First-use Reactions: A Potential Hazard for Referral Centers

1989 ◽  
Vol 12 (11) ◽  
pp. 688-691 ◽  
Author(s):  
R.J. Caruana
Keyword(s):  
Renal Failure ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Potential Hazard ◽  
End Stage Renal Failure ◽  
Increased Risk ◽  
Dialysis Facility ◽  
Clinical Signs And Symptoms ◽  
End Stage

First-use reactions comprise a spectrum of adverse clinical signs and symptoms occurring in end-stage renal failure patients during hemodialysis treatments. This report describes four patients experiencing first-use reactions in the context of being referred to or from a tertiary care inpatient dialysis facility. Theories on the pathogenesis of first-use reactions are reviewed and recommendations for identifying patients at increased risk for this problem are proposed.

scholarly journals Clinico-epidemiological features of Japanese encephalitis patients hospitalized in a tertiary care center

2018 ◽  
Vol 5 (10) ◽  
pp. 4548
Author(s):  
Abu Hasan Sarkar ◽  
Bishnu Ram Das
Keyword(s):  
Japanese Encephalitis ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Complete Recovery ◽  
High Morbidity ◽  
Medical College ◽  
Clinical Signs And Symptoms ◽  
One Year

Background: Japanese encephalitis (JE) is of particular interest as it has a high morbidity and mortality. Neurological sequale is the most dreaded damage caused by JE. It is a preventable disease with specific interventions. The objective of the study was to study the demography, clinical profile and outcome of patients with Japanese Encephalitis admitted to the wards of Internal Medicine and Pediatrics at Jorhat Medical College Hospital.Methods: Hospital based observational study for one year in Jorhat Medical College, Jorhat, Assam.Results: The mean age for JE was 32.25±27 years for male, 27.47±22 years for female and 29.94±24 years overall. Assessment of clinical signs and symptoms showed that fever and change in mental status were present in 100% of JE cases followed by neck rigidity in 79.3% and headache in 68.9%. 44.8% of JE cases had history of seizure, 37.9% had vomiting, 34.5% had irritability, 13.8% were unconscious. The peak of JE incidence occurred in the month of July (77.6%). Complete recovery was seen in 39.2%, followed by death in 32.6% and recovery with neurological sequalae in 28.2% at the time of discharge.Conclusions: Vigorous awareness activities should be carried out to sensitize people on prevention of JE. 

scholarly journals COVID-19 versus Seasonal Influenza: Comparison of Profiles of Older Adults Hospitalized in a Short-Term Geriatric Ward in France

2021 ◽  
Author(s):  
Lidvine Godaert ◽  
Agnès Cebille ◽  
Emeline Proye ◽  
Moustapha Dramé
Keyword(s):  
Older Adults ◽  
Renal Failure ◽  
Seasonal Influenza ◽  
Influenza Infection ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Short Stay ◽  
Intergroup Comparison ◽  
Clinical Signs And Symptoms ◽  
Collective Housing

The objective was to compare the profile and outcomes of older adults admitted to a geriatric short-stay unit for COVID-19, to those of older adults admitted to the same unit for seasonal influenza infection. This was an observational study performed in a General Hospital in France. Patients ≥ 70 years admitted to a geriatric short-stay unit for COVID-19 between March 18 and November 15, 2020 were included. They were compared with patients of the same age group, admitted to the same geriatric short-stay unit for seasonal influenza infection over the periods January to March 2019 and January to March 2020. Data collection included demographic information, medical history, clinical signs and symptoms, outcomes, and hospital discharge patterns. Descriptive and intergroup comparison analyses were performed. In total, 153 patients were included in the study, 82 in the seasonal influenza group, and 71 in the COVID-19 group. The average age was 87.6 ± 4.8 and 87.6 ± 6.5 years in the COVID-19 and seasonal influenza groups, respectively. There was no difference between groups regarding the Charlson comorbidity index (3.4 ± 3.0 versus 3.4 ± 2.8). The seasonal influenza group more often had fever, cough, sputum, and renal failure, whereas the COVID-19 group more often experienced diarrhea, and death. The COVID-19 group was frequently living in collective housing. The profile at admission of older adults hospitalized for COVID-19 or seasonal influenza infection was similar. Although fever and respiratory signs were less common in the COVID-19 group, these patients experienced more complications (such as renal failure or oxygen therapy requirement) and higher mortality.

scholarly journals COVID-19 in End-stage Renal Disease (ESRD) Patients Undergoing Hemodialysis: A Close Follow-up of Clinical Findings and Evolutions in Chest CT Imaging: A Retrospective Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Hamid Tayebi khosroshahi ◽  
Armin Zarrintan ◽  
Hesam Manaflouyan ◽  
Dara Rahmanpour ◽  
Ebrahim Farashi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
End Stage Renal Disease ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Chest Ct ◽  
Clinical Signs And Symptoms ◽  
Stage Renal Disease ◽  
End Stage ◽  
Imaging Signs ◽  
Esrd Patients

Background: Coronavirus disease 2019 (COVID-19) has infected millions and caused tens of thousands of casualties. Epidemiologic studies show that specific individuals with pre-existing conditions are prone to severe disease caused by the virus. Thus, it is necessary to determine clinical signs and symptoms and disease progression course in various pre-existing conditions, namely end-stage renal disease (ESRD) patients undergoing hemodialysis. Methods: The present retrospective study was conducted on 17 ESRD patients undergoing chronic hemodialysis. Clinical signs and symptoms were extracted, and laboratory test results and imaging findings were retrieved using the health information systems of the institute where the study was performed. Results: Of 17 patients in the study, six patients were females, and 11 were males. The mean age of the patients was 62.29 ± 15.6 years (22 - 82). The most common pre-existing conditions were hypertension and diabetes. The most common imaging signs were ground-glass opacities. The most common pattern of involvement was peripheral, bilateral, and multifocal involvement, and interestingly, uncommon imaging signs such as crazy-paving, peribronchovascular involvement, and reticulonodular pattern of involvement. The most common laboratory findings were lymphopenia, lymphocytosis, increased erythrocyte sedimentation rate, and positive C reactive protein. Conclusions: ESRD patients undergoing COVID-19 seem to have higher mortalities than the general public and show more significant lung involvement on chest CT imaging. Furthermore, uncommon imaging signs are more common in this group of patients.

Predicted burden of venous disease

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 74-79 ◽  
Author(s):  
Sarah Onida ◽  
Alun Huw Davies
Keyword(s):  
Varicose Veins ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Venous Ulceration ◽  
Increased Risk ◽  
Future Burden ◽  
Clinical Signs And Symptoms

Chronic venous disease is a common condition with clinical signs and symptoms ranging from spider veins, to varicose veins, to active venous ulceration. Both superficial and deep venous dysfunction may be implicated in the development of this disease. Socio-economic factors are shaping our population, with increasing age and body mass index resulting in significant pressure on healthcare systems worldwide. These risk factors also lead to an increased risk of developing superficial and/or deep venous insufficiency, increasing disease prevalence and morbidity. In this chapter, the authors review the current and future burden of chronic venous disease from an epidemiological, quality of life and economic perspective.

scholarly journals Serum thyroglobulin is associated with orbitopathy in Graves’ disease

2021 ◽  
Author(s):  
S. Khamisi ◽  
M. Lundqvist ◽  
P. Emadi ◽  
K. Almby ◽  
Ö. Ljunggren ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Signs And Symptoms ◽  
Drug Regimen ◽  
Tsh Receptor ◽  
Thyroid Peroxidase ◽  
Graves Disease ◽  
Serum Thyroglobulin ◽  
Increased Risk ◽  
Eye Symptoms ◽  
Clinical Signs And Symptoms

Abstract Purpose Serum thyroglobulin levels are often elevated in Graves’ disease (GD) and in most cases decrease during treatment. Its relation to Graves’ orbitopathy (GO) has not been clarified. Previously, a risk of GO has been linked to smoking, TSH receptor stimulation, high TSH-receptor antibodies (TRAb), low thyroid peroxidase and thyroglobulin antibodies (TPOAb, TgAb). Methods We examined Tg levels in 30 consecutive patients with GD were given drug therapy (methimazole + thyroxine) for up to 24 months. GO was identified by clinical signs and symptoms. 17 patients had GO, 11 of whom had it at diagnosis while 6 developed GO during treatment. During the study, 5 subjects were referred to radioiodine treatment, 3 to surgery. The remaining 22 subjects (GO n = 12, non-GO n = 10) completed the drug regimen. Results At diagnosis, Tg levels in GO patients (n = 11) were higher (84, 30–555 µg/L, median, range) than in non-GO patients (n = 19) (38, 3.5–287 µg/L), p = 0.042. Adding the 6 subjects who developed eye symptoms during treatment to the GO group (n = 17), yielded p = 0.001 vs. non-GO (n = 13). TRAb tended to be higher, while TPOAb and TgAb tended to be lower in the GO group. For the 22 patients who completed the drug regimen, Tg levels were higher in GO (n = 12) vs. non-GO (n = 10), p = 0.004, whereas TRAb levels did not differ. Conclusion The data may suggest that evaluation of thyroglobulin levels in GD could contribute to identify patients at increased risk of developing GO. Possibly, thyroidal release of Tg in GD reflects a disturbance that also impacts retroorbital tissues.

scholarly journals Emerging hazard for women of new era: ovarian malignancy.

2021 ◽  
Vol 28 (09) ◽  
pp. 1229-1233
Author(s):  
Khadija Saleem ◽  
Tabinda Roheen ◽  
Faiza Wattoo ◽  
Sadia Ijaz ◽  
Farhan Javed ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Benign Tumors ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Study Results ◽  
Clinical Signs And Symptoms ◽  
Mucinous Cystadenomas

Objective: The present study aims to assess the incidence of ovarian malignancies and its rise from 2010 to 2020 at subnational levels in tertiary care hospital in Faisalabad. Study Design: Retrospective Analysis. Setting: Madina Teaching Hospital, Faisalabad. Period: January 2010 and January 2020. Material & Methods: After the precise processing of data extracted from the Pakistan Cancer Registry and hospital records, annual standardized incidence and increasing trends were calculated during the period of the study. Results: A total of 103 patients of ovarian tumors were included in the study. During this period 550 oophorectomies were received out of 4752 (11.5%) gynecological admissions. 103 cases(18.73%) selected after formulating an inclusion criteria. The data showed 75 benign (74.25%) cases, 7 borderline tumors (6.93%) and 21 malignant tumors (20.79%). Age of patients ranged from 14-69 years. Out of all the benign tumors, serous cystadenomas were most common (45.33%) followed by mucinous cystadenomas (24%), dermoid cyst (30.66%). Commonest malignant tumor was serous cystadenocarcinoma (42.85%) followed by mucinous cystadenocarcinoma (33.33%) granulosa cell tumors (14.28%) krukenberg tumor (4.76%) and dysgerminoma (4.76%). Clinical signs and symptoms were mostly abdominal pain and distention. Conclusion: Ovarian malignancies are increasing in frequency at an early age with relatively longer duration of symptoms. This emphasizes the need of early detection and management because of desirability of maintaining patient’s menstrual and reproductive capabilities.

scholarly journals Clinical and biomarker profile of COVID-19 patients admitted in a tertiary care hospital

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 268-273
Author(s):  
Archana Bhat ◽  
Don Gregory Mascarenhas ◽  
J Manjunath ◽  
Anand Kumar R ◽  
Sucharitha Suresh ◽  
...  
Keyword(s):  
Disease Severity ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Care Hospital ◽  
Male Predominance ◽  
Co Morbidity ◽  
Clinical Signs And Symptoms ◽  
D Dimer

Introduction and Aim:A novel beta-coronavirus emerged in Wuhan, China during the early December 2019 and spread globally. The clinical signs and symptoms and the disease severity in people infected with COVID-19 can be varied. The present study was conducted to study the biomarker profile and their association with disease severity in COVID-19.   Materials and Methods:This was a single-centre Cohort study of data regarding epidemiological, clinical and biomarker parameters, and outcome of COVID-19 patients admitted in a tertiary care hospital in South India. CDC guidelines were followed for assessing disease severity.   Results:A total of 336 COVID-19 patients were admitted during the study period. Of these 16 were excluded and 320 cases were analysed. Mean age of patients was 44.82 years. A male predominance was observed. Diabetes mellitus was the most common co-morbidity. Asymptomatic, Mild, moderate, severe and critical disease was seen in 15%, 52.5%, 20.3%, 6.3% and 5.9% patients respectively. ICU care was required in 15.3%. Overall mortality was 5.3%. The mean NLR, ALC, CRP, LCR, LDH, Ferritin and D-dimer in the severe group vs non-severe groupwere19.03 vs 4.2, 1025cells/cumm vs 1740cells/cumm, 185.8mg/L vs 31.7mg/L, 17.1 vs 996.3, 552.8IU/L vs 252.7IU/L, 2531.9ng/ml vs 414.1ng/ml and 2245.5ng/ml vs 339.4ng/ml respectively.   Conclusion:An increased NLR, CRP, LDH, Ferritin and D-dimer and a reduced ALC and LCR are significantly associated with disease severity, need for ICU and mortality. These biomarkers will be useful adjunct to clinical assessment in better categorising and management of COVID-19 patients.

Nephrotic syndrome

2020 ◽  
Vol 13 (3) ◽  
pp. 159-163
Author(s):  
Thuvaraka Ware
Keyword(s):  
Primary Care ◽  
Renal Failure ◽  
Renal Function ◽  
Nephrotic Syndrome ◽  
Diagnostic Process ◽  
Risk Of Infection ◽  
Rare Presentation ◽  
End Stage Renal Failure ◽  
Increased Risk ◽  
End Stage

Nephrotic syndrome is characterised by proteinuria, hypoalbuminaemia and oedema. The renal function is often normal and symptoms may mimic other common pathologies presenting in the community. The underlying aetiology is more heterogenous in adults compared with children, further confounding the diagnostic process and leading to delays in recognition. It is a relatively rare presentation in primary care, but the consequences of nephrotic syndrome can be significant. Complications include hyperlipidaemia, hypercoaguability, increased risk of infection and end-stage renal failure. It is, therefore, important to diagnose, investigate and manage nephrotic syndrome appropriately.

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