scholarly journals Prevalence and Pathophysiology of Pediatric Urolithiasis - A Review

2021 ◽  
pp. 236-242
Author(s):  
Ahmed Abdelsamie Fadl ◽  
Zakiah Esmail Pasha ◽  
Abdulaziz Adel Abanumay ◽  
Albatool Mohammad Baz ◽  
Lena Mohammed Noor Hariri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Presentation ◽  
Common Type ◽  
Idiopathic Hypercalciuria ◽  
Metabolic Risk ◽  
Metabolic Abnormalities ◽  
Pediatric Urolithiasis ◽  
Treatment And Prevention ◽  
The Common ◽  
Causes And Risk Factors

Urolithiasis is a condition in which hard deposits made of salts and minerals are accumulated inside the kidneys. A lot of studies demonstrated adult urolithiasis but studies on pediatric urolithiasis is still scarce. Studies had shown that pediatric urolithiasis prevalence is progressively increasing worldwide. The main cause for this increase is not totally clear but has been associated to changes in climate, nutritional habits and other environmental factors.  Pediatric urolithiasis is distinctive and different from adult urolithiasis concerning prevalence, etiology and clinical presentation. Over the time while the condition was evolving, the main cause has changed from predominantly infectious to metabolic in nature. Pediatric urolithiasis should not be underestimated as it is associated with morbidity mainly since it possesses a striking feature which is ability to recur. Metabolic risk factors are more communal in pediatric urolithiasis than in adults. The common type of calculi in children is comprised of either calcium oxalate or calcium phosphate mainly and is often associated with a metabolic abnormality. Informed as metabolic abnormalities, Idiopathic hypercalciuria and hypocitraturia are the most frequently reported. A good understanding of the causes and risk factors of pediatric urolithiasis will provide better strategies and techniques for calculi treatment and prevention in children.

scholarly journals Coital trauma as seen at Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria

2019 ◽  
Vol 5 (10) ◽  
pp. 279
Author(s):  
Assumpta Nnenna Nweke ◽  
Johnbosco Ifunanya Nwafor ◽  
Bridget Nkiruka Uche-Nwidagu ◽  
Wendy Chinwe Oliobi ◽  
Malachy Chizoba Onyema ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Teaching Hospital ◽  
Clinical Presentation ◽  
University Teaching ◽  
Clinical Notes ◽  
Clinical Presentations ◽  
Posterior Fornix ◽  
The Common ◽  
Causes And Risk Factors

<p class="abstract"><strong>Background:</strong> Though pleasurable, coitus may result in morbidity and even mortality. One of such morbidities is coital trauma, a global occurrence that is grossly under reported. This study aimed to determine the causes and risk factors for coital trauma as well as its clinical presentation.</p><p class="abstract"><strong>Methods:</strong> This was a 4 year retrospective study of patients that presented with coital injuries at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Data were obtained from patients’ clinical notes using a specially designed proforma. Statistical analysis was performed using Epi Info<sup>TM </sup>7.2.1.  </p><p class="abstract"><strong>Results:</strong> The majority of women that presented with coital trauma were adolescents (67.9%). Most of them were single (92.9%), nulliparous (89.3%) and had only primary education (57.1%). The commonest cause of coital trauma was rape (75%). The commonest risk factors were inadequate foreplay (57.1%) and coitarche (42.9%). Other risk factors were genital disproportion, pregnancy, puerperium and influence of drugs. The common clinical presentations were vaginal bruises (75%) and vaginal lacerations (64.3%) while the commonest site of injury was the hymen (42.9%) followed by the vulva (35.7%). Other less common sites of injury were the lower vagina and posterior fornix.</p><p><strong>Conclusions:</strong> Coital trauma is relatively common and young girls are mainly affected. Rape is the major cause while inadequate foreplay and coitarche are the major predisposing factors. </p>

scholarly journals Post-treatment heterogeneity of cardio-metabolic risk in acromegalic patients: The Impacts of GH and IGF-1

2020 ◽  
Author(s):  
Mahshid Heydari ◽  
Nahid Hashemi Madani ◽  
Zahra Emami ◽  
Alireza Khajavi ◽  
Mohammad Ghorbani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Multivariate Analysis ◽  
Regression Models ◽  
Metabolic Risk Factors ◽  
Metabolic Risk ◽  
Metabolic Abnormalities ◽  
Logistic Regression Models ◽  
The Impact ◽  
Prevalence Of Diabetes Mellitus

Abstract Background: Metabolic abnormalities are frequently seen in patients with acromegaly. However, it is not clear to what extent GH /IGF-1 contribute to the development of these abnormalities. This study aimed to explore the impact of GH/IGF-1 on different aspects of metabolic abnormalities in patients with acromegaly. Methods: This retrospective, registry-based study conducted on 102 patients with acromegaly. Prevalence of diabetes mellitus (DM), hypertension (HTN), and dyslipidemia (DLP) at the time of diagnosis has been explored. Moreover, the impact of GH/IGF-1 on these cardio-metabolic risk factors at 3-12 months after surgery has been investigated using linear and logistic regression models.Results: At the time of diagnosis, the prevalence of cardio-metabolic risk factors was 79.17 % for DLP, 29.41% for DM, and 15% for HTN. Furthermore, each 1 ng/ml increase in the level of GH was significantly associated with 2 mg/dl increase in the level of FBS, 0.54 mmHg increase in the level of SBP, and 0.88 mmHg increase in the level of DBP. Upon multivariate analysis GH, but not IGF-1, significantly increased the odds of DM (OR; 1.17, 95% CI; 1.02-1.35, p= 0.025). Conclusions: Our findings showed at early postoperative stage, GH is significantly associated with the levels of FBS, SBP, and DBP. Moreover, GH, but not IGF-1, appears as a predictive factor for the presence of DM. However, neither GH nor IGF-1 could predict the presence of HTN, or DLP in this study.

Stroke in Pregnancy

2017 ◽  
Vol 37 (06) ◽  
pp. 669-678 ◽  
Author(s):  
Steven Feske ◽  
Christina Sells
Keyword(s):  
Risk Factors ◽  
Postpartum Period ◽  
Clinical Presentation ◽  
Vascular System ◽  
Significant Risk ◽  
Future Directions ◽  
Increased Risk ◽  
Tissue Changes ◽  
The Common ◽  
Substantial Morbidity

AbstractPregnancy and the postpartum period confer an increased risk of stroke. The risk appears to be increased for all strokes during the puerperium and for hemorrhagic strokes during pregnancy. During pregnancy, physiologic systems are under increased stress to accommodate the growing fetus, which results in substantial hemodynamic, cardiovascular, hematologic, immunologic, and structural connective tissue changes that account for much of this increased risk. In addition, preeclampsia–eclampsia has major effects on the vascular system, and this disorder, unique to pregnancy, is another major contributor to this risk. The common independent vascular risk factors for stroke, such as hypertension, diabetes, hyperlipidemia, and smoking, may also be present to contribute to the risks conferred by pregnancy. Though uncommon, stroke during pregnancy and in the postpartum period causes substantial morbidity and mortality in affected women, and it poses a significant risk to the fetus. This review will discuss the epidemiology of pregnancy-associated stroke, specific risk factors and mechanisms, clinical presentation and management, and future directions.

Steatohepatitic Hepatocellular Carcinoma, a Morphologic Indicator of Associated Metabolic Risk Factors: A Study From India

2013 ◽  
Vol 137 (7) ◽  
pp. 961-966 ◽  
Author(s):  
Deepali Jain ◽  
Nabeen C. Nayak ◽  
Vinay Kumaran ◽  
Sanjiv Saigal
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Metabolic Diseases ◽  
Liver Parenchyma ◽  
Metabolic Risk Factors ◽  
Metabolic Risk ◽  
Nonalcoholic Fatty Liver ◽  
Persistent Viral Infection ◽  
Common Risk Factors ◽  
The Common

Context.—The common risk factors for hepatocellular carcinoma (HCC) include persistent viral infection with either hepatitis B or C virus, alcohol abuse, hemochromatosis, and metabolic syndrome. Steatohepatitic (SH) HCC has been recently recognized as a special morphologic variant of HCC associated with metabolic risk factors. Objective.—To assess the SH pattern in HCC cases of various etiologies in Indian patients and to further correlate this morphology with the presence of metabolic risk factors. Design.—A total of 101 cases of HCC with various etiologies in explanted livers from adults were included in the study. Morphologic examination was performed to identify SH lesions within the tumor and in the nontumorous liver parenchyma. Correlation of nontumor and tumor SH morphology with clinically identifiable metabolic risk factors and with non-SH type of HCC was performed. Results.—The SH variant of HCC was identified in 19 livers (18.8%). Most SH-HCC cases were associated with metabolic risk factors such as obesity, diabetes, hypertension, and hyperlipidemias. Comparison of SH-HCC with non–SH-HCC was statistically significant in terms of presence of metabolic risk factors. Conclusions.—Steatohepatitic morphology in HCC is frequent in nonalcoholic fatty liver disease–associated cirrhosis (P = .009) and is significantly associated with metabolic risk factors (P = .03). By recognizing SH pattern, one may predict associated metabolic diseases and determine the prognosis both in pretransplant and posttransplant patients.

Investigation and management of pulmonary embolism 1: a probability-based approach

2021 ◽  
pp. 1-16
Author(s):  
Stephanie Stolberg ◽  
Dalia Mudawi ◽  
Katrina Dean ◽  
Andrew Cheng ◽  
Richard Barraclough
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Clinical Presentation ◽  
Recurrent Disease ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Outpatient Management ◽  
Treatment And Prevention ◽  
Thromboembolic Pulmonary Hypertension ◽  
Deadly Disease ◽  
Multifactorial Approach

Pulmonary embolism remains a common and potentially deadly disease, despite advances in diagnostic imaging, treatment and prevention. Managing pulmonary embolism requires a multifactorial approach involving risk stratification, determining appropriate diagnostics and selecting individualised therapy. This article reviews the pathophysiology, risk factors, clinical presentation, diagnostic evaluation and therapeutic management and early outpatient management of pulmonary embolism. The second part summarises pulmonary embolism in the setting of pregnancy, COVID-19, recurrent disease and chronic thromboembolic pulmonary hypertension.

Peripartum Embolism

2017 ◽  
Author(s):  
Elizabeth M. S. Lange ◽  
Paloma Toledo
Keyword(s):  
Risk Factors ◽  
Amniotic Fluid ◽  
Maternal Morbidity ◽  
Clinical Presentation ◽  
Air Embolism ◽  
Common Type ◽  
Amniotic Fluid Embolism ◽  
Maternal Risk ◽  
Venous Air Embolism ◽  
Maternal Morbidity And Mortality

Embolic disease during pregnancy is a significant contributor to maternal morbidity and mortality. The most common type of embolism is venous air embolism, but this is rarely symptomatic or hemodynamically significant. However, both thromboembolism and amniotic fluid embolism (AFE) are associated with significant maternal risk, and in the case of AFE, frequent major hemodynamic sequelae and fatal results ensue. As each class of embolic disease has slightly different risk factors, pathophysiology, clinical presentation, and treatment, they will each be discussed in separate sections in this chapter with an overview of these components.

scholarly journals Nonalcoholic Fatty Liver Disease Cirrhosis: A Review of Its Epidemiology, Risk Factors, Clinical Presentation, Diagnosis, Management, and Prognosis

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Bei Li ◽  
Chuan Zhang ◽  
Yu-Tao Zhan
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Clinical Presentation ◽  
Chronic Liver ◽  
Nonalcoholic Fatty Liver ◽  
The Common ◽  
End Stage

Cirrhosis is the common end stage of a number of chronic liver conditions and a significant cause of morbidity and mortality. With the growing epidemic of obesity and metabolic syndrome, nonalcoholic fatty liver disease (NAFLD) has become the most common cause of chronic liver disease worldwide and will become one of the leading causes of cirrhosis. Increased awareness and understanding of NAFLD cirrhosis are essential. To date, there has been no published systematic review on NAFLD cirrhosis. Thus, this article reviews recent studies on the epidemiology, risk factors, clinical presentation, diagnosis, management, and prognosis of NAFLD cirrhosis.

scholarly journals Atypical presentation and clinical management of jaundice secondary to Choledocoduodenal fistula: A Case Report

2017 ◽  
Vol 7 (1) ◽  
pp. 55-57
Author(s):  
Smit Shah ◽  
Praful Shah
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Case Report ◽  
Bile Duct ◽  
Clinical Presentation ◽  
Ampulla Of Vater ◽  
Atypical Presentation ◽  
Different Types ◽  
The Common ◽  
Hepatobiliary Complications

Choledocoduodenal fistula (CDDF) is an abnormal connection between the common bile duct and the duodenum which bypasses the normal opening of Ampulla of Vater. In this case, we describe the initial clinical presentation, diagnosis and treatment of a patient with CDDF along with prophylactic surgical management in order to prevent future hepatobiliary complications. In addition, we also discuss various risk factors of CDDF. Finally, we also discuss different types of CDDF along with its various hematologic and radiologic findings.South East Asia Journal of Public Health Vol.7(1) 2017: 55-57

scholarly journals Obesity and Risk for First Ischemic Stroke Depends on Metabolic Syndrome: The HUNT Study

Stroke ◽  
2021 ◽  
Author(s):  
Jens W. Horn ◽  
Tingting Feng ◽  
Bjørn Mørkedal ◽  
Linn Beate Strand ◽  
Julie Horn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Normal Weight ◽  
Hazard Ratio ◽  
Metabolic Risk ◽  
Metabolic Abnormalities ◽  
Hunt Study ◽  
Metabolically Healthy ◽  
Healthy Participants

Background and Purpose: Obesity is one of the most prevalent modifiable risk factors of ischemic stroke. However, it is still unclear whether obesity itself or the metabolic abnormalities due to obesity increase the risk of ischemic stroke. We therefore investigated the association between metabolic health, weight, and risk of ischemic stroke in a large prospective cohort study. Methods: In the Norwegian HUNT study (Trøndelag Health Study), we included 35 105 participants with complete information on metabolic risk factors and relevant covariates. Metabolically unhealthy state was defined as sex specific increased waist circumference in addition to 2 or more of the following criteria: hypertension, increased blood pressure, decreased high-density lipoprotein, triglycerides or glucose, or self-reported diagnosis of diabetes. We then applied Cox proportional hazard models to estimate the risk for ischemic stroke among overweight and obese metabolically healthy and unhealthy participants compared with metabolically healthy, normal weight participants. Results: A total of 1161 ischemic stroke cases occurred after an average observation time of 11.9 years. In general, metabolically unhealthy participants were at increased risk of ischemic stroke (for obese participants: hazard ratio, 1.30 [95% CI, 1.09–1.56] compared with metabolically healthy participants with a normal body mass index). Hypertension appeared to be the most important metabolic risk factor. Metabolically healthy participants with overweight or obesity were at similar risk of ischemic stroke compared with normal weight participants (hazard ratio, 1.02 [95% CI, 0.81–1.28] for participants with obesity). Obesity and overweight even over an extended period of time seems to be benign about ischemic stroke, as long as it was not associated with metabolic abnormalities. Conclusions: Obesity was not an independent ischemic stroke risk factor in this cohort, and the risk depended more on the metabolic consequences of obesity.

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