scholarly journals Correct identification of incomplete Kawasaki disease

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110017
Author(s):  
Tianhua Li ◽  
Jie Feng ◽  
Na Li ◽  
Tingting Liu
Keyword(s):  
Kawasaki Disease ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Age Of Onset ◽  
Correct Diagnosis ◽  
Correct Identification ◽  
Incomplete Kawasaki Disease ◽  
Younger Age ◽  
Artery Disease ◽  
Timely Treatment

Incomplete Kawasaki disease (IKD) is characterized by a longer fever time, younger age of onset, and higher incidence of coronary artery disease compared with complete Kawasaki disease. Kawasaki disease is often difficult to diagnose early because of its incomplete clinical symptoms. This issue could delay treatment and harm the health of the child. This article reviews the clinical characteristics and pathogenesis of IKD to help clinicians understand the symptoms of IKD, make the correct diagnosis, and provide timely treatment.

The Maudsley bipolar disorder project Clinical characteristics of bipolar disorder I in a Catchment area treatment sample

2003 ◽  
Vol 18 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Vanessa Raymont ◽  
David Bettany ◽  
Sophia Frangou
Keyword(s):  
Bipolar Disorder ◽  
Substance Abuse ◽  
Catchment Area ◽  
Clinical Characteristics ◽  
Age Of Onset ◽  
Psychiatric Service ◽  
Male Gender ◽  
Younger Age ◽  
Male Patients ◽  
Psychotic Features

AbstractThe clinical characteristics of bipolar I disorder (BD1) have prognostic and therapeutic importance. The aim of this study was to examine the effect of demographic and clinical variables on the course of BD1. We reviewed the case notes of all BD1 patients (n = 63) receiving treatment in a London psychiatric service during a 1-month period. Depressive and manic onsets were equally likely without any gender difference. The earlier the age of onset, the more likely it was for patients to experience psychotic features. Only depressive onsets predicted a higher number of episodes of the same polarity. Male gender and substance abuse were associated with younger age at first presentation, while women with co-morbid substance abuse had more manic episodes. Male patients were more likely than females to be unemployed or single.

Clinicopathological Features and Outcomes of T- and NK-Cell Lymphomas in European Russia

2012 ◽  
Vol 5 ◽  
pp. CMBD.S7804
Author(s):  
Yulia E. Vinogradova ◽  
Irina B. Kaplanskaya ◽  
Rimma S. Samoilova ◽  
Ivan A. Vorobiev ◽  
Boris V. Zingerman ◽  
...  
Keyword(s):  
Nk Cell ◽  
Age Of Onset ◽  
Correct Diagnosis ◽  
World Health ◽  
Lymphoid Tissues ◽  
Treatment Regimens ◽  
Younger Age ◽  
Classification Of Tumors ◽  
Health Organization ◽  
T Cell Malignancies

With the introduction of the revised World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues in 2001, many patients had to be re-evaluated for the correct diagnosis of T- and NK-cell lymphomas. Because some T-cell malignancies are associated with poor outcome, it is important to identify subsets of patients that may benefit from novel or more intensive therapies. The purpose of this study was to determine, for the first time, the relative frequencies, pathological features and outcomes of patients with T- and NK-cell lymphomas in a predominantly Russian Slavic population. We identified 291 patients with a diagnosis of T- and NK-cell malignancies treated at our Center between 2000-2008. In applying the revised WHO classification, we confirmed the diagnosis and had complete clinical follow up and pathological information on 264 cases that were included in the analysis. We found some differences in frequency of several subsets as compared with previously published reports, including younger age of onset and relatively higher incidence of T-LGL in our patients. We also confirm that intensive treatment regimens of advanced stage PTCL and ALK—ALCL led to considerable improvement in response rates, but not in the overall survival.

scholarly journals P358 Prevalence of suicide in a cohort of subjects submitted to exercise echocardiography: clinical characteristics and exercise echocardiography results

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
J C Peteiro Vazquez ◽  
A Bouzas-Mosquera ◽  
A Varela-Cancelo ◽  
C Barbeiro-Caamano ◽  
J Broullon ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Suspected Coronary Artery Disease ◽  
P Value ◽  
Exercise Echocardiography ◽  
Double Product ◽  
Wall Motion Abnormalities ◽  
Artery Disease ◽  
Commit Suicide

Abstract Patients with clinical symptoms and morbidities might be more prone to commit suicide. Suicidal rate reaches up to 25-30/100.000 subjects in the countries most affected by this problem. We aimed to establish the rate of suicides among a large cohort of patients submitted to Exercise echocardiography (ExE), and also to study their clinical and ExE results, to better understand possible explanations. Methods Retrospective analysis of prospectively collected data on 12,615 patients (age 62 ± 12 years, 63% men) with a first treadmill ExE performed in our center for known/suspected coronary artery disease. Exclusion criteria were significant valve disease, cardiomyopathy, congenital heart disease, and age <18 year-old. Ischemia was defined as the development of new wall motion abnormalities (WMAs) with exercise; abnormal ExE as ischemia or resting WMAs. Results During a follow-up of 4.7± 4.8 years (interquartil range 0.1-8.0 years) there were 2,578 deaths, including 21 due to suicide (rate 166/100.000 subjects). We compare clinical characteristics and ExE results between patients that committed suicide (S), patients that died of other causes (OC), and patients that survived (Surv). The worst clinical and ExE characteristics were found in patients that died of non-suicidal causes, whereas patients that committed suicide were in an intermediate risk position (Table). In conclusion, suicidal rate seems to be very high among patients with a clinically indicated ExE. Clinical characteristics and ExE results of suicidal subjects are worse than in survivor patients and could in part explain this event. Surv S OC P value Age, y 61 ± 12 65 ± 11 69 ± 9 <0.001 Male 60% 86% 72% <0.001 Diabetes Mellitus 17.5% 24% 31% <0.001 Achieved METS 9.7 ± 3.2 8.3 ± 3.6 7.6 ± 2.9 <0.001 Good functional capacity (≥10 METs) 55% 52% 29% <0.001 Symptoms during ExE 16% 14% 19% 0.01 Maximal double product 25.0 ± 5.9 22.5 ± 6.4 22.9 ± 6.0 <0.001 Submaximal test 20% 31% 32% <0.001 Ischemia 27% 38% 44% <0.001 ExE abnormal 37% 50% 63% <0.001 LVEF at rest 59 ± 7 53 ± 13 54 ± 11 <0.001 LVEF at peak 64 ± 11 60 ± 16 55 ± 15 <0.001

scholarly journals Kawasaki-like syndrome in children from Greater Poland during the first wave of COVID-19 pandemic

2020 ◽  
Vol 16 (4) ◽  
pp. 396-403
Author(s):  
Katarzyna Mazur-Melewska ◽  
◽  
Anna Mania ◽  
Paweł Małecki ◽  
Iwona Klimecka ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Systemic Vasculitis ◽  
Developed Countries ◽  
Kawasaki Syndrome ◽  
Incomplete Kawasaki Disease ◽  
Viral Aetiology ◽  
History Of ◽  
The Mean ◽  
Artery Disease ◽  
Inflammatory Syndrome

Kawasaki disease is an acute disease caused by systemic vasculitis, which predominantly affects children younger than 5 years of age. It is the leading cause of acquired coronary artery disease in childhood in developed countries. Currently, in the era of COVID-19, an increased number of cases, most likely related to SARS-CoV-2, are being observed. Our study aimed to describe the incidence and course of Kawasaki-like syndrome in patients admitted to the Polish department of infectious diseases during the first wave of COVID-19 pandemic. We identified 6 children with Kawasaki disease within almost 6 weeks of the pandemic. Medical history of 3 children showed contact with a person suspected of SARS-CoV-2 infection. One patient had confirmed SARS-CoV-2 serology (a female patient who lived in the epidemic centre). We did not confirm any bacterial or viral aetiology in 3 patients. Conclusions: Based on the conducted analysis comparing the number of cases during the “spring wave” of SARS-CoV-2 pandemic compared to previous years, an increased incidence of Kawasaki syndrome among children from the Greater Poland was found, similar to that reported by doctors from various European countries. The mean age of patients with Kawasaki disease was higher than previously reported. Analysis of clinical forms in our patients showed the entire spectrum from incomplete Kawasaki disease to full blown Kawasaki disease shock syndrome and multisystem inflammatory syndrome in children. The risk assessment of immunoglobulin resistance using the Kobayashi and Egami scores had no predictive value in patients with Kawasaki disease during the COVID-19 period.

scholarly journals Clinical Characteristics and Diagnostic Challenges of COVID−19: An Update From the Global Perspective

2021 ◽  
Vol 8 ◽  
Author(s):  
S. M. Hasan Israfil ◽  
Md. Moklesur Rahman Sarker ◽  
Parisa Tamannur Rashid ◽  
Ali Azam Talukder ◽  
Khandkar Ali Kawsar ◽  
...  
Keyword(s):  
Ct Scan ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Correct Diagnosis ◽  
Case Fatality ◽  
Clinical Information ◽  
Ground Glass Opacity ◽  
Global Perspective ◽  
Global Features ◽  
Laboratory Findings

Clinical characteristics are essential for the correct diagnosis of diseases. The current review aimed to summarize the global clinical characteristics of the COVID-19 patients systematically and identify their diagnostic challenges to help the medical practitioners properly diagnose and for better management of COVID-19 patients. We conducted a systematic search in PubMed, Web of Science, Scopus, Science Direct, and Google Scholar databases for original articles containing clinical information of COVID-19 published up to 7th May 2020. Two researchers independently searched the databases to extract eligible articles. A total of 34 studies from 8 different countries with 10889 case-patients were included for clinical characteristics. The most common clinical symptoms were cough 59.6, fever 46.9, fatigue 27.8, and dyspnea 20.23%. The prominent laboratory findings were lymphocytopenia 55.9, elevated levels of CRP 61.9, aspartate aminotransferase 53.3, LDH 40.8, ESR 72.99, serum ferritin 63, IL-6 52, and prothrombin time 35.47%, and decreased levels of platelets 17.26, eosinophils 59.0, hemoglobin 29, and albumin 38.4%. CT scan of the chest showed an abnormality in 93.50% cases with bilateral lungs 71.1%, ground-glass opacity 48%, lesion in lungs 78.3%, and enlargement of lymph node 50.7%. Common comorbidities were hypertension, diabetes, obesity, and cardiovascular diseases. The estimated median incubation period was 5.36 days, and the overall case fatality rate was 16.9% (Global case fatality outside China was 22.24%: USA 21.24%, Italy 25.61%, and others 0%; whereas the case fatality inside the Hubei Province of China was found to be 11.71%). Global features on the clinical characteristics of COVID-19 obtained from laboratory tests and CT scan results will provide useful information to the physicians to diagnose the disease and for better management of the patients as well as to address the diagnostic challenges to control the infection.

scholarly journals The MEFV gene pathogenic variants and phenotype-genotype correlation in children with familial Mediterranean fever in the Çanakkale population

2016 ◽  
Vol 19 (2) ◽  
pp. 23-28 ◽  
Author(s):  
F Battal ◽  
F Silan ◽  
N Topaloğlu ◽  
H Aylanç ◽  
Ş Yıldırım ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Familial Mediterranean Fever ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Correct Diagnosis ◽  
Mefv Gene ◽  
Pathogenic Variants ◽  
Spin Column ◽  
Mediterranean Fever ◽  
Genotype Correlation

AbstractThe aim of the current study was to determine the frequency of the Mediterranean fever (MEFV) gene pathogenic variants in 60 children diagnosed with familial Mediterranean fever (FMF) and to compare the phenotype-genotype correlation. Genomic DNA was isolated by the spin-column method from peripheral blood samples (collected in vacutainers containing EDTA) and buccal smears. TheMEFVgene profiles for the current FMF cohort were genotyped by pyrosequencing and direct Sanger sequencing techniques for the target pathogenic variants. The most prominent clinical symptoms were abdominal pain (53.4%), fever (23.4%) and arthritis (23.3%). Eighteen different pathogenic variants were identified and the most frequent were p.Met694Val (20.0%), p.Glu148Gln (13.3%), p.Met680 Ile (11.7%) and p.Arg202Gln (11.7%). Abdominal pain, fever and arthritis were the most common presenting clinical characteristics. Results showed that not only clinical characteristics, but also genotyping of theMEFVgene is needed to establish the correct diagnosis of FMF in children and other family members.

scholarly journals Diagnosis and management of Kawasaki disease

2020 ◽  
Vol 63 (7) ◽  
pp. 374-381
Author(s):  
Da Eun Roh ◽  
Jung Eun Kwon ◽  
Yeo Hyang Kim
Keyword(s):  
Kawasaki Disease ◽  
Coronary Artery Aneurysm ◽  
Clinical Symptoms ◽  
Delayed Diagnosis ◽  
Artery Aneurysm ◽  
Accurate Information ◽  
Mucocutaneous Lymph Node Syndrome ◽  
Incomplete Kawasaki Disease ◽  
Recent Trends ◽  
Lymph Node Syndrome

Kawasaki disease, also known as mucocutaneous lymph node syndrome, is a common form of vasculitis in childhood. Among the recent trends in Kawasaki disease, it is notable that the prevalence rate is increasing, and the proportion of “incomplete” Kawasaki disease is also increasing. A delayed diagnosis with prolonged fever can cause complications, such as coronary artery aneurysm and decreased myocardial contractility. These complications might lead to significant morbidity and mortality. Kawasaki disease is diagnosed when the patient meets the principal criteria for clinical symptoms. Following the diagnostic criteria can prevent overdiagnosis but lead to missing of the incomplete form of the disease. Therefore, it is important to accurately understand Kawasaki disease. As the coronavirus disease 2019 (COVID-19) pandemic continues, concerns about a novel severe Kawasaki-like disease in children related to COVID-19 emerges. Indeed, there have been several reports of Kawasaki-like disease related to COVID-19 in children. Kawasaki disease is no longer rare and is often encountered at hospitals. This paper will provide useful and accurate information on Kawasaki disease.

scholarly journals Etiologies and Clinical Characteristics of Patients with Macular Hole: A 8-Years Single-Center Retrospective Study

2021 ◽  
Author(s):  
Huifang Yue ◽  
Chenyu Liu ◽  
Yunda Zhang ◽  
Lijuan Zhang ◽  
Zhao Gao ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Correlation Analysis ◽  
Macular Hole ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Age Of Onset ◽  
Related Factors ◽  
Multivariate Correlation ◽  
Younger Age ◽  
Multivariate Correlation Analysis

Abstract Background: To investigate the etiologies and clinical characteristics of full-thickness macular hole (FTMH) patients at Shanxi eye hospital of North China. Methods: Patients diagnosed with FTMH and treated with surgery from 2012 to 2020 were included, and the etiologies and clinical features of different types of MHs were analysed in the 8-years cross sectional retrospective study. Multivariate correlation analysis was used to predict the related factors affecting baseline vision.Results: A total of 752 cases (776 eyes) were analysed. The top three causes of MH were idiopathic (IMH, 64.4%), myopic (MMH, 21.1%) and traumatic (TMH, 3.7%). Among these three causes’ groups, there were significant differences in sex distribution, age, and baseline BCVA. Female was predominated in IMH and MMH, while it was the opposite in TMH. The age of onset in IMH was older than MMH and TMH. The baseline Logarithm of the Minimum Angle of Resolution (logMAR) best-corrected visual acuity (BCVA) in IMH (Z=8.9, p<0.001) and Others group (Z=4.0, p<0.001) were significantly better than in MMH. In IMH, female patients had younger age, shorter axial length, and poorer baseline BCVA than male, while in MMH there were no significant differences between sexes. Multivariate correlation analysis showed that the smaller hole diameter of IMH, MMH without retinal detachment and younger age in TMH, may resulted in better baseline BCVA. Conclusions: The most common etiologies in MH were idiopathic, myopic and traumatic, which contributed to the different clinical features. Female was more common in IMH and MMH, and patients with MMH were 6.5 years earlier than IMH in onset. Therefore earlier monitoring fundus for female and people with high myopia is helpful for early detection and timely treatment.

scholarly journals DIAGNOSTIC VALUE OF THE REACTION AT THE BACILLUS CALMETTE-GUÉRIN VACCINATION SITE IN KAWASAKI DISEASE

2021 ◽  
Vol 39 ◽  
Author(s):  
Lilian Martins Oliveira Diniz ◽  
Raquel Gomes Castanheira ◽  
Yala Gramigna Giampietro ◽  
Matheus Sewastjanow Silva ◽  
Flávia Duarte Nogueira ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Kawasaki Disease ◽  
Cervical Lymphadenopathy ◽  
Diagnostic Value ◽  
Case Description ◽  
Bacillus Calmette Guerin ◽  
Incomplete Kawasaki Disease ◽  
Vaccination Site ◽  
Artery Disease ◽  
Subsequent Onset

ABSTRACT Objective: To describe the case of an infant - diagnosed with incomplete Kawasaki disease - who developed BCG scar reactivation. Case description: A 6-month-old patient was admitted to hospital with fever associated with ocular hyperemia, cervical lymphadenopathy, and hyperemic lips, and remained hospitalized for 12 days. The physical examination revealed an inflammatory reaction at the site of the BCG scar, leading to the diagnosis of incomplete Kawasaki disease. The patient was treated with venous immunoglobulin, but presented recurrence of Kawasaki disease, with subsequent onset of coronary artery disease. Comments: BCG scar reactivation is an important finding in countries where the vaccine is routinely given and may be a useful marker for early diagnosis of Kawasaki disease, especially in its incomplete form.

Off-Pump Supraarterial Decompression Myotomy for Myocardial Bridging

2005 ◽  
Vol 8 (1) ◽  
pp. 49 ◽  
Author(s):  
Mersa M. Baryalei ◽  
Theodorus Tirilomis ◽  
Wolfgang Buhre ◽  
Stephan Kazmaier ◽  
Friedrich A. Schoendube ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Exercise Testing ◽  
Clinical Symptoms ◽  
Therapeutic Option ◽  
Median Sternotomy ◽  
Myocardial Bridging ◽  
Off Pump ◽  
Hemodynamic Compromise ◽  
Artery Disease ◽  
The Right

Background: Myocardial bridging of the left anterior descending (LAD) artery may result in clinical symptoms. Surgery with cardiopulmonary bypass (CPB) is a therapeutic option with considerable risk. We hypothesized that off-pump supraarterial myotomy could be an effective treatment modality. Methods: Between October 1998 and May 2000, 13 patients were referred for surgery. All were symptomatic despite medical therapy. Anteroseptal ischemia had been proven by thallium scintigraphy in all 13 patients, exercise testing was positive in 11. All patients were operated on with an off-pump approach after median sternotomy. Results: Mean patient age was 61 8 years (range, 43-71 years). Coronary artery disease mandating additional bypasses was present in 3 patients. The bypasses were done off pump in 2 patients. Conversion to on-pump surgery was necessary in 3 of 13 patients (23%) because of hemodynamic compromise (1 patient), opening of the right ventricle (1 patient), and injury to the LAD (1 patient). Supraarterial myotomy was performed in all patients. One patient who underwent surgery with CPB developed postoperative anteroseptal myocardial infarction. Postoperative exercise testing was performed in all patients and did not reveal any persistent ischemia. Mortality was 0%. All patients were free from symptoms and had not undergone repeat interventions after an average of 51 7 months of follow-up. Conclusions: Off-pump supraarterial myotomy effectively relieves coronary obstruction but has a certain periprocedural risk as evidenced by 1 myocardial infarction, 1 right ventricular injury, and 1 LAD injury. Long-term freedom from symptoms and from reintervention favor further investigation of this surgical therapy.

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