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Development of a Score Based on Urinalysis to Improve the Management of Urinary Tract Infection in Children
Mohamed Hamed Bahbah,
Ahmed Anower Khattab,
Rania Salah El Zayat,
Abdelwahab Mohamed Badr
Issue:
Volume 3, Issue 1, January 2015
Pages:
1-6
Received:
12 December 2014
Accepted:
23 December 2014
Published:
31 December 2014
Abstract: Objectives: Our aim is to develop a score that may help in reducing the misuse of antibiotics in treatment of urinary tract infection before appearance of urine culture. Background: The need for reducing unnecessary antibiotic treatment is being emphasized in the management of urinary tract infections (UTI), a disease frequent in childhood. An ideal test should provide early diagnosis without the waiting times of urine culture, but even a simple test of exclusion could significantly improve patient management. Methods: We evaluated the sensitivity, specificity, negative and positive predictive value of urine analysis, dipstick (leukocyte esterase and nitrite) and bacterial colony count in children with suspected UTI. Multivariable logistic regression analysis was used to identify the set of variables that best predict positive culture results and develop a numerical risk score. Results: Of 200 children were having symptoms of UTI, 93 child had confirmed UTI with prevalence 46.5%. Parameters significantly associated with the presence of infection in multivariable analysis were age 9-12 years (p < 0.05), leukocyte esterase positive (p < 0.001), nitrite positive (p < 0.05), pus cell >10/HPF (p < 0.05), RBCs>10/HPF (p < 0.05) and bacteria ≥ 10^6 (p < 0.05).The derived score ranged from 1 to 7, with higher values indicating higher risk of UTI. Conclusion: This routine method could improve the management of UTI in children by early identifying patients with low probability of infection, for which antibiotic treatment can be withheld until the results of urine culture become available.
Abstract: Objectives: Our aim is to develop a score that may help in reducing the misuse of antibiotics in treatment of urinary tract infection before appearance of urine culture. Background: The need for reducing unnecessary antibiotic treatment is being emphasized in the management of urinary tract infections (UTI), a disease frequent in childhood. An idea...
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Gestational Trophoblastic Diseases in a Teaching Hospital in Northern, Nigeria
Ibrahim Yakasai,
Idris Abubakar,
Yunus Eze
Issue:
Volume 3, Issue 1, January 2015
Pages:
7-10
Received:
6 December 2014
Accepted:
22 December 2014
Published:
20 January 2015
Abstract: Background: Gestational trophoblastic diseases (GTD) is a spectrum of pregnancy-related premalignant disorders of complete and partial hydatidiform mole, and the malignant disorders of invasive mole, choriocarcinoma, and the rare placental-site trophoblastic tumour. Objective: This study was carried out to determine the incidence of gestational trophoblastic disease, the clinical features and management outcome at the Aminu Kano Teaching Hospital, Kano, Nigeria. Materials and Methods: This was a retrospective study of the demographic and clinical data as well as management outcome of all patients with gestational trophoblastic disease managed between January, 2008 and December, 2012 at the Aminu Kano Teaching Hospital. Kano,Nigeria Results: There were 103 cases of GTD and 22,680 deliveries; giving an incidence of GTD as 4.5 per 1000 deliveries. Among them, 69 (67.0%) cases were hydatidiform mole while Choriocarcinoma was diagnosed in 34 cases (33.0%). The antecedent pregnancy among the cases of choriocarcinoma were hydatidiform mole in 18 cases (52.9%), miscarriage in 10 cases (29.4%) and ectopic pregnancy in 1 case (3.0%) and full term pregnancy in 5(14.7%) patients. GTD was commoner at the extremes of reproductive age. Hydatidiform mole was high 37(53.6%) in those aged 24 years and below, while choriocarcinoma was high 13(38.2%) in 45 - 49 years age group. The most common presenting symptom was vaginal bleeding occurring in all the cases, while anaemia was the most common complication. Suction evacuation and follow up (67.0%) was the mode of treatment in all cases of molar pregnancy. Only cases of choriocarcinoma 34 (33.0%) had chemotherapy, 11(32.4%) cases had single agent while 23 cases (67.6%) had multi-agent chemotherapy. There were seven maternal deaths in this study, given a case fatality of 6.8%. Conclusion: The incidence of GTD in this study was 4.5 per 1000 deliveries. Vaginal bleeding was the commonest presenting symptom. Early diagnosis and appropriate treatment of this disease has an excellent prognosis, while late presentation was associated with high maternal mortality as found in this study.
Abstract: Background: Gestational trophoblastic diseases (GTD) is a spectrum of pregnancy-related premalignant disorders of complete and partial hydatidiform mole, and the malignant disorders of invasive mole, choriocarcinoma, and the rare placental-site trophoblastic tumour. Objective: This study was carried out to determine the incidence of gestational tro...
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Age-Related Decrease in Glucagon-Like Peptide-1 in Mouse Prefrontal Cortex but Not in Hippocampus Despite the Preservation of Its Receptor
Ryo Ohshima,
Kanae Hotsumi,
Christian Holscher,
Kenjiro Seki
Issue:
Volume 3, Issue 1, January 2015
Pages:
11-27
Received:
5 January 2015
Accepted:
20 January 2015
Published:
30 January 2015
Abstract: Glucagon-like peptide-1 receptor (GLP-1R) agonist treatment has the potential to be a novel therapeutic treatment for Alzheimer’s disease (AD). We previously reported that exendin-4, a Gαs protein-coupled GLP-1R agonist, up-regulates the membrane AMPA receptor GluR1 subunit in the neocortex. However, it is uncertain whether GLP-1R agonists have an advantage as an AD treatment target compared with other Gαs protein-coupled receptors. Here we show that both the protein level of proglucagon, a precursor of GLP-1, and the immunoreactivity level of GLP-1 are significantly decreased in the medial prefrontal cortex (mPFC) of aged mice (14 months old) compared with young (3 weeks old) or adult (6 months old) mice, but not in area CA1, the dentate gyrus (DG) nor in the nucleus of the solitary tract. However, the protein and immunoreactivity levels of GLP-1R in the mPFC, DG and hippocampal CA1 and CA3 areas were preserved in the aged mice. We then confirmed whether the age-dependent decrease in GLP-1 in the mPFC was associated with the activity level or the number of microglial cells in the mPFC. Co-staining of CD11b and GLP-1 in the mPFC revealed that the number of CD11b-positive cells was increased in the aged mice. Moreover, lipopolysaccharide (LPS) injection increased the number of CD11b-positive cells in the mPFC, but the number of GLP-1-positive cells was unchanged. However, the number of CD11b-positive cells that co-localized with GLP-1R in the mPFC is increased by LPS and aging. Because the GLP-1R is preserved in aged mPFC, but the amount of GLP-1 produced in the brain region is diminished, and spatial cognitive memory was impaired in aged mice, we propose that treatment with GLP-1 analogues has great promise for rescuing and ameliorating the age-related mPFC-dependent decline of cognitive functions.
Abstract: Glucagon-like peptide-1 receptor (GLP-1R) agonist treatment has the potential to be a novel therapeutic treatment for Alzheimer’s disease (AD). We previously reported that exendin-4, a Gαs protein-coupled GLP-1R agonist, up-regulates the membrane AMPA receptor GluR1 subunit in the neocortex. However, it is uncertain whether GLP-1R agonists have an ...
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