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.

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 Changes in clinical patterns of Chinese patients with primary hyperparathyroidism in recent 12 years: a single-center experience

2021 ◽  
Author(s):  
Yuan Liu ◽  
Siyi Guo ◽  
Jinsong Wu ◽  
Rongai Wang ◽  
Jinbo Liu ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Chinese Patients ◽  
Female Ratio ◽  
Hydroxyvitamin D ◽  
Single Center Experience ◽  
Predominant Type ◽  
Group A ◽  
Group B

The clinical presentation of primary hyperparathyroidism (PHPT) differs between patients from developed and developing countries. In China, the clinical pattern has changed over the past few decades. Our aim was to elucidate general changes in the clinical characteristics of PHPT from 2010 to 2021. We enrolled 343 patients with PHPT at the Qilu Hospital of Shandong University, Jinan, China, from January 2010 to May 2021, including both surgical and non-surgical patients. Patients were divided into two subgroups, 2010–2016 (group A, n = 152) and 2017–2021 (group B, n = 191), based on the time span. We compared clinical manifestations and laboratory result data between these two groups. The mean patient age was 52.59 ± 13.55 years, and the male-to-female ratio was 1:2.54. Of the 343 patients, 183 (53.35%) had symptomatic PHPT; bone pain, urolithiasis, and fatigue were the most common symptoms. Postoperative pathology showed that 96.20% of the patients had parathyroid adenoma, whereas 2.41% had parathyroid carcinoma. Great changes occurred between 2010 and 2021; the percentage of patients with asymptomatic PHPT (aPHPT) increased from 36.18% in group A to 54.97% in group B. Moreover, patients in group B showed significantly lower serum calcium, alkaline phosphatase, parathyroid hormone, and urinary phosphate levels but higher serum 25-hydroxyvitamin D levels than those in group A. Clinical presentations in group B were also milder. In conclusion, the clinical characteristics of Chinese PHPT patients changed dramatically from 2010 to 2021, with asymptomatic PHPT (aPHPT) becoming the predominant type over the last 3 years.

Comparative Study Between Clean Intermittent Self-Catheterization (Cisc) and Continuous Indwelling Catheterization (Cidc) in Relieving Acute Refractory Retention of Urine Due to Benign Enlargement of Prostate (Bep)

2020 ◽  
Vol 21 (2) ◽  
pp. 105-110
Author(s):  
Md Shawkat Alam ◽  
Sudip Das Gupta ◽  
Hadi Zia Uddin Ahmed ◽  
Md Saruar Alam ◽  
Sharif Muhammod Wasimuddin
Keyword(s):  
Comparative Study ◽  
Acute Urinary Retention ◽  
Bladder Capacity ◽  
Inclusion Criteria ◽  
College Hospital ◽  
Medical College ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
Better Than

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110

RANDOMIZED COMPARATIVE STUDY OF ONDANSETRON AND COMBINATION OF ONDANSETRON AND DEXAMETHASONE, AS A PROPHYLAXIS OF POST-OPERATIVE NAUSEAAND VOMITING IN ADULTS UNDERGOING ELECTIVE LAPAROSCOPIC SURGERIES

2021 ◽  
pp. 48-49
Author(s):  
Rumani Ruku ◽  
Jasmeen Chowdhary
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Care ◽  
Demographic Variables ◽  
Nausea And Vomiting ◽  
Age Group ◽  
Patient Response ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
Post Operative Nausea

Background: Post-operative nausea and vomiting (PONV) is quite associated with laparoscopic surgery. In-spite of advances in surgery and post surgical care, nausea and vomiting still has a high incidence. This study was planned to explore the efcacy of a combination therapy of ondansetron with dexamethasone against PONVand compare the results with the efcacy of ondensetron-only. Method:Arandomized clinical trial study was conducted in the Department of Anesthesia, GMC Jammu, over a period of 6 months, on 50 patients in the age group of 18-50 years, of either gender, undergoing laparoscopic surgeries under general anesthesia. Patients were divided into two groups of 25 each: Group A received 4 mg of Ondansetron intravenously, while Group B received 4 mg of Ondansetron and 8 mg of Dexamethasone intravenously, soon after intubation. Results: The demographic variables of two groups were similar. While 19 (76%) patients showed post-operative nausea in Group A, while in Group B, only 8 (32%) patients experienced nausea, which was very signicant. Similarly, 11 (44%) patients showed post-operative vomiting in GroupAand only 2 (8%) complained of vomiting. 24% patients did not complain about any kind of nausea or vomiting in GroupA. Mild nausea was observedin60%patientsinGroupA,while amongonly32%patientsingroupB.Nocomplications of anykindwereobservedduringthisstudy. Conclusion: Ondensetron and dexamethasone, administered intravenously, after intubation, in laparoscopic surgery, is safe and has a better patient response in preventing post-operative nausea and vomiting.

scholarly journals Palmoplantar psoriasis: a comparative therapeutic study

2019 ◽  
Vol 5 (4) ◽  
pp. 779
Author(s):  
Sathya Narayanan Rajendran ◽  
Sukanya Mathupal Gurusamy
Keyword(s):  
Treatment Options ◽  
Clinical Manifestations ◽  
Simple Random Sampling ◽  
Inflammatory Dermatosis ◽  
Duration Of Illness ◽  
Erythrodermic Psoriasis ◽  
Life Threatening ◽  
Group A ◽  
Group B ◽  
Therapeutic Study

<p class="abstract"><strong>Background:</strong> Psoriasis is an immunologically mediated inflammatory dermatosis presenting with extremely variable clinical manifestations ranging from indolent lesions to life threatening forms of pustular and erythrodermic psoriasis. Palmoplantar psoriasis present as hyperkeratotic scaly plaques with fissures and can be managed with different treatment forms. This study was done to compare the efficacy between topical and systemic treatment options.</p><p class="abstract"><strong>Methods:</strong> The study was conducted in a tertiary level teaching hospital after ethical committee clearance. Fifty patients with palmoplantar psoriasis were allocated into the two groups using simple random sampling. PPPASI scoring was calculated to assess the extent of involvement. Patients in Group A were prescribed calcipotriol with clobetasol propionate ointment. Group B patients were given tablet methotrexate.<strong></strong></p><p class="abstract"><strong>Results:</strong> Twenty eight patients were males M: F of 1.27: 1. Mean age was 36. Mean duration of illness was eleven months. Most of these patients were manual laborers. 32 patients had lesions over both palms and soles, 9 over palms alone and 9 involving soles alone. Mean PASI reduction at 16 weeks was seen maximum with methotrexate. Compliance was comparatively good with methotrexate than topical. Though mean PASI reduction and compliance was good, relapse rates were higher with methotrexate in our study.</p><p class="abstract"><strong>Conclusions:</strong> There was no significant change in clinico-epidemiology and presentation of palmoplantar psoriasis. Methotrexate was observed to be the more efficacious modality in treating palmoplantar psoriasis.</p>

scholarly journals Genome-wide variations of SARS-CoV-2 infer evolution relationship and transmission route

2020 ◽  
Author(s):  
Lehai Zhang ◽  
Shifu Wang ◽  
Qian Ren ◽  
Junjie Yang ◽  
Yanqin Lu ◽  
...  
Keyword(s):  
Molecular Detection ◽  
Detection Efficiency ◽  
Evolutionary Relationship ◽  
Clinical Manifestations ◽  
Coding Region ◽  
Gene Coding ◽  
Genome Wide ◽  
Group A ◽  
Group B ◽  
Relationship Of

AbstractIn the epidemic evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the issues of mutation, origin, typing and the effect of mutation on molecular detection remain to be unrevealed. In order to identify the evolutionary relationship of SARS-CoV-2 and evaluate the detection efficiency of primers that are currently used in different countries, we retrieved genomic sequences of 373 SARS-CoV-2 strains from multiple databases and performed genome-wide variation analysis. According to the nucleotide C28144T variation, the SARS-CoV-2 can be divided into group A (117 strains) and group B (256 strains). The spike protein gene (S gene) coding region 1841 (total 23403) A1841G, formed a B1 subgroup (40 strains) in group B, of which 30 strains were from European and American countries in March (especially Washington, USA). These mutations are likely to be influenced by the environment or the immunization selection pressure of different populations. Although the mutation is not in the receptor binding region (RBD) and alkaline cleavage region, it may also affect the ability of transmission and pathogenicity; however, the significance is not yet clear. As the ratio of A / B strains in the epidemic months showed an increasing trend (0.35: 1 in January, 0.62: 1 in February and 0.76: 1 in March), it seems that the transmissibility of group A strains becomes stronger with time. Based on the variation of 11 nucleotide sites during the epidemic process, it is speculated that the Washington strain is more like an ancestor type, and the Wuhan strain is the offspring of the group A virus strain. By comparing the detection capabilities of primers in different countries, the SARS-CoV-2 nucleotide variation may only affect molecular detection of very few strains. The differences in the transmissibility, pathogenicity and clinical manifestations of different types of strains require further investigations.

scholarly journals Can We Do Away With PTBD?

HPB Surgery ◽  
1995 ◽  
Vol 9 (1) ◽  
pp. 5-11 ◽  
Author(s):  
R. D. Bapat ◽  
N. N. Rege ◽  
R. S. Koti ◽  
N. K. Desai ◽  
S. A. Dahanukar
Keyword(s):  
Percutaneous Transhepatic Biliary Drainage ◽  
Biliary Tree ◽  
Tinospora Cordifolia ◽  
Sepsis Group ◽  
High Incidence ◽  
Group A ◽  
Pmn Functions ◽  
Group B ◽  
Group D ◽  
Transhepatic Biliary Drainage

Percutaneous Transhepatic Biliary Drainage (PTBD) is performed in surgical jaundice to decompress the biliary tree and improve hepatic functions. However, the risk of sepsis is high in these patients due to immunosuppression and surgical outcome remains poor. This raises a question—can we do away with PTBD? To answer this query a study was carried out in 4 groups of patients bearing in mind the high incidence of sepsis and our earlier studies, which have demonstrated immunotherapeutic potential of Tinospora cordifolia (TC): (A) those undergoing surgery without PTBD (n = 14), (B) those undergoing surgery after PTBD (n = 13). The mortality was 57.14% in Group A as compared to 61.54% in Group B. Serial estimations of bilirubin levels carried out during the course of drainage (3 Wks) revealed a gradual and significant decrease from 12.52 ± 8.3 mg% to 5.85 ± 3.0 mg%. Antipyrine half-life did not change significantly (18.35 ± 4.2 hrs compared to basal values 21.96 ± 3.78 hrs). The phagocytic and intracellular killing (ICK) capacities of PMN remained suppressed (Basal: 22.13 ± 3.68% phago, and 19.1 ± 4.49% ICK; Post drainage: 20 ± 8.48% Phago and 11.15 ± 3.05% ICK). Thus PTBD did not improve the metabolic capacity ofthe liver and mortality was higher due to sepsis. Group (C) patientg received TC during PTBD (n = 16) and Group (D) patients received TC without PTBD (n = 14). A significant improvement in PMN functions occurred by 3 weeks in both groups (30.29 ± 4.68% phago, 30 ± 4.84% ICK in Group C and 30.4 ± 2.99% phago, 27.15 ± 6.19% ICK in Group D). The mortality in Groups C and D was 25% and 14.2% respectively during the preoperative period. There was no mortality after surgery. It appears from this study that host defenses as reflected by PMN functions play an important role in influencing prognosis. Further decompression of the biliary tree by PTBD seems unwarranted.

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 Age-related differences in clinical characteristics of invasive group G streptococcal infection: Comparison with group A and group B streptococcal infections

PLoS ONE ◽  
2019 ◽  
Vol 14 (3) ◽  
pp. e0211786 ◽  
Author(s):  
Yoshihiro Fujiya ◽  
Kayoko Hayakawa ◽  
Yoshiaki Gu ◽  
Kei Yamamoto ◽  
Momoko Mawatari ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Streptococcal Infection ◽  
Streptococcal Infections ◽  
Invasive Group ◽  
Age Related ◽  
Group A ◽  
Group B

scholarly journals Role of enteric pathogens in the aetiology of neonatal diarrhoea in lambs and goat kids in Spain

1996 ◽  
Vol 117 (1) ◽  
pp. 203-211 ◽  
Author(s):  
M. Muñoz ◽  
M. Álvarez ◽  
I. Lanza ◽  
P. Cármenes
Keyword(s):  
Escherichia Coli ◽  
Synergistic Effect ◽  
Cryptosporidium Parvum ◽  
Clinical Characteristics ◽  
Enteric Pathogens ◽  
E Coli ◽  
Neonatal Diarrhoea ◽  
Group A ◽  
Group B

SummaryFaeces samples from diarrhoeic and non-diarrhoeic lambs and goat kids aged 1–45 days were examined for enteric pathogens.Cryptosporidium parvumwas detected in both diarrhoeic lambs (45%) and goat kids (42%) but not in non-diarrhoeic animals. F5+(K99+) and/or F41+Escherichia colistrains were isolated from 26% and 22% of the diarrhoeic lambs and goat kids, respectively, although these strains, which did not produce enterotoxins ST I or LT I, were found with similar frequencies in non-diarrhoeic animals. A F5−F41−ST I+E. colistrain was isolated from a diarrhoeic lamb (0·6%). VerotoxigenicE. coliwas isolated from both diarrhoeic and non-diarrhoeic lambs (4·1% and 8·2%, respectively) and there was no association between infection and diarrhoea. The prevalence of group A rotavirus infection in diarrhoeic lambs was very low (2·1%). Groups A and B rotaviruses were detected in three (8·1%) and five (13·5%) diarrhoeic goat kids from two single outbreaks. Group C rotaviruses were detected in four non-diarrhoeic goat kids. An association of diarrhoea and infection was demonstrated only for group B rotavirus.Clostridium perfringenswas isolated from 10·8% of the diarrhoeic goat kids but not from non-diarrhoeic goat kids or lambs.Salmonella arizonaewas isolated from a diarrhoeic goat kid (2·7%) and the clinical characteristics of the outbreaks where these two latter enteropathogens were found different from the rest. Picobirnaviruses were detected in a diarrhoeic lamb. No coronaviruses were detected using a bovine coronavirus ELISA. No evidence was found of synergistic effect between the agents studied. Enteric pathogens were not found in four (8·7%) and three (20%) outbreaks of diarrhoea in lambs and goat kids, respectively.

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