scholarly journals Characterisation of Disease Patterns of Dermatomyositis with Different Initial Manifestations

2021 ◽  
Author(s):  
Yue Sun ◽  
Dai-Feng Li ◽  
Yin-Li Zhang ◽  
Liang Xu ◽  
Tian-Fang Li
Keyword(s):  
Survival Rate ◽  
Respiratory Symptom ◽  
Respiratory Symptoms ◽  
Pulmonary Function Tests ◽  
Laboratory Data ◽  
Atypical Symptoms ◽  
Disease Patterns ◽  
Initial Symptoms ◽  
Positive Rate ◽  
Symptom Group

Abstract Objectives To study the characteristics and prognosis of dermatomyositis (DM) with different initial symptoms. Patients and methods: A retrospective analysis was performed on the patients who were first diagnosed with DM from 1 Jan. 2019 to 1 Jan. 2021. According to different initial symptoms, patients were divided into five groups, including rash, myasthenia, arthritis, respiratory symptom and atypical symptom group. Clinical and laboratory data were recorded. All patients were followed up until 31st May 2021. Results In total 136 patients, rash (40%) was the most common initial symptoms of DM, followed by respiratory symptoms (22%), arthritis (20%), muscle weakness (10%) and atypical symptoms (8%). Rash groups and atypical groups had a higher positive rate of anti-TIF1γ antibodies than arthritis groups and respiratory symptom groups (P < 0.05). Respiratory symptom and arthritis groups had a higher positive rate of anti-Ro52 antibodies than rash and myasthenia groups (P < 0.05). Respiratory groups had a higher incidence of ILD than rash and atypical groups. The FVC and DLCO in respiratory group were significantly lower than rash, arthritis and atypical groups (P < 0.05). The 3-year survival rate of rash groups was significantly higher than myasthenia groups and arthritis groups (P < 0.05). Conclusions DM patients with different initial manifestations had different pulmonary function tests, myositis antibodies and prognosis.

scholarly journals Respiratory Health Status of Workers in a Bottling Factory in Benin City, Nigeria

2018 ◽  
Vol 15 (9) ◽  
pp. 1919
Author(s):  
Sunday Oghuvwu ◽  
Eruke Egbagbe ◽  
Joshua Aigbirior ◽  
Bright Oniovokukor ◽  
Gregory Erhabor
Keyword(s):  
Health Status ◽  
Policy Development ◽  
Respiratory Symptom ◽  
Respiratory Symptoms ◽  
Respiratory Health ◽  
Health And Safety ◽  
Forced Expiratory Volume ◽  
European Respiratory Society ◽  
Benin City ◽  
Exposed Workers

Introduction: There is a paucity of data on the respiratory health status of workers in bottling factories in Benin City, Nigeria. Such data will help to drive future studies and influence policy development on occupational health and safety in the country. This study assesses the respiratory symptoms and spirometric indices of exposed workers and controls. Methods: Respiratory symptoms and spirometric parameters of 18 workers on routine mandatory annual lung screening were assessed using the modified MRC (Medical Research Council) questionnaire and spirometer respectively, according to the European Respiratory Society and American Thoracic Society (ERS/ATS) guidelines. Results: The mean age of workers was 35.1 ± 6.7 years. Workers and controls were similar in age, sex, BMI (Body Mass Index) and health status (p > 0.05). Respiratory symptoms were significantly higher among workers compared to controls. Overall, the result was statistically significant in the variables of wheeze in a smoky or dusty environment, presence of at least one respiratory symptom, better symptoms at weekends and better symptoms during holidays (p < 0.05). In particular, 6 (33.3%) exposed workers had wheeze in a smoky or dusty environment, 9 (50.0%) exposed workers reported at least one respiratory symptom compared with 2 (11.1%) controls, 5 (27.8%) had better symptoms at weekends, and 7 (38.9%) had better symptoms at holidays (p < 0.05). Generally, the reported frequency of respiratory symptoms among exposed workers were: cough (22.2%), sputum production (5.6%), breathlessness (11.1%) and wheeze (44.4%). Similarly, workers had significantly lower spirometric indices than controls, particularly in forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity (FVC) ratio and forced expiratory flow between 25% and 75% of FVC (FEF 25–75%) measurements. Conclusions: This study provides evidence of adverse respiratory health effects among bottling factory workers which requires further investigation.

scholarly journals Clinical characteristics of a group of deaths with COVID-19 pneumonia in Wuhan, China: retrospective case series

2020 ◽  
Author(s):  
Tao Yao ◽  
Yan Gao ◽  
Qin Cui ◽  
Bo Peng ◽  
Yan Chen ◽  
...  
Keyword(s):  
Control Strategies ◽  
Antiviral Treatment ◽  
Invasive Mechanical Ventilation ◽  
Laboratory Data ◽  
Case Series ◽  
The Elderly ◽  
Retrospective Case ◽  
Initial Symptoms ◽  
Comorbid Diseases ◽  
Death Cases

Abstract Background: With the widespread outbreak of novel coronavirus diseases 2019(COVID-19), more and more death cases were reported, however, limited data are available for the patients who died. We aimed to explore the clinial characteristics of deaths with COVID-19 pneumonia Methods: We abstracted and analyzed epidemiological, demographic, clinical, and laboratory data from 83 death cases with COVID-19 pneumonia in East hospital of Wuhan university Renmin hospital,between January 26, 2020, and February 28, 2020.Results: Of the 83 deaths, none was the medical staff. The mean age was 71.8 years (SD 13.2; range, 34-97 years) and 53(63.9%) were male. The median from onset to admission was 10 days (IQR 7-14: range, 2-43 days), to death was 17days (IQR 14-21: range, 6-54 days). Most deaths (66[80%]) had underlying comorbid diseases, the most of which was hypertension [47(57%)]. The main initial symptoms of these 83 deaths were shortness of breath(98.8%), fever(94%) and myalgia or fatigue(90.4%). Laboratory analyses showed the lymphocytopenia in 69(83%) deaths, hypoalbuminemia in 77(93%) deaths, the elevation of lactate dehydrogenase in 79(95%) deaths, procalcitonin in 69(83%) deaths and C-reactive protein in 79(95%) deaths. All 83 patients received antiviral treatment, 81(97.6%) deaths received antibiotic therapy, and 54(65.1%) deaths received glucocorticoid therapy and 20(24.1%) patients received invasive mechanical ventilation.Conclusion: Most of the deaths with COVID-19 pneumonia were elderly patients with underlying comorbid diseases, especially those over 70 years of age. The time of death was mostly 15-21 days after the onset of the disease. More care should be given to the elderly in the further prevention and control strategies of COVID-19.

scholarly journals PREVALENCE OF RESPIRATORY SYMPTOMS AND PULMONARY FUNCTION STATUS OF RESTAURANT WORKERS

2020 ◽  
Vol 20 (3) ◽  
pp. 163-172
Author(s):  
Mohammed Abdulrazzaq Jabbar Jabbar ◽  
Retneswari Masilamani ◽  
Lim Zhi Yik ◽  
Chen Pei Fei ◽  
Loh Xin Ni ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Respiratory Symptoms ◽  
Prolonged Exposure ◽  
Respiratory Health ◽  
Pulmonary Function Tests ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Mean Values ◽  
Cooking Fumes

The cooking process may emit toxic compounds and airway irritants from both the fuel combustion and cooking fumes which is harmful to the respiratory health among the restaurant workers. A cross-sectional study of 243 restaurant workers from the selected restaurants in Sungai Long, Malaysia was conducted. The standardized British Medical Research Council questionnaire on Respiratory Symptoms (1986) was used during the interview to access the symptoms and the spirometry test was performed to evaluate the pulmonary functions of the participants. The data of socio-demography and occupational characteristics were also collected. The most complaint respiratory symptoms by the restaurant workers were breathlessness, which accounted for 33.7%, followed by wheezing (14%). The mean values of all pulmonary function tests (PFT) of the restaurant workers were within the normal range (>80%), except for the Peak Expiratory Flow (PEF) (79.09%). The results of the bivariate statistical analysis, Chi-square, ANOVA and t-test, showed the determining factors of the respiratory health among the workers were workers’ age and gender in addition to the working duration and the ethnicity. The restaurant workers in Sungai Long were at risk of developing respiratory symptoms and lower pulmonary function values due to prolonged exposure to cooking fumes. Emphasis should be given to the safety and health of restaurant workers and health education should be provided to the restaurant workers and owners. Strategies to increase notification of such occurrences among these workers should be looked into by related agencies in the country.

scholarly journals Toxocariasis in children: epidemiological, clinical and laboratory aspects

2020 ◽  
Vol 4 (11) ◽  
pp. 670-675
Author(s):  
A.O. Andreeva ◽  
◽  
N.V. Golovchenko ◽  
A.S. Zhuravlev ◽  
◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Laboratory Data ◽  
Enzyme Linked Immunosorbent Assay ◽  
Blood Eosinophilia ◽  
Rights Protection ◽  
Human Wellbeing ◽  
Consumer Rights ◽  
Positive Rate ◽  
Peripheral Blood Eosinophilia ◽  
Research Institute

Aim: to optimize the diagnosis of toxocariasis based on the analysis of epidemiological, clinical and laboratory data in children with the infestation. Patients and Methods: the analysis of official statistical data for the period of 2014–2018, literature sources, a retrospective analysis of 57 medical records of patients (40 children and 17 adults) who received treatment and diagnostic in the clinic of the Rostov Research Institute of Microbiology and Parasitology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing in 2015–2018 was conducted. Results: a decrease in the incidence of newly diagnosed infestation cases was revealed (registered in the clinic of the Rostov Research Institute of Microbiology and Parasitology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing). It correlated with official statistics (r=0.9, p=0.05). Based on clinical and laboratory examination, the diagnosis was established in 26 patients (45.6%). Among patients with a verified diagnosis of toxocariasis, the proportion of children aged 1 years and 1 months to 10 years old, was 96%. An analysis of epidemiological data showed that 76% of children had close contact with the soil. The infestation occurred in the form of latent toxocariasis in 36% of patients. In more than half of the cases, the disease was clinically manifested by geophagy (56.0%). A permanent laboratory parameter was the eosinophilic leukemoid reaction in patients with toxocariasis. Peripheral blood eosinophilia ranged from 15.66.2±9.31% in latent toxocariasis to 25.5±15.0 % in visceral toxocariasis. The positive rate in ELISA with Toxocara antigen was higher than that in the group of patients with visceral toxocariasis. However, there was no correlation between the eosinophilia level and positive rate (r=0.1, p=0.05). Conclusion: in areas where the incidence of toxocariasis and environmental contamination with invasive helminth eggs are high, it is advisable to perform tests of the peripheral blood in children at least one time per year in the autumn for timely diagnosis of infestation. The use of ELISA with Toxocara antigen is reasonable in the cases of peripheral blood eosinophilia. KEYWORDS: toxocariasis, statistics, incidence, eosinophilia, enzyme-linked immunosorbent assay, Toxocara antigen. FOR CITATION: Andreeva A.O., Golovchenko N.V., Zhuravlev A.S. Toxocariasis in children: epidemiological, clinical and laboratory aspects. Russian Medical Inquiry. 2020;4(11):670–675. DOI: 10.32364/2587-6821-2020-4-11-670-675.

Efficacy of two-stage Meek micrografting in patients with severe burns

2021 ◽  
Author(s):  
Gaozhong Hu ◽  
Peng Zhang ◽  
Yan Chen ◽  
Zhiqiang Yuan ◽  
Huapei Song
Keyword(s):  
Survival Rate ◽  
Skin Graft ◽  
Laboratory Data ◽  
Length Of Hospital Stay ◽  
Skin Grafting ◽  
Two Stage ◽  
Cumulative Survival ◽  
Severe Burns ◽  
Group A ◽  
Group B

Abstract Background Burns are common injuries associated with high disability and mortality. In recent years, Meek micrografting technique has been gradually applied for the wound treatment of severe burns. However, the efficacy of two-stage Meek micrografting in patients with severe burns keeps unclear. Methods The data of eligible patients with severe burns who were admitted to Southwest Hospital of the Third Military Medical University from January 2013 to December 2019 were retrospectively analysed. The patients were divided into two groups according to the Meek micrografting method: one-stage skin grafting (group A) and two-stage skin grafting (group B). The baseline data, survival rate of skin graft, length of hospital stay, treatment costs, laboratory data and cumulative survival were statistically analysed. Results 127 patients (91 in group A and 36 in group B) were included in the study. There were no significant difference in the baseline data, the length of hospital stay and treatment costs between the two groups. The survival rate of skin graft was higher in group B. Total protein and albumin level, platelet count in group B were superior to those in group A, while there were no difference in other laboratory data (prealbumin, serum creatinine, urea nitrogen, cystatin C, blood cultures, wound exudate cultures) and cumulative survival between the two groups. Conclusion Our results demonstrated that staged Meek micrografting could improve the survival rate of skin graft, by reducing the risks of hypoproteinaemia, hypoalbuminemia and low platelet counts after adequate resuscitation.

scholarly journals Ovarian fibrosarcoma: A single-institution experience and a review of the literature

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Ting-Ting Sun ◽  
Ning-Hai Cheng ◽  
Dong-Yan Cao ◽  
Peng Peng
Keyword(s):  
Large Scale ◽  
Pelvic Mass ◽  
Final Diagnosis ◽  
College Hospital ◽  
Ki 67 ◽  
Nccn Guidelines ◽  
Surgical Methods ◽  
Initial Symptoms ◽  
Positive Rate ◽  
Low Incidence

AbstractOvarian fibrosarcoma is an extremely rare and malignant sex cord-stromal tumor. Due to its low incidence and poor prognosis, until now, very few cases have been reported, and most of the reported cases have been sporadic. Therefore, the treatments and prognostic factors of ovarian fibrosarcoma are still debatable. Here, we report 5 cases of ovarian fibrosarcoma that presented at Peking Union Medical College Hospital over the past 20 years. The 5 patients were 41, 51, 54, 76, and 76 years of age when initial symptoms of pelvic mass or pain appeared. On ultrasound, this disease usually manifests as unilateral pelvic masses, within which uneven echo enhancement and some blood flow signals are observed. No significant increase was observed in the levels of preoperative tumor markers, such as serum CA125 and sex hormones. The final diagnosis depends on postoperative histopathological results since these tumors are easily misdiagnosed when intraoperative frozen sections are used for examination. Pathologic examinations showed that the tumor cells were spindle-shaped with moderate to severe atypia and high mitotic counts. The immunohistochemistry profile is not specific, but the positive rate of Ki-67 was consistent with the degree of malignancy and the prognosis of patients with this tumor. In addition, the tumor may also be positive for Vimentin, α-inhibin, SMA, estrogen receptor and progesterone receptor. Significant differences were observed in the surgical methods used, and no unified chemotherapy regimen has been established. The overall survival was > 15, >7, > 6, <1, and < 1 year for each patient. After reviewing the literature, evidence-based large-scale case studies were lacking. For treatments, complete cytoreductive surgery plus regimens typically used against malignant sex cord-stromal tumors, as described in the NCCN guidelines, are recommended. Due to its low incidence, both multicenter clinical studies and molecular studies are required to provide gynecologists with a better understanding and guidance for future management of patients with ovarian fibrosarcoma.

scholarly journals Low Incidence of Biphasic Allergic Reactions in Patients Admitted to Intensive Care after Anaphylaxis

2019 ◽  
Vol 130 (2) ◽  
pp. 284-291 ◽  
Author(s):  
Sofie Højlund ◽  
Peter Søe-Jensen ◽  
Anders Perner ◽  
Morten H. Bestle ◽  
Peder Carl ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Allergic Reaction ◽  
Respiratory Symptoms ◽  
Allergic Reactions ◽  
Total Incidence ◽  
Skin Symptoms ◽  
Initial Symptoms ◽  
Patient Groups ◽  
Low Incidence

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Biphasic allergic reactions—recurrence of allergy symptoms after a symptom-free period—are reported to occur in 1 to 23% of allergic reactions. Patients admitted to an intensive care unit after anaphylaxis potentially have more severe reactions and a higher risk of biphasic allergic reactions. The purpose of this study was to examine incidence, triggers, symptoms, and treatment of biphasic allergic reactions, in patients admitted to an intensive care unit. Methods Records of patients admitted to intensive care units with anaphylaxis from 2011 to 2014 were reviewed. Only patients with a reaction fulfilling internationally accepted criteria for anaphylaxis were included. Potential biphasic allergic reactions, defined as renewed allergy symptoms 1 to 72 h after initial symptoms had resolved, without further exposure to the trigger, were identified. Results A total of 83 cases of anaphylaxis were identified, and the most frequent triggers were medications (58 of 83 [70%]). Skin symptoms occurred in 69 (83%) cases, and circulatory and respiratory symptoms in 48 (58%) and 45 (54%) cases, respectively. In total, 82 (99%), 80 (96%), and 66 (80%) were treated with antihistamines, corticosteroids, and epinephrine, respectively. Only 10 patients presented with one or more relevant symptoms after the initial allergic reaction. Of these, three were possible, and one was a probable biphasic allergic reaction, giving a total incidence of 4 of 83 (4.8% [95% CI, 1.6 to 12.5]) or 1 of 83 (1.2% [95% CI, 0.1 to 7.46]), respectively. All cases were mild, presenting with skin symptoms only, occurring on average 14 h after initial reactions. Conclusions The authors observed a low incidence of biphasic reactions in patients admitted to an intensive care unit after anaphylaxis, at a rate equivalent to that reported in other patient groups.

scholarly journals Impact of first-wave COronaVIrus disease 2019 infection in patients on haemoDIALysis in Alsace: the observational COVIDIAL study

2020 ◽  
Vol 35 (8) ◽  
pp. 1338-1411 ◽  
Author(s):  
Nicolas Keller ◽  
François Chantrel ◽  
Thierry Krummel ◽  
Dorothée Bazin-Kara ◽  
Anne Laure Faller ◽  
...  
Keyword(s):  
Laboratory Data ◽  
Case Fatality ◽  
Patient Characteristics ◽  
Complete Recovery ◽  
High Rate ◽  
Atypical Symptoms ◽  
Reactive Protein ◽  
Risk Of Death ◽  
Included Patient

Abstract Background There are only scarce data regarding the presentation, incidence, severity and outcomes of coronavirus disease 2019 (COVID-19) in patients undergoing long-term haemodialysis (HD). A prospective observational study was conducted in eight HD facilities in Alsace, France, to identify clinical characteristics of HD patients with COVID-19 and to assess the determinants of the risk of death. Methods All HD patients tested positive for COVID-19 from 5 March to 28 April 2020 were included. Collected data included patient characteristics, clinical features at diagnosis, laboratory data, treatments and outcomes. Results Among 1346 HD patients, 123 tested positive for COVID-19. Patients had a median age of 77 years (interquartile range 66–83), with a high number of comorbidities (3.2 ± 1.6 per patient). Symptoms were compatible in 63% of patients. Asthenia (77%), diarrhoea (34%) and anorexia (32%) were frequent at diagnosis. The delay between the onset of symptoms and diagnosis, death or complete recovery was 2 (0–5), 7 (4–11) and 32 (26.5–35) days, respectively. Treatment, including lopinavir/ritonavir, hydroxychloroquine and corticosteroids, was administered in 23% of patients. The median C-reactive protein (CRP) and lymphocyte count at diagnosis was 55 mg/L (IQR 25–106) and 690 Ly/µL (IQR 450–960), respectively. The case fatality rate was 24% and determinants associated with the risk of death were body temperature {hazard ratio [HR] 1.96 [95% confidence interval (CI) 1.11–3.44]; P = 0.02} and CRP at diagnosis [HR 1.01 (95% CI 1.005–1.017); P &lt; 0.0001]. Conclusions HD patients were found to be at high risk of developing COVID-19 and exhibited a high rate of mortality. While patients presented severe forms of the disease, they often displayed atypical symptoms, with the CRP level being highly associated with the risk of death.

scholarly journals Distinct Clinical Characteristics and Risk Factors for Mortality in Female Inpatients With Coronavirus Disease 2019 (COVID-19): A Sex-stratified, Large-scale Cohort Study in Wuhan, China

2020 ◽  
Author(s):  
Jing Chen ◽  
Hualin Bai ◽  
Jia Liu ◽  
Ge Chen ◽  
Qiuyue Liao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Characteristics ◽  
Large Scale ◽  
Cardiac Injury ◽  
Laboratory Data ◽  
Coagulation Disorder ◽  
Risk Of Death ◽  
Initial Symptoms

Abstract Background As the coronavirus disease 2019 (COVID-19) outbreak accelerates worldwide, it is important to evaluate sex-specific clinical characteristics and outcomes, which may affect public health policies. Methods Patients with COVID-19 admitted to Tongji Hospital between 18 January and 27 March 2020 were evaluated. Clinical features, laboratory data, complications, and outcomes were compared between females and males. Risk factors for mortality in the whole population, females, and males were determined respectively. Results There were 1667 (50.38%) females among the 3309 patients. The mortality rate was 5.9% in females but 12.7% in males. Compared with males, more females had no initial symptoms (11.1% vs 8.3%, P = .008). Complications including acute respiratory distress syndrome, acute kidney injury, septic shock, cardiac injury, and coagulation disorder were less common in females; critical illness was also significantly less common in females (31.1% vs 39.4%, P &lt; .0001). Significantly fewer females received antibiotic treatment (P = .001), antiviral therapy (P = .025), glucocorticoids treatment (P &lt; .0001), mechanical ventilation (P &lt; .0001), and had intensive care unit admission (P &lt; .0001). A lower risk of death was found in females (OR, .44; 95% CI, .34–.58) after adjusting for age and coexisting diseases. Among females, age, malignancy, chronic kidney disease, and days from onset to admission were significantly associated with mortality, while chronic kidney disease was not a risk factor in males. Conclusions Significantly milder illness and fewer deaths were found in female COVID-19 inpatients and risk factors associated with mortality varied among males and females.

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