MANAGEMENT OF PRIMARY HYPERADOSTERONISM : DON'T WAIT UNTIL IT'S TOO LATE

Introduction: Arterial hypertension by primary hyperaldosteronism is the most frequent cause of endocrine hypertension. It is responsible for 10% of endocrine arterial hypertension. In our context, there is a delay in the diagnosis of primary hyperaldosteronism because it is under traked and also because of the high cost of check-ups. The aim of our study is to highlight the challenges in the management of these patients. This observational study i Material And Method: ncludes patients admitted at the department of endocrinology of Sheikh Khalifa Ibn Zayd universitary hospital for primary aldosteronism between January 2019 and January 2021. Primary hyperaldosteronism was dened according to the Consensus on Primary Hyperaldosteronism of The French Society of Endocrinology (SFE), in collaboration with the French Society of Hypertension (SFHTA) and the French Association of Endocrine Surgery (AFCE). For all patients, we collected demographic characteristics, familial history of hypertension and cardiovascular diseases, patient's history of hypertension and its complications. We performed biological assessments and imaging investigations. We included 10 patients .The mean age of patients Results: was 42.5 years (+/-12.06). 7/10 of patients was males. We found a family history of hypertension in 7/10 of the cases . The mean age of onset of arterial hypertension was 36.4 years (+/-7,87) . Grade 3-hypertension was found in 4/10 of the cases. Hypokalemia was found in 6/10 of the cases. The etiological investigation found bilateral adrenal hyperplasia in 4/10 of the cases. Among them 5/10 have performed catheterization of the adrenal veins, which revealed lateralization of aldosterone secretion. Conn's adenoma was found in 4/10 of the cases and unilateral adrenal hyperplasia in 2/10 of the cases. Our study illustrate the value of screening for Conclusion: primary hyperaldosteronism in young subjects with severe hypertension associated with hypokalemia and also given the curable and reversible nature of hypertension.

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Clinical, epidemiological and autoimmune associations in childhood vitiligo in Qatar

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20200594 ◽

2020 ◽

Vol 6 (2) ◽

pp. 151

Author(s):

Haya Al Mannai ◽

Mohamed Allam ◽

Hassan Riad

Keyword(s):

Family History ◽

Autoimmune Diseases ◽

Age Of Onset ◽

Positive Family History ◽

Thyroid Peroxidase ◽

Base Line ◽

Adult Onset ◽

Prognostic Features ◽

History Of ◽

The Mean

Background: Childhood vitiligo although clinically similar to adult onset vitiligo but it has distinct clinical, epidemiological and prognostic features compared to adult onset vitiligo.Methods: This is a retrospective study that was carried out on 85 pediatric patients up to age of 18 years old with the diagnosis of vitiligo, where the clinical and epidemiological data including clinical type of vitiligo, family history of autoimmune diseases like thyroid disorders and diabetes mellitus and laboratory results including anti-thyroid peroxidase antibodies (anti-TPO antibodies), anti-parietal cell antibodies, antinuclear antibodies (ANA), Vitamin D and Vitamin B12 were retrieved from the files of these patients.Results: The mean age of the children affected by vitiligo was 10.4 years, the mean age of onset of vitiligo was 5.4 years, 54 (63.5%) percent were girls and 31 (36.5%) were boys. A positive family history of vitiligo was found in 44.7% of the participants, family history of DM was found in 64.7% of patients and family history of thyroid disease was found in 32.9% of the participants. The prevalence of thyroid autoimmunity was found to be in 22.4% of total participants.Conclusions: Childhood vitiligo has distinct clinical features, more common family history for autoimmune diseases and thyroid autoantibodies rather than overt clinical diseases, which raise the necessity to perform a routine initial immunological and thyroid screening in children with vitiligo and to repeat them at annual bases if there were abnormal values at base line or strong family history.

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Epidemiology and associated factors of atopic dermatitis in Malagasy children

Allergy Asthma & Clinical Immunology ◽

10.1186/s13223-019-0398-2 ◽

2020 ◽

Vol 16 (1) ◽

Cited By ~ 1

Author(s):

F. A. Sendrasoa ◽

I. M. Ranaivo ◽

N. H. Razanakoto ◽

M. Andrianarison ◽

O. Raharolahy ◽

...

Keyword(s):

Atopic Dermatitis ◽

Low Income ◽

Rural Areas ◽

Associated Factors ◽

Age Of Onset ◽

Descriptive Study ◽

History Of ◽

The Mean ◽

Urban And Rural Areas ◽

Duration Of Breastfeeding

Abstract Background Little is known about the epidemiology and associated factors of childhood AD in the markedly different, low-income, tropical environment like Madagascar. Methods We aim to assess the epidemiology and associated factors of AD in individuals fewer than 15 years of age in Antananarivo Madagascar. It was a retrospective and descriptive study over a period of 7 years (2010 to 2016) in children 6 months to 14 years in the Department of Dermatology, Joseph Raseta Befelatanana Antananarivo Madagascar. The diagnosis of AD was based on clinical data. Results The prevalence of AD was 5.6% in children aged 6 months to 14 years. The details of 151 cases of atopic dermatitis were analyzed. The mean age of patients was 4 years. There was a female preponderance (sex ratio: 0.7). A family history of AD was noted in 56 cases (37%). No association between breast-feeding and AD was found. The age of onset of AD was before the age of 3 months in 7.5% and between 6 months to 5 years in 70%. Children born in March (dry season) had the highest risk of AD. Consultations for AD increased during the winter (from July to October; p = 0.005). However, the prevalence of AD was similar in urban and rural areas. Conclusion Weather may have an impact on the prevalence of atopic dermatitis in Madagascar. No significant correlation was found between the duration of breastfeeding and AD, as well as urbanization.

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A Family with Multiple Instances of Definite, Probable and Possible Early-Onset Alzheimer's Disease

The British Journal of Psychiatry ◽

10.1192/bjp.159.4.524 ◽

1991 ◽

Vol 159 (4) ◽

pp. 524-530 ◽

Cited By ~ 9

Author(s):

H. Karlinsky ◽

E. Madrick ◽

J. Ridgley ◽

J. M. Berg ◽

R. Becker ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Early Onset ◽

Age Of Onset ◽

Diagnostic Difficulties ◽

History Of ◽

Early Onset Alzheimer’S Disease ◽

The Mean ◽

Age Of Death

A family with a multigenerational history of proven or suspected early-onset Alzheimer's disease (AD) consistent with autosomal-dominant inheritance is described. To date, the pedigree comprises five generations in which there are 13 known affected individuals. The mean age of onset of cognitive deficits in those for whom data are available (n = 11) is 47.6 (s.d. 3.0) years and the mean age of death (n = 10) is 58.8 (s.d. 4.0) years. The variability in the extent and quality of available data illustrates the diagnostic difficulties encountered in ascertaining such an extended pedigree, and the need for caution in interpreting the evidence.

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Time to recovery predicted by the severity of postoperative C5 palsy

Journal of Neurosurgery Spine ◽

10.3171/2019.8.spine19602 ◽

2020 ◽

Vol 32 (2) ◽

pp. 191-199 ◽

Cited By ~ 3

Author(s):

Zach Pennington ◽

Daniel Lubelski ◽

Erick M. Westbroek ◽

A. Karim Ahmed ◽

Jeff Ehresman ◽

...

Keyword(s):

Clinical Symptoms ◽

Complete Recovery ◽

Radicular Pain ◽

Tertiary Referral Center ◽

C5 Palsy ◽

Kaplan Meier ◽

History Of ◽

The Mean ◽

Grade 3 ◽

Degenerative Cervical Spine

OBJECTIVEPostoperative C5 palsy affects 7%–12% of patients who undergo posterior cervical decompression for degenerative cervical spine pathologies. Minimal evidence exists regarding the natural history of expected recovery and variables that affect palsy recovery. The authors investigated pre- and postoperative variables that predict recovery and recovery time among patients with postoperative C5 palsy.METHODSThe authors included patients who underwent posterior cervical decompression at a tertiary referral center between 2004 and 2018 and who experienced postoperative C5 palsy. All patients had preoperative MR images and full records, including operative note, postoperative course, and clinical presentation. Kaplan-Meier survival analysis was used to evaluate both times to complete recovery and to new neurological baseline—defined by deltoid strength on manual motor testing of the affected side—as a function of clinical symptoms, surgical maneuvers, and the severity of postoperative deficits.RESULTSSeventy-seven patients were included, with an average age of 64 years. The mean follow-up period was 17.7 months. The mean postoperative C5 strength was grade 2.7/5, and the mean time to first motor examination with documented C5 palsy was 3.5 days. Sixteen patients (21%) had bilateral deficits, and 9 (12%) had new-onset biceps weakness; 36% of patients had undergone C4–5 foraminotomy of the affected root, and 17% had presented with radicular pain in the dermatome of the affected root. On univariable analysis, patients’ reporting of numbness or tingling (p = 0.02) and a baseline deficit (p < 0.001) were the only predictors of time to recovery. Patients with grade 4+/5 weakness had significantly shorter times to recovery than patients with grade 4/5 weakness (p = 0.001) or ≤ grade 3/5 weakness (p < 0.001). There was no difference between those with grade 4/5 weakness and those with ≤ grade 3/5 weakness. Patients with postoperative strength < grade 3/5 had a < 50% chance of achieving complete recovery.CONCLUSIONSThe timing and odds of recovery following C5 palsy were best predicted by the magnitude of the postoperative deficit. The use of C4–5 foraminotomy did not predict the time to or likelihood of recovery.

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P1949Changes in prevalence patients with arterial hypertension in Russia

European Heart Journal ◽

10.1093/eurheartj/ehz748.0696 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

Y Badin ◽

I V Fomin ◽

D S Polyakov ◽

S S Yakushin ◽

E A Smirnova ◽

...

Keyword(s):

Blood Pressure ◽

Drug Treatment ◽

Arterial Hypertension ◽

Antihypertensive Drug ◽

P Value ◽

Antihypertensive Drug Treatment ◽

European Guidelines ◽

The Mean ◽

Grade 3

Abstract Aim The present study shows the dynamics of the prevalence different grades of AH and treatment coverage over15 years of observation. Methods 8740 apartments were randomized in 2002 year in eight regions of Russia and 19449 individuals were included. Re-examination was carried out in 2017 year. The representative sample was separated in four groups: Grade 0 – individuals with systolic blood pressure (BP) <140 mm Hg and diastolic blood pressure <90 mm Hg; and three Grades of arterial hypertension (AH) in accordance with European guidelines. Also, we select patient with and without antihypertensive drug treatment (AHDT). Results The mean age individuals was 44.4±19.3 years in 2002 year. Grade 0 had 63.3% participants (mean age 36.5±17.1 y.), Grade 1 – 19.5% (mean age 55.2±15.4 y.), Grade 2 – 11.7% (mean age 60.6±13.5 y.) and Grade 3 – 5.6% (mean age 62.4±12.8 y.). 3.0% participants had AHDT and blood pressure meets Grade 0. Patients with AH Grade 1 used drugs in 25.5% cases, with Grade 2 – 49.4% and with Grade 3 – 60.8% patients respectively. The mean age of participants with AHTD was significantly higher than mean age group without AHTD in Grade 0, 1 and 2 (p<0.001). In group Grade 3 mean age was not difference (p=0.16). The mean age individuals (51.3±16.9 y.) in 2017 year was significantly higher on 6.9 years than mean age in 2002 year (p<0.001). The proportion of patients with AHDT in all grades groups in sample 2017 year were significantly higher than in sample 2002 year (Table). The prevalence of AH in 2002 y. amounted to 38.6%. In 2017 y. prevalence of AH was significantly higher – 41.4% (p<0.001). Structure of samples Grade 2002 2017 AHDT Mean age AHDT P value Mean age 0 63,3% No 35,8±16,8 70,1% 42,6±13,9 Yes 3,0% 57,4±14,5 16,3% <0,001 63,6±12,0 1 19,5% No 53,3±15,7 23,6% 57,3±13,3 Yes 25,5% 60,9±13,0 68,4% <0,001 66,3±11,3 2 11,7% No 58,5±14,2 5,4% 58,0±14,9 Yes 49,4% 62,7±12,3 80,6% <0,001 66,5±11,5 3 5,6% No 61,7±13,9 1,0% 63,6±17,6 Yes 60,8% 62,8±12,0 71,1% 0,03 66,0±12,8 ALL 100% 44,4±19,3 100% 51,3±16,9 AHDT: antihypertensive drug treatment. Conclusion Over 15 years follow up period the prevalence of hypertension in Russia increased to 41.4%, but the effectiveness of therapy remains low.

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Depersonalisation disorder: clinical features of 204 cases

The British Journal of Psychiatry ◽

10.1192/bjp.182.5.428 ◽

2003 ◽

Vol 182 (5) ◽

pp. 428-433 ◽

Cited By ~ 116

Author(s):

Dawn Baker ◽

Elaine Hunter ◽

Emma Lawrence ◽

Nicholas Medford ◽

Maxine Patel ◽

...

Keyword(s):

Age Of Onset ◽

Past History ◽

Self Report ◽

Anxiety And Depression ◽

Dissociative Amnesia ◽

Male Preponderance ◽

History Of ◽

Dsm Iv ◽

The Mean ◽

State Examination

BackgroundDepersonalisation disorder is a poorly understood and underresearched syndrome.AimsTo carry out a large and comprehensive clinical and psychopathological survey of a series of patients who made contact with a research clinic.MethodA total of 204 consecutive eligible referrals were included: 124 had a full psychiatric examination using items of the Present State Examination to define depersonalisation/derealisation and 80 had either a telephone interview (n=22) or filled out a number of self-report questionnaires. Cases assessed were diagnosed according to DSM–IV criteria.ResultsThe mean age of onset was 22.8 years; early onset was associated with greater severity There was a slight male preponderance. The disorder tended to be chronic and persistent. Seventy-one per cent met DSM–IV criteria for primary depersonalisation disorder. Depersonalisation symptom scores correlated with both anxiety and depression and a past history of these disorders was commonly reported. ‘Dissociative amnesia’ was not prominent.ConclusionsDepersonalisation disorder is a recognisable clinical entity but appears to have significant comorbidity with anxiety and depression. Research into its aetiology and treatment is warranted.

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Chronic Spontaneous Urticaria

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475415623777 ◽

2015 ◽

Vol 20 (3) ◽

pp. 241-243 ◽

Cited By ~ 2

Author(s):

Natasha Gattey ◽

Bahar Bahrani ◽

Peter R. Hull

Keyword(s):

Autoimmune Diseases ◽

Autoimmune Thyroiditis ◽

Age Of Onset ◽

Average Duration ◽

Chronic Spontaneous Urticaria ◽

Duration Of Symptoms ◽

Disturbed Sleep ◽

Significant Disability ◽

History Of ◽

The Mean

Background: Chronic spontaneous urticaria (CSU) is urticaria persisting for more than 6 weeks with no identifiable provoking cause and associated with significant disability. Objectives: The aim of this study was to survey patients with CSU with a view to establishing prognosis, efficacy of treatments, suspected causality, and effects on lifestyle. Methods: One hundred seventy-four patients with CSU were seen between 2003 and 2013. A questionnaire was sent to all, and 101 participated. Results: The ratio of female to male participants was 4:1. The mean age of onset was 36 years. The average duration of symptoms was 8.8 years, with a range of 0.33 to 55 years. Seven percent of participants had autoimmune thyroiditis, and another 17% had various other autoimmune diseases. Common symptoms were pruritus, disturbed sleep, and anxiety. Slightly more than 70% had missed work or school. Most were frustrated at the lack of efficacy of treatments. Conclusions CSU is frequently associated with a history of autoimmune diseases. It may persist for decades and causes significant disruption to lifestyle.

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De Novo Aneurysm: Case Reports and Literature Review

Neurosurgery ◽

10.1227/neu.0b013e3182196489 ◽

2011 ◽

Vol 69 (3) ◽

pp. E761-E767 ◽

Cited By ~ 17

Author(s):

Nunung Nur Rahmah ◽

Tetsuyoshi Horiuchi ◽

Yoshikazu Kusano ◽

Tetsuo Sasaki ◽

Kazuhiro Hongo

Keyword(s):

Arterial Hypertension ◽

De Novo ◽

Past History ◽

Case Reports ◽

Previous History ◽

Anterior Circulation ◽

Risk Of Rupture ◽

History Of ◽

The Mean

Abstract BACKGROUND AND IMPORTANCE: Formation of cerebral de novo aneurysms (CDNAs) is rare, and the pathogenesis remains obscure. We analyzed factors involved in formation of CDNAs and suggest guidelines for follow-up of patients. CLINICAL PRESENTATION: We retrospectively reviewed intracranial aneurysms at our institute and published reports from 1964 to 2008. Eleven patients were found with CDNAs, and 138 patients were collected from the published literature. We assessed the clinical characteristics, such as sex, size, and site of CDNA, past history, and time to occurrence of CDNAs. Of 11 patients, 10 were female and 1 was male; the mean age of the first onset was 53 years (range, 25-69 years). The mean time between first aneurysms and CDNAs was 10.6 years (range, 3-29 years). The most common site of occurrence was anterior circulation. One patient experienced contralateral occurrence, and 2 patients changed from anterior to posterior circulation CDNAs. Six (54.5%) patients had a history of arterial hypertension. Results from analysis of the whole series from the literature revealed that the risk of rupture increased with a previous history of hemorrhage. Contralateral occurrence of CDNAs was related to previous location, and multiplicity, whereas the occurrence of anterior to posterior changes of CDNAs and shorter interval only correlated with an older age group. CONCLUSION: Although the formation of CDNAs is rare, several factors may contribute to its occurrence. Female patients with a history of arterial hypertension were at a higher risk for CDNA occurrence. We recommend follow-up imaging studies within 10 years after the initial aneurysms; therefore, at least 50% of CDNAs can be found before rupture.

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AB0736 JUVENILE IDIOPATHIC ARTHRITIS IN ADULTHOOD: TRENDS OF THE DISEASE AND SOCIO-PROFESSIONAL FUTURE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2924 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1397.3-1398

Author(s):

S. Miladi ◽

M. Yasmine ◽

S. Mariem ◽

A. Fazaa ◽

K. Ouenniche ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Rheumatoid Factor ◽

Transition To Adulthood ◽

Age Of Onset ◽

Adult Life ◽

Systemic Jia ◽

Disease Subtype ◽

Prosthetic Joint ◽

History Of ◽

The Mean

Background:Juvenile idiopathic arthritis (JIA) is the most common arthropathy of childhood that may lead to physical disability and reduced quality of life, thus hindering the ability of the patients to achieve a meaningful adult life.Objectives:The aim of this study was to assess the trends of the disease and socio-professional future.Methods:We conducted a retrospective study including adult patients aged > 18 years with a history of JIA according to the International League of Associations for Rheumatology (ILAR). Collected data included age, sex, the characteristics of the disease (subtype of JIA, disease duration). The level of education, marital status as well as the profession were recorded.Results:The study included 32 patients with a female perdominance: sex ratio was 1,5. The mean age was 29,5 years old [18-64]. The mean age of onset of the disease was 6 years and 2 months [2-17]. The frequency of each JIA subset was at follows: polyarticular with rheumatoid factor (n= 14), polyarticular without rheumatoid factor (n=9), systemic (n= 2), enthesitis-related arthritis (n=7), oligoarthritis (n= 5). Four patients suffered from bilateral cataract due to corticosteroid intake. Polyarticular RF+ and RF- progressed into an authentic seropositive and seronegative RA in 71.4% and 66.7% respectively. Among oligoarticular subtype, an extension of the disease to a polyarticular FR+ form (n=1) and to a seronegative rheumatoid arthritis (n=1) was noted. Systemic JIA forms remained in remission with an articular involvement. All the patients with ERA developed spondylarthritis. Although forty–two percent of the patients were married, only half of them had children. Ten percent of patients stopped attending school because of disease flares and deformation. A university level was found in 16% of cases. Only Thirty patients had a profession. Of the patients, 74.4% had received disease-modifying anti-rheumatic drugs (DMARDs) and 36.3% of them were still taking a DMARD. Ten patients were on biologics. Severe disability was found in 20% of patients and concerned mainly the hip (57,2%), the wrist (28,5%) and the elbows (14,3%). Prosthetic joint replacement was found in 2% of cases with a revision of the latter in one patient.Conclusion:Adults with JIA often have significant levels of disability, usually related to severe joint complications. There is a clear requirement for a better transition to adulthood and a socio-professional rehabilitation.Disclosure of Interests:None declared

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McLean Hospital Depression Research Facility: early-onset phobic disorders and adult-onset major depression

The British Journal of Psychiatry ◽

10.1192/s0007125000293495 ◽

1998 ◽

Vol 173 (S34) ◽

pp. 29-34 ◽

Cited By ~ 36

Author(s):

A. F. Schatzberg ◽

J. A. Samson ◽

A. J. Rothschild ◽

T. C. Bond ◽

D. A. Regier

Keyword(s):

Anxiety Disorder ◽

Major Depression ◽

Anxiety Disorders ◽

Early Onset ◽

Depressive Disorders ◽

Age Of Onset ◽

Exact Test ◽

Current Prevalence ◽

History Of ◽

The Mean

Background This study explores the temporal relationship between anxiety and major depressive disorders in a cohort of patients with current major depression.Method Current prevalence and lifetime history of specific anxiety disorders were assessed using the Structured Clinical Interview for DSM–III–R Diagnosis (SCID–P) in 85 patients with DSM–III–R major depression. Consensus DSM–III–R diagnoses were assigned by at least two psychiatrists or psychologists.Results Twenty-nine per cent met criteria for at least one current anxiety disorder and 34% had at least one anxiety disorder at some point in their lives. The mean (s.d.) age of onset of anxiety disorder in the depressed patients with comorbid social or simple phobia (15 (9) years) was significantly younger than was that of their major depression (25 (9) years). In contrast, the mean (s.d.) age of onset of anxiety in patients with comorbid panic or OCD (20 (8) years) was similar to that seen for their major depression (21 (9) years). In patients with major depression with comorbid anxiety disorders, both the social phobia (10 of 13) and simple phobia (4 of 4) were more commonly reported to start at least two years prior to their major depression in contrast to depressives with comorbid panic (3 of 10 subjects) – Fisher's exact test, P=0.01.Conclusions Early-onset social and simple phobias appear to be risk factors for later onset of major depression.

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