Clinical presentation of different severities of hemorrhagic fever with renal syndrome: How to recognize it

Background/Aim. Besides viral serotype, HLA haplotype and cytokine genes polymorphism are associated with clinical presentation of hemorrhagic fever with renal syndrome. Since these analyses are unavailable in routine clinical practice, the aim of this study was to assess clinical, laboratory and radiographic findings associated with clinical presentation of disease severity. Methods. A total of 30 patients (27 men and 3 women), average age 40 ? 14.9 years, treated for hemorrhagic fever with renal syndrome from January 1, 1999 to December 31, 2009 in Clinical Center of Serbia, were included in the study. Nine patients (30%) had mild, 14 (46.7%) moderate and 7 (23.3%) severe form of the disease; 24 (80%) recovered, 6 (20%) died in the acute phase of the illness, and 19 patients (63.3%) required hemodialysis. Results. The average titer of antiviral antibodies in patients infected with Belgrade serotype virus were significantly higher in those with severe clinical presentation. Hypotension, anuria, macrohaematuria, pulmonary infiltration, pleural effusion, hepatomegalia and positive meningeal signs were more frequent in the patients with severe form of the disease. Statistically significant differences between groups with mild, moderate and severe clinical picture were found in serum total protein, albumin, calcium, glutamate pyruvate and glutamate oxaloacetate transaminase on admittance; serum creatinine and phosphorus concentration on day 14 and day 21; serum sodium and calciums on day 14; hemoglobine concentration on day 21. A statistically significant correlation was found between clinical presentation of the disease severity and platelet count, white blood cell count, hemoglobine concentration, serum calcium and serum transaminases on admittance. Multivariate analysis identified variables` combinations associated with clinical presentation of the disease. Conclusion. Our study confirmed that we can distinguish patients who will manifest different severities of the disease on the basis of careful consideration of laboratory and clinical findings on admission.

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Application of ribavirin in patients having hemorrhagic fever with renal syndrome

Medicinski pregled ◽

10.2298/mpns0902063z ◽

2009 ◽

Vol 62 (1-2) ◽

pp. 63-67 ◽

Cited By ~ 2

Author(s):

Milovan Zivkovic ◽

Zoran Todorovic ◽

Predrag Canovic ◽

Zeljko Mijanovic

Keyword(s):

Mortality Rate ◽

Clinical Picture ◽

Good Reason ◽

Hemorrhagic Fever ◽

Severe Form ◽

Number Of Patients ◽

Severe Clinical Picture ◽

Infective Disease ◽

Acute Renal Insufficiency ◽

Symptoms And Signs

Introduction. Hemorrhagic fever with renal syndrome (HFRS) is an acute infective disease of a zoonose type characterized by an abrupt beginning, prominent hemorrhagic syndrome as well as symptoms and signs of acute renal insufficiency. The clinical picture of this disease, which is leading in terms of its natural principal seat in the region of Northern-east Montenegro, ranges from non-apparent to very severe forms and mortality it causes is about 10%.Up to date, no efficient etio-trophic means has been discovered. Several studies suggest that an early use of anti virus medicament Ribavirine leads to decrease of mortality rate. The main aim of this study is to present our results achieved in an attempt to apply this medicament in treating HFRS. Material and methods. In total, we have treated 58 patients with symptoms and signs of HGSBS. Five of them, who were admitted to the Department in the first three days were treated by Ribavirine orally in doses of 2x400 mg. Compared to patients who were not treated by Ribavirine, a faster decrease of thrombocytes was noticed in them, which required the discontinuation of the medicament treatment. Thereafter, thrombocytes started to increase and their normalization followed faster than in patients who were not treated by this medicament. The above patients developed a moderately severe clinical picture of the disease, and middle maximum values of urea and creatinine were lower in patients who were not treated by the medicament. No patient developed a severe form of the disease and there were neither dialyzed nor died ones. The mortality rate in patients who were not treated by the medicament was 3.44% and the percent of the dialyzed was 5.17%. Results. Application of Ribavirine at the very beginning of HFRS is considered to be with a very good reason in combination with obligatory follow up of clinical and laboratory parameters and particularly of thrombocyte values, the decrease of which can lead to spontaneous bleedings. Because of the small number of patients to whom we gave this medicament it is difficult to come to a conclusion on the extent of its affect on the clinical picture in our patients.

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Diagnostic Tests and Clinical, Laboratory and Radiological Charactersitics of COVID-19 in Pregnant Women: A Review

The Journal of Qazvin University of Medical Sciences ◽

10.32598/jqums.24.2.2392.1 ◽

2020 ◽

Vol 24 (2) ◽

pp. 146-157

Author(s):

Sedigheh Hasani Moghadam ◽

◽

Abbas Alipour ◽

Saeid Abedian Kenari ◽

Soghra Khani ◽

...

Keyword(s):

Pregnant Women ◽

Clinical Laboratory ◽

Ground Glass Opacity ◽

Clinical Findings ◽

Diagnostic Methods ◽

Laboratory Findings ◽

Radiographic Findings ◽

Controllable Factors ◽

Second Category ◽

Do So

The emerging Coronavirus (COVID-19) is a new infectious disease and the definitive gold standard for its diagnosis in pregnancy has not yet been established. Therefore, this study was conducted with the aim of reviewing the diagnostic methods and clinical, laboratory and radiological symptoms of COVID-19 disease in pregnant women. The present study is a Narrative review. To do so, the keywords were searched in the Scopus, Google scholar, PubMed, Embase, Science Direct, WHO databases from April 1, 2020 to May 9, 2020. 34 articles were obtained and finally 6 articles were used to write this study. Evidence related to the purpose of this study was identified in three categories. The first category examines clinical findings (fever and cough), the second category examines laboratory findings (leukocytosis and lymphopenia), and a third category examines chest radiographic findings (Pure ground-glass opacity). Since infection is one of the most important causes of death in pregnant women and is one of the preventable and controllable factors, so by identifying the correct diagnostic methods of this infection, at-risk pregnant women will be identified and Prevent the consequences of this infection.

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Reporte de un probable caso de Hemoglobina S / Talasemia Beta.

Revista Medica Herediana ◽

10.20453/rmh.v15i3.788 ◽

2013 ◽

Vol 15 (3) ◽

pp. 173

Author(s):

John RAMÍREZ CUENTAS ◽

Olga LIZAMA OLAYA ◽

Josilú MARTÍNEZ LA ROSA ◽

Mercy JHONG OLIVERA ◽

Eduardo SALAZAR LINDO

Keyword(s):

Cell Morphology ◽

Clinical Presentation ◽

Clinical Laboratory ◽

Reticulocyte Count ◽

Clinical Manifestations ◽

Electrophoretic Analysis ◽

Clinical Findings ◽

Red Cell ◽

Careful Observation ◽

Hematological Evaluation

We report the case of a patient with Hemoglobin S / Thalassemia. It is feasible to recognize this infrequent disease by its clinical presentation and the aid of clinical laboratory . On this patient, the diagnosis was established based on the clinical findings, hematological evaluation (with careful observation of the red cell morphology and reticulocyte count) and electrophoretic analysis of hemoglobin. We discusse the physiopathology, clinical manifestations, treatment and alternative of prevention of this disease.

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Parameters for assessing the severity of clinical presentation of hemorrhagic fever with kindey syndrome

Medicinski pregled ◽

10.2298/mpns1006361z ◽

2010 ◽

Vol 63 (5-6) ◽

pp. 361-365

Author(s):

Milovan Zivkovic ◽

Zoran Todorovic ◽

Oligica Gajovic ◽

Ljiljana Nesic ◽

Zeljko Mihailovic

Keyword(s):

Clinical Picture ◽

Clinical Presentation ◽

Clinical Course ◽

Severe Disease ◽

Hemorrhagic Fever ◽

Shock Condition ◽

Severe Clinical Picture ◽

Acute Infectious Disease ◽

Kidney Insufficiency ◽

Symptoms And Signs

Introduction. Hemorrhagic fever with kidney syndrome is an acute infectious disease of the zoonotic character, which is characterized by the sudden beginning, high temperature, distinct hemorrhagic syndrome and symptoms and signs of the acute kidney insufficiency. Hemorrhagic fever with kidney syndrome can have mild, moderate and severe clinical picture and the mortality ranges from 5%-15% in our area. The pupose of this study was to try to present criteria on the basis of which it would be possible to forsee, on time, the severity of the clinical picture and to recognize the patient with the most severe disease form. Material and methods. Within the period of ten years, 87 patients became ill of hemorrhagic fever with kidney syndrome and were treated at General Hospital in Berane, where they were followed from the aspect of clinical and laboratory analyses while the serologic confirmation of the disease was done at the institute of Immunology and Virology ?Torlak? in Belgrade. Results. The results show that the severity of the clinical picture can be forseen on time on the basis of the dynamics of increase of the values of urea and creatinine, duration of the shock condition, duration of the oliguria less than 300 ml/24h, number of the collapses, presence of the meningitic syndromes and appearance of the asciteses and pleuritic hemorrhage. When, on the basis of these parameters, we classify the patients into the categories of mild, moderate and severe clinical picture, using the appropriate statistics methods we find out the differences in duration of the disease as well as in the result of treatment and number of the dialyzed patients. Conclusion. It is possible to forsee clinical course in a patient on time by making timely diagnosis and careful following the clinical and laboratory parameters, important for the result of treatment.

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Comparison of clinical findings and CT scan in patients with COVID-19 pneumonia based on disease severity

10.21203/rs.3.rs-639747/v1 ◽

2021 ◽

Author(s):

Sonia Hesam-Shariati ◽

Susan Mohammadi ◽

Morteza Abouzaripour ◽

Behzad Mohsenpour ◽

Bushra Zareie ◽

...

Keyword(s):

Ct Scan ◽

Disease Severity ◽

Clinical Laboratory ◽

Clinical Symptoms ◽

White Blood Cells ◽

Severe Pneumonia ◽

Clinical Findings ◽

Duration Of Hospitalization ◽

Severity Of The Disease ◽

Interlobular Septal Thickening

Abstract The SARS-CoV-2 can cause severe pneumonia and highly impact general health. We aimed to investigate different clinical features and CT scan findings of patients with COVID-19 based on disease severity to have a better understanding of this disease. For this purpose, 90 patients with coronavirus were examined retrospectively, which were divided into three categories based on the severity of the disease: mild/moderate, severe, and very severe. It has been shown that mean age and duration of hospitalization of patients increased with increasing the severity of disease. The most common clinical symptoms were shortness of breath, cough, and fever. As the severity of the disease increased from mild/moderate to very severe, there was an increase in neutrophile counts and a decrease in lymphocytes and white blood cells (WBC) showing excessive inflammation associated with severe forms of COVID-19. Subpleural changes (81%) and ground-glass opacification/opacity (GGO) lesions (73%) of the lung were the most common features among CT images of COVID-19 patients, and interlobular septal thickening (10%) was the lowest CT feature among patients. Regarding the affected parts of the lung in COVID-19 patients, bilaterial, peripheral and multiple lesions had the highest prevalence. Overall, it has been shown that clinical, laboratory and CT scan findings vary in COVID-19 patients based on disease severity, which need to be considered carefully in early diagnosis and treatment of this illness.

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Follow-up of Osteomyelitis of Infants with Systemic Serum Parameters and Bone Scintigraphy

Nuklearmedizin ◽

10.1055/s-0038-1629824 ◽

1996 ◽

Vol 35 (04) ◽

pp. 116-121 ◽

Cited By ~ 4

Author(s):

G. E Fueger ◽

M. Vejda ◽

R. M. Aigner

Keyword(s):

Bone Scintigraphy ◽

Antibiotic Treatment ◽

Diagnostic Value ◽

Clinical Findings ◽

Laboratory Findings ◽

Radiographic Findings ◽

Serum Parameters ◽

Wbc Count ◽

Differential White Blood Cell

Summary Aim: To prevent orthopedic sequelae in acute hematogenous pyogenic osteomyelitis (AHPO) of infants early diagnosis, recognition of recurrence and effective therapy is needed. This retrospective study of 47 infants with bacteriologically confirmed AHPO concerned with an analysis of the diagnostic value of systemic serum parameters compared to bone scintigraphy (BSC). Methods: AHPO was characterized initially and during the course of disease by clinical findings, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total and differential white blood cell (WBC) count, BSC, and plain radiography. Results: CRP was the most effective serum parameter for follow- up of disease. The first sign of BSC to signal adequate response to antibiotic treatment was the decrease or normalization of hyperperfusion. Escape from therapy or poor prognosis, even when the serum parameters were normalized, was signaled by the recurrence of focal hyperperfusion and the persistent or increasing local uptake ratios on the 3-h-image over 6 weeks during a course of antibiotic treatment. Conclusion: Antibiotic treatment masks the clinical presentation, and the radiographic findings, causes non-characteristic laboratory findings, but do not prevent the scintigraphic visualization; BSC and serum parameters used in the right completion are the most successful and efficient modalities for follow-up of AHPO. Maintenance of antibiotic therapy should be done until BSC findings have reverted to normal.

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Computer-Aided Diagnosis in Jaundice: Comparison of Knowledge-based and Probabilistic Approaches

Methods of Information in Medicine ◽

10.1055/s-0038-1634634 ◽

1996 ◽

Vol 35 (01) ◽

pp. 41-51 ◽

Cited By ~ 3

Author(s):

F. Molino ◽

D. Furia ◽

F. Bar ◽

S. Battista ◽

N. Cappello ◽

...

Keyword(s):

Clinical Presentation ◽

Clinical Information ◽

Diagnostic Value ◽

Clinical Findings ◽

Clinical Documentation ◽

Data Set ◽

Knowledge Based ◽

Number Of Patients ◽

Support Tools ◽

Aided Diagnosis

AbstractThe study reported in this paper is aimed at evaluating the effectiveness of a knowledge-based expert system (ICTERUS) in diagnosing jaundiced patients, compared with a statistical system based on probabilistic concepts (TRIAL). The performances of both systems have been evaluated using the same set of data in the same number of patients. Both systems are spin-off products of the European project Euricterus, an EC-COMACBME Project designed to document the occurrence and diagnostic value of clinical findings in the clinical presentation of jaundice in Europe, and have been developed as decision-making tools for the identification of the cause of jaundice based only on clinical information and routine investigations. Two groups of jaundiced patients were studied, including 500 (retrospective sample) and 100 (prospective sample) subjects, respectively. All patients were independently submitted to both decision-support tools. The input of both systems was the data set agreed within the Euricterus Project. The performances of both systems were evaluated with respect to the reference diagnoses provided by experts on the basis of the full clinical documentation. Results indicate that both systems are clinically reliable, although the diagnostic prediction provided by the knowledge-based approach is slightly better.

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Hydrocephalus in Spinal Muscular Atrophy: A Case Report and Review of the Literature

Journal of Pediatric Neurology ◽

10.1055/s-0040-1721131 ◽

2020 ◽

Author(s):

Jeetendra P. Sah ◽

Aaron W. Abrams ◽

Geetha Chari ◽

Craig Linden ◽

Yaacov Anziska

Keyword(s):

Spinal Muscular Atrophy ◽

Clinical Characteristics ◽

Clinical Presentation ◽

Muscular Atrophy ◽

Communicating Hydrocephalus ◽

Type I ◽

Review Of The Literature ◽

Radiographic Findings ◽

Comprehensive Review ◽

The Relationship

AbstractIn this article, we reported a case of spinal muscular atrophy (SMA) type I noted to have tetraventricular hydrocephalus with Blake's pouch cyst at 8 months of age following intrathecal nusinersen therapy. The association of hydrocephalus with SMA is rarely reported in the literature. Development of hydrocephalus after intrathecal nusinersen therapy is also reported in some cases, but a cause–effect relationship is not yet established. The aim of this study was to describe the clinical characteristics of a patient with SMA type I and hydrocephalus, to review similar cases reported in the literature, and to explore the relationship between nusinersen therapy and development of hydrocephalus. The clinical presentation and radiographic findings of the patient are described and a comprehensive review of the literature was conducted. The adverse effect of communicating hydrocephalus related to nusinersen therapy is being reported and the authors suggest carefully monitoring for features of hydrocephalus developing during the course of nusinersen therapy.

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New Insight for the Prognosis of CCHF: Clinical, Laboratory and Sonography Findings

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405615666191111115354 ◽

2020 ◽

Vol 16 (9) ◽

pp. 1125-1130

Author(s):

Hamid Owaysee Osquee ◽

Sepehr Taghizadeh ◽

Mehdi Haghdoost ◽

Hadi Pourjafar ◽

Fereshteh Ansari

Keyword(s):

Odds Ratio ◽

Clinical Laboratory ◽

Fatal Outcome ◽

Hemorrhagic Fever ◽

Demographic Characteristics ◽

Pelvic Cavity ◽

Fatal Disease ◽

Laboratory Findings ◽

Report Data ◽

Sistan And Baluchestan

Introduction: In this article, we report data on confirmed CCHF cases from Iran and describe the association between studying factors and outcomes of the disease. Objective: Crimean Congo Hemorrhagic Fever (CCHF) is an acute and fatal disease with various clinical and paraclinical characteristics. Methods: In the Study design, we evaluated demographic characteristics, clinical, laboratory and sonographic findings of 160 CCHF confirmed cases during 2003 and 2012 in Zabol (A city in Sistan and Baluchestan province of Iran). The association between these factors and the fatal outcome was evaluated by regression analysis. Results: The disease had a fatal outcome in 7 (4.4%) of patients. Females had more severe symptoms and higher odds for death (odds ratio11.57, p=0.005). Leukocytosis (p<0.001), PT (p<0.001) and PTT (p=0.008) elongation, AST (p=0.010) and ALT (p<0.001) elevation were significantly associated with fatal outcome. CNS related symptoms (odds ratio 5.9, p=0.027) in clinical examination and ascites (odds ratio 38.4, p=0.012) and liquid in the pelvic cavity (odds ratio 24.2, p=0.004) were also identified as risk factors of death in this study. Conclusions: Our data suggest that in addition to clinical and laboratory findings practitioners consider sonography for CCHF prognosis.

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Obesity as a Risk Factor for Severe COVID-19 and Complications: A Review

Cells ◽

10.3390/cells10040933 ◽

2021 ◽

Vol 10 (4) ◽

pp. 933

Author(s):

Fien Demeulemeester ◽

Karin de Punder ◽

Marloes van Heijningen ◽

Femke van Doesburg

Keyword(s):

Risk Factor ◽

Disease Severity ◽

Viral Entry ◽

Thrombus Formation ◽

Clinical Findings ◽

High Risk Group ◽

Therapeutic Interventions ◽

Cytokine Storm ◽

Negative Consequences ◽

Major Complications

Emerging data suggest that obesity is a major risk factor for the progression of major complications such as acute respiratory distress syndrome (ARDS), cytokine storm and coagulopathy in COVID-19. Understanding the mechanisms underlying the link between obesity and disease severity as a result of SARS-CoV-2 infection is crucial for the development of new therapeutic interventions and preventive measures in this high-risk group. We propose that multiple features of obesity contribute to the prevalence of severe COVID-19 and complications. First, viral entry can be facilitated by the upregulation of viral entry receptors, like angiotensin-converting enzyme 2 (ACE2), among others. Second, obesity-induced chronic inflammation and disruptions of insulin and leptin signaling can result in impaired viral clearance and a disproportionate or hyper-inflammatory response, which together with elevated ferritin levels can be a direct cause for ARDS and cytokine storm. Third, the negative consequences of obesity on blood coagulation can contribute to the progression of thrombus formation and hemorrhage. In this review we first summarize clinical findings on the relationship between obesity and COVID-19 disease severity and then further discuss potential mechanisms that could explain the risk for major complications in patients suffering from obesity.

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