scholarly journals Frequency of myocarditis in cases of fatal meningococcal infection in children: observations on 31 cases studied at autopsy

1999 ◽  
Vol 32 (5) ◽  
pp. 517-522 ◽  
Author(s):  
Norma S. Garcia ◽  
Jane S. Castelo ◽  
Valmin Ramos ◽  
Greyce S.M. Rezende ◽  
Fausto E.L. Pereira
Keyword(s):  
United States ◽  
South Africa ◽  
Survival Time ◽  
High Frequency ◽  
Myocardial Dysfunction ◽  
Case Series ◽  
The United States ◽  
Meningococcal Infection ◽  
Mean Survival Time ◽  
The Mean

The frequency of myocarditis associated with meningococcal disease in children was reported only in two autopsied series (United States and South Africa). Here we report the frequency of associated myocarditis in 31 children who died of meningoccal infection at Hospital Infantil N.S. da Glória in Vitória, Espirito Santo State, Brazil. The diagnosis was confirmed by isolation of Neisseria meningitidis . At least three sections of fragments of both atria and ventricles were studied using the Dallas Criteria for the morphologic diagnosis of myocarditis. The mean age was 47.6 ± 39.8 months and the mean survival time after the onset of symptoms was 46.1 ± 26.5h (12-112h). Myocarditis was present in 13 (41.9%) patients, being of minimal severity in 11 cases and of moderate severity in 2 cases. There were no cases with severe diffuse myocarditis. The frequency of myocarditis was not influenced by sex, presence of meningitis, survival time after the onset of symptoms or use of vasoactive drugs. The frequency of myocarditis reported here was intermediate between the values reported in the only two case series published in the literature (57% in the United States and 27% in South Africa). Although our data confirm the high frequency of myocaditis in meningoccal disease, further investigations are necessary to elucidate the contribution of myocarditis to myocardial dysfunction observed in cases of meningococcal infection in children.

Impact of colonoscopy on patients older than 75.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15096-e15096
Author(s):  
Dhauna Karam ◽  
Mohammed Al-Hamadani ◽  
Shah Pallavi ◽  
Mohamed Shanshal ◽  
Janos Molnar
Keyword(s):  
United States ◽  
Overall Survival ◽  
Survival Time ◽  
The United States ◽  
Young Age ◽  
Screening Colonoscopy ◽  
Rank Test ◽  
P Value ◽  
Age Group ◽  
Mean Survival Time

e15096 Background: Colorectal cancer is the second leading cause of cancer related deaths in the United States. As per current screening guidelines, screening should begin by age 50 and be continued till age 75. Routine screening over 75 years is not recommended. Methods: Our primary objective was to compare survival time in patients undergoing colonoscopy aged 75 years or older to those aged 50-74. The study was conducted at Captain James A. Lovell Federal Health Care Center (FHCC), North Chicago, United States between 2002 and 2012. A retrospective chart review was performed for patients who underwent colonoscopy. Mortality in terms of survival time was compared between patients equal or older than 75 versus those aged 50-74 years with similar procedural indications and life expectancy of 5 years or more. Survival analysis was performed via Kaplan Meier curve with log-rank test. Results: A total of 213 patients were included in the study . Fifty one percent of the patients (108) were 50-74 years old (young age group), while 49% (105) were 75 or older (old age group). Patients had colonoscopy done for following indications: 92 (43%) screening colonoscopy, 62 (29.1%) diagnostic colonoscopy and 59 (27.7%) surveillance colonoscopy. There was no statistical difference between the age groups based on indication of colonoscopy (P = 0.899). Overall mean survival time for all patients was 123.6 months (10.3 years). Survival time was significantly higher for young age group with a mean overall survival of 131.1 months (10.9 years). Older age group had a mean overall survival time of 106.9 months (8.9 years). P-value = 0.009. The highest overall mean survival time was observed in patients who were under 75 and had colonoscopy for screening purposes 138.9 months (11.6 years) (P = 0.019). The lowest overall mean survival time was seen in those who were > 75 years and had colonoscopy due to diagnostic purposes 93.6 months(7.8 years). (P = 0.055) Conclusions: Although statistically significant higher survival time was noted in patients younger than 75, older patients also had a survival time of more than 7 years. This will impact the decision to offer screening colonoscopy to older people who will definitely benefit from the test.

Intermediate-term Experience With the STAR Total Ankle in the United States

2018 ◽  
Vol 40 (3) ◽  
pp. 268-275 ◽  
Author(s):  
Evan M. Loewy ◽  
Thomas H. Sanders ◽  
Arthur K. Walling
Keyword(s):  
United States ◽  
Perioperative Complications ◽  
Case Series ◽  
Major Complication ◽  
The United States ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Patient Reported ◽  
The Mean

Background: Limited intermediate and no real long-term follow-up data have been published for total ankle arthroplasty (TAA) in the United States. This is a report of clinical follow-up data of a prospective, consecutive cohort of patients who underwent TAA by a single surgeon from 1999 to 2013 with the Scandinavian Total Ankle Replacement (STAR) prosthesis. Methods: Patients undergoing TAA at a single US institution were enrolled into a prospective study. These patients were followed at regular intervals with history, physical examination, and radiographs; American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Scale scores were obtained and recorded. Primary outcomes included implant survivability and functional outcomes scores. Secondary outcomes included perioperative complications such as periprosthetic or polyethylene fracture. Between 1999 and 2013, a total of 138 STAR TAAs were performed in 131 patients; 81 patients were female. The mean age at surgery was 61.5 ± 12.3 years (range, 30-88 years). The mean duration of follow-up for living patients who retained both initial components at final follow-up was 8.8±4.3 years (range 2-16.9 years). Results: The mean change in AOFAS Ankle-Hindfoot scores from preoperative to final follow-up was 36.0 ± 16.8 ( P < .0001). There were 21 (15.2%) implant failures that occurred at a mean 4.9 ± 4.5 years postoperation. Ten polyethylene components in 9 TAAs (6.5%) required replacement for fracture at an average 8.9 ± 3.3 years postoperatively. Fourteen patients died with their initial implants in place. Conclusion: This cohort of patients with true intermediate follow-up after TAA with the STAR prosthesis had acceptable implant survival, maintenance of improved patient-reported outcome scores, and low major complication rates. Level of Evidence: Level IV, case series.

scholarly journals Sorafenib plus partial splenic embolism for treatment of hepatocellular carcinoma Barcelona stage C combined with hypersplenism: a case series

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110233
Author(s):  
Jianting Zeng ◽  
Chunmei Wang ◽  
Yu Wang ◽  
Zhenhua Luo ◽  
Yanlin Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cancer ◽  
Survival Time ◽  
Case Series ◽  
Incidence Rates ◽  
Clinical Safety ◽  
Mean Survival Time ◽  
The Mean ◽  
Complications Of Cirrhosis ◽  
Severe Cirrhosis

Background Sorafenib is mainly used to treat patients with hepatocellular carcinoma (HCC) Barcelona Clinic Liver Cancer (BCLC) stage C, many of whom also have severe cirrhosis. However, hypersplenism and digestive tract hemorrhage are common complications of cirrhosis, which increase the risk and difficulty of treatment. Methods Nineteen patients with HCC BCLC stage C with hypersplenism were treated with sorafenib plus partial splenic embolism at Chongqing University Cancer Hospital, Chongqing, China, between January 2015 and June 2018. We analyzed the therapeutic effect and clinical safety of this treatment in these patients. Result Hypersplenism was rectified in all patients. The incidence rates of hemorrhage and myelosuppression were 0%, and the mean survival time was 11.2 months. Conclusion Sorafenib plus partial splenic embolism could relieve hypersplenism and prolong survival in patients with BCLC stage C HCC.

Alexander Hamilton and the Early Republic in Edwardian Imperial Thought

2019 ◽  
Vol 12 (1) ◽  
pp. 28-50 ◽  
Author(s):  
Patrick M. Kirkwood
Keyword(s):  
United States ◽  
South Africa ◽  
Early Republic ◽  
The United States ◽  
Alexander Hamilton ◽  
George Washington ◽  
American Federation ◽  
Treaty Of Versailles ◽  
The Federalist ◽  
The Federalist Papers

In the first decade of the twentieth century, a rising generation of British colonial administrators profoundly altered British usage of American history in imperial debates. In the process, they influenced both South African history and wider British imperial thought. Prior usage of the Revolution and Early Republic in such debates focused on the United States as a cautionary tale, warning against future ‘lost colonies’. Aided by the publication of F. S. Oliver's Alexander Hamilton (1906), administrators in South Africa used the figures of Hamilton and George Washington, the Federalist Papers, and the drafting of the Constitution as an Anglo-exceptionalist model of (modern) self-government. In doing so they applied the lessons of the Early Republic to South Africa, thereby contributing to the formation of the Union of 1910. They then brought their reconception of the United States, and their belief in the need for ‘imperial federation’, back to the metropole. There they fostered growing diplomatic ties with the US while recasting British political history in-light-of the example of American federation. This process of inter-imperial exchange culminated shortly after the signing of the Treaty of Versailles when the Boer Generals Botha and Smuts were publicly presented as Washington and Hamilton reborn.

Clinical Characteristics of Patients Diagnosed with Strongyloidiasis in a United States Urban Outpatient Dermatology Department: A Case Series

2017 ◽  
Vol 1 (3) ◽  
pp. 156-160
Author(s):  
Jacqueline Watchmaker ◽  
Sean Legler ◽  
Dianne De Leon ◽  
Vanessa Pascoe ◽  
Robert Stavert
Keyword(s):  
United States ◽  
Case Series ◽  
The United States ◽  
Screening Tools ◽  
Dermatology Department ◽  
Cutaneous Manifestations ◽  
Serologic Testing ◽  
Patient Reported ◽  
History Of ◽  
Endemic Areas

Background: Although considered a tropical disease, strongyloidiasis may be encountered in non-endemic regions, primarily amongst immigrants and travelers from endemic areas.  Chronic strongyloides infection may be under-detected owing to its non-specific cutaneous presentation and the low sensitivity of commonly used screening tools. Methods: 18 consecutive patients with serologic evidence of strongyloides infestation who presented to a single urban, academic dermatology clinic between September 2013 and October 2016 were retrospectively included.  Patient age, sex, country of origin, strongyloides serology titer, absolute eosinophil count, presenting cutaneous manifestations, and patient reported subjective outcome of pruritus after treatment were obtained via chart review.  Results: Of the 18 patients, all had non-specific pruritic dermatoses, 36% had documented eosinophila and none were originally from the United States. A majority reported subjective improvement in their symptoms after treatment. Conclusion:  Strongyloides infection and serologic testing should be considered in patients living in non-endemic regions presenting with pruritic dermatoses and with a history of exposure to an endemic area.Key Points:Chronic strongyloidiasis can be encountered in non-endemic areas and clinical manifestations are variableEosinophilia was not a reliable indicator of chronic infection in this case series Dermatologists should consider serologic testing for strongyloidiasis in patients with a history of exposure and unexplained pruritus

Global Power Shift

2017 ◽  
Author(s):  
Roberts Cynthia ◽  
Leslie Armijo ◽  
Saori Katada
Keyword(s):  
United States ◽  
South Africa ◽  
Data Analysis ◽  
The United States ◽  
Rising Powers ◽  
Extensive Data ◽  
Power Shift ◽  
Multiple Dimensions ◽  
Global Power ◽  
Rise Of China

This chapter evaluates multiple dimensions of the global power shift from the incumbent G5/G7 powers to the rising powers, especially the members of the BRICS (Brazil, Russia, India, China, and South Africa). Taking note of alternative conceptualizations of interstate “power,” the text maps the redistribution of economic capabilities from the G7 to the BRICS, most particularly the relative rise of China and decline of Japan, and especially Europe. Given these clear trends in measurable material capabilities, the BRICS have obtained considerable autonomy from outside pressures. Although the BRICS’ economic, financial, and monetary capabilities remain uneven, their relative positions have improved steadily. Via extensive data analysis, the chapter finds that whether one examines China alone or the BRICS as a group, BRICS members have achieved the necessary capabilities to challenge the global economic and financial leadership of the currently dominant powers, perhaps even the United States one day.

scholarly journals Longer Residence in the United States is Associated With More Physical Function Limitations in African Immigrant Older Adults

2020 ◽  
pp. 073346482097760
Author(s):  
Manka Nkimbeng ◽  
Yvonne Commodore-Mensah ◽  
Jacqueline L. Angel ◽  
Karen Bandeen-Roche ◽  
Roland J. Thorpe ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
Confidence Interval ◽  
Physical Function ◽  
Racial Discrimination ◽  
African Immigrants ◽  
The United States ◽  
African Immigrant ◽  
High Discrimination ◽  
The Mean

Acculturation and racial discrimination have been independently associated with physical function limitations in immigrant and United States (U.S.)-born populations. This study examined the relationships among acculturation, racial discrimination, and physical function limitations in N = 165 African immigrant older adults using multiple linear regression. The mean age was 62 years ( SD = 8 years), and 61% were female. Older adults who resided in the United States for 10 years or more had more physical function limitations compared with those who resided here for less than 10 years ( b = −2.62, 95% confidence interval [CI] = [–5.01, –0.23]). Compared to lower discrimination, those with high discrimination had more physical function limitations ( b = −2.51, 95% CI = [–4.91, –0.17]), but this was no longer significant after controlling for length of residence and acculturation strategy. Residing in the United States for more than 10 years is associated with poorer physical function. Longitudinal studies with large, diverse samples of African immigrants are needed to confirm these associations.

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