Epilepsy
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Abstract This chapter begins with a discussion of the taxonomy of seizure disorders and the clinical features of epilepsy that pose methodological challenges in clinical and epidemiologic studies. Descriptive studies of incidence and prevalence are described for the following seizure types: partial, generalized tonic-clonic, myoclonic, and absence seizures. Risk factors for epilepsy are discussed in the context of case-control and cohort designs, and evidence is summarized regarding the role of non-genetic risk factors (traumatic brain injury, infections, cerebrovascular disease, brain tumors, degenerative CNS diseases, and developmental deficits). The chapter discusses factors associated with prognosis and mortality of epilepsy, as well as common causes of death in epilepsy patients. The final section addresses evidence for familial aggregation and genetic causes of seizures.Foot (prosody)
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The aim of this prospective epidemiological study was to establish the incidence rate of childhood epilepsy in Estonia, to describe the clinical spectrum and to identify etiology of childhood epilepsy. The overall incidence rate was 86.3/100 000. The incidence rate was the highest (141.9/100 000) in the age group from 5 to 9 years. Specific electroclinical syndromes were identified in 22.8% of cases. Structural or metabolic etiology was identified in 20.0% of cases, presumed genetic origin was identified in 33.9% of cases, and in 46.1% of cases the cause of epilepsy remained unknown. The incidence rate of childhood epilepsy in Estonia (86.3/100 000) is similar to the other European countries. In comparison with the results of the first epidemiological study of childhood epilepsy in Estonia (incidence rate 45/100 000; Beilmann et al), the incidence rate in this study is almost 2 times higher, what can be explained with better case collection and improved diagnostic modalities in Estonia.
Etiology
Epilepsy in children
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Objective To summarize the elderly patient's clinical manifestations of appendicitis,and to explore perioperative issues.Methods Retrospective analysis of age≥70 years old,received surgical treatment of 72 cases of clinical data of patients with appendicitis.Results The results of 72 cases of elderly patients,73.6%with preoperative hypertension, coronary heart disease,diabetes and other chronic lung disease and old age diseases;lines are 72 cases of small incision appendectomy,the incidence of postoperative complications was 12.5%,preoperative persons with other diseases the incidence of complications(20.8%) was significantly higher than those without other diseases(9.7%),P 0.01.Conclusion Elderly patients with appendicitis associated with many diseases,the high incidence of postoperative complications,we should strengthen the treatment of peri - operative,small - incision surgery to improve the safety of laparoscopic appendectomy is superior to,the elderly find it easier to accept.
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<b><i>Background:</i></b> The incidence of childhood and adolescence epilepsy varies in different areas and over time. Published reports in the Italian pediatric population are few and there is no information on the incidence of epilepsy using the new clinical definition of the disease signed by the International League Against Epilepsy. An increased risk of epilepsy is reported in subjects who presented with neonatal seizures (NS), but few population-based studies are available that compare incidence and age at onset of epilepsy in children with and without NS. <b><i>Objectives:</i></b> Ascertain the incidence of epilepsy in children in the province of Parma by applying the new practical clinical definition of epilepsy, and compare incidence and age of epilepsy onset in children with and without previous NS. <b><i>Methods:</i></b> The study was carried out in the province of Parma, Emilia-Romagna Region, Northern Italy, using different data sources (clinical records and administrative data), and considered all the children born in the province of Parma between January 2002 and December 2014 and developing epilepsy by December 2016. We calculated the incidence of epilepsy in patients up to 14 years of age, incidence of epilepsy after NS and cumulative incidence of epilepsy at 1, 5, and 10 years’ follow-up. To evaluate age at onset of epilepsy, we divided patients into 3 groups (epilepsy onset within 1 month, between 1 and 12 months, and after 1 year of life) and we compared age at onset of epilepsy between patients who had had previous NS and those who had not. <b><i>Results:</i></b> The incidence of epilepsy was 78.6/100,000 persons-years (boys 88.1/100,000, girls 68.6/100,000). The incidence of epilepsy after NS was 15.2% (8.2% for male, 23.5% for female; 16.3% in born at term, 14.3% in pre-term). The incidence of epilepsy at 1, 5, and 10 years’ follow-up was higher in patients with previous NS than in others. The age at onset of epilepsy was significantly different in the 2 groups, and was younger in those with history of NS: mean age at onset was 10.5 months in those with NS and of 61.8 months in the others. <b><i>Conclusions:</i></b> The incidence rate of epilepsy in the Parma district was higher than that reported in other Italian areas studied, probably due to the different methodology used and the application of the most recent definition of epilepsy. Children with NS were at higher risk of epilepsy and develop the disease at a younger age.
Epilepsy in children
Cumulative incidence
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Abstract Hospitalized adult patients suffer from high rates of acute kidney injury (AKI), which puts them at risk for multiple nutrition problems. The etiology and management strategy of AKI has major implications for the management of the hospitalized patient. The purpose of this review is to understand the incidence and management of AKI in hospitalized adult patients and review the challenges to providing adequate nutrition support.
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Background: Atrial Fibrillation (AF) ablations are performed in pts of all age groups. No data exists on the outcomes or Quality of Life (QOL) specific to the octogenarian population undergoing this procedure. We hypothesize the outcomes and risks would not be too dissimilar when compared to a younger cohort between 65-79 years. Methods: From a retrospective database we selected octogenarian pts compared to an age and sex matched control group, ages 65-79. Pre-ablation tests were performed as well as quality of life (QoL) and symptom inventories. Results of the ablation procedure, follow up QoL and symptom inventories, peri-procedure morbidity and freedom from AF or control of AF with anti-arrhythmic agents were compared between the 2 groups. Results: During follow-up (mean 2.3 ± 2.2 years), AF elimination (70% vs 81%, p 0.942) and AF control including those on antiarrhythmic agents (86% vs 86%, p 0.249) were compared. Conclusion: Outcomes of ablation in the octogenarians are highly favorable with no increase in procedural complications. Improvement in QOL scores is impressive in patients with advancing age. Comparison of variables between the Young-Old and the Octagenerian cohort of patients undergoing ablation of drug-refractory AF Comparison of variables between the Young-Old and the Octagenerian cohort of patients undergoing ablation of drug-refractory AF
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Summary: Purpose: The current understanding of epilepsy has changed significantly in the past 2 decades. This report presents a description of newly diagnosed childhood‐onset epilepsy, with a special emphasis on epilepsy syndromes, in a large, prospectively ascertained community‐based cohort evaluated and diagnosed in the mid‐1990s. Methods: Children, aged 0 through 15 years at the time of the first seizure, were prospectively identified at the time of diagnosis of epilepsy through the practices of 16 of the 17 child neurologists in Connecticut as well as five adult neurologists and seven pediatricians from January 1993 through December 1997. Parents were interviewed, and all relevant medical records were reviewed. Classification of seizures and of epilepsy syndromes was done for each child by each of three pediatric neurologists, Discrepancies were resolved in conference. Results: A total of 613 children was recruited into the study. The median age at time of the first seizure was 5.3 years. Half the cohort was boys. Eighteen percent had a remote symptomatic etiology. Epilepsy syndromes were classifiable in all but four children, although some syndromes are, by definition, relatively nonspecific. In this childhood‐onset cohort, 58.6% of the syndromes were localization related, 29.0% generalized, and 12.4% undetermined as to whether focal or generalized. Benign rolandic epilepsy occurred in 10% of the cohort. Primarily generalized syndromes accounted for 20.6%, with childhood absence being the single most common syndrome in this subgroup (12.1% of the cohort). Secondarily generalized syndromes accounted for 8.5% of the total, with infantile spasms being the most common in this grouping (3.9% of the cohort). Conclusions: This study presents a description of childhood‐and adolescent‐onset epilepsy as it is diagnosed and evaluated in the 1990s in one state in the United State and based on current classification guidelines. The results should be generalizable to the rest of the country. The prognostic value of early identification of epilepsy syndromes will be determined through subsequent follow‐up of this cohort.
Etiology
Epilepsy syndromes
Generalized epilepsy
Rolandic epilepsy
Medical record
Presentation (obstetrics)
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Rheumatic disease
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Abstract INTRODUCTION: Post-transplant diabetes mellitus (PTDM) contributes to the risk for cardiovascular disease and infection, reducing graft and patient survival. This study was conducted to identify incidence and risk factors for development of PTDM. METHODS: We studied 50 non-diabetic adult dialyzed patients awaiting renal transplantation prospectively. Oral glucose tolerance test () was performed pre- and post-transplantation. The relation of age, weight (BMI), dialysis modality, family history of diabetes, duration of dialysis was assessed with occurring PTDM. RESULTS: Based on 1 , 13 patients had unknown Diabetes Mellitus; however after transplantation only 9 of them had same results. Based on 2 6(16.22%) patients had actually PTDM. Age of patients with PTDM were significantly higher than those with normal test (43± 17 versus 31± 11 year old) (P 0.05). CONCLUSION: Risk factors for diabetes in our study were age and duration of dialysis before transplantation. Then identifying them might allow modification of post transplant immunosuppressant with nondibetogenic agents in high risk patients. Keywords: post-transplant diabetes mellitus, oral glucose tolerance test, renal transplantation.
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Bicer, Y.; Altuntas, Y.; Yapici, N.; Aydin, O.; Golcukcu, G.; Aykac, Z. Author Information
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