Childhood Infectious Encephalitis: An Overview of Clinical Features, Investigations, Treatment and Recent Patents

2020 ◽  
Vol 14 ◽  
Author(s):  
Cheuk C. Au ◽  
Kam L. Hon ◽  
Alexander K.C. Leung ◽  
Alcy R. Torres
Keyword(s):  
Antimicrobial Agents ◽  
Viral Encephalitis ◽  
Diagnostic Yield ◽  
Clinical Manifestations ◽  
Supportive Therapy ◽  
Electrolyte Balance ◽  
Common Cause ◽  
Treatment And Prevention ◽  
Infectious Organism ◽  
Infectious Encephalitis

Background:: Infectious encephalitis is a serious and challenging condition to manage. This overview summarizes the current literature regarding the etiology, clinical manifestations, diagnosis, management and recent patents of acute childhood infectious encephalitis. Methods:: We used PubMed Clinical Queries and keywords of “encephalitis” AND “childhood” as a search engine, and patents were searched using the key term “encephalitis” in google.patents.com and patentsonline.com. Results:: Viral encephalitis is the most common cause of acute infectious encephalitis in children. In young children, the clinical manifestations can be non-specific. Provision of empiric antimicrobial therapy until a specific infectious organism has been identified, which in most cases includes acyclovir, is the cornerstone of therapy. Advanced investigation tools, including nucleic acid-based test panel and metagenomic next generation sequencing, improve diagnostic yield of identifying an infectious organism. Supportive therapy includes adequate airway and oxygenation, fluid and electrolyte balance, and cerebral perfusion pressure support and seizure control. Recent patents are related to diagnosis, treatment and prevention of acute infectious encephalitis. Conclusions:: Viral encephalitis is the most common cause of acute infectious encephalitis in children and is associated with significant morbidity. Recent advances in understanding the genetic basis and immunological correlation of infectious encephalitis may improve treatment. Third-tier diagnostic tests may be incorporated into clinical practice. Treatment is targeted at the infectious process but remains mostly supportive. Specific antimicrobial agents and vaccines development is ongoing.

scholarly journals Probiotics as Antiviral Agents in Shrimp Aquaculture

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
Bestha Lakshmi ◽  
Buddolla Viswanath ◽  
D. V. R. Sai Gopal
Keyword(s):  
Antimicrobial Agents ◽  
Antiviral Agents ◽  
Shrimp Farming ◽  
Shrimp Aquaculture ◽  
Viral Diseases ◽  
Human Consumption ◽  
Treatment And Prevention ◽  
Power Enhancement ◽  
Shrimp Farms ◽  
Criteria For Selection

Shrimp farming is an aquaculture business for the cultivation of marine shrimps or prawns for human consumption and is now considered as a major economic and food production sector as it is an increasingly important source of protein available for human consumption. Intensification of shrimp farming had led to the development of a number of diseases, which resulted in the excessive use of antimicrobial agents, which is finally responsible for many adverse effects. Currently, probiotics are chosen as the best alternatives to these antimicrobial agents and they act as natural immune enhancers, which provoke the disease resistance in shrimp farm. Viral diseases stand as the major constraint causing an enormous loss in the production in shrimp farms. Probiotics besides being beneficial bacteria also possess antiviral activity. Exploitation of these probiotics in treatment and prevention of viral diseases in shrimp aquaculture is a novel and efficient method. This review discusses the benefits of probiotics and their criteria for selection in shrimp aquaculture and their role in immune power enhancement towards viral diseases.

scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: Pituitary tumour apoplexy

2015 ◽  
Vol 172 (5) ◽  
pp. R179-R190 ◽  
Author(s):  
Cristina Capatina ◽  
Warrick Inder ◽  
Niki Karavitaki ◽  
John A H Wass
Keyword(s):  
Elective Surgery ◽  
Visual Fields ◽  
Clinical Manifestations ◽  
Pituitary Tumour ◽  
Clinical Syndrome ◽  
Electrolyte Balance ◽  
Pituitary Mass ◽  
Optimal Care ◽  
Wide Range

Pituitary tumour apoplexy (PA) is a rare clinical syndrome that occurs as a result of acute haemorrhage and/or infarction within a frequently undiagnosed pituitary tumour. The sudden enlargement of the pituitary mass undergoing PA is responsible for a wide range of acute symptoms/signs (severe headache, visual loss, diplopia, hypopituitarism, impaired consciousness) which, together with the radiological evidence of a pituitary lesion, establish the diagnosis. The optimal care of PA requires involvement of a multidisciplinary team including endocrinologist, neurosurgeon, neuroophthalmologist and the management strategy that depends on the clinical manifestations, as well as the presence of co-morbidities. Prompt surgical decompression is initially indicated in cases with severe or progressive impairment of the visual acuity or the visual fields or with altered mental state and leads to visual and neurological recovery in most of the patients. The patients with mild, stable clinical picture (including those with isolated ocular palsies) can be managed conservatively (support of fluid and electrolyte balance and stress doses of steroids in most cases) with favourable visual and neurological outcome. Frequent reassessment is mandatory because the clinical course can be unpredictable; if progression of symptoms occurs, later elective surgery is indicated and is beneficial, especially in terms of visual outcome. The endocrinological outcome is less favourable, irrespective of the treatment option, with many patients remaining on long-term replacement therapy. Despite the above guidelines, clear proof of optimal outcomes in the form of randomised controlled trials is lacking. Regrowth of the pituitary tumour years after a PA episode is possible and patients require long-term surveillance.

scholarly journals Drug-Induced Heart Failure (Part 2: Mechanisms of Development, Clinical Signs, Differential Diagnosis, Risk Factors, Treatment and Prevention)

2020 ◽  
Vol 8 (2) ◽  
pp. 57-65
Author(s):  
O. D. Ostroumova ◽  
I. V. Goloborodova
Keyword(s):  
Heart Failure ◽  
Beta Blockers ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Left Ventricular ◽  
Clinical Syndrome ◽  
Channel Blockers ◽  
Drug Induced ◽  
Treatment And Prevention ◽  
Developing Heart

Heart failure is a complex clinical syndrome caused by an impaired pumping function of the heart muscle, etiologically associated with cardiovascular disease and, in the vast majority of cases, requiring complex therapeutic regimens and simultaneous prescription of several drugs. To date, we know several classes of drugs (including those used for heart failure) which can induce development/progression of heart failure in both patients with left ventricular dysfunction, and in patients who do not have cardiovascular diseases. The aim of the study was to analyse and systematize data on development mechanisms, as well as methods of prevention and treatment of drug-induced heart failure when using diff erent groups of drugs. It has been established that drug-induced heart failure is most often associated with the use of calcium channel blockers (verapamil, diltiazem, nifedipine), beta-blockers, antiarrhythmic drugs (disopyramide, fl ecainide, propafenone, amiodarone, ibutilide, dofetilide, dronedarone), anthracyclines (doxorubicin) and other antitumor drugs (trastuzumab, bevacizumab, infl iximab), hypoglycemic drugs (thiazolidinediones, saxagliptin, alogliptin), and nonsteroidal anti-infl ammatory drugs, including selective cyclooxygenase-2 inhibitors. The study revealed various mechanisms of heart failure development following drug treatment. In some patients, heart failure development is associated with the cardiotoxic eff ect of a particular drug, in others with adverse eff ects on hemodynamics. Much depends on risks of developing heart failure, including specifi c risks attributable to groups of drugs and individual drugs. The identifi cation of drugs that can contribute to the development/ progression of heart failure, and possible clinical manifestations of drug-induced heart failure, as well as provision of timely information to physicians, and engagement of clinical pharmacologists with the aim of optimizing treatment of patients can facilitate timely diagnosis, treatment and prevention of drug-induced heart failure. 

scholarly journals Experience in treatment and prevention of respiratory diseases relapses in children with the use of the phytotherapeutic complex «Alpicol»: feedback of doctors in Ukraine

2021 ◽  
pp. 12-22
Author(s):  
О.К. Koloskova ◽  
◽  
A.L. Kosakovskyi ◽  
T.M. Bilous ◽  
I.B. Horbatiuk ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Therapeutic Efficacy ◽  
Respiratory Diseases ◽  
Conflicts Of Interest ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Herbal Medicines ◽  
Upper Respiratory Tract ◽  
Treatment And Prevention ◽  
Parents And Children

Infectious and inflammatory diseases of the respiratory tract in children are the «leaders» among all pathologies of childhood. Optimization of therapeutic and prophylactic approaches for infectious and inflammatory pathologies of the respiratory system by reducing the frequency of unreasonable antibiotic therapy and eliminating polypragmatic use is a relevant problem of modern pediatrics and otolaryngology. According to WHO guidelines, modern standardized herbal medicines are not inferior in efficiency to synthetic ones. The aim — to analyze the results of assessment by doctors of the preventive and therapeutic efficacy of the remedy «Alpicol» on the basis of a questionnaire, as well as clinical examination of patients before using the medication and after completion of the course of treatment. Materials and methods. The advantages of «Alpicol» were analyzed through a questionnaire offered by first contact practitioners to children in order to receive feedback on the assessment of the preventive and therapeutic efficacy of this medication. Doctors from 9 regions of Ukraine were involved, and 6,093 questionnaires of children of different ages were analyzed. Results. The frequency of registration of a pronounced paediatric pain (3 scores) with the use of the «Alpicol» medication significantly decreased (23.7 times), a moderate manifestation of the disease (2 scores), was 17 times less at the same time, mild manifestations of paediatric pain remained at the same level. Patients with a comorbid pathology of the respiratory tract in the form of recurrent lesions of the upper and lower airways during the 2nd visit received a zero score (no symptoms) significantly less frequently than children with pathology of the upper respiratory tract with 62.6% of cases versus 72.2% of observations, respectively (p<0.05). As a result of the use of the course of «Alpicol» medication, a statistically significant decrease in the severity of the catarrhal symptom complex was achieved, since the proportion of the course of disease, assessed by the maximum number of scores, decreased by 29.6 times, moderate (score 2) — 13.3 times, and zero scores appeared 5.7 times more often. At the same time, the proportion of patients with a mild course of catarrh practically did not change. Conclusions. «Alpicol» has a multi;vector efficacy against the complex of symptoms that accompany infectious and inflammatory exacerbations of recurrent respiratory diseases. This is manifested by a decrease in the severity of clinical manifestations of the disease, as well as in an increase in cases of clinical stabilization of the patient's condition, which demonstrates the therapeutic and prophylactic effect of the drug «Alpicol» on the course of recurrent respiratory diseases in children. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was adopted by the Local Ethics Committee of all institutions indicated in this research. The informed consent of parents and children was obtained. The authors declare that they have no conflicts of interest. Key words: ecurrent respiratory diseases, treatment and prevention, children, phytocomplexes.

scholarly journals The use of interferon inducers in the comprehensive treatment for the prevention of tick-borne viral encephalitis

2016 ◽  
Vol 21 (6) ◽  
pp. 329-334
Author(s):  
Sergey L. Kazakovtsev ◽  
T. V Sologub ◽  
V. V Tsvetkov
Keyword(s):  
Viral Encephalitis ◽  
High Efficiency ◽  
Clinical Symptoms ◽  
Standard Dose ◽  
Clinical Manifestations ◽  
Post Exposure Prophylaxis ◽  
Comprehensive Treatment ◽  
Post Exposure ◽  
Immunoglobulin Preparations ◽  
Exposure Prophylaxis

The use of immunoglobulin preparations for the postexposure prevention of tick-borne encephalitis as the main therapeutic and prophylactic agent fails to have enough high efficiency. For the postexposure prevention and treatment of tick-borne viral encephalitis the use of preparation tioloroin seems to be appropriate. Objective. To determine the expedience of the use of the preparation tiloron for the emergency prevention of tick-borne viral encephalitis and to evaluate its effectiveness in the treatment of patients with febrile and meningeal forms of this infection. Materials and Methods. The evaluation ofpost-exposure prophylaxis of tick-borne was carried out in two groups of individuals (each group was consisted of 100 cases), suffered from the suction of ticks infected by encephalitis virus. Both groups sought for medical help in the first 48 hours after the moment of the tick suction. None of the victims has not been vaccinated against the disease and had no serological markers of infection. According to existing regulations, patients in both groups received post-exposure prophylaxis antiviral tick immunoglobulin in the standard dose. Patients of the second group additionally received an interferon inducer drug tiloron. For the evaluation of the therapeutic efficacy of the drug tiloron there was executed the analysis of clinical and laboratory picture of verified tick-borne viral encephalitis in 40 patients treated at "Republican Hospital for Infectious Diseases" of the city of Syktyvkar in the period from 2010 to 2015. There were studied the dynamics of clinical symptoms, haematological and biochemical markers, CSF, certain immunological indices: CD4, CD8, CD4/CD8, IgM and IgG. For the comparative assessment of the effectiveness of treatment, all the examined patients were divided into 4 groups depending on the clinical diagnosis and ongoing taken causal treatment. Results. Among the patients received post-exposure prophylaxis with inclusion of the preparation tiloron, the disease developed significantly less often, without the formation offocal forms. The use of tiloron in combination therapy reduced the duration of main clinical manifestations in patients with febrile and meningeal forms of the disease, contributed to a more rapid rehabilitation of cerebrospinal fluid, recovery of subpopulations of T-lymphocytes. Conclusions. Immunomodulating inductor tiloron is effective in complex treatment and prevention of tick-borne viral encephalitis.

scholarly journals The role of the new coronavirus infection (COVID-19) in the progression and development of cerebrovascular diseases. A competent choice of pathogenic treatment is the key to success in treatment and prevention. An expert’s view from the ‘red zone’

2021 ◽  
Vol 13 (1) ◽  
pp. 57-66
Author(s):  
V. V. Kovalchuk
Keyword(s):  
Emotional Disorders ◽  
Clinical Manifestations ◽  
Cerebrovascular Diseases ◽  
Recent Experience ◽  
Treatment And Prevention ◽  
State Recovery ◽  
Group 2 ◽  
State Examination ◽  
Group 1

COVID-19 worsens the course of cerebrovascular diseases (CVD), including chronic cerebral ischaemia (CCI). The Actovegin drug, which has long been widely used in CCI treatment, has an antioxidant and endothelium protective effect. It makes sense to study the effect of Actovegin therapy on the clinical manifestations of CCI in patients with a recent experience of COVID-19.Objective: to evaluate Actovegin efficacy in the treatment of CCI in patients with a recent experience of COVID-19.Patients and methods. The study included 440 patients (234 female; 206 male) with a recent experience of COVID-19, suffering from CCI, their average age being 67.8 years (from 54 to 85 years). All patients were broken down into two groups of 220 people (the patients in Group 1 were administrated Actovegin, the ones in Group 2 – were not). All patients were followed up for 90 days; their condition was assessed by the severity of clinical manifestations of CCI, using special scales and questionnaires.Results and discussion. After 90 days of follow-up, the frequency of complaints of cognitive impairment, sleep disorder, dizziness, fatigue, emotional disorders, and headache in Group 1 was significantly lower than in Group 2 (p<0.05). According to Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), Multidimensional Fatigue Inventory (MFI-20), and Spiegel Sleep Questionnaire (SSQ), the average indicators improved significantly more in Group 1 than in Group 2 (p<0.05). The absence of quality of life impairment and their minimal severity were observed in Group 1 in 77.9%; in Group 2 – in 33.7% (p<0.001). Statistically significant differences between the groups of patients were also observed in relation to emotional state recovery according to the Wakefield Questionnaire and the Spielberger State Trait Anxiety inventory.Conclusion. The observational study demonstrated the efficacy of Actovegin in the treatment of main clinical manifestations of CCI in patients with recent COVID-19 experience.

scholarly journals The analysis of complex influence of the adverse ecological/ professional factors on reproduction health of the women

2003 ◽  
Vol 52 (2) ◽  
pp. 35-46
Author(s):  
Vitaly F. Bezhenar ◽  
Evgeny F. Kira ◽  
Yuri V. Tsvelev ◽  
А. E. Antushevich ◽  
А. M. Nikiforov
Keyword(s):  
Reproductive Health ◽  
Clinical Manifestations ◽  
Toxic Chemical ◽  
Radiation Accident ◽  
Chemical Production ◽  
Occupational Factors ◽  
Treatment And Prevention ◽  
Comprehensive Examination ◽  
Health Disorders ◽  
Complex Influence

As a result of the study and generalization of the results of a comprehensive examination of 3339 women, the main mechanisms of occurrence, clinical manifestations and dynamics of reproductive health disorders in women under the combined influence of unfavorable environmental and occupational factors (radiation accident, toxic chemical production) were established and the main directions for their diagnosis, treatment and prevention were substantiated.

Disorders of Water and Sodium Balance: Hyponatremia

2019 ◽  
Author(s):  
Danilea M. Carmona Matos ◽  
Herbert Chen
Keyword(s):  
Antidiuretic Hormone ◽  
Sodium Transport ◽  
Clinical Manifestations ◽  
Electrolyte Imbalance ◽  
Renal Physiology ◽  
Sodium Balance ◽  
Electrolyte Balance ◽  
Clear Understanding ◽  
Drug Induced ◽  
Clinical Scenarios

Disorders of water and sodium balance are common in clinical practice. To better assess them, we must have a clear understanding of water-electrolyte homeostasis and renal function. The following review goes over practical equations necessary for electrolyte balance analysis as well as the foundations of renal physiology. Emphasis is placed on the understanding of sodium transport and its physiologic and pharmacologic regulation. In addition, we explore the most common electrolyte imbalance affecting up to 28% of hospitalized patients: hyponatremia (ie, low sodium concentration). Hyponatremia has been found in several acute and chronic clinical scenarios including postoperative, drug-induced, and exercise-associated hyponatremia. However, it is not uncommon to find this disorder coexisting with other diseases such as syndrome of inappropriate secretion of antidiuretic hormone (SIADH), acquired immunodeficiency syndrome (AIDS), cancer, and in rare cases, hypothyroidism. To better understand this disorder, the etiology, diagnosis with clinical manifestations and laboratory values, and treatment options are explored. This review contains 9 figures, 6 tables, and 52 references. Key Words: aldosterone, antidiuretic hormone, body fluids, electrolyte balance, hyponatremia, hypovolemia, osmolality, sodium transport, vasopressin

Disorders of Water and Sodium Balance: Hyponatremia

2019 ◽  
Author(s):  
Danilea M. Carmona Matos ◽  
Herbert Chen
Keyword(s):  
Antidiuretic Hormone ◽  
Sodium Transport ◽  
Clinical Manifestations ◽  
Electrolyte Imbalance ◽  
Renal Physiology ◽  
Sodium Balance ◽  
Electrolyte Balance ◽  
Clear Understanding ◽  
Drug Induced ◽  
Clinical Scenarios

Disorders of water and sodium balance are common in clinical practice. To better assess them, we must have a clear understanding of water-electrolyte homeostasis and renal function. The following review goes over practical equations necessary for electrolyte balance analysis as well as the foundations of renal physiology. Emphasis is placed on the understanding of sodium transport and its physiologic and pharmacologic regulation. In addition, we explore the most common electrolyte imbalance affecting up to 28% of hospitalized patients: hyponatremia (ie, low sodium concentration). Hyponatremia has been found in several acute and chronic clinical scenarios including postoperative, drug-induced, and exercise-associated hyponatremia. However, it is not uncommon to find this disorder coexisting with other diseases such as syndrome of inappropriate secretion of antidiuretic hormone (SIADH), acquired immunodeficiency syndrome (AIDS), cancer, and in rare cases, hypothyroidism. To better understand this disorder, the etiology, diagnosis with clinical manifestations and laboratory values, and treatment options are explored. This review contains 9 figures, 6 tables, and 52 references. Key Words: aldosterone, antidiuretic hormone, body fluids, electrolyte balance, hyponatremia, hypovolemia, osmolality, sodium transport, vasopressin

Report of the Task Force on Diagnosis and Management of Meningitis

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 959-982
Author(s):  
Jerome O. Klein ◽  
Ralph D. Feigin ◽  
George H. McCracken
Keyword(s):  
Bacterial Meningitis ◽  
American Academy ◽  
Antimicrobial Agents ◽  
Task Force ◽  
Diagnosis And Treatment ◽  
Diagnosis And Management ◽  
Treatment And Prevention ◽  
American Academy Of Pediatrics ◽  
Early Signs ◽  
Neurologic Sequelae

Children still die or suffer permanent neurologic sequelae as a result of bacterial meningitis. Prompt diagnosis and aggressive management are the goals, but early signs of meningitis are often subtle and nonspecific and, therefore, may be recognized only in retrospect. The physician must identify among the many febrile children seen every day in office practice—most of whom have spontaneously resolving illnesses usually caused by viruses—the few children who have serious bacterial infection requiring early intervention. No single test or battery of tests replaces the clinical acumen of the physician in identifying the child with early signs of bacterial meningitis. Because of controversies about diagnosis and treatment of meningitis voiced in various forums, including the courtroom, the Task Force on Diagnosis and Management of Meningitis has been asked by the Executive Board of the American Academy of Pediatrics to prepare a report on the causes, diagnosis, management, and outcome of meningitis in infants and children. This task force selected for discussion issues of current relevance and controversy in the diagnosis and treatment of bacterial and nonbacterial meningitis. Many other aspects of meningitis are discussed elsewhere. Commentaries on the prevention of disease by chemoprophylaxis (antimicrobial agents) or immunoprophylaxis (vaccines) have been prepared by the Committee on Infectious Diseases of the American Academy of Pediatrics. In addition the Morbidity and Mortality Weekly Report (Centers for Disease Control, Atlanta) publishes recommendations on vaccine usage and chemoprophylaxis formulated by the Advisory Committee on Immunization Practices. These resources are of value to the practitioner who cares for children and needs information on optimal measures for the treatment and prevention of meningitis.

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