Medicine
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Observational Study
Neurological, psychological, and cognitive disorders in patients with chronic kidney disease on conservative and replacement therapy.
Chronic kidney disease (CKD) is a highly prevalent condition in the world. Neurological, psychological, and cognitive disorders, related to CKD, could contribute to the morbidity, mortality, and poor quality of life of these patients. The aim of this study was to assess the neurological, psychological, and cognitive imbalance in patients with CKD on conservative and replacement therapy. ⋯ Moreover, all NPZ5 scores showed a significant difference between the means of nephropathic patients and the means of the HC, and a positive correlation with eGFR, serum nitrogen, CRP, iPTH, and vitamin D. In CKD patients, simple and noninvasive instruments, as EEG, and cognitive-psychological tests, should be performed and careful and constant monitoring of renal risk factors, probably involved in neuropsychological complications (inflammation, disorders of mineral metabolism, electrolyte disorders, etc.), should be carried out. Early identification and adequate therapy of neuropsychological, and cognitive disorders, might enable a better quality of life and a major compliance with a probable reduction in the healthcare costs.
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Recently, 2 new anthropometric indices, the A Body Shape Index (ABSI) and Body Roundness Index (BRI), have been developed. Our study was to compare the associations between different anthropometric indices, including ABSI, BRI, body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR), and hypertension in a rural population of northeast China. This cross-sectional study was conducted in the rural areas of northeast China from January 2012 to August 2013 using a multistage, stratified random cluster-sampling scheme. ⋯ BRI had the highest AROCs for hypertension (AROC: 0.65, 95% CI: 0.64-0.67 for men and AROC: 0.68, 95% CI: 0.67-0.70 for women), while ABSI had the lowest AROCs for hypertension (AROC: 0.60, 95% CI: 0.58-0.61 for men and AROC: 0.59, 95% CI: 0.58-0.61 for women). Our results showed that ABSI, BMI, BRI, WC, and WHR were all associated with hypertension. ABSI showed the weakest association with hypertension, while BRI showed potential for use as an alternative obesity measure in assessment of hypertension.
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Hereditary hemorrhagic telangiectasia (HHT) is characterized by mucocutaneous telangiectasia and visceral vascular malformations (VMs). Liver involvement with VMs may lead to high-output cardiac failure, portal hypertension, and biliary disease. There is no curative treatment for the disease, and liver transplantation is indicated for life-threatening complications. Herein, we report a case of multiple hepatic artery aneurysms (HAAs) in a patient with HHT in which open arterial reconstruction was performed. There have only been a few case reports on HAA occurring with HHT. Thus, this case provides important information for the management of HHT-associated HAAs. ⋯ When treating HAAs, there are a variety of options. However, hepatic VMs might affect HHT patients in various ways postprocedurally. Ligation and embolization of the hepatic artery may lead to complications, such as massive hepatic necrosis. Hepatectomy should be avoided if possible, because a postoperative hyperperfusive state in the remaining liver can cause adverse events. We believe that arterial reconstruction of HHT-associated HAAs might reduce the risk of postprocedural complications with minimal hemodynamic changes in the liver, thus obviating the need for hepatectomy or liver transplantation.
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Observational Study
Correlation between T2* (T2 star) relaxation time and cervical intervertebral disc degeneration: An observational study.
To demonstrate the potential benefits of T2 relaxation time of intervertebral discs (IVDs) regarding the detection and grading of degenerative disc disease using 3.0-T magnetic resonance imaging (MRI) in a clinical setting. ⋯ Our standardized method of region-specific quantitative T2 relaxation time evaluation seems capable of characterizing different degrees of disc degeneration quantitatively. The T2 values obtained in these cervical IVDs may serve as baseline values for future T2 measurements in both healthy and degenerated cervical discs.
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A cross-sectional area (CSA) and thickness reduction of the abductor hallucis (AbH) is shown in subjects with hallux valgus (HV). To date, other soft-tissue structures have not been researched in relation with HV. The aim of this study was to compare the CSA and thickness of the intrinsic plantar muscles and fascia (PF) between feet with and without HV. ⋯ Consequently, statistically significant differences were observed between the groups (P < 0.05) for the AbH and FHB thickness, and CSA reduction, and also the plantar fascia thickness increase in favor of the HV group. On the contrary, the FDB thickness and CSA did not show statistically significant differences (P ≥ 0.05). In conclusion, the CSA and thickness of the AbH and FHB intrinsic plantar muscles are reduced, whereas the thickness of the anterior, middle, and posterior PF portions are increased, in subjects with HV compared with those without HV.