Abstract O.39: The Incidence Of Abnormal Electroencephalographic Findings And Mild Encephalitis/encephalopathy With A Reversible Splenial Lesion In Kawasaki Disease

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Naomi Nakagawa ◽  
Masahiro Kamada ◽  
Yukiko Ishiguchi ◽  
Yuji Moritoh ◽  
Kengo Okamoto
Keyword(s):  
Kawasaki Disease ◽  
Therapy Response ◽  
Ivig Therapy ◽  
Liver Disorder ◽  
Neurological Symptoms ◽  
Splenial Lesion ◽  
First Case ◽  
Consciousness Disturbance ◽  
Group A ◽  
Group B

Background: Central nervous system inflammation sometimes occurs in Kawasaki disease (KD). In 2012, we reported the first case of KD complicated with mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) in a 14-year-old. Since then, similar cases have been reported. We studied the incidence of KD complicated with encephalitis/encephalopathy and MERS. Methods: We selected 36 patients (22 boys and 14 girls; age: range, 5-80 months; mean, 22 months) from 42 patients who had undergone electroencephalography (EEG) before intravenous immunoglobulin (IVIG) therapy between May 2013 and August 2014. Patients with and without abnormal EEG findings were assigned to groups A and B, respectively. Age; sex; time of diagnosis; neurological symptoms; N-terminal pro-brain natriuretic peptide, serum procalcitonin, serum sodium, serum albumin, and C-reactive protein (CRP) levels; liver disorder, coronary artery lesion, and IVIG therapy response were examined. Results: Group A comprised 6 patients (17%); and group B, 30 patients (83%). Consciousness disturbance was noted in 5 of 6 patients with abnormal EEG findings, without sequelae. Patients in group A were significantly older (56.5±16.8 vs 25.0±19.9 months ) and had higher CRP levels than those in group B (12.3±5.62 vs 6.56±3.47 mg/dL ). No other parameters showed significant differences. Magnetic resonance imaging revealed edema in 2 of 5 patients and MERS in the remaining patient in group A. Pleocytosis was noted in 1 of 4 patients in group A. Cytokine Il-6 and INF-γ levels were very high in the patient with MERS. Conclusion: EEG findings indicating central nerve disorders were noted in 17% patients, a lower incidence than that reported by Mitudome et al . We performed EEG early before IVIG therapy; thus, central nerve symptoms encountered may have occurred in the early stages of the disorders. MERS was noted in 1 of 6 patients with abnormal EEG findings, or 2 of 9 patients if past cases with neurological symptoms were included, suggesting that central nerve complications occur in a certain group of KD patients.

scholarly journals A humán parechovírusok klinikai jelentősége súlyos újszülött- és csecsemőkori fertőzésekben hazánkban

2019 ◽  
Vol 160 (10) ◽  
pp. 386-395
Author(s):  
Ákos Boros ◽  
Zsófia Hamarics ◽  
Hajnalka Fenyvesi ◽  
Zoltán Liptai ◽  
Zoltán Nyul ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Neurological Symptoms ◽  
Human Parechovirus ◽  
Faecal Samples ◽  
Group A ◽  
Polymerase Chain ◽  
Group B ◽  
Loss Of Appetite ◽  
Leading Symptom

Abstract: Introduction: Most human parechovirus (HPeV, family Picornaviridae) infections are asymptomatic but may cause gastroenteritis in children. New reports show that HPeVs can be associated with severe central nervous system symptoms and sepsis-like syndromes in infants. The clinical significance of HPeVs in Hungary has not been investigated before. Aim: The aim of this study was to detect genotype HPeV in faecal samples of children and analysis of the clinical symptoms. Method: For the detection and genotyping of HPeV strains, reverse transcription–polymerase chain reaction and sequencing methods were used from faecal samples of children with gastroenteritis divided into three groups: group A) hospitalised children younger than 10 years (n = 75); group B) 0–12 months infants (n = 237) and group C) children less than 18 years of age with sepsis-like/neurological symptoms (n = 105) were tested. Results: Three HPeV positive samples (3/75, 4%) were found in group A, two of them belong to the HPeV type 1, the third was non-typeable. All positive samples were from infants of 7 to 11 months of age. In group B, HPeV was detected in 6.8% (16/237) of the samples. Five were HPeV1, six were HPeV3 and five were non-typeable. While most of the infants with HPeV1 (4/5) did not require hospitalisation, 83% of the HPeV3 infected infants (5/6) did. Five (4.8%) HPeV strains detected from children less than 18 years of age with sepsis-like/neurological symptoms (group C) belonged to HPeV1 (three) and HPeV3 (two). All positive samples were from hospitalised infants less than 2 months of age. Conclusion: HPeV1 infections are less severe in infants than HPeV3 infections. The leading symptom of HPeV1 was diarrhoea, although in infants less than 1–2 months neurological symptoms (somnolence, lassitude) were also present. HPeV3 infections were more common among newborns. The main symptoms of severe HPeV3 infection are: gastroenteritis (7/8), fever ≥38 °C (6/7), loss of appetite (6/7), rash (4/7), somnolence/lassitude (3/7), sepsis-like syndrome (3/7) and respiratory symptoms (2/7). Orv Hetil. 2019; 160(10): 386–395.

scholarly journals Epidemiological investigation and intergenerational clinical characteristics of 24 coronavirus disease patients associated with a supermarket cluster: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suochen Tian ◽  
Min Wu ◽  
Zhenqin Chang ◽  
Yunxia Wang ◽  
Guijie Zhou ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Clinical Characteristics ◽  
First Generation ◽  
Clinical Manifestations ◽  
Index Patient ◽  
Time Interval ◽  
First Case ◽  
Group A ◽  
Group B ◽  
Epidemiological Characteristics

Abstract Background In view of the ongoing coronavirus disease (COVID-19) pandemic, it remains unclear whether the severity of illness and time interval from symptom onset to release from quarantine differ between cases that originated from clusters and cases reported in other areas. This study aimed to assess epidemiological and intergenerational clinical characteristics of COVID-19 patients associated with cluster outbreaks to provide valuable data for the prevention and control of COVID-19. Methods We identified the first employee with COVID-19 at a supermarket and screened the close contacts of this index patient. Confirmed cases were divided into two groups according to the generation (first generation comprising supermarket employees [group A] and second or third generations comprising family members or friends of the supermarket employees [group B]). The epidemiological and clinical characteristics of the two groups were retrospectively compared. Results A total of 8437 people were screened, and 24 COVID-19 patients were identified. Seven patients (29.2%) were asymptomatic; three patients were responsible for six symptomatic cases. The interval from the confirmation of the first case to symptom onset in symptomatic patients was 5–11 days. The clinical manifestations of symptomatic patients upon admission were non-specific. All patients (including the seven asymptomatic patients) were admitted based on chest computed tomography features indicative of pneumonia. There were 11 cases in group A (first generation) and 13 cases in group B (second generation, 11 cases; third generation, 2 cases), with no significant differences in clinical and epidemiological characteristics between the two groups, except for sex, duration from symptom onset to hospitalization, and underlying disease (P > 0.05). Conclusions For cluster outbreaks, it is important to comprehensively screen close the contacts of the index patient. Special attention should be paid to asymptomatic cases. The clinical management of cluster patients is similar to that of other COVID-19 patients.

scholarly journals Necrotizing Fasciitis Associated withStaphylococcus lugdunensis

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Tony Hung ◽  
Soroush Zaghi ◽  
Jonathan Yousefzadeh ◽  
Matthew Leibowitz
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Staphylococcal Infection ◽  
Tissue Destruction ◽  
First Case ◽  
Life Threatening ◽  
Group A ◽  
Group B

Necrotizing fasciitis is a life-threatening soft tissue infection that results in rapid local tissue destruction. Type 1 necrotizing fasciitis is characterized by polymicrobial, synergistic infections that are caused by non-Group Astreptococci, aerobic and anaerobic organisms. Type 2 necrotizing fasciitis involves Group AStreptococcus(GAS) with or without a coexisting staphylococcal infection. Here we provide the first report of necrotizing fasciitis jointly associated with the microbes Group BStreptococcusandStaphylococcus lugdunensis.S. lugdunensisis a commensal human skin bacterium known to cause often painful and prolonged skin and soft tissue infections. To our knowledge, however, this is the first case ofStaph. lugdunensis-associated necrotizing fasciitis to be reported in the literature.

scholarly journals Comparison of cross-sectional area and fat infiltration of suboccipital muscles between normal dogs and dogs with atlantoaxial instability

2021 ◽  
Author(s):  
Namsoon Lee ◽  
Munsu Yun ◽  
Junghee Yoon
Keyword(s):  
Quantitative Information ◽  
Cross Sectional Area ◽  
Neurological Symptoms ◽  
Atlantoaxial Instability ◽  
Sectional Area ◽  
Large Area ◽  
Cross Sectional ◽  
Fat Infiltration ◽  
Group A ◽  
Group B

Abstract Background Atlantoaxial instability (AAI) is primarily a congenital neurological disorder affecting young toy-breed dogs. So far, most studies have focused on bones and ligaments related to AAI, and there are no studies on the suboccipital muscles (SOMs) that occupy a large area from the occipital bone to C2 in dogs. This study evaluated the cross-sectional area (CSA) and fat infiltration of the SOMs using magnetic resonance imaging (MRI), specifically, T1-weighted images, in normal dogs (≤ 5 kg) and AAI dogs. The relationship between the severity of the neurological symptoms of AAI (group A and group B) and the values from MRI was also assessed. Results AAI dogs had significantly smaller CSA (P = 0.029) and greater fat infiltration (P = 0.044) of the SOMs compared to normal dogs. AAI dogs with mild neurological symptoms for a long period (group A) had greater fat infiltration than AAI dogs with severe neurological symptoms (group B) (P = 0.035). Conclusions The muscle changes are most likely due to spinal cord compression resulting from instability; however, the possibility that chronic changes of the muscle may play an additional role in maintaining stability in this region cannot be excluded. This study provides fundamental quantitative information of the SOMs in normal and AAI dogs.

scholarly journals Clinical characteristics of Kawasaki disease in adolescents

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110568
Author(s):  
Xiaoliang Liu ◽  
Fang Wang ◽  
Kaiyu Zhou ◽  
Yimin Hua ◽  
Mei Wu ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Clinical Characteristics ◽  
Community Health Center ◽  
Clinical Manifestations ◽  
Intermittent Fever ◽  
Local Hospital ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
Ivig Administration

Objective Studies focusing on Kawasaki disease (KD) in adolescents are lacking in Southwest China. We systematically summarized the clinical characteristics of KD in adolescents to improve pediatricians’ recognition of this condition. Methods The clinical data of patients with adolescent-onset KD in our center were retrospectively analyzed. The patients were divided into Group A (n = 7), whose first hospitalization was at our hospital, and Group B (n = 10), who were transferred from their local hospital or community health center. Results Seventeen patients with adolescent-onset KD were identified (constituent ratio of 0.8%). Seven patients had an intermittent fever for >10 days. The incidence of incomplete KD was 52.9%. These patients had a high incidence of other atypical clinical manifestations. Fifteen patients were initially misdiagnosed with other infectious diseases. Although the incidence of typical KD was higher in Group B, the overall misdiagnosis rate at the initial stages was higher and the average fever duration on arrival and before IVIG administration were much longer in Group B than A. Conclusions KD in adolescents was frequently misdiagnosed, which might be associated with its atypical, diverse clinical features and pediatricians’ poor recognition. Pediatricians must be aware of the possibility of KD in adolescents.

Surgical treatment of patients with vestibular schwannomas after failed previous radiosurgery

2012 ◽  
Vol 116 (4) ◽  
pp. 713-720 ◽  
Author(s):  
Venelin M. Gerganov ◽  
Mario Giordano ◽  
Amir Samii ◽  
Madjid Samii
Keyword(s):  
Facial Nerve ◽  
Previous Treatment ◽  
Neurological Symptoms ◽  
Vestibular Schwannomas ◽  
Control Group ◽  
Complication Rates ◽  
Tumor Removal ◽  
Group A ◽  
Group B ◽  
Tumor Enlargement

Object An increasing number of patients with vestibular schwannomas (VSs) are being treated with radiosurgery. Treatment failure or secondary regrowth after radiosurgery, however, has been observed in 2%–9% of patients. In large tumors that compress the brainstem and in patients who experience rapid neurological deterioration, surgical removal is the only reasonable management option. Methods The authors evaluated the relevance of previous radiosurgery for the outcome of surgery in a series of 28 patients with VS. The cohort was further subdivided into Group A (radiosurgery prior to surgery) and Group B (partial tumor removal followed by radiosurgery prior to current surgery). The functional and general outcomes in these 2 groups were compared with those in a control group (no previous treatment, matched characteristics). Results There were 15 patients in Group A, 13 in Group B, and 30 in the control group. The indications for surgery were sustained tumor enlargement and progression of neurological symptoms in 12 patients, sustained tumor enlargement in 15 patients, and worsening of neurological symptoms without evidence of tumor growth in 1 patient. Total tumor removal was achieved in all patients in Groups A and B and in 96.7% of those in the control group. There were no deaths in any group. Although no significant differences in the neurological morbidity or complication rates after surgery were noted, the risk of new cranial nerve deficits and CSF leakage was highest in patients in Group B. Patients who underwent previous radiosurgical treatment (Groups A and B) tended to be at higher risk of developing postoperative hematomas in the tumor bed or cerebellum. The rate of facial nerve anatomical preservation was highest in those patients who were not treated previously (93.3%) and decreased to 86.7% in the patients in Group A and to 61.5% in those in Group B. Facial nerve function at follow-up was found to correlate to the previous treatment; excellent or good function was seen in 87% of the patients from the control group, 78% of those in Group A, and 68% of those in Group B. Conclusions Complete microsurgical removal of VSs after failed radiosurgery is possible with an acceptable morbidity rate. The functional outcome, however, tends to be worse than in nontreated patients. Surgery after previous partial tumor removal and radiosurgery is most challenging and related to worse outcome.

scholarly journals Functional Brain Alterations in Individuals with Motor Conversion Disorder

2021 ◽  
pp. 139-150
Author(s):  
Mai Ahmed Salem ◽  
Mohammad Abdel Hakeem ◽  
Rasha Ahmed El Shafey ◽  
Gamal Ibrahim Taha Shamma ◽  
Ahmed Abdel Rahman Mubarak
Keyword(s):  
Psychometric Evaluation ◽  
Conversion Disorder ◽  
Cross Sectional Study ◽  
Neurological Symptoms ◽  
Cross Sectional ◽  
Affected Side ◽  
Egyptian Patients ◽  
Group A ◽  
Group B ◽  
Increased Activity

Background: Conversion disorder (CD) is characterized by neurological symptoms affecting voluntary motor control and incompatible with organic damage to the nervous system. Since novel insights have been gained with the advent of functional magnetic resonance imaging, we aimed to explore potential functional alterations in various areas of the brain in a sample of Egyptian patients suffering from conversion disorder. Methods: This cross-sectional study was carried out on patients who met the DSM-5 criteria for conversion disorder presented with weakness or paralysis aged from 18- 40 years old. Group A (Cases): include 30 patients with motor conversion disorder. Group B (Control): include 30 normal healthy individuals free from any psychiatric disorders. Structured Clinical Interview DSM-IV (SCID-I) and (SCID-II) were applied for psychometric evaluation. Results: The cases had increased activity in the contralateral amygdala of the affected side of patients with CD. Cases also showed decreased activation of contralateral basal ganglia in the affected side as well as a decreased activity of the motor cortex contralateral to the affected side. There was a decrease in activation of SMA contralateral to the side of disability. There was an increase in the activity of the contralateral insula. Conclusions: Functional abnormal alterations in motor and sensory systems are related to the presence of neurological symptoms in conversion disorder.

An ultrastructural study of sertoli cells in two geographically isolated populations of Aphanius dispar

1992 ◽  
Vol 50 (1) ◽  
pp. 548-549
Author(s):  
Taber A. Ba-Omar ◽  
Philip F. Prentis
Keyword(s):  
Ultrastructural Level ◽  
Uranyl Acetate ◽  
Freshwater Teleost ◽  
Isolated Populations ◽  
En Bloc ◽  
The North ◽  
Group A ◽  
Ultrathin Sections ◽  
Group B ◽  
Geographically Isolated

We have recently carried out a study of spermiogenic differentiation in two geographically isolated populations of Aphanius dispar (freshwater teleost), with a view to ascertaining variation at the ultrastructural level. The sampling areas were the Jebel Al Akhdar in the north (Group A) and the Dhofar region (Group B) in the south. Specimens from each group were collected, the testes removed, fixed in Karnovsky solution, post fixed in OsO, en bloc stained with uranyl acetate and then routinely processed to Agar 100 resin, semi and ultrathin sections were prepared for study.

Comparison of one-year prognosis of patients classified as chronic critical lower limb ischaemia according to TASC II or European consensus definition in the COPART cohort

VASA ◽  
2015 ◽  
Vol 44 (3) ◽  
pp. 0220-0228 ◽  
Author(s):  
Marion Vircoulon ◽  
Carine Boulon ◽  
Ileana Desormais ◽  
Philippe Lacroix ◽  
Victor Aboyans ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Medical Group ◽  
Consensus Definition ◽  
Transcutaneous Oxygen ◽  
European Consensus ◽  
Group A ◽  
One Year ◽  
Group B

Background: We compared one-year amputation and survival rates in patients fulfilling 1991 European consensus critical limb ischaemia (CLI) definition to those clas, sified as CLI by TASC II but not European consensus (EC) definition. Patients and methods: Patients were selected from the COPART cohort of hospitalized patients with peripheral occlusive arterial disease suffering from lower extremity rest pain or ulcer and who completed one-year follow-up. Ankle and toe systolic pressures and transcutaneous oxygen pressure were measured. The patients were classified into two groups: those who could benefit from revascularization and those who could not (medical group). Within these groups, patients were separated into those who had CLI according to the European consensus definition (EC + TASC II: group A if revascularization, group C if medical treatment) and those who had no CLI by the European definition but who had CLI according to the TASC II definition (TASC: group B if revascularization and D if medical treatment). Results: 471 patients were included in the study (236 in the surgical group, 235 in the medical group). There was no difference according to the CLI definition for survival or cardiovascular event-free survival. However, major amputations were more frequent in group A than in group B (25 vs 12 %, p = 0.046) and in group C than in group D (38 vs 20 %, p = 0.004). Conclusions: Major amputation is twice as frequent in patients with CLI according to the historical European consensus definition than in those classified to the TASC II definition but not the EC. Caution is required when comparing results of recent series to historical controls. The TASC II definition of CLI is too wide to compare patients from clinical trials so we suggest separating these patients into two different stages: permanent (TASC II but not EC definition) and critical ischaemia (TASC II and EC definition).

Absorbable suture material in carotid surgery

VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  
Keyword(s):  
Suture Material ◽  
Absorbable Suture ◽  
Paediatric Surgery ◽  
Carotid Surgery ◽  
Suture Materials ◽  
Absorbable Suture Material ◽  
Absorbable Sutures ◽  
Group A ◽  
Group B

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.

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