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Microalbuminuria in pediatric patients with hypertension  [PDF]
Nata?a Mar?un Varda
Health (Health) , 2013, DOI: 10.4236/health.2013.54A006

Microalbuminuria in adults has been found to be an early indicator of both renal and systemic vascular disease, as well as significant cardiovascular risk predictor and therapeutic marker. Its role in essential hypertension in adults has also been well established. As diseases like hypertension and obesity have their roots in childhood and are already present in children, influencing the morbidity in adulthood, the role of microalbuminuria has been extensively investigated in children as well. Most investigations have been performed in diabetic children, confirming its clinical significance. There is also enough evidence to suggest that microalbuminuria in obese children should be taken as seriously as in children with diabetes. In children with hypertension rare studies also indicate that its presence identifies hypertensive children with higher risk, although the exact role has to be confirmed in prospective and larger studies. The mechanisms of microalbuminuria onset could be the result of renal damage secondary to hypertension or underlying renal and systemic endothelial dysfunction. Evidence from small intervention studies in children with microalbuminuria also suggests that early intervention with antihypertensive drugs is likely to be beneficial, pointing out the role of microalbuminuria as a therapeutic marker in children too. In addition, we have to stress the importance of follow-up of children with microalbuminuria, confirmation of its persistence and identification of progression. However, longitudinal prospective studies in children, investigating its future cardiovascular risk, are still lacking.

Microalbuminuria represents a feature of advanced renal disease in patients with sickle cell haemoglobinopathy
C.K N'Guessan, M.W Tia, D.A Lagou, A Cissoko, C.M Guei, D.A Gnionsahe
Annals of Ibadan Postgraduate Medicine , 2006,
Abstract: Chronic renal failure (CRF) occurring in sickle cell disease has a dismal outcome. The systematic screening for microalbuminuria represents the touchstone to prevent CRF in patients with diabetes mellitus. Microalbuminuria has also been demonstrated in patients with sickle cell disease. Whether this has the same prognostic significance as it does in diabetes mellitus has never been clearly stated. The purpose of the present study was to determine the prevalence of microalbuminuria and to establish the clinical significance of microalbuminuria in patients with sickle cell disease. Patients with sickle cell disease of both sexes and all ages were consecutively recruited at the haematology outpatient clinic of the Yopougon Teaching Hospital, Abidjan, Ivory Coast. in a prospective study from July to September 2004. In each patient characteristics such as age, gender, ethnic group, weight, height, blood pressure, type of haemoglobinopathy , glomerular filtration rate, complications related to the disease and current treatment were collected. Microalbuminuria was assessed in all the patients. Statistical analysis was performed to identify factors related to microalbuminuria. The prevalence of microalbuminuria was 17.3% in our study population. Glomerular filtration rate was significantly lower in the microalbuminuric group than in the normoalbuminuric group both on univariate analysis (p<0.01) and on multivariate analysis (OR=1.074) CI 95% [1.020 1.136]) (p<0.01). Height was significantly lower in the microalbuminuric group than in the normoalbuminuric group both on univariate analysis (p=0.05) and on multivariate analysis (OR=1.029 CI 95% [1.003 1.056])(p<0.05). Anaemia was more prevalent in the microalbuminuric group than in the normoalbuminuric group(p<0.05) on univariate analysis but not on multivariate analysis. No relationship has been found between microabuminuria and age, as well as with disease duration and body mass index. Microalbuminuria in sickle cell disease patients represents a feature of more advanced disease as it is significantly related to low glomerular filtration rate. The high prevalence of anaemia in the microalbuminuric patients corroborates the depressed renal function. The role of short height in the promotion of microalbuminuria is unclear.
Microalbuminuria in relation to the metabolic syndrome and its components in a Chinese population
Chang-Sheng Sheng, Bang-Chuan Hu, Wang-Xiang Fan, Jun Zou, Yan Li, Ji-Guang Wang
Diabetology & Metabolic Syndrome , 2011, DOI: 10.1186/1758-5996-3-6
Abstract: The study subjects were recruited from a newly established residential area in the suburb of Shanghai. We measured anthropometry, blood pressure (BP), fasting plasma glucose, and serum lipids, and collected spot urine samples for the determination of albumin-creatinine ratio. We defined microalbuminuria as a urinary albumin-to-creatinine ratio of 30 to 299 mg/g. The metabolic syndrome was defined according to the International Diabetes Federation criteria.The 1079 participants included 410 (38.0%) hypertensive patients, and 66 (6.1%) diabetic patients. The prevalence of microalbuminuria (4.3%) was 3.2 times higher in 167 patients with the metabolic syndrome than 912 subjects without the metabolic syndrome (12.0% vs. 2.9%, P < 0.0001). In multiple regression adjusted for sex, age, body mass index, current smoking, alcohol intake and the use of antihypertensive drugs, and mutually adjusted for the components, microalbuminuria was significantly associated with diastolic BP (odds ratio 1.74 for +10 mmHg; 95% confidence interval [CI] 1.10-2.76; P = 0.02) and fasting plasma glucose (1.18; 95% CI 1.01-1.41; P = 0.04), but not with waist circumference, systolic BP, or serum HDL cholesterol and triglycerides (P > 0.10).Microalbuminuria is common in the Chinese population, and much more prevalent in the presence of the metabolic syndrome, mainly attributable to elevated diastolic BP and plasma glucose.Micoralbuminuria is an early marker of chronic kidney disease (CKD) [1] and vascular dysfunction [2], and is associated with a higher risk of renal function loss [1], cardiovascular events [1,3], and all-cause mortality [3]. Microalbuminuria is relatively common in patients with metabolic disorders, such as type 2 diabetes mellitus [4], and has been incorporated into the definition of the metabolic syndrome of the World Health Organization [5]. However, whether microalbuminuria should be an essential component of the metabolic syndrome remains controversial. Indeed, the Adult Tr
The Significance of Hair for Face Recognition  [PDF]
Umar Toseeb, David R. T. Keeble, Eleanor J. Bryant
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0034144
Abstract: Hair is a feature of the head that frequently changes in different situations. For this reason much research in the area of face perception has employed stimuli without hair. To investigate the effect of the presence of hair we used faces with and without hair in a recognition task. Participants took part in trials in which the state of the hair either remained consistent (Same) or switched between learning and test (Switch). It was found that in the Same trials performance did not differ for stimuli presented with and without hair. This implies that there is sufficient information in the internal features of the face for optimal performance in this task. It was also found that performance in the Switch trials was substantially lower than in the Same trials. This drop in accuracy when the stimuli were switched suggests that faces are represented in a holistic manner and that manipulation of the hair causes disruption to this, with implications for the interpretation of some previous studies.
Microalbuminuria and Kidney Disease Risk in HIV Patients Taking Combined Antiretroviral Therapy  [PDF]
Huylmer Lucena Chaves, Mayanna Pinho Batista, Adriana de Menezes Gomes, Amanda Antunes Costa, André Tigre Lima, Vinícius Diniz Arcelino do Ceará, Pedro Rubens Araújo Carvalho, Linna Albuquerque Sampaio, Fabrício de Maicy Bezerra, Melissa Soares Medeiros
World Journal of AIDS (WJA) , 2014, DOI: 10.4236/wja.2014.42029

Objectives: This study proposes to evaluate risk factors for kidney disease in HIV patients treated chronically and correlate with microalbuminuria measurements. Methods: Review charts and analyses of microalbuminuria in subgroup of HIV patients treated at Ceara/Brazil. Results: 149 patients, 69.1% male, mean 38.5 years old, infection mean 86.8 months. Mean Creatinine Clearance 110.2%, Creatinine 0.97, Urea 27.76 mg/dl, CD4+ 600.37 cels/mm3 and detectable viral load 530.59 copies with 61.7% undetectable. Mean Dosages of microalbuminuria/24h 147, 46 ± 820, 45 (N = 48) and microalbuminuria (mg/dl) 32.05 ± 85.25 (N = 43). Kidney Diseases Classification analyses evidenced 6.4% patients in stages ≥3 and 6.2% presented altered Microalbuminuria/24h. Patients using Tenofovir (TDF) 27.27% had Stage 2 and protease inhibitors (PI) had 4.1% in Stage 3. Proteinuria was observed in 5% stage ≥3. Association PI/TDF had 4.1% in Stage 3. No statistical difference between CD4 > or < 350 cels/mm3 and microalbuminuria/24h > 300 mg (p = 0.69); detectable/undetectable viral load and microalbuminuria/24h (p = 0.63) or stage ≥3 (p = 0.17); relation to Diabetes or arterial hypertension and microalbuminuria 24 h (p = 0.5 and p = 0.21); relation stage ≥3 and microalbuminuria/24h (p = 0.33); relation HIV diagnoses >/< 60 months and stage ≥3 (p = 0.51); or microalbuminuria/24h and TDF (p = 0.4), PI (p = 1), TDF/PI (p = 0.69), Atazanavir (p = 0.4) or Lopinavir/r (p = 1) regimens. There was statistical significance comparing age > or < 50 years and stage ≥3 (p = 0.001) without difference with age > or < 50 years and microalbuminuria/24h (p = 0.55) or microalbuminuria mg/d (p = 0.32). Relating comorbidities risk (Diabetes Mellitus plus Systemic Arterial Hypertension) to Kidney Diseases, it was found that 55.5% patients in Stage 3 or above with comorbidities compared with 15% with comorbidities in lower stages (P = 0.005).

Prevalence and Correlates of Microalbuminuria in Children with Sickle Cell Anaemia: Experience in a Tertiary Health Facility in Enugu, Nigeria  [PDF]
Christopher Bismarck Eke,Henrietta Uche Okafor,Bede Chidozie Ibe
International Journal of Nephrology , 2012, DOI: 10.1155/2012/240173
Abstract: Microalbuminuria is a pre-clinical marker of renal damage in children with sickle cell anaemia and can predict renal failure. Reported prevalence rates increased with age. In Nigeria, burden of disease and prevailing poor health facilities necessitate its screening, determination of prevalence and associated risk factors. It is a cross-sectional as well as descriptive study. Screening microalbuminuria used subjects’ early morning urine. Socio-demographic as well as clinical details were ascertained using semi-structured questionnaires and case files. Associations and statistical relationship of prevalence rates and clinical/epidemiological data were ascertained using chi-squared and multivariate analysis . Two hundred children with sickle cell anaemia (4–17 years) in steady state and 200 age/gender-matched controls were enrolled. Prevalence of microalbuminuria was ,respectively, 18.5% and 2.5% for subjects and controls . Microalbuminuria was commoner in females (19.8%) than males (17.4%) , increased with age , significantly associated with haemoglobin level and hospitalizations (0.001). Subjects had normal renal function. Hospitalizations and haemoglobin levels showed statistical significance on multivariate analysis. Prevalence of microalbuminuria is 18.5%. Age, haemoglobin concentrations, and higher hospitalizations influenced microalbuminuria among subjects. Screening for microalbuminuria should be incorporated in the case management of subjects with identified risk factors. 1. Introduction Sickle cell nephropathy is a major complication of sickle cell disease and results from recurrent renal vasoocclusion, ischaemia-reperfusion injury, and loss of renal mass [1]. It is characterized by glomerular hypertrophy and focal glomerulosclerosis [2, 3]. Proteinuria is one of the most common clinical manifestations of sickle cell nephropathy [4, 5]. Lowest level of albuminuria (20–200?mg/L) known as microalbuminuria [6] is a preclinical marker of glomerular damage predicting progressive renal failure in conditions like diabetes mellitus also associated with hyperfiltration, and hyperperfusion [7]. Microalbuminuria has been defined as an abnormally or supranormal urinary excretion of albumin in the absence of clinical proteinuria (i.e., proteinuria detectable by use of conventional dipstick like Albustix) [8]. Marshall et al. [9] defined microalbuminuria in terms of timed overnight urine collection as an albumin excretion rate greater than 20?μg per minute. Various proportional rates of microalbuminuria have been reported in children with sickle cell anaemia
Expiratory Flow Limitation Definition, Mechanisms, Methods, and Significance  [PDF]
Claudio Tantucci
Pulmonary Medicine , 2013, DOI: 10.1155/2013/749860
Abstract: When expiratory flow is maximal during tidal breathing and cannot be increased unless operative lung volumes move towards total lung capacity, tidal expiratory flow limitation (EFL) is said to occur. EFL represents a severe mechanical constraint caused by different mechanisms and observed in different conditions, but it is more relevant in terms of prevalence and negative consequences in obstructive lung diseases and particularly in chronic obstructive pulmonary disease (COPD). Although in COPD patients EFL more commonly develops during exercise, in more advanced disorder it can be present at rest, before in supine position, and then in seated-sitting position. In any circumstances EFL predisposes to pulmonary dynamic hyperinflation and its unfavorable effects such as increased elastic work of breathing, inspiratory muscles dysfunction, and progressive neuroventilatory dissociation, leading to reduced exercise tolerance, marked breathlessness during effort, and severe chronic dyspnea. 1. Definition Expiratory (air) flow limitation (EFL) during tidal breathing is a well-defined, mechanical pathophysiological condition occurring, either during physical exercise or at rest, before in supine and later on in sitting-standing position, when expiratory flow cannot be further increased by increasing expiratory muscles effort (i.e., by increasing pleural and alveolar pressure) because it is maximum at that tidal volume [1]. In other words, under the prevailing conditions, the respiratory system is globally limited as flow generator even during tidal expiration, and greater expiratory flow rates may be achieved just by increasing operating lung volumes, (i.e., moving progressively the end-expiratory lung volume (EELV) towards total lung capacity). In fact, the volume-related decrease of airway resistance and increase of elastic recoil are the only effective mechanisms to obtain higher expiratory flows in case of EFL [2]. As a consequence, the term airflow limitation widely used to indicate the abnormal decrease of maximal expiratory flow rates at a given lung volume, as compared to predicted (i.e., airflow reduction or airflow obstruction), is inappropriate and should not be adopted unless the condition previously described is present (Figure 1). Figure 1: Maximal and tidal flow-volume curve in two representative COPD patients: one with airflow reduction and tidal expiratory flow limitation (EFL) at rest (a), the other only with airflow reduction at rest and potential EFL during exercise (b). The NEP application at rest does not increase expiratory flow in the
Periodic EEG patterns: importance of their recognition and clinical significance
Andraus, Maria Emilia Cosenza;Andraus, Cesar Fantezia;Alves-Leon, Soniza Vieira;
Arquivos de Neuro-Psiquiatria , 2012, DOI: 10.1590/S0004-282X2012000200014
Abstract: periodic electroencephalographic (eeg) patterns consist of discharges usually epileptiform in appearance, which occur at regular intervals, in critical patients. they are commonly classified as periodic lateralized epileptiform discharges (pleds), bilateral independent pleds or bipleds, generalized epileptiform discharges (gpeds) and triphasic waves. stimulus-induced rhythmic, periodic or ictal discharges (sirpids) are peculiar eeg patterns, which may be present as periodic discharges. the aim of this study is to make a review of the periodic eeg patterns, emphasizing the importance of their recognition and clinical significance. the clinical significance of the periodic eeg patterns is uncertain, it is related to a variety of etiologies, and many authors suggest that these patterns are unequivocally epileptogenic in some cases. their recognition and classification are important to establish an accurate correlation between clinical, neurological, laboratorial and neuroimaging data with the eeg results.
Microalbuminuria y retinopatía diabética Microalbuminuria and diabetic retinopathy
V.M. Asensio-Sánchez,B. Rodríguez-Delgado,E. García-Herrero,V. Cabo-Vaquera
Archivos de la Sociedad Espa?ola de Oftalmología , 2008,
Abstract: Objetivo: Estudiar la prevalencia de microalbuminuria y su asociación con las formas más severas de retinopatía diabética en una población de diabéticos insulinodependientes. Material y método: Se estudiaron 360 pacientes con diabetes insulinodependiente con al menos cinco a os de evolución en un periodo comprendido entre enero de 1998 y diciembre de 2005. Se evaluó la presencia de microalbuminuria por inmunoanálisis. Los pacientes fueron estudiados con oftalmoscopía directa e indirecta y clasificados como no retinopatía, retinopatía no proliferante, retinopatía no proliferante severa / proliferante y edema macular. Resultados: En este estudio el 24,1% de los pacientes tenían microalbuminuria. La mayoría de los pacientes con microalbuminuria y macroalbuminuria eran varones con mayor tiempo de evolución de la diabetes. La microalbuminuria se asoció con las formas más severas de retinopatía diabética. Conclusiones: Todos los pacientes diabéticos insulinodependiente con al menos cinco a os de evolución deberían ser evaluados en su función renal incluida la microalbuminuria y los pacientes con microalbuminuria deberían ser revisados más frecuentemente. Objective: To study the prevalence of microalbuminuria and its association with more severe diabetic retinopathy in a group of insulin-dependent diabetic patients. Materials and methods: During the period of January 1998 to December 2005 we examined 360 insulin-dependent diabetic patients with at least five years of evolution. We evaluated the presence of microalbuminuria by immunoanalysis. Patients were evaluated by direct and indirect ophthalmoscopy and classified as non-retinopathy, non-proliferative, severe non-proliferative/proliferative, or macular edema. Results: In this study, 24.1% of patients had microalbuminuria. Most of the patients with microalbuminuria and macroalbuminuria were male and had a longer history of diabetes. Microalbuminuria was associated with more severe diabetic retinopathy. Conclusions: All patients with insulin-dependent diabetes of at least five years’ evolution should undergo an evaluation of renal function including tests for microalbuminuria. In the presence of microalbuminuria an ophthalmologic follow-up may be particularly important.
A Survey: Face Recognition Techniques  [cached]
Muhammad Sharif,Sajjad Mohsin,Muhammad Younas Javed
Research Journal of Applied Sciences, Engineering and Technology , 2012,
Abstract: In this study, the existing techniques of face recognition are to be encountered along with their pros and cons to conduct a brief survey. The most general methods include Eigenface (Eigenfeatures), Hidden Markov Model (HMM), geometric based and template matching approaches. This survey actually performs analysis on these approaches in order to constitute face representations which will be discussed as under. In the second phase of the survey, factors affecting the recognition rates and processes are also discussed along with the solutions provided by different authors.
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