Search results for " Mal"

Arteriovenous fistula of the vertebral artery in a female infant with hypotonia and cephalocorporal disproportion

2010

Background:  Congenital arteriovenous fistulas are exceptional in childhood and imply a therapeutic challenge. Case report: A 9-month-old female infant was studied for cephalocorporal disproportion, hypotonia, progressive muscular atrophy and hyperreflexia. Computed tomography of the brain and electroencephalography were normal. Electromyographic patterns suggested proximal myopathic involvement. A continuous murmur with systolic reinforcement was audible in the neck. Angioresonance detected intracranial aneurysmal dilatations behind the bulbo-medullary junction and cerebral panangiography evidenced a direct vertebrovertebral fistula with extra- and intra-cranial varices and extreme medulla…

Inspiration through the nose increases the bronchoprotective effect of lung inflation

2007

Asthma in the elderly

2010

Asthma is frequent among older people. Nevertheless, under-recognition, misdiagnosis and under-treatment are still relevant issues. We aim to provide an overview of epidemiology of asthma in the elderly, and a thorough description of its pathology and clinical presentation, with special emphasis on the distinction of late versus early-onset asthma. We also discuss selected treatment topics of special interest for older patients, such as compliance with therapy and ability with the inhalers, which are basic to the success of the prescribed therapy. Finally, we suggest that multidimensional geriatric assessment of older asthmatics could help in tailoring the therapy to the individual needs a…

An atypical clinical presentation of acute appendicitis in a young man with midgut malrotation

2007

Abstract Midgut malrotation occurs as a result of failure in normal intestinal rotation and fixation during early pregnancy. Pathological conditions reported in the literature involving midgut malrotation predominantly relate to infants and children. In adults malrotation is often revealed as an incidental finding on computed tomography (CT), or the associated altered anatomy can be the cause of atypical clinical symptoms of relatively common intestinal disorders. An unusual presentation of acute appendicitis, with fever and recurrent pain in left iliac fossa is reported. Underlying intestinal malrotation delayed the correct clinical diagnosis of acute appendicitis. It was not until a CT sc…

Chronic cerebrospinal venous insufficiency: current perspectives

2014

This review summarizes the research to date on chronic cerebrospinal venous insufficiency (CCSVI). CCSVI was initially defined as a clinical syndrome comprising stenoses of the internal jugular and/or azygos veins, characterized by collateral venous outflows and reduced cerebral blood flow, and was found primarily in patients with multiple sclerosis. However, the published evidence on CCSVI is very discordant. Catheter venography studies gave a regular picture, with the majority of patients with multiple sclerosis presenting with demonstrable outflow abnormalities in the veins draining the central nervous system. The prevalence of these lesions was over 50%, and even higher (about 90%) when…

Nutrition in Pediatric Kidney Disease

2018

AbstractNutrition has a major impact on the health of children with chronic kidney disease (CKD). Special diets and additional replacement therapies may be chosen according to the specific renal disease. Persistent low-grade inflammation, which contributes to CKD-associated cardiovascular and all-cause mortality, protein-energy wasting, oxidative stress, acidosis, chronic and recurrent infections, and altered metabolism of adipose tissue may result from dietary deficits and are important targets for nutritive intervention. Therefore, many guidelines have been developed regarding nutrient intake adequation to assist pediatricians treating these children. Acute kidney injury (AKI) has multifa…

Delayed versus early initiation of renal replacement therapy for severe acute kidney injury: a systematic review and individual patient data meta-ana…

2020

Summary Background The timing of renal replacement therapy (RRT) for severe acute kidney injury is highly debated when no life-threatening complications are present. We assessed whether a strategy of delayed versus early RRT initiation affects 28-day survival in critically ill adults with severe acute kidney injury. Methods In this systematic review and individual patient data meta-analysis, we searched MEDLINE (via PubMed), Embase, and the Cochrane Central Register of Controlled Trials for randomised trials published from April 1, 2008, to Dec 20, 2019, that compared delayed and early RRT initiation strategies in patients with severe acute kidney injury. Trials were eligible for inclusion …

Mesh Plates for Scapula Fixation

2015

While scapula fractures are often treated nonoperatively, there are a number of displaced fractures in which surgical treatment can be considered. When necessary, open reduction and internal fixation with plates is the accepted method for stabilization. However, there are limited options of commercially available plates for fixation of the scapula. The authors describe 2 cases of scapula fracture and 1 scapula osteotomy that were managed with internal fixation using low-profile mesh plates. The mesh plate is a stainless steel lattice that can be molded and trimmed to create a plate that matches the unusual 3-dimensional anatomy of the scapula. It accepts 2.4/2.7 mm cortical and variable ang…

Radiosurgical Treatment of low flow Carotid-Cavernous Fistulae

1991

The good results obtained by stereotactic radiosurgery in arteriovenous malformations has led the authors to expect similar results in low flow carotid-cavernous fistulae. In this paper, 20 cases who underwent radiosurgery with a conventional gamma source are presented. The total dose delivered was 36 to 40 Gy. 90% of the patients were cured after radiosurgery after a mean time of 7 months. Those presenting a mild improvement after a mean time of 2 months and those with a marked improvement after 4 months.

Single Intravenous Dose Kinetics and Accumulation of Atenolol in Patients with Impaired Renal Function and on Hemodialysis

1980

The concentration of atenolol in plasma and urine was determined following an intravenous (i.v.) dose given to 17 hypertensive patients with a glomerular filtration rate (GFR) between 5 and 105 ml/min and in 4 patients on hemodialysis. In patients with normal renal function the mean half life of elimination was calculated to be 6.8 h. This value increased to a mean of 50.1 h in patients with a GFR below 10 ml/min. In patients on hemodialysis the half life of elimination was about 4 h. The elimination rate constants as well as the body and renal clearances of atenolol have a significant correlation with the GFR. Although accumulation of atenolol was observed, especially after multiple oral d…