TKE: Mining Top-K Frequent Episodes

Author(s):  
Philippe Fournier-Viger ◽  
Yanjun Yang ◽  
Peng Yang ◽  
Jerry Chun-Wei Lin ◽  
Unil Yun
Keyword(s):  



PEDIATRICS ◽  
1982 ◽  
Vol 69 (4) ◽  
pp. 463-465
Author(s):  
Gregory L. Johnson ◽  
Nirmala S. Desai ◽  
Thomas H. Pauly ◽  
M. Douglas Cunningham

Eighteen infants, each weighing less than 1,500 gm, were treated with low dose digoxin therapy for patent ductus arteriosus and signs of circulatory congestion. Nine of the 18 developed one or more signs of clinical deterioration felt to be related to digoxin therapy: eight infants experienced frequent episodes of bradycardia, six had cardiac arrhythmias, and six experienced feeding difficulties. All signs disappeared when digoxin therapy was discontinued. Digoxin, even in relatively low dosages, can have deleterious complications in seriously ill low-birth-weight infants. Alternatives to digoxin in this patient population should be considered before institution of digoxin therapy.



2021 ◽  
Vol 14 (2) ◽  
pp. e239310
Author(s):  
Meredith Sooy ◽  
Rachel L Randell ◽  
Dmitry Tchapyjnikov ◽  
Klaus Werner ◽  
Kristina Nazareth-Pidgeon

A 4-year-old boy with atypical, complete DiGeorge and CHARGE (coloboma, heart defects, atresia choanae, growth retardation, genital abnormalities and ear abnormalities) syndromes presented with frequent episodes of a painful, markedly erythematous eruption associated with swelling. Evaluation revealed non-specific findings on skin biopsy at the time of eruption and no pathogenic mutation in the SCN9A gene. The patient was diagnosed with secondary erythromelalgia based on clinical presentation. Erythromelalgia is a rare disorder characterised by recurrent episodes of pain and erythema typically affecting the distal extremities. This case represents the first case of erythromelalgia in the setting of DiGeorge and CHARGE syndromes.







Author(s):  
Deepak S. Khawale ◽  
Sudha Singh ◽  
Varsha N. Sane

Irritable bowel syndrome (IBS) is a common and bothersome disorder in children with an increasing prevalence noted during the past two decades. It has a significant effect on the lives of affected children and their parents and poses a significant burden on healthcare systems. As the patho-physiology of IBS is multifactorial It is difficult to overcome the therapeutic demand of childhood IBS using the same conventional therapeutic agents. The treatment trials are still going on to understand the paediatric IBS and currently focusing on multiple combined interventions in modern science. Background: A 14 years old male patient came to OPD (29/02/2020) having complaint of frequent abdominal pain with increased frequency of motion along with visible mucus discharge whole day since 15 days with frequent episodes since last 2 years. Methodology: In Ayurveda this problem comes under Jatharagni dusti and the present case has been successfully treated as per treatment regimen of Grahani chikitsa. Result: The complete relief has been seen in 6 weeks.



Author(s):  
Aoife Garrahy ◽  
Matilde Bettina Mijares Zamuner ◽  
Maria M Byrne

Summary Coexistence of autoimmune diabetes and maturity-onset diabetes of the young (MODY) is rare. We report the first case of coexisting latent autoimmune diabetes of adulthood (LADA) and glucokinase (GCK) MODY. A 32-year-old woman was treated with insulin for gestational diabetes at age 32 years; post-partum, her fasting blood glucose was 6.0 mmol/L and 2-h glucose was 11.8 mmol/L following an oral glucose tolerance test, and she was maintained on diet alone. Five years later, a diagnosis of LADA was made when she presented with fasting blood glucose of 20.3 mmol/L and HbA1C 125 mmol/mol (13.6%). GCK-MODY was identified 14 years later when genetic testing was prompted by identification of a mutation in her cousin. Despite multiple daily insulin injections her glycaemic control remained above target and her clinical course has been complicated by multiple episodes of hypoglycaemia with unawareness. Although rare, coexistence of latent autoimmune diabetes of adulthood and monogenic diabetes should be considered if there is a strong clinical suspicion, for example, family history. Hypoglycaemic unawareness developed secondary to frequent episodes of hypoglycaemia using standard glycaemic targets for LADA. This case highlights the importance of setting fasting glucose targets within the expected range for GCK-MODY in subjects with coexisting LADA. Learning points: We report the first case of coexisting latent autoimmune diabetes of adulthood (LADA) and GCK-MODY. It has been suggested that mutations in GCK may lead to altered counter-regulation and recognition of hypoglycaemia at higher blood glucose levels than patients without such mutation. However, in our case, hypoglycaemic unawareness developed secondary to frequent episodes of hypoglycaemia using standard glycaemic targets for LADA. This case highlights the importance of setting fasting glucose targets within the expected range for GCK-MODY in subjects with coexisting LADA to avoid hypoglycaemia.



Author(s):  
Nilo Serpa ◽  
Richard Brook Cathcart

<p><strong>Abstract: </strong>Exclusion Territories are geographical areas under the action of degenerative environmental phenomena of anthropogenic origin, which compromise quality of life in general. One of the greatest examples of such areas is the Guanabara Bay and its surroundings, the scene of some of the worst disastrous incidents and locale of frequent episodes of human misery. This article presents a brief description of the main characteristics of the region, providing some technological suggestions of biogeographic recovery to be adopted by public policies that intend to align themselves with the good practices of ecological economy, sustainability and quality of life. The work falls within the context of macro-engineering <em>cum</em> eco-innovation applied to the preservation and management of water sources and water bodies that serve productive purposes as natural niches and breeding grounds.</p><p><strong>Key words: </strong>Exclusion Territories, Guanabara Bay, waste management, quality of life.</p><p class="-1">===========================================================================</p><p class="-1"><strong>Resumo: </strong>Territórios de Exclusão são áreas geográficas sob ação de fenômenos ambientais degenerativos de origem antropogênica, os quais comprometem a qualidade de vida em geral. Um dos maiores exemplos de zonas desse tipo é a Baía de Guanabara e seu entorno, palco de alguns dos piores incidentes desastrosos e de frequentes episódios da miséria humana. O presente artigo descreve sumariamente as principais características da região, fornecendo algumas sugestões tecnológicas de recuperação biogeográfica a serem adotadas por políticas públicas que pretendam alinhar-se às boas práticas de economia ecológica, sustentabilidade e qualidade de vida. O trabalho se insere no contexto da macroengenharia <em>cum</em> eco-inovação aplicada à preservação e à gestão das fontes hídricas e dos corpos de água que servem a propósitos produtivos como nichos naturais e criadouros.</p><p class="-1"><strong>Palavras-chave: </strong>Territórios de Exclusão, Baía de Guanabara, gestão de resíduos, qualidade de vida.</p>





Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
H Immo Lehmann

A 63-year old Caucasian female with history of aortic valve replacement and CAD with prior drug-eluting stent placement (DES) to proximal LAD and LCX, presented as a hospital transfer with recurrent episodes of chest pain. Chest discomfort was described as severe chest pressure, radiating to bilateral upper extremities. Episodes were not associated with significant exertion and frequently occurred at night/early morning. Of note, the patient had undergone coronary angiography at the outside hospital, revealing no in-stent restenosis or new coronary lesions. Soon after the patient’s arrival in the CCU, she developed profound chest pressure, accompanied by hypotension, diaphoresis and nausea. Her 12-lead ECG revealed 2-mm ST-elevation in aVR, accompanied by ST-depression in inferior, anterior, and apical leads. Initial high-sensitivity (hs)-troponin T was 26 ng/L. She was given sublingual nitroglycerin and was started on a nitroglycerin and nicardipine infusion, with resolution of symptoms after ~30 minutes, followed by normalization of hs-troponin T. A transthoracic echocardiogram did not reveal focal left ventricular (LV) wall motion abnormalities, mild LV hypertrophy was present. Given the patients’ presentation with no in-stent restenosis or new lesions, frequent episodes of chest pain-not related to exertion with occurrence at nighttime and early morning, her presentation was deemed to be consistent with epicardial coronary vasospasm. Subsequently, the patients’ anti-anginal regimen was uptitrated to include extended-release nitrates, calcium-channel blockade, and I Na blockade. Unfortunately, she continued to have frequent episodes of profound angina, accompanied by hypotension, and significant ischemic ECG changes. This prompted us to pursue bilateral sympathectomy. Subsequently, the patient had resolution of prior symptoms. She was continued on an anti-vasospastic regimen, consisting of extended release nitrates and calcium-channel blockade. This case represents the challenging management of medication-resistant epicardial coronary artery vasospasm. As previously described, sympathectomy remains an effective therapeutic option for management in these difficult and life-threatening situations.



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