scholarly journals Clinical Characteristics And Prognosis of Vasovagal Syncope With Sinus Arrest In Children

2021 ◽  
Author(s):  
Rui Sun ◽  
Yingying Kang ◽  
Yeshi Chen ◽  
Xiaohui Li ◽  
Mingming Zhang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Vasovagal Syncope ◽  
Interquartile Range ◽  
Autonomic Nerve ◽  
Sinus Arrest ◽  
Oral Rehydration ◽  
Autonomic Nerve Function ◽  
Oral Rehydration Salts

Abstract The aim of this study was to analyze the clinical characteristics and prognosis of vasovagal syncope(VVS) with sinus arrest in children. From July 2017 to October 2020, cases of VVS with sinus arrest were recruited from patients diagnosed as VVS in our department. The clinical data, the results of the head-up tilt testing (HUTT), and follow-up information were analyzed. 223 patients were diagnosed as VVS during the time, and 10 cases of VVS with sinus arrest were recruited, who had a median age of 9.5 years（interquartile range: 6.8 to 10.4 years), a gender ratio of 1:1, and median sinus arrest time of 7.7s(range: 3.39 to 19s). These patients were given oral rehydration salts and orthostatic training, as well as 2 children treated with metoprolol and 5 children with sertraline hydrochloride. No child was implanted with pacemakers. During a median of 26 months of follow-up (interquartile range: 21 to 33 months), only one of the children had once syncope episode, three children had 1~4 times of prodromal symptoms. Conclusion The present research most crucial finding was that VVS patients with sinus arrest in children were younger than ordinary pediatric VVS patients. Oral rehydration salts(ORS) and autonomic nerve function exercise may improve clinical symptoms in children with VVS accompanied by sinus arrest. Pacemakers for VVS with sinus arrest in children should be cautious.

scholarly journals The Value of Sacral Reflex and Sympathetic Skin Reflex in the Diagnosis of Multiple System Atrophy P-Type

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xiaohang Li ◽  
Chengju Wang ◽  
Xueming Zhang ◽  
Wanli Zhang ◽  
Binbin Deng ◽  
...  
Keyword(s):  
Multiple System Atrophy ◽  
Clinical Symptoms ◽  
Latency Period ◽  
Sympathetic Skin Response ◽  
Autonomic Nerve ◽  
Control Group ◽  
Autonomic Nerve Function ◽  
The Difference ◽  
Sacral Reflex ◽  
P Type

Objectives. To observe the characteristics of sacral reflex and sympathetic skin reflex in patients with Parkinson’s disease (PD) and multiple system atrophy P-type (MSA-P) and to analyze their value as a differential diagnostic method. Methods. The data of 30 healthy people, 58 PD patients, and 52 MSA-P patients from the First Affiliated Hospital of Wenzhou Medical University were collected. Electrophysiological bulbocavernosus reflex (BCR) and sympathetic skin response (SSR) were evaluated using the Keypoint EMG/EP system. The latency period, amplitude, and extraction rate of BCR and SSR were compared between the control, PD, and MSA-P groups. Results. The incidence of the related autonomic damage in the PD group was lower than that of the MSA-P group. For BCR, the latency period was shorter and the amplitude and elicitation rates were lower in the PD group than in the MSA-P group. For SSR, the latency period was longer in the MSA-P and PD groups than in the control group, but the difference was not statistically significant. Conclusion. SSR cannot be used to assess autonomic nerve function. PD patients can have clinical symptoms similar to those of MSA-P patients, but the incidence is lower. Both MSA-P and PD patients have a damage to the BCR arc, but the MSA-P patients have a more severe damage.

scholarly journals Diagnosis and Treatment of Tuberous Sclerosis Manifestations in Children: A Multicenter Study

2018 ◽  
Vol 49 (03) ◽  
pp. 193-199 ◽  
Author(s):  
Daniel Ebrahimi-Fakhari ◽  
Ludwig Gortner ◽  
Martin Poryo ◽  
Michael Zemlin ◽  
Alfons Macaya-Ruiz ◽  
...  
Keyword(s):  
Tuberous Sclerosis ◽  
Clinical Symptoms ◽  
Medical Center ◽  
Interquartile Range ◽  
University Hospital ◽  
Cardiac Rhabdomyoma ◽  
Cutaneous Manifestations ◽  
Ocular Manifestations ◽  
Made In

AbstractTuberous sclerosis complex (TSC) is a genetic disease with a significant morbidity and mortality. We conducted a retrospective analysis of two cohorts (Vall d'Hebron University Hospital [HVH], Barcelona, Spain, 1982–2015, and at Saarland University Medical Center [UKS], Homburg, Germany, 1998–2015) to assess prevalence and treatment of TSC associated manifestations and to evaluate if the follow-up was in line with published recommendations. This was considered if more than 15% of patients did not receive adequate examination with regard to potential organ involvement. A definite diagnosis was made in 52 patients (96%), and a possible diagnosis was made in 2 patients (4%). Thirty-four (63%) patients were from HVH and 20 (37%) from UKS. Median age at first presentation was 6 months (interquartile range: 0–38 months), and median time of follow-up was 6 years (interquartile range: 2–13 years). Clinical symptoms that led to a diagnosis of TSC were cardiac rhabdomyoma (22/54), epilepsy (20/54), and cutaneous manifestations (4/54). Assessment of neuropsychiatric, renal, and ocular manifestations was inadequate in both hospitals, whereas cutaneous manifestation was inadequate at UKS only. Our data demonstrate insufficient examinations in a substantial number of TSC patients with regard to neuropsychiatric, renal, ocular, and cutaneous manifestations. The recently published guidelines may prove valuable in establishing a more comprehensive approach.

Oral Rehydration Salts: An Effective Choice for the Treatment of Children with Vasovagal Syncope

2015 ◽  
Vol 36 (4) ◽  
pp. 867-872 ◽  
Author(s):  
Weihong Chu ◽  
Cheng Wang ◽  
Lijia Wu ◽  
Ping Lin ◽  
Fang Li ◽  
...  
Keyword(s):  
Vasovagal Syncope ◽  
Oral Rehydration ◽  
Effective Choice ◽  
Oral Rehydration Salts

scholarly journals P358 Prevalence of suicide in a cohort of subjects submitted to exercise echocardiography: clinical characteristics and exercise echocardiography results

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
J C Peteiro Vazquez ◽  
A Bouzas-Mosquera ◽  
A Varela-Cancelo ◽  
C Barbeiro-Caamano ◽  
J Broullon ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Suspected Coronary Artery Disease ◽  
P Value ◽  
Exercise Echocardiography ◽  
Double Product ◽  
Wall Motion Abnormalities ◽  
Artery Disease ◽  
Commit Suicide

Abstract Patients with clinical symptoms and morbidities might be more prone to commit suicide. Suicidal rate reaches up to 25-30/100.000 subjects in the countries most affected by this problem. We aimed to establish the rate of suicides among a large cohort of patients submitted to Exercise echocardiography (ExE), and also to study their clinical and ExE results, to better understand possible explanations. Methods Retrospective analysis of prospectively collected data on 12,615 patients (age 62 ± 12 years, 63% men) with a first treadmill ExE performed in our center for known/suspected coronary artery disease. Exclusion criteria were significant valve disease, cardiomyopathy, congenital heart disease, and age <18 year-old. Ischemia was defined as the development of new wall motion abnormalities (WMAs) with exercise; abnormal ExE as ischemia or resting WMAs. Results During a follow-up of 4.7± 4.8 years (interquartil range 0.1-8.0 years) there were 2,578 deaths, including 21 due to suicide (rate 166/100.000 subjects). We compare clinical characteristics and ExE results between patients that committed suicide (S), patients that died of other causes (OC), and patients that survived (Surv). The worst clinical and ExE characteristics were found in patients that died of non-suicidal causes, whereas patients that committed suicide were in an intermediate risk position (Table). In conclusion, suicidal rate seems to be very high among patients with a clinically indicated ExE. Clinical characteristics and ExE results of suicidal subjects are worse than in survivor patients and could in part explain this event. Surv S OC P value Age, y 61 ± 12 65 ± 11 69 ± 9 <0.001 Male 60% 86% 72% <0.001 Diabetes Mellitus 17.5% 24% 31% <0.001 Achieved METS 9.7 ± 3.2 8.3 ± 3.6 7.6 ± 2.9 <0.001 Good functional capacity (≥10 METs) 55% 52% 29% <0.001 Symptoms during ExE 16% 14% 19% 0.01 Maximal double product 25.0 ± 5.9 22.5 ± 6.4 22.9 ± 6.0 <0.001 Submaximal test 20% 31% 32% <0.001 Ischemia 27% 38% 44% <0.001 ExE abnormal 37% 50% 63% <0.001 LVEF at rest 59 ± 7 53 ± 13 54 ± 11 <0.001 LVEF at peak 64 ± 11 60 ± 16 55 ± 15 <0.001

scholarly journals Bordetella parapertussis Infection in Children: Epidemiology, Clinical Symptoms, and Molecular Characteristics of Isolates

1998 ◽  
Vol 36 (4) ◽  
pp. 999-1002 ◽  
Author(s):  
Paola Mastrantonio ◽  
P. Stefanelli ◽  
M. Giuliano ◽  
Y. Herrera Rojas ◽  
M. Ciofi degli Atti ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Pulsed Field Gel Electrophoresis ◽  
Molecular Characteristics ◽  
Duration Of Symptoms ◽  
Bordetella Parapertussis ◽  
Severe Clinical Picture ◽  
Genomic Dnas ◽  
High Degree

The clinical trial conducted in Italy to evaluate the efficacy of acellular pertussis vaccines provided an opportunity to estimate the frequency of clinical infections with Bordetella parapertussis and to compare the clinical characteristics of children suffering from Bordetella pertussis illness with those of children with B. parapertussis illness. This study dealt with 76 B. parapertussis infections diagnosed from a population of 15,601 children participating in the follow-up of suspected cases of pertussis. An overall incidence of 2.1 cases of laboratory-confirmed parapertussis per 1,000 person-years was observed. Children affected by B. parapertussisinfections showed a less severe clinical picture both in the duration of symptoms and in the percentage of patients affected, even when compared with vaccinated children with pertussis. To characterize the isolated strains, we performed assays for susceptibility to erythromycin and sulfamethoxazole-trimethoprim, and we examined the genomic DNAs by pulsed-field gel electrophoresis. The results showed a high degree of genetic stability among B. parapertussis strains regardless of time of collection and geographical distribution.

scholarly journals The Impact of Comorbidities on the Outcomes of Egyptian COVID-19 Patients: A Follow-Up Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Reda M. Albadawy ◽  
Bismeen A. Jadoon ◽  
Mysara M. Mogahed ◽  
Mohamed E. Ibrahim ◽  
Tarek S. Essawy ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Distress Syndrome ◽  
Clinical Symptoms ◽  
Adverse Outcomes ◽  
Shortness Of Breath ◽  
Chi Square ◽  
Follow Up Study ◽  
Group I ◽  
The Impact

Objectives. This study evaluated the clinical manifestation of COVID-19 and adverse outcomes in patients with comorbidities (outcome: death). Methods. A comparative follow-up investigation involving 148 confirmed cases of COVID-19 was performed for a month (between April and May 2020) at Qaha Hospital to describe the clinical characteristics and outcomes resulting from comorbidities. Participants were divided into two clusters based on the presence of comorbidities. Group I comprised cases with comorbidities, and Group II included subjects without comorbidity. Survival distributions were outlined for the group with comorbidities after the follow-up period. Results. Fever (74.3%), headache (78.4%), cough (78.4%), sore throat (78.4%), fatigue (78.4%), and shortness of breath (86.5%) were the most prevalent symptoms observed in COVID-19 patients with comorbidities. Such patients also suffered from acute respiratory distress syndrome (37.8%) and pneumonia three times more than patients without comorbidities. The survival distributions were statistically significant (chi-square = 26.06, p ≤ 0.001 ). Conclusion. Multiple comorbidities in COVID-19 patients are linked to severe clinical symptoms, disease complications, and critical disease progression. The presence of one or more comorbidities worsened the survival rate of patients.

scholarly journals Treatment of Vasovagal Syncope Associated with Asystole: Literature Review and Case Report of Long-term Follow-up

2021 ◽  
Vol 17 (2) ◽  
pp. 315-322
Author(s):  
A. V. Pevzner ◽  
E. A. Kuchinskaya ◽  
V. G. Kiktev ◽  
G. I. Kheimets
Keyword(s):  
Case Report ◽  
Clinical Symptoms ◽  
Vasovagal Syncope ◽  
Sinus Node ◽  
Pacemaker Implantation ◽  
Cerebral Hypoperfusion ◽  
Double Blind ◽  
Conduction Disturbances ◽  
Long Term Follow Up

Vasovagal syncope (VVS) can occur in every third of human population. Clinical symptoms of VVS areas a result of arterial hypotension with critical global cerebral hypoperfusion due to vasodilatation and bradicardia. Bradicardia is manifested as sinus node dysfunction and atrioventricular conduction disturbances due to activation of nervus vagus. Asystole can take place in some cases. Lack of efficacy of permanent pacemaker founds in patients to prevent of VVS. The results of double blind placebo controlled studies, European and American expert's opinions, probable causes of lack of efficacy of pacemakers in such category of patients and way of solution of this problem are discussed in the review. Syncope recurrences in spite of pacemaker implantation, risk of surgery complications and good life prognosis are arguments for therapeutic approach, now suitable for the most of patients with VVS. Case report (VVS with asystole but without of pacemaker implantation) with successful follow-up is analyzed in the article.

scholarly journals Duration of treatment with oral rehydration salts for vasovagal syncope in children and adolescents

2020 ◽  
Vol 62 (5) ◽  
pp. 820
Author(s):  
Chuan Wen ◽  
Shuo Wang ◽  
Runmei Zou ◽  
Yuwen Wang ◽  
Chuanmei Tan ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Vasovagal Syncope ◽  
Duration Of Treatment ◽  
Oral Rehydration ◽  
Oral Rehydration Salts

scholarly journals Hepatoblastoma relapses after front-line therapy according to SIOPEL protocols: clinical characteristics and outcome

2020 ◽  
Vol 19 (4) ◽  
pp. 32-44
Author(s):  
R. A. Moiseenko ◽  
A. V. Filin ◽  
D. G. Akhaladze ◽  
S. R. Talypov ◽  
M. A. Rakov ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Risk Group ◽  
Demographic Data ◽  
Complete Response ◽  
High Risk Group ◽  
Front Line ◽  
Malignant Liver Tumor ◽  
Line Therapy

Hepatoblastoma (HB) is the most common primary malignant liver tumor in children. Relapses of HB are rare and make up no more than 12% of cases among patients who have achieved complete response after the first-line therapy. The aim of the study was to analyze the incidence, clinical characteristics and outcome of HB relapses in patients treated according to SIOPEL protocols. This study is supported by the Independent Ethics Committee and approved by the Academic Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology. 74 patients with HB were treated for the period 02.2012–12.2018 (82 months). Patients were stratified and treated according to SIOPEL protocols. Relapses were detected in 7/70 (10,0%) patients, who achieved complete response after front-line therapy. We analyzed demographic data, initial tumor characteristics, details of front-line therapy, characteristics of HB relapses and treatment of relapse. Median age at the time of diagnosis of HB was 13,3 (range 0,6–62,9) months. Male:female ratio – 1:0,4. The distribution by PRETEXT stages: II – 2 (28,6%), III – 1 (14,3%), IV – 4 (57,1%). 4 (57,1%) patients had distant metastases. Patients were stratified to standard-risk group – 2 (28,6%) and high-risk group – 5 (71,4%). 3 (42,8%) underwent liver transplantation (LT). Median age at the time of relapse was 33,5 (range 11,9–74,4) months. Median time from the completion of front-line therapy to relapse – 5,3 (range 3,2–19,1) months. Median AFP level at relapse – 35,0 (range 1,8–34160,4) ng/ml. Methods of relapse detection: routine follow-up – 5 (71,4%), clinical symptoms – 2 (28,6%). The latter 2 patients with initially AFP-secreting HB had normal AFP levels at relapse. Pattern of relapse: systemic – 5 (71,4%), combined – 2 (28,6%). The majority of patients received irinotecan-based chemotherapy – 5 (71,4%). Chemotherapy was combined with surgery in 6 (85,7%) cases. Median follow-up time from the moment of relapse was 22,4 (range 5,2–51,3) months. Outcomes: 5 (71,4%) alive (4/5 – with no evidence of disease, 1/5 – with active disease), 2 (28,6%) died of the disease. 3-year overall survival after relapse was 66,6 ± 19,2%. The main conclusion of the study was that combination of second-line chemotherapy with surgical resections allowed achieving long-lasting survival in some HB relapsed patients, including patients who had previously undergone LT.

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