scholarly journals Chlamydia pneumoniae (TWAR).

1995 ◽  
Vol 8 (4) ◽  
pp. 451-461 ◽  
Author(s):  
C C Kuo ◽  
L A Jackson ◽  
L A Campbell ◽  
J T Grayston
Keyword(s):  
Chlamydia Pneumoniae ◽  
Clinical Manifestations ◽  
The United States ◽  
Elementary Body ◽  
Acute Respiratory Disease ◽  
Dna Homology ◽  
Clinical Specimens ◽  
Chlamydial Species ◽  
Serologic Assay ◽  
Pcr Techniques

Chlamydia pneumoniae (TWAR) is a recently recognized third species of the genus Chlamydia that causes acute respiratory disease. It is distinct from the other two chlamydial species that infect humans, C. trachomatis and C. psittaci, in elementary body morphology and shares less than 10% of the DNA homology with those species. The organism has a global distribution, with infection most common among children between the ages of 5 and 14 years. In children, TWAR infection is usually mild or asymptomatic, but it may be more severe in adults. Pneumonia and bronchitis are the most common clinical manifestations of infection, and TWAR is responsible for approximately 10% of cases of pneumonia and 5% of cases of bronchitis in the United States. The microimmunofluorescence serologic assay is specific for TWAR and can distinguish between recent and past infections. The organism can be isolated in cell culture; however, PCR techniques have recently facilitated its detection in tissues and clinical specimens.

Postherpetic Neuralgia: A Patient’s and a Physician’s Perspective

2016 ◽  
Author(s):  
James H. Diaz
Keyword(s):  
Neuropathic Pain ◽  
Herpes Zoster ◽  
Postherpetic Neuralgia ◽  
Clinical Manifestations ◽  
The United States ◽  
Evidence Based ◽  
Pain Medicine ◽  
High Prevalence ◽  
Antiviral Medications ◽  
Physician’S Perspective

Herpes zoster can plague anyone who has had varicella or has received the varicella or chickenpox vaccine. The incidence of herpes zoster increases with age and rises exponentially after 60 years of age. Postherpetic neuralgia (PHN) may occur after herpes zoster at any age but typically occurs after 50 years of age, with over 40% of persons over 60 years of age suffering from PHN after a shingles attack. Up to 1 million new cases of herpes zoster and 200,000 new cases of PHN may now be anticipated in the United States every year, with the incidence rate increasing as the population grows and ages with prolonged life expectancies. Although new antiviral medications will improve and shorten the course of herpes zoster, they do not guarantee the prevention of PHN. Given the high prevalence of PHN in an aging population and the availability of primary prevention by vaccination, the objectives of this review are to describe the epidemiology, pathophysiology, and clinical manifestations of zoster and PHN and to recommend a combination of strategies for the clinical management and prevention of PHN. This review contains 6 figures, 4 tables and 13 references Key words: evidence-based pain medicine, herpes zoster, neuropathic pain, postherpetic neuralgia

scholarly journals Species identification of Candida isolated from clinical specimens in a tertiary care hospital

2016 ◽  
Vol 9 (1) ◽  
pp. 20 ◽  
Author(s):  
Lsmet Nigar ◽  
Shirin Tarafder ◽  
Rehana Razzak Khan ◽  
S. M. Ali Ahmed ◽  
Ahmed Abu Saleh
Keyword(s):  
Candida Albicans ◽  
Candida Species ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Common Species ◽  
Blood Stream ◽  
Care Hospital ◽  
Emerging Pathogens ◽  
Predisposing Factor ◽  
Clinical Specimens

<p><strong>Background:</strong> Candida species are responsible for various clinical manifestations from mucocutaneous overgrowth to blood stream infections especially in immunocompromized situations. Although C. albicans is the most prevalent species, high incidence of non-albicans Candida species with antifungal resistance are emerging which is posing a serious threat to the patients care.</p><p><strong>Objective:</strong> This study aimed to isolate and identify different species of Candida from different clinical specimens. Methods: A total of 100 different clinical specimens were studied of which 35 were oral swab, 28 were high vaginal swab, 15 were urine, 14 were nail, 04 were bronchoalveolar lavage and peritoneal fluid were 04. Among 100 clinical specimens, Candida isolates were identified in 64 specimens. Isolation of Candida species was done by primary culture in SDA. Subsequent identification of species were performed by germ tube test, subculture in chromo­genic agar medium and carbohydrate assimilation test with commonly used twelve sugars.</p><p><strong>Results:</strong> Out of 64 isolated Candida species, Candida albicans were 51.56% and the non-albicans Candida species were 48.44%. The most prevalent Candida species was C. albicans 33 (51.53%) followed by C. tropicalis 17 (26.56%). C. glabrata 4 (6.25%), C. parapsilo­sis 4 (6.25%), C. krusei 3 (4.68%) and C. guilliermondii 2 (3.2%). One of the isolated Candida species was unidentified.</p><p><strong>Conclusion:</strong> Though Candida albicans was found as the most common species, but non-albicans Candida species are appearing as emerging pathogens as well. Exposure to chemotherapy appeared to be the commonest predisposing factor for Candida infection followed by indwelling urinary catheter in situ for prolong period.</p>

scholarly journals Serological evidence of Rickettsia parkeri as the etiological agent of rickettsiosis in Uruguay

2009 ◽  
Vol 51 (6) ◽  
pp. 337-339 ◽  
Author(s):  
Ismael A. Conti-Díaz ◽  
Jonas Moraes-Filho ◽  
Richard C. Pacheco ◽  
Marcelo B. Labruna
Keyword(s):  
Spotted Fever ◽  
Clinical Manifestations ◽  
The United States ◽  
Immunofluorescence Assay ◽  
Etiological Agent ◽  
Serological Evidence ◽  
Rickettsia Parkeri ◽  
Rickettsia Rickettsii ◽  
Antibody Absorption ◽  
Mild Fever

We report three new rickettsiosis human cases in Uruguay. The three clinical cases presented clinical manifestations similar to previous reported cases of Rickettsia parkeri in the United States; that is mild fever (< 40 ºC), malaise, headache, rash, inoculation eschar at the tick bite site, regional lymphadenopathy, and no lethality. Serological antibody-absorption tests with purified antigens of R. parkeri and Rickettsia rickettsii, associated with immunofluorescence assay indicated that the patients in two cases were infected by R. parkeri. Epidemiological and clinical evidences, coupled with our serological analysis, suggest that R. parkeri is the etiological agent of human cases of spotted fever in Uruguay, a disease that has been recognized in that country as cutaneous-ganglionar rickettsiosis.

Chronic Kidney Failure and Dialysis

2018 ◽  
Author(s):  
Raghu V Durvasula ◽  
Jonathan Himmelfarb
Keyword(s):  
United States ◽  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Clinical Manifestations ◽  
Kidney Injury ◽  
The United States ◽  
Clinical Syndrome

Chronic kidney disease (CKD) is a clinical syndrome arising from progressive kidney injury, formerly known as chronic renal failure, chronic renal disease, and chronic renal insufficiency. It is classified into five stages based primarily on glomerular filtration rate (GFR). This article discusses the epidemiology of CKD and end-stage renal disease (ESRD), as well as etiology and genetics, pathophysiology, and pathogenesis. The section on diagnosis looks at clinical manifestations and physical findings, laboratory (and other) tests, imaging studies, and biopsy. A short section on differential diagnosis is followed by a discussion of treatment, including hemodialysis and peritoneal dialysis. Long-term complications of patients on dialysis include cardiovascular disease, renal osteodystrophy, dialysis-related amyloidosis, and acquired cystic disease (renal cell carcinoma). The final section addresses prognosis and socioeconomic burden. Figures include the classification system for CKD, prevalence of CKD in the United States, rising prevalence, risk of, and leading causes of ESRD in the United States, plus the changing prevalence of ESRD over time, clinical manifestations of uremia, and an overview of hemodialysis circuit. Tables look at the burden of CKD relative to other chronic disorders, the specific hereditary causes of kidney disease, and situations when serum creatinine does not accurately predict GFR. Other tables list equations for estimating GFR, the causes of CKD without shrunken kidneys, and clinical features distinguishing chronic kidney disease from acute kidney injury. ESRD and indications for initiation of dialysis are presented, as well as typical composition of dialysate and reasons for failure of peritoneal dialysis. This chapter contains 71 references.

Chronic Kidney Failure and Dialysis

2017 ◽  
Author(s):  
Raghu V Durvasula ◽  
Jonathan Himmelfarb
Keyword(s):  
United States ◽  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Clinical Manifestations ◽  
Kidney Injury ◽  
The United States ◽  
Clinical Syndrome

Chronic kidney disease (CKD) is a clinical syndrome arising from progressive kidney injury, formerly known as chronic renal failure, chronic renal disease, and chronic renal insufficiency. It is classified into five stages based primarily on glomerular filtration rate (GFR). This article discusses the epidemiology of CKD and end-stage renal disease (ESRD), as well as etiology and genetics, pathophysiology, and pathogenesis. The section on diagnosis looks at clinical manifestations and physical findings, laboratory (and other) tests, imaging studies, and biopsy. A short section on differential diagnosis is followed by a discussion of treatment, including hemodialysis and peritoneal dialysis. Long-term complications of patients on dialysis include cardiovascular disease, renal osteodystrophy, dialysis-related amyloidosis, and acquired cystic disease (renal cell carcinoma). The final section addresses prognosis and socioeconomic burden. Figures include the classification system for CKD, prevalence of CKD in the United States, rising prevalence, risk of, and leading causes of ESRD in the United States, plus the changing prevalence of ESRD over time, clinical manifestations of uremia, and an overview of hemodialysis circuit. Tables look at the burden of CKD relative to other chronic disorders, the specific hereditary causes of kidney disease, and situations when serum creatinine does not accurately predict GFR. Other tables list equations for estimating GFR, the causes of CKD without shrunken kidneys, and clinical features distinguishing chronic kidney disease from acute kidney injury. ESRD and indications for initiation of dialysis are presented, as well as typical composition of dialysate and reasons for failure of peritoneal dialysis. This chapter contains 71 references.

scholarly journals Anorectal diseases in patients with Antiphospholipid syndrome: a cross-sectional study

2020 ◽  
Vol 60 (1) ◽  
Author(s):  
E. Cunha ◽  
V. Guzela ◽  
G. G. M. Balbi ◽  
C. Sobrado ◽  
D. Andrade
Keyword(s):  
Surgical Treatment ◽  
Antiphospholipid Syndrome ◽  
Clinical Manifestations ◽  
Warfarin Dose ◽  
The United States ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Significance Level ◽  
Anal Bleeding ◽  
Internal Hemorrhoids

Abstract Background Hemorrhoid disease (HD) is one of the most common gastrointestinal complaints worldwide, affecting 4.4% of the general population in the United States. Since antiphospholipid syndrome (APS) may lead to intra-abdominal thrombosis, one may expect that this condition can impact the risk for HD development. Additionally, as APS patients are more prone to thrombosis and treatment with anticoagulants may increase risk of bleeding, one may also infer that rates of HD complications may be higher in this scenario. Nevertheless, no data in these regards have been published until now. The objective of the present study is to evaluate frequency of HD and describe its complications rates in antiphospholipid syndrome APS patients. Methods We consecutively invited patients who fulfilled APS criteria to undergo proctological examination. After examination, patients were divided in two groups, based on the presence of HD, and compared regarding different clinical manifestations and antiphospholipid profile. We performed the analysis of the data, using chi-square and Mann Whitney U when applicable and considering a significance level of 0.05. Multivariate regression analysis included age and variables with p < 0.10 in the bivariate analysis. Results Forty-one APS patients agreed to undergo proctological examination. All were female and overall median age was 43 (36–49). Seventeen (41.4%) patients were diagnosed with HD, with the following frequency distribution: 7 internal (41.2%), 4 external (23.5%) and 5 mixed hemorrhoids (29.4%). Of the internal hemorrhoids, 5 patients were classified as grade I (71.4%), 1 grade II (14.3%), and 1 grade IV (14.3%). Prior gestation (p = 0.067) and constipation (p = 0.067) correlated with a higher frequency of HD. In multivariate analysis, constipation remained as an important risk factor (OR 3.92,CI95% 1.03–14.2,p = 0.037). Five out of 17 patients (29.4%) reported anal bleeding, but it did not correlate with warfarin dose (p = 0.949). Surgical treatment was indicated for 10 patients (58.8%). Other anorectal findings were anal fissure, plicoma, condyloma and one chlamydial retitis. Conclusion We found an unexpected high frequency of hemorrhoids in APS patients, with a great proportion requiring surgical treatment.

THYROTOXIC PERIODIC PARALYSIS AND COMPLICATED THYROTOXICOSIS, TWO PRESENTATIONS OF HYPERTHYROIDISM WITH NOTABLE DIFFERENCES IN THEIR CLINICAL MANIFESTATIONS: AN EXPERIENCE FROM A TERTIARY CARE HOSPITAL IN THE UNITED STATES

2020 ◽  
Vol 26 (7) ◽  
pp. 699-706
Author(s):  
Ana M. Rivas ◽  
Subhanudh Thavaraputta ◽  
Menfil Andres Orellana-Barrios ◽  
John Drew Payne ◽  
David Sotello ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
The United States ◽  
Periodic Paralysis ◽  
Admission Diagnosis ◽  
Care Hospital ◽  
Qtc Prolongation ◽  
Free Triiodothyronine ◽  
Thyrotoxic Periodic Paralysis

Objective: Thyrotoxic periodic paralysis (TPP) is a muscular disorder characterized by sudden episodes of muscle weakness and hypokalemia in the setting of thyrotoxicosis. We aimed to report our experience with TPP in West Texas and compare its clinical presentation to that of patients admitted for complicated thyrotoxicosis. Methods: Retrospective review of records of adult patients with admission diagnosis of hyperthyroidism, thyrotoxicosis, and/or discharge diagnosis of periodic paralysis seen at our institution in a 6-year period. Results: Patients admitted for complicated thyrotoxicosis were more commonly females of a mean age of 44 years. Patients with TPP were more commonly Hispanic males of a mean age of 27 years. Despite no significantly different thyroid hormone levels, patients with TPP presented with less-severe signs and symptoms of hyperthyroidism, as reflected by lower Burch-Wartofsky score on admission (19 vs. 35; P<.001) and lower occurrence of atrial fibrillation in the TPP group (0% vs. 36%; P<.001). Finally, 89% of TPP patients presented with corrected QT (QTc) prolongation, whereas only 19% of thyrotoxic patient presented with a prolonged QTc. Conclusion: Hispanic patients with TTP seems to have relative resistance to the actions of thyroid hormones and commonly present with QTc prolongation, a risk factor for cardiac arrhythmias. Abbreviations: BWS = Burch-Wartofsky point scale; EKG = electrocardiogram; FT3 = free triiodothyronine; FT4 = free thyroxine; ICD = International Classification of Diseases; QTc = corrected QT; TPP = thyrotoxic periodic paralysis

scholarly journals Chlamydia pneumoniae infection in adult patients with persistent cough

2003 ◽  
Vol 52 (3) ◽  
pp. 265-269 ◽  
Author(s):  
Naoyuki Miyashita ◽  
Hiroshi Fukano ◽  
Koichiro Yoshida ◽  
Yoshihito Niki ◽  
Toshiharu Matsushima
Keyword(s):  
Respiratory Disease ◽  
Causative Agent ◽  
Chlamydia Pneumoniae ◽  
Adult Patients ◽  
Acute Respiratory Disease ◽  
Serological Evidence ◽  
Bacterial Isolation ◽  
Control Subjects ◽  
Persistent Cough

Chlamydia pneumoniae is a frequent causative agent of acute respiratory disease. To assess whether C. pneumoniae plays a role in persistent cough, the prevalence of C. pneumoniae infection in adult patients with persistent cough was investigated. Nasopharyngeal swabs and serology samples from 366 adult patients with a persistent cough lasting in excess of 2 weeks and 106 control subjects were analysed for bacterial isolation and by PCR. C. pneumoniae was isolated from two patients and from none of the controls and was detected by PCR in 20 patients and one control. Serological evidence of acute C. pneumoniae infection was present in 24 patients but in none of the controls. Of these 20 patients who were positive by culture and/or PCR, three were still positive by PCR after 2 weeks of treatment with clarithromycin and symptoms either continued or relapsed. However, when patients were treated with clarithromycin for 5–6 weeks, their symptoms disappeared completely and the results of their cultures and/or PCR for C. pneumoniae became negative. These data suggest that C. pneumoniae infection may cause persistent cough in adults. Furthermore, these data also indicate that it may be necessary to eradicate the organism when C. pneumoniae is detected by culture and/or PCR in patients with persistent cough.

scholarly journals Novel Hepatitis B Virus Genotype A Subtyping Assay That Distinguishes Subtype Aa from Ae and Its Application in Epidemiological Studies

2004 ◽  
Vol 78 (14) ◽  
pp. 7575-7581 ◽  
Author(s):  
Izumi Hasegawa ◽  
Yasuhito Tanaka ◽  
Anna Kramvis ◽  
Takanobu Kato ◽  
Fuminaka Sugauchi ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Clinical Manifestations ◽  
The United States ◽  
Sub Saharan Africa ◽  
Virus Genotype ◽  
Hbv Genotype ◽  
Specificity And Sensitivity ◽  
B Virus ◽  
Genotype A

ABSTRACT The eight genotypes of hepatitis B virus (HBV) have different geographical distributions, virological characteristics, and clinical manifestations. A unique subtype of HBV genotype A (HBV/A) was reported in sub-Saharan Africa, raising the possibility that patients infected with this subtype (HBV/Aa [“a” for African and Asian]) may have different clinical outcomes than other HBV/A isolates (HBV/Ae [“e” for European]). Comparison between 30 HBV/Aa and 30 HBV/Ae isolates indicated that almost all HBV/Ae isolates had G at nucleotide (nt) 1809 and C at nt 1812, whereas HBV/Aa isolates had T1809/T1812. Taking advantage of these two single nucleotide polymorphisms (SNPs), a novel subtype-specific PCR assay in the X/precore/core region was developed. This assay was combined with a restriction fragment length polymorphism assay using BglII in a different region (nt 1984 to 1989), which has a SNP distinguishing HBV/Aa from HBV/Ae, resulting in 100% specificity for the combined assay. Application of the subtyping assay using sera from 109 paid donors in the United States indicated significantly different distributions of HBV/A subtypes among races; African-Americans, Caucasians, and Hispanics had HBV/Ae, whereas Asians had mainly HBV/Aa, suggesting that the HBV/Aa isolates may have been imported by recent immigration from Asia. In conclusion, the specificity and sensitivity of the combined subtyping assay were confirmed, and its usefulness was demonstrated in a practical context.

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