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Significant Abnormalities (significant + abnormality)
Selected AbstractsWhen to image neurologically normal children with headaches: development of a decision ruleACTA PAEDIATRICA, Issue 6 2010MAS Ahmed Abstract Aims:, The aim of this study was to develop and refine a decision rule on when to undertake brain imaging (BI) in neurologically normal children with headaches. Methods:, From the literature and a questionnaire study, a list of red flags (RFs) was drawn-up. During the prospective 4-year period, consecutive children with headache were classified according to RFs and the headache diagnosis. Result:, Three of 709 (0.4%) neurologically normal children had significant brain abnormalities. BI was carried out in 389 of 498 (78%) children with RFs. Significant abnormalities were found in three of 389 children (0.8%), all had unclassified headache (UH). BI was not arranged for the 211 children with no RFs. None of these developed RFs or abnormal signs on follow-up for a mean of 13 months. Conclusion:, In addition to BI for those with neurological signs, we think BI should be considered for neurologically normal patients with UH and RFs. This would have saved imaging children needlessly: only 101 of 709 (14%) would have had scans arranged, instead of 389 of 709. [source] Ophthalmological problems of the premature infantDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 4 2002Michael X. Repka Abstract Preterm infants are more likely than term infants to have significant abnormalities of all parts of the visual system leading to reduced vision. The most common problem is retinopathy of prematurity (ROP). The frequency and severity of this disorder is inversely related to gestational age. Damage ranges from minor to catastrophic. Preterm infants also have higher rates of amblyopia, strabismus, refractive error, and cortical visual impairment. The later problem is largely associated with neonatal brain injury. Years later, these children may develop glaucoma and retinal detachments. MRDD Research Reviews 2002;8:249,257. © 2002 Wiley-Liss, Inc. [source] Impact of body fat mass extent on cardiac autonomic alterations in womenEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 8 2009J. Sztajzel Abstract Background, Obesity has been associated with significant abnormalities of the cardiac autonomic regulation. However, the precise impact of increasing body weight on cardiac autonomic function and the metabolic and hormonal contributors to these changes are presently unclear. The aim of our study was to explore in subjects with increasing values of body mass index (BMI) the alterations of cardiac autonomic function and to establish the potential role of various metabolic and hormonal contributors to these alterations. Materials and methods, We investigated time and frequency domain heart rate variability (HRV) parameters taken from 24-h Holter recordings, and several anthropometric, metabolic and hormonal parameters (plasma glucose, insulin, triglycerides, free fatty acids, leptin and adiponectin) in 68 normoglycaemic and normotensive women (mean age of 40 ± 3 years), subdivided according to their BMI into 15 normal body weight (controls), 15 overweight, 18 obese and 20 morbidly obese. Results, Heart rate was increased and HRV was decreased in the morbidly obese group as compared with controls. In overall population, a negative association linked body fat mass (FM) to HRV indices. None of the metabolic and hormonal parameters were significantly related to the HRV indices, after they were adjusted for the body FM. Conclusions, Morbidly obese, normoglycaemic and normotensive young women have increased HR and low HRV, indicating an abnormal cardiac autonomic function and representing a risk factor for adverse cardiovascular events. A decrease of HRV parameters is associated with a progressive increase of body FM. Other metabolic and hormonal factors, characterising obesity, do not show an independent influence on these HRV alterations. [source] The Effects of Heparin Versus Normal Saline for Maintenance of Peripheral Intravenous Locks in Pregnant WomenJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 4 2003Kathryn M. Niesen MSN, RN director of clinical nursing Objective: To compare the efficacy of two available preparations (heparin, 10 U/mL, 1 mL, vs. normal saline, 1 mL) used for maintaining patency in peripheral intravenous (IV) locks during pregnancy. Design: Prospective, randomized, and double-blind. Eligible patients who were to receive a peripheral intermittent IV lock were randomly assigned to receive either heparin flushes or normal saline flushes for IV lock maintenance. IV locks were flushed after each medication administration, or at least every 24 hours, with the assigned blinded flush solution. Intermittent IV lock sites were also evaluated every 12 hours for the development of phlebitis. Setting: A large academic medical center in the Midwest that has both community-based and regional-referral obstetric practices with more than 2,000 deliveries per year. Participants: A convenience sample included 73 hospitalized pregnant women who were between 24 and 42 weeks gestation. Exclusions from the study were women with significant abnormalities in the fetal heart tracing on admission, cervical dilation > 4 cm, presence of hypersensitivity to heparin, presence of clotting abnormalities, and anticoagulation therapy (including low-dose aspirin). Results: Data indicate there were no statistically significant differences in IV lock patency nor in phlebitis between heparin or normal saline flushes. Conclusions: This study provides support that both normal saline and heparin in the doses studied may be equally effective in the maintenance of peripheral IV locks. Due to small sample size, additional studies are needed to determine optimal therapy over time. [source] Ciclosporin use in multi-drug therapy for meningoencephalomyelitis of unknown aetiology in dogsJOURNAL OF SMALL ANIMAL PRACTICE, Issue 9 2007P. F. Adamo Objective: To evaluate the efficacy and safety of ciclosporin therapy alone or in combination with corticosteroids and/or ketoconazole in dogs with diagnosis of meningoencephalomyelitis of unknown aetiology. Methods: Medical records of 10 dogs diagnosed with meningoencephalomyelitis of unknown aetiology and treated with ciclosporin therapy alone or in combination with corticosteroids and/or ketoconazole were reviewed at the Veterinary Medical Teaching Hospital, University of Wisconsin-Madison. Laboratory abnormalities, side effects, clinical and cerebrospinal fluid responses to treatment and association between blood ciclosporin level and response to treatment were evaluated. Histopathological diagnosis was available in three patients. Results: No significant abnormalities were detected on serial complete blood count and serum chemistry panel in any of the dogs. Side effects of ciclosporin therapy included excessive shedding, gingival hyperplasia and hypertrichosis. Overall median survival time for all dogs in the study was 930 days (range, 60 to more than 1290 days). In all dogs, serial cerebrospinal fluid analysis showed a marked improvement in the inflammation. Clinical Significance: Results suggest that ciclosporin either alone or in combination with ketoconazole may be a safe and effective treatment for meningoencephalomyelitis of unknown aetiology in dogs. [source] Autonomic Nervous System Evaluation of Patients With Vasomotor Rhinitis ,THE LARYNGOSCOPE, Issue 11 2000Safwan S. Jaradeh MD Abstract Objective To demonstrate the utility of quantitative neurological laboratory testing of autonomic nervous system dysfunction and to apply this methodology to further study the relation of chronic vasomotor (nonallergic) rhinitis to the autonomic nervous system. Methods It has been suspected that vasomotor rhinitis is due either to a hyperactive parasympathetic nervous system or an imbalance between it and the sympathetic nervous system. The exact relation has not been determined. Recently neurological laboratories have been developed in which a battery of tests can be performed to determine reactivity of the autonomic nervous system. Results Autonomic nervous system testing was performed on 19 patients with symptoms fulfilling the diagnostic criteria for vasomotor rhinitis and the results were compared with 75 sex- and age-matched control subjects. Patients with vasomotor rhinitis had significant abnormalities of their sudomotor, cardiovagal, and adrenergic subscores. Their composite autonomic scale score was significantly impaired at 2.43, as compared with 0.11 for controls (P < .005). Conclusion Autonomic nervous system dysfunction is significant in patients with vasomotor rhinitis. Possible factors that trigger this dysfunction including nasal trauma and extraesophageal manifestations of gastroesophageal reflux are discussed. [source] The outcomes of pregnancies following a prenatal diagnosis of fetal exomphalos in Western AustraliaAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2009Nick CALVERT Aims: To review the perinatal outcomes for prenatally diagnosed exomphalos from a single geographical region. Methods: Retrospective review of cases of prenatally identified exomphalos in the state of Western Australia in the ten-year period 1998,2007 using the medical databases of the sole tertiary obstetric and paediatric hospitals. Results: Ninety-four cases of prenatally identified exomphalos comprise this consecutive case series. Culture-proven karyotypic abnormalities occurred in 40 (42.6%) fetuses. No karyotypically abnormal fetus survived the neonatal period, with 33 of 40 (82.5%) pregnancies interrupted, five of 40 (12.5%) resulting in fetal demise and two (5%) neonatal deaths. For the 49 (52.1%) fetuses with a normal karyotype, 26 (53.1%) had associated abnormalities with termination occurring in 22 (84.6%). Prenatally isolated exomphalos was present in 23 cases (24.5%), with live birth in 15 cases (30.6% of euploid fetuses). Fourteen (93.3%) of the liveborn prenatally isolated exomphalos cases survived with no postoperative deaths, although four (28.5%) had significant abnormalities detected postdelivery and most have experienced childhood morbidity. Conclusions: In the the majority of cases of prenatally detected exomphalos the pregnancy was interrupted secondary to chromosomal or structural abnormalities. In only 10.6% of prenatally recognised fetuses with exomphalos was the disorder truly isolated with neonatal survival occurring. [source] Multifocal objective perimetry compared with Humphrey full-threshold perimetry in patients with optic neuritisCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2006Nima Pakrou MBBS(Hons) Abstract Background:, The aim of the study is to compare multifocal visual evoked potential (mfVEP) objective perimetry with Humphrey full-threshold visual field (HVF) perimetry, in the assessment of patients with optic neuritis (ON). Methods:, We assessed 16 patients with clinically diagnosed ON. A comparison was made between the HVF and mfVEP, based on the global severity indices of both tests and number and topography of significant abnormalities detected. The latency data and inter-eye asymmetry findings on the mfVEP were also evaluated. Results:, From a total of 128 quadrants analysed in the 16 patients (100 affected, 28 unaffected eyes), HVF perimetry identified a scotoma in 39/128 (30.5%) quadrants, all of which were in affected eyes; the mfVEP detected a scotoma in 68/128 (53.1%) quadrants using amplitude and/or asymmetry data (XV2 = 7.2485, P = 0.0071). Latency plots on the mfVEP identified a significant latency deviation cluster in 20/25 (80%) affected eyes. Abnormalities were also detected in 4/7 (57%) unaffected eyes. The global severity indices in the affected eyes showed a high correlation between the two tests (r = 0.73). Conclusions:, The mfVEP detected more abnormalities in patients with ON than HVF perimetry. The use of latency recordings as well as combined amplitude and asymmetry plots is advantageous and has the potential to detect abnormalities not otherwise detected on HVF perimetry. [source] The diagnostic value of barium swallow in globus syndromeINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 1 2004Daniel Hajioff Summary Serious lesions presenting as globus syndrome appear to be extremely rare, but many clinicians routinely request barium swallow to exclude these. No data yet exist on the diagnostic yield of contrast radiography. We reviewed 2854 barium swallows from one department over 7 years. The false-positive rate (37%) depended on presenting symptoms and differed between radiology departments, suggesting substantial subjectivity. No serious radiological abnormalities occurred in the estimated 2011 patients with globus syndrome. The 95% confidence interval for the likelihood of finding a significant abnormality on routine barium swallow in a patient with globus symptoms is 0,0.00145. The 2854 barium swallows cost an estimated £685,000 and 0.22,0.48 deaths. As the risk of missing a serious lesion in a patient with globus is very unlikely to exceed one in 700, we support the opinion that barium swallow should be reserved for those with risk factors or atypical features. [source] Commentary: The federal ,Prenatally and Postnatally Diagnosed Conditions Awareness Act'PRENATAL DIAGNOSIS, Issue 9 2009Philip R. Reilly Abstract The recently enacted federal law, the ,Prenatally and Postnatally Diagnosed Conditions Awareness Act' (United States Public Law 110,374) seeks to improve opportunities for parents and pregnant women to anticipate and understand the likely life course of children born with Down syndrome and other (unspecified) conditions. The law is in part a response to the continued growth of prenatal screening and testing. For example, the American College of Obstetricians and Gynecologists' Practice Bulletin 77 recommends that ,Screening and invasive diagnostic testing for aneuploidies be available to all women who present for prenatal care before 20 weeks of gestation regardless of maternal age.' Emerging technologies anticipate an era in which the scope of prenatal screening and testing will be much larger than it is today. Inevitably, more women will find themselves facing the hard question of whether to continue or end a pregnancy in which a fetus has been found to have a significant abnormality. While the new federal law is not likely to have a major impact on obstetric practice, it may be a harbinger of renewed wide-scale public debate concerning the ethics of prenatal screening. Copyright © 2009 John Wiley & Sons, Ltd. [source] Annular erythema with eosinophilia: A subset of Wells' syndromeAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 4 2007R. Howes We present a 52-year-old lady with a 5-year history of a persistent, widespread, annular erythema associated with lethargy, arthralgias, and an inflammatory synovitis. Skin biopsies have shown mild lichenoid change at the dermoepidermal junction; and oedema, mucin, and a diffuse lymphocytic and eosinophilic infiltrate without flame figures in the dermis. A full blood count including an eosinophil count; liver, renal and thyroid function; rheumatoid factor, ANA, ENA, dsDNA, complement studies, immunoglobulins, and serum protein elecrophoresis and immunoelectrophoresis; flow cytometry of peripheral blood for lymphocyte markers; stool examination for ova, cysts and parasites; and a CT scan of the chest and abdomen have shown no significant abnormality. Hydroxychloroquine has stabilised but not cleared her condition. Cases presenting clinically with annular erythema and histologically with eosinophilic cellulitis are difficult to classify. We discuss the classification of this case in the context of the literature. [source] | ||||||||||