR augments a bacterial infection is unknown. Objective Our purpose in this study was to test whether an H1 receptor antagonist, desloratadine, could reduce the augmented effect of an ongoing allergic reaction on acute bacterial rhinosinusitis. Methods Three groups of infected and ovalbumin (OVA)-sensitized mice were studied: (1) infected and allergic mice treated with desloratadine, (2) infected and allergic mice treated with placebo, and (3) infected mice. A fourth group of uninfected, non-sensitized mice served as a control for the cellular changes. BALB/c mice were sensitized by two intraperitoneal injections of OVA given 8 days apart. One day after the second injection, the mice were nasally exposed daily to 6% OVA (the groups treated with desloratadine or placebo) or phosphate-buffered saline (PBS) (the infection-only group) for 5 days. After the second OVA exposure, the mice were intranasally inoculated with Streptococcus pneumoniae. Desloratadine or placebo was given daily throughout the OVA exposure period. Nasal allergic symptoms were observed by counting of nasal rubbing and sneezing for 10 min after OVA or PBS nasal challenge. On day 5 post-infection, nasal lavage culture was done, and the inflammatory cells in the sinuses were evaluated by flow cytometry. Results Mice that were made allergic, infected, and treated with placebo showed more organisms and phagocytes than did only infect mice. They also manifested allergic nasal symptoms and eosinophil influx into the sinuses. Desloratadine treatment during allergen exposure reduced allergic symptoms and reduced sinonasal infection (P<0.05). There tended to be less myeloid cell and neutrophil influx (P=0.09 both), but not eosinophil influx (P=0.85) compared with that in the placebo-treated group. Conclusion Desloratadine treatment during nasal challenge inhibited allergic symptoms and reduced sinonasal infection, suggesting that histamine via an H1 receptor plays a role in the augmented infection in mice with an ongoing allergic reaction. [source] The prevalence, aetiological agents and therapy of onychomycosis in patients with psoriasis: a prospective controlled trialCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 1 2007N. Kaçar Summary Background., Nail involvement morphologically resembling onychomycosis frequently accompanies psoriatic lesions. The role of psoriasis as a predisposing factor for onychomycosis and the possible influence of psoriasis on responsiveness of onychomycosis to treatment are controversial. Aim., To investigate the frequency of onychomycosis, the aetiological agents responsible for it, and the efficacy of terbinafine 250 mg/day in patients with psoriasis compared with controls in order to reveal the role of psoriatic process on fungal growth. Methods., Over a 1-year period, 168 patients with psoriasis and 164 nonpsoriatic controls were recruited. In the case of clinically suspected of fungal infection, further mycological investigations were performed. Systemic terbinafine therapy 250 mg daily for 12 weeks was administered to the patients with onychomycosis. Patients were followed up clinically and mycologically for 24 weeks. Results., Onychomycosis was diagnosed in 22 patients with psoriasis (13.1% of the psoriasis group, which constituted 28.6% of patients with suspicion of onychomycosis) and 13 controls (7.9% of control group; 40.6% of controls with suspicion of onychomycosis). The prevalence rates of onychomycosis were similar in both groups. The most commonly isolated fungi were dermatophytes in the psoriasis group and nondermatophytic moulds in controls. Dermatophytes were more common in psoriatic than control nails (P = 0.02). All patients in each group were cured at the end of the therapy. Conclusion., It seems that nail psoriasis constitutes a risk factor not for onychomycosis, but specifically for dermatophytic nail infections. Because of the similar therapeutic results in each group, different antifungal treatment protocols may not be needed in psoriasis. However, to confirm this, new comprehensive studies are necessary. [source] Parasitological diagnosis combining an internally controlled real-time PCR assay for the detection of four protozoa in stool samples with a testing algorithm for microscopyCLINICAL MICROBIOLOGY AND INFECTION, Issue 9 2009L. E. S. Bruijnesteijn van Coppenraet Abstract Molecular detection of gastrointestinal protozoa is more sensitive and more specific than microscopy but, to date, has not routinely replaced time-consuming microscopic analysis. Two internally controlled real-time PCR assays for the combined detection of Entamoeba histolytica, Giardia lamblia, Cryptosporidium spp. and Dientamoeba fragilis in single faecal samples were compared with Triple Faeces Test (TFT) microscopy results from 397 patient samples. Additionally, an algorithm for complete parasitological diagnosis was created. Real-time PCR revealed 152 (38.3%) positive cases, 18 of which were double infections: one (0.3%) sample was positive for E. histolytica, 44 (11.1%) samples were positive for G. lamblia, 122 (30.7%) samples were positive for D. fragilis, and three (0.8%) samples were positive for Cryptosporidium. TFT microscopy yielded 96 (24.2%) positive cases, including five double infections: one sample was positive for E. histolytica/Entamoeba dispar, 29 (7.3%) samples were positive for G. lamblia, 69 (17.4%) samples were positive for D. fragilis, and two (0.5%) samples were positive for Cryptosporidium hominis/Cryptosporidium parvum. Retrospective analysis of the clinical patient information of 2887 TFT sets showed that eosinophilia, elevated IgE levels, adoption and travelling to (sub)tropical areas are predisposing factors for infection with non-protozoal gastrointestinal parasites. The proposed diagnostic algorithm includes application of real-time PCR to all samples, with the addition of microscopy on an unpreserved faecal sample in cases of a predisposing factor, or a repeat request for parasitological examination. Application of real-time PCR improved the diagnostic yield by 18%. A single stool sample is sufficient for complete parasitological diagnosis when an algorithm based on clinical information is applied. [source] | |||||||||||||||||||||||||||||||||||||||||||