Complications and causes of mortality in patients with primary necrotizing systemic vasculitis

2021 ◽  
pp. 30-34
Author(s):  
V. I. Mazurov ◽  
I. B. Belyaeva ◽  
A. L. Chudinov ◽  
O. V. Inamova
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Clinical Symptoms ◽  
Microscopic Polyangiitis ◽  
Systemic Vasculitis ◽  
High Incidence ◽  
Primary Systemic Vasculitis ◽  
Causes Of Mortality ◽  
The Relationship

The article reviews the clinical symptoms, main complications in patients with ANCA-associated systemic vasculitis (granulomatous with polyangiitis, microscopic polyangiitis, eosinophilic granulomatous with polyangiitis) and polyarteritis nodosa during the first three years of the disease. We evaluated the relationship between complications and long-term glucocorticosteroid therapy. Patients with granulomatosis had the most unfavourable course of the disease with a high risk of complications. A high incidence of ischemic strokes and chronic kidney disease in patients with microscopic polyangiitis has been identified. We also analyzed cases of lethal outcomes in patients with primary systemic vasculitis.

RISK OF CHRONIC KIDNEY DISEASE IN PREMATURE NEWBORNS

2021 ◽  
Vol 100 (4) ◽  
pp. 53-58
Author(s):  
A.I. Safina ◽  
◽  
M.A. Daminova ◽  
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Preventive Measures ◽  
Research Data ◽  
Premature Newborns ◽  
Long Term Consequences ◽  
Long Term Monitoring ◽  
Term Monitoring

The article provides a literature review and own research data on the problem of the formation of chronic kidney disease (CKD) in premature newborns. The long-term consequences of prematurity associated with impaired nephrogenesis, the influence of damaging factors after birth with a high risk of additional kidney damage dictate the need for long-term monitoring and preventive measures that will help preserve kidney function and prevent the development of CKD.

scholarly journals Cesarean scar defect and its association with clinical symptoms, uterine position and the number of cesarean sections

2020 ◽  
Vol 9 (10) ◽  
pp. 4091
Author(s):  
Madhangi V. B. ◽  
Ramany C.
Keyword(s):  
Clinical Symptoms ◽  
Transvaginal Ultrasound ◽  
Multiple Logistic Regression Analysis ◽  
Tertiary Care ◽  
Cesarean Sections ◽  
History Of ◽  
Caesarean Scar Defect ◽  
Relationship Of ◽  
The Relationship

Background: Caesarean scar defect (CSD), also called isthmocele or niche is a long-term complication, which can be asymptomatic or can give rise to chronic pelvic pain, dyspareunia and postmenstrual spotting. The objective of this study was to assess the association of CSD with clinical symptoms, position of the uterus and the number of caesarean sections.Methods: This was a prospective observational study done at a tertiary care teaching hospital from January 2019 to December 2019. The study included women with history of previous one or more caesarean sections with demonstrable CSD on transvaginal ultrasound. Various scar dimensions noted were width and depth of the scar. A deficiency ratio was calculated as a ratio of residual myometrium at the scar to the adjacent myometrium.Univariate analysis was done to assess the relationship of clinical symptoms with the defect parameters and number of previous caesarean sections. Multiple logistic regression analysis was done to find out the association between symptoms and number of previous caesarean sections with the scar defect dimensions.Results: The width, depth and deficiency ratio of the CSD were significantly higher in study subjects with a greater number of caesarean sections. Retroflexed uteri had larger CSD. There was no association of clinical features with the defect dimensions and the position of the uterus.Conclusions: CSD dimensions and deficiency ratio correlate with the number of previous caesarean sections and the position of the uterus. There was no association of clinical symptoms with the defect parameters.

scholarly journals Shaping reversibility? Long-term deep brain stimulation in dystonia: the relationship between effects on electrophysiology and clinical symptoms

Brain ◽  
2011 ◽  
Vol 134 (7) ◽  
pp. 2106-2115 ◽  
Author(s):  
D. Ruge ◽  
L. Cif ◽  
P. Limousin ◽  
V. Gonzalez ◽  
X. Vasques ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Clinical Symptoms ◽  
The Relationship ◽  
Deep Brain

Implications of rapidity of response to initial therapy in multiple myeloma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 8606-8606
Author(s):  
Krishna Bilas Ghimire ◽  
Vincent Rajkumar ◽  
Angela Dispenzieri ◽  
Martha Lacy ◽  
Morie Gertz ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
High Risk ◽  
Initial Therapy ◽  
M Protein ◽  
Newly Diagnosed ◽  
Long Term Outcomes ◽  
High Risk Disease ◽  
M Spike ◽  
The Relationship

8606 Background: The rapidity of response to initial therapy in multiple myeloma (MM) depends on a variety of factors. There is limited data on its implications on long term outcomes in patients (pts) with newly diagnosed MM. Methods: We retrospectively examined the outcomes in a cohort of 454 pts with newly diagnosed MM between Jan 2000- Dec 2011 undergoing induction therapy. Results: The median age at diagnosis was 66 yrs (29-92). Pts had measurable serum M-spike (>= 1 g/dL), dFLC (>=10 mg/dl) or 24 hour urinary M protein excretion (UrM; >=200 mg) in 70, 63 and 39% respectively. We first examined the relationship between the response to first cycle of therapy and overall survival (OS). We divided pts into quartiles based on their % reduction in the serum M spike, dFLC or UrM. The median OS (Table) was poorest for pts with the least reduction of serum M protein (P<0.001) and of dFLC. The cutoffs for Q1 was 25, 40and 40% decrease for serum M spike, dFLC and 24 hr UrM respectively. Among various baseline characteristics only higher age was predictive of a poor (Q1) response. Given the trend toward worse OS among the Q 4 group (maximum decrease in serum M spike), we examined the relationship to cytogenetic risk. Among 232 pts with FISH data available, proportion of pts with high-risk disease was 27, 12, 22 and 31% respectively in quartiles 1 - 4). In a multivariate analysis, quartile 1 and 4 of serum M-protein response and the high-risk FISH were independent risk factors associated inferior OS. Conclusions: Both shallow and very deep response to therapy in cycle 1 is a strong indicator of eventual disease outcome and should be considered as marker of high-risk disease, likely through different mechanisms. For the shallow responders, prospective trials should assess if a change in therapeutic management will alter the outcome of these pts. The rapid deep responders also appear represent a different high-risk biology, emphasizing the fact that pts with high-risk disease often have excellent initial responses, but poor long term outcomes. [Table: see text]

scholarly journals Using CHADS2 and CHA2DS2-VASc scores for mortality prediction in patients with chronic kidney disease

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Po-Chao Hsu ◽  
Wen-Hsien Lee ◽  
Szu-Chia Chen ◽  
Yi-Chun Tsai ◽  
Ying-Chih Chen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Mortality Prediction ◽  
Multivariate Model ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Basic Model ◽  
All Cause Mortality

Abstract Chronic kidney disease (CKD) is a public health issue and is associated with high morbidity and mortality. How to identify the high-risk CKD patients is very important to improve the long-term outcome. CHADS2 and CHA2DS2-VASc scores are clinically useful scores to evaluate the risk of stroke in patients with atrial fibrillation. However, there was no literature discussing about the usefulness of CHADS2 and CHA2DS2-VASc scores for cardiovascular (CV) and all-cause mortality prediction in CKD patients. This longitudinal study enrolled 437 patients with CKD. CHADS2 and CHA2DS2-VASc scores were calculated for each patient. CV and all-cause mortality data were collected for long-term outcome prediction. The median follow-up to mortality was 91 (25th–75th percentile: 59–101) months. There were 66 CV mortality and 165 all-cause mortality. In addition to age and heart rate, CHADS2 and CHA2DS2-VASc scores (both P value < 0.001) were significant predictors of CV and all-cause mortality in the multivariate analysis. Besides, in direct comparison of multivariate model, basic model + CHA2DS2-VASc score had a better additive predictive value for all-cause mortality than basic model + CHADS2 score (P = 0.031). In conclusion, our study showed both of CHADS2 and CHA2DS2-VASc scores were significant predictors for long-term CV and all-cause mortality in CKD patients and CHA2DS2-VASc score had a better predictive value than CHADS2 score for all-cause mortality in direct comparison of multivariate model. Therefore, using CHADS2 and CHA2DS2-VASc scores to screen CKD patients may be helpful in identifying the high-risk group with increased mortality.

scholarly journals Syringomyelia in children with closed spinal dysraphism: long-term outcomes after surgical intervention

2020 ◽  
Vol 25 (3) ◽  
pp. 319-325 ◽  
Author(s):  
Amy K. Bruzek ◽  
Jordan Starr ◽  
Hugh J. L. Garton ◽  
Karin M. Muraszko ◽  
Cormac O. Maher ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Clinical Symptoms ◽  
Spinal Dysraphism ◽  
Tethered Cord ◽  
Presenting Symptoms ◽  
Age At Surgery ◽  
Intradural Lipoma ◽  
The Relationship

OBJECTIVEThe nature of the relationship between spinal cord syrinx and tethered cord is not well known. It is unclear if surgical cord untethering results in resolution or improvement of an associated syrinx. The objective of this study was to report the response of spinal cord syrinx to surgical cord untethering.METHODSThe authors retrospectively reviewed all patients with a syrinx and tethered cord who presented to a single institution over an 11-year interval. Patients with open neural tube defects were excluded. Thirty-one patients were identified, 25 of whom had both clinical and imaging follow-up after surgery. Patients were grouped according to etiology of the tethered cord. Clinical outcomes and syrinx characteristics were recorded.RESULTSOf the 25 patients with tethered cord, 68% (n = 17) were male. The average age at presentation was 2.5 years (0–10.1 years) and age at surgery was 3.7 years (range 1 day to 17 years). Etiologies of tethered cord were lipomyelomeningocele (n = 8), thickened/fatty filum (n = 7), intradural lipoma (n = 5), myelocystocele (n = 2), meningocele (n = 2), and diastematomyelia (n = 1). Twenty-three of the patients underwent primary untethering, whereas 2 patients had received untethering previously at another institution. The average syrinx length and width prior to surgery were 4.81 vertebral levels (SD 4.35) and 5.19 mm (SD 2.55 mm), respectively. Conus level ranged from L1 to S3. Patients were followed for an average of 8.4 years (1.35–15.85 years). Overall there was no significant change in syrinx length or width postoperatively; the average syrinx length increased by 0.86 vertebral levels (SD 4.36) and width decreased by 0.72 mm (SD 2.94 mm). Seven of 25 patients had improvement in at least one presenting symptom, including scoliosis, weakness, bowel/bladder dysfunction, and pain. Eight patients had stable presenting symptoms. Six patients were asymptomatic and 5 patients had new or worsening symptoms, which included scoliosis, pain, or sensory changes.CONCLUSIONSAlthough some syrinxes improved after surgery for tethered cord, radiological improvement was not consistent and did not appear to be associated with change in clinical symptoms. The decision to surgically untether a cord should be focused on the clinical symptoms and not the presence of a syrinx alone. Further studies are needed to confirm this finding.

scholarly journals LONG OF HEMODIALYSIS THERAPY WITH QUALITY LIFE PATIENT FAILS OF KIDNEY CHRONIC IN RS GATOEL MOJOKERTO: STUDY CROSS-SECTIONAL

2017 ◽  
Vol 1 (1) ◽  
pp. 56-64
Author(s):  
Arif Wicaksono ◽  
Muhammad Sajidin
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cross Sectional ◽  
Quality Life ◽  
Cross Sectional Design ◽  
The Individual ◽  
The Relationship

Hemodialysis therapy of patients with chronic kidney disease can changes the patients physically, psychological, social and economics because they have to deal with it for the rest of their life. This can affect the quality of life of the patients because of the long-term of hemodialysis therapy, this is one of the factors that affect the quality of life of the patients with chronic kidney disease. Quality of life is focused on the assessment of the individual against conditions acceptance. Each individual takes different phases to accept the condition. The purposes of the study were to determine if the relationship between the duration of hemodialysis and quality of life of the patients with chronic kidney disease at Gatoel Hospital Mojokerto. This research used cross-sectional design. The patient's population with chronic kidney disease undergoing hemodialysis is 150 people. The research sample is drawn using sampling techniques with the type of nonprobability purposive sampling with 130 people as a sample. Data obtained from questionnaires KDQoL 36. The result using Spearman rho test using SPSS V.16 shows p < α (0,006 < 0,05). H0 rejected, this means that there is a relationship between the duration of hemodialysis and quality of life with chronic kidney disease at Gatoel Hospital Mojokerto. The quality of life of the patients fluctuated based on the stage adaptation of the hemodialysis and disease. However, most patients with the duration of hemodialysis for more than 12 months had a sufficient quality of life and their therapy are already familiar with the symptoms and complications, but there are other factors that affect the quality of life such as gender, marital status, and education level. Patients are also expected to cooperate in what to do and not to do to improve the quality of life of the patients.

scholarly journals Pre-Operative Kidney Biomarkers and Risks for Death, Cardiovascular and Chronic Kidney Disease Events: The TRIBE-AKI Study

2021 ◽  
Author(s):  
George Vasquez-Rios ◽  
Dennis G. Moledina ◽  
Yaqi Jia ◽  
Eric McArthur ◽  
Sherry G. Mansour ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cardiac Surgery ◽  
Cohort Study ◽  
High Risk ◽  
Kidney Disease ◽  
Cardiovascular Events ◽  
Kidney Injury ◽  
Multicenter Cohort Study ◽  
Clinical Model

Background: Soluble tumor necrosis factor receptor (sTNFR)1, sTNFR2, and plasma kidney injury molecule 1 (KIM1) are associated with kidney events in patients with and without diabetes. However, their associations with clinical outcomes when obtained pre operatively have not been explored. Methods: The TRIBE AKI cohort study is a prospective, multicenter, cohort study of high risk adults undergoing cardiac surgery. We assessed the associations between pre operative concentrations of plasma sTNFR1, sTNFR2, and KIM1 and post operative long term outcomes including mortality, cardiovascular events, and chronic kidney disease (CKD) incidence or progression, ascertained after discharge. Results: Among 1378 participants included in the analysis with a median follow up period was 6.7 (IQR 4.0,7.9), 434 (31%) patients died, 256 (19%) experienced cardiovascular events and out of 837 with available long term kidney function data, 30% developed CKD. After adjustment for clinical covariates, each log increase in biomarker concentration was independently associated with mortality with 95% CI adjusted hazard ratios (aHRs) of 3.0 (2.3,4.0), 2.3 (1.8,2.9) and 2.0 (CI 1.6,2.4) for sTNFR1, sTNFR2 and KIM1, respectively. For cardiovascular events, the 95%CI aHRs were 2.1 (1.5,3.1), 1.9 (1.4,2.6) and 1.6 (1.2,2.1) for sTNFR1, sTNFR2 and KIM1, respectively. For CKD events, the aHRs were 2.2 (1.5,3.1) for sTNFR1, 1.9 (1.3,2.7) for sTNFR2, and 1.7 (1.3,2.3) for KIM1. Despite the associations, each of the biomarkers alone or in combination failed to result in robust discrimination on an absolute basis or compared to a clinical model. Conclusion: sTNFR1, sTNFR2, and KIM1 were independently associated with longitudinal outcomes after discharge from a cardiac surgery hospitalization including death, cardiovascular and CKD events when obtained pre operatively in high risk individuals. Pre operative plasma biomarkers could serve to assist during the evaluation of patients in whom cardiac surgery is planned.

scholarly journals LONG OF HEMODIALYSIS THERAPY WITH QUALITY LIFE PATIENT FAILS OF KIDNEY CHRONIC IN RS GATOEL MOJOKERTO: STUDY CROSS-SECTIONAL

2017 ◽  
Vol 1 (1) ◽  
pp. 56-64
Author(s):  
Arif Wicaksono ◽  
Muhammad Sajidin
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cross Sectional ◽  
Quality Life ◽  
Cross Sectional Design ◽  
The Individual ◽  
The Relationship

Hemodialysis therapy of patients with chronic kidney disease can changes the patients physically, psychological, social and economics because they have to deal with it for the rest of their life. This can affect the quality of life of the patients because of the long-term of hemodialysis therapy, this is one of the factors that affect the quality of life of the patients with chronic kidney disease. Quality of life is focused on the assessment of the individual against conditions acceptance. Each individual takes different phases to accept the condition. The purposes of the study were to determine if the relationship between the duration of hemodialysis and quality of life of the patients with chronic kidney disease at Gatoel Hospital Mojokerto. This research used cross-sectional design. The patient's population with chronic kidney disease undergoing hemodialysis is 150 people. The research sample is drawn using sampling techniques with the type of nonprobability purposive sampling with 130 people as a sample. Data obtained from questionnaires KDQoL 36. The result using Spearman rho test using SPSS V.16 shows p < α (0,006 < 0,05). H0 rejected, this means that there is a relationship between the duration of hemodialysis and quality of life with chronic kidney disease at Gatoel Hospital Mojokerto. The quality of life of the patients fluctuated based on the stage adaptation of the hemodialysis and disease. However, most patients with the duration of hemodialysis for more than 12 months had a sufficient quality of life and their therapy are already familiar with the symptoms and complications, but there are other factors that affect the quality of life such as gender, marital status, and education level. Patients are also expected to cooperate in what to do and not to do to improve the quality of life of the patients.

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