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  1. Artikel ; Online: Ruptured bilateral brain arteriovenous malformations in a young woman with early pregnancy

    Ng’weina F. Magitta / Emmanuel M. Sindato / John R. Meda / Hasna N. Toroha / Alfred J. Meremo

    Journal of Medical Case Reports, Vol 17, Iss 1, Pp 1-

    a case report

    2023  Band 7

    Abstract: Abstract Background Brain arteriovenous malformations (AVMs) are rare congenital developmental vascular lesions, and often presents with symptoms upon rupture. The controversy exists as to whether pregnancy confers an increased risk of intracranial ... ...

    Abstract Abstract Background Brain arteriovenous malformations (AVMs) are rare congenital developmental vascular lesions, and often presents with symptoms upon rupture. The controversy exists as to whether pregnancy confers an increased risk of intracranial hemorrhage. The diagnosis of brain AVMs, in the absence of brain imaging, is challenging in resource-limited settings, particularly in sub-Saharan Africa. Case presentation A 22-year old black African woman, primigravida at 14 weeks of gestation, presented with a history of persistent throbbing headache which was treated at primary health care facilities with analgesics and anti-migraine medications without relief. She later developed severe headache 2 weeks prior to admission and one-day history of serial partial generalized tonic–clonic seizures which were followed by post-ictal confusion and persistent right upper limb weakness. Initial evaluation revealed her to be pregnant and she later underwent a brain magnetic resonance angiography (MRA) at a university teaching hospital which revealed bleeding bilateral parietal AMVs with intracerebral haematoma and associated perilesional vasogenic oedema. The patient was managed conservatively using antifibrinolytic drugs and prophylactic anti-seizure drugs. Seven months later, she underwent a control brain MRA which revealed resolution of intracranial haematoma and associated vasogenic oedema and had her seizures well controlled. The headache had subsided and the pregnancy was allowed to continue to term under close obstetric and neurological observation. On follow up visits she reported episodes of nasal bleeding which upon ENT examination revealed nasal AVMs, suggesting the diagnosis of hereditary hemorrhagic telangiectasia (HHT). Conclusion AVMs are rare but should prompt suspicion in young patients with atypical Central Nervous System (CNS) manifestations without evident underlying causes.
    Schlagwörter Brain arteriovenous malformation ; Intracranial hemorrhage ; Seizures ; Pregnancy ; Spetzler-Martin classification ; Medicine ; R
    Thema/Rubrik (Code) 616
    Sprache Englisch
    Erscheinungsdatum 2023-05-01T00:00:00Z
    Verlag BMC
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  2. Artikel ; Online: Prevalence and factors associated with renal dysfunction among children with sickle cell disease attending the sickle cell disease clinic at a tertiary hospital in Northwestern Tanzania.

    Fransisca D Kimaro / Shakilu Jumanne / Emmanuel M Sindato / Neema Kayange / Neema Chami

    PLoS ONE, Vol 14, Iss 6, p e

    2019  Band 0218024

    Abstract: Background Little is known on how the interaction between Sickle Cell Disease (SCD) and renal insults caused by other coexisting conditions in Sub Saharan Africa such as urinary schistosomiasis, malnutrition and HIV affect the prevalence of renal ... ...

    Abstract Background Little is known on how the interaction between Sickle Cell Disease (SCD) and renal insults caused by other coexisting conditions in Sub Saharan Africa such as urinary schistosomiasis, malnutrition and HIV affect the prevalence of renal dysfunction in children with SCD. Objectives To determine the prevalence and factors associated with renal dysfunction among children with SCD aged 6 months to 12 years attended at a tertiary hospital in Northwestern Tanzania. Methods A cross sectional hospital-based study with a short follow up component of 3 months for 153 children with SCD was done to document demographics, clinical characteristics and features of renal dysfunction including urine dipstick albuminuria (>20mg/l) and eGFR (<60ml/ml/min/1.73m2). Other potential renal insults such as HIV infection and Schistosomiasis were also evaluated. Results At enrollment, 48/153(31.37%) children had renal dysfunction declining to 31(20.3%) at 3 months follow up. Acute chest syndrome (OR 3.04, 95% CI [1.08-8.96], p = 0.044), severe anemia (OR 0.44, 95% CI [0.26-0.76],p = 0.003), urinary schistosomiasis (OR 7.43, 95% CI [2.10-26.32] p<0.002) and acute malnutrition (OR 4.92, 95% CI [1.29-18.84], p = 0.020). were associated with renal dysfunction. Conclusion Where prevalent, urinary schistosomiasis and acute malnutrition increase the risk for renal dysfunction in children with SCD. We recommend albuminuria routine screening in children with SCD especially those presenting with acute chest syndrome, severe anemia and features of acute malnutrition for early detection of renal dysfunction among children with SCD.
    Schlagwörter Medicine ; R ; Science ; Q
    Thema/Rubrik (Code) 360 ; 616
    Sprache Englisch
    Erscheinungsdatum 2019-01-01T00:00:00Z
    Verlag Public Library of Science (PLoS)
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

    Volltext online

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