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physical diagnosis & nephrology

Pierpaolo Di Nicolò, Luca Zanoli, Michele Figuera, Antonio Granata
This paper deals with two recent cases of Inferior Caval Vein (IVC) duplicity, congenital anomaly often but not always asymptomatic that should be considered in the differential diagnosis of flank pain when other more common disorders have been excluded. Here are described the clinical and surgical significance together with the typical sonographic findings useful for the diagnosis of IVC duplicity. Particular attention is given to a peculiar and easily repeatable sonographic aspect associated with IVC duplicity, not previously reported in Literature and that we called the "Neptune's sign"...
December 2016: Journal of Ultrasound
M Rahman, S Afroz, R Ali, M Hanif
Outcome of children with nephrotic syndrome has continued to improve over time. However minimal data exist to describe health-related quality of life in children with nephrotic syndrome. This cross sectional study was conducted over a period of six months to assess the health related quality of life in children with nephrotic syndrome in the Department of Pediatric Nephrology, Dhaka Medical College Hospital, Bangladesh. Fifty children (age ranged 2-12 years) with nephrotic syndrome who had three or more relapses diagnosed at least one year back receiving treatment and on follow up were included in this study...
October 2016: Mymensingh Medical Journal: MMJ
Nagaraju Sarabu, Mahboob Rahman
Acute kidney injury (AKI) refers to any acute decrease in glomerular filtration rate, regardless of etiology. Staging of AKI has been recommended to stratify AKI patients according to severity of the condition, based on serum creatinine level and urine output. Classification of AKI into prerenal, intrinsic renal, and postrenal etiologies is helpful in differential diagnosis and management. AKI in hospitalized patients typically occurs due to decreased renal perfusion. Drug-induced, contrast-associated, postoperative, and sepsis-associated AKI also can occur...
May 2016: FP Essentials
Michelle M Kelly
Health-related quality of life (HRQOL) of children and adolescents with chronic health conditions is a multifactorial concept that combines a child's perception and adaptation to physical, social, emotional, and school environments regardless of particular medical diagnosis. Children with chronic kidney disease (CKD) experience non-kidney specific co-morbidities, including depression, body image alterations, and sleep disturbance, that impair their daily lives. This article reviews the pediatric nephrology literature to highlight the evidence identifying these riskr to HRQOL and suggesting ways in which nurses in both nephrology and primary care are poised to identify and modify these risk factors...
January 2016: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Walter G Wasser, Amnon Gil, Karl L Skorecki
During the past 50 years, a dramatic reduction in the mortality rate associated with cardiovascular disease has occurred in the US and other countries. Statistical modeling has revealed that approximately half of this reduction is the result of risk factor mitigation. The successful identification of such risk factors was pioneered and has continued with the Framingham Heart Study, which began in 1949 as a project of the US National Heart Institute (now part of the National Heart, Lung, and Blood Institute)...
July 30, 2015: Rambam Maimonides Medical Journal
Bennett G Zier
Clinical podiatric medical practice encompasses a wide spectrum of podiatric medical and surgical problems. Technological advances such as imaging have greatly improved diagnostic acumen; however, physical diagnosis and blood testing remain extremely important factors in reinforcing diagnostic hypotheses as a part of differential diagnosis. There are certain blood tests of importance that the podiatric medical practitioner should be familiar with in everyday medical and surgical practice. The purpose of this article is to identify and highlight which blood tests are truly essential and practical in terms of diagnosis...
January 2015: Journal of the American Podiatric Medical Association
Paula Caitano Fontela, Eliane Roseli Winkelmann, Joice Nedel Ott, Douglas Prestes Uggeri
OBJECTIVE: to estimate the glomerular filtration using the Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, and serum creatinine in the screening of reduced renal function in patients with type two diabetes (T2DM) enrolled in the Family Health Strategy (ESF, Brazilian federal health-care program). METHODS: a cross-sectional descriptive and analytical study was conducted...
November 2014: Revista da Associação Médica Brasileira
David C Fiore, Cara-Louise Fox
Proteinuria and hematuria can be benign or can be signs of more serious underlying pathology. The diagnostic evaluation should take into account the age of the patient as well as medical history, family history, concurrent symptoms, initial physical examination findings, and basic office laboratory test results. There are many tests to consider for proteinuria and hematuria. Routine screening for proteinuria is not recommended in the general population, but it is recommended for high-risk patients, such as those with diabetes and hypertension...
January 2014: FP Essentials
Zaher Armaly, Shehadeh Haj, Abdalla Bowirrat, Mohammed Alhaj, Adel Jabbour, Yumna Fahoum, Zaid Abassi
PATIENT: Female, 17 FINAL DIAGNOSIS: Acute kidney injury Symptoms: Flank pain • nausea • vomiting MEDICATION: Isotretinoin Clinical Procedure: Acne treatment Specialty: Nephrology Objective: Unknown etiology. BACKGROUND: Isotretinoin is widely used for the treatment of acne that is unresponsive to topical therapy. Despite its efficacy, isotretinoin has various adverse effects, including cheilitis, increased risk of cutaneous Staphylococcus aureus infections, and liver function abnormalities...
2013: American Journal of Case Reports
Chad J Cooper, Sarmad Said, Sayeed Khalillullah, Hasan J Salameh, German T Hernandez
PATIENT: Female, 21 FINAL DIAGNOSIS: Multicystic Dysplastic Kidney Disease complicated by pyelonephritis Symptoms: Left flank pain (CVAT) • dysuria • fever MEDICATION: Levofloxacin Clinical Procedure: Dimercaptosuccinic acid scan • voiding cystouretrogram Specialty: Nephrology. OBJECTIVE: Rare disease. BACKGROUND: Multicystic dysplastic kidney (MCDK) is a renal dysplasia characterized by the presence of multiple cysts that are non-communicating, separated by dysplastic parenchyma that consumes the renal cortex resulting in a nonfunctional kidney...
2013: American Journal of Case Reports
Luis Coentrão, Luc Turmel-Rodrigues
Vascular access problems are a daily occurrence in hemodialysis units. Loss of patency of the vascular access limits hemodialysis delivery and may result in underdialysis that leads to increased morbidity and mortality. Despite the known superiority of autogenous fistulae over grafts, autogenous fistulae also suffer from frequent development of stenosis and subsequent thrombosis. International guidelines recommend programmes for detection of stenosis and consequent correction in an attempt to reduce the rate of thrombosis...
July 2013: Journal of Vascular Access
F Fiorini, L Barozzi
Diagnostic techniques in nephrology include clinical history, physical examination, laboratory tests, scintigraphy, diagnostic imaging techniques as well as renal biopsy. In kidney diseases, ultrasonography is used as a first-line imaging technique, and its role in medical nephropathy is to exclude urological pathologies, to differentiate between acute and chronic renal failure, to follow-up on the course of a disease, to guide needle biopsy, etc. Ultrasound images are useful at characterizing the pelvis, assessing renal dimensions and parenchymal echogenicity, sampling color-power Doppler signals and evaluating their characteristics and distribution as well as measuring parenchymal resistive index...
December 2007: Journal of Ultrasound
Garabed Eknoyan
The 19th century was a period of momentous scientific discoveries, technological achievements, and societal changes. A beneficiary of these revolutionary upheavals was medical empiricism that supplanted the rationalism of the past giving rise to early modern scientific medicine. Continued reliance on sensory data now magnified by technical advances generated new medical information that could be quantified with increasing precision, verified by repeated experimentation, and validated by statistical analysis...
January 2013: Seminars in Dialysis
Harika Alpay, Ibrahim Gokce, Ahmet Özen, Nese Bıyıklı
PURPOSE: We have evaluated the clinical, radiological and metabolic features of infantile urolithiasis (UL). MATERIALS AND METHODS: We have reviewed the medical records of 93 children who were diagnosed as having UL before 1 year of age. We recorded patient demographics, the age at diagnosis, presenting symptoms, family history, the localizations and dimensions of stones, urinary metabolic examinations, as well as physical, laboratory, and radiologic findings. Our secondary objective was to compare some features of this group with those of older children with UL followed-up in the same clinic which were previously reported...
March 2013: Pediatric Surgery International
Wen-di Dai, Wen-Hu Liu, Dong-Liang Zhang
We reported a rare case of a dialysis patient coincident pituitary prolactinoma with calcification. A 55-year-old woman who had undergone hemodialysis for 8 years was admitted to the nephrology unit because of headache, blurred vision, and hypotension. Physical examination was normal; endocrinological examination demonstrated elevated serum levels of prolactin (> 4240 mIU/L), but other hormonal profiles, such as growth hormon, adrenocorticotropic hormone, thyroid stimulating hormone, free triiodothyronine, free thyroxine, follicle-stimulating hormone and luteinizing hormone, were absolutely or relatively lower...
August 2012: Chinese Medical Journal
Christian Bieglmayer, Hans Peter Dimai, Rudolf Wolfgang Gasser, Stefan Kudlacek, Barbara Obermayer-Pietsch, Wolfgang Woloszczuk, Elisabeth Zwettler, Andrea Griesmacher
AIM: Reasonable application of laboratory parameters in prevention, diagnosis, treatment and therapy monitoring of osteoporosis. TARGET GROUPS: Physicians from different specialist disciplines (general medicine, geriatrics, gynaecology, urology, internal medicine-especially endocrinology and metabolism, nephrology, laboratory medicine, rheumatology, nuclear medicine, orthopaedics, paediatrics, rehabilitation and physical medicine, radiology, social medicine, transplantation medicine, accident surgery), moreover social insurances, hospitals and self-help groups...
November 2012: Wiener Medizinische Wochenschrift
Mario Meola, Ilaria Petrucci, Chandra Bortolotto, Luisa Carone
Advances in digital technology in the last decades have led to a fast development of ultrasound technology. Ultrasound information originating from stationary structures or red blood cells moving into the vessels can be visualized with different imaging modalities. Conventional B-mode sonography provides anatomical details based on acoustic impedance differences. Gray-scale sonography represents the structural echoes as brightness points. Based on the Doppler effect, vascular scattering can be represented as spectral wave velocity depending on time (velocity/time curve), or as dual-scale color mapping depending on the changes in average blood velocity...
March 2012: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Luís Coentrão, Bernardo Faria, Manuel Pestana
BACKGROUND: Physical examination (PE) of arteriovenous fistulae (AVF) has recently emerged as an important element in the detection of stenotic lesions. This study examines the accuracy of PE in the assessment of AVF dysfunction by non-interventionalists in comparison with angiography. METHODS: A total of 177 consecutive patients who had AVF dysfunction and were referred to our centre by general nephrologists for angioplasty between November 2009 and July 2010 were included in this analysis...
May 2012: Nephrology, Dialysis, Transplantation
Alberto Donzelli, Donatella Sghedoni, Francesco A Carelli, Saverio Chirchiglia, Paolo Manunta
The Clinical Pathway (in its complete definition Diagnostic, Clinical and Therapeutic Pathway - Percorso Diagnostico Terapeutico Assistenziale - PDTA), originally started to deal with the newly diagnosed hypertensive patient, developed also recommendations for the first-line drugs in case of specific indications/contraindications and organ damages. It has been developed by a working group of specialists in cardiology, nephrology, internal medicine (faculty included) designated by their hospitals (both public and private accredited), including all the main city hospitals, by general practitioners designated by the Medical Unions SNAMI, FIMMG, SMI and SiMI and by public health doctors belonging to the Local Health Unit of Milan, who have coordinated the proceedings and have guaranteed that possible conflicts of interest of single participants could not interfere with the PDTA, anyway approved by all in July 2009...
January 2011: Reviews on Recent Clinical Trials
Antoine Samaha, Loay Salman, Arif Asif
A chronic hemodialysis patient was referred to interventional nephrology for evaluation of left hand pain. The patient had been receiving hemodialysis through a left radial-cephalic arteriovenous fistula and reporting hand pain during dialysis. Physical examination demonstrated cold hand and reduced capillary refill compared with the right hand. Clinical features, differential diagnosis, and physical examination findings were consistent with the diagnosis of hand ischemia due to dialysis access. Arteriography revealed >80% stenosis of the distal ulnar artery...
September 2009: Seminars in Dialysis
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