scholarly journals Sex Differences in Incidence, Clinical Characteristics and Outcomes in Children and Young Adults Hospitalized for Clinically Suspected Myocarditis in the Last Ten Years—Data from the MYO-PL Nationwide Database

2021 ◽  
Vol 10 (23) ◽  
pp. 5502
Author(s):  
Krzysztof Ozierański ◽  
Agata Tymińska ◽  
Aleksandra Skwarek ◽  
Marcin Kruk ◽  
Beata Koń ◽  
...  
Keyword(s):  
Young Adults ◽  
Sex Differences ◽  
Clinical Characteristics ◽  
Hospital Admissions ◽  
Young Patients ◽  
Diagnostic Procedures ◽  
Early Spring ◽  
Public Healthcare ◽  
Number Of Patients ◽  
Children And Young Adults

There is a widespread lack of systematic knowledge about myocarditis in children and young adults in European populations. The MYO-PL nationwide study aimed to evaluate sex differences in the incidence, clinical characteristics, management and outcomes of all young patients with a clinical diagnosis of myocarditis, hospitalized in the last ten years. The study involved data (from the only public healthcare insurer in Poland) of all (n = 3659) patients aged 0–20 years hospitalized for myocarditis in the years 2011–2019. We assessed clinical characteristics, management and five-year outcomes. Males comprised 75.4% of the study population. The standardized incidence rate of myocarditis increased over the last ten years and was, on average, 7.8 and 2.5 (in males and females, respectively). It was the highest (19.5) in males aged 16–20 years. The highest rates of hospital admissions occurred from late autumn to early spring. Most myocarditis-directed diagnostic procedures, including laboratory tests, echocardiography, coronary angiography, cardiac magnetic resonance and endomyocardial biopsy, were performed in a low number of patients, particularly in females. Most patients required rehospitalization for cardiovascular reasons. The results of this large epidemiological study showed an increasing incidence of myocarditis hospitalizations in young patients over last ten years and that it was sex-, age- and season-dependent. Survival in young patients with myocarditis was age- and sex-related and usually it was worse than in the national population. The general management of myocarditis requires significant improvement.

Abstract 16899: Sex Differences in Young Adults With Acute Myocardial Infarction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Malini Nadadur ◽  
Rikin Tank ◽  
Cheng Chen ◽  
Anne ICHIUJI ◽  
Yuh-Jer A Shen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Young Adults ◽  
Sex Differences ◽  
Clinical Characteristics ◽  
Obstructive Coronary Artery Disease ◽  
Young Patients ◽  
Men And Women ◽  
Patients Âgés

Introduction: There are important sex differences in the pathophysiology and clinical presentation of cardiovascular disease. Cardiovascular disease is understudied in women, despite it being the leading cause of mortality. The goal of this study is to report sex differences in clinical characteristics, treatment, and outcomes in young patients presenting with acute myocardial infarction. Methods: This is a retrospective observational study that included patients ages 18 to 40 hospitalized for acute myocardial infarction between 2006 and 2016 in Kaiser Permanente Southern California, a large integrated healthcare system. Differences in demographics, clinical characteristics, and management were examined between men and women. Multivariable Cox proportional hazard models were used to examine the association between sex and mortality. Results: Between 2006 and 2016, a total of 26,390 patients were hospitalized with a principal diagnosis of acute myocardial infarction and underwent coronary catheterization. In this cohort, 603 patients were young adults between age 18 to 40, of whom 144 (24%) were women. Women were more likely to be black. There were no significant sex differences in the prevalence of hypertension, hyperlipidemia, diabetes, heart failure and renal failure. There was a higher prevalence of obesity in women. Women were more likely to have no obstructive disease on coronary angiogram (43.4% vs. 33.2%, p=0.03). Treatment with percutaneous coronary intervention was less likely in women (38.2% vs. 56.2%, p<0.001). Mortality was low for both women and men during index hospitalization (0.7% vs 0.9%, p=0.84) and at one year (1.4% vs. 1.5%, p=0.91), with no significant differences (adjusted HR 1.3, 95% CI 0.5-3.1). Conclusions: Compared to young men, young women presenting with acute myocardial infarction as less likely to have obstructive coronary artery disease. Mortality rates for both men and women were low, with no significant differences observed.

scholarly journals Coronary lesions suggestive of kawasaki disease in young patients presenting with acute myocardial infarction

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
F Solis-Jimenez ◽  
H Gonzalez Pacheco ◽  
J Calderon Colmenero ◽  
J Cervantes Salazar ◽  
D Manzur Sandoval ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Adults ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Angiography ◽  
Clinical Characteristics ◽  
Young Patients ◽  
Coronary Aneurysms ◽  
Coronary Lesions

Abstract Background Approximately 25% of patients with untreated Kawasaki disease (KD) in childhood develop coronary aneurysms, which represent a higher likelihood for the occurrence of acute myocardial infarction (AMI) in young adults. Although the clinical characteristics of young adults with KD and suspected ischemia have been studied, the available data about suggestive lesions of KD in AMI is scarce. Purpose To describe the prevalence, clinical characteristics and in-hospital mortality of young adults with AMI and coronary artery lesions suggestive of KD. Methods We conducted a retrospective study of consecutive ≤40-year old patients hospitalized with AMI and coronary angiography in a coronary care unit of a Mexican teaching hospital between 2006–2020. Patients were classified according to the presence or absence of suggestive lesions of KD sequelae such as proximal aneurysms, larger size and normal distal segments Results There were included 488 patients of 40 years of age and younger, diagnosed with AMI, in whom a coronary angiography was performed. Among them, 44 patients (9%) showed coronary aneurysm or ectasia, within this group, 16 patients (36.3%) had angiographic lesions compatible with KD. The patients were classified according to the type of coronary lesions: Angiographic lesions compatible with KD, 3.3% (n=16); Diffuse coronary artery ectasia (CAE), 5.7% (n=28); and Obstructive coronary disease (OCD), 91% (n=444). The prevalence of smoking, dyslipidemia, and hypertension were similar between the groups, whereas a history of diabetes was absent in KD patients (0%, 10.7%, and 22.1% for KD, CAE and OCD, respectively; P=0.04). At admission, ST-elevation myocardial infarction was more frequent in patients with KD (81.3%, 75%, and 67.1% for KD, CAE and OCD, respectively; P=0.35). More than half of patients with KD had coronary aneurysms in two or more vessels. The right coronary artery was the most commonly affected artery followed by the left anterior descending artery and left circumflex coronary artery (87.5%, 56.3% and 56.3%, respectively). The presence of intracoronary thrombus identified at the time of angiography was more frequent in patients with KD (62.5%, 60.7% and 44.1% for KD, CAE and OCD, respectively; P=0.09). Overall, unadjusted in-hospital mortality was 3.9% and there were no deaths in the KD group (0%, 0% and 4.3% for KD, CAE, and OCD, respectively; P=0.37). Conclusion In young patients with AMI, the sequelae of KD should be considered as a possible etiology, based on their angiographic characteristics. To bear in mind the nature of the pathogenesis is crucial to assess medical and interventional management strategies, which are not well defined yet, in order to evaluate cardiovascular risk and optimize a patient-tailored treatment, which could differ from the treatment of atherosclerotic coronary artery disease FUNDunding Acknowledgement Type of funding sources: None. Figure 1 Figure 2

The CHI3L1 rs4950928 polymorphism is associated with asthma-related hospital admissions in children and young adults

2011 ◽  
Vol 106 (5) ◽  
pp. 381-386 ◽  
Author(s):  
Jason Cunningham ◽  
Kaninika Basu ◽  
Roger Tavendale ◽  
Colin N.A. Palmer ◽  
Helen Smith ◽  
...  
Keyword(s):  
Young Adults ◽  
Hospital Admissions ◽  
Children And Young Adults

Aetiological evaluation of chest pain in childhood and adolescence

2020 ◽  
Vol 30 (5) ◽  
pp. 617-623
Author(s):  
Emre Aygun ◽  
Sibel Tugce Aygun ◽  
Taciser Uysal ◽  
Fatih Aygun ◽  
Hasan Dursun ◽  
...  
Keyword(s):  
Chest Pain ◽  
Musculoskeletal System ◽  
Clinical Characteristics ◽  
Hospital Admissions ◽  
Comprehensive Analysis ◽  
Childhood And Adolescence ◽  
Cardiac Diseases ◽  
Number Of Patients ◽  
Wide Range ◽  
Psychogenic Disorders

AbstractBackground:Chest pain, as a common cause of hospital admissions in childhood, necessitates detailed investigations due to a wide range of differential diagnoses. In this study, we aimed to determine the distribution of diseases causing chest pain in children and investigate the clinical characteristics of children with chest pain.Methods:This study included 782 patients aged between 3 and 18 years who presented to a paediatric cardiology outpatient clinic with chest pain between April 2017 and March 2018. Aetiological causes and demographic features of the patients were analysed.Results:Most prevalent causes of chest pain were musculoskeletal system (33%) and psychogenic (28.4%) causes. Chest pain due to cardiac reasons was seen in eight patients (1%). Diseases of musculoskeletal and gastrointestinal systems and psychogenic disorders were significantly more common in male and female patients, respectively (p < 0.001 for all). In winter, patients’ age and the number of patients with ≥12 years were higher than those in other seasons (p < 0.001). Most of the parents (70.8%) and patients (90.2%) thought that chest pain in their children was caused by cardiac causes.Conclusion:Most of the diagnoses for chest pain in childhood period are benign and include the musculoskeletal system and psychogenic diseases. Although chest pain due to cardiac diseases is rare, a comprehensive analysis of medical history, detailed physical examination and cardiac imaging with echocardiography is needed to reach more accurate diagnoses.

Normal Pressure Hydrocephalus in Children and Young Adults

Neurosurgery ◽  
1987 ◽  
Vol 20 (6) ◽  
pp. 904-907 ◽  
Author(s):  
Gene H. Barnett ◽  
Joseph F. Hahn ◽  
Joann Palmer
Keyword(s):  
Young Adults ◽  
Normal Pressure Hydrocephalus ◽  
Neurological Disorders ◽  
Young Patients ◽  
Normal Pressure ◽  
Neurological Dysfunction ◽  
Neurological Deficits ◽  
Normal Ranges ◽  
Ventriculoperitoneal Shunting ◽  
Children And Young Adults

Abstract Normal pressure hydrocephalus (NPH) is generally considered to be a disorder of adult and geriatric patients. We report four patients who are children or young adults with chronic neurological disorders, recent deterioration of their levels of function, normal cerebrospinal fluid (CSF) pressures, and ventricular enlargement. All four patients improved after the placement or revision of a ventriculoperitoneal shunt. Frequent symptoms and signs included irritability (three patients), vomiting (three patients), and abnormal limb posturing (two patients). Correct diagnosis was hampered by two factors: (a) Multiple or prolonged recordings of CSF pressures were invariably well within the normal ranges with respect to age, and (b) the patients had chronic neurological deficits. After ventriculoperitoneal shunting, subjective and objective improvement was seen in all cases. Young patients with large ventricles may benefit from shunting procedures despite low CSF pressures. These patients may be clinically identified by symptoms of new neurological dysfunction in cases of previously static neurological disease or acceleration of slowly progressive neurological dysfunction. Some of these underlying neurological disorders may predispose children and young adults to NPH.

scholarly journals 1454Renal disease in Aboriginal children and young adults (ARDAC): evolution to a data linkage study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Jacqueline Stephens ◽  
Victoria Sinka ◽  
Marianne Kerr ◽  
Michelle Dickson ◽  
Armando Teixeira-Pinto ◽  
...  
Keyword(s):  
Young Adults ◽  
First Nations ◽  
Data Linkage ◽  
Hospital Admissions ◽  
Large Population ◽  
Population Based ◽  
Advisory Group ◽  
Children And Young Adults ◽  
Aboriginal Children ◽  
Kidney Health

Abstract Focus of Presentation The ‘Antecedents of Renal Disease in Aboriginal Children and Young Adults’ (ARDAC) Study was the first large population-based longitudinal cohort study seeking to identify the early emergence and trajectory of kidney disease among Aboriginal and non-Aboriginal children. Since 2002, 3758 young people (2155 Aboriginal and 1603 non-Aboriginal) from across New South Wales, Australia, were enrolled, with clinical data collected every two years. However, the confluence of a maturing cohort, local issues (bushfires), and the COVID19 pandemic made follow-up screenings a challenge. As such, in 2021, ARDAC evolved into a data linkage to evaluate the cohort’s healthcare utilization and kidney health trajectory. Findings The ARDAC dataset contains 340 variables, which have been linked to a further 878 variables from state and federal government agency administrative datasets. Data incorporated in the linkage includes perinatal, pharmaceutical, hospital admissions, literacy, kidney health, kidney transplant, and death data. Preliminary findings from this unique and important linkage will be the focus of this presentation. Conclusions/Implications The breadth and scope of this data linkage makes it the largest on the kidney health of First Nations Peoples internationally. Analysis will provide a detailed understanding of the healthcare usage of this population and identify critical gender-specific timepoints and risk factors to inform the development of co-designed, community-driven strategies for future action. Key messages With governance provided by a strong Investigator-Advisory Group nexus, with extensive representation from Aboriginal and Torres Strait Islander researchers, patients, and community leaders, ARDAC is an exemplar of Aboriginal community-led research.

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