Mortality Rate. Importance of Different Symptoms and Signs

AbstractBackground and objective:Cutaneous anthrax usually has a mortality rate of less than 1 per cent. However, since December 2009 there have been more than 13 deaths in the UK due to anthrax-contaminated heroin. We therefore wish to raise clinical awareness of this treatable disease.Case report:We describe the case of a heroin user with an equivocal presentation of cellulitis in the neck. Within 36 hours, this led to death due to cutaneous anthrax.Conclusion:Whilst cutaneous anthrax remains rare, this case report aims to raise awareness of the fact that the symptoms and signs of this condition in intravenous drug users may not always fit the typical picture.

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Application of ribavirin in patients having hemorrhagic fever with renal syndrome

Medicinski pregled ◽

10.2298/mpns0902063z ◽

2009 ◽

Vol 62 (1-2) ◽

pp. 63-67 ◽

Cited By ~ 2

Author(s):

Milovan Zivkovic ◽

Zoran Todorovic ◽

Predrag Canovic ◽

Zeljko Mijanovic

Keyword(s):

Mortality Rate ◽

Clinical Picture ◽

Good Reason ◽

Hemorrhagic Fever ◽

Severe Form ◽

Number Of Patients ◽

Severe Clinical Picture ◽

Infective Disease ◽

Acute Renal Insufficiency ◽

Symptoms And Signs

Introduction. Hemorrhagic fever with renal syndrome (HFRS) is an acute infective disease of a zoonose type characterized by an abrupt beginning, prominent hemorrhagic syndrome as well as symptoms and signs of acute renal insufficiency. The clinical picture of this disease, which is leading in terms of its natural principal seat in the region of Northern-east Montenegro, ranges from non-apparent to very severe forms and mortality it causes is about 10%.Up to date, no efficient etio-trophic means has been discovered. Several studies suggest that an early use of anti virus medicament Ribavirine leads to decrease of mortality rate. The main aim of this study is to present our results achieved in an attempt to apply this medicament in treating HFRS. Material and methods. In total, we have treated 58 patients with symptoms and signs of HGSBS. Five of them, who were admitted to the Department in the first three days were treated by Ribavirine orally in doses of 2x400 mg. Compared to patients who were not treated by Ribavirine, a faster decrease of thrombocytes was noticed in them, which required the discontinuation of the medicament treatment. Thereafter, thrombocytes started to increase and their normalization followed faster than in patients who were not treated by this medicament. The above patients developed a moderately severe clinical picture of the disease, and middle maximum values of urea and creatinine were lower in patients who were not treated by the medicament. No patient developed a severe form of the disease and there were neither dialyzed nor died ones. The mortality rate in patients who were not treated by the medicament was 3.44% and the percent of the dialyzed was 5.17%. Results. Application of Ribavirine at the very beginning of HFRS is considered to be with a very good reason in combination with obligatory follow up of clinical and laboratory parameters and particularly of thrombocyte values, the decrease of which can lead to spontaneous bleedings. Because of the small number of patients to whom we gave this medicament it is difficult to come to a conclusion on the extent of its affect on the clinical picture in our patients.

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Prognostic Factors and Clinical Features of Neonatal Splenic Rupture/Hemorrhage: Two Cases Reports and Literature Review

Frontiers in Pediatrics ◽

10.3389/fped.2021.616247 ◽

2021 ◽

Vol 9 ◽

Author(s):

Han-Pi Chang ◽

Ren-Huei Fu ◽

Jainn-Jim Lin ◽

Ming-Chou Chiang

Keyword(s):

Mortality Rate ◽

Literature Review ◽

Clinical Features ◽

Splenic Rupture ◽

English Literature ◽

Demographic Data ◽

Surgical Approaches ◽

Study Cohort ◽

Presenting Symptoms ◽

Symptoms And Signs

Background: Neonatal splenic rupture/hemorrhage (SRH), an extremely rare and potentially fatal presentation, can spontaneously resolve without surgical treatment; However, treatment approaches remain controversial. The present study aimed to describe and analyze the clinical features and therapies of neonatal SRH and therapeutic approaches.Methods: We present the cases of two patients and review another 37 cases reported in English-literature. The literature search included all articles published in PUBMED from inception between January 1968 and December 2019. Demographic data, precipitating factors, clinical characteristics including presenting symptoms and signs, presenting time, age at SRH presentation, imaging findings, as well as treatments and outcomes were analyzed.Results: In addition to the two cases treated at our hospital, 37 neonates with SRH were reported during the study period. The rate of full-term neonates was 72% (28/39). The cause was idiopathic in most cases, and congenital coagulation disorders were underlying causes in 13% (5/39) of the cases. The most common presenting symptom and sign of neonatal SRH were pallor or anemia, followed by abdominal discoloration/distension. Additionally, 18% (7/39) of the cases presented with scrotal hematoma or swelling. The age at SRH presentation ranged between 3 h and 5 days of age. Abdominal ultrasonography or computed tomography was used as the diagnostic tool. Twenty-seven cases (69%) received surgical management. The prognosis was comparable between the neonates treated with splenectomy and those treated with non-surgical approaches. The mortality rate was 18% (7/39) in the study cohort. SRH presentation at ≤12 h of age was associated with higher mortality compared to SRH presenting time at >12 h of age (odds ratio 25.0, 95% CI 2.514–248.575, p = 0.001).Conclusion: Our literature review revealed that the mortality rate of neonatal SRH was 18% and that the mortality risk was higher in neonates presenting with SRH symptoms and signs at ≤12 h of age.

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Analysis of the treatment of 12 consecutive cases of brain abscess

Journal of Neurosurgery ◽

10.3171/jns.1972.37.2.0182 ◽

1972 ◽

Vol 37 (2) ◽

pp. 182-184 ◽

Cited By ~ 8

Author(s):

Zacharias Kapsalakis ◽

Helen C. Askitopoulou ◽

Athanasios Gregoriades

Keyword(s):

Mortality Rate ◽

Brain Abscess ◽

Primary Source ◽

Simultaneous Treatment ◽

Content Type ◽

Brain Scans ◽

Source Of Infection ◽

Focus Of Infection ◽

Symptoms And Signs ◽

Fine Print

✓ An analysis of 12 consecutive cases of brain abscess is reported. In nine patients a distant focus of infection was identified in the middle ear, the cranial sinuses, the lungs, the pleura, the tonsils, or the skull. The most frequent early symptoms and signs were headache, vomiting, papilledema, focal neurological abnormalities, and pyrexia. Angiography, electroencephalography, and brain scans were abnormal in all cases in which they were obtained. Therapy was based on early diagnosis with accurate location, aspiration or excision of the abscess, use of chloramphenicol instead of penicillin, use of steroids, the accomplishment of simultaneous treatment of the primary source of infection, and reevaluation of the patient some time after discharge. The mortality rate was 8% and the morbidity 8%; the six patients with postoperative epilepsy have returned to normal life.

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Questions and Answers

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2000.marapr02 ◽

2000 ◽

Vol 5 (2) ◽

pp. 3-3

Author(s):

Christopher R. Brigham ◽

James B. Talmage

Keyword(s):

Nervous System ◽

Peripheral Nervous System ◽

Spinal Nerve ◽

Sensory Loss ◽

Residual Symptoms ◽

Additional Information ◽

Questions And Answers ◽

Motor Nerves ◽

Symptoms And Signs ◽

Limited Motion

Abstract Lesions of the peripheral nervous system (PNS), whether due to injury or illness, commonly result in residual symptoms and signs and, hence, permanent impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) describes procedures for rating upper extremity neural deficits in Chapter 3, The Musculoskeletal System, section 3.1k; Chapter 4, The Nervous System, section 4.4 provides additional information and an example. The AMA Guides also divides PNS deficits into sensory and motor and includes pain within the former. The impairment estimates take into account typical manifestations such as limited motion, atrophy, and reflex, trophic, and vasomotor deficits. Lesions of the peripheral nervous system may result in diminished sensation (anesthesia or hypesthesia), abnormal sensation (dysesthesia or paresthesia), or increased sensation (hyperesthesia). Lesions of motor nerves can result in weakness or paralysis of the muscles innervated. Spinal nerve deficits are identified by sensory loss or pain in the dermatome or weakness in the myotome supplied. The steps in estimating brachial plexus impairment are similar to those for spinal and peripheral nerves. Evaluators should take care not to rate the same impairment twice, eg, rating weakness resulting from a peripheral nerve injury and the joss of joint motion due to that weakness.

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