Challenging Cases in Neonatology

2018 ◽  
Keyword(s):  
Real Life ◽  
Clinical Manifestations ◽  
Medical Professionals ◽  
Learning Tool ◽  
Visual Diagnosis

This valuable reference and learning tool showcases 50 unique, real-life cases from NeoReviews™ popular "Index of Suspicion in the Nursery" and "Visual Diagnosis". These 50 cases cover rare conditions or unusual clinical manifestations of common conditions that medical professionals see every day.

scholarly journals Factors Driving Users’ Engagement in Patient Social Network Systems

Informatics ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 8
Author(s):  
Ira Puspitasari ◽  
Shukor Sanim Mohd Fauzi ◽  
Cheng-Yuan Ho
Keyword(s):  
Social Network ◽  
Structural Equation ◽  
Clinical Manifestations ◽  
Behavioral Model ◽  
Self Determination Theory ◽  
Equation Modeling ◽  
Medical Professionals ◽  
Network Systems ◽  
Constructive Engagement ◽  
Participatory Medicine

Participatory medicine and e-health help to promote health literacy among non-medical professionals. Users of e-health systems actively participate in a patient social network system (PSNS) to share health information and experiences with other users with similar health conditions. Users’ activities provide valuable healthcare resources to develop effective participatory medicine between patients, caregivers, and medical professionals. This study aims to investigate the factors of patients’ engagement in a PSNS by integrating and modifying an existing behavioral model and information system model (i.e., affective events theory (AET) and self-determination theory (SDT)). The AET is used to model the structure, the affective aspects of the driven behavior, and actual affective manifestation. The SDT is used to model interest and its relations with behavior. The data analysis and model testing are based on structural equation modeling, using responses from 428 users. The results indicate that interest and empathy promote users’ engagement in a PSNS. The findings from this study suggest recommendations to further promote users’ participation in a PSNS from the sociotechnical perspective, which include sensitizing and constructive engagement features. Furthermore, the data generated from a user’s participation in a PSNS could contribute to the study of clinical manifestations of disease, especially an emerging disease.

scholarly journals Fabry Disease Therapy: State-of-the-Art and Current Challenges

2020 ◽  
Vol 22 (1) ◽  
pp. 206
Author(s):  
Olga Azevedo ◽  
Miguel Fernandes Gago ◽  
Gabriel Miltenberger-Miltenyi ◽  
Nuno Sousa ◽  
Damião Cunha
Keyword(s):  
Fabry Disease ◽  
State Of The Art ◽  
Large Body ◽  
Real Life ◽  
Clinical Manifestations ◽  
Substrate Reduction Therapy ◽  
Lysosomal Storage ◽  
New Therapies ◽  
Enzyme Replacement

Fabry disease (FD) is a lysosomal storage disorder caused by mutations of the GLA gene that lead to a deficiency of the enzymatic activity of α-galactosidase A. Available therapies for FD include enzyme replacement therapy (ERT) (agalsidase alfa and agalsidase beta) and the chaperone migalastat. Despite the large body of literature published about ERT over the years, many issues remain unresolved, such as the optimal dose, the best timing to start therapy, and the clinical impact of anti-drug antibodies. Migalastat was recently approved for FD patients with amenable GLA mutations; however, recent studies have raised concerns that “in vitro” amenability may not always reflect “in vivo” amenability, and some findings on real-life studies have contrasted with the results of the pivotal clinical trials. Moreover, both FD specific therapies present limitations, and the attempt to correct the enzymatic deficiency, either by enzyme exogenous administration or enzyme stabilization with a chaperone, has not shown to be able to fully revert FD pathology and clinical manifestations. Therefore, several new therapies are under research, including new forms of ERT, substrate reduction therapy, mRNA therapy, and gene therapy. In this review, we provide an overview of the state-of-the-art on the currently approved and emerging new therapies for adult patients with FD.

scholarly journals COVID-19: A Thunderstorm for mankind

2020 ◽  
Vol 31 (2) ◽  
pp. 81-93
Author(s):  
Ham Nazmul Ahasan ◽  
Musavvir Samin
Keyword(s):  
Causative Agent ◽  
Clinical Manifestations ◽  
Hubei Province ◽  
Viral Pneumonia ◽  
Medical Professionals ◽  
New Findings

In December 2019 an outbreak of viral pneumonia occurredinWuhan, Hubei Province of People’sRepublic of China (PRC). Later, it was found the responsible virus was SARS-CoV-2 and WHOrecognized it as a Pandemic on 11th March 2020. As of 15th July, in 213 countries, 580,038 deathshave occurred among 13,382,020 cases. Currently, many research are going on throughout theworld and they are coming up with new findings and observations every day. Based on the currentpublished literatures, this review systemically summarizes up to date information regarding structureof the causative agent, epidemiology, pathogenesis, clinical manifestations, diagnosis and treatmentoptions of COVID-19 in the hope that it will add to the knowledge of medical professionals andformulate better plans for future. Bangladesh J Medicine July 2020; 31(2) :81-93

Fibromuscular dysplasia – results of a multicentre study in Flanders

VASA ◽  
2017 ◽  
Vol 46 (3) ◽  
pp. 211-218 ◽  
Author(s):  
Marie De Groote ◽  
Patricia Van der Niepen ◽  
Dimitri Hemelsoet ◽  
Bert Callewaert ◽  
Frank Vermassen ◽  
...  
Keyword(s):  
Multicentre Study ◽  
Fibromuscular Dysplasia ◽  
Real Life ◽  
Clinical Manifestations ◽  
Vascular Involvement ◽  
Interventional Treatment ◽  
Cerebrovascular Event ◽  
Atherosclerotic Vascular Disease ◽  
Imaging Results ◽  
The Us

Abstract. Background: Fibromuscular dysplasia (FMD) is an idiopathic, non-inflammatory, non-atherosclerotic vascular disease, resulting in focal narrowing of small and medium-sized arteries. Systematic recording of clinical data in central databases as in the US and France provided new insights into FMD. The main objectives of this multicentre study were to explore the epidemiology, pattern of vascular involvement, clinical manifestations, and management of FMD patients in Flanders. Patients and methods: Multicentre, retrospective registry of patients diagnosed with FMD based on medical imaging. Results: Hundred-twenty-three FMD patients (83.7 % female) were included. Mean age at FMD diagnosis was 57.3 years (SD 15.8). More than half of patients (59.5 %) were hypertensive at the time of diagnosis. Neurological complaints such as headache (26.4 %) and dizziness (23.1 %) were also frequently reported. FMD was discovered incidentally in 10 patients (8.3 %). Nearly one quarter (22.8 %) of patients experienced a cerebrovascular event. Aneurysms were found in one-fifth (20.3 %) of patients and 11.4 % had an arterial dissection. FMD affected most frequently the renal (85.3 %), carotid (74.7 %), and vertebral (39.8 %) arteries. Renovascular FMD was more prevalent in men, whereas cerebrovascular FMD was more frequent in women. Multiple affected sites were documented in 25 of 61 (41.0 %) patients, having two or more vascular beds imaged. Digital subtraction angiography was most frequently used for detecting FMD. One third (32.9 %) of patients received an interventional treatment, mainly patients with renovascular FMD (32.8 % underwent percutaneous transluminal angioplasty) and patients with an intracranial carotid aneurysm (36.4 % were treated by means of coiling). Conclusions: Although differences existed, results of the Flemish registry were broadly in line with the US and French registries. Patient databases help to learn more about the natural history, progression, and management of FMD, based on real life clinical evidence.

scholarly journals Features of the Use of Personal Protective Equipment in the Foci of a New Coronavirus Infection

2021 ◽  
Vol 19 (6) ◽  
pp. 4-7
Author(s):  
A. A. Kuzin ◽  
A. P. Yumanov ◽  
A. A. Degtyarev ◽  
G. G. Eremin
Keyword(s):  
General Practitioner ◽  
Personal Protective Equipment ◽  
Clinical Manifestations ◽  
Medical Professionals ◽  
Protective Equipment ◽  
Nurse Anesthetist ◽  
Field Hospital ◽  
Emergency Medical ◽  
Coronavirus Infection ◽  
Medical Teams

Relevance. In the context of the new SARS-CoV-2 coronavirus pandemic, the range of use of personal protective equipment (hereinafter referred to as PPE) is becoming increasingly broad, from emergency and emergency medical teams that go to patients with suspected COVID-19, to specialized covid hospitals. Aim. Identification of features in the operation of PPE in a strict anti-epidemic regime and development of recommendations on the use of PPE to improve the efficiency of medical professionals. Materials and methods. In the period from April to May 2020 in the field hospital of the Association of Alpine shooters at the exhibition centre, FIERA DI BERGAMO Italian Republic (hereinafter - the hospital), 8 medical and nursing teams, each of them included the doctors-epidemiologist, anesthesiologist-resuscitation, general practitioner, and nurse anesthetist (total number 32 professionals) conducted relevant sanitary-antiepidemic (preventive) and treatment-and-prophylactic interventions among patients with clinical manifestations of COVID-19. Conclusion. As a result of using a whole range of disposable PPE of various modifications, the features and disadvantages of their operation in the field were established. The main recommendations for using PPE when working with patients infected with SARS-CoV-2 are formulated.

Long-term follow-up of antiphospholipid syndrome: real-life experience from a single center

Lupus ◽  
2020 ◽  
Vol 29 (9) ◽  
pp. 1050-1059
Author(s):  
Rosa Serrano ◽  
Guillermo J Pons-Estel ◽  
Gerard Espinosa ◽  
Rosana M. Quintana ◽  
Joan C Reverter ◽  
...  
Keyword(s):  
Antiphospholipid Syndrome ◽  
Life Experience ◽  
Disease Onset ◽  
Real Life ◽  
Clinical Manifestations ◽  
Current Treatment ◽  
Single Center ◽  
Live Births ◽  
Laboratory Features ◽  
Long Term Follow Up

Objective The objective of this paper is to assess the prevalence of the main clinical manifestations and laboratory features at disease onset and during the ensuing 10 years of a large cohort of patients with antiphospholipid syndrome (APS) from a single center. Methods The study included all consecutive APS patients followed longitudinally in our center from 2003 to 2013. Descriptive statistics for demographics, clinical and laboratory features and mortality were performed. Results A total of 160 patients were included. Most of them, 128 (78.8%), were women and the mean (SD) age at diagnosis was 39.1 (14.0) years. The majority of them, 104 (65.0%), had primary APS, 36 (22.5%) had APS associated with systemic lupus erythematous, and 20 (12.5%) had APS associated with other autoimmune disease. During the study period, thrombotic events occurred in 27 (16.9%) patients, the most common being strokes, nonbacterial thrombotic endocarditis and deep venous thrombosis. Regarding obstetric morbidity, 18 women (14.3%) became pregnant and 90% of pregnancies succeeded in having live births. The most common obstetric complication was early pregnancy loss (15% of pregnancies). Prematurity (11.1% of live births) and intrauterine growth restriction (5.6% of live births) were the most frequent fetal morbidities. Ten (6.3%) patients died and the most frequent causes of death were severe thrombosis, hemorrhage, and cancer. Three (0.9%) cases of catastrophic APS occurred. The survival probability at 10 years was 93.8%. Conclusions Patients with APS develop significant morbidity and mortality despite current treatment. It is imperative to identify prognostic factors and therapeutic measures to prevent these complications.

scholarly journals P.015 Long-term progression and prognosis in different subtypes of Parkinson’s disease: validation of a new multi-domain subtyping method

2019 ◽  
Vol 46 (s1) ◽  
pp. S17
Author(s):  
S Fereshtehnejad ◽  
Y Zeighami ◽  
A Dagher ◽  
RB Postuma
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
De Novo ◽  
Early Stage ◽  
Real Life ◽  
Clinical Manifestations ◽  
Personalized Care ◽  
Autonomic Disturbance ◽  
Progression Markers

Background: Parkinson’s disease (PD) varies in clinical manifestations and course of progression from person to person. Identification of distinct PD subtypes is of great priority to develop personalized care approaches. We aimed to compare long-term progression and prognosis between different PD subtypes. Methods: Data on 421 individuals with de novo early-onset PD was retrieved from Parkinson’s Progression Markers Initiative (PPMI). Using a newly developed multi-domain subtyping method (based on motor phenotype, RBD, autonomic disturbance, early cognitive deficit), we divided PD population into three subtypes at baseline: “mild motor-predominant”, “Diffuse malignant” and “Intermediate”. Rate of global progression (mixed motor and non-motor features) and developing dementia were compared between the subtypes. Results: Patients with “diffuse malignant” PD experienced 0.5 z-score further worsening of global composite outcome (p=0.017) and 2.2 further decline in MOCA score (p=0.001) after 6-years of follow-up. Hazard for MCI/dementia was significantly higher in “diffuse malignant” (HR=3.2, p<0.001) and “intermediate” (HR=1.8, p<0.001) subtypes. Individuals with “diffuse malignant” PD had the lowest level of CSF amyloid-beta (p=0.006) and SPECT striatal binding ratio (p=0.001). Conclusions: This multi-domain subtyping is a valid method to predict subgroups of PD with distinct patterns of long-term progression at drug-naïve early-stage with potential application in real-life clinical practice.

Empowerment for sustainability in higher education through the EYE learning tool

2017 ◽  
Vol 18 (3) ◽  
pp. 341-358 ◽  
Author(s):  
Valentina C. Tassone ◽  
Giel Dik ◽  
Thekla Anna van Lingen
Keyword(s):  
Higher Education ◽  
Real Life ◽  
Actual Process ◽  
Learning Tool ◽  
Instrumental Approach ◽  
Content Type ◽  
Life Project ◽  
Sustainability Learning ◽  
Key Aspects

Purpose While empowerment for sustainability is considered a major objective within sustainability-oriented educational programs and policies, little is known about the actual process of empowering students for sustainability through higher education. This study aims to explore this field, by introducing the EYE (Educating Yourself in Empowerment) for Sustainability learning tool and by analyzing the effects of its application within a higher education context, including a reflection about key aspects contributing to students’ empowerment for sustainability. Design/methodology/approach The effects of the EYE tool are analyzed by means of questionnaires. Through a qualitative codification process and quantitative analysis, the authors have reflected on the effects of the EYE tool and on the empowerment process as perceived by the students exposed to the EYE at Wageningen University. Findings Results suggest that the EYE is a comprehensive and adaptive tool, conducive to empowerment for sustainability. Adopting, only partly, an instrumental approach to education and, largely, an emancipatory one appears to be a possible and successful combination. A key aspect contributing to students’ empowerment for sustainability is the development and execution of a real-life project of own choice. Learning about the diverse worldviews underlying the search for sustainability appears to be an eye opener for the students. Empowerment does not seem to require long-term training. Rather, it emerges and is experienced by university students within a few weeks. Originality/value This paper introduces a novel tool and discusses insights deriving from the application of this tool. The value of the paper lies in its potential to support educators in reflecting upon and designing their educational strategy for empowering students for sustainability.

scholarly journals EULAR guidelines on ANCA-associated vasculitis in the real life

2021 ◽  
Vol 2 (3) ◽  
pp. 74-78
Author(s):  
Chiara Marvisi ◽  
Elena Galli ◽  
Carlo Umberto Manzini ◽  
Gilda Sandri ◽  
Carlo Salvarani
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Inflammatory Diseases ◽  
Real Life ◽  
Clinical Manifestations ◽  
Remission Induction ◽  
Induction Treatment ◽  
Management Approach ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Remission Maintenance ◽  
The Future

Anti-neutrophil cytoplasmic antibodies-associated vasculitides (AAVs) are a heterogenous group of inflammatory diseases which primarily involve small vessels and include granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA). They present heterogeneous clinical manifestations, while their diagnosis and management still remain a challenge for clinicians. Nowadays, the treatment is based on two different regimens: the remission-induction treatment and the remission-maintenance treatment. The therapeutic armamentarium has grown over the years, with the aim to lessen adverse effects, improve quality of life of patients and maintain the disease under control. Biological treatments are the future: they act on different pathogenic pathways and may offer in the future a personalized management approach tailored to actual clinical manifestations. The latest guidelines were published in 2015 by the European League Against Rheumatism (EULAR) and still represent the vade mecum for the management of AAVs. In this review, we will focus on the principal strategies to treat AAVs. We discuss the remission-induction therapy and the remission- maintenance therapy; we have also distinguished the management of GPA and MPA from that of EGPA, because of their different clinical pictures.

scholarly journals The What, Where, How and Why: A Review of Being Ethnographic: A Guide to the Theory and Practice of Ethnography

2018 ◽  
Author(s):  
Jetlexis Carlos
Keyword(s):  
Life Experiences ◽  
Real Life ◽  
Theory And Practice ◽  
Ethnographic Research ◽  
Learning Tool ◽  
The Way

In Being Ethnographic: A Guide to the Theory and Practice of Ethnography, Raymond Madden presents ethnography in a way that is easily understood by describing real life experiences from both his own work and others working in the field. This book is a great resource to guide those who wish to conduct ethnographic research or need a learning tool to understand the underlying nature of ethnographic research. Madden links the way ethnographic research is done to how ethnographic research is thought about. It is a great introduction to the “what,” “where,” “how,” and “why” of practicing of ethnography.

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