scholarly journals Spectrum of SARS-CoV-2-Related Clinical Syndromes in Children: A Year in the Life

2021 ◽  
pp. 000992282110646
Author(s):  
Mahjabeen Khan ◽  
LeQuan Dang ◽  
Harjinderpal Singh ◽  
Austin Dalrymple ◽  
Aaron Miller ◽  
...  
Keyword(s):  
Early Recognition ◽  
Clinical Syndrome ◽  
Respiratory Complications ◽  
Care Needs ◽  
Prompt Treatment ◽  
Symptom Profiles ◽  
Clinical Syndromes ◽  
Cardiovascular Involvement ◽  
Hospital Stays ◽  
Inflammatory Syndrome

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a wide pediatric clinical spectrum. Initial reports suggested that children had milder symptoms compared with adults; then diagnosis of multisystem inflammatory syndrome in children (MIS-C) emerged. We performed a retrospective cohort study of hospitalized patients at a children’s hospital over 1 year. Our objectives were to study the demographic and clinical profile of pediatric SARS-CoV-2-associated diagnoses. Based on the clinical syndrome, patients were classified into coronavirus disease 2019 (COVID-19; non-MIS-C) and MIS-C cohorts. Among those who tested positive, 67% were symptomatic. MIS-C was diagnosed in 24 patients. Both diagnoses were more frequent in Caucasians. Both cohorts had different symptom profiles. Inflammatory markers were several-fold higher in MIS-C patients. These patients had critical care needs and longer hospital stays. More COVID-19 patients had respiratory complications, while MIS-C cohort saw cardiovascular involvement. Health care awareness of both syndromes is important for early recognition, diagnosis, and prompt treatment.

scholarly journals Imaging Evaluation of Pulmonary and Non-Ischaemic Cardiovascular Manifestations of COVID-19

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1271
Author(s):  
Sebastiano Cicco ◽  
Antonio Vacca ◽  
Christel Cariddi ◽  
Rossella Carella ◽  
Gianluca Altamura ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Myocardial Injury ◽  
Nuclear Imaging ◽  
Emergency Setting ◽  
Imaging Evaluation ◽  
Coagulation Abnormalities ◽  
Cardiovascular Involvement ◽  
Highly Sensitive ◽  
Inflammatory Syndrome ◽  
Inflammatory Burden

Coronavirus Disease 2019 (COVID-19) has been a pandemic challenge for the last year. Cardiovascular disease is the most described comorbidity in COVID-19 patients, and it is related to the disease severity and progression. COVID-19 induces direct damage on cardiovascular system, leading to arrhythmias and myocarditis, and indirect damage due to endothelial dysfunction and systemic inflammation with a high inflammatory burden. Indirect damage leads to myocarditis, coagulation abnormalities and venous thromboembolism, Takotsubo cardiomyopathy, Kawasaki-like disease and multisystem inflammatory syndrome in children. Imaging can support the management, assessment and prognostic evaluation of these patients. Ultrasound is the most reliable and easy to use in emergency setting and in the ICU as a first approach. The focused approach is useful in management of these patients due its ability to obtain quick and focused results. This tool is useful to evaluate cardiovascular disease and its interplay with lungs. However, a detailed echocardiography evaluation is necessary in a complete assessment of cardiovascular involvement. Computerized tomography is highly sensitive, but it might not always be available. Cardiovascular magnetic resonance and nuclear imaging may be helpful to evaluate COVID-19-related myocardial injury, but further studies are needed. This review deals with different modalities of imaging evaluation in the management of cardiovascular non-ischaemic manifestations of COVID-19, comparing their use in emergency and in intensive care.

scholarly journals An Innovative Personalised Management Program for Older Adults with Parkinson’s Disease: New Concepts and Future Directions

2021 ◽  
Vol 11 (1) ◽  
pp. 43
Author(s):  
Piyush Varma ◽  
Lakshanaa Narayan ◽  
Jane Alty ◽  
Virginia Painter ◽  
Chandrasekhara Padmakumar
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Older Persons ◽  
Clinical Manifestations ◽  
Clinical Syndrome ◽  
Management Program ◽  
Older Person ◽  
Care Needs ◽  
Future Directions ◽  
New Concepts

Introduction: Parkinson’s disease is a heterogeneous clinical syndrome. Parkinson’s disease in older persons presents with a diverse array of clinical manifestations leading to unique care needs. This raises the need for the healthcare community to proactively address the care needs of older persons with Parkinson’s disease. Though it is tempting to categorise different phenotypes of Parkinson’s disease, a strong evidence based for the same is lacking. There is considerable literature describing the varying clinical manifestations in old age. This article aims to review the literature looking for strategies in personalising the management of an older person with Parkinson’s disease.

Recognition and management of neonatal sepsis

2021 ◽  
Vol 30 (7) ◽  
pp. 410-415
Author(s):  
Luke William Crocker ◽  
Ayesha White ◽  
Paul Anthony Heaton ◽  
Débora Pascoal Horta ◽  
Siba Prosad Paul
Keyword(s):  
Neonatal Sepsis ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Evidence Based ◽  
Suspected Sepsis ◽  
Serious Illness ◽  
Prompt Treatment ◽  
Serious Infection ◽  
Common Causes ◽  
Red Flag

Neonatal sepsis results from acute bacterial or viral infection occurring in the first 28 days of life. It causes significant morbidity and mortality, although the outcome can be improved by early recognition and prompt treatment by health professionals. This article describes the most common causes of sepsis, and explains why neonates are particularly vulnerable to infection. It highlights the non-specific way in which an infant with a serious infection may present, indicating the crucial features to elicit during history taking and examination, and emphasising the ‘red-flag’ signs and symptoms that should increase suspicion of a serious illness. The authors have adapted National Institute for Health and Care Excellence guidelines to produce an evidence-based approach to the management of an infant with suspected sepsis, and describe the roles of nurses in ensuring effective treatment and best outcomes for these babies.

Postpartum ovarian vein thrombosis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Kelly Ribeiro ◽  
Samir Mahboobani ◽  
Katherine Van Ree ◽  
Katy Clifford ◽  
TG Teoh
Keyword(s):  
Abdominal Pain ◽  
Complete Resolution ◽  
Early Recognition ◽  
Ovarian Vein ◽  
Transabdominal Ultrasound ◽  
Case Presentation ◽  
Vein Thrombosis ◽  
Prompt Treatment ◽  
Life Threatening ◽  
Ovarian Vein Thrombosis

Abstract Objectives Postpartum ovarian vein thrombosis (POVT) is a rare pathology that can lead to severe complications such as sepsis, extension of the thrombus leading to organ failure, and pulmonary embolism. It therefore requires early recognition and prompt treatment. Case presentation A patient with right POVT presented four days after delivery with acute right-sided abdominal pain and fever. Appendicitis was initially considered, before an abdominal-pelvic computed tomography raised the suspicion of POVT, subsequently confirmed through transabdominal ultrasound. Antibiotics and anticoagulation were initiated, with rapid clinical improvement and complete resolution of the thrombus three months later. Conclusions Diagnosing POVT is challenging as it clinically mimics other more frequent conditions. It is rare but life-threatening and should be considered in all females presenting with abdominal pain and fever in the postpartum period.

Changes in care in the fourth trimester in Ireland: 2010–2020

2021 ◽  
Vol 29 (12) ◽  
pp. 683-691
Author(s):  
Jean Doherty ◽  
Mary Brosnan ◽  
Lucille Sheehy
Keyword(s):  
Negative Impact ◽  
Maternity Hospital ◽  
Care Needs ◽  
High Quality ◽  
Midwifery Care ◽  
Hospital Stays ◽  
Current Context ◽  
Discharge From Hospital ◽  
The Impact

Background There has been a shift in maternity care over the past decade. The changes encountered by postnatal ward staff and the impact of these changes on women postnatally requires exploration. This study aimed to ascertain midwives' and healthcare assistants' perspectives of the changes in postnatal care and challenges to providing care in the current context. Methods This was a qualitative study involving two focus groups of 15 midwives and healthcare assistants from an Irish urban maternity hospital. The participants' responses were analysed thematically. Results Changes in women's clinical characteristics, including increased comorbidities and caesarean section rates, were highlighted as creating additional care needs. Furthermore, additional midwifery tasks and clinical protocols as well as shorter hospital stays leave little time for high-quality, woman-centred care. Participants highlighted a negative impact on maternal health from limited follow-up midwifery care in the community. Conclusions With additional midwifery duties and a reduction in time to complete them, additional community midwifery care is key to providing high-quality follow-on care after postnatal discharge from hospital.

Cranial arteritis: treatment is urgent

1984 ◽  
Vol 22 (3) ◽  
pp. 11-12
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Early Recognition ◽  
Prompt Treatment

Cranial (temporal or giant-cell) arteritis is a debilitating condition commonest in those aged over 70 years and therefore likely to become more widespread as this population increases. One serious manifestation is blindness which develops rapidly and is usually irreversible. This can be prevented by early recognition of the disease and prompt treatment with a corticosteroid.

Caecal volvulus: untwisting the mystery

2021 ◽  
Vol 14 (3) ◽  
pp. e237165
Author(s):  
Martha Sara Kedrzycki ◽  
Jaya Roy Choudhury ◽  
Sherif Hakky
Keyword(s):  
Differential Diagnosis ◽  
Small Bowel ◽  
Closed Loop ◽  
Early Recognition ◽  
Case Series ◽  
University Hospital ◽  
Single Centre ◽  
Bowel Ischaemia ◽  
Prompt Treatment ◽  
Mobile Cecum

Caecal volvulus is an infrequent cause of acute surgical abdomen, where an abnormally mobile cecum twists on its own axis. It can lead to the development of closed-loop obstruction, small bowel ischaemia and perforation. Early recognition and prompt treatment is key; however, due to the rarity of this pathology, it is seldom listed as a differential diagnosis. Here, we present a single-centre case series of two patients presenting with caecal volvulus to an Emergency Surgery Unit at a University Hospital.

scholarly journals Reexpansion pulmonary edema

2003 ◽  
Vol 29 (2) ◽  
pp. 101-106 ◽  
Author(s):  
Eduardo Henrique Genofre ◽  
Francisco S. Vargas ◽  
Lisete R. Teixeira ◽  
Marcelo Alexandre Costa Vaz ◽  
Evaldo Marchi
Keyword(s):  
Pulmonary Edema ◽  
Pulmonary Surfactant ◽  
Preventive Measures ◽  
Early Recognition ◽  
Patient Handling ◽  
Prompt Treatment ◽  
Treatment And Prevention ◽  
Inflammatory Status ◽  
Reexpansion Pulmonary Edema ◽  
Practical Recommendations

Reexpansion pulmonary edema (RPE) is a rare, but frequently lethal, clinical condition. The precise pathophysiologic abnormalities associated with this disorder are still unknown, though decreased pulmonary surfactant levels and a pro-inflammatory status are putative mechanisms. Early diagnosis is crucial, since prognosis depends on early recognition and prompt treatment. Considering the high mortality rates related to RPE, preventive measures are still the best available strategy for patient handling. This review provides a brief overview of the pathophysiology, diagnosis, treatment, and prevention of RPE, with practical recommendations for adequate intervention.

Immune Reconstitution Inflammatory Syndrome

2011 ◽  
Vol 23 (1) ◽  
pp. 90-96 ◽  
Author(s):  
A.R. Tappuni
Keyword(s):  
Antiretroviral Therapy ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
T Regulatory Cells ◽  
Clinical Presentation ◽  
Early Recognition ◽  
Clinical Intervention ◽  
Suppressor Cell ◽  
Life Threatening ◽  
Inflammatory Syndrome

Immune reconstitution inflammatory syndrome (IRIS) is a phenomenon observed in patients recovering from immunodeficiency. The clinical presentation of IRIS involves the unmasking of covert infections or the worsening of overt conditions. Several causes and pathways have been suggested, most recognizing an inflammatory flare component occurring in the context of rapid immune reconstitution. In HIV-infected patients, IRIS inadvertently occurs as the consequence of successful antiretroviral therapy, and it is affiliated with improvement of the immune function, complicating the course of the disease and presenting treatment challenges to clinicians. The pathogenesis of IRIS is poorly understood, but in recovering HIV patients, its initiation and progression seem to be primarily linked to an increase in CD4+ T-helper and CD8+ T-suppressor cell count and a reduction in T-regulatory cells, all endorsed by exaggerated cytokine release and activity. The clinical presentation of IRIS is usually atypical. The manifestations depend on the trigger antigen, which can be an infective agent (viable or nonviable), a host antigen, or a tumor antigen. Most IRIS cases are self-limiting, but a few cases can be overwhelming and life-threatening; hence, early recognition is important. In most cases, there is no need to discontinue the antiretroviral therapy, although in the more severe cases, other clinical intervention may be necessary.

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