scholarly journals Association Between Endoscopic, Radiologic and Patient-reported Chronic Rhinosinusitis with Nasal Polyps

2019 ◽  
Vol 10 (1) ◽  
pp. 1-8
Author(s):  
A. Luukkainen ◽  
J. Numminen ◽  
M. Rautiainen ◽  
A. Julkunen ◽  
H. Huhtala ◽  
...  
Keyword(s):  
Family History ◽  
Early Detection ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Positive Family History ◽  
Ct Scans ◽  
Nasal Endoscopy ◽  
Controlled Study ◽  
Patient Reported ◽  
History Of

Objectives: Chronic Rhinosinusitis without Nasal Polyps (CRSsNP) and with Nasal Polyps (CRSwNP) affect 10% and 1-4% of the general population respectively. Early detection and treatment of CRSwNP might prevent recalcitrant disease forms. The aim of this prospective controlled study was to evaluate association between endoscopic, radiologic, and self-reported CRSwNP, and a family history in defining CRSwNP. Methods: This study involved 73 CRS patients aged 18 years or over undergoing CRS-surgical consultation at the Tampere University Hospital. Data of sinus Computed Tomography (CT) scans and nasal endoscopy was obtained from patient records. Sixty controls ±allergic rhinitis underwent clinical examination. All subjects filled a questionnaire. Associations were analyzed by Chi square and adjusted regression models. The predictive performance of various parameters was assessed using the Area Under the Receiver Operating Characteristic curve (AUROC). Results: A total of 33% of CRSwNP patients reported not having Nasal Polyps (NPs), while 18% of CRSsNP patients reported having NPs (p < 0.001). Radiologic Nasal Polyp (NP) score differentiated CRSwNP from CRSsNP with an AUROC of 0.95 (95% CI 0.91-1.00). The AUROC value for Lund-Mackay (LM) score was 0.84 (0.75-0.94). Positive family history of NP did not differ significantly between CRS and control groups. Family history of allergy or asthma was given with certainty, whereas CRS patients had uncertainty of reporting NPs in family compared to controls (adjusted OR=6.02, 95% CI 1.98-18.30, p = 0.002). Conclusion: Our findings suggest that in situations where nasal endoscopy cannot be performed, early detection of CRSwNP could result from information obtained from sinus CT scans and patients, in comparison to family history which has lower predictive value. However validation studies with larger sample sizes are still needed.

scholarly journals Two Cases of Acute Cholecystitis and Symptomatic Choledocholithiasis in Two Women Less than 40-Years-of-Age with Hormonal Intrauterine Devices

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Helen M. Shields ◽  
Hasrat Sidhu
Keyword(s):  
Family History ◽  
Acute Cholecystitis ◽  
Gallbladder Disease ◽  
Gallstone Disease ◽  
Positive Family History ◽  
Controlled Study ◽  
Women Patients ◽  
Intrauterine Devices ◽  
History Of ◽  
Clinical Risks

Levonorgestrel uterine implants are accepted as a safe and efficacious method of contraception. One of the two major health side effects in a large controlled study of subcutaneous hormonal implants with levonorgestrel was a significant increase in gallbladder disease. Gallbladder hypomotility is recognized as a side effect of the levonorgestrel (progesterone). We recently saw on a Gastroenterology Consult Service, two women under 40-years-of-age who had been transferred from outside hospitals with acute cholecystitis with symptomatic choledocholithiasis. Both required Endoscopic Retrograde Cholangiopancreatography and sphincterotomies in addition to laparoscopic cholecystectomies. Both had hormonal (levonorgestrel-releasing) intrauterine devices in place for contraception. Although one patient had a family history of gallstones, the other did not. Both were nonobese, young women patients. We were struck by the coincidence of seeing two such patients. Few articles in the medical literature detail the clinical risks of gallstone disease in patients with hormonal (levonorgestrel-releasing) intrauterine devices. Our experiences with these two patients led us to believe that patients with risk factors for gallstone disease, such as a positive family history, ethnic predisposition, or obesity, should be warned of possible problems, not only with gallbladder disease, but also of common duct stones.

scholarly journals Routine orthostatic LVOT gradient assessment in patients with basal septal hypertrophy and LVOT flow acceleration at rest: please stand up

2019 ◽  
Vol 6 (1) ◽  
pp. K1-K6
Author(s):  
H C Sinclair ◽  
P Russhard ◽  
C H Critoph ◽  
C D Steadman
Keyword(s):  
Cardiac Output ◽  
Hypertrophic Cardiomyopathy ◽  
Family History ◽  
Cardiac Mri ◽  
Positive Family History ◽  
Left Ventricular ◽  
List Type ◽  
Patient Reported ◽  
Septal Hypertrophy ◽  
History Of

Summary A 70-year-old female with exertional dyspnoea was found to have basal septal hypertrophy (BSH), or a ‘basal septal bulge’, with evidence of mild left ventricular outflow tract obstruction (LVOT) at rest on her initial echocardiogram. She was usually fit and well with no significant past medical history. She had no history of hypertension. She had never smoked. There was no family history of hypertrophic cardiomyopathy (HCM). A cardiac MRI did not demonstrate any typical features of HCM. ECG showed sinus tachycardia with a rate of 101 bpm but was otherwise unremarkable. She was referred for exercise echocardiography to assess for latent LVOT obstruction. Prior to commencing exercise, her LVOT gradient was re-assessed at rest. Her LVOT gradients were 30 mmHg at rest, 49 mmHg during Valsalva and 91 mmHg on standing. A diagnosis of significant latent LVOT obstruction was made and the patient was started on bisoprolol, a cardioselective beta-blocker. Bisoprolol was slowly uptitrated from 1.25 mg to 5 mg once daily, following which the patient reported a significant improvement in her symptoms with an improved exercise capacity. Follow-up echocardiography demonstrated a dramatic reduction in LVOT gradient, with a maximum of 11 mmHg assessed both with Valsalva and on standing. This case is a reminder that patients with a ‘common’ basal septal bulge can develop significant LVOT obstruction, the symptoms of which may respond to pharmacological therapy. Orthostatic assessment of LVOT gradient using echocardiography should be considered during standard LVOT obstruction provocation manoeuvres such as a Valsalva. Learning points: Differentiation between basal septal hypertrophy (BSH) and hypertrophic cardiomyopathy (HCM) may be challenging. Key factors favouring HCM include a positive family history of HCM or sudden cardiac death, septal thickness >15 mm/posterior wall thickness >11 mm, systolic anterior motion of the anterior mitral valve (SAM), late gadolinium enhancement on cardiac MRI, a causative genetic mutation associated with HCM and an abnormal ECG. Significant LVOT obstruction may develop in patients with BSH and is potentially responsive to pharmacotherapy. Standing reduces venous return, resulting in decreased LV volume. Compensatory mechanisms to maintain cardiac output involve sympathetic nervous system activation leading to increased LV contractility and subsequent increased LVOT gradient. Significant LVOT obstruction may be unmasked by an orthostatic posture. Orthostatic LVOT gradient assessment should be part of the routine echocardiographic assessment of all patients with an increased LVOT gradient at rest. The post-prandial state has been associated with increased LVOT gradient due to splanchnic dilatation and the consequent increased cardiac output required to maintain blood pressure. Post-prandial status should therefore be considered when assessing LVOT gradient.

scholarly journals Knowledge, Attitudes, and Practices toward Breast Cancer

2020 ◽  
pp. 25-32
Author(s):  
Hesam Adin Atashi ◽  
Mohammad Eslami Vaghar ◽  
Maedeh Olya ◽  
Parisa Mirzamohammadi ◽  
Hamid Zaferani Arani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Family History ◽  
Early Detection ◽  
Marital Status ◽  
Breast Cancer Screening ◽  
Positive Family History ◽  
Attitudes And Practices ◽  
History Of ◽  
Knowledge Attitudes And Practices

Background: The incidence of breast cancer is rising rapidly worldwide. Midwives have an important role in early detection of the disease by providing the patients with awareness and an accurate Clinical Breast Examination (CBE) of the patients that are effective in early detections. This study investigated the knowledge, attitudes and practices of midwives toward breast cancer.Methods: The study was conducted on 210 of midwives aged 20-62 who participated in a seminar for clarifying the role of knowledge, attitudes and practices in breast cancer early detection and prevention. The data were collected using a standard questionnaire which has 4 sections with 55 items including age, educational level, number of family members, marital status, family history of breast cancer and their knowledge, attitude and practices about breast cancer screening. Data were analyzed using SPSS version 13.0.Results: About two-third of the participants (65.9%) had excellent knowledge about the signs and symptoms of breast cancer. The results revealed that 30.8% of respondents performed self-examination once a month. There was a significant correlation between the knowledge of breast cancer and adopting preventive practices (P = 0.02). The level of their attitude was significantly associated with a positive family history of breast cancer (P= 0.03). There was no significant relationship between marital status or family history of breast cancer with CBE. Conclusion: An appropriate level of knowledge and practice of breast cancer screening was observed to help prevention among midwives. The findings can have remarkable practical implications as midwives can play an important role to broaden the breast-cancer-related knowledge of women.

scholarly journals Evaluation of Breast Cancer Awareness Campaign, Screening Drivers

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 26s-26s
Author(s):  
K. Ammar ◽  
S. Alsater
Keyword(s):  
Breast Cancer ◽  
Family History ◽  
Early Detection ◽  
Strong Predictor ◽  
Positive Family History ◽  
Diagnostic Group ◽  
Screening Rate ◽  
Significant Difference ◽  
History Of

Background: King Hussein Cancer Foundation and Center (KHCF & KHCC) lead Breast Cancer (BC) awareness in Jordan through the Jordan Breast Cancer Program. The program aims to reduce morbidity and mortality from BC, and shift the current state of diagnosis from late stages to earlier ones, where the disease is curable, survival rates are higher, and treatment costs are lower. In October, the international BC awareness month, many activities are organized to encourage Jordanian women to undergo screening. Aim: To find out predictors of screening visits at KHCC early detection clinic in October 2015 to evaluate echo of the campaign. In addition, we aim to find the screening rate among women at KHCC early detection clinic. Methods: This is a cross sectional study, using a self-administered questionnaire, carried out in October 2015 and follow-up was completed on August 2016. Results: 291 women responded to the questionnaire, they were categorized into two groups; screening and diagnostic. Screening rate was 57.8% (N=166). In women above 40 years old, 69.3% (N=113) were in the screening group and 30.7% (N= 50) in the diagnostic group. There was no statistically significant difference in the average ages between two groups (49.49 year, 47.82 year, P = 0.218). Positive family history of BC in a first-degree relative was found to be a strong predictor for mammogram screening in comparison with screening group (65.4% vs 16%, P = 0.05); other screening behaviors like commitment to self-breast exam, clinical breast exam and attending educational lecture about BC did not significantly affect screening rates. In addition, screened women were more likely to complete their investigations and follow-up procedures. In this sample, five women were diagnosed with BC; two in advanced stages among the diagnostic group 4%, (N=50) with mean age 54.5 year, and three in early stage among screened group 2.7%, (N=113) with a mean age of 50 year. Conclusion: First-degree family history of BC is a strong predictor of BC screening. Awareness activities might lead to higher screening rates among women in general. Further studies need to be conducted on larger scale to confirm the results of this study.

Podwójne zęby środkowe szczęki w uzębieniu mlecznym – opis przypadku i przegląd piśmiennictwa

2020 ◽  
Vol 25 (3) ◽  
Author(s):  
Agnieszka Bruzda-Zwiech ◽  
Katarzyna Marut-Krawczyńska ◽  
Anna Janas-Naze ◽  
Joanna Szczepańska
Keyword(s):  
Family History ◽  
Early Detection ◽  
General Anaesthesia ◽  
Root Resorption ◽  
Positive Family History ◽  
The Other ◽  
Supernumerary Teeth ◽  
Supernumerary Tooth ◽  
History Of ◽  
Adequate Management

Mesiodens is the most common form of supernumerary teeth, usually located in maxilla, in the region of medial line. The overall prevalence of mesiodens in primary, mixed and young permanent dentition varies between 0.09 and 2.05%. However, occurrence of double mesiodentes in patient without any associated systemic conditions or syndromes is a rare phenomenon. This paper presents a report of nonsyndromic double mesiodentes in 3.5-year-old girl with positive family history of supernumerary teeth. Both of mesiodentes had conical shape. One of supernumerary tooth was partially erupted and caused mesial displacement of deciduous maxillary right incisor, root resorption of that tooth found on intraoral radiograph, as well as rotation of the germ of permanent incisor. While the other was impacted and inverted. Mesiodentes were surgically removed under general anaesthesia. The healing was uneventful. As the mesiodens is a single or multiple anomaly that a dental practitioner may come across, the paper discusses signs, complications and management of mesiodentes. It also emphasizes the importance of early detection and adequate management of single or double mesiodentes to minimize the future dental complication or malocclusion caused by this anomaly.

Development and Psychometric Testing of the Coping With Breast Cancer Threat Instrument

2004 ◽  
Vol 12 (1) ◽  
pp. 33-46
Author(s):  
Diane R. Lancaster
Keyword(s):  
Breast Cancer ◽  
Family History ◽  
Primary Prevention ◽  
Early Detection ◽  
Positive Family History ◽  
Psychometric Testing ◽  
Coping Behaviors ◽  
Research Attention ◽  
Clinical Breast ◽  
History Of

Women with a positive family history of breast cancer have a higher relative breast cancer risk. Research pertinent to this “at-risk” population has focused primarily on the early detection measures of breast self-exam, clinical breast exam, and mammography. Other specific primary prevention coping behaviors have received little research attention and, while there are instruments that measure general coping behaviors in the face of illness threat, there are no known instruments that measure coping behaviors specific to dealing with breast cancer threat. This study tested the psychometric properties of the Coping with Breast Cancer Threat instrument (CBCT). The CBCT was designed to measure primary prevention and early detection coping strategies used by women with family histories of breast cancer in response to their appraised breast cancer threat. The tool’s format was modeled after the Jalowiec Coping Scale (JCS) and included use and effectiveness scales. Internal consistency reliabilities and content and construct validity of the CBCT were assessed in a sample of 209 women with a family history of breast cancer. Alpha coefficients for the CBCT’s total use and effectiveness scales were .70 and .76, respectively. Principal components factor analysis with a varimax rotation revealed three conceptually relevant subcales that accounted for 52% of the variance in breast cancer threat coping behaviors. The CBCT was shown to be a reliable and valid measure of coping with breast cancer threat in a well-educated, European Amercian sample of middle-aged women.

scholarly journals The association between diabetes and thyroid cancer risk: a hospital-based case-control study in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meng Wang ◽  
Wei-Wei Gong ◽  
Feng Lu ◽  
Ru-Ying Hu ◽  
Qing-Fang He ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Family History ◽  
Case Control Study ◽  
Positive Family History ◽  
Case Control ◽  
Diabetes Duration ◽  
Family History Of Diabetes ◽  
Thyroid Cancer Risk ◽  
History Of ◽  
Control Study

Abstract Background Previous studies have indicated inconsistent relationships of diabetes with thyroid cancer risk, yet little is known in China. In this study, we aimed to investigate the associations between diabetes, diabetes duration and the risk of thyroid cancer in Chinese population. Methods A 1:1 matched case-control study was performed between 2015 and 2017 in Zhejiang Province including 2,937 thyroid cancer cases and 2,937 healthy controls. Odds ratios (ORs) with 95 % confidence intervals (CIs) for thyroid cancer were estimated in logistic regression models. Specific effects stratified by age, as well as sex, body mass index (BMI) and family history of diabetes were also examined. Results Overall, neither diabetes (OR = 0.75, 95 % CI: 0.21–2.73) nor diabetes duration (OR = 0.14, 95 % CI: 0.02–1.22 for diabetes duration ≦ 5 years; OR = 2.10, 95 % CI: 0.32–13.94 for diabetes duration > 5 years) was significantly associated with thyroid cancer. In stratified analyses, significant lower risk of thyroid cancer was observed among subjects with diabetes and shorter diabetes duration ( ≦ 5 years), but limited to those who were aged more than 40 years, female, overweight/obese and had positive family history of diabetes. Conclusions Diabetes and shorter diabetes duration were significantly associated with decreased risk of thyroid cancer in individuals characterized by older age, female sex, higher BMI and positive family history of diabetes.

scholarly journals Differential expression of micro RNA-29 family in non-diabetic adults of diabetic and non-diabetic parents

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Uzair Abbas ◽  
Bushra Imdad ◽  
Sikander Adil Mughal ◽  
Israr Ahmed Baloch ◽  
Afshan Mehboob Khan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Family History ◽  
Positive Family History ◽  
Cross Sectional Study ◽  
Vital Role ◽  
Micro Rna ◽  
Cross Sectional ◽  
Family History Of Diabetes ◽  
History Of

Abstract Objective MicroRNAs are known to regulate 60% of genes at post translational level. MicroRNAs including Micro RNA-29 family play a vital role in cellular activities and have validate role in numerous metabolic disorders inclusive of diabetes mellitus and its complications. While micro RNA profile changes years before the occurrence of disease. This cross-sectional study was conducted in non-diabetic adults of diabetic and non-diabetic parents to explore the early changes in expression of micro RNA-29 family as it can be served as early biomarker of type 2 diabetes in non-diabetic adults. This study was conducted from January 2019 to January 2021. Micro RNA was extracted from plasma of 50 participants and expression was compared through qPCR. While data was analyzed through SPSS version 21.0. Results 29a and 29b had lower expression in participants with family history of DM compared to those having no family history of DM (P < 0.0001). While micro RNA 29c was found to be significantly higher in participants with positive family history of type 2 diabetes as compared to those without family history of diabetes (P = 0.001).

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