Premature ovarian insufficiency (POI), by definition, occurs when a woman has her last menstrual period before the age of 40, because of variable, and most often permanent ovarian dysfunction. It presents as hypergonadotropic hypogonadism with peripheral amenorrhea. It has a prevalence of 1-2%, but in women under 20 years its prevalence is one case in every 10,000 women. POI is a devastating diagnosis for women of reproductive age. Many conditions can lead to POI, but it is most commonly idiopathic, and it has a variable clinical presentation. It has serious health consequences, including psychological disorders such as anxiety or depression, infertility, osteoporosis, autoimmune disorders, cardiovascular diseases, and an increased risk of mortality. Continue reading “Diagnosis and Initial Evaluation of Premature Ovarian Insufficiency (POI)”
CKD is defined as kidney damage or glomerular filtration rate (GFR) <60 mL/min/1.73 m(2) for 3 months or more, irrespective of cause. Kidney damage in many kidney diseases can be ascertained by the presence of albuminuria, defined as albumin-to-creatinine ratio >30 mg/g in two of three spot urine specimens. Continue reading “Classification and Prognosis of Chronic Kidney Disease”
International practice guidelines for the care of patients with valvular heart disease were most recently updated in 2017, before the publication of the results of the COAPT and MITRA-FR trials in 2018, and these guidelines were conservative in their recommendations regarding surgery for secondary mitral regurgitation. Continue reading “Guidelines for Intervention in Patients with Chronic Severe Secondary Mitral Regurgitation”
The Ross Heart Failure Classification was developed to provide a global assessment of heart failure severity in infants, and has subsequently been modified to apply to all pediatric ages. The modified Ross Classification incorporates feeding difficulties, growth problems, and symptoms of exercise intolerance into a numeric score comparable with the NYHA classification for adults.
Continue reading “NYHA and Modified Ross Heart Failure Classification for Children”