Anatomical abnormalities

The precise etiology of bipolar disorder is unknown. Thought to be genetically based, bipolar disorder is influenced by a variety of factors that may enhance gene expression. These include trauma, environmental factors, anatomic abnormalities, exposure to chemicals or drugs, and others.3-5 Neurochemical abnormalities in bipolar disorder may be caused by these factors, as discussed further in the pathophysiology section. 

Pelvic ultrasound may be used to identify anatomic abnormalities such as masses/lesions or to detect ovarian cysts and endometriomas. 

Penile disease (Peyronie s disease or anatomic abnormalities) Surgical Procedures Perineal surgery Radical prostatectomy Vascular surgery Lifestyle Age... 

Investigate for underlying diseases of nonallergic origin (i.e., anatomic abnormalities, chronic sinusitis, or nasal polyps) if combination therapy does not provide sufficient relief. 

In patients with normal gallbladder function, effective agents for eradication of chronic carriage include amoxicillin (3 g divided three times a day in adults for 3 months), trimethoprim-sulfamethoxazole (one double-strength tablet twice a day for 3 months), and ciprofloxacin (750 mg twice daily for 4 weeks). In patients with anatomic abnormalities, such as biliary or kidney stones, surgery combined with antibiotic therapy is indicated. 

Etiology H. pylori-induced atrophy of gastric mucosa, drug-induced etc. Failure of small bowel motility or intestinal anatomical abnormality... 

If anatomical abnormalities have been ruled out, testing of the small bowel motor activity is useful to elucidate the pathogenesis of bacterial overgrowth with Gram-negative bacilli (table 1). This choice is encouraged by the correlation between clinical disorders associated with bacterial overgrowth and disorders associated with dysmotility of the small bowel [113]. 

Anatomical changes can alter luminal flow into a surgically prepared blind loop, a diverticulum, or through a fistula. These anatomical abnormalities of relevance for the development of bacterial overgrowth have been carefully defined in previous literature [2, 7,98]. 

The absence of Gram-negative bacilli is a reliable and valid indication of preserved intestinal clearance, which precludes a significant failure of intestinal motility and anatomical abnormalities inducing stasis or recycling of contents from the lower gastrointestinal tract. 

Pantelis, C., Velakoulis, D., McGorry, P. D. et al. Neuro-anatomical abnormalities before and after onset of psychosis a cross-sectional and longitudinal MRI comparison. Lancet 361 281-288, 2003. 

The approach to the treatment of constipation in infants and children should consider neurologic, metabolic, or anatomic abnormalities when constipation is a persistent problem. When not related to an underlying disease, the approach to constipation is similar to that in an adult. High-fiber diet should be emphasized. 

Stasis of the urinary flow (e.g. caused by kidney stones, anatomic abnormalities or an enlarged prostate), female gender and diabetes mellitus are risk factors for a UTI. 

The susceptibility of both an embryo and a fetus to a teratogen is variable, depending on the stage of development when exposure occurs. For gross anatomical abnormalities, the critical periods of organogenesis are the most susceptible to exposure, whereas other types of abnormality may have other critical periods for exposure. 

Some, like trisomy 13 and 15, produce gross deformities and lead to death in infancy or early childhood. Others, such as trisomy 21, lead to mental retardation and a number of anatomic abnormalities, but cure compatible with long life. The social burden of such conditions may be large, not only for the individual, but for the family and for the public if institutional care is required. 

Gill WB, Schumacher GF, Bibbo M (1977) Pathological semen and anatomical abnormalities of the genital tract in human male subjects exposed to diethylstilbestrol in utero. J Urol, 117 477 t80. 

In her review of neuroimaging studies, Jackson (2005) commented on the inconsistency of results. The common finding is that studies of patients exposed to neuroleptics reveal a wide variety of anatomical abnormalities in the brain. As Lang et al. (2004) stated, Antipsychotic medications are known to alter the structure and metabolism of basal ganglia in humans and animals. ... 

Suddath, R., Christison, G., Torrey, E., Casanova, M., 8c Weinberger, D. (1990). Anatomical abnormalities in the brain of monozygotic twins discordant for schizophrenia. New England Journal of Medicine, 322, 789—794. 

Suddath RL, Christison GW, Torrey EF, Casanova MF, Weinberger DR. 1990. Anatomical abnormalities in the brains of monozygotic twins discordant for schizophrenia. NEJM... 

A 41-year-old woman developed seizures that progressed to status epilepticus, and died from secondary rhabdomyolysis and disseminated intravascular coagulation (128). She had been taking olanzapine 10 mg/ day for 5 months. No other toxic, metabolic, or anatomical abnormalities were identified pre- or postmortem to explain the seizures. However, her medications also included levothyroxine 0.15 mg/day, clonazepam 1.0 mg qds, and propranolol 20 mg tds. 

Drugs known to be teratogenic include cytotoxics, warfarin, alcohol, lithium, methotrexate, phenytoin, valproate, ACE inhibitors and isotretinoin. Selective interference can produce characteristic anatomical abnormalities, and the phocomelia (flipper-Uke) limb defect was one factor that caused thalidomide to be so readily recognised. (For an account of thalidomide see p. 81.)... 

Detection of teratogens. Anatomical abnormalities are the easiest to detect. Nonanatomical (functional) effects can also occur, though it is not appropriate to use the term teratogenesis (see definition above). They include effects on brain biochemistry which may have late behavioural consequences. 

Obstruction of ventricular outflow where sympathetic activity occurs in the presence of anatomical abnormalities, e.g. Fallot s tetralogy (cyanotic attacks) ... 

Accessory lobe This anatomical abnormality is rare and without clinical significance. Up to 16 accessory lobes have been reported in a single patient. They are usually located on the inferior surface of the liver, (s. fig. 2.4) Therefore they are generally detected only during the course of imaging examinations, surgery or autopsy. 

Among the other causes of male infertility are anatomical abnormalities, abnormal spermatogenesis, abnormal motility, and psychosocial causes. A list of drugs that can affect male reproductive function is given in Table 53-3. 

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