Syncope

1992 ◽  
Vol 7 (3) ◽  
pp. 138-148 ◽  
Author(s):  
Kevin H. Silver ◽  
Joseph S. Alpert
Keyword(s):  
Intensive Care ◽  
Surgical Treatment ◽  
Physical Examination ◽  
Intensive Care Units ◽  
Diagnostic Tests ◽  
Venous Return ◽  
Clinical Presentation ◽  
Diagnostic Tools ◽  
Peripheral Vascular ◽  
Conduction Disturbances

Syncope is a common admitting diagnosis to intensive care units; however, in half the cases, the etiology goes undiagnosed. The prognosis is adversely affected in patients with a cardiogenic etiology. We discuss the clinical presentation and pathophysiology of cardiovascular causes of syncope (including arrhythmia and conduction disturbances, myocardial disorders, and valvular disorders), vascular causes (obstruction and decreased venous return), peripheral vascular causes (arterial and venous), and noncardiovascular causes (neurological and hematological). A thorough history and physical examination are the best diagnostic tools. In addition, electrocardiograms and 24-hour telemetry monitoring are also useful. Other diagnostic tests should be ordered judiciously, depending on the findings of the initial evaluation. Medical or surgical treatment is directed at the underlying cause.

scholarly journals Primary hyperparathyroidism: epidemiology, clinical features, diagnostic tools and current management

2015 ◽  
Vol 9 (4) ◽  
pp. 330
Author(s):  
Andrea Percivale ◽  
Paola Gnerre ◽  
Giulio Damonte ◽  
Sandra Buscaglia ◽  
Mario Monachesi ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Surgical Treatment ◽  
Primary Hyperparathyroidism ◽  
Clinical Presentation ◽  
Definitive Treatment ◽  
Diagnostic Tools ◽  
Current Management ◽  
Knowledge Based ◽  
Relevant Role

Primary hyperparathyroidism (PHPT) is a clinical condition characterized by overactive parathyroid gland secretion of parathyroid hormone with concurrent alteration of the phosphocalcemic metabolism. We present a literature review on primary hyperparathyroidism addressing key on clinical presentation, causes, medical and surgical treatment at the best of our knowledge. Based on this review we confirm the role of serum calcium and serum level examination, as well as we define the definitive treatment for PHPT being parathyroidectomy. In case of contraindication for surgery, medical treatment can play a relevant role.

scholarly journals SLAP lesions: current controversies

2019 ◽  
Vol 4 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Filippo Familiari ◽  
Gazi Huri ◽  
Roberto Simonetta ◽  
Edward G. McFarland
Keyword(s):  
Surgical Treatment ◽  
Physical Examination ◽  
Clinical Presentation ◽  
Patient Characteristics ◽  
Diagnostic Value ◽  
Shoulder Injuries ◽  
Biceps Tenodesis ◽  
Glenoid Labrum ◽  
Slap Lesions ◽  
Slap Tear

Knowledge of the pertinent anatomy, pathogenesis, clinical presentation and treatment of the spectrum of injuries involving the superior glenoid labrum and biceps origin is required in treating the patient with a superior labrum anterior and posterior (SLAP) tear. Despite the plethora of literature regarding SLAP lesions, their clinical diagnosis remains challenging for a number of reasons. First, the diagnostic value of many of the available physical examination tests is inconsistent and ambiguous. Second, SLAP lesions most commonly occur concomitantly with other shoulder injuries. Third, SLAP lesions have no specific associated pain pattern. Outcomes following surgical treatment of SLAP tears vary depending on the method of treatment, associated pathology and patient characteristics. Biceps tenodesis has been receiving increasing attention as a possible treatment for SLAP tears. Cite this article: EFORT Open Rev 2019;4:25-32. DOI: 10.1302/2058-5241.4.180033.

Osteomyelitis in the Neonate

2002 ◽  
Vol 21 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Deanna McPherson
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Bacterial Infection ◽  
Intensive Care Units ◽  
Musculoskeletal System ◽  
Gestational Age ◽  
Clinical Presentation ◽  
Long Term Outcomes

Osteomyelitis is defined as a bacterial infection of the musculoskeletal system. Osteomyelitis in the newborn is relatively rare, but if missed can have devastating, lifelong consequences for the growing infant. Those of us who care for neonates in intensive care units should have an understanding of this disease and be equipped to recognize it and begin treatment quickly to prevent long-term sequelae.This article reviews the pathophysiology of osteomyelitis and explains why the neonate is at an extraordinary risk for this disease. It reviews risk factors, clinical presentation, etiology and pathophysiology, diagnostic evaluation, treatment and monitoring of treatment, and long-term outcomes. A case study of a 27-week gestational age infant who presented with osteomyelitis and septic hip is presented, looking at the infant’s hospital course and outcome.

scholarly journals Epidemiology and Clinical Presentation of Children Hospitalized with SARS-CoV-2 Infection in Suburbs of Paris

2020 ◽  
Vol 9 (7) ◽  
pp. 2227 ◽  
Author(s):  
Louise Gaborieau ◽  
Celine Delestrain ◽  
Philippe Bensaid ◽  
Audrey Vizeneux ◽  
Philippe Blanc ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Clinical Presentation ◽  
Paediatric Intensive Care ◽  
Nasopharyngeal Swab ◽  
Suspected Infection ◽  
Radiological Data ◽  
One Year ◽  
Epidemiological Characteristics ◽  
Paediatric Intensive Care Units

Understanding the clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and prognosis in children is a major issue. Children often present mild symptoms, and some severe forms require paediatric intensive care, with in some cases a fatal prognosis. Our aim was to identify the epidemiological characteristics, clinical presentation, and prognosis of children with coronavirus disease 2019 (Covid-19) hospitalized in Paris suburb hospitals. In this prospective, observational, multicentre study, we included children hospitalized in paediatric departments of Paris suburb hospitals from 23 March 2020 to 10 May 2020, during the national lockdown in France with confirmed SARS-CoV-2 infection (positive RNA test on a nasopharyngeal swab) or highly suspected infection (clinical, biological, and/or radiological data features suggestive for SARS-CoV-2 infection). A total of 192 children were included for confirmed (n = 157) or highly suspected (n = 35) SARS-CoV-2 infection. The median age was one year old (interquartile range 0.125–11) with a sex ratio 1.3:1. Fever was recorded in 147 (76.6%) children and considered poorly tolerated in 29 (15.1%). The symptoms ranged from rhinorrhoea (34.4%) and gastrointestinal (35.5%) to respiratory distress (25%). Only 10 (5.2%) children had anosmia and five (2.6%) had chest pain. An underlying condition was identified in almost 30% of the children in our study. Overall, 24 (12.5%) children were admitted to paediatric intensive care units, 12 required mechanical ventilation, and three died. For children in Paris suburbs, most cases of Covid-19 showed mild or moderate clinical expression. However, one-eighth of children were admitted to paediatric intensive care units and three died.

scholarly journals Gender-differences in outcomes of patients in Intensive Care Unit: findings from the SPINUTI network

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
G Favara ◽  
M Barchitta ◽  
A Maugeri ◽  
G Rapisarda ◽  
R Vinci ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gender Differences ◽  
Intensive Care ◽  
Surgical Treatment ◽  
Gender Equality ◽  
Intensive Care Units ◽  
Coronary Disease ◽  
Surgical Intervention ◽  
P Values ◽  
Non Surgical Treatment

Abstract Background Achieving gender equality is one of the most important Sustainable Development Goals to guarantee health and wellbeing worldwide. Here, we aimed to assess gender-differences in risk factors and outcomes among patients admitted to Italian Intensive Care Units (ICUs). Methods Here, we included 12,534 patients from the “Italian Nosocomial Infections Surveillance in Intensive Care Units” (SPIN-UTI) project, who stayed in ICU for more than 48 hours. Firstly, characteristics at ICU admission were compared between males and females using the Mann-Whitney U or the Chi-Squared tests. Next, we compared the probability of death between genders by applying a logistic regression analysis. Results were adjusted for covariates (i.e., age, patient's origin, trauma, non-surgical treatment for acute coronary disease, surgical intervention and presence of intubation) and reported as Odds ratio (OR) and 95% Confidence Interval (CI). Finally, the Kaplan-Meier analysis was applied to assess gender difference in survival. Results Compared with male patients, females were older, more likely to come from other wards or healthcare facilities and to undergo a surgical intervention (p-values<0.05). By contrast, they were less likely to be intubated or traumatized and to undergo non-surgical treatment for acute coronary disease (p-values<0.05). Interestingly, a higher proportion of deaths was reported in female patients (p < 0.001), so that their odds of dying was 13% higher than males (OR = 1.13; 95%CI=1.00-1.28; p = 0.046) after adjusting for covariates. Accordingly, females reported lower survival in ICU than males (median= 32.0 days vs. median= 34.0 days; p < 0.001). Conclusions Our results pointed out gender-differences in patients' characteristics at ICU admission, which resulted into a higher risk of death and lower survival among females. In a Public Health point of view, these findings underline that is still important to sustain gender equality in ICUs and other hospital wards. Key messages There are several gender-differences in risk factors and outcomes among patients admitted to ICUs. Gender poses per se a higher risk for death in ICU, also considering other risk factors.

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