scholarly journals Kawasaki Disease Shock Syndrome in Japan and Comparison With Multisystem Inflammatory Syndrome in Children in European countries

2021 ◽  
Vol 9 ◽  
Author(s):  
Junko Suzuki ◽  
Kota Abe ◽  
Takuya Matsui ◽  
Takafumi Honda ◽  
Kumi Yasukawa ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Patient Characteristics ◽  
Good Prognosis ◽  
European Countries ◽  
Cardiovascular Agents ◽  
Clinical Signs And Symptoms ◽  
Inflammatory Syndrome

Multisystem inflammatory syndrome in children (MIS-C) is a severe Kawasaki-like illness that was first linked to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in European countries in the spring of 2020 and has been suggested to have overlap with Kawasaki disease shock syndrome (KDSS). There are few reports of MIS-C from Asia. This observational study aimed to identify the clinical features in children presenting with KDSS in Japan over a 5-year period and to summarize similarities and differences between KDSS and MIS-C. We retrospectively collected data on patient characteristics, clinical signs and symptoms, treatment, and prognosis including coronary artery abnormalities (CAAs), which were compared with data of patients with KDSS worldwide and patients with MIS-C from a review. KDSS was identified in 6 (1.1%) of 552 patients with Kawasaki disease (KD) treated at a single institution in Japan between 2015 and 2020 (1 in 2020). In patients with KDSS in Japan or worldwide vs. patients with MIS-C, KDSS was more likely to have a diagnosis of complete KD (100, 70 vs. 6.3%), a higher incidence of CAAs (50, 65 vs. 11%), and a greater requirement for vasoactive agonists (67, 67 vs. 43%) because of circulatory shock (100, 50 vs. 26%). Both KDSS and MIS-C had good prognosis (mortality 0, 6.7 vs. 1.7%). Although KDSS in Japan and MIS-C show some overlap in clinical symptoms, they are unlikely to be the same disease entity. KDSS is more likely to have a cardiovascular phenotype with CAAs and requires treatment with cardiovascular agents.

ELECTRODIAGNOSTIC CRITERIA FOR DIAGNOSING CARPAL TUNNEL SYNDROME NEED TO BE REVISED IN HYPOTHYROID PATIENTS

2017 ◽  
Vol 20 (03) ◽  
pp. 1750014
Author(s):  
Mahdieh Asadi ◽  
Sharareh Roshanzamir
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Control Group ◽  
Tunnel Syndrome ◽  
Clinical Signs And Symptoms ◽  
Relationship Of ◽  
Hypothyroid Patients

Background: Previous studies do not agree with each other on the association between electrodiagnostic findings and clinical symptoms of Carpal tunnel syndrome (CTS). In most of these studies, many variables such as age, sex, obesity and hypothyroidism have not been taken into account. Material & methods: About 62 patients with hypothyroidism and 62 patients without hypothyroidism with sign and symptoms of CTS were included in this study. Electrodiagnostic tests were done for all patients. And relationship of the severity of CTS signs and symptoms with electrodiagnostic parameters was examined statistically in each group. Results: This study showed that distal motor latency in control group (without hypothyroidism) is significantly more prolonged than hypothyroid patients. Also there was significant correlation between clinical symptoms and electrodiagnostic findings in control group, but there was not such correlation in hypothyroid patients. In 62% of hypothyroid patients with clinical signs and symptoms of CTS, electrodiagnostic findings were normal and only in 38% of cases, electrodiagnostic findings were suggestive of CTS. Conclusion: Relationship of the severity of CTS signs and symptoms with electrodiagnostic parameters is very weak in hypothyroid patients. Many hypothyroid patients with clinical signs and symptoms of CTS have normal electrodiagnostic findings; so we need more studies for revising the para-clinic criteria of labeling patients having CTS in hypothyroid patients.

scholarly journals Clinical Features, Diagnosis and Management of Patients with Suspicion of Fascioliasis in Kohgiluyeh and Boyer-Ahmad Province, Southwestern Iran

2020 ◽  
Author(s):  
Abdolali MOSHFE ◽  
Arash ARIA ◽  
Najme ERFANI ◽  
Ali JAMSHIDI ◽  
Bahador SARKARI ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Epigastric Pain ◽  
Serological Test ◽  
Demographic Data ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Diagnosis And Management ◽  
History Of ◽  
Clinical Signs And Symptoms

Background: In the current study, we described the epidemiological features, clinical presentation, diagnosis and management of patients with suspicion of fascioliasis in Kohgiluyeh and Boyer-Ahmad Province in southwest of Iran.    Methods: Overall, 56 patients with suspicion of fascioliasis, based on their clinical signs and symptoms that referred to Clinic of Internal Medicine in Yasuj city, from 2014 to 2016 were enrolled. Demographic data, history of eating aquatic local plants, the chief complains, and laboratory findings were recorded for each patient. Stool samples were obtained from each case for detection of Fasciola eggs. Moreover, blood samples were taken from each patient and evaluated for detection of anti-Fasciola antibodies by an indirect ELISA. Patients who defined as having fascioliasis were treated with triclabendazole and were followed for at least three months for clinical improvement. Results: Serological test was positive in 5 patients. Of these 5 cases, three cases had a history of ingesting raw aquatic vegetables. The main clinical signs and symptoms in positive cases were; abdominal pain (60%), epigastric pain (40%), anemia (60%), and dermal pruritus (20%). Hypereosinophilia was seen in all of 5 positive cases. No Fasciola egg was found in stool specimens of any of the patients. The fascioliasis cases were treated by triclabendazole and clinical symptoms disappeared in all of 5 cases. Conclusion: Our observation further confirmed Yasuj district as a human endemic area for fascioliasis in Iran. The study also highlighted the importance of clinical features together with eosinophilia, as key parameters, in the diagnosis of human fascioliasis. Clinicians need to be aware of this disease and should keep in mind fascioliasis when hypereosinophilia present in patients in such endemic areas.

scholarly journals Evaluate the Therapeutic Effect of Allicin (L-cysteine) on Clinical Presentation and Prognosis in Patients with COVID-19

2021 ◽  
Author(s):  
Hosein Yaghoubian ◽  
Hossein Niktale ◽  
Arash Peivandi Yazdi ◽  
Vahideh Ghorani ◽  
Masoud Mahdavi Rashed ◽  
...  
Keyword(s):  
Therapeutic Effect ◽  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Healing Process ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Blood Parameters ◽  
Radiological Data ◽  
Clinical Signs And Symptoms ◽  
Chest Ct Scan

The antiviral effectiveness of allicin (L-cysteine) has been shown by numerous studies in both levels of clinical and animals. The aim of this study was to evaluate the therapeutic effect of allicin (L-cysteine) on clinical presentation and prognosis. In the current study, 66 patients with COVID-19 based on clinical, radiological presentations and RT-PCR results, were enrolled in two groups of placebo and allicin. In the both allicin (L-cysteine) and placebo groups (n=33 in each group), the capsules were prescribed two times a day for two weeks. Clinical signs and symptoms, blood parameters and chest CT scan were evaluated before and two weeks after treatment. The results showed that allicin (L-cysteine) could significantly impact on improvement of signs and symptoms of COVID-19 after two weeks of treatment in comparison to placebo. Allicin (L-cysteine) not only improve the clinical signs, but also ameliorate the lab and radiological data, which suggest a therapeutic effect for this agent in COVID-19. Our data suggest the therapeutic effect of allicin (L-cysteine) on COVID-19 through improvement of clinical symptoms and acceleration of the healing process.

scholarly journals Clinical characteristics of COVID-19 in children compared with adults in Shandong, China

2020 ◽  
Author(s):  
Wenjun Du ◽  
Jinhong Yu ◽  
Hui Wang ◽  
Xiaoguo Zhang ◽  
Shouwei Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Health Workers ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Case Series ◽  
Signs And Symptoms ◽  
Asymptomatic Patients ◽  
Positive Indicators ◽  
Clinical Signs And Symptoms

Abstract Aims & Background: The COVID-19 outbreak spread in China and is a threat to the world. We reported on the epidemiological, clinical, laboratory, and radiological characteristics of children cases to help health workers better understand and provide timely diagnosis and treatment.Methods: Retrospectively, two research centers’ case series of 67 consecutive hospitalized cases including 14 children cases with COVID-19 between 23 Jan 2020 to 15 Feb 2020 from Jinan and Rizhao were enrolled in this study. Epidemiological, clinical, laboratory, and radiological characteristics of children and adults were analyzed and compared.Results: Most cases in children were mild(21.4%) and conventional cases(78.6%), with mild clinical signs and symptoms, and all cases were of family clusters. Fever (35.7%) and dry cough(21.4%) were described as clinical manifestations in children cases. Dry cough and phlegm were not the most common symptoms in children compared with adults(p=0.03). In the early stages of the disease, lymphocyte counts did not significantly decline but neutrophils counts did in children compared with adults(p=0.00).There was an elevated level of LDH(p=0.01) and a lower level of CRP(p=0.00)and IL-6(p=0.01) in children compared with adults. There were 8 (57.1%)asymptomatic cases and 6 (42.9%)symptomatic cases among the 14 children cases. The age of asymptomatic patients was younger than that of symptomatic patients(p=0.03). Even among asymptomatic patients, 5(62.5%)cases had pneumonia including 3 (60%) cases with bilateral pneumonia, which was not different compared with that of asymptomatic cases(p=0.58, p=0.74).Conclusions: The clinical symptoms of children are mild, and the positive indicators of laboratory tests are rare, which may easily cause clinical misdiagnoses.

scholarly journals Specialized Dermatological - Rheumatological Patient Management Improves Diagnostic Outcome and Patient Journey: A Four-Year Analysis

2021 ◽  
Author(s):  
Jana Ziob ◽  
Charlotte Behning ◽  
Peter Brossart ◽  
Thomas Bieber ◽  
Dagmar Wilsmann-Theis ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Clinical Signs ◽  
Interdisciplinary Approach ◽  
Signs And Symptoms ◽  
Patient Characteristics ◽  
Classification Criteria ◽  
Close Collaboration ◽  
Patient Journey ◽  
Before And After ◽  
Rheumatological Diseases

Abstract Background:Management of psoriatic arthritis (PsA) and other rheumatological diseases requires an interdisciplinary approach involving dermatologists and rheumatologists. The aim of the study was to analyze the specialized dermatological-rheumatological management before and after foundation of a PsA center. Methods:A retrospective cohort study of all dermatology-rheumatology consultations during two periods was conducted. Period one, from April 1st, 2016 to February 28th, 2018 versus period two, from March 1st, 2018 to January 31st, 2020, after foundation of a PsA center. Clinical data on patient characteristics including psoriasis subtypes, clinical symptoms and signs, disease activity scores, classification criteria and comorbidities as well as patient journey were extracted and analyzed.Results: 404 consultations were studied. Close collaboration in a PsA center lead to a relevantly shortened patient journey concerning rheumatological complaints: period 1: median (IQR): 36.0 (10.0-126.0) months, period 2: median (IQR): 24.0 (6.0-60.0) months. Established scores and classification criteria such as GEPARD or CASPAR did not assist in diagnosis of PsA. Arthralgia (p=0.0407), swollen joints (p=0.0151), morning stiffness (p=0.0451) and dactylitis (p=0.0086) helped to distinguish between osteoarthritis and PsA.Conclusions: Clinical signs and symptoms, scores and classification criteria usually assessed were less helpful than expected in diagnosis of PsA and other rheumatological diseases. Close collaboration in a specialized PsA center yielded the fastest way of diagnosis.

scholarly journals MicroRNA-Based Therapeutic Perspectives in Myotonic Dystrophy

2019 ◽  
Vol 20 (22) ◽  
pp. 5600 ◽  
Author(s):  
Arturo López Castel ◽  
Sarah Joann Overby ◽  
Rubén Artero
Keyword(s):  
Myotonic Dystrophy ◽  
Rna Binding ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Neuromuscular Diseases ◽  
Signs And Symptoms ◽  
Disease Biomarkers ◽  
Clinical Signs And Symptoms

Myotonic dystrophy involves two types of chronically debilitating rare neuromuscular diseases: type 1 (DM1) and type 2 (DM2). Both share similarities in molecular cause, clinical signs, and symptoms with DM2 patients usually displaying milder phenotypes. It is well documented that key clinical symptoms in DM are associated with a strong mis-regulation of RNA metabolism observed in patient’s cells. This mis-regulation is triggered by two leading DM-linked events: the sequestration of Muscleblind-like proteins (MBNL) and the mis-regulation of the CUGBP RNA-Binding Protein Elav-Like Family Member 1 (CELF1) that cause significant alterations to their important functions in RNA processing. It has been suggested that DM1 may be treatable through endogenous modulation of the expression of MBNL and CELF1 proteins. In this study, we analyzed the recent identification of the involvement of microRNA (miRNA) molecules in DM and focus on the modulation of these miRNAs to therapeutically restore normal MBNL or CELF1 function. We also discuss additional prospective miRNA targets, the use of miRNAs as disease biomarkers, and additional promising miRNA-based and miRNA-targeting drug development strategies. This review provides a unifying overview of the dispersed data on miRNA available in the context of DM.

scholarly journals Differentiating multisystem inflammatory syndrome in children: a single-centre retrospective cohort study

2021 ◽  
pp. archdischild-2021-322290
Author(s):  
Jordan E Roberts ◽  
Jeffrey I Campbell ◽  
Kimberlee Gauvreau ◽  
Gabriella S Lamb ◽  
Jane Newburger ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Oral Mucosa ◽  
Multivariable Analysis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Laboratory Findings ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Clinical Signs And Symptoms ◽  
Inflammatory Syndrome

ObjectiveFeatures of multisystem inflammatory syndrome in children (MIS-C) overlap with other febrile illnesses, hindering prompt and accurate diagnosis. The objectives of this study were to identify clinical and laboratory findings that distinguished MIS-C from febrile illnesses in which MIS-C was considered but ultimately excluded, and to examine the diseases that most often mimicked MIS-C in a tertiary medical centre.Study designWe identified all children hospitalised with fever who were evaluated for MIS-C at our centre and compared clinical signs and symptoms, SARS-CoV-2 status and laboratory studies between those with and without MIS-C. Multivariable logistic LASSO (least absolute shrinkage and selection operator) regression was used to identify the most discriminative presenting features of MIS-C.ResultsWe identified 50 confirmed MIS-C cases (MIS-C+) and 68 children evaluated for, but ultimately not diagnosed with, MIS-C (MIS-C-). In univariable analysis, conjunctivitis, abdominal pain, fatigue, hypoxaemia, tachypnoea and hypotension at presentation were significantly more common among MIS-C+ patients. MIS-C+ and MIS-C- patients had similar elevations in C-reactive protein (CRP), but were differentiated by thrombocytopenia, lymphopenia, and elevated ferritin, neutrophil/lymphocyte ratio, BNP and troponin. In multivariable analysis, predictors of MIS-C included age, neutrophil/lymphocyte ratio, platelets, conjunctivitis, oral mucosa changes, abdominal pain and hypotension.ConclusionsAmong hospitalised children undergoing evaluation for MIS-C, children with MIS-C were older, more likely to present with conjunctivitis, oral mucosa changes, abdominal pain and hypotension, and had higher neutrophil/lymphocyte ratios and lower platelet counts. These data may be helpful for discrimination of MIS-C from other febrile illnesses, including bacterial lymphadenitis and acute viral infection, with overlapping features.

scholarly journals Black Quarter (BQ) Disease in Cattle and Diagnosis of BQ Septicaemia Based on Gross Lesions and Microscopic Examination

1970 ◽  
Vol 25 (1) ◽  
pp. 13-16 ◽  
Author(s):  
Mahmuda Sultana ◽  
Abdul Ahad ◽  
Paritosh Kumar Biswas ◽  
M Ashiqur Rahman ◽  
Himel Barua
Keyword(s):  
Clinical Symptoms ◽  
Body Condition Score ◽  
Demographic Variable ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Body Part ◽  
Condition Score ◽  
Acute Infectious Disease ◽  
Clinical Signs And Symptoms ◽  
Clostridium Chauvoei

Black quarter (BQ) is an acute, infectious disease caused by Clostridium chauvoei - a Gram-positive, anaerobic organism. This disease is characterized by inflammation with gaseous oedema of skeletal muscle and severe toxaemia. This study was done in Upazilla Veterinary Hospital at Raozan in Chittagong from June to August 2006. During the study period, 25 cases of BQ in cattle were found in eight Unions. Among them the highest (32%) proportion of BQ was found in Raozan Union. Frequency of BQ according to demographic variable was: age incidence of >12 month (60%), male (60%), breed of Red Chittagong (44%), body condition score (BCS) of BCS-2 (88%), and affected body part involving hind quarter muscle (35%). Death was observed with 73% cases. In case of animals that were suffered from BQ, septicaemia developed after 12 h of onset of clinical signs and symptoms. Treatment was ineffective in advanced septicaemic stage. Antibiotic therapy was found to be effective when administered within 12 h of the clinical symptoms. Keywords: Black quarter; Clostridium chauvoei; Demographic variable; Septicaemia; Antibiotic therapyDOI: http://dx.doi.org/10.3329/bjm.v25i1.4848 Bangladesh J Microbiol, Volume 25, Number 1, June 2008, pp 13-16

scholarly journals Histopathological Findings in the Gastrointestinal Tract of Patients with COVID-19

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S57-S58
Author(s):  
C E Middleton ◽  
N Varshney ◽  
D Roland
Keyword(s):  
Gastrointestinal Tract ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Time Frame ◽  
Multiple Systems ◽  
Endoscopic Findings ◽  
Clinical Signs And Symptoms ◽  
Histopathologic Analysis ◽  
Histopathologic Findings

Abstract Introduction/Objective Amidst the SARS-CoV-2 pandemic, we have learned that other organs, aside from the lungs, are affected by the virus. Tissue damage has been documented both clinically and histologically in multiple systems including the gastrointestinal tract. Clinical symptoms of gastrointestinal distress may be correlated with histopathologic findings. Studies have shown direct infection of epithelial cells in the GI tract in patients with the disease. The objective of this study is to identify specific histologic alterations that are present in patients with COVID-19. Methods/Case Report At our institution, a retrospective analysis was conducted to evaluate all COVID-positive patients who underwent any gastrointestinal procedure within 30 days after their positive test. The time frame included January 1, 2020 to December 31, 2020. Chart reviews were performed to document radiographic studies, endoscopic findings, histopathologic analysis, and clinical symptoms. Results (if a Case Study enter NA) A total of 26 patients met our criteria for inclusion in the study. The cohort consisted of 10 males and 16 females ranging in age from 13 to 78 years. Tissue was sent for histologic analysis in 19 of these individuals. Tubular adenomas (13), chronic gastritis (11), and prominent intestinal lymphoid aggregates (7) were the most common pathologic findings (Table 1). Conclusion These findings suggest that the histopathologic findings rendered from GI procedures of patients with COVID-19 may be non-specific and may not reveal any morphologic correlate to the clinical signs and symptoms. We propose that histopathological abnormalities identified from GI samples of SARS-CoV-2 positive patients must be correlated with clinical symptoms, endoscopic findings, and imaging when available.

Pathology of the Heart in Kawasaki Disease

PEDIATRICS ◽  
1978 ◽  
Vol 61 (1) ◽  
pp. 100-107 ◽  
Author(s):  
Hisayoshi Fujiwara ◽  
Yoshihiro Hamashima
Keyword(s):  
Kawasaki Disease ◽  
Clinical Signs ◽  
Stage Iv ◽  
Signs And Symptoms ◽  
Conduction System ◽  
Coagulation Necrosis ◽  
Duration Of Illness ◽  
Cardiac Lesions ◽  
The Media ◽  
Clinical Signs And Symptoms

Pathologic studies were done on 20 hearts of patients who had typical clinical signs and symptoms of Kawasaki disease. The cardiac lesions were classified according to the duration of illness at the time of death. Stage I (zero to nine days) was characterized by acute perivasculitis and vasculitis of the microvessels (arterioles, capillaries, and venules) and small arteries, and acute perivasculitis and endartenitis of the three major coronary arteries (MCAs). Penicarditis, myocarditis, inflammation of the atrioventricular conduction system, and endocarditis with valvulitis were also present. Stage II (12 to 25 days) was characterized by panvasculitis of the MCAs and aneurysm with thrombus in the stems. Myocarditis, coagulation necrosis, lesion of the conduction system, pericarditis, and endocarditis with valvulitis were also present. In stage III (28 to 31 days), granulation of the MCAs and disappearance of inflammation in the microvessels were noted. Patients in stage IV (40 days to 4 years) had scarring with severe stenosis in the MCAs. Fibrosis of the myocardium, coagulation necrosis, lesions of the conduction system, and endocardial fibroelastosis were also present. The features observed revealed Kawasaki disease to be acute and inflammatory. The angiitis begins in the microvessels and fibrinoid necrosis of the media is rare. The disease is one with a pathologic pattern previously unknown.

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