scholarly journals Abnormal Balloon Expulsion Test in Patients with Fecal Incontinence

2020 ◽  
Author(s):  
Leila Neshatian ◽  
Chimi Fosso ◽  
Eamonn Quigley
Keyword(s):  
Fecal Incontinence ◽  
Clinical Symptoms ◽  
Pressure Profile ◽  
Sensory Threshold ◽  
Factors Associated ◽  
Wilcoxon Rank Sum Test ◽  
Balloon Expulsion ◽  
Surgical History ◽  
Balloon Expulsion Test ◽  
Anorectal Pressure

Background and Aims: Functional defecatory dysfunction is attributed to the pathophysiology of fecal incontinence (FI) in some patients. We hypothesized that patients with FI and abnormal balloon expulsion test (BET) have distinct manometric characteristics as compared to the patients with FI and normal BET. We aimed to compare the anorectal pressure profile in patients with FI, with or without abnormal BET and to identify risk factors associated with abnormal BET in FI. Methods: We performed a retrospective review of 77 consecutive patients with ROME IV FI. Wilcoxon rank sum test, t-test, and Fisher exact tests were performed for comparison. Multivariable logistic regression was performed to identify factors associated with abnormal BET. Results: Thirty-two percent of patients had abnormal BET. Demographics and surgical history and clinical symptoms, except for sensation of incomplete evacuation (p=0.02) and abdominal pain (p=0.03), were comparable in both groups. Anorectal pressure profile except for the median rectal propulsive pressures were similar between groups. Rectal propulsive pressures at simulated defecation were significantly lower in patients with abnormal BET (p=0.02). Mean sensory threshold for first sensation was also significantly higher in patients who had abnormal BET (p=0.03). Rectal propulsive pressures (OR: 1.03, 95% CI: 1.00-1.06, p=0.032) and rectal sensory threshold for first sensation (OR:0.94, 95% CI: 0.90-0.99, p=0.02) were able to predict abnormal BET independently. Conclusions: In patients with FI and similar clinical and anal pressure profile, rectal sensory threshold and rectal propulsive pressures at simulated defecation can determine normal BET.

Anorectal Pressure Profile in IBD Patients as Compared to Non-IBD Patients With Fecal Incontinence

2017 ◽  
Vol 112 ◽  
pp. S238
Author(s):  
Pramoda Koduru ◽  
Chimi Fosso ◽  
Bincy Abraham ◽  
Leila Neshatian ◽  
Eamonn Quigley
Keyword(s):  
Fecal Incontinence ◽  
Pressure Profile ◽  
Anorectal Pressure

scholarly journals Risk and Environmental Factors Associated with the Presence of Canine Parvovirus Type 2 in Diarrheic Dogs from Thessaly, Central Greece

Pathogens ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 590
Author(s):  
Maria Kantere ◽  
Labrini V. Athanasiou ◽  
Alexios Giannakopoulos ◽  
Vassilis Skampardonis ◽  
Marina Sofia ◽  
...  
Keyword(s):  
Environmental Factors ◽  
Clinical Symptoms ◽  
Gastrointestinal Disease ◽  
Environmental Parameters ◽  
Canine Parvovirus ◽  
Geographical Information ◽  
Factors Associated ◽  
Working Dogs ◽  
Canine Parvovirus Type 2

Canine parvovirus type 2 (CPV-2) primarily infects dogs, which are the main host reservoir, causing severe gastrointestinal disease associated with immunosuppression. The present study was conducted in Thessaly, Greece and aimed to identify risk and environmental factors associated with CPV-2 infection in diarrheic dogs. Fecal samples were collected from 116 dogs presenting diarrhea and were tested by polymerase chain reaction (PCR) for the presence of CPV-2 DNA. Supplementary data regarding clinical symptoms, individual features, management factors and medical history were also gathered for each animal during clinical evaluation. Sixty-eight diarrheic dogs were found to be positive for the virus DNA in their feces. Statistical analysis revealed that CPV-2 DNA was less likely to be detected in senior dogs, while working dogs, namely hounds and shepherds, had higher odds to be positive for the virus. Livestock density and land uses, specifically the categories of discontinuous urban fabric and of human population density, were identified as significant environmental parameters associated with CPV-2 infection by using Geographical Information System (GIS) together with the Ecological Niche Model (ENM). This is the first description of the environmental variables associated with the presence of CPV-2 DNA in dogs’ feces in Greece.

scholarly journals Effectiveness and safety of infliximab dose escalation in patients with refractory Takayasu arteritis: A real-life experience from a monocentric cohort

2021 ◽  
Author(s):  
Alessandro Tomelleri ◽  
Corrado Campochiaro ◽  
Silvia Sartorelli ◽  
Francesco Baldassi ◽  
Federico Fallanca ◽  
...  
Keyword(s):  
Takayasu Arteritis ◽  
Dose Escalation ◽  
Dose Group ◽  
Life Experience ◽  
Clinical Symptoms ◽  
Standard Dose ◽  
Univariate Analysis ◽  
Real Life ◽  
Factors Associated ◽  
Observational Cohort

ABSTRACT Objectives To evaluate effectiveness and safety of infliximab dose escalation in Takayasu arteritis (TAK) patients. To identify factors associated with refractoriness to standard-dose infliximab. Methods Medical records of infliximab-treated TAK patients from a large single-centre observational cohort were reviewed. Infliximab therapy duration, concomitant therapies, and reasons for dose escalation and therapy suspension were evaluated. Occurrence of adverse events was recorded. A comparison between patients who maintained infliximab standard-dose and those who needed dose-escalation was performed. Factors associated with refractoriness to standard dose were analysed. Results Forty-one patients were included. Starting infliximab dose was 5 mg/kg 6-weekly and 28 patients (68%) needed dose escalation. Persistence/recurrence of clinical symptoms was the most frequent reason for escalation. Median therapy duration was 39 (IQR, 26–61) months in the standard-dose group and 68 (38–87) months in the intensified-dose group. In the intensified-dose-group, infliximab was suspended in eight patients (29%) after a median of 38 (31–71) months, due to loss of response (n = 7) or patient’s request (n = 1). Patients in the intensified-dose group had a higher number of relapses (3.4 vs 0.8 events/patient) and received a higher cumulative steroid dose (1.7 [1.6–2.3] vs 1.3 [1–1.6] g/month of prednisone). Three patients from the intensified-dose group had serious infections; one patient from the standard-dose group developed paradoxical psoriasis. At univariate analysis, age at diagnosis and age at infliximab start were associated with infliximab escalation. Conclusion In TAK, dose escalation is safe and allows to optimise infliximab durability in refractory patients. Younger patients seem to be more refractory to standard dosages.

scholarly journals An Optical-Fiber-Based Smart Textile (Smart Socks) to Manage Biomechanical Risk Factors Associated With Diabetic Foot Amputation

2017 ◽  
Vol 11 (4) ◽  
pp. 668-677 ◽  
Author(s):  
Bijan Najafi ◽  
Hooman Mohseni ◽  
Gurtej S. Grewal ◽  
Talal K. Talal ◽  
Robert A. Menzies ◽  
...  
Keyword(s):  
Fiber Optics ◽  
Peak Pressure ◽  
Pressure Profile ◽  
Joint Angles ◽  
Factors Associated ◽  
Optical Wavelength ◽  
Smart Textile ◽  
Flexible Fiber ◽  
Gold Standards

Objective: This study aimed to validate a smart-textile based on fiber-optics for simultaneous measurement of plantar temperature, pressure, and joint angles in patients with diabetic peripheral neuropathy (DPN). Methods: After in-vitro validation in the laboratory, 33 eligible subjects with DPN were recruited (age: 58 ± 8 years, BMI: 31.5 ± 8 kg/m2) for assessing plantar pressure and temperature during habitual gait-speed in a clinical-setting. All participants were asked to walk at their habitual speed while wearing a pair of sensorized socks made from highly flexible fiber optics (SmartSox). An algorithm was designed to estimate temperature, pressure, and toe range of motion from optical wavelength generated from SmartSox. To validate the device, results from thermal stress response (TSR) using thermography and peak pressure measured by computerized pressure insoles (F-Scan) were used as gold standards. Results: In laboratory and under controlled conditions, the agreements for parameters of interest were excellent ( r > .98, P = .000), and no noticeable cross-talks between measurements of temperature, angle, and pressure were observed. During clinical data acquisition, a significant correlation was found for pressure profile under different anatomical regions of interest between SmartSox and F-Scan ( r = .67, P < .050) as well as between thermography and SmartSox ( r = .55, P < .050). Conclusion: This study demonstrates the validity of an innovative smart textile for assessing simultaneously the key parameters associated with risk of foot ulcers in patients with DPN. It may empower clinicians to objectively stratify foot risk and provide timely care. Another study is warranted to validate its clinical application in preventing limb threating problems in patients with DPN.

Prevalence and Risk Factors Associated with First-Line Anti-Tuberculosis Induced Hepatotoxicity in Suratthani Hospital, Thailand

2021 ◽  
Vol 104 (2) ◽  
pp. 233-239
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Clinical Symptoms ◽  
Significant Risk ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
First Line ◽  
Drug Induced ◽  
Factors Associated ◽  
Drug Risk

ackground: Tuberculosis (TB) is a major public health problem, including Thailand. Anti-TB drugs are very effective treatment, but they can cause hepatotoxicity. Data on the prevalence of anti-TB drug-induced hepatotoxicity (DIH), as well as the contributing risk factors, are scarce in Thailand. Objective: To measure the prevalence and identify risk factors associated with first-line drugs (FLD) induced hepatoxicity in TB patients. Materials and Methods: The present study was a retrospective study design in TB clinic of Suratthani Hospital, in Southern Thailand. All patients diagnosed with TB and received FLD between January and December 2017, were eligible for the study. Hepatoxicity defined as the following criteria: serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels >5x upper limit of normal (ULN) without symptoms, or AST or ALT >3x ULN with clinical symptoms. Results: Of all the 198 TB cases, 18 were identified as DIH. Prevalence of DIH was 9.1%. Hepatitis after FLD was independently associated with age>60 years (adjusted OR [aOR] 28.49, 95% CI 2.68 to 302.95, p=0.005) and serum albumin <3.5 g/dL (aOR 20.97, 95% CI 2.11 to 208.51, p=0.009). Conclusion: Age of more than 60 years and low serum albumin of less than 3.5 g/dL were significant risk factors associated with first-line anti-TB drugs induced hepatoxicity. Keywords: Hepatoxicity, Anti-tuberculosis drug, Risk factor, Thailand

PARK2 and PARK7 Gene Polymorphisms as Risk Factors Associated with Serum Element Concentrations and Clinical Symptoms of Parkinson’s Disease

2019 ◽  
Vol 40 (3) ◽  
pp. 357-367
Author(s):  
Jaya Sanyal ◽  
Athira Anirudhan ◽  
Tapas Kumar Banerjee ◽  
Gautam Guha ◽  
Ramakrishnan Veerabathiran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gene Polymorphisms ◽  
Clinical Symptoms ◽  
Factors Associated ◽  
Element Concentrations

scholarly journals Prevalence of and Factors Associated With Fecal Incontinence: Results From a Population-Based Survey

2018 ◽  
Vol 154 (6) ◽  
pp. 1672-1681.e3 ◽  
Author(s):  
Stacy B. Menees ◽  
Christopher V. Almario ◽  
Brennan M.R. Spiegel ◽  
William D. Chey
Keyword(s):  
Fecal Incontinence ◽  
Population Based ◽  
Factors Associated ◽  
Population Based Survey
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