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Pathophysiology Prevention and Management of Chronic Neurogenic Constipation in Adults
Jacek Hermann,
Sławomir Michalak,
Michał Dopierała,
Dariusz Tertoń,
Michał Drews
Issue:
Volume 2, Issue 4, July 2013
Pages:
122-128
Received:
1 June 2013
Published:
30 June 2013
Abstract: Neurogenic constipation occurs most commonly after spinal cord injury, in multiple sclerosis and in Parkinson`s disease. Slow colonic transit time is a major disorder. Patients also develop pelvic floor dysfunction. Spinal cord patients are unable to defecate voluntarily due to the loss of the rectal fullness sensation and they depend on the spinal reflexes. Obstructed defecation in upper motor neuron spinal cord injury and in Parkinson`s disease is a result of inability to relax the pelvic floor muscles, whereas in the lower type of injury it is due to hyporeactivity of the rectum. In multiple sclerosis it is a combination of lesions from different levels of the nervous system. In diagnosis, neurological and proctologic examinations are required followed by colonic transit time, defecography and anorectal manometry. Most of the patients respond positively on medical treatment. However, a small group of them requires surgical treatment in the form of either colostomy or ileostomy.
Abstract: Neurogenic constipation occurs most commonly after spinal cord injury, in multiple sclerosis and in Parkinson`s disease. Slow colonic transit time is a major disorder. Patients also develop pelvic floor dysfunction. Spinal cord patients are unable to defecate voluntarily due to the loss of the rectal fullness sensation and they depend on the spinal...
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Management of Idiopathic Dilated Cardiomyopathy with Intramyocardial Stem Cell Transplantation in Children: A Retrospective Study of 7 Patients
Aris Lacis,
Inguna Lubaua,
Andrejs Erglis,
Andis Lacis,
Inta Bergmane
Issue:
Volume 2, Issue 4, July 2013
Pages:
129-133
Received:
21 June 2013
Published:
10 July 2013
Abstract: This retrospective report presents findings on 7 patients with idiopathic dilated cardiomyopathy who underwent transplantation of autologous bone marrow derived mononuclear cells (BMSC) after failed routine conservative treatment, and were on a waiting list for cardiac transplantation. In two out of seven patients, we performed intramyocardial delivery of BMSC twice, 22 and 24 months respectively after the first transplant. All patients received anti-congestive therapy by diu-retics, ACE inhibitors, carvedilol, digitalis and aspirin. We discuss potential disadvantages of intracoronary injections of autologous bone marrow stem cells. We believe that our BMSC transplantation method as opposed to intravascular input is the method of choice, particularly in children with idiopathic dilated cardiomyopathy because it is safe, gentle and is not associated with risks for coronary circulation.
Abstract: This retrospective report presents findings on 7 patients with idiopathic dilated cardiomyopathy who underwent transplantation of autologous bone marrow derived mononuclear cells (BMSC) after failed routine conservative treatment, and were on a waiting list for cardiac transplantation. In two out of seven patients, we performed intramyocardial deli...
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Prediction of Postoperative Lung Function and Chronic Dyspnea in Lung Cancer Patients by Using Quantitative Computed Tomography
CV Papageorgiou,
Dimosthenis Antoniou,
Georgios Kaltsakas,
Foteini Karakontaki,
Panagiotis Misthos,
Iris Tsangaridou,
Loukas Thanos,
NG Koulouris
Issue:
Volume 2, Issue 4, July 2013
Pages:
134-140
Received:
9 May 2013
Published:
20 July 2013
Abstract: Background-Aim: Prediction of postoperative FEV1 and diffusion capacity of the lung for carbon monoxide (DLCO) has a key role in the preoperative evaluation of lung resection candidates with impaired lung function. Additionally, dyspnea is a symptom which significantly affects patients’ quality of life. The aim of our study is to evaluate the role of quantitative Computed Tomography (CT) in predicting postoperative FEV1, DLCO, and chronic dyspnea in lung cancer patients undergoing lung resection. Methods: Thirty lung cancer patients were evaluated. Pulmonary function tests (PFTs) and low-dose chest CT scan were performed preoperatively. Fifteen patients (group A) had normal PFTs and fifteen patients (group B) had impaired lung function. Quantitative evaluation of CT using dual threshold of -910 to -500 Hounsfield Units estimated functional lung volumes. Dyspnea was evaluated using the modified Medical Research Council (mMRC) scale. Patients were reevaluated 3 months after surgery. Results: Predicted values of FEV1 and DLCO correlate significantly with the actual postoperative measurements in both groups. DLCO is the lung function index that demonstrates the highest correlation with postoperative dyspnea (r= -0.755, p<0.001). Predicted volume loss correlates well with the postoperative mMRC (r=0.662, p<0.001). Dyspnea score increases by one mMRC score unit per 21% of functional lung parenchyma resected during surgery. Conclusion: Quantitative CT is a valuable tool in the preoperative evaluation of lung cancer patients since it can simultaneously be used for staging, prediction of postoperative lung function, and prediction of postoperative chronic dyspnea.
Abstract: Background-Aim: Prediction of postoperative FEV1 and diffusion capacity of the lung for carbon monoxide (DLCO) has a key role in the preoperative evaluation of lung resection candidates with impaired lung function. Additionally, dyspnea is a symptom which significantly affects patients’ quality of life. The aim of our study is to evaluate the role ...
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Report of Bilateral Microtia in 2 Successive Female Siblings in Fallujah General Hospital
Samira Telfah Alaani,
Abdulqadir Abdulkareem Alrawi
Issue:
Volume 2, Issue 4, July 2013
Pages:
141-143
Received:
7 July 2013
Published:
10 August 2013
Abstract: Microtia is a congenital anomaly; characterized by a small, abnormally shaped auricle (pinna). It is usually accompanied by a narrow, blocked or absent ear canal. Microtia can occur as the only clinical abnormality or as part of a syndrome. The estimated incidence of microtia is (1 / 5000) to (1/ 20000) of total births and it is more common in males. Microtia can have a genetic or environmental predisposition. Here we reported a family with 2 successive deliveries of female infants within 12 months period, with bilateral microtia in the absence of any of the known risk factors or teratogens, in addition to the absence of previous family history of any kind of birth anomalies.
Abstract: Microtia is a congenital anomaly; characterized by a small, abnormally shaped auricle (pinna). It is usually accompanied by a narrow, blocked or absent ear canal. Microtia can occur as the only clinical abnormality or as part of a syndrome. The estimated incidence of microtia is (1 / 5000) to (1/ 20000) of total births and it is more common in male...
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