Neonatal Polycythemia: Frequency of Clinical Manifestations and Other Associated Findings

PEDIATRICS ◽  
1986 ◽  
Vol 78 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Thomas E. Wiswell ◽  
J. Devn Cornish ◽  
Ralph S. Northam
Keyword(s):  
Respiratory Distress ◽  
United States Army ◽  
Premature Infants ◽  
Gonadal Dysgenesis ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Feeding Problems ◽  
Intracranial Hemorrhages ◽  
Army Hospitals

We report the results of a two-part study examining the frequency of symptoms and other findings associated with neonatal polycythemia. In the first part of the investigation, we evaluated the occurrence and features of the disorder in a cohort of 3,768 infants born at our institution that had been screened for the disorder during a 4-year period. Fifty-five infants (1.46%) had neonatal polycythemia. Of these infants, 85% had features associated with the disorder. Frequent signs and symptoms included "feeding problems" (21.8%), plethora (20.0%), lethargy (14.5%), cyanosis (14.5%), respiratory distress (9.1%), jitteriness (7.3%), and hypotonia (7.3%). Other findings included hypoglycemia (40.0%) and hyperbilirubinemia (21.8%). Of the polycythemic infants, 14.5% had no clinical symptoms or associated laboratory abnormalities. In the second portion of the study, we reviewed the features of polycythemia in all infants so diagnosed who were born in United States Army hospitals, worldwide, during a 5-year period. There were 220,050 infants born during this period; 932 (0.42%) were diagnosed as having neonatal polycythemia. Frequent findings were hyperbilirubinemia (33.5%), hypoglycemia (13.0%), and respiratory distress (6.6%). In this large group, only 13 (1.4%) had necrotizing enterocolitis, and nine (1.0%) were thrombocytopenic. Several findings among the 932 infants were unexpected. Six of the infants (only one premature) had intracranial hemorrhages. Additionally, three of the 932 had gonadal dysgenesis and three had cystic fibrosis. We found that premature infants were not less prone to having polycythemia and that the overall frequency of the disorder was less than that which has been previously reported.

CLINIC AND COMPLICATIONS OF COVID-19 CORONAVIRUS DISEASE WITH PATHOGENESIS ELEMENTS

2020 ◽  
pp. 72-79
Author(s):  
I. V. Аndrusovich
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Tract ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Second Phase ◽  
Upper Respiratory Tract

The longer the COVID−19 coronavirus pandemic lasts, the more information about its clinical manifestations is accumulated. The incubation period of COVID−19 ranges from 2 to 14 days, rarely up to 3 weeks, but in a significant number of cases an infection is not accompanied with the appearance of clinical symptoms. Currently, the following variants of the clinical course of COVID−19 can be identified as follows: viral load; subclinical; slight; uncomplicated with damage to only the upper respiratory tract; mild pneumonia, severe pneumonia, acute respiratory distress syndrome, etc. The clinical course of COVID−19 depends on the severity, the criteria of which are the intoxication manifestation, the degree of fever and the dominant syndrome. Mild / moderate forms are manifested by frequent increase in body temperature up to 38 ° C, respiratory symptoms, headache, myalgias, palpitations and general malaise. Patients stop distinguishing smells and feel the taste of food. Approximately from the 7th to the 9th days of the disease there are problems with breathing, which indicates the impairment of the lower respiratory tract and the beginning of the second phase of the disease, and its course is regarded as severe. Severe forms of the disease can also be manifested by impaired coordination of movements, slurred speech. In 1 to 4 % of patients there is developed the psychosis in the form of hallucinations. In the elderly, COVID−19 may be accompanied by delirium, lowering blood pressure. The risks of adverse disease are associated with somatic diseases: cardiovascular and nervous systems, respiratory tract, hormonal disorders, etc. Otitis, sinusitis, sepsis, bronchopulmonary infection, thrombosis, myocarditis etc. can be the complications of COVID−19. Computer tomography is an instrumental test that demonstrates the damage of lungs with coronavirus and allows to assess its severity. Key words: coronavirus infection, COVID−19, clinical variants, severity, pneumonia, acute respiratory distress syndrome.

scholarly journals Retrospective study of clinical profile and outcome of pediatric dengue cases in a teaching hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 226
Author(s):  
Alok Kumar M. K. ◽  
Timmangouda R. Patil ◽  
Santhosh Veerabadhraiah
Keyword(s):  
Retrospective Study ◽  
Respiratory Distress ◽  
Dengue Fever ◽  
Clinical Symptoms ◽  
Fluid Management ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Severe Dengue ◽  
Study Results ◽  
Wide Range

Background: Dengue fever is an acute febrile illness caused by 4 closely related viral serotypes of the genus Flavivirus. Dengue has a broad range of clinical manifestations and often with unpredictable clinical evaluation and outcome. So this study has been done to see the wide range of clinical presentation of dengue and its outcome.Methods: It is a retrospective study done in tertiary hospital during the period of 8 months. Study was done by collecting the previous records from hospital record section. There were 48 cases of serologically confirmed cases of dengue which satisfied the inclusion and exclusion criteria were included in the study. Results: In our study there were 52% of the cases of dengue fever, 16.6% of cases were dengue fever with warning signs and remaining 31.4% of patients were severe dengue. Common Clinical symptoms at admission were fever (100%), vomiting (77%), respiratory distress (56.25%), generalised weakness (54.1%) and pain abdomen (33.3%). Less common symptoms were loose stools (6.25%), periorbital puffiness (6.25%), altered sensorium (4.1%), oliguria (2%) and bleeding manifestations (2%). Out of these dengue children 70.8% of these children improved without complication, 20.8 % of children improved with complication, in the form of ARDS, acute liver failure, DSS, meningitis, 6.25 % of these children went DAMA and  2 % of children expired.Conclusions: In our study atypical presentations like respiratory distress, loose stools meningitis were commonly noted and bleeding manifestation at admission was rare in our study. Platelet transfusions have little role in management of dengue patients. Early diagnosis, careful monitoring and proper fluid management goes a long way in reducing the mortality due to dengue hemorrhagic fever and shock syndrome.  

scholarly journals Common Presenting Signs and Symptoms in Children with Acute Lymphoblastic Leukemia

2021 ◽  
Author(s):  
Ehsan Shahverdi ◽  
Mehdi Shahriari ◽  
Soonia Zare ◽  
Mohammad Saeid Rahimine- jad ◽  
Fatemeh Hosseinpour Soleimani ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Retrospective Cohort ◽  
Clinical Symptoms ◽  
Lymphoblastic Leukemia ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Medical Sciences ◽  
Early Stages ◽  
Specific Symptoms ◽  
Common Malignancy

Background: Acute lymphoblastic leukemia (ALL) is one of the blood cancers responsible for 80% of children’s leukemia and is also the most common malignancy in patients aged under 14 years (frequency of 23% among all types of cancers). Regarding the importance of identifying clinical symptoms to diagnose the disease in the early stages, this study is conducted to investigate the symptoms at diagnosis in ALL children. Methods: In this retrospective cohort study, 350 patients aged under 14, referring to four hospitals of Shiraz University of Medical Sciences as reference hospitals in Southern Iran, participated between 2013 and 2019. Their information was collected using patients’ records, and the data were analyzed using SPSS version16. Results: Based on the findings of this study, the first clinical manifestations of the disease happened suddenly and acute, occurring within a few days to a maximum of 6 weeks before diagnosis. Fever (70%) and hepatomegaly (60%) were the most common signs and symptoms in patients. However, a significant percentage of ALL patients referred with non-specific symptoms. Conclusion:The results of this study indicate the importance of recognizing common and unusual signs and symptoms based on a complete and thorough history taking and accurate physical examination as well as rare symptoms that may be ignored or misdiagnosed by physicians. The knowledge of common signs and symptoms results in early diagnosis of the disease in early stages.

scholarly journals Clinical characteristics of COVID-19 in children compared with adults in Shandong, China

2020 ◽  
Author(s):  
Wenjun Du ◽  
Jinhong Yu ◽  
Hui Wang ◽  
Xiaoguo Zhang ◽  
Shouwei Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Health Workers ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Case Series ◽  
Signs And Symptoms ◽  
Asymptomatic Patients ◽  
Positive Indicators ◽  
Clinical Signs And Symptoms

Abstract Aims & Background: The COVID-19 outbreak spread in China and is a threat to the world. We reported on the epidemiological, clinical, laboratory, and radiological characteristics of children cases to help health workers better understand and provide timely diagnosis and treatment.Methods: Retrospectively, two research centers’ case series of 67 consecutive hospitalized cases including 14 children cases with COVID-19 between 23 Jan 2020 to 15 Feb 2020 from Jinan and Rizhao were enrolled in this study. Epidemiological, clinical, laboratory, and radiological characteristics of children and adults were analyzed and compared.Results: Most cases in children were mild(21.4%) and conventional cases(78.6%), with mild clinical signs and symptoms, and all cases were of family clusters. Fever (35.7%) and dry cough(21.4%) were described as clinical manifestations in children cases. Dry cough and phlegm were not the most common symptoms in children compared with adults(p=0.03). In the early stages of the disease, lymphocyte counts did not significantly decline but neutrophils counts did in children compared with adults(p=0.00).There was an elevated level of LDH(p=0.01) and a lower level of CRP(p=0.00)and IL-6(p=0.01) in children compared with adults. There were 8 (57.1%)asymptomatic cases and 6 (42.9%)symptomatic cases among the 14 children cases. The age of asymptomatic patients was younger than that of symptomatic patients(p=0.03). Even among asymptomatic patients, 5(62.5%)cases had pneumonia including 3 (60%) cases with bilateral pneumonia, which was not different compared with that of asymptomatic cases(p=0.58, p=0.74).Conclusions: The clinical symptoms of children are mild, and the positive indicators of laboratory tests are rare, which may easily cause clinical misdiagnoses.

Pulmonary Paragonimiasis in Laotian Refugee Children

PEDIATRICS ◽  
1982 ◽  
Vol 70 (2) ◽  
pp. 246-248
Author(s):  
Karen Burton ◽  
Ram Yogev ◽  
Naomi London ◽  
Kenneth Boyer ◽  
Stanford T. Shulman
Keyword(s):  
Family History ◽  
Respiratory Distress ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Refugee Children ◽  
Chest Roentgenogram ◽  
Lung Fluke ◽  
One Year ◽  
Physical Findings ◽  
Indochinese Refugee

Three Laotian refugee children with chronic pulmonary complaints and findings were found to have pulmonary paragonimiasis during a one-year period in Chicago. These patients ranged from 8 to 11 years of age and the diagnosis was delayed five to six months in two children because of the unfamiliarity of American physicians with signs and symptoms of this disorder. Clinical manifestations included chronic cough for up to two years, apparent hemoptysis in two patients, lack of fever or sweats, and family history negative for tuberculosis. Physical findings included rales and dullness to percussion, clubbing (one patient), and lack of fever or respiratory distress. All three patients showed interstitial infiltrates on chest roentgenogram whereas two had multiple small cystic areas. Moderate eosinophilia was present. Paragonimus westermani ova were found in stools of two patients, in sputum of two patients, and in bronchoscopic specimens in one patient. All patients demonstrated striking clinical and radiologic improvement following treatment with bithionol (50 mg/kg every other day for 15 doses), which was well tolerated. Lung fluke infestation must be considered in Indochinese refugee children with apparent hemoptysis or chronic pulmonary symptoms, and sputum and stool should be examined for P westermani ova.

scholarly journals Relationship Between Rhinitis, Asthma, and Eczema and the Presence of Sensitization in Young Swiss Adults

2018 ◽  
Vol 9 ◽  
pp. 215265671877360 ◽  
Author(s):  
Urs C. Steiner ◽  
Lucas M. Bachmann ◽  
Micheal B. Soyka ◽  
Stephan Regenass ◽  
Lukas Steinegger ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Allergic Sensitization ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Rapid Test ◽  
Signs And Symptoms ◽  
Causative Factor ◽  
Common Disease ◽  
Common Symptom ◽  
Perennial Rhinitis

Background Rhinitis is a very common disease with allergies being the most frequent causative factor. It can co-occur together with asthma and eczema in atopic as well as in nonatopic patients. Objectives To assess the prevalence of allergic sensitization within patient groups with rhinitis in consideration of the co-occurring disorders of asthma and eczema. Methods Students of the third year of medical school completed an anonymous questionnaire on age, gender, and clinical symptoms, such as seasonal rhinitis, perennial rhinitis, asthma, and eczema, and underwent an ImmunoCAP Rapid test. We calculated the prevalence of sensitization within subgroups of patients reporting allergic disorders, such as rhinitis, asthma, and eczema. Results Questionnaires and ImmunoCAP Rapid tests of 1513 medical students were analyzed. The participants’ self-reported presence of seasonal/perennial rhinitis, asthma, and eczema was compared to the presence of sensitization. Data of 1467 subjects could be analyzed. Seasonal rhinitis was the most common symptom, followed by eczema, asthma, and perennial rhinitis. The participants were differentiated into 16 subgroups according to the combined clinical manifestations of the different symptoms and association to sensitization within subgroups. The prevalence of sensitization ranged from 18% in subjects reporting only eczema without any other symptom to 100% in those reporting to have asthma, seasonal/perennial rhinitis, and eczema together. In subjects reporting no sign or symptom at all, the prevalence of sensitization was 19%. Seasonal rhinitis was the strongest single predictor for sensitization with the highest proportion of sensitized participants in all symptom combinations (67%–100%), followed by perennial rhinitis (31%–100%), asthma (30%–100%), and eczema (18%–100%). Conclusion Rhinitis most often is associated with allergen sensitization, and the probability of sensitization is substantially enhanced by co-occurrence of asthma. A careful assessment of clinical signs and symptoms is important and enables the selection of patients in whom targeted diagnostic analysis and therapy is appropriate. Trial registration: retrospectively registered by the Cantonal Ethics Committee Zurich on 22.01.2016; Nr: 08-2016.

scholarly journals Ocular Paraneoplastic Syndromes

Biomedicines ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. 490
Author(s):  
Joanna Przeździecka-Dołyk ◽  
Anna Brzecka ◽  
Maria Ejma ◽  
Marta Misiuk-Hojło ◽  
Luis Fernando Torres Solis ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Fundus Autofluorescence ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Paraneoplastic Syndromes ◽  
Fundus Photography ◽  
Fundus Fluorescein Angiography ◽  
Systematic Analysis ◽  
Electrophysiological Examination ◽  
Cancer Associated Retinopathy

Ocular-involving paraneoplastic syndromes present a wide variety of clinical symptoms. Understanding the background pathophysiological and immunopathological factors can help make a more refined differential diagnosis consistent with the signs and symptoms presented by patients. There are two main pathophysiology arms: (1) autoimmune pathomechanism, which is presented with cancer-associated retinopathy (CAR), melanoma-associated retinopathy (MAR), cancer-associated cone dysfunction (CACD), paraneoplastic vitelliform maculopathy (PVM), and paraneoplastic optic neuritis (PON), and (2) ectopic peptides, which is often caused by tumor-expressed growth factors (T-exGF) and presented with bilateral diffuse uveal melanocytic proliferation (BDUMP). Meticulous systematic analysis of patient symptoms is a critical diagnostic step, complemented by multimodal imaging, which includes fundus photography, optical coherent tomography, fundus autofluorescence, fundus fluorescein angiography, electrophysiological examination, and sometimes fundus indocyjanin green angiography if prescribed by the clinician. Assessment of the presence of circulating antibodies is required for diagnosis. Antiretinal autoantibodies are highly associated with visual paraneoplastic syndromes and may guide diagnosis by classifying clinical manifestations in addition to monitoring treatment.

THE RESPIRATORY DISTRESS SYNDROME AND ITS SIGNIFICANCE IN PREMATURE INFANTS

PEDIATRICS ◽  
1959 ◽  
Vol 24 (2) ◽  
pp. 194-204
Author(s):  
William Allen Bauman
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Clinical Manifestations ◽  
Hyaline Membrane Disease ◽  
Respiratory Difficulty ◽  
Hyaline Membrane ◽  
Central Nervous Systems ◽  
Physical Findings

THE RESPIRATORY distress syndrome of the newborn period is recognized as a clinical entity predominantly afflicting newborn premature infants. Although disorders of the cardiovascular and central nervous systems as well as metabolic derangements are capable of causing a newborn infant to have dyspnea, in those who die the pathologist more frequently finds pulmonary disease. Microscopic examination of the premature infant's lung often discloses atelectasis, emphysema, edema, pneumonia, hemorrhage, aspiration of amniotic debris and the presence of hyaline membrane. In a previous study a significant relationship between respiratory difficulty in early life, pulmonary roentgenographic abnormalities, and the presence of pulmonary hyaline membrane at necropsy was demonstrated. Curtis has most recently reviewed much of the literature relating to etiology and treatment of "hyaline membrane disease." The clinical manifestations of the syndrome, however, have been infrequently recorded. Miller and Jennison in a survey of more than 4,000 births indicated that the infants who died with hyaline-like material in the lungs had had symptoms characterized by marked respiratory difficulty including retraction of the lower chest wall on inspiration. Parmelee stated that dyspnea was frequently associated with retractions of the rib margins and lower sternum and that there also was grunting and cyanosis to a varying degree. Blystad showed that 15 of 25 dyspneic newborn prematures who died had hyaline membrane formation in the lungs. It is the purpose of this paper to present a clinical appraisal of the respiratory distress syndrome and further to demonstrate its relationship to the presence of pulmonary hyaline membrane at necropsy. CLINICAL DIAGNOSIS The newborn premature infant may manifest the respiratory distress syndrome by several physical findings. Characteristically he breathes as if he has glottic obstruction; intercostal retractions accompany strong inspiratory movements.

Etiology and clinical features of epididymo-orchitis: A single-center study in Tehran, Iran

2020 ◽  
Vol 20 ◽  
Author(s):  
Sara Abolghasemi ◽  
Mohammad Alizadeh ◽  
Ali Hashemi ◽  
Shabnam Tehrani
Keyword(s):  
Chlamydia Trachomatis ◽  
Clinical Symptoms ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
Urinary Frequency ◽  
Serological Tests ◽  
Duration Of Symptoms ◽  
Two Samples ◽  
History Of ◽  
Tract Infections

Introduction: Epididymo-orchitis is a common urological disease among men. Little is known about the clinical and epidemiological aspects of the disease in Iran. Thus, the present study was aimed to investigate the etiology, clinical sequelae and risk factors of patients with epididymo-orchitis in Tehran, Iran. Materials and Methods: Patients presenting with epididymo-orchitis were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, molecular and serological tests were undertaken to look for Chlamydia trachomatis, Neisseria gonorrhoeae, Brucella spp., Mycoplasma spp, and other bacteria. Results: Fifty patients with epididymo-orchitis were evaluated according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The mean age of the patients was 53 years. Fever, dysuria, pain in the flanks, urinary frequency and discharges occurred in 58.0%, 50.0%, 50.0%, 28.0% and 6.0%, respectively. Bacterial pathogen was identified in 26% (13/50) of patients by urine culture. Escherichia coli was the etiological agent in 11/13 patients (84.6%). Two out of 50 patients (4.0%) were also positive for Chlamydia trachomatis. Two samples were serologically positive for Brucella spp. High Mean age, fever, urinary frequency, history of the underlying disease and history of urinary tract infections were found to have a significant association with the positive bacteriologic urine culture (P<0.05). Conclusions: The most common clinical manifestations were fever, dysuria, and abdominal pain. E. coli and C. trachomatis were the major causative agents. Use of a set of diagnostic approaches including clinical symptoms, urine culture and more precise techniques such as PCR should be taken into consideration for the definitive diagnosis.

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