Childhood Headache Risk: Warning Signs and Symptoms Present During the First Six Months of Life*

In the history of children suffering from non-organic headache, the presence of periodic syndromes can often be found. In previous observations we ascertained that periodic syndromes are a common finding in children showing physical and behavioural characteristics of “hyperreactivity” in the first months of their lives. We have tried to verify, through a prospective study, whether children with “hyperreactivity” in the first months of life are particularly prone to develop periodic syndromes and/or non-organic headache. We have developed an appropriate test for the assessment of hyperreactivity in the first 6 months of life. We have isolated 183 hyperreactive subjects; 102 of them have been followed-up to an average age of 10.8 years, together with a control group of 80 subjects followed-up to an average age of 10.2 years. Of the 102 hyperreactive infants, 54 (52.9%) suffered from common migraine, versus 12 (15%) of the control group; 66 (64.5%) hyperreactive infants suffered from periodic syndrome, versus 10 (12.5%) of the control group. There was frequently a co-existence of migraine and periodic syndrome. It is thus possible to identify infants who are particularly prone to develop periodic syndromes and headache.

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Vancomycin-Induced Red Man Syndrome

PEDIATRICS ◽

10.1542/peds.86.4.572 ◽

1990 ◽

Vol 86 (4) ◽

pp. 572-580

Author(s):

Maurice Levy ◽

Gideon Koren ◽

Lee Dupuis ◽

Stanley E. Read

Keyword(s):

Signs And Symptoms ◽

The Body ◽

Control Group ◽

Severe Hypotension ◽

The Face ◽

Red Man Syndrome ◽

History Of ◽

Serum Vancomycin ◽

Mild Temperature ◽

Cold Extremities

A total of 11 cases of red man syndrome collected among 650 children who had received vancomycin in our hospital between 1986 and 1988 (estimated prevalence 1.6%) were retrospectively analyzed. These 11 children were compared with 11 age-matched children who received vancomycin in whom red man syndrome did not develop. Of the patients with red man syndrome, 73%, and of the patients with no reaction, 45.4% received vancomycin for penicillin-resistant Staphylococcus epidermidis-positive cultures, or because of history of penicillin allergy. No difference was observed in the dose per kilogram given to both groups (12.9 ± 3.5 mg/kg per dose in those with red man syndrome vs 12.3 ± 6.9 mg/kg per dose in control childrens. The duration (mean ± standard deviation) of vancomycin infusion was 45.9 ± 16.7 minutes (range 10 to 90 minutes) in patients with red man syndrome and 54.5 ± 7.6 minutes (range 45 to 65 minutes) in the control group (P = .07). In the 5 children with red man syndrome rechallenged with vancomycin, slower infusion rates prevented or reduced the syndrome, which emphasized the fact that the rate of administration is the important determinant of red man syndrome in susceptible cases. Clinically, the syndrome developed at the end of the infusion in most patients, but appeared as early as 15 minutes after initiation of the infusion. It was mostly manifested as a flushed, erythematous rash on the face, neck, and around the ears. Less frequently, the rash was distributed all over the body. Pruritus was usually localized to the upper trunk but was also generalized (2 of 11 children). Associated signs and symptoms were hypotension, watery puffy eyes, tachycardia, respiratory distress, dizziness, agitation, and mild temperature increase. A premature infant with the red man syndrome had skin rash associated with poor perfusion, cold extremities, increased need for oxygen, and severe hypotension. The rash disappeared within 20 minutes (range 5 minutes to 7 hours) after vancomycin infusion was stopped. There was no association between serum vancomycin concentrations and red man syndrome; in both groups of patients therapeutic as well as subtherapeutic concentrations were observed, suggesting that this is an idiosyncratic and not a concentration-dependent phenomenon.

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Evaluation of The 10 Warning Signs In Immunodeficient Patients: Additional Suggestions

10.21203/rs.3.rs-1189503/v1 ◽

2021 ◽

Author(s):

Fadime Ceyda Eldeniz ◽

Yahya Gül ◽

Alaattin Yorulmaz ◽

Şükrü Nail Güner ◽

Sevgi Keles ◽

...

Keyword(s):

Family History ◽

Early Diagnosis ◽

Chronic Diarrhea ◽

Warning Signs ◽

Control Group ◽

Healthy Children ◽

Physician Awareness ◽

History Of ◽

And Control ◽

Immunological Evaluation

Abstract Objective: Ten warning signs of primary immunodeficiency (PID) were suggested by the Jeffrey Modell Foundation (JMF), to increase physician awareness of PID. These warning signs have not yet been evaluated for patients with secondary immunodeficiency (SID). This study investigated whether the 10 warning signs used for the diagnosis of PID are sufficient for the diagnosis of SID, and explored the possibility of additional signs.Methods: This prospective study was conducted between June and December 2020. The mothers of 162 patients with PID and SID, and mothers of 200 healthy children, were asked to complete a questionnaire about family and personal history in addition to the warning signs of PID developed by the JMF. A JMF score was created by giving one point for each “Yes” answer for the 10 warning signs of PID. Medical records of the patients were evaluated for possible additional warning signs for PID and SID. Results: The JMF scores of the PID (3.36 ± 1.65) and SID (3.72 ± 1.12) groups were significantly higher than the scores of the control group (0.34 ± 0.61) (p < 0.05). A sign for immunological evaluation in two patients without warning signs in the PID group was found to be chronic diarrhea. In addition to the 10 JMF warning signs, we found that consanguinity and a family history of tuberculosis were statistically significant in our PID group, compared with the SID and control groups. Conclusions: The JMF warning signs are important for early diagnosis of PID. Our study showed that these signs may also be used for the early diagnosis of SID in patients and, according to our results, in addition to the 10 JMF signs for PID, parental consanguinity, chronic diarrhea, and a family history of tuberculosis may also be considered warning signs for the early diagnosis of PID.

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Suicide in probation: Towards the ideation-to-action model

Probation Journal ◽

10.1177/02645505211041581 ◽

2021 ◽

pp. 026455052110415

Author(s):

Charlie Brooker ◽

Karen Tocque ◽

Georgia West ◽

Alice Norman-Taylor ◽

James Fowler

Keyword(s):

Suicide Ideation ◽

Suicide Attempts ◽

Psychological Treatment ◽

Secondary Analysis ◽

Control Group ◽

Significant Difference ◽

Action Model ◽

History Of ◽

Clinically Significant ◽

A Prospective Study

Suicide in probation services is far higher than the general population. This paper presents secondary analysis of data previously used to evaluate the outcome of delivering psychological treatment to probationers in London. A sample of probation service users who screened positive for clinically significant symptoms of distress and were subsequently assessed and offered treatment ( n = 274) were allocated retrospectively to one of three groups: those with a history of suicidal ideations but no suicide attempts (ideation group), those with a history of a suicidal act (attempt group) or a control group where suicide was not evident (no history group). Results indicate no significant difference between the ideation and the attempt groups, but significant differences between these and the no history group. The findings are discussed within the context of the suicide ideation-to-action models that have been debated in other offender settings. We conclude that a more nuanced understanding of suicidal acts and suicide attempts is required in probation services including a prospective study that tests the ideation-to-action model.

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A prospective study of N-acetylcysteine treatment in drug-induced fulminant hepatic failure

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20191591 ◽

2019 ◽

Vol 8 (5) ◽

pp. 1000

Author(s):

Tauseef Nabi ◽

Nadeema Rafiq ◽

Quratul Ain Arifa

Keyword(s):

Length Of Hospital Stay ◽

Signs And Symptoms ◽

Control Group ◽

Rapid Progression ◽

Drug Induced ◽

Life Threatening ◽

Baseline Characteristics ◽

A Prospective Study ◽

Tuberculosis Therapy ◽

Control Study

Background: Acute liver failure (ALF) is a rare but severe, life-threatening, complex, multisystemic gastroenterological emergency. Its rapid progression and high mortality demand early diagnosis and expert management. Drug-induced ALF (DI-ALF) remains the uncommon cause of ALF in India. To date, there is no established treatment for DI-ALF other than liver transplantation and little is known about the use of N-acetylcysteine (NAC) in DI-ALF. A prospective case-control study was carried with the aim to determine the effect of NAC on mortality of DI-FHF patients and also to evaluate the safety and efficacy of NAC use.Methods: A total of 18 patients with a diagnosis of DI-FHF were included in the study. 10 patients received NAC infusion for 72 hours whereas the control group received placebo. The variables evaluated were demographic, signs and symptoms, biochemical parameters, outcome and length of hospital stay.Results: Out of 18 DI-FHF patients, 13 (72.2%) had anti-tuberculosis therapy (ATT) induced FHF and 5 (27.8%) patients had ayurvedic induced FHF. The two groups were comparable for the various baseline characteristics (age, INR, alanine aminotransferase, creatinine, albumin, grade of encephalopathy, etc.). The mortality decreased to 20% with the use of NAC versus 75% in the control group (P=0.023). Use of NAC was associated with a shorter length of hospital stay of survived patients (P=0.043). Moreover, the overall survival was improved by NAC (P=0.023) in DI-FHF. ATT induced FHF showed better outcome as compared to ayurvedic induced FHF use (P=0.019).Conclusions: Author recommended the use of NAC along with conventional treatments in patients with DI-FHF in non-transplant centers while awaiting referrals. ATT induced FHF showed better outcome as compared to ayurvedic induced FHF with NAC administration and its use was safe.

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Prospective Study on the Value of a Single Infusion of Dextran 70 During Surgical Operation in the Prevention of Fatal Postoperative Pulmonary Embolism (PE)

10.1055/s-0039-1680610 ◽

1977 ◽

Cited By ~ 1

Author(s):

Karl-Gösta Ljungström

Keyword(s):

Prospective Study ◽

Major Surgery ◽

Control Group ◽

Controlled Clinical Trial ◽

Urological Surgery ◽

Dextran 70 ◽

Routine Prophylaxis ◽

History Of ◽

The Difference ◽

A Prospective Study

At Danderyd’s Hospital a controlled clinical trial of dextran 70 using phlebography in all patients demonstrated a significant reduction in postoperative deep venous thrombosis (DVT) from 52% in the untreated control group to 4% in the dextran group. Johnson et al. 1968. As a consequence, routine prophylaxis of postoperative DVT with dextran 70 was instituted for all patients over 50 years of age undergoing abdominal, orthopedic or urological surgery. A retrospective investigation of. the result of this two-year period of routine prevention with dextran 70, which was preceded and superceded by 2 two-year periods when no dextran was given, revealed the following sequence of fatal PE verified at autopsy over the six-year period:15 (no prophylaxis), 6 (dextran) and 15 (no prophylaxis), Ljungström, 1975.At this stage a prospective study for a new two-year period was started. Infusion of 100 ml of dextran 70 was started during operation in all patients filling one of the following criteria: 1. All patients over 50 years of age undergoing abdominal, orthopedic or urological surgery. 2. All patients undergoing re-operation regardless of age. 3. All patients undergoing major surgery with a history of previous thromboembolic disease regardless of age.During this last two-year period only 3 patients died of fatal postoperative PE. The difference between 15 fatal PE in the non-dextran and 3 in the dextran group was significant, P 0.05. A comparable number of surgical operations were performed during each year of the eight-year period.

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The Risk of Dementia in Adults with Abdominal Aortic Aneurysm

10.21203/rs.3.rs-870520/v1 ◽

2021 ◽

Author(s):

Hyung-jin Cho ◽

Ju-hwan Yoo ◽

Mi-hyeong Kim ◽

Kyung-jai Ko ◽

Kang-woong Jun ◽

...

Keyword(s):

Cardiovascular Disease ◽

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Signs And Symptoms ◽

Control Group ◽

National Health Insurance System ◽

Abdominal Aortic ◽

Increased Risk ◽

History Of ◽

Incidence Of Dementia

Abstract Background Abdominal aortic aneurysm (AAA) and dementia have similar epidemiological profiles and common pathogenic mechanisms. However, there have been few studies on the link between these two diseases.Materials and methods For this study, information from 2009 to 2015 was extracted from the Korean National Health Insurance system database. A total of 15,251 participants with a new diagnosis of AAA was included. Propensity score matching by age and sex with patients in whom AAA was not diagnosed was used to select the control group of 45,753 participants. The primary endpoint of this study was newly diagnosed dementia (Alzheimer’s disease (AD), vascular dementia (VD), or other type of dementia). ResultsThe incidence of dementia was 23.084 per 1000 person years in the AAA group, which was higher than that of the control group (15.438 per 1000 person years). When divided into AD and VD groups, the incidence of AD was higher than that of VD, but the HR of AAA for occurrence of dementia was higher in VD (1.382 vs. 1.784). Among the various risk factors, there was an interaction if age, hypertension, and history of cardiovascular disease with incidence of dementia (p < 0.05). In the presence of hypertension, the HR for occurrence of dementia was high according to presence or absence of AAA (1.474 vs 1.165). In addition, this study showed higher HR in the younger age group (age < 65) and in the group with no history of cardiovascular disease [1.659 vs. 1.403 (age), 1.521 vs. 1.255 (history of cardiovascular disease)].Conclusions AAA was associated with increased risk of dementia regardless of AD or VD, even after adjusting for several comorbidities. These findings indicate that follow-up with AAA patients is necessary for early detection of signs and symptoms of dementia.

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Study of Mumps in Children attending a Tertiary Care Centre

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v32i1.5499 ◽

2012 ◽

Vol 32 (1) ◽

pp. 53-56

Author(s):

K Keyal ◽

BG Joshi ◽

S Bhatt ◽

R Pandey ◽

RM Shrestha

Keyword(s):

Care Center ◽

Tertiary Care ◽

Signs And Symptoms ◽

Tertiary Care Centre ◽

Number Of Children ◽

Immunization Programme ◽

Parotid Swelling ◽

History Of ◽

A Prospective Study ◽

Mumps Infection

Introduction: Mumps is a self-limiting viral infection of the salivary glands with systemic manifestations and complications. It primarily affects young children, with increased incidence in winter and spring. Mumps infection is endemic in developing countries because of poor vaccination coverage. This study is intended to highlight the increased number of mumps cases in children attending tertiary care center in Nepal and thus to emphasize the importance of mumps vaccination, so as to decrease the disease occurrence and disease burden by vaccinating all children. Materials and Methods: This was a prospective study done in Civil Service Hospital of Nepal over a period of 2 years from November 2009 to October 2011. All children less than 14years of age with symptoms of fever and parotid swelling were included in the study group. A detailed history pertaining to the disease was taken, that included; history of exposure and prior vaccination against mumps. Children were asked to follow up either after 5 days or in case of noticing any signs and symptoms of complication. Results: There were total 113 cases diagnosed clinically as mumps of which there were 71 males (62.83%) and 42 females (37.16%) with the peak incidence of disease in the month of March and September with 22 cases (19.46%) in each month. The increase incidence was seen in 4-6 years of age with 58 cases (51.32%). There were 70 patients (61.94%) that had history of exposure to mumps infection. All the patients in this study had either unilateral or bilateral parotitis. None of the children were vaccinated against mumps. And all the school going children had to be off school for a period of 3-5 days. Conclusion: There were large number of children with mumps and none of them were vaccinated. Child can be prevented from the infection by vaccination and thus avoiding possible sufferings and complications. Thus we recommend the use of mumps vaccination in Routine immunization programme. Key words: Mumps; Parotitis; School absenteeism; Nepal; Vaccine DOI: http://dx.doi.org/10.3126/jnps.v32i1.5499 J. Nepal Paediatr. Soc. Vol.32(1) 2012 53-56

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Dementia as Risk Factor for Severe Coronavirus Disease 2019: A Case-Control Study

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.698184 ◽

2021 ◽

Vol 13 ◽

Author(s):

Mariantonietta Pisaturo ◽

Federica Calò ◽

Antonio Russo ◽

Clarissa Camaioni ◽

Agnese Giaccone ◽

...

Keyword(s):

Case Control Study ◽

Severe Disease ◽

Signs And Symptoms ◽

Case Control ◽

Control Group ◽

Case Group ◽

Moderate Disease ◽

Increased Risk ◽

History Of ◽

Control Study

BackgroundThe aim of the present study was to investigate the outcome of patients with SARS-CoV-2 infection and dementia.Patients and MethodsIn a multicenter, observational, 1:2 matched case-control study all 23 patients with a history of dementia, hospitalized with a diagnosis of SARS-CoV-2 infection from February 28th 2020 to January 31st 2021 were enrolled. For each Case, 2 patients without dementia observed in the same period study, pair matched for gender, age (±5 years), PaO2/FiO2 (P/F) ratio at admission (<200, or >200), number of comorbidities (±1; excluding dementia) were chosen (Control group).ResultsThe majority of patients were males (60.9% of Cases and Controls) and very elderly [median age 82 years (IQR: 75.5–85) in the Cases and 80 (IQR: 75.5–83.75) in the Controls]. The prevalence of co-pathologies was very high: all the Cases and 43 (93.5%) Controls showed a Charlson comorbidity index of at least 2. During hospitalization the patients in the Case group less frequently had a moderate disease of COVID-19 (35 vs. 67.4%, p = 0.02), more frequently a severe disease (48 vs. 22%, p = 0.03) and more frequently died (48 vs. 22%, p = 0.03). Moreover, during coronavirus disease 2019 (COVID-19), 14 (60.8%) patients in the Case group and 1 (2.1%; p < 0.000) in the Control group showed signs and symptoms of delirium.ConclusionPatients with dementia are vulnerable and have an increased risk of a severe disease and death when infected with COVID-19.

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Bacterial Vaginosis, Educational Level of Pregnant Women, and Preterm Birth: A Case-Control Study

ISRN Infectious Diseases ◽

10.5402/2013/980537 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Lindita Yzeiraj-Kalemaj ◽

Vjollca Shpata ◽

Gentian Vyshka ◽

Afërdita Manaj

Keyword(s):

Preterm Birth ◽

Bacterial Vaginosis ◽

Pregnant Women ◽

Educational Level ◽

Preterm Labor ◽

Late Complications ◽

Control Group ◽

Hospital Facility ◽

History Of ◽

A Prospective Study

Objective. In a prospective study, we have recruited two groups of pregnant women (the first one with preterm labor activity; the second one with labor in term), trying to find a correlation between bacterial vaginosis (BV) and preterm birth activity. Other parameters influencing the presence of BV have been studied as well, such as educational level and history of previous preterm deliveries. Materials and Methods. Each group was composed of 75 women; recruitment stopped when the number was reached. Bacteriological data were retrospectively collected from the follow-up visits that pregnant women had performed at the regional hospital facility, where the study was performed. The diagnosis of BV was made according to Amsel criteria. Results. Our study showed a significant correlation between BV and preterm labor. BV seems to be an independent risk factor for preterm labor. In the study group, the prevalence of BV was 32%, whereas in the control group, the figure was 14.6% (). Conclusion. Highly risked groups for a preterm birth activity, such as pregnant women presenting BV and with a low educational level, have to be followed up and eventually treated cautiously in order to avoid early and late complications of preterm delivery.

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A study to analyses the clinical features and various treatment modalities of varicose veins of lower limbs

International Surgery Journal ◽

10.18203/2349-2902.isj20185467 ◽

2018 ◽

Vol 6 (1) ◽

pp. 173

Author(s):

Santosh Nayak ◽

Parthiban M. S.

Keyword(s):

Clinical Features ◽

Varicose Veins ◽

Color Doppler ◽

Signs And Symptoms ◽

Lower Limbs ◽

Treatment Modalities ◽

Medical College ◽

History Of ◽

Primary Varicose Veins ◽

A Prospective Study

Background: Varicose veins are defined by WHO as abnormally dilated saccular or cylindrical superficial veins, which can be circumscribed or segmental. This includes tiny spider telangiectasia’s as well as grossly dilated saphenous varicosities. It involves at least 1 out of 5 in the world and with increasing population, increased life span and change in life style, the problem is ever growing. The objective of this study is to analyse the clinical features and various treatment modalities adopted for the management of varicose veins of 40 has some form of varicosity or telangiectasia of the veins.Methods: A prospective study was conducted in CG hospital and Bapuji hospital attached to JJM Medical College, Davangere from June 2009 to May 2011. A total of 40 cases were included in the study duration. All patients who presented to the outpatient department with signs and symptoms of primary varicose veins were interviewed with preformed performa, meticulously examined and later subjected to color doppler studies before they underwent surgery for the same.Results: The incidence of varicose veins was seen most commonly in male when compared to female in this study. The family history of varicose veins was seen in only 12.5% of the subjects. In this study patients presented with varied symptoms, out of which dilated veins was most common 37 (92.5%) patients followed by aching pain 22 patients (55%).Conclusions: Varicosity of the lower limb is a common clinical entity. The number of cases reporting to the hospital is much less than the real incidence because in the absence of symptoms due to varicose veins patients do not seek treatment in our country. Most of the patient presented to the hospital for one or the other complications not for the cosmetic purpose.

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