Management of Functional Voice Disorders in Adolescents

1996 ◽  
Vol 27 (3) ◽  
pp. 257-270 ◽  
Author(s):  
Robert C. Peppard
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Case Studies ◽  
Voice Disorders ◽  
Intensive Treatment ◽  
Diagnosis And Treatment ◽  
Screening Programs ◽  
High Risk Factors ◽  
Symptoms And Signs

This article describes the nature and treatment of functional voice disorders in adolescents. It summarizes physiological and psychological changes that occur in adolescence, the types of functional voice disorders common to that period, and the incidence and possible causes, including high-risk factors. Three case studies illustrate the importance of obtaining accurate laryngeal data, typical symptoms and signs, and the use of voice probes in diagnosis and treatment. The use of intensive treatment and carryover is stressed. The role of the school clinician in management is discussed, as is the need for screening programs and further research.

Role of Colour Doppler in High Risk Pregnancy

2021 ◽  
Vol 6 (2) ◽  
pp. 185-191
Author(s):  
Hiral Parekh ◽  
Sneha Chaudhari
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
High Risk Pregnancy ◽  
Colour Doppler ◽  
High Risk Factors ◽  
Risk Pregnancy ◽  
A Prospective Study

This was a prospective study conducted in pregnant patients with high risk factors who got admitted in the Department of Obstetrics and Gynaecology at Care Hospital, Jamnagar during the period from May 2018 to September 2020. Background: High-risk pregnancies causes many adverse perinatal outcomes. Doppler ultrasound is a non-invasive technique to study the feto-maternal circulation to guide the clinical management. Objective: This study aims at evaluating the role of colour Doppler in high-risk pregnancies and their perinatal outcome. Materials and Methods: This was a prospective study carried out for 29 months in the Department of Radiology with antenatal women in the age group of 18-35 years with singleton pregnancy of gestational age of <28 weeks to >35 weeks having high-risk factors considered in study. The risk factors considered were pregnancy induced hypertension (PIH), gestational diabetes, anemia, oligohydramnios, polyhydramnios and IUGR. Doppler study of umbilical artery and fetal middle cerebral artery (MCA) arteries was done and amniotic fluid index (AFI) was measured. Parameters in the form of resistive index, pulsatility index, and systolic/diastolic ratio were taken. obstetric history was taken with regular interval follow up. Results: The study was carried out with 50 patients. High-risk pregnancy was more common in the age group of 21-25 years. The most common high-risk factor in pregnancy was oligohydramnios which accounted for 30% of cases. Out of 50 high-risk pregnancies, 5 (10 %) of cases resulted in intrauterine growth restriction (IUGR). Out of 50 high-risk cases, in 36 cases, umbilical artery findings were abnormal. 3 patients had intrauterine death (IUD) and 27 patients had poor perinatal outcome. Umbilical artery abnormality showed significant sensitivity and negative predictive value for adverse (poor + IUD) perinatal. Correlation was seen between high risk pregnancy and need of emergency caesarean section and induction and associated adverse perinatal outcome. Conclusion: Combination of different arterial waveform study enhance the diagnostic accuracy in identifying those intrauterine growth restricted foetuses that were at risk. Keywords: Colour Doppler, high risk pregnancy, perinatal outcome.

scholarly journals Cause Analysis and Diagnosis and Treatment of Intestinal Fistulas After Ultrasound-Guided Microwave Ablation of Abdominopelvic Lesions

2021 ◽  
Vol 8 ◽  
Author(s):  
Shuilian Tan ◽  
Xiaoling Yu ◽  
Zhigang Cheng ◽  
Jing Zhang ◽  
Jie Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
High Risk ◽  
Clinical Data ◽  
Microwave Ablation ◽  
Diagnosis And Treatment ◽  
Ultrasound Guided ◽  
Cause Analysis ◽  
High Risk Factors ◽  
Intestinal Fistulas

Objective: To determine the cause and high-risk factors for the development of intestinal fistulas (IFs) after ultrasound-guided microwave ablation (MA) of abdominopelvic lesions, and to identify effective prophylactic and therapeutic actions.Methods: Clinical data were collected from patients with an IF after ultrasound-guided MA of abdominopelvic lesions in our hospital from January 1, 2010 to December 31, 2018. The cause, diagnosis, and treatment of IFs in these patients were analyzed.Results: Among 8,969 patients who underwent ultrasound-guided MA of abdominopelvic lesions, eight patients developed IF after MA, Seven patients were discharged after being cured and one died.Conclusion: Abdominopelvic lesions are close to the intestines, so histories of surgery, radiotherapy, and abdominopelvic infection are high-risk factors for IF development after MA of these lesions. Surgical treatment should be provided as soon as an IF is identified.

scholarly journals Mild cases of Covid-19 in children. is it really true or a mirage?

2020 ◽  
Vol 7 (8) ◽  
pp. 446-451
Author(s):  
Abhishek Mandal ◽  
◽  
Dr. Santosh Kondekar ◽  
Rishi Bothara ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Secretion ◽  
High Risk ◽  
Infectious Diseases ◽  
Antioxidant Potential ◽  
Trained Immunity ◽  
High Risk Factors ◽  
Few Data

To date, very few data on pediatric COVID 19 cases have been published, and most reports originatefrom China. There is an urgent need to understand why the course of the coronavirus that started inlate 2019 is affecting different groups of individuals with varying severity during the ongoing globalpandemic. Globally, the greatest burden of most infectious diseases, especially infections of therespiratory system are borne by children, hence the low burden of COVID 19 in children has beenviewed by many as surprising. This article will provide insights regarding the role of constitutionalhigher trained immunity in children, physiological advantages of children, higher insulin secretion,higher ACE2 levels, better antioxidant potential, and absence of high-risk factors in protectingchildren against severe COVID 19 infections.

scholarly journals Prognostic role of circulating exosomal miRNAs in multiple myeloma

Blood ◽  
2017 ◽  
Vol 129 (17) ◽  
pp. 2429-2436 ◽  
Author(s):  
Salomon Manier ◽  
Chia-Jen Liu ◽  
Hervé Avet-Loiseau ◽  
Jihye Park ◽  
Jiantao Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
High Risk ◽  
Survival Prediction ◽  
Prognostic Role ◽  
High Risk Factors ◽  
Key Points ◽  
Exosomal Mirnas

Key Points Two circulating exosomal microRNAs, let-7b and miR-18a, improved survival prediction in patients with MM. Circulating exosomal miRNAs enhanced the stratification of patients with high-risk factors.

scholarly journals Complementary role of 18F-FDG PET/CT for sentinel lymph node algorithm in endometrial cancer with high-risk factors for lymphatic metastasis

2020 ◽  
Vol 41 (4) ◽  
pp. 389-394
Author(s):  
Salih Taşkin ◽  
Bulut Varli ◽  
Cevriye Cansiz Ersöz ◽  
Duygu Altin ◽  
Çiğdem Soydal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Lymph Node ◽  
High Risk ◽  
High Risk Factors ◽  
Complementary Role ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Role of Abdominal Aortic Balloon Placement in Planned Conservative Management of Placenta Previa With Placenta Increta or Percreta

2021 ◽  
Vol 8 ◽  
Author(s):  
Ruihui Lu ◽  
Ran Chu ◽  
Qiannan Wang ◽  
Yintao Xu ◽  
Ying Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Propensity Score ◽  
Blood Loss ◽  
Conservative Management ◽  
Placenta Previa ◽  
Intraoperative Blood Loss ◽  
Placenta Increta ◽  
High Risk Factors

Background: We investigated the role of balloon placement in the abdominal aorta (BPAA) in planned conservative management of placenta previa with placenta increta or percreta and the effects of BPAA on perinatal adverse maternal events.Methods: This retrospective case-control study included women with placenta previa (increta or percreta), who underwent pregnancy termination at the Qilu Hospital of Shandong University between January 2016 and June 2019. Patients were categorized into the BPAA and non-BPAA groups based on the BPAA placement before delivery. The Chi-square and non-parametric rank-sum tests were used for the intergroup comparison of patient characteristics. The propensity score matching algorithm was used to minimize the intergroup differences in clinical characteristics. Logistic regression analysis was used to identify the factors associated with a high risk of adverse pregnancy outcomes. The area under the receiver operating characteristic curve [area under the curve (AUC)] was used to evaluate the classification of the selected high-risk factors.Results: The study included 260 patients, and 104 patients were identified after propensity score matching. In the post-matched cohort, intraoperative blood loss was significantly lower in the BPAA than in the non-BPAA group (median 1,000 vs. 2,250 ml, P &lt; 0.001). Intraoperative B-Lynch suture was performed in fewer patients in the BPAA (15.4 vs. 34.6%, P = 0.024) than in the non-BPAA group. The packed red blood cell (PRBC) transfusion rate was lower in the BPAA group (median 4 vs. 8 units, P &lt; 0.001). Overall, 46 (45.1%) patients developed adverse maternal events; however, the rate of adverse maternal events was lower in the BPAA group (19.6 vs. 80.4%, P &lt; 0.001). No ligation of the ascending branch of the uterine artery (P = 0.034), no BPAA (P &lt; 0.001), intraplacental vascular lacunae (P = 0.046), and cervical hypervascularity (P = 0.001) were associated with a high risk of adverse perinatal maternal events. The AUC of the high-risk factors was 0.89 in the post-matched and 0.76 in the pre-matched cohorts.Conclusion: Planned conservative management using BPAA significantly minimized the intraoperative blood loss, the need for a B-Lynch suture, and PRBC transfusion in patients with severe placenta accreta spectrum and placenta previa.

scholarly journals Clinical Features of Extragastrointestinal Stromal Tumor Compared with Gastrointestinal Stromal Tumor: A Retrospective, Multicenter, Real-World Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Huolun Feng ◽  
Weixian Hu ◽  
Chengbin Zheng ◽  
Wei Wang ◽  
Guoliang Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Subgroup Analysis ◽  
Small Sample ◽  
Stromal Tumor ◽  
Diagnosis And Treatment ◽  
Unmeasured Confounding ◽  
Extragastrointestinal Stromal Tumor ◽  
High Risk Factors ◽  
Worse Prognosis

Importance. Extragastrointestinal stromal tumor (EGIST) is a rare tumor, and its diagnosis and treatment strategy lack clinical guideline and relative literature evidence. In clinical practice, EGIST only misuses the pattern of GIST of diagnosis and treatment. The study hopes to find evidence of the treatment pattern for EGIST. Objective. This study aimed to compare the tumor characteristics and long-term outcomes between EGIST and GIST. The confounding function was applied to improve the result credibility in the case of small sample size. Design, Setting, and Participants. This cohort study enrolled 55 patients with EGIST who underwent surgery and were selected from four high-volume hospitals in China and 221 GIST patients who were collected from one of the four hospitals between January 2006 and September 2017. We used propensity score matching (PSM) and subgroup analysis to compare EGIST with GIST in terms of prognosis. The confounding function was used for sensitivity analysis to reduce unmeasured confounding. Results. We matched 43 patients in each of the GIST and EGIST groups by PSM. We compared EGIST data with GIST data to explore the prognostic factors between them. In the multivariate Cox regression model, tumor location of EGIST was negatively correlated with overall survival (after PSM: HR, 4.32; 95% CI, 1.22–15.26) or disease-free survival (after PSM: HR, 9.79; 95% CI, 2.22–43.31), which was also intuitively shown in the Kaplan–Meier survival curves (all P values < 0.05). In the subgroup analysis, EGIST with high risk factors had a worse prognosis than GIST. In unmeasured confounding analysis, the overall curve tends to show all combinations of c(0) of c(1) up to 2.0, none of which would bring the corrected relative risk to 1 for OS and DFS. Conclusions and Relevance. EGIST was associated with worse prognosis compared with GIST patients, particularly in EGIST patients with high risk factors, while there was a similar prognosis without those high risk factors.

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