scholarly journals PIMS-TS- (Paediatric Inflammatory Multisystem Syndrome – Temporally Associated with SARS-CoV-2)- a new challenging medical condition

2021 ◽  
Vol 11 (9) ◽  
pp. 11-16
Author(s):  
Robert Dubel ◽  
Kinga Ruszel ◽  
Wiktoria Chodun ◽  
Barbara Nieradko-Iwanicka
Keyword(s):  
Pediatric Patients ◽  
Medical Condition ◽  
Systemic Disease ◽  
Respiratory Viral Infection ◽  
Efficient Treatment ◽  
Global Pandemic ◽  
Number Of Patients ◽  
Icd 10 ◽  
Inflammatory Syndrome ◽  
First Time

 At the beginning of pandemic of SARS-CoV-2 children were thought to go through COVID 19 in  a definitely milder way than adults, in most cases even asymptomatically. However, even though the period of infection in pediatric patients is benign, SARS-CoV-2 found a way to take its toll on children’s health. Here comes PIMS-TS:  Paediatric inflammatory multisystem syndrome - temporally associated with SARS-CoV-2 (PIMS-TS) [ICD-10: U 10.9]. Since the global pandemic of COVID-19 is still on the go, for over a year now, SARS-CoV-2 tends to constantly mutate and affect children at increasingly young age either by oligosymptomatic respiratory viral infection, or more distant SARS-CoV-2-related medical condition- PIMS-TS. Paediatric inflammatory multisystem syndrome - temporally associated with SARS-CoV-2 (PIMS-TS), or Multisystem inflammatory syndrome in children (MIS-C) as it’s also called, is a rare systemic disease manifested by persistent fever and extreme inflammatory reaction following exposure to SARS-CoV-2, 2-4 weeks before the symptoms occur. It’s a brand new medical condition, described for the first time in May 2020. PIMS-TS affects 1 out of 1000 children infected with SARS-CoV-2 and can lead to very dangerous cardiological complications such as acute pancarditis, shock or aneurysms of coronary arteries. Efficient treatment performed in the accurate time and hospitalization in ICU allow to overcome PIMS-TS in the prevalent number of patients and get better in a few days. Mortality of PIMS-TS ranges from 1,5% to 2% of all cases. 

scholarly journals Optimization of Pressurized Liquid Extraction of Lycopodiaceae Alkaloids Obtained from Two Lycopodium Species

Molecules ◽  
2021 ◽  
Vol 26 (6) ◽  
pp. 1626
Author(s):  
Aleksandra Dymek ◽  
Jarosław Widelski ◽  
Krzysztof Kamil Wojtanowski ◽  
Paulina Płoszaj ◽  
Rostyslav Zhuravchak ◽  
...  
Keyword(s):  
Solid Phase ◽  
Developed Countries ◽  
Extraction Process ◽  
Efficient Treatment ◽  
Ache Inhibitors ◽  
Methanolic Extracts ◽  
Number Of Patients ◽  
Antidepressant Effects ◽  
Oasis Hlb ◽  
First Time

Alkaloids of the Lycopodiaceae family are of great interest to researchers due to their numerous properties and wide applications in medicine. They play a very important role mainly due to their potent antioxidant, antidepressant effects and a reversible ability to inhibit acetylcholinesterase (AChE) enzyme activity. This property is of immense importance due to the growing problem of an increasing number of patients with neurodegenerative diseases in developed countries and a lack of effective and efficient treatment for them. Numerous studies have shown that Lycopodiaceae alkaloids are a rich source of AChE inhibitors. In the obtaining of new therapeutic phytochemicals from plant material, the extraction process and its efficiency is crucial. Therefore, the aim of this work was to optimize the conditions of modern PLE to obtain bioactive alkaloids from two Lycopodium species: L. clavatum L. and L. annotinum L. Five different solvents of different polarity were used for prepared plant extracts in order to compare the alkaloid content in and thereby effectiveness of the entire extraction. PLE parameters were used based on multiple studies conducted that gave the highest alkaloids recovery. Crude extracts were purified using solid-phase extraction (SPE) on Oasis HLB cartridge and examined by HPLC/ESI-QTOF–MS of the highly abundant alkaloids. To the best of our knowledge, this is the first time such high recoveries have been obtained for known Lycopodiaceae alkaloids. The best extraction results of alkaloid-lycopodine were detected in the dichloromethane extract from L. clavatum, where the yield exceeded 45%. The high recovery of annotinine above 40% presented in L. annotinum was noticed in dichloromethane and ethyl acetate extracts. Moreover, chromatograms were obtained with all isolated alkaloids and the best separation and quality of the bands in methanolic extracts. Interestingly, no alkaloid amounts were detected in cyclohexane extracts belonging to the non-polar solvent. These results could be helpful for understanding and optimizing the best conditions for isolating potent AChE inhibitors.

scholarly journals Gastrointestinal tract diseases at different stages of COVID-19 in children

2021 ◽  
Vol 1 (6) ◽  
pp. 18-28
Author(s):  
G. S. Karpovich ◽  
I. V. Kuimova ◽  
A. E. SHestakov ◽  
I. Ya. Izvekova ◽  
L. M. Panasenko ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Gastrointestinal Tract ◽  
Laboratory Tests ◽  
Pediatric Patients ◽  
Clinical Signs ◽  
Pain Syndrome ◽  
Immune Development ◽  
Icd 10 ◽  
One Year ◽  
Inflammatory Syndrome

Purpose of the study. To investigate the features of lesions of the gastrointestinal tract in diff erent variants of the course of COVID-19 in children.Materials and methods. A single-center prospective study was carried out to study the clinical and laboratory manifestations of gastrointestinal tract (GIT) lesions in different variants of the course of COVID-19 in children. The study was carried out in the following groups: group No. 1 — pediatric patients with a verified diagnosis (according to ICD 10) “U07.1. COVID-19 virus identified, confirmed by laboratory tests, regardless of the severity of clinical signs or symptoms ”, n = 524; group No. 2 — pediatric patients with a verified diagnosis (according to ICD 10) “U10.9 Multisystem inflammatory syndrome associated with COVID-19, unspecified”, n = 46. The article provides a brief description of the observations of the development of autoimmune pathologies (ulcerative colitis, autoimmune hepatitis) in pediatric patients, for whom a postponed COVID-19 infection could be a probable trigger.Results. The leading symptoms of the gastrointestinal tract in patients of group No. 1 were symptoms of acute gastroenteritis, registered in 37.6% of cases. Diarrhea was detected in 21.2% of cases, vomiting — in 16.5%; abdominal pain syndrome — 9.2%. These manifestations were statistically more significant in patients under one year of age, as well as in children of the first three years of life (p≤0.05). Gastrointestinal syndrome in patients of group No. 2 was registered in 67.4% of cases, with vomiting — 60.9% of cases, diarrheal syndrome — 23.9% of cases, abdominal pain syndrome — 82.6%. Other manifestations of the gastrointestinal tract in patients of this group were: reactive hepatitis — 69.6% of cases (average ALT — 98 (47; 347); AST — 107 (34; 347)), reactive pancreatitis — 60.8% of cases (average values of amylase — 127 (28; 269); lipase — 196 (47; 107)). These lesions were of a reactive inflammatory nature, with a probable immune development mechanism.

scholarly journals Establishment of in-hospital clinical network for patients with neurofibromatosis type 1 in Nagoya University Hospital

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoshihiro Nishida ◽  
Kunihiro Ikuta ◽  
Atsushi Natsume ◽  
Naoko Ishihara ◽  
Maki Morikawa ◽  
...  
Keyword(s):  
Medical Care ◽  
Neurofibromatosis Type 1 ◽  
Malignant Tumors ◽  
Systemic Disease ◽  
Neurofibromatosis Type ◽  
University Hospital ◽  
Care Network ◽  
Number Of Patients ◽  
First Time

AbstractNeurofibromatosis type 1 (NF1) is a genetic multisystem disorder. Clinicians must be aware of the diverse clinical features of this disorder in order to provide optimal care for it. We have set up an NF1 in-hospital medical care network of specialists regardless of patient age, launching a multidisciplinary approach to the disease for the first time in Japan. From January 2014 to December 2020, 246 patients were enrolled in the NF1 patient list and medical records. Mean age was 26.0 years ranging from 3 months to 80 years. The number of patients was higher as age at first visit was lower. There were 107 males (41%) and 139 females. After 2011, the number of patients has increased since the year when the medical care network was started. Regarding orthopedic signs, scoliosis was present in 60 cases (26%), and bone abnormalities in the upper arm, forearm, and tibia in 8 cases (3.5%). Neurofibromas other than cutaneous neurofibromas were present in 90 cases (39%), and MPNST in 17 cases (7.4%). We launched a multidisciplinary NF1 clinic system for the first time in Japan. For patients with NF1, which is a hereditary and systemic disease associated with a high incidence of malignant tumors, it will be of great benefit when the number of such clinics in Japan and the rest of Asia is increased.

scholarly journals Epidemiology and disease burden of sickle cell disease in France: A descriptive study based on a French nationwide claim database

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253986
Author(s):  
Henri Leleu ◽  
Jean Benoit Arlet ◽  
Anoosha Habibi ◽  
Maryse Etienne-Julan ◽  
Mehdi Khellaf ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Disease Burden ◽  
Systemic Disease ◽  
Annual Number ◽  
Claim Database ◽  
Cell Disease ◽  
Screening Programs ◽  
Number Of Patients ◽  
Icd 10

Context Sickle cell disease (SCD) is a severe hematological disorder. The most common acute complication of SCD is vaso-occlusive crisis (VOC), but SCD is a systemic disease potentially involving all organs. SCD prevalence estimates rely mostly on extrapolations from incidence-based newborn screening programs, although recent improvements in survival may have led to an increase in prevalence, and immigration could account for a substantial number of prevalent patients in Europe. The primary objective of this study was to estimate SCD prevalence in France. Methods A cross-sectional observational study was conducted using a representative sample of national health insurance data. SCD patients followed up in France between 2006 and 2011 were captured through hydroxyurea reimbursement and with the International Classification of Diseases (ICD-10) SCD specific code D570.1.2, excluding code D573 (which corresponds to sickle cell trait (SCT)). Nevertheless, we assumed that ICD-10 diagnosis coding for inpatient stays could be imperfect, with the possibility of SCT being miscoded as SCD. Therefore, prevalence was analyzed in two groups of patients [with at least one (G1) or two (G2) inpatient stay] based on the number of SCD-related inpatient stays in the six-year study period, assuming that SCT patients are rarely rehospitalized compared to SCD. The prevalence of SCD in the sample, which was considered to be representative of the French population, was then extrapolated to the general population. The rate of vaso-occlusive crisis (VOC) events was estimated based on hospitalizations, emergencies, opioid reimbursements, transfusions, and sick leave. Results Based on the number of patients identified for G1 and G2, the 2016 French prevalence was estimated to be between 48.6 per 100,000 (G1) or 32,400 patients and 29.7 per 100,000 (G2) or 19,800 patients. An average of 1.51 VOC events per year were identified, with an increase frequency of 15 to 24 years of age. The average annual number of hospitalizations was between 0.70 (G1) and 1.11 (G2) per patient. Intensive care was observed in 7.6% of VOC-related hospitalizations. Fewer than 34% of SCD patients in our sample received hydroxyurea at any point in their follow-up. The annual average cost of SCD care is €5,528.70 (G1) to €6,643.80 (G2), with most costs arising from hospitalization and lab testing. Conclusion Our study estimates SCD prevalence in France at between 19,800 and 32,400 patients in 2016, higher than previously published. This study highlights the significant disease burden associated with vaso-occlusive events.

Ixekizumab in the Management of Non-Selected Out Patients with Moderate to Severe Psoriasis -New Data and Personal Clinical Experience

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Clinical Experience ◽  
Personal Experience ◽  
Therapeutic Response ◽  
Systemic Disease ◽  
Severe Psoriasis ◽  
Adequate Treatment ◽  
Scalp Psoriasis ◽  
Number Of Patients ◽  
Genital Psoriasis

Introduction: Too many patients with moderate to severe psoriasis do not receive adequate treatment. This means a vast undersupply in the treatment of patients with psoriasis. Only biologics fulfill the whole range of the treatment of psoriasis – psoriasis does not affect only skin but the whole organism: It is a systemic disease! Between the biologics are evident differences concerning the effect. Discussion: Based on broad personal experience in the management of patients with moderate to severe psoriasis new data from clinical studies with ixekizumab are examined. This contains new data on long-term-efficacy of ixekizumab, effectiveness in special localizations (scalp psoriasis, nail psoriasis, palmoplantar psoriasis, genital psoriasis) as well as safely data and experience on patients switched to ixekizumab from other biologics. Personal clinical experience is based on >300 non-selected outpatients with moderate to severe psoriasis, >250 patients on biological therapies, > 50 patients with ixekizumab. Conclusions: Focusing on a relevant number of patients switched from secukinumab to ixekizumab due to first or secondary loss of efficacy significant differences between both IL-17A-inhibitors mainly in terms of efficacy and speed of therapeutic response are shown. Finally the correlation between PASI-90-/PASI-100 response and significant changes in DLQI are highlighted.

scholarly journals Masses of the Sternoclavicular Area: Case Series and Review of the Literature

2021 ◽  
Vol 15 ◽  
pp. 117955652110216
Author(s):  
Parisa Oviedo ◽  
Morgan Bliss
Keyword(s):  
English Language ◽  
Pediatric Patients ◽  
Tertiary Care ◽  
Case Series ◽  
Review Of The Literature ◽  
Incision And Drainage ◽  
Surgical Interventions ◽  
Ganglion Cysts ◽  
Icd 10 ◽  
Bronchogenic Cysts

Objective: Masses of the sternoclavicular area are rare, and are not well described in the literature. We aim to present a series of patients with masses in this location and to review all reported English language cases of sternoclavicular masses in pediatric patients. Methods: This is a case series of pediatric patients with masses of the sternoclavicular area presenting to a tertiary care pediatric hospital from 2010 through 2017. Data was collected by using ICD-9 and ICD-10 codes to query the electronic medical record. Chart review included age at presentation, mass characteristics, medical and surgical interventions, and pathology results. A review of the literature was then performed. Results: Ten patients with masses overlying the sternoclavicular area were identified. Four patients presented with abscess and were treated with incision and drainage. Three of these patients were then treated with staged excision once infection cleared. Two additional patients were treated with primary excision. Four patients were treated with observation. The most common histopathologic finding was epidermoid. One patient was found to have a dermoid cyst, and 1 had a congenital cartilaginous rest. Conclusion: Epidermoids and dermoids are the most common masses overlying the sternoclavicular area. Controversy remains regarding the embryologic origin of sternoclavicular masses. The differential for masses in this area also includes branchial remnants, bronchogenic cysts, ganglion cysts, or septic arthritis.

scholarly journals The Differential Diagnosis of Sterile Pyuria in Pediatric Patients: A Review

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199371
Author(s):  
Donald W. Bendig
Keyword(s):  
Differential Diagnosis ◽  
Pediatric Patients ◽  
Systemic Disease ◽  
Common Finding ◽  
Extensive Literature ◽  
Sexually Transmitted ◽  
Persistent Symptoms ◽  
Sterile Pyuria ◽  
Extensive Literature Search ◽  
Definition Of

Sterile pyuria is a common finding in pediatric patients. Literature describing the diagnoses as well as clinical characteristics of children with sterile pyuria is lacking. This review was performed to establish an evidence-based approach to the differential diagnosis by way of an extensive literature search. The definition of pyuria is inconsistent. The various causes of pediatric sterile pyuria identified were classified as either Infectious or Non-Infectious. Sub-categories of Infectious causes include: Viral Infection, Bacterial Infection, Other Infections (tuberculosis, fungal, parasitic), Sexually Transmitted Infections, Recent Antibiotic Therapy. Non-Infectious causes include: Systemic Disease, Renal Disease, Drug Related, Inflammation adjacent to Genitourinary Tract. Clinicians that encounter pediatric patients with sterile pyuria and persistent symptoms should consider the substantial differential diagnosis described in this study.

scholarly journals Health system wide “big data” analysis of rheumatologic conditions and scleritis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meghan K. Berkenstock ◽  
Andrew R. Carey
Keyword(s):  
Relative Risk ◽  
Health System ◽  
Systemic Disease ◽  
Autoimmune Disorder ◽  
Future Research ◽  
Inflammatory Conditions ◽  
Autoimmune Conditions ◽  
Icd 10 ◽  
Autoimmune Condition ◽  
Referral Bias

Abstract Background The development of scleritis in the setting of autoimmune conditions has been well documented. Prior series have assessed the relationship between systemic autoimmune disorders and scleritis only in patients referred for rheumatologic or ocular inflammation. This can lead to a referral bias. We reviewed all charts within the electronic medical record (EMR) of a health system for patients with systemic autoimmune and scleritis diagnoses to determine the prevalence of both and which disorders had the highest relative risk of developing scleritis. Methods The EMR was searched for scleritis and systemic inflammatory diagnoses in the past medical history and diagnosis tabs, and for associated disease specific laboratory values. The intersection of scleritis and systemic inflammatory conditions was assessed through searching both SNOMED Clinical Terminology and ICD-10 codes for diagnoses. The prevalence of each autoimmune disorder, scleritis prevalence, the percentage of patients with an autoimmune condition having scleritis, the percentage of patients with scleritis having an autoimmune condition; the relative risk (RR) of scleritis patients having a specific autoimmune disorder were calculated. Results A total of 5.9 million charts were searched with autoimmune conditions identified in 148,993 patients. The most common autoimmune conditions overall were HLA-B27-associated diseases (n = 26,680; prevalence 0.45%); rheumatoid arthritis (RA)(N = 19,923; prevalence 0.34%). Conversely, 2702 patients were identified with scleritis (prevalence 0.05%), of which 31.4% had an associated autoimmune condition. Patients with RA represented the highest percentage of patients with an autoimmune condition having scleritis. Granulomatosis with polyangiitis (GPA) represented the highest the percentage of patients with scleritis having an autoimmune condition. Sjogrens was the third most common condition associated with scleritis- making up 4.5% of cases. An association with juvenile idiopathic arthritis (JIA) was seen in 0.3% of patients. Conclusions While this is the largest retrospective review examining the association between autoimmune disease and scleritis, the findings are similar to prior studies with nearly a third of scleritis patients having an underlying autoimmune diagnosis. Limitations of the study included accurate chart coding; having laboratory results within the searchable EMR. Future research is needed to delineate associations of systemic disease with the anatomic location of scleritis using EMR.

scholarly journals New onset diabetes with diabetic ketoacidosis in a child with multisystem inflammatory syndrome due to COVID-19

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Monica N. Naguib ◽  
Jennifer K. Raymond ◽  
Alaina P. Vidmar
Keyword(s):  
Metabolic Acidosis ◽  
Diabetic Ketoacidosis ◽  
Pediatric Patients ◽  
Systolic Function ◽  
Hemodynamic Instability ◽  
Case Presentation ◽  
Onset Diabetes ◽  
Potential Trigger ◽  
Inflammatory Syndrome ◽  
New Onset

AbstractIntroductionMultisystem inflammatory syndrome in children (MIS-C) is a unique clinical complication of SARS-CoV-2 infection observed in pediatric patients. COVID-19 is emerging as a potential trigger for the development of diabetes in children. Here, we report a patient presenting with MIS-C and new onset diabetes, and discuss the implication and clinical management of these concomitant conditions.Case presentationAn eight-year-old female presented with hyperglycemia, ketosis and metabolic acidosis consistent with diabetic ketoacidosis (DKA) in the setting of fever, rash, respiratory distress, hemodynamic instability, reduced systolic function with dilation of the left anterior descending artery, and positive SARS-CoV-2 antibodies suggestive of MIS-C.

Clinical characteristics and outcome of hospitalized children and adolescent patients with type 1 diabetes during the COVID-19 pandemic: data from a single center surveillance study in Egypt

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Eman Monir Sherif ◽  
Yasmine Ibrahim Elhenawy ◽  
Randa Mahmoud Matter ◽  
Hanan Hassan Aly ◽  
Rasha Adel Thabet ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Pediatric Patients ◽  
Surveillance Study ◽  
Single Center ◽  
Children And Adolescent ◽  
Mean Delay ◽  
Patients With Diabetes ◽  
Constant Feature ◽  
Inflammatory Syndrome

Abstract Objectives COVID-19 pandemic significantly impacted the diagnosis of type 1 diabetes and its acute complications. Thus, the study aimed to evaluate the characteristics of pediatric patients with type 1 diabetes hospitalized during the first wave of the pandemic and the prevalence of new onset diabetes among patients with evidence of COVID-19 infection. Methods A single-center surveillance study included all patients with diabetes admitted to Children’s Hospital, Ain Shams University, in Egypt between May to August 2020. Data were collected to evaluate patients’ clinical and laboratory characteristics as well as their outcomes. Results Thirty-six patients were admitted during the study period. The mean age was 8.4 ± 3.8 years. Patients presented late to the emergency department with a mean delay of 3.05 ± 1.19 days from onset of symptoms. 34/36 patients presented in diabetic ketoacidosis (DKA), 50% presenting in severe DKA. Almost 81% of the patients were newly diagnosed. During the study period, SARS-CoV-2 PCR was found positive in four patients, COVID Ig M antibodies were positive in another two patients; all were symptomatic requiring ICU admission. Four patients showed a picture suggestive of the multi-inflammatory syndrome (MIS-C); cardiac affection was a constant feature. Conclusions The pandemic affected both the prevalence and severity of DKA among pediatric patients. The increased prevalence of severe DKA could be partly related to delayed hospital admission or the effect of COVID-19 in triggering DKA. Efforts should be done to continuously raise awareness about diabetes in children as well as the importance of seeking timely medical guidance.

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