Coronary heart disease

2014 ◽  
pp. 109-118
Keyword(s):  
Coronary Arteries ◽  
Stable Angina ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Premature Death ◽  
Common Symptom ◽  
Acute Mi ◽  
Coronary Syndromes ◽  
Clinical Signs And Symptoms ◽  
The Uk

CHD remains one of the largest causes of premature death in the UK. Angina is the most common symptom of CHD. It is usually described as a central, retrosternal pain or ache that is crushing or choking in nature. Pain may radiate down the left arm and/or up into the neck and is often accompanied by shortness of breath and sweating. Some patients may describe it as chest discomfort. The presentation of CHD, however, covers a broad spectrum of clinical signs and symptoms that vary in severity. An individual may be asymptomatic despite disease within the coronary arteries; may present with gradually worsening symptoms of angina; or the first presentation may be death following an acute MI. The progress of the disease is variable, depending on the individual’s risk factors and the coronary arteries affected. Terminology varies but, generally speaking, CHD is divided into two subtypes: stable angina—with reversible ischaemia, and acute coronary syndromes—which is an umbrella term that includes unstable angina and MI. This chapter outlines the pathophysiology and clinical management of stable angina.

Coronary heart disease: stable angina

2020 ◽  
pp. 129-140
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Stable Angina ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Premature Death ◽  
Common Symptom ◽  
Retrosternal Pain ◽  
Clinical Signs And Symptoms ◽  
The Uk

Although rates of premature death from coronary heart disease (CHD) have fallen 80% over the past 40 years, it is still a significant cause of premature death in the UK. Angina is the most common symptom of CHD. It is usually described as a central, retrosternal pain or ache that is crushing or choking in nature. Pain may radiate down the left arm and/or up into the neck and is often accompanied by shortness of breath (SOB) and sweating. Some patients may describe it as chest discomfort. The presentation of CHD, however, covers a broad spectrum of clinical signs and symptoms that vary in severity. An individual may be asymptomatic despite disease within the coronary arteries; may present with gradually worsening symptoms of angina; or the first presentation may be death following an acute myocardial infarction (MI). This chapter outlines the pathophysiology and clinical management of stable angina.

scholarly journals Viral and bacterial infection elicit distinct changes in plasma lipids in febrile children

2019 ◽  
Author(s):  
Xinzhu Wang ◽  
Ruud Nijman ◽  
Stephane Camuzeaux ◽  
Caroline Sands ◽  
Heather Jackson ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Viral Infection ◽  
Bacterial Infections ◽  
Plasma Lipids ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cholesterol Sulfate ◽  
Inappropriate Use ◽  
Clinical Signs And Symptoms ◽  
The Uk

AbstractFever is the most common reason that children present to Emergency Departments in the UK. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. As a result, many children are prescribed antibiotics often unnecessarily, while others with life-threatening bacterial infections can remain untreated. The ‘omics’ approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n=20) and confirmed viral infection (n=20). We show for the first time that bacterial and viral infection elicit distinct changes in the host lipidome. Glycerophosphoinositol, sphingomyelin, lysophosphotidylcholine and cholesterol sulfate were increased in the confirmed virus infected group, while fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were increased in cases with confirmed bacterial infection. A combination of three lipids achieved the area under the receiver operating characteristic (ROC) curve of 0.918 (95% CI 0.835 to 1). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics.

scholarly journals Hand pain in elderly patients

2015 ◽  
Vol 10 (4) ◽  
pp. 342-347
Author(s):  
Adriana Sarah NICA ◽  
◽  
Gilda MOLOGHIANU ◽  
Roxana NARTEA ◽  
Mariana-Isabela CONSTANTINOVICI ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Functional Outcomes ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Clinical Aspects ◽  
Common Symptom ◽  
Aged People ◽  
Hand Pain ◽  
Functional Consequences ◽  
Clinical Signs And Symptoms

Painful hand of aged people is a very common symptom but is often disregarded in comparaison with other clinical signs and symptoms analyzed in these patients. When is reported, are rarely taken into account the multiple pathophysiological and clinical aspects of aging that characterize also the hand. Pain and all these other signs induce unexpected aspects of dysfunctions, from functional impairment to disability. Our aim was to present a review of the most common situations related to painful hand in elderly patients, especially in rheumatological and posttraumatic context. This paper is an update of the most common situations in older patients, that often neglect their distal upper limb in a context of polipathology or in a problematically family and social environment. Also are presented the associated functional consequences and the main therapeutic objectives related to pathophysiological, clinical and functional outcomes.

scholarly journals Confidence and willingness among laypersons in the UK to act in a head injury situation: a qualitative focus group study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033531
Author(s):  
Stefan Tino Kulnik ◽  
Mary Halter ◽  
Ann Hilton ◽  
Aidan Baron ◽  
Stuart Garner ◽  
...  
Keyword(s):  
Decision Making ◽  
Head Injury ◽  
Focus Group ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
First Aid ◽  
Snowball Sampling ◽  
Focus Group Study ◽  
Clinical Signs And Symptoms ◽  
The Uk

ObjectivesTo explore factors influencing confidence and willingness among laypersons in the UK to act in a head injury situation, in order to inform first aid education offered by the British Red Cross.DesignQualitative focus group study.SettingSouth East England.ParticipantsForty-four laypersons (37 women, 7 men) were purposively recruited from the general public using snowball sampling, into one focus group each for six population groups: parents of young children (n=8), informal carers of older adults (n=7), school staff (n=7), sports coaches (n=2), young adults (n=9) and ‘other’ adults (n=11). The median (range) age group across the sample was 25–34 years (18–24, 84–95). Participants were from Asian (n=6), Black (n=6), Mixed (n=2) and White (n=30) ethnic backgrounds.ResultsThe majority of participants described being confident and willing to act in a head injury scenario if that meant calling for assistance, but did not feel sufficiently confident or knowledgeable to assist or make decisions in a more involved way. Individuals’ confidence and willingness presented as fluid and dependent on an interplay of situational and contextual considerations, which strongly impacted decision-making: prior knowledge and experience, characteristics of the injured person, un/observed head injury, and location and environment. These considerations may be framed as enablers or barriers to helping behaviour, impacting decision-making to the same extent as—or even more so than—the clinical signs and symptoms of head injury. An individual conceptual model is proposed to illustrate inter-relationships between these factors.ConclusionsOur findings show that confidence and willingness to act in a head injury scenario are dependent on several contextual and situational factors. It is important to address such factors, in addition to knowledge of clinical signs and symptoms, in first aid education and training to improve confidence and willingness to act.

scholarly journals Comparative analysis of COVID-19 guidelines from six countries: A qualitative study on the US, China, South Korea, the UK, Brazil and Haiti

2020 ◽  
Author(s):  
JI YOUN YOO ◽  
Samia Valeria Ozorio Dutra ◽  
Dany Fanfan ◽  
Sarah Sniffen ◽  
Hao Wang ◽  
...  
Keyword(s):  
Qualitative Study ◽  
South Korea ◽  
Healthcare Professionals ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Healthcare Systems ◽  
Contact Tracing ◽  
Clinical Signs And Symptoms ◽  
The Government ◽  
The Uk

Abstract Background: In late January, a worldwide crisis known as COVID-19 was declared a Public Health Emergency of International Concern by the WHO. Within only a few weeks, the outbreak took on pandemic proportions, affecting over 100 countries. It was a significant issue to prevent and control COVID-19 on both national and global scales due to the dramatic increase in confirmed cases worldwide. Government guidelines provide a fundamental resource for communities, as they guide citizens on how to protect themselves against COVID-19, however, they also provide critical guidance for policy makers and healthcare professionals on how to take action to decrease the spread of COVID-19. We aimed to identify the differences and similarities between six different countries' (US, China, South Korea, UK, Brazil and Haiti) government-provided community and healthcare system guidelines, and to explore the relationship between guideline issue dates and the prevalence/incidence of COVID-19 cases.Methods: To make these comparisons, this exploratory qualitative study used document analysis of government guidelines issued to the general public and to healthcare professionals. Documents were purposively sampled (N=55) and analyzed using content analysis.Results: The major differences in the evaluation and testing criteria in the guidelines across the six countries centered around the priority of testing for COVID-19 in the general population, which was strongly dependent on each country’s healthcare capacity. However, the most similar guidelines pertained to the clinical signs and symptoms of COVID-19, and methods to prevent its contraction.Conclusion: In the initial stages of the outbreak, certain strategies were universally employed to control the deadly virus’s spread, including quarantining the sick, contact tracing, and social distancing. However, each country dealt with differing healthcare capacities, risks, threats, political and socioeconomic challenges, and distinct healthcare systems and infrastructure. Acknowledging these differences highlights the importance of examining the various countries’ response to the COVID-19 pandemic with a nuanced view, as each of these factors shaped the government guidelines distributed to each country’s communities and healthcare systems.

scholarly journals Comparative analysis of COVID-19 guidelines from six countries: a qualitative study on the US, China, South Korea, the UK, Brazil, and Haiti

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ji Youn Yoo ◽  
Samia Valeria Ozorio Dutra ◽  
Dany Fanfan ◽  
Sarah Sniffen ◽  
Hao Wang ◽  
...  
Keyword(s):  
Qualitative Study ◽  
South Korea ◽  
Healthcare Professionals ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Healthcare Systems ◽  
Contact Tracing ◽  
Clinical Signs And Symptoms ◽  
The Government ◽  
The Uk

Abstract Background In late January, a worldwide crisis known as COVID-19 was declared a Public Health Emergency of International Concern by the WHO. Within only a few weeks, the outbreak took on pandemic proportions, affecting over 100 countries. It was a significant issue to prevent and control COVID-19 on both national and global scales due to the dramatic increase in confirmed cases worldwide. Government guidelines provide a fundamental resource for communities, as they guide citizens on how to protect themselves against COVID-19, however, they also provide critical guidance for policy makers and healthcare professionals on how to take action to decrease the spread of COVID-19. We aimed to identify the differences and similarities between six different countries’ (US, China, South Korea, UK, Brazil and Haiti) government-provided community and healthcare system guidelines, and to explore the relationship between guideline issue dates and the prevalence/incidence of COVID-19 cases. Methods To make these comparisons, this exploratory qualitative study used document analysis of government guidelines issued to the general public and to healthcare professionals. Documents were purposively sampled (N = 55) and analyzed using content analysis. Results The major differences in the evaluation and testing criteria in the guidelines across the six countries centered around the priority of testing for COVID-19 in the general population, which was strongly dependent on each country’s healthcare capacity. However, the most similar guidelines pertained to the clinical signs and symptoms of COVID-19, and methods to prevent its contraction. Conclusion In the initial stages of the outbreak, certain strategies were universally employed to control the deadly virus’s spread, including quarantining the sick, contact tracing, and social distancing. However, each country dealt with differing healthcare capacities, risks, threats, political and socioeconomic challenges, and distinct healthcare systems and infrastructure. Acknowledging these differences highlights the importance of examining the various countries’ response to the COVID-19 pandemic with a nuanced view, as each of these factors shaped the government guidelines distributed to each country’s communities and healthcare systems.

scholarly journals Comparative analysis of COVID-19 guidelines from six countries: a qualitative study in the US, China, South Korea, the UK, Brazil and Haiti

2020 ◽  
Author(s):  
JI YOUN YOO ◽  
Samia Valeria Ozorio Dutra ◽  
Dany Fanfan ◽  
Sarah Sniffen ◽  
Hao Wang ◽  
...  
Keyword(s):  
Qualitative Study ◽  
South Korea ◽  
Healthcare Professionals ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Healthcare Systems ◽  
Contact Tracing ◽  
Clinical Signs And Symptoms ◽  
The Government ◽  
The Uk

Abstract Background On January 30, 2020, the WHO declared the outbreak of COVID-19 a Public Health Emergency of International Concern. Within only a few weeks, the outbreak took on pandemic proportions, affecting over 100 countries. This rapid increase in confirmed cases made the prevention and control of COVID-19 critical on both national and global scales in order to prevent the healthcare systems from being overwhelmed. Government guidelines provide a fundamental resource for communities, as they guide citizens on how to protect themselves against COVID-19, however, they also provide critical guidance for policy makers and healthcare professionals for taking action to slow the spread of COVID-19. Objective We aimed to identify the differences and similarities between six different countries' (U.S., China, South Korea, UK, Brazil and Haiti) government provided community and healthcare system guidelines, and to explore the relationship between guideline issue dates and the prevalence/incidence of COVID-19 cases. Research design and Methods: To make these comparisons, this exploratory qualitative study used document analysis of government guidelines issued to the general public and to healthcare professionals. Results The major differences in the evaluation and testing criteria in the guidelines across the six countries centered around the priority of testing for COVID-19 in the general population, which was strongly dependent on each country’s healthcare capacity. However, the most similar guidelines pertained to the clinical signs and symptoms of COVID-19, and methods to prevent its contraction. Conclusion In the initial stages of the outbreak, certain strategies were universally employed to control the deadly virus’s spread, including quarantining the sick, contact tracing, and social distancing. However, each country dealt with differing healthcare capacities, risks, threats, political and socioeconomic challenges, and distinct healthcare systems and infrastructure. Acknowledging these differences highlights the importance of examining the various countries’ response to the COVID-19 pandemic with a nuanced view, as each of these factors shaped the government guidelines distributed to each country’s communities and healthcare systems.

Serum digoxin concentrations and clinical signs and symptoms of digoxin toxicity in the paediatric population

2015 ◽  
Vol 26 (3) ◽  
pp. 493-498 ◽  
Author(s):  
Brady S. Moffett ◽  
April Garner ◽  
Troy Zapata ◽  
Jeffrey Orcutt ◽  
Mary Niu ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Digoxin Concentration ◽  
Signs And Symptoms ◽  
Paediatric Population ◽  
Serum Digoxin Concentration ◽  
Digoxin Toxicity ◽  
Common Symptom ◽  
Serum Digoxin ◽  
Included Patient ◽  
Clinical Signs And Symptoms

AbstractBackgroundSerum digoxin levels have limited utility for determining digoxin toxicity in adults. Paediatric data assessing the utility of monitoring serum digoxin concentration are scarce. We sought to determine whether serum digoxin concentrations are associated with signs and symptoms of digoxin toxicity in children.MethodsWe carried out a retrospective review of patients <19 years of age who received digoxin and had serum digoxin concentrations assessed between January, 2007 and June, 2013. Data collection included patient demographics, digoxin indication, serum digoxin concentrations, signs and symptoms of digoxin toxicity, electrocardiograms, and co-morbidities. Reviewers performing chart review and electrocardiogram analysis were blinded to digoxin levels. Descriptive statistical methods were used and comparisons were made between patients with and without toxic serum digoxin concentrations (>2 ng/ml).ResultsThere were 87 patients who met study criteria (male 46%, mean age 8.4 years). CHD was present in 67.8% and electrocardiograms were performed in 72.4% of the patients. The most common indication for digoxin toxicity was heart failure symptoms (61.5%). Toxic serum digoxin concentrations were present in 6.9% of patients (mean 2.6 ng/ml). Symptoms associated with digoxin toxicity occurred in 48.4%, with nausea/vomiting as the most common symptom (36.4%), followed by tachycardia (29.5%). Compared with those without toxic serum digoxin concentrations, significantly more patients with toxic serum digoxin concentrations were female (p=0.02). The presence of electrocardiogram abnormalities and/or signs and symptoms of digoxin toxicity was not significantly different between patients with and without serum digoxin concentrations (p>0.05).ConclusionSerum digoxin concentrations in children are not strongly associated with signs and symptoms of digoxin toxicity.

scholarly journals Comparative analysis of COVID-19 guidelines from six countries: a qualitative study on the US, China, South Korea, the UK, Brazil, and Haiti 

2020 ◽  
Author(s):  
JI YOUN YOO ◽  
Samia Valeria Ozorio Dutra ◽  
Dany Fanfan ◽  
Sarah Sniffen ◽  
Hao Wang ◽  
...  
Keyword(s):  
Qualitative Study ◽  
South Korea ◽  
Healthcare Professionals ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Healthcare Systems ◽  
Contact Tracing ◽  
Clinical Signs And Symptoms ◽  
The Government ◽  
The Uk

Abstract Background: In late January a worldwide crisis known as COVID-19 was declared a Public Health Emergency of International Concern by the WHO. Within only a few weeks, the outbreak took on pandemic proportions, affecting over 100 countries. It was a significant issue to prevent and control COVID-19 on both national and global scales due to the dramatic increase in confirmed cases worldwide. Government guidelines provide a fundamental resource for communities, as they guide citizens on how to protect themselves against COVID-19, however, they also provide critical guidance for policy makers and healthcare professionals on how to take action to decrease the spread of COVID-19.Objective: We aimed to identify the differences and similarities between six different countries' (US, China, South Korea, UK, Brazil and Haiti) government provided community and healthcare system guidelines, and to explore the relationship between guideline issue dates and the prevalence/incidence of COVID-19 cases. Research design and Methods: To make these comparisons, this exploratory qualitative study used document analysis of government guidelines issued to the general public and to healthcare professionals. Documents were purposively sampled (N=55) and analyzed using content analysis.Results: The major differences in the evaluation and testing criteria in the guidelines across the six countries centered around the priority of testing for COVID-19 in the general population, which was strongly dependent on each country’s healthcare capacity. However, the most similar guidelines pertained to the clinical signs and symptoms of COVID-19, and methods to prevent its contraction. Conclusion: In the initial stages of the outbreak, certain strategies were universally employed to control the deadly virus’s spread, including quarantining the sick, contact tracing, and social distancing. However, each country dealt with differing healthcare capacities, risks, threats, political and socioeconomic challenges, and distinct healthcare systems and infrastructure. Acknowledging these differences highlights the importance of examining the various countries’ response to the COVID-19 pandemic with a nuanced view, as each of these factors shaped the government guidelines distributed to each country’s communities and healthcare systems.

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