Appendiceal Rupture: A Continuing Diagnostic Problem

PEDIATRICS ◽  
1979 ◽  
Vol 63 (1) ◽  
pp. 37-43
Author(s):  
Ronald A. Savrin ◽  
H. William Clatworthy
Keyword(s):  
Mortality Rate ◽  
Natural History ◽  
Physical Examination ◽  
Early Recognition ◽  
Correct Diagnosis ◽  
Diagnostic Problem ◽  
Children's Hospital ◽  
Primary Physician ◽  
History Of ◽  
Physical Findings

The mortality rate for appendicitis in children has remained relatively unchanged since the 1940s, when antibiotics were introduced in the treatment of appendiceal peritonitis. However, since this time the incidence of appendiceal rupture has increased appreciably, presumably owing to a failure of early recognition and treatment. At Columbus Children's Hospital, one half of all patients undergoing appendectomy for ruptured appendix in 1975 had been seen by another physician before admission, but the correct diagnosis had not been made. The history obtained by the primary physician and that given on admission were similar, yet differed from the histories given by patients whose disease had been correctly diagnosed. Findings on in-hospital physical examination of incorrectly diagnosed patients differed from those recorded by the primary physician, but were similar to those of patients whose disease had been correctly diagnosed. Since it is unlikely that the natural history of the disease has changed, the increased incidence of rupture must result either from early misinterpretation of physical findings or from greater delay by parents in responding to the child's illness. Physicians and parents must share the responsibility equally for the increasing incidence of appendiceal rupture in children.

Clinical usefulness of measuring prothrombin time as a routine admission test.

1976 ◽  
Vol 22 (10) ◽  
pp. 1644-1647 ◽  
Author(s):  
J M Eisenberg ◽  
S Goldfarb
Keyword(s):  
Liver Disease ◽  
Physical Examination ◽  
Prothrombin Time ◽  
Veterans Administration ◽  
Bleeding Disorders ◽  
Additional Information ◽  
Coagulation Defects ◽  
History Of ◽  
Admission Test ◽  
Physical Findings

Abstract A questionnaire indicating the presence of a history or physical findings consistent with liver desease or bleeding disorders was completed by house officers on 301 admissions to a Veterans Administration medical service. Each patient had prothrombin time determined on admission. Only two of 107 patients for whom the prothrombin time was measured as a screening test had an abnormal results and one of these was normal when repeated. Of 73 patients with a history of alcoholism but no other pertient case history or physical examination results, only one had an abnormal prothrombin time. Of the remaining 121 patients, who had a pertinent history or physical examination, 41 had an abnormal admission prothrombin time. We conclude that measurement of prothrombin time adds little additional information to that obtained by history and physical examination in screening for liver disease and coagulation defects unless the patient has specific clinical evidence of liver disease, anticoagulation, or other conditions predisposing to bleeding disorders.

ACUTE JEJUNAL OBSTRUCTION SECONDARY TO TRAUMATIC INTRAMURAL HEMATOMA

PEDIATRICS ◽  
1957 ◽  
Vol 19 (5) ◽  
pp. 863-868
Author(s):  
E. Earl Moody
Keyword(s):  
Abdominal Wall ◽  
Intestinal Tract ◽  
Correct Diagnosis ◽  
Laboratory Data ◽  
Intramural Hematoma ◽  
Coiled Spring ◽  
History Of ◽  
A Minor ◽  
Physical Findings ◽  
Jejunal Obstruction

This case report acids one more to the nine reported cases of intestinal obstruction in children due to hemorrhage occurring in the duodenum or jejunum following a minor nonpenetrating injury to the abdominal wall. Delay in making a correct diagnosis and instituting the proper treatment was due primarily in this case, as in all others reported, to a lack of knowledge that such obstruction could follow such an apparently minor injury to the abdominal wall. Nothing in the symptomatology, physical findings or laboratory data alone can be considered diagnostic of an intramural or subserosal hematoma in the intestinal tract. These, however, coupled with a history of trauma to the abdominal wall and roentgenograms which show the "coiled spring" appearance, lead to a correct diagnosis.

Natural history of retained surgical items supports the need for team training, early recognition, and prompt retrieval

2014 ◽  
Vol 208 (1) ◽  
pp. 65-72 ◽  
Author(s):  
S. Peter Stawicki ◽  
Charles H. Cook ◽  
Harry L. Anderson ◽  
Laurie Chowayou ◽  
James Cipolla ◽  
...  
Keyword(s):  
Natural History ◽  
Early Recognition ◽  
Team Training ◽  
History Of

scholarly journals Early Preinvasive Lesions in Ovarian Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Gautier Chene ◽  
Gery Lamblin ◽  
Karine Le Bail-Carval ◽  
Philippe Chabert ◽  
Naoual Bakrin ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Mortality Rate ◽  
Natural History ◽  
Early Detection ◽  
Molecular Characteristics ◽  
Molecular Signatures ◽  
Cancer Subtypes ◽  
Screening Strategies ◽  
Preinvasive Lesions ◽  
History Of

Faced with the catastrophic prognosis for ovarian cancer due to the fact that it is most often diagnosed late at the peritoneal carcinomatosis stage, screening and early detection could probably reduce the mortality rate. A better understanding of the molecular characteristics of the different ovarian cancer subtypes and their specific molecular signatures is indispensable prior to development of new screening strategies. We discuss here the early natural history of ovarian cancer and its origins.

scholarly journals Gambaran Determinan Kematian Ibu di Kota Surabaya Tahun 2015-2017

2019 ◽  
Vol 7 (2) ◽  
pp. 178
Author(s):  
Hazar Rochmatin
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Health Workers ◽  
Early Recognition ◽  
Secondary Data ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Second Child ◽  
History Of ◽  
High Level

Maternal mortality rate is one of indicator in assessing the welfare of the community in a region. The high level of Maternal Mortality Rate is a low level signals of public health. Data on maternal mortality in the city of Surabaya shows a decrease in the last 6 years from 144.66 in 2012 to 79.40 in 2017. Although it has shown a decline in progress, this figure still puts Surabaya as the second largest contributor to maternal deaths in East Java in 2017. The study aims to describe the determinants of maternal mortality in Surabaya based on contextual, intermediate and proxy determinants for 2015-2017. This research is descriptive by using secondary data in the form of recapitulation of Maternal Verbal Autopsy (OVM) data on maternal deaths at Surabaya City Health Office The results showed that based on education, the majority of mothers who died had secondary education of 52.29% (57 people). Based on work, the majority of mothers have jobs as housewives of 68.81% (75 people). Based on the age of the mother, the majority of deaths occurred in women aged 20-34 years with a percentage of 66.97% (73 people). According to parity, the majority of mothers who died occurred during pregnancy of the second child by 31.19% (34 people). Based on the period of death, the majority occurred in the puerperium with a percentage of 66.97% (70 people). According to the cause of single death, the majority of maternal deaths were caused by pre-eclampsia/eclampsia with a percentage of 26.61% (29 people). This study recommends the need for early recognition of mothers about antenatal care and danger during pregnancy, childbirth and the puerperium period and increased alertness of health workers to complications of pregnancy, especially in mothers with a history of disease.

Natural History of Renal Vein Thrombosis: Incidence of Recurrent Venous Thromboembolism and Survival.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1060-1060
Author(s):  
Waldemar E. Wysokinski ◽  
Izabela Gosk-Bierska ◽  
Krzysztof Karnicki ◽  
Rajiv K. Pruthi ◽  
Robert D. McBane
Keyword(s):  
Venous Thromboembolism ◽  
Mortality Rate ◽  
Natural History ◽  
Renal Vein ◽  
Wilms Tumor ◽  
Case Series ◽  
Renal Vein Thrombosis ◽  
Antiphospholipid Antibody ◽  
Vein Thrombosis ◽  
History Of

Abstract Renal vein thrombosis (RVT), although uncommon, is associated with considerable morbidity and mortality. Neither the etiology nor the natural history of RVT has been adequately described in a large case series. Objective: To determine whether incident RVT is associated with an increased likelihood of recurrent local and systemic venous thromboembolic disease. Methods: Cases were identified by reviewing the Diagnostic Index for all patients with RVT at our institution between 1981 and 2000. Results: The study group consisted of 240 patients (34% women) with a mean age 55± 19 years. The diagnosis of RVT was made by CT (35%), Duplex Ultrasound (35%), MRI±gadolinium (10%) and either at surgery or autopsy in the remainder. The underlying etiology was deemed to be malignancy in 65% of cases. Of these, renal cell carcinoma (74%) and Wilms tumor (3%) made up the majority. Nephrotic syndrome primarily membranous glomerulonephritis was the second most common underlying etiology (23%). Of those tested, a definable thrombophilia was found in only 13 cases including lupus anticoagulant/antiphospholipid antibody (n=4); deficiencies of protein C or S, (n=2 each); heparin induced thrombocytopenia (n=2); antithrombin deficiency, dysfibrinogenemia and hyperhomocysteinemia (n=1 each). Eighty-one patients (34%) were treated with warfarin. Over a mean follow up of 3 years, the rate of recurrence of venous thrombosis at any site was 5%. The mortality rate over this time period was 49%. Conclusion: RVT represents a distinct clinical entity relative to venous thromboembolism of the lower extremity. The observed low rate of recurrence may be explained by the high mortality rate owing to a high percentage of renal malignancy. RVT should prompt an evaluation for an underlying renal malignancy.

scholarly journals The nosology of involuntary movements in older people

2002 ◽  
Vol 12 (3) ◽  
pp. 187-189
Author(s):  
Jolyon Meara ◽  
Peter Hobson
Keyword(s):  
Older Adults ◽  
Motor Control ◽  
Cognitive Function ◽  
Natural History ◽  
Older People ◽  
Correct Diagnosis ◽  
Involuntary Movements ◽  
History Of ◽  
Older Subjects ◽  
Gait Abnormalities

Involuntary movements become increasingly common with age and often lead to considerable disability, handicap and social embarrassment. Many causes of involuntary movements can be readily treated once the correct diagnosis is established. Getting the diagnosis right in older people is often challenging even for specialists. Even the identification of conditions thought easy to classify in younger people, such as Parkinson's disease, can be very difficult in older adults. This burden of movement disorder in older people reflects the increasing prevalence of neurodegenerative and vascular disease with age as well as the growing exposure to medication and the natural history of conditions such as essential tremor, which tend to worsen with age and precipitate medical presentation later in life. A complex and poorly understood relationship exists between motor control, disorders of mood and cognitive function. In older subjects involuntary movements are often associated with gait abnormalities and poor mobility and falls may be the presenting feature.

scholarly journals Natural History of 11 Cases of Twin-twin Transfusion Syndrome Without Intervention

Twin Research ◽  
2003 ◽  
Vol 6 (4) ◽  
pp. 263-266 ◽  
Author(s):  
Ahmet Gul ◽  
Halil Aslan ◽  
Ibrahim Polat ◽  
Altan Cebeci ◽  
Hasan Bulut ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Natural History ◽  
Uterine Contraction ◽  
Live Births ◽  
Uterine Contractions ◽  
Prognostic Sign ◽  
History Of ◽  
Twin Pregnancies

AbstractThe natural history of 11 cases of twin–twin transfusion syndrome (TTTS) in monochorionic diamniotic (MCDA) twin pregnancies has been reviewed. Seven cases before 28 weeks and four pregnancies after 28 weeks had been followed up without intervention. Eight cases had premature uterine contractions. All seven pregnancies before 28 weeks aborted, leading to a 100% mortality rate. After 28 weeks all mothers delivered live births. The diagnosis of TTTS before 28 weeks, and with premature uterine contraction, seems to be a poor prognostic sign.

scholarly journals A clinical, radiological and etiological study of neonatal pneumonia

2019 ◽  
Vol 6 (6) ◽  
pp. 2309
Author(s):  
Mallikarjun R. Kobal ◽  
Prashant S. Gadgi ◽  
Sharanabasappa S. Dhanwadkar ◽  
Ashwini Kumari N. B.
Keyword(s):  
Early Recognition ◽  
Tertiary Care ◽  
Coagulase Negative Staphylococcus ◽  
Klebsiella Pneumonia ◽  
Positive Finding ◽  
Tertiary Care Centre ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
History Of ◽  
Home Deliveries

Background: Pneumonia contributes to between 7, 50,000 and 1.2 million neonatal deaths and an unknown number of stillbirths each year worldwide1. It is estimated that 3.9 million of the 10.8 million deaths in children annually worldwide occur in the first 28 days of life.2 Neonatal pneumonia can be preventable if it is diagnosed as early as possible. Early recognition and prompt management are essential for the better outcome.Aim and objective: To determine bacterial etiology of neonatal pneumonia and to study the risk factors associated with neonatal pneumonia.Methods: A prospective, descriptive study was conducted for the duration of one year from July 2014 to June 2015 in Pragna children’s Hospital, a tertiary care centre, Hyderabad, Telangana, India. A total of 100 neonates were admitted in Pragna children’s Hospital with the signs and symptoms of neonatal pneumonia. A detailed history was taken including age, obstetric history of the mother, detailed birth history including resuscitation details and gestational age assessment were evaluated.Results: Out of 100 cases, 39(39%) neonates were preterm babies and 61(61%) were term. Also found history of Prolonged Rupture of Membrane (PROM) in 22% cases, maternal fever in 18%, home deliveries in 14% and foul smelling liquor in 18%. Out of 100 cases, 51 (51%) cases had positive finding in Chest X-Ray for neonatal pneumonia and 57(57%) had pneumonia with septicemia. Out of 100 cases, 9% of cases are positive for Coagulase negative staphylococcus (CONS), 5% for Klebsiella pneumonia, 2% for Pseudomonas aeroginosa and the remaining 84% of the cases had no growth for any organism.Conclusions: Major predisposing factors included PROM, foul smelling liquor, maternal fever, and home deliveries. CONS was the commonest organism isolated in blood culture.

scholarly journals The natural history of hypertrophic cardiomyopathy

2020 ◽  
Vol 22 (Supplement_L) ◽  
pp. L11-L14
Author(s):  
Camillo Autore ◽  
Maria Beatrice Musumeci
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Mortality Rate ◽  
Natural History ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Early Years ◽  
Therapeutic Interventions ◽  
Refractory Heart Failure ◽  
History Of ◽  
Annual Mortality

Abstract In the early years of the disease recognition, hypertrophic cardiomyopathy (HCM) was viewed as an ominous disease with unfavourable prognosis and with an annual mortality between 4% and 6%. At that time, 73% of the patients reported in the literature came from only two referral centres. With the introduction of echocardiography, our understanding of HCM has improved and non-selected patient populations were assembled in several centres. A more benign prognostic profile was documented with an annual mortality rate of 1.5% or less. In the 2000s, important therapeutic interventions further improved the prognosis of patients with HCM: implantable-cardioverter defibrillator for prevention of sudden death, heart transplantation for treatment of severe refractory heart failure, and an extensive treatment with myectomy for relief of left ventricular outflow tract gradient. The natural history of HCM has changed substantially with contemporary treatment achieving an annual mortality rate less than 1% with extended longevity and a greatly improved quality of life.

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