Abstract P581: Neonatal Stroke is Not Associated With Birth Trauma

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Mary Dunbar ◽  
Abbey Norris ◽  
Brandon T Craig ◽  
Khorshid Mohammad ◽  
Michael Esser ◽  
...  

Acute neonatal stroke causes cerebral palsy, lifelong morbidity and mortality. Neonatal arterial ischemic stroke (NAIS) and hemorrhagic stroke (NHS) are most common. Pathophysiology is poorly understood and causation is often attributed to observed obstetrical factors such as instrumentation (forceps or vacuum) or operative delivery despite no empiric evidence supporting an association. We explored the relationship between birth trauma and neonatal stroke via population-based, prospectively collected registries in Southern Alberta, Canada. Consecutive cases of NAIS (n=59), NHS (n=20), and neonatal hypoxic-ischemic encephalopathy HIE with MRI-confirmed injury (HIE+, n=78)) were compared to neonates without injury (HIE-n=77). Cranial soft tissue swelling was objectively quantified as a trauma score from T1-weighted images using a semi-automatic segmentation method performed by two blinded investigators. Maternal, obstetrical, perinatal, and outcome variables were obtained from medical records. Multinomial regression modeling evaluated the relationship between diagnosis and birth trauma as measured by total soft tissue swelling score and diagnosis (HIE- as controls). Across the 234 infants studied, mean age at MRI (4.1+/-1.3 days) and sex (54% male) were comparable. Measurable scalp trauma was present in 93(40%), the proportion of which did not differ across groups. On univariate analysis, mean trauma scores did not differ between groups, were not associated with NHS or HIE+, and were lower for the NAIS group compared to HIE- (controls). Multinomial modeling revealed no relationship between scalp trauma and outcome. We conclude that the leading forms of acquired neonatal brain injury are not associated with objectively measured birth trauma. The term “birth trauma” should be removed from the perinatal stroke vernacular to help counsel traumatized parents and advance studies of genuine pathophysiology.

Hand Surgery ◽  
2011 ◽  
Vol 16 (01) ◽  
pp. 19-27 ◽  
Author(s):  
Anil Agarwal ◽  
Nadeem Akhtar Qureshi ◽  
Pawan Kumar ◽  
Shariq Khan

The purpose of the series is to describe the management of tubercular osteomyelitis of metacarpals and phalanges in 11 children (range, 3–12 years) and to retrospectively analyse the relationship between radiological staging and clinical outcome following treatment. The available literature on the clinical and radiological manifestations of tubercular osteomyelitis of the hand (excluding wrist) was also reviewed. Follow-up averaged 17.7 months following completion of treatment. The different radiological descriptions of the condition could be grouped into three stages: Stage 1 (stage of soft tissue swelling and no bony changes), Stage 2 (stage of bony expansion) and Stage 3 (stage of destruction). The previously described different radiological entities of tubercular osteomyelitis of metacarpals and phalanges appear to be a sequential manifestation of the disease spectrum. Healing with non-operative treatment is excellent provided the diagnosis is made when tuberculosis presents with soft tissue swelling alone and before bony destruction occurs.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Satoru Kanda ◽  
Takumi Hara ◽  
Ryosuke Fujino ◽  
Keiko Azuma ◽  
Hirotsugu Soga ◽  
...  

AbstractThis study aimed to investigate the relationship between autofluorescence (AF) signal measured with ultra-wide field imaging and visual functions in patients with cone-rod dystrophy (CORD). A retrospective chart review was performed for CORD patients. We performed the visual field test and fundus autofluorescence (FAF) measurement and visualized retinal structures with optical coherence tomography (OCT) on the same day. Using binarised FAF images, we identified a low FAF area ratio (LFAR: low FAF/30°). Relationships between age and logMAR visual acuity (VA), central retinal thickness (CRT), central choroidal thickness (CCT), mean deviation (MD) value, and LFAR were investigated. Thirty-seven eyes of 21 CORD patients (8 men and 13 women) were enrolled. The mean patient age was 49.8 years. LogMAR VA and MD were 0.52 ± 0.47 and − 17.91 ± 10.59 dB, respectively. There was a significant relationship between logMAR VA and MD (p = 0.001). LogMAR VA significantly correlated with CRT (p = 0.006) but not with other parameters. Conversely, univariate analysis suggested a significant relationship between MD and LFAR (p = 0.001). In the multivariate analysis, LFAR was significantly associated with MD (p = 0.002). In conclusion, it is useful to measure the low FAF area in patients with CORD. The AF measurement reflects the visual field deterioration but not VA in CORD.


Author(s):  
Agnieszka Jankowska ◽  
Joanna Janiszewska-Olszowska ◽  
Katarzyna Grocholewicz

Nose shape, size, and inclination influence facial appearance, but few studies concern the relationship between the nasal profile and craniofacial structures. The objective of this study was to analyze association of nasal cephalometric variables with skeletal structures, age, and sex. Cephalometric and nasal analysis was performed in 386 Polish orthodontic patients (aged 9–25 years). Student t-test and Mann–Whitney test were used to compare quantitative variables and Pearson’s or Spearman’s correlation coefficients—to find correlations. Soft tissue facial convexity angle correlates to Holdaway ratio, ANB (A-Nasion-B), and Wits appraisal. Nasal dorsum axis, nose length, nose depth (1) and nose depth (2), nose hump, lower dorsum convexity, and columella convexity increase with age. Nasal base angle, nasolabial angle, nasomental angle, soft tissue facial convexity and nasal bone angle decrease with age. Nasal base angle and nasomental angle are smaller in females. Thus, a relationship exists between nasal morphology and sagittal jaw configuration. Nasal parameters significantly change with age. Sexual dimorphism characterizes nasal bone angle and nasomental angle.


2021 ◽  
pp. 107780122097880
Author(s):  
Golshan Golriz ◽  
Skye Miner

This article uses the 2008 Egypt Demographic and Health Survey to explore the relationship between religion and women’s attitudes toward intimate partner violence (IPV). It also asks whether modernization, as measured by having a higher education or living in an urban area, can mediate or moderate this relationship. Using latent class analysis to create categories of women’s wife-beating attitudes, and multinomial regression to explore the relationship between religion, education, and urbanity, we find no significant relationship between being Muslim and justifying wife beating. Our data further suggest that neither education nor urbanity mediate or moderate this relationship.


Author(s):  
E. Quiros-Roldan ◽  
T. Porcelli ◽  
L. C. Pezzaioli ◽  
M. Degli Antoni ◽  
S. Paghera ◽  
...  

Abstract Purpose Hypogonadism is frequent in HIV-infected men and might impact on metabolic and sexual health. Low testosterone results from either primary testicular damage, secondary hypothalamic-pituitary dysfunction, or from liver-derived sex-hormone-binding-globulin (SHBG) elevation, with consequent reduction of free testosterone. The relationship between liver fibrosis and hypogonadism in HIV-infected men is unknown. Aim of our study was to determine the prevalence and type of hypogonadism in a cohort of HIV-infected men and its relationship with liver fibrosis. Methods We performed a cross-sectional retrospective study including 107 HIV-infected men (median age 54 years) with hypogonadal symptoms. Based on total testosterone (TT), calculated free testosterone, and luteinizing hormone, five categories were identified: eugonadism, primary, secondary, normogonadotropic and compensated hypogonadism. Estimates of liver fibrosis were performed by aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) scores. Results Hypogonadism was found in 32/107 patients (30.8%), with normogonadotropic (10/107, 9.3%) and compensated (17/107, 15.8%) being the most frequent forms. Patients with secondary/normogonadotropic hypogonadism had higher body mass index (BMI) (p < 0001). Patients with compensated hypogonadism had longer HIV infection duration (p = 0.031), higher APRI (p = 0.035) and FIB-4 scores (p = 0.008), and higher HCV co-infection. Univariate analysis showed a direct significant correlation between APRI and TT (p = 0.006) and SHBG (p = 0.002), and between FIB-4 and SHBG (p = 0.045). Multivariate analysis showed that SHBG was independently associated with both liver fibrosis scores. Conclusion Overt and compensated hypogonadism are frequently observed among HIV-infected men. Whereas obesity is related to secondary hypogonadism, high SHBG levels, related to liver fibrosis degree and HCV co-infection, are responsible for compensated forms.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yann Combret ◽  
Guillaume Prieur ◽  
Roger Hilfiker ◽  
Francis-Edouard Gravier ◽  
Pauline Smondack ◽  
...  

Abstract Background Little interest has been paid to expiratory muscle strength, and the impact of expiratory muscle weakness on critical outcomes is not known. Very few studies assessed the relationship between maximal expiratory pressure (MEP) and critical outcomes. The aim of this study was to investigate the relationship between MEP and critical outcomes. Methods This work was a secondary analysis of a prospective, observational study of adult patients who required mechanical ventilation for ≥ 24 h in an 18-bed ICU. MEP was assessed before extubation after a successful, spontaneous breathing trial. The relationships between MEP and extubation failure, and short-term (30 days) mortality, were investigated. Univariate logistic regressions were computed to investigate the relationship between MEP values and critical outcomes. Two multivariate analyses, with and without maximal inspiratory pressure (MIP), both adjusted using principal component analysis, were undertaken. Unadjusted and adjusted ROC curves were computed to compare the respective ability of MEP, MIP and the combination of both measures to discriminate patients with and without extubation failure or premature death. Results One hundred and twenty-four patients were included. Median age was 66 years (IQR 18) and median mechanical ventilation duration was 7 days (IQR 6). Extubation failure rate was 15% (18/124 patients) and the rate for 30-day mortality was 11% (14/124 patient). Higher MEP values were significantly associated with a lower risk of extubation failure in the univariate analysis [OR 0.96 95% CI (0.93–0.98)], but not with short-term mortality. MEP was independently linked with extubation failure when MIP was not included in the multivariate model, but not when it was included, despite limited collinearity between these variables. This study was not able to differentiate the respective abilities of MEP, MIP, and their combination to discriminate patients with extubation failure or premature death (adjusted AUC for the combination of MEP and MIP: 0.825 and 0.650 for extubation failure and premature death, respectively). Conclusions MEP is related to extubation failure. But, the results did not support its use as a substitute for MIP, since the relationship between MEP and critical outcomes was no longer significant when MIP was included. The use of MIP and MEP measurements combined did not reach higher discriminative capacities for critical outcomes that MEP or MIP alone. Trial Registration This study was retrospectively registered at https://clinicaltrials.gov/ct2/show/NCT02363231?cond=NCT02363231&draw=2&rank=1 (NCT02363231) in 13 February 2015


1994 ◽  
Vol 35 (4) ◽  
pp. 311-318 ◽  
Author(s):  
Á. Jónsson ◽  
A. Borg ◽  
P. Hannesson ◽  
K. Herrlin ◽  
K. Jonsson ◽  
...  

In a prospective investigation the diagnostic accuracy of film-screen and digital radiography in rheumatoid arthritis of hands was compared. Seventy hands of 36 patients with established rheumatoid arthritis were included in the study. Each of 11 joints in every hand was evaluated regarding the following radiologic parameters: soft tissue swelling, joint space narrowing, erosions and periarticular osteopenia. The digital images were obtained with storage phosphor image plates and evaluated in 2 forms; as digital hard-copy on film and on a monitor of an interactive workstation. The digital images had a resolution of either 3.33 or 5.0 lp/mm. ROC curves were constructed and comparing the area under the curves no significant difference was found between the 3 different imaging forms in either resolution group for soft tissue swelling, joint space narrowing and erosions. The film-screen image evaluation of periarticular osteopenia was significantly better than the digital hard-copy one in the 3.33 lp/mm resolution group, but no significant difference was found in the 5.0 lp/mm group. These results support the view that currently available digital systems are capable of adequate diagnostic performance.


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