scholarly journals Rhabdophis tigrinus (Yamakagashi) Bites in Japan Over the Last 50 Years: A Retrospective Survey

2022 ◽  
Vol 9 ◽  
Author(s):  
Toru Hifumi ◽  
Atsushi Sakai ◽  
Akihiko Yamamoto ◽  
Kazunori Morokuma ◽  
Norio Otani ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Clinical Course ◽  
Laboratory Data ◽  
Patient Characteristics ◽  
Scientific Data ◽  
Definitive Treatment ◽  
Related Factors ◽  
Epidemiological Features ◽  
Rhabdophis Tigrinus ◽  
Almost All

Introduction:Rhabdophis snakes, which include 27 species, are rear-fanged venomous snakes that are widely distributed from India to East Asia and Russia. Severe envenomation by R. tigrinus (Yamakagashi snake) in Japan and R. subminiatus in Southeast Asia has been reported. The epidemiology of R. tigrinus bites, such as geographical features, the incidence, and changes in the number of bites over time have not been comprehensively examined. Hence, we intended to clarify the epidemiological features of R. tigrinus bites through a careful review of scientific data over the last 50 years in Japan.Methods: Patient records of R. tigrinus bites between 1971 and 2020 at the Japan Snake Institute were examined retrospectively. The following were ascertained: patient characteristics, clinical symptoms, laboratory data, treatment-related factors, and hospital mortality. These variables were compared in the antivenom and the without-antivenom groups.Results: Over the 50-year study period, 43 R. tigrinus bites, including five fatal cases, were encountered. Severe cases of R. tigrinus bites have been treated with antivenom since 1985; however, fatalities occurred in 2006 and 2020. R. tigrinus bite cases have been well-distributed in the western part of Japan since 2000. The mortality rate in the antivenom group was significantly lower in the patient group that was not administered the antivenom (0 vs. 23.8%, p = 0.048).Conclusion: This study clarified the epidemiology of R. tigrinus bites in Japan over a 50-year period. Almost all severe cases of R. tigrinus bites have been treated with the antivenom in the current situation, and fatalities occurred in cases not treated with the antivenom. It is important to diagnose R. tigrinus bites in the early phase of the clinical course. The antivenom, the definitive treatment for R. tigrinus bites, is an unapproved drug. Hence, approval needs to be obtained for the drug.

scholarly journals PTBD During COVID-19 Pandemic: A Life Saving Procedure in Malignant Obstructive Jaundice Patients

2021 ◽  
Vol 6 (S1) ◽  
pp. 17-19
Author(s):  
Khushboo Rani ◽  
Kumar Gaurav ◽  
Naveen Kumar
Keyword(s):  
Obstructive Jaundice ◽  
Biliary Tract ◽  
Percutaneous Drainage ◽  
Positive Impact ◽  
Laboratory Data ◽  
Patient Characteristics ◽  
Endoscopic Drainage ◽  
Malignant Obstructive Jaundice ◽  
Abdominal Ultrasonography ◽  
Almost All

Objective: PTBD is an important lifesaving alternative for biliary tract decompression to endoscopic drainage in the treatment of malignant obstructive jaundice patients. The aim of this study was to evaluate the usefulness of PTBD in terms of the relief of symptoms and laboratory data, survival after PTBD, and the relationship between patient characteristics and survival during COVID-19 pandemic. Methods: During this study, in total thirteen patients’ procedures of percutaneous drainage were applied during a three-month period. The average age of men was 59 years and women was 55 years. The causes of obstructive jaundice were investigated using both abdominal computed tomography and abdominal ultrasonography. Results: In examined group percutaneous drainage was successful in 92.3% (12 patients) and drainage procedure application was ineffective in 7.7% (1 patient). After PTBD, almost all the symptoms of obstructive jaundice were relieved, except in one patient. Transient haemobilia was the only complication seen in one patient. Conclusion: In present scenario of COVID-19 pandemic, PTBD emerges as an effective method of biliary tract decompression and an important alternative to endoscopic drainage. It decreased the jaundice and relieved the symptoms caused by biliary tract obstruction. Thus, our study shows a positive impact in quality of life of patients after PTBD.

AB0 Blood Groups and Coronary Heart Disease (CHD)

1980 ◽  
Vol 43 (02) ◽  
pp. 137-140 ◽  
Author(s):  
Jan Erikssen ◽  
Erik Thaulow ◽  
Helge Stormorken ◽  
Ole Brendemoen ◽  
Arvid Hellem
Keyword(s):  
Coronary Artery ◽  
Blood Group ◽  
Artery Bypass ◽  
Laboratory Data ◽  
Epidemiological Data ◽  
Consecutive Series ◽  
Related Factors ◽  
Ab0 Blood Groups ◽  
Clinically Significant ◽  
Artery Disease

SummaryThe view based on epidemiological and laboratory data that blood group A subjects (=A) have clinically significant higher thrombotic potential than blood group 0 subjects (= O), is supported by the present finding of a significantly higher platelet retention in A than 0.The completely normal ABO distribution found among 71 cases of proven latent CHD, and the disproportionate excess of 0 vs. A in a consecutive series of 191 coronary artery bypass candidates apparently conflict with epidemiological data indicating a higher risk of achieving CHD in A than 0. The conflict may be solved by suggestinga) that the »thrombotic proneness« in A compared with 0 causes a poorer prognosis in CHD among the former, leaving a disproportionate excess of 0 among longterm CHD survivors, and b) that AB0-related factors have had an insignificant, independent impact on the evolution of preclinical coronary artery disease in our 71 men with latent CHD.

scholarly journals Pediatric COVID-19 and the Factors That May Mitigate Its Clinical Course

2020 ◽  
Vol 10 (01) ◽  
pp. e137-e140
Author(s):  
Mosaad Abdel-Aziz ◽  
Nada M. Abdel-Aziz ◽  
Dina M. Abdel-Aziz ◽  
Noha Azab
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Angiotensin Converting Enzyme 2 ◽  
Compulsory Vaccination ◽  
Specific Factors ◽  
Novel Coronavirus ◽  
Radiographic Data

AbstractThe clinical manifestations of novel coronavirus disease 2019 (COVID-19) vary from mild flu-like symptoms to severe fatal pneumonia. However, children with COVID-19 may be asymptomatic or may have mild clinical symptoms. The aim of this study was to investigate clinical features of pediatric COVID-19 and to search for the factors that may mitigate the disease course. We reviewed the literature to realize the clinical features, laboratory, and radiographic data that may be diagnostic for COVID-19 among children. Also, we studied the factors that may affect the clinical course of the disease. Fever, dry cough, and fatigue are the main symptoms of pediatric COVID-19, sometimes flu-like symptoms and/or gastrointestinal symptoms may be present. Although some infected children may be asymptomatic, a recent unusual hyperinflammatory reaction with overlapping features of Kawasaki's disease and toxic shock syndrome in pediatric COVID-19 has been occasionally reported. Severe acute respiratory syndrome-coronvirus-2 (SARS-CoV-2) nucleic acid testing is the corner-stone method for the diagnosis of COVID-19. Lymphocyte count and other inflammatory markers are not essentially diagnostic; however, chest computed tomography is highly specific. Factors that may mitigate the severity of pediatric COVID-19 are home confinement with limited children activity, trained immunity caused by compulsory vaccination, the response of the angiotensin-converting enzyme 2 receptors in children is not the same as in adults, and that children are less likely to have comorbidities. As infected children may be asymptomatic or may have only mild respiratory and/or gastrointestinal symptoms that might be missed, all children for families who have a member diagnosed with COVID-19 should be investigated.

scholarly journals Covid-19 FAQ’s in Paediatric and Congenital Cardiology – AEPC position paper.

2021 ◽  
pp. 1-21
Author(s):  
Skaiste Sendzikaite ◽  
Ruth Heying ◽  
Ornella Milanesi ◽  
Katarina Hanseus ◽  
Ina Michel-Behnke
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Systems ◽  
Scientific Data ◽  
Position Paper ◽  
Paediatric Cardiology ◽  
European Paediatric ◽  
Care Systems ◽  
The Times ◽  
Almost All

Abstract The Covid-19 pandemic has had a huge influence in almost all areas of life, affecting societies, economics and health care systems worldwide. The paediatric cardiology community is no exception. As the challenging battle with Covid-19 continues, professionals from the Association for the European Paediatric and Congenital Cardiology (AEPC) receive many questions regarding Covid-19 in a Paediatric and Congenital Cardiology setting. The aim of this paper is to present the AEPC position on frequently asked questions based on the most recent scientific data, as well as to frame a discussion on how to take care of our patients during this unprecedented crisis. As the times are changing quickly and information regarding Covid-19 is very dynamic, continuous collection of evidence will help guide constructive decision-making.

Retrospective evaluation of 85 patients with urea cycle disorders: one center experience, three new mutations

2020 ◽  
Vol 33 (6) ◽  
pp. 721-728
Author(s):  
Özlem Saritaş Nakip ◽  
Yılmaz Yıldız ◽  
Ayşegül Tokatlı
Keyword(s):  
Mortality Rate ◽  
Urea Cycle ◽  
Laboratory Data ◽  
Patient Characteristics ◽  
Hereditary Diseases ◽  
Urea Cycle Disorders ◽  
Carbamoyl Phosphate ◽  
Term Survival ◽  
Genetic Features ◽  
Cycle Disorders

AbstractObjectivesUrea cycle disorders (UCDs) are rare hereditary diseases. This study was conducted to help identify the characteristics of UCDs in Turkey.MethodsThe primary outcome was to determine patient characteristics. Investigating the relationships between the patient outcomes and ammonia levels were the secondary outcomes. Eighty five patients from 79 families, diagnosed with UCD at a single metabolic referral center between 1979 and 2017, were included. Clinical and laboratory data were retrieved retrospectively from hospital records.ResultsClassical citrullinemia was the most common type of UCD; citrin deficiency and carbamoyl phosphate synthase 1 deficiency (CPS1D) were the rarest. One thirty one hyperammonemic episodes were recorded. The peak ammonia levels were found to be significantly associated with polycythemia and hypocalcemia at presentation. The median peak ammonia values of the patients who died were higher than those of the survivors. The highest mortality rate was in the classical citrullinemia group. The mortality rate of the first hyperammonemic crisis was 28.6%, while it was 6.7% in subsequent episodes with an odds ratio of 4.28 (95% CI: 1.67–11.0) (p=0.001). Forty-four patients underwent genetic analysis and genetic variants were detected in 42 patients (95%). Three of the detected variants have not been previously reported.ConclusionsThis is the largest UCD series in Turkey and may serve as a guide to clinical, biochemical and genetic features of UCDs in our country. Prevention of hyperammonemia may be the most influential measure to improve long term survival.

scholarly journals Similar glycaemic control and risk of hypoglycaemia with patient- versus physician-managed titration of insulin glargine 300 U/mL across subgroups of patients with T2DM: a post hoc analysis of ITAS

2021 ◽  
Author(s):  
Andrea Giaccari ◽  
R. C. Bonadonna ◽  
R. Buzzetti ◽  
G. Perseghin ◽  
D. Cucinotta ◽  
...  
Keyword(s):  
Glycaemic Control ◽  
Insulin Glargine ◽  
Patient Characteristics ◽  
Efficacy And Safety ◽  
Clinical Trial Registration ◽  
Post Hoc Analysis ◽  
Almost All ◽  
Antihyperglycaemic Drugs ◽  
Post Hoc ◽  
Patient Subgroups

Abstract Aims The Italian Titration Approach Study (ITAS) demonstrated comparable HbA1c reductions and similarly low hypoglycaemia risk at 6 months in poorly controlled, insulin-naïve adults with T2DM who initiated self- or physician-titrated insulin glargine 300 U/mL (Gla-300) in the absence of sulphonylurea/glinide. The association of patient characteristics with glycaemic and hypoglycaemic outcomes was assessed. Methods This post hoc analysis investigated whether baseline patient characteristics and previous antihyperglycaemic drugs were associated with HbA1c change and hypoglycaemia risk in patient- versus physician-managed Gla-300 titration. Results HbA1c change, incidence of hypoglycaemia (any type) and nocturnal rates were comparable between patient- and physician-managed arms in all subgroups. Hypoglycaemia rates across subgroups (0.03 to 3.52 events per patient-year) were generally as low as observed in the full ITAS population. Small increases in rates of 00:00–pre-breakfast and anytime hypoglycaemia were observed in the ≤ 10-year diabetes duration subgroup in the patient- versus physician-managed arm (heterogeneity of effect; p < 0.05). Conclusions Comparably fair glycaemic control and similarly low hypoglycaemia risk were achieved in almost all patient subgroups with patient- versus physician-led Gla-300 titration. These results reinforce efficacy and safety of Gla-300 self-titration across a range of phenotypes of insulin-naïve people with T2DM. Clinical trial registration EudraCT 2015-001167-39

scholarly journals 421. If at first you do not succeed…. Repeat SARS-COV2 PCR testing

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S277-S278
Author(s):  
Stephanie M Shea ◽  
Gopi Patel ◽  
Sarah Schaefer ◽  
Michael D Nowak ◽  
Emilia Mia Sordillo ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Patient Characteristics ◽  
Nucleic Acid Amplification ◽  
Duration Of Symptoms ◽  
Radiographic Findings ◽  
Repeat Testing ◽  
Clinical Sensitivity ◽  
Viral Transport Medium ◽  
Minimum Interval ◽  
Roche Diagnostics

Abstract Background Nucleic Acid Amplification Tests (NAATs) of nasopharyngeal specimens (NPS) have become standard for diagnosis of SARS-COV2. IDSA guidelines suggest repeat testing after 24–48 h when initially negative and clinical suspicion persists. We characterized patients from whom initial NPS were NAAT-negative, but repeats were NAAT-positive, in order to identify which patients might benefit from repeat NAAT for SARS-CoV-2, and the appropriate interval. Methods We conducted an IRB-approved retrospective review of laboratory and electronic medical record data for all patients evaluated for SARS-CoV-2 infection at the Mount Sinai Health System, whose initial NAATs were done between March 16 – March 30, 2020, and who were retested within one month. NAATs were performed on NPS in viral transport medium using the Roche Diagnostics cobas® 6800 SARS-CoV-2 Test. Baseline patient characteristics, clinical and radiographic findings were identified. Results Of 235 patients eligible for inclusion, 172 (70.5%) were initially NAAT-negative, and 118 (68.6%) remained NAAT-negative over 1 month follow up. 54 (31.4%) converted to NAAT-positive over the next 1-month. Of patients who became NAAT-positive, 31 (57.4%) were inpatients who converted results within a single admission; the average interval was 6d 7h between the NAAT-negative and NAAT-positive results, and the minimum interval was 10.5 h. Symptoms examined for correlation for conversion to NAAT-positive were: fever, cough, shortness of breath, and combined nausea/vomiting/diarrhea. Duration of symptoms reported at triage did not appear to affect time to conversion to NAAT-positive. No individual symptom was more likely to be associated with conversion to NAAT- positive. However, time to conversion to NAAT-positive was shorter for patients with multiple symptoms. In general, chest radiography (CXR) findings correlated with NAAT results; interval to NAAT-positive was shorter for patients with worsening CXR findings. Conclusion Our data supports repeat testing in patients with multiple clinical symptoms suggestive of SARS CoV-2 infection and negative initial NP test results. Further studies are needed to determine the true clinical sensitivity and specificity of SARS-CoV-2 NAAT assays. Disclosures All Authors: No reported disclosures

Analysis of Conservative Surgical Treatment and Prognosis of Microinvasive Squamous Cell Carcinoma of the Cervix Stage IA1: Results of Follow-Up to 20 Years

2017 ◽  
Vol 27 (2) ◽  
pp. 357-363 ◽  
Author(s):  
Caio Augusto Hartman ◽  
Julio Cesar Teixeira ◽  
Sergio Bruno Barbosa ◽  
Stephanye Mariano Figueiredo ◽  
Liliana Aparecida Lucci De Angelo Andrade ◽  
...  
Keyword(s):  
Residual Disease ◽  
Disease Free Survival ◽  
Cervical Neoplasia ◽  
Good Prognosis ◽  
Positive Cone ◽  
Definitive Treatment ◽  
Younger Women ◽  
Grade 3 ◽  
Almost All

ObjectiveThe aim of this study was to evaluate the prognosis and recurrence of microinvasive squamous cervical (MIC) cancer stage IA1 in women treated conservatively or by hysterectomy, and followed-up to 20 years.MethodsIt was studied in a cohort of 139 women with MIC, 41 definitively managed by conization and 98 by hysterectomy from January 1994 to December 2003 and followed-up until 2013. The definitive treatment, age, conization technique (loop electrosurgical excision procedure or cold knife conization), cone margin, residual disease in hysterectomy specimen, and the association with recurrence (intraepithelial cervical neoplasia grade 3/intraepithelial vaginal neoplasia grade 3 or worse, and microinvasive or worse) were analyzed.ResultsThere were 2.5 times more conservative treatment in younger women than older (>40 years), and high proportion of residual disease in hysterectomy specimens (67% of intraepithelial cervical neoplasia grade 3 or worse), more common if positive cone margin (74% vs 35%, P < 0.002). There were 2.3% (3/133) recurrences detected as microinvasive or worse, and 6% (8/133) recurrences detected as intraepithelial cervical neoplasia grade 3/intraepithelial vaginal neoplasia grade 3 or worse: 7.3% (3/41) in the conization group and 5.4% (5/92) in the hysterectomy group (P = 0.701). Almost all recurrences (88%, 7/8) were diagnosed until 36 months after treatment, and they were not associated with conization technique. There were no differences in risk of recurrence and overall disease-free survival time related to type of treatment.ConclusionsThis study demonstrates the good prognosis of MIC, regardless the treatment. When fertility is not a concern, hysterectomy should be considered as definitive treatment to avoid the risk of residual disease. Regular follow-up for a long period should be maintained.

COVID-19 situation in Baden-Württemberg, Germany: Preliminary case series study during the first wave

2021 ◽  
Vol 1 (1) ◽  
pp. 6-11
Author(s):  
Dzmitry Katovich ◽  
Claudia Grun ◽  
Hanna Katovich ◽  
Bastian Hauer ◽  
Thomas Iber ◽  
...  
Keyword(s):  
Intensive Care ◽  
Clinical Symptoms ◽  
Fatal Outcome ◽  
Laboratory Data ◽  
Case Series ◽  
Severe Illness ◽  
Case Series Study ◽  
Regional Factors ◽  
Series Study

The present case series study presents the preliminary data of 347 of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) positively tested patients in the Mittelbaden hospital, Baden-Baden Bühl, Germany, during the period from March to June 2020. Among the 347 patients, 55% were males. The mean age-wise was 52.5±20.2 years in the overall cohort and 78.9±11.1 years in fatal outcome cases. A total of 120/347 patients (34.6%) required hospitalization, but only 36/347 (10.37%) cases required intensive care. The overall fatality rate was 6.6% (23/347), of which 12 patients were from the intensive care unit. The most frequent clinical symptoms observed were cough (62.5%), hyperthermia (47.8%), rhinorrhea (25.1%), sore throat (23.1%), dyspnea (22.8%), and headache (19.3%). Laboratory data analysis showed no specific findings, but severe laboratory disturbances could predict critical illness. A higher risk of severe illness or lethal outcome in elderly patients with several comorbidities was the most frequent. The fight against COVID-19 infection in Germany seems to be more successful during the first wave than in other countries. The improvement of the healthcare system against infectious outbreaks depends directly on the analysis of regional factors.

CLINIC AND COMPLICATIONS OF COVID-19 CORONAVIRUS DISEASE WITH PATHOGENESIS ELEMENTS

2020 ◽  
pp. 72-79
Author(s):  
I. V. Аndrusovich
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Tract ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Second Phase ◽  
Upper Respiratory Tract

The longer the COVID−19 coronavirus pandemic lasts, the more information about its clinical manifestations is accumulated. The incubation period of COVID−19 ranges from 2 to 14 days, rarely up to 3 weeks, but in a significant number of cases an infection is not accompanied with the appearance of clinical symptoms. Currently, the following variants of the clinical course of COVID−19 can be identified as follows: viral load; subclinical; slight; uncomplicated with damage to only the upper respiratory tract; mild pneumonia, severe pneumonia, acute respiratory distress syndrome, etc. The clinical course of COVID−19 depends on the severity, the criteria of which are the intoxication manifestation, the degree of fever and the dominant syndrome. Mild / moderate forms are manifested by frequent increase in body temperature up to 38 ° C, respiratory symptoms, headache, myalgias, palpitations and general malaise. Patients stop distinguishing smells and feel the taste of food. Approximately from the 7th to the 9th days of the disease there are problems with breathing, which indicates the impairment of the lower respiratory tract and the beginning of the second phase of the disease, and its course is regarded as severe. Severe forms of the disease can also be manifested by impaired coordination of movements, slurred speech. In 1 to 4 % of patients there is developed the psychosis in the form of hallucinations. In the elderly, COVID−19 may be accompanied by delirium, lowering blood pressure. The risks of adverse disease are associated with somatic diseases: cardiovascular and nervous systems, respiratory tract, hormonal disorders, etc. Otitis, sinusitis, sepsis, bronchopulmonary infection, thrombosis, myocarditis etc. can be the complications of COVID−19. Computer tomography is an instrumental test that demonstrates the damage of lungs with coronavirus and allows to assess its severity. Key words: coronavirus infection, COVID−19, clinical variants, severity, pneumonia, acute respiratory distress syndrome.

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