-
Paediatrics and International Child... May 2015It has been argued that the oedema of kwashiorkor is not caused by hypoalbuminaemia because the oedema disappears with dietary treatment before the plasma albumin... (Review)
Review
It has been argued that the oedema of kwashiorkor is not caused by hypoalbuminaemia because the oedema disappears with dietary treatment before the plasma albumin concentration rises. Reanalysis of this evidence and a review of the literature demonstrates that this was a mistaken conclusion and that the oedema is linked to hypoalbuminaemia. This misconception has influenced the recommendations for treating children with severe acute malnutrition. There are close pathophysiological parallels between kwashiorkor and Finnish congenital nephrotic syndrome (CNS) pre-nephrectomy; both develop protein-energy malnutrition and hypoalbuminaemia, which predisposes them to intravascular hypovolaemia with consequent sodium and water retention, and makes them highly vulnerable to develop hypovolaemic shock with diarrhoea. In CNS this is successfully treated with intravenous albumin boluses. By contrast, the WHO advise the cautious administration of hypotonic intravenous fluids in kwashiorkor with shock, which has about a 50% mortality. It is time to trial intravenous bolus albumin for the treatment of children with kwashiorkor and shock.
Topics: Albumins; Edema; Humans; Hypoalbuminemia; Kwashiorkor; Nephrotic Syndrome
PubMed: 25223408
DOI: 10.1179/2046905514Y.0000000154 -
Arthritis & Rheumatology (Hoboken, N.J.) Sep 2022
Topics: Bone Marrow; Bone Marrow Diseases; Edema; Humans; Sacroiliac Joint
PubMed: 35436388
DOI: 10.1002/art.42143 -
Ugeskrift For Laeger Sep 2018Flights longer than four hours pose a risk of venous thromboembolism in the general population, and the risk increases when additional risk factors are present.... (Review)
Review
Flights longer than four hours pose a risk of venous thromboembolism in the general population, and the risk increases when additional risk factors are present. Compression stockings have proven beneficial on deep as well as superficial vein thrombosis and oedema during long-haul flights, without causing side effects or discomfort. However, no data exist for flights shorter than four hours. Passengers can use compression stockings as general prophylaxis, and this should be recommended based on an assessment of endogenous risk factors and the duration of the travel.
Topics: Air Travel; Edema; Humans; Risk Factors; Stockings, Compression; Time Factors; Venous Thromboembolism; Venous Thrombosis
PubMed: 30274571
DOI: No ID Found -
BMJ Case Reports Jun 2017
Topics: Child, Preschool; Diagnosis, Differential; Edema; Face; Humans; Male; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Recurrence
PubMed: 28667169
DOI: 10.1136/bcr-2017-220523 -
International Wound Journal Feb 2022Wounds and chronic oedema are common disorders, but rarely studied together. The objective of this cross-sectional study was to investigate the point-prevalence and risk...
Wounds and chronic oedema are common disorders, but rarely studied together. The objective of this cross-sectional study was to investigate the point-prevalence and risk factors of wounds on the leg, in chronic leg oedema. Forty sites in nine countries were included. Of 7077 patients with chronic leg oedema, 12.70% had wounds. Independent risk factors were: peripheral arterial disease (odds ratio (OR) 4.87, 95% confidence intervals (CI) 3.63-6.52), cellulitis within the past 12 months (OR 2.69, 95% CI 2.25-3.21), secondary lymphoedema (OR 2.64, 95% CI 1.93-3.60), being male (OR 2.08, 95% CI 1.78-2.44), being over 85 years of age (OR 1.80, 95% CI 1.23-2.62), underweight (OR 1.79, 95% CI 1.14-2.79), bed bound (OR 1.79, 95% CI 1.01-3.16), chair bound (OR 1.52, 95% CI 1.18-1.97), diabetes (OR 1.47, 95% CI 1.23-1.77), and walking with aid (OR 1·41, 95% CI 1.17-1.69). 43.22% of those with wounds had clinically defined well-controlled oedema, associated with a significantly lower risk of wounds (OR 0.50, 95% CI 0.42-0.58, P < .001). Hard/fibrotic tissue (OR 1.71, 95% CI 1.19-2.48), and a positive Stemmers sign (OR 1.57, 95% CI 1.05-2.35) were associated with wounds. The study reinforces the importance of measures to control oedema, as controlled swelling was associated with a 50% lower risk of wounds.
Topics: Cellulitis; Chronic Disease; Cross-Sectional Studies; Edema; Humans; Leg; Lymphedema; Male
PubMed: 34258856
DOI: 10.1111/iwj.13642 -
Seminars in Arthritis and Rheumatism Apr 2016The aim of this systematic review was to determine the validity and inter- and intra-observer reliability of the assessment of knee joint effusion in osteoarthritis (OA)... (Review)
Review
OBJECTIVE
The aim of this systematic review was to determine the validity and inter- and intra-observer reliability of the assessment of knee joint effusion in osteoarthritis (OA) of the knee.
METHODS
MEDLINE, Web of Knowledge, CINAHL, EMBASE, and AMED were searched from their inception to February 2015. Articles were included according to a priori defined criteria: samples containing participants with knee OA; prospective evaluation of clinical tests and assessments of knee effusion that included reliability, sensitivity, and specificity of these tests.
RESULTS
A total of 10 publications were reviewed. Eight of these considered reliability and four on validity of clinical assessments against ultrasound effusion. It was not possible to undertake a meta-analysis of reliability or validity because of differences in study designs and the clinical tests. Intra-observer kappa agreement for visible swelling ranged from 0.37 (suprapatellar) to 1.0 (prepatellar); for bulge sign 0.47 and balloon sign 0.37. Inter-observer kappa agreement for visible swelling ranged from -0.02 (prepatellar) to 0.65 (infrapatellar), the balloon sign -0.11 to 0.82, patellar tap -0.02 to 0.75 and bulge sign kappa -0.04 to 0.14 or reliability coefficient 0.97. Reliability and diagnostic accuracy tended to be better in experienced observers. Very few data looked at performance of individual clinical tests with sensitivity ranging 18.2-85.7% and specificity 35.3-93.3%, both higher with larger effusions.
CONCLUSION
The majority of unstandardized clinical tests to assess joint effusion in knee OA had relatively low intra- and inter-observer reliability. There is some evidence experience improved reliability and diagnostic accuracy of tests. Currently there is insufficient evidence to recommend any particular test in clinical practice.
Topics: Edema; Female; Humans; Knee Joint; Male; Osteoarthritis, Knee; Physical Examination; Reproducibility of Results; Sensitivity and Specificity; Ultrasonography
PubMed: 26581486
DOI: 10.1016/j.semarthrit.2015.10.004 -
American Journal of Physiology. Renal... Oct 2015There have been two major theories surrounding the development of edema in nephrotic syndrome (NS), namely, the under- and overfill hypotheses. Edema is one of the... (Review)
Review
There have been two major theories surrounding the development of edema in nephrotic syndrome (NS), namely, the under- and overfill hypotheses. Edema is one of the cardinal features of NS and remains one of the principal reasons for admission of children to the hospital. Recently, the discovery that proteases in the glomerular filtrate of patients with NS are activating the epithelial sodium channel (ENaC), resulting in intrarenal salt retention and thereby contributing to edema, might suggest that targeting ENaC with amiloride might be a suitable strategy to manage the edema of NS. Other potential agents, particularly urearetics and aquaretics, might also prove useful in NS. Recent evidence also suggests that there may be other areas involved in salt storage, especially the skin, and it will be intriguing to study the implications of this in NS.
Topics: Child; Diuretics; Edema; Epithelial Sodium Channels; Humans; Nephrotic Syndrome; Sodium
PubMed: 26290369
DOI: 10.1152/ajprenal.00229.2015 -
Journal of the American Veterinary... Oct 2017
Topics: Animals; Biopsy; Bone Neoplasms; Chondrosarcoma; Diagnosis, Differential; Dog Diseases; Dogs; Edema; Face; Male
PubMed: 28959930
DOI: 10.2460/javma.251.8.903 -
The British Journal of Dermatology Jul 2021Burian 2021; :110–118.
Burian 2021; :110–118.
Topics: Cellulitis; Edema; Humans; Leg
PubMed: 33764505
DOI: 10.1111/bjd.20047 -
Reumatismo Jul 2014Bone marrow edema (BME) is a descriptive term which identifies a specific magnetic resonance imaging (MRI) pattern that can be observed in a number of clinical entities,... (Review)
Review
Bone marrow edema (BME) is a descriptive term which identifies a specific magnetic resonance imaging (MRI) pattern that can be observed in a number of clinical entities, which are often characterized by pain as their main symptom, but show significant differences in terms of histopathological findings, causal mechanisms and prognosis. Bone marrow lesions in the subchondral bone of subjects with knee osteoarthritis (OA) seem to be associated with pain and progression of cartilage damage over time. Some histopathological studies of advanced OA have shown a prevalent fibrosis and bone marrow necrosis. BME of the subchondral bone in rheumatoid arthritis is associated with an infiltrate of inflammatory cells and osteoclasts and has a predictive value of further development of erosions. In spondyloarthritis, BME of the sacroiliac joints identifies an active sacroiliitis and is associated with histological inflammation and radiographic progression, whereas the relationship between BME lesions of the spine and syndesmophyte development is still controversial. BME syndromes (BMES), such as transient osteoporosis of the hip, regional migratory osteoporosis, and transient post-traumatic BMES, are characterized by a BME pattern on MRI and a self-limiting course. The potential evolution of BMES toward osteonecrosis is still controversial.
Topics: Arthritis, Rheumatoid; Bone Marrow Diseases; Edema; Humans; Magnetic Resonance Imaging; Osteoarthritis; Spondylarthritis; Syndrome
PubMed: 25069499
DOI: 10.4081/reumatismo.2014.790