scholarly journals Hydronephrosis in Infants and Children: Natural History and Risk Factors for Persistence in Children Followed by a Medical Service

2009 ◽  
Vol 3 ◽  
pp. CMPed.S3584 ◽  
Author(s):  
Kristy Van Dervoort ◽  
Stephanie Lasky ◽  
Christine Sethna ◽  
Rachel Frank ◽  
Suzanne Vento ◽  
...  
Keyword(s):  
Risk Factors ◽  
Natural History ◽  
Time Course ◽  
Spontaneous Resolution ◽  
Infants And Children ◽  
Clinical Feature ◽  
Voiding Cystourethrogram ◽  
Neonatal Hydronephrosis ◽  
Radiological Abnormality ◽  
History Of

Background Infants with neonatal hydronephrosis and a normal voiding cystourethrogram (VCUG) are presumed to have ureteropelvic junction obstruction (UPJO). There is little current information about the natural history of children with hydronephrosis or clinical factors that predict resolution of the radiological abnormality. Objective To determine the time course until spontaneous resolution of neonatal hydronephrosis and define risk factors for persistence of the abnormality. Methods This retrospective single center review examined infants and children <5 years of age with hydronephrosis who were followed for at least 12 months. Results 136 children were identified (96 male:40 female). The mean age at diagnosis of hydronephrosis was 3.3 ± 9.7 months and 76% of the patients were diagnosed at birth. The hydronephrosis was unilateral in 98 (72%) of cases, and hydronephrosis was at least moderate in severity in 22% of affected kidneys. At last follow-up at 30 ± 10 months, the abnormality had resolved in 77 out of 115 (67%) available patients, 30 (26%) had been referred to urology, and 12 (10%) had persistent hydronephrosis. Severity of hydronephrosis was the only clinical feature that predicted persistence of the abnormality (P < 0.001). There was an association between detection at birth and lack of resolution of hydronephrosis. Conclusions Children with hydronephrosis and presumed UPJO and normal kidney parenchyma can be followed for at least 2 years to allow for spontaneous resolution before referral to urology. Serial sonography can be performed at 6 month intervals in uncomplicated cases. More severe hydronephrosis and presence of the lesion at birth may predict infants and children requiring closer observation and referral for possible surgical correction of the hydronephrosis.

The physiopathology of spontaneous hemorrhagic stroke: a systematic review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Alcivan Batista de Morais Filho ◽  
Thiago Luis de Holanda Rego ◽  
Letícia de Lima Mendonça ◽  
Sulyanne Saraiva de Almeida ◽  
Mariana Lima da Nóbrega ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Ischemic Stroke ◽  
Subarachnoid Hemorrhage ◽  
Natural History ◽  
Hemorrhagic Stroke ◽  
Recent Literature ◽  
Clinical Manifestations ◽  
The Road ◽  
History Of

Abstract Hemorrhagic stroke (HS) is a major cause of death and disability worldwide, despite being less common, it presents more aggressively and leads to more severe sequelae than ischemic stroke. There are two types of HS: Intracerebral Hemorrhage (ICH) and Subarachnoid Hemorrhage (SAH), differing not only in the site of bleeding, but also in the mechanisms responsible for acute and subacute symptoms. This is a systematic review of databases in search of works of the last five years relating to the comprehension of both kinds of HS. Sixty two articles composed the direct findings of the recent literature and were further characterized to construct the pathophysiology in the order of events. The road to the understanding of the spontaneous HS pathophysiology is far from complete. Our findings show specific and individual results relating to the natural history of the disease of ICH and SAH, presenting common and different risk factors, distinct and similar clinical manifestations at onset or later days to weeks, and possible complications for both.

scholarly journals The spontaneous resolution of a vortex vein varix: case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara L Weidmayer ◽  
Hakan Demirci
Keyword(s):  
Case Report ◽  
Natural History ◽  
Extended Period ◽  
Spontaneous Resolution ◽  
Case Presentation ◽  
Clinical Resolution ◽  
History Of ◽  
Vortex Vein ◽  
Insight Into

Abstract Background The natural course of a vortex vein varix, though not well understood, has been known to remain stable. However, here we report a novel case of a vortex vein varix that resolved after an extended period of monitoring. Case presentation An asymptomatic 96-year-old Caucasian man was found to have a vortex vein varix. At his previous examination 13 months prior, his fundus was normal. At 13 months of observation, his vortex vein varix become clinically undetectable. Further follow-up confirmed continued absence of the varix. Conclusion This case demonstrates the development then clinical resolution of a vortex vein varix with no clear identifiable factors for its evolution. This case is novel and offers new insight into the natural history of some vortex vein varices, implicating venous congestion as an instigator and venous collateralization as its alleviator, suggesting that vortex vein varices are likely more common than previously reported since some may be temporary and under-identified.

Real-World Experience with Type I Endoleaks after Endovascular Repair of the Thoracic Aorta

2010 ◽  
Vol 76 (6) ◽  
pp. 599-605 ◽  
Author(s):  
Joshua D. Adams ◽  
Margaret C. Tracci ◽  
Sahir Sabri ◽  
Kenneth J. Cherry ◽  
John F. Angle ◽  
...  
Keyword(s):  
Natural History ◽  
Thoracic Endovascular Aortic Repair ◽  
Spontaneous Resolution ◽  
Type I ◽  
Single Center ◽  
Type I Endoleak ◽  
History Of ◽  
Aortic Pathologies ◽  
Initial Results

Endoleaks are a frequent complication of thoracic endovascular aortic repair (TEVAR) and will likely increase in incidence with application of the technique to more complicated aortic anatomy and a wider range of thoracic aortic pathologies. Management generally consists of aggressive repair of Type I endoleaks; however, the natural history of Type I endoleaks after TEVAR remains largely unknown. The purpose of this study was to examine the incidence and characteristics of Type I endoleaks and to evaluate clinical outcomes of patients with Type I endoleaks after TEVAR. A single-center retrospective review was performed on all patients who underwent TEVAR over a 4-year period. Type I endoleaks were detected in 21 per cent (27 of 129) of patients on post-deployment aortography or CT angiography. During a mean follow-up of 750.63 ± 483 days, 59 per cent (16 of 27) closed spontaneously; 30 per cent (eight of 27) required secondary endovascular intervention; and 11 per cent (three of 27) have persisted with no increase in maximum aortic diameter. No patients have died or required open surgical conversion as a result of their Type I endoleak. Although accurate predictors of spontaneous resolution of Type I endoleaks have yet to be definitively characterized, our initial results suggest that it may be safe to observe small Type I endoleaks given that a large percentage resolve spontaneously and no endoleak-related deaths have occurred.

Spontaneous resolution of a Chiari malformation with syringomyelia

2021 ◽  
Vol 14 (6) ◽  
pp. e241789
Author(s):  
Hadleigh Cuthbert ◽  
Joshua Pepper ◽  
Rupert Price
Keyword(s):  
Natural History ◽  
Literature Review ◽  
Chiari Malformation ◽  
Surgical Intervention ◽  
Chiari I Malformation ◽  
Spontaneous Resolution ◽  
Conservative Approach ◽  
Resonance Imaging ◽  
History Of ◽  
Chiari I

The Chiari I malformation (CM-I) is characterised by overcrowding of the posterior fossa and descent of the cerebellar tonsils and is associated with syringomyelia. With the increasing availability of magnetic resonance imaging, CM-I is placing a growing burden on neurosurgical services. However, its natural history remains poorly understood, and the timing and nature of surgical intervention is controversial. We present a case of a significant, symptomatic CM-I with associated syrinx which underwent complete spontaneous resolution over a 4-year period. Spontaneous regression of Chiari malformation and syringomyelia is exceedingly rare; a literature review reveals 15 other cases and only one case which underwent complete resolution. The present case and literature review suggest a more benign natural history of CM-I and support a more conservative approach to its management. Further studies are required to determine whether any factors can predict resolution for certain patient cohorts.

Mortality in Children and Adolescents With Sickle Cell Disease

PEDIATRICS ◽  
1989 ◽  
Vol 84 (3) ◽  
pp. 500-508 ◽  
Author(s):  
Sanford L. Leikin ◽  
Dianne Gallagher ◽  
Thomas R. Kinney ◽  
Desirée Sloane ◽  
Panpit Klug ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sickle Cell Disease ◽  
Natural History ◽  
Parental Education ◽  
Young Patients ◽  
Cell Disease ◽  
Cerebrovascular Accidents ◽  
Limited Success ◽  
History Of ◽  
Overall Mortality

A study of the natural history of sickle hemoglobinopathies was begun in March 1979. By August 1987, a total of 2824 patients &lt;20 years of age were enrolled. There have been 14 670 person-years of followup. Seventy-three deaths have occurred. Most of the deaths were in patients with hemoglobin SS. The peak incidence of death was between 1 and 3 years of age, and the major cause in these young patients was infection. Cerebrovascular accidents and traumatic events exceeded infections as a cause of death in patients &gt; 10 years of age. There was limited success in identifying risk factors for death. Comparison of this study's overall mortality of 2.6% (0.5 deaths per 100 person-years) with previous reports indicates improvement of survival in US patients &lt;20 years of age with sickle hemoglobinopathies. This improvement is most likely due to parental education and counseling about the illness and the early institution of antibotics in suspected infections.

scholarly journals Different Contributions of Dyslipidemia and Obesity to the Natural History of Type 2 Diabetes: 3-Year Cohort Study in China

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Lu Liu ◽  
Xiaoling Guan ◽  
Zhongshang Yuan ◽  
Meng Zhao ◽  
Qiu Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Natural History ◽  
Glucose Tolerance ◽  
Serum Triglyceride ◽  
Glycemic Status ◽  
History Of

Aim. It is known that different stages of type 2 diabetes represent distinct pathophysiological changes, but how the spectrum of risk factors varies at different stages is not yet clarified. Hence, the aim of this study was to compare the effect of different metabolic variables on the natural history of type 2 diabetes. Methods. A total of 5,213 nondiabetic (normal glucose tolerance (NGT) and prediabetes) Chinese older than 40 years participated this prospective cohort study, and 4,577 completed the 3-year follow-up. Glycemic status was determined by standard oral glucose tolerance test both at enrollment and follow-up visit. Predictors for conversion in glycemic status were studied in a corresponding subcohort using the multiple logistic regression analysis. Results. The incidence of prediabetes and diabetes of the cohort was 93.6 and 42.2 per 1,000 person-years, respectively. After a 3-year follow-up, 33.1% of prediabetes patients regressed to NGT. The predictive weight of body mass index (BMI), serum triglyceride, total cholesterol, and systolic blood pressure in different paths of conversions among diabetes, prediabetes, and NGT differed. Specifically, BMI was the strongest predictor for regression from prediabetes to NGT, while triglyceride was most prominent for onset of diabetes. One SD increase in serum triglyceride was associated with a 1.29- (95% CI 1.10–1.52; P=0.002) or 1.12- (95% CI 1.01–1.27; P=0.039) fold higher risk of diabetes for individuals with NGT or prediabetes, respectively. Conclusion. Risk factors for different stages of diabetes differed, suggesting personalized preventive strategies for individuals with different basal glycemic statuses.

scholarly journals Prevalence and natural history of and risk factors for subaneurysmal aorta among 65-year-old men

2019 ◽  
Vol 124 (3) ◽  
pp. 180-186 ◽  
Author(s):  
Knut Thorbjørnsen ◽  
Sverker Svensjö ◽  
Khatereh Djavani Gidlund ◽  
Nils-Peter Gilgen ◽  
Anders Wanhainen
Keyword(s):  
Risk Factors ◽  
Natural History ◽  
History Of ◽  
Old Men
Sign in / Sign up

Export Citation Format

Share Document