Two-year follow-up of children with congenital Zika syndrome: the evolution of clinical patterns

2021 ◽  
Author(s):  
Erica Conti Rua ◽  
Solange Artimos de Oliveira ◽  
Renata Artimos de Oliveira Vianna ◽  
Luis Antonio Bataglin Dalcastel ◽  
Teresa Cristina de Castro Sarmet dos Santos ◽  
...  
Keyword(s):  
Congenital Zika Syndrome ◽  
Clinical Patterns

scholarly journals Clinical patterns and the evolution of relapsing polychondritis based on organ involvement: a Chinese retrospective cohort study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lei Zhang ◽  
Shuang Yun ◽  
Tiange Wu ◽  
Yujie He ◽  
Jinyan Guo ◽  
...  
Keyword(s):  
Early Recognition ◽  
Age At Onset ◽  
Relapsing Polychondritis ◽  
Organ Involvement ◽  
Strong Negative Correlation ◽  
Negative Pattern ◽  
Inflammatory Status ◽  
Clinical Patterns ◽  
Systemic Form

Abstract Background Relapsing polychondritis (RPC) is a rare autoimmune disease and its early diagnosis remains challenging. Defining the clinical patterns and disease course may help early recognition of RPC. Results Sixty-six males and 60 females were included in this study. The average age at onset were 47.1 ± 13.8 years and the median follow-up period was 18 months. Correlation analysis revealed a strong negative correlation between airway involvement and auricular chondritis (r = − 0.75, P < 0.001). Four distinct clinical patterns were identified: Ear pattern (50.8%), Airway pattern (38.9%), Overlap pattern (4.8%) and Airway-Ear negative pattern (5.6%), and patients with Ear pattern and Airway pattern were further divided into limited and systemic form of RPC (27.8% with limited form of Ear pattern and 24.6% with limited form of Airway pattern initially). During follow-up, a minority of patients with Ear pattern and Airway pattern progressed into Overlap pattern, and some Airway-Ear negative pattern patients progressed into Ear pattern. While a large majority of limited RPC patients remained limited form during follow-up, a minority of limited RPC patients progressed into systemic form. Patients with Ear pattern had the highest survival rate and relatively lower inflammatory status. Conclusions RPC patients can be categorized as 4 different clinical patterns and 2 distinct presenting forms (limited and systemic) based on organ involvement. The clinical patterns and presenting forms may evolve during follow-up. Our findings may facilitate early recognition of this rare disease.

scholarly journals Severe Histamine Mediated Reactions to Intravenous Drugs Used in Anaesthesia

1975 ◽  
Vol 3 (3) ◽  
pp. 180-197 ◽  
Author(s):  
M. McD. Fisher
Keyword(s):  
Intravenous Drugs ◽  
Anaphylactoid Reactions ◽  
Clinical Patterns

Severe histamine mediated reactions to intravenous drugs used in anaesthesia may occur as a result of anaphylactic and anaphylactoid reactions. The incidence is rare, but appears to be increasing. The difficulties in diagnosing such reactions and in determining the drug responsible and how these difficulties have led to confusion in the literature are discussed. Six cases of severe histamine mediated reactions are presented and detailed analyses of the drugs in these and other reported reactions is made showing varied clinical patterns with different drugs. The prevention, treatment, and follow-up of severe histamine mediated reactions are considered.

scholarly journals Go Zika Go: A Feasibility Protocol of a Modified Ride-on Car Intervention for Children with Congenital Zika Syndrome in Brazil

2020 ◽  
Vol 17 (18) ◽  
pp. 6875
Author(s):  
Egmar Longo ◽  
Ana Carolina De Campos ◽  
Amanda Spinola Barreto ◽  
Dinara Laiana de Lima Nascimento Coutinho ◽  
Monique Leite Galvão Coelho ◽  
...  
Keyword(s):  
Goal Attainment ◽  
Social Cognitive ◽  
Low Cost ◽  
The Body ◽  
Global Perspective ◽  
Computer Adaptive Test ◽  
Motor Disability ◽  
Severe Motor ◽  
Congenital Zika Syndrome

Children with congenital Zika syndrome (CZS) present severe motor disability and can benefit from early powered mobility. The Go Zika Go project uses modified ride-on toy cars, which may advance the body functions, activities, and participation of children. This paper describes the study protocol aiming to assess the feasibility of a modified ride-on car intervention for children with CZS in Brazil. A mixed-methods design with a multiple 1-week baseline, 3-month intervention, and 1-month follow-up will be implemented. Modified ride-on car training sessions will be conducted three times a week at the participants’ home or in the clinic. The primary outcome will be a narrative description of study feasibility (photovoice method, focus groups, parent feasibility questionnaire and assessment of learning powered mobility). Secondary outcomes will be switch activation, driving sessions journal, social-cognitive interactions, mobility (pediatric evaluation of disability inventory computer adaptive test), goal attainment scaling (GAS), and participation (young children’s participation and environment measure). Go Zika Go is expected to be viable and to improve function, activity, and participation of children with CZS, providing a low-cost, evidence-based rehabilitation option that will be relevant to early child development in a global perspective.

scholarly journals Clinical Outcomes of a Zika Virus Mother–Child Pair Cohort in Spain

Pathogens ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 352 ◽  
Author(s):  
Antoni Soriano-Arandes ◽  
Marie Antoinette Frick ◽  
Milagros García López-Hortelano ◽  
Elena Sulleiro ◽  
Carlota Rodó ◽  
...  
Keyword(s):  
Zika Virus ◽  
Adverse Outcomes ◽  
Zikv Infection ◽  
Child Pair ◽  
Referral Hospitals ◽  
Congenital Zika Syndrome ◽  
Endemic Areas ◽  
Neurodevelopmental Abnormalities ◽  
Congenital Microcephaly

Background: Zika virus (ZIKV) infection has been associated with congenital microcephaly and other neurodevelopmental abnormalities. There is little published research on the effect of maternal ZIKV infection in a non-endemic European region. We aimed to describe the outcomes of pregnant travelers diagnosed as ZIKV-infected in Spain, and their exposed children. Methods: This prospective observational cohort study of nine referral hospitals enrolled pregnant women (PW) who travelled to endemic areas during their pregnancy or the two previous months, or those whose sexual partners visited endemic areas in the previous 6 months. Infants of ZIKV-infected mothers were followed for about two years. Results: ZIKV infection was diagnosed in 163 PW; 112 (70%) were asymptomatic and 24 (14.7%) were confirmed cases. Among 143 infants, 14 (9.8%) had adverse outcomes during follow-up; three had a congenital Zika syndrome (CZS), and 11 other potential Zika-related outcomes. The overall incidence of CZS was 2.1% (95%CI: 0.4–6.0%), but among infants born to ZIKV-confirmed mothers, this increased to 15.8% (95%CI: 3.4–39.6%). Conclusions: A nearly 10% overall risk of neurologic and hearing adverse outcomes was found in ZIKV-exposed children born to a ZIKV-infected traveler PW. Longer-term follow-up of these children is needed to assess whether there are any later-onset manifestations.

scholarly journals Follow-up brain imaging of 37 children with congenital Zika syndrome: case series study

BMJ ◽  
2017 ◽  
pp. j4188 ◽  
Author(s):  
Natacha Calheiros de Lima Petribu ◽  
Maria de Fatima Vasco Aragao ◽  
Vanessa van der Linden ◽  
Paul Parizel ◽  
Patricia Jungmann ◽  
...  
Keyword(s):  
Brain Imaging ◽  
Case Series ◽  
Case Series Study ◽  
Congenital Zika Syndrome ◽  
Series Study

scholarly journals Clinical characteristics of children with congenital Zika syndrome: a case series

2020 ◽  
Vol 78 (7) ◽  
pp. 403-411
Author(s):  
Thais MASSETTI ◽  
Dafne HERRERO ◽  
Julliana ALENCAR ◽  
Talita SILVA ◽  
Cristina MORIYAMA ◽  
...  
Keyword(s):  
Birth Weight ◽  
Motor Function ◽  
Gestational Age ◽  
Head Circumference ◽  
Motor Performance ◽  
Clinical Characteristics ◽  
Gross Motor ◽  
Congenital Zika Syndrome ◽  
Motor Outcomes

ABSTRACT Background: The congenital Zika syndrome involves structural brain changes, including ventriculomegaly, thin cerebral cortices, abnormal gyral pattern, cortical malformations, hypoplasia of the corpus callosum, myelination delay, subcortical diffuse calcifications, brainstem hypoplasia, and microcephaly in newborns. Objective: This study aimed to describe the clinical characteristics of children with congenital Zika syndrome; to compare the outcomes of infants infected in the first (1T, n=20) and second trimesters of pregnancy (2T, n=11); to investigate correlations between birth weight, birth and follow-up head circumference, birth gestational age, and gross motor scores. Methods: Participants were evaluated with Alberta Infant Motor Scale (AIMS) and part A of the Gross Motor Function Measure (GMFM-A). ANOVA compared head circumference, birth gestational age, birth weight, and gross motor performance of 1T and 2T. Results: The correlations were investigated by Pearson correlation coefficients. ANOVA showed differences in birth and follow-up head circumferences. Head circumference was smaller in 1T, compared to 2T. Motor performance was classified as below the fifth percentile in AIMS in all children and 1T showed lower scores in prone, sitting, and total AIMS score, compared to 2T. Children ranged from 8 to 78% on GMFM-A and there was a poorer motor performance of 1T. Nineteen children showed hypertonia, six showed normal tone and six showed hypotonia. Birth head circumference was correlated with AIMS prone postural control. Follow-up head circumference was correlated to prone, supine and total AIMS scores. Smaller head circumference at birth and follow-up denoted poorer postural control. Discussion: Children with congenital Zika syndrome showed microcephaly at birth and follow-up. Smaller head circumferences and poorer motor outcomes were observed in 1T. Infants showed poor visual and motor outcomes. Moderate positive correlations between birth and follow-up head circumference and gross motor function were found.

scholarly journals Evaluation of liver test abnormalities in a patient-centered medical home: do liver test patterns matter?

2018 ◽  
Vol 66 (8) ◽  
pp. 1118-1123 ◽  
Author(s):  
Andrew D Schreiner ◽  
William P Moran ◽  
Jingwen Zhang ◽  
Elizabeth B Kirkland ◽  
Marc E Heincelman ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Repeat Testing ◽  
Liver Test ◽  
Clinical Patterns ◽  
Multiple Abnormalities ◽  
Liver Tests

Abnormal liver tests are extremely common in clinical practice, present with varying patterns and degrees of elevation, and can signal liver injury from a variety of causes. Responding to these abnormalities requires complex medical decision-making and merits investigation in primary care. This retrospective study investigates the association of patterns of liver test abnormality with follow-up in primary care. Using administrative data, this study includes patients with abnormal liver tests seen between 2007 and 2016 in a patient-centered medical home. Liver tests examined include serum bilirubin, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase. Patients entered the cohort on the first liver test elevation. The outcome examined was completion of repeat testing, and the proportions of patients without follow-up were compared by patterns of index abnormality. 9545 patients met the inclusion criteria. Of these, 6155 (64.5%) possessed one liver test abnormality and 3390 (35.5%) possessed multiple abnormalities on index testing. Overall 1119 (11.7%) patients did not have repeat testing performed during the study period. A greater proportion of patients with lone abnormalities lacked repeat testing compared with those patients with multiple abnormalities. Differences in repeat testing appeared when comparing clinical patterns of abnormality, with higher proportions of follow-up in patients with testing suggestive of cholestasis. Over 11% of patients with abnormal liver tests did not undergo repeat testing during the study period. Repeat testing occurred more often in patients with multiple abnormalities and in clinical patterns suggestive of cholestasis. This study highlights a potential opportunity to improve quality of care.

scholarly journals Audiological Follow-up of Children with Congenital Zika Syndrome

Heliyon ◽  
2022 ◽  
pp. e08720
Author(s):  
Lilian F. Muniz ◽  
Rebeka J.F. Maciel ◽  
Danielle S. Ramos ◽  
Kátia M.G. Albuquerque ◽  
Ângela C. Leão ◽  
...  
Keyword(s):  
Congenital Zika Syndrome

scholarly journals Clinical patterns and the evolution of relapsing polychondritis based on organ involvement: a Chinese retrospective cohort study

2020 ◽  
Author(s):  
Lei Zhang ◽  
Shuang Yun ◽  
Tiange Wu ◽  
Yujie He ◽  
Jinyan Guo ◽  
...  
Keyword(s):  
Rare Disease ◽  
Early Recognition ◽  
Relapsing Polychondritis ◽  
Organ Involvement ◽  
Disease Evolution ◽  
Negative Pattern ◽  
Inflammatory Status ◽  
Clinical Patterns ◽  
Systemic Form

Abstract BackgroundRelapsing polychondritis(RPC) is a rare autoimmune disease, of which the diagnosis in early stage is challenging. Defining the clinical patterns and disease evolution may help early recognition of this rare disease.ResultsSixty-six males and 60 females were included with onset age of 47.1±13.8 years and followed up for a median of 18 months. Correlation analysis revealed a strong negative correlation between airway involvement and auricular chondritis (r=-0.75，P<0.001). Four distinct clinical patterns were identified: Ear pattern (50.8%), Airway pattern (38.9%), Overlap pattern (4.8%) and Airway-Ear negative pattern (5.6%) and patients with Ear pattern and Airway pattern were subdivided as limited and systemic form of RPC (27.8% with limited form of Ear pattern and 24.6% with limited form of Airway pattern). During follow-up, a small part of patients with Ear pattern and Airway pattern progressed into Overlap pattern and some Airway-Ear negative pattern patients progressed into Ear pattern. Most of the limited RPC patients remained limited form during follow-up while some patients with limited form progressed into systemic form. Patients with Ear pattern had the highest survival rate and relative lower inflammatory status.ConclusionsRPC patients can be categorized as 4 different clinical patterns and 2 distinct presenting forms (limited and systemic) based on organ involvement, and clinical patterns and presenting forms can evolve during follow-up. Our findings may facilitate early recognition of this rare disease and contribute to an updated classification criteria covering all the clinical spectrum of RPC

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