scholarly journals Angioedema - Our Experience Focused On Socio-Demographic, Etiological and Clinical Characteristics of the Condition and Its Management

2019 ◽  
Vol 7 (3) ◽  
pp. 341-346
Author(s):  
Svetlan Dermendjiev ◽  
Vesela Slavcheva Blagoeva
Keyword(s):  
Family History ◽  
Medical Condition ◽  
Working Women ◽  
Clinical Importance ◽  
Demographic Characteristics ◽  
Upper Respiratory Tract ◽  
Life Threatening ◽  
History Of ◽  
Inflammatory Drugs ◽  
Voluntary Basis

BACKGROUND: Angioedema (AE) is acute oedema of the skin and mucous surfaces, involving the respiratory and gastrointestinal tracts. AE could be a life-threatening medical condition. Regardless of its growing clinical importance, many aspects of its aetiology and pathogenesis remain poorly understood. Its incidence, demographic characteristics, diagnosis and therapy, need further investigation. AIM: This study reports our experience with angioedema concerning its social and demographic characteristics, aetiology, clinical features, diagnosis and treatment outcomes. Study design: Eighty-eight patients with AE were enrolled. The study is a retrospective analysis of patients treated in our Clinics. METHODS: All participants were asked on a voluntary basis to fill out a specially designed questionnaire on the day of their discharge. Other important data sources included: patients’ history and notes during the hospital stay, information from previous admissions, etc. Parametric and non-parametric statistical methods were used for data processing. Data analysis was performed using SPSS (SPSS Inc., IBM SPSS Statistica) version 20.0 RESULTS: Based on our results, AE affects more frequently patients over 50 years of age, regardless of their sex. Urban residents prevail, among them - more commonly working women. Non-steroidal anti-inflammatory drugs (NSAIDs), hormones and antibiotics were among the most common triggers – in 8%, 4.5% and 11.4% of the cases respectively. In 9.09% of the patients, food-induced AE was seen, the most common foods reported, were – nuts, eggs and egg products. The common sites of involvement were periorbital area and lips. In only 9.1% of the patients, oedema progressed to spread to the upper respiratory tract. Cardiac conditions were the most frequent underlying disorders – 33%, of the patients, auto-immune thyroiditis was the second most common-14.8%, followed by musculo- skeletal disorders (10.2%) and diabetes (4.5%) Family history of allergy was seen in 8.4% of the patients, the most frequent allergic disorder, reported, was asthma. In patients with HAE, family history was present in 2.9% of the patients. CONCLUSIONS: All patients received therapy with steroids and antihistamines, resulting in resolution of symptoms and no invasive procedures were necessary. Based on our results, the diagnosis of AE is often difficult and delayed and requires specialist evaluation. If recognised on time and adequately treated, the outcomes are favourable.

scholarly journals Familial pneumothorax: towards precision medicine

Thorax ◽  
2017 ◽  
Vol 73 (3) ◽  
pp. 270-276 ◽  
Author(s):  
Rachel M Scott ◽  
Elizabeth P Henske ◽  
Benjamin Raby ◽  
Philip M Boone ◽  
Rosemary A Rusk ◽  
...  
Keyword(s):  
Family History ◽  
Precision Medicine ◽  
Genetic Disorders ◽  
Clinical Manifestations ◽  
Genetic Causes ◽  
Life Threatening ◽  
History Of

One in 10 patients suffering from primary spontaneous pneumothoraces has a family history of the disorder. Such familial pneumothoraces can occur in isolation, but can also be the presentation of serious genetic disorders with life-threatening vascular or cancerous complications. As the pneumothorax frequently precedes the more dangerous complications by many years, it provides an opportunity to intervene in a focused manner, permitting the practice of precision medicine. In this review, we will discuss the clinical manifestations and underlying biology of the genetic causes of familial pneumothorax.

scholarly journals Correlation between Breast Self-Examination Practices and Demographic Characteristics, Risk Factors and Clinical Stage of Breast Cancer among Iraqi Patients

2019 ◽  
Vol 7 (19) ◽  
pp. 3216-3220
Author(s):  
Ahmad S. A. Al-Gburi ◽  
Nada A. S. Alwan
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Family History ◽  
Early Detection ◽  
Clinical Stage ◽  
Cancer Control ◽  
Demographic Characteristics ◽  
Breast Self Examination ◽  
History Of ◽  
Self Examination

BACKGROUND: Breast Cancer (BC) is the most common cancer and the leading cause of cancer death among women globally. The disease can be cured with limited resources if detected early. Breast self-examination (BSE) is considered a cost-effective feasible approach for early detection of that cancer in developing countries. AIM: To determine the correlation between BSE performance and demographic characteristics, risk factors and clinical stage of BC among Iraqi patients. METHODS: This retrospective study included a total of 409 female patients diagnosed with BC at the Referral Training Center for Early Detection of Breast Cancer and the National Cancer Research Center in Baghdad. The studied variables included the age of the patient, occupation, marital and educational status, parity, history of lactation, contraceptive pill intake, family history of cancer and the clinical stage of the disease. RESULTS: Our findings revealed that the most important predictors for practicing BSE was family history of BC or any other cancers (OR = 3.87, P = 0.018) followed by being a governmental employee (OR = 1.87, P = 0.024), history of contraceptive use (OR = 1.80, P = 0.011) and the high level of education (OR = 1.73, P = 0.004). On the other hand, there was no significant correlation between the practice of BSE and the BC stage at the time of presentation. CONCLUSION: There is a relatively poor practice of BSE among Iraqi patients diagnosed with BC. It is mandatory to foster the national cancer control strategies that focus on raising the level of awareness among the community through public education as a major approach to the early detection of cancer in Iraq.

scholarly journals A rare case of acquired benign tracheoesophageal fistula

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Sarah Bouayyad ◽  
Meera Beena ◽  
Ajay Nigam
Keyword(s):  
Case Report ◽  
Patient Selection ◽  
Tracheoesophageal Fistula ◽  
Rare Case ◽  
Foreign Bodies ◽  
Medical Condition ◽  
Surgical Methods ◽  
Life Threatening ◽  
History Of ◽  
Tracheoesophageal Puncture

Abstract Acquired benign tracheoesophageal fistula (TOF) is a rare medical condition that usually results from trauma, foreign bodies or granulomatous infections. This is an unusual presentation of a male patient with a history of laryngectomy who has had over a period of several years inappropriately and vigorously used valve cleaning brushes to clean tracheal secretions, which has led to the formation of a TOF. Due to the patient’s obsessive habit, we could not manage him using conventional surgical methods. Instead, we opted for the placement of a salivary bypass tube, which yielded good results and recovery. To the best of our knowledge, no other case of similar aetiology has been published. We would like to highlight the importance of appropriate patient selection and education prior to performing a tracheoesophageal puncture to avoid developing life-threatening complications as demonstrated in our case report.

Abstract P320: Discordance of Framingham Risk Score and Reynolds Risk Score to Global Vascular Risk Score: Results from the Hispanic Community Health Study/Study of Latinos

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Molly Jung ◽  
Hector M Medina ◽  
Martha Daviglus ◽  
Marina DelRios ◽  
Mario Garcia ◽  
...  
Keyword(s):  
Family History ◽  
High Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Demographic Characteristics ◽  
Vascular Risk ◽  
Framingham Risk ◽  
Chd Risk ◽  
History Of ◽  
Reynolds Risk Score

Introduction: The Framingham Risk Score (FRS) is a coronary heart disease (CHD) risk model established using an ethnically homogeneous population that predicts 10-year hard CHD events, myocardial infarction (MI) and coronary death. The Reynolds Risk Score (RRS) and Global Vascular Risk Score (GVRS) are validated CHD risk models that, in addition to hard CHD events, predict stroke and other CHD outcomes. In addition to major CHD risk factors, RRS adds systemic inflammation and family history of MI as GVRS adds behavioral and anthropometric measures. This study aims to compare agreement of RRS and GVRS with FRS among Hispanic/Latino adults and to describe discordance in RRS and GVRS with FRS categories, by socio-demographic characteristics. Methods: HCHS/SOL is a population-based cohort study of Hispanics/Latinos in four US communities. The analytic sample includes 6,058 non-diabetic participants 45-74 years of age with no past history of CHD and stroke who underwent comprehensive baseline examination. 10-year hard CHD risk score was calculated; participants were categorized as low (<10%), moderate (10-<20%), and high (≥20%) risk. Kappa scores were calculated to compare agreement of RRS and GVRS with FRS. Socio-demographic characteristics of concordance and discordance were characterized overall; multinomial logistic regression models was used to examine age-sex-adjusted likelihood of in discordance by these factors. Results: Mean age of the participants was 55 (SE=0.15) years, 54.3% were women, 41% had family history of CHD, and 90% were foreign born. Overall, 4,805 (74%) had low FRS, 1,143 (24%) had moderate FRS, and 110 (2%) had high FRS. There was poor agreement between RRS and FRS (Kappa=0.16, P<0.01) and fair agreement between GVRS and FRS (Kappa=0.36, P<0.01). In age-sex-adjusted analyses, RRS and GVRS were both more likely to classify persons of moderate and high risk who are between the ages of 60-74; GVRS classified more moderate and high risk women than the FRS. RRS and GVRS discordance with FRS was not associated with nativity and length of time in US. Conclusion: Significant discordance was observed between RRS and GVRS compared to FRS. Among Hispanic/Latino adults, use of RRS or GVRS may be more inclusive in classifying older age adults and women at high 10-year CHD risk.

scholarly journals POS1372 EVALUATION OF E148Q AND CONCOMITANT AA AMYLOIDOSIS SECONDARY TO FAMILIAL MEDITERRANEAN FEVER AFTER ADJUSTED CLINICAL-DEMOGRAPHIC CHARACTERISTICS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 968.1-968
Author(s):  
Z. S. Arici ◽  
M. Romano ◽  
D. Piskin ◽  
F. Guzel ◽  
M. Yilmaz ◽  
...  
Keyword(s):  
Family History ◽  
Familial Mediterranean Fever ◽  
Allele Frequency ◽  
Demographic Characteristics ◽  
Renal Amyloidosis ◽  
Histopathological Diagnosis ◽  
Aa Amyloidosis ◽  
History Of ◽  
Mediterranean Fever

Background:Amyloid A (AA) amyloidosis, previously known as secondary or reactive amyloidosis, is a long-recognized severe complication of some chronic inflammatory diseases. The pathogenesis and risk factors for amyloidosis in Familial Mediterranean Fever (FMF) remain partially understood (1). The development of AA amyloidosis is dependent on ethnicity and country of residence (2). In the pre-colchicine era, renal AA-amyloidosis was largely reported patients of Turkish (67%) and Sephardic Jewish ancestry (26.5%) (2,3). Currently it’s well known that the MEFV M694V variant associated with high risk of amyloidosis however, mutations on exon 2, specifically E148Q variant remained controversial.Objectives:To evaluate the E148Q mutation variant and concomitant AA Amyloidosis secondary to FMF after adjusted clinical-demographic characteristics.Methods:Patients were recruited from the renal unit at Epigenetic Health Center outpatient clinic in Turkey between September 2003 and February 2020. Patients who had biopsy confirmed FMF related AA amyloidosis were included the study. Tel-Hashomer criteria were applied in the diagnosis of FMF. The clinical characteristics of FMF patients and medication history were recorded by the physician at the time of registry entry. All patients had detailed baseline assessment of clinical features, renal functions, genetic testing, histopathological diagnosis of amyloidosis, and treatment received. We performed multiple comparisons according to the age of diagnosis, demographic features, disease phenotype, allele frequency, type of mutation and mortality. Statistical analysis was performed with Statistical Package of Social Science (SPSS) for Windows, version 15.0 (SPSS Inc, Chicago, IL).Results:Our registry consists of 195 patients with a diagnosis of AA amyloidosis. Complete information on 169 patients (lost to follow up, n=26) were included. The median age was 36 (19-49) years; male/female ratio was 1.6 (104/65). The median follow-up duration was 15.0 years (4-17 years). There were 101 patients diagnosed with FMF <18 years of age and 68 patients diagnosed ≥18 years of age. All participants developed renal amyloidosis before the age of 32 years. Family history of FMF was documented in 56 patients (33.1%) and family history of amyloidosis was present in 41 patients (24.3%). The three most common clinical symptoms were fever (84,6%), abdominal pain (71.6%) and arthritis (66.9%). During the follow-up, 5 patients started dialysis treatment and 9 patients had kidney transplantation. The most common allele frequency across patients was M694V (60.6%), E148Q (21.4%) and M680I (10.3%). The most frequent mutations were M694V/M694V (63.3%), M694V/E148Q (20.8%) and E148Q/E148Q (15.8%). During the follow up period, 15 patients (10 male, 5 female) died. In those that died, the mutations in 14 had M694V/M694Vand one demonstrated E148Q/E148Q.Conclusion:Patients with FMF related AA amyloidosis have an increased risk for mortality. This study confirmed the association between M694V and FMF-associated AA amyloidosis, which has been reported in many studies. Close clinical follow-up and further evaluation of patients with the E148Q mutation is warranted specifically if residing in FMF endemic areas. The possible relationship between E148Q and AA amyloidosis need to be confirmed in other cohorts.References:[1]Erer B, Demirkaya E, Ozen S, Kallinich T. What is the best acute phase reactant for familial Mediterranean fever follow-up and its role in the prediction of complications? A systematic review. Rheumatology international. 2016;36(4):483-7.[2]Touitou I, Sarkisian T, Medlej-Hashim M, Tunca M, Livneh A, Cattan D, et al. Country as the primary risk factor for renal amyloidosis in familial Mediterranean fever. Arthritis and rheumatism. 2007;56(5):1706-12.[3]Pras M, Bronshpigel N, Zemer D, Gafni J. Variable incidence of amyloidosis in familial Mediterranean fever among different ethnic groups. Johns Hopkins Med J. 1982;150(1):22-6.Disclosure of Interests:None declared

scholarly journals Unexplained Syncope: The Importance of the Electrophysiology Study

Hearts ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 495-505
Author(s):  
Ioannis Doundoulakis ◽  
Stergios Soulaidopoulos ◽  
Petros Arsenos ◽  
Polychronis Dilaveris ◽  
Dimitris Tsiachris ◽  
...  
Keyword(s):  
Heart Disease ◽  
Clinical Importance ◽  
Electrophysiology Study ◽  
Responsible Mechanism ◽  
Increased Risk ◽  
Inclusive Approach ◽  
Acquired Heart Disease ◽  
Life Threatening ◽  
History Of ◽  
Unexplained Syncope

Syncope of cardiac origin may be associated with an increased risk of sudden cardiac death if not treated in a timely and appropriate manner. The diagnostic approach of syncope imposes a significant economic burden on society. The investigation and elucidation of the pathogenetic mechanism of syncope are of great clinical importance, as both prognosis and appropriate therapeutic approaches depend on these factors. The responsible mechanism of presyncope or syncope can only be revealed through the patient history, baseline clinical examination and electrocardiogram. The percentage of patients who are diagnosed with these tests alone exceeds 50%. In patients with a history of organic or acquired heart disease or/and the presence of abnormal findings on the electrocardiogram, a further diagnostic electrophysiology inclusive approach should be followed to exclude life threatening arrhythmiological mechanism. However, if the patient does not suffer from underlying heart disease and does not show abnormal electrocardiographic findings in the electrocardiogram, then the probability in the electrophysiology study to find a responsible cause is small but not absent. The role of a two-step electrophysiology study inclusive risk stratification approach for the effective management of the former is thoroughly discussed in this review.

scholarly journals Clinical, epidemiological and laboratory characteristics of children with febrile seizures

2020 ◽  
Vol 7 (7) ◽  
pp. 1598
Author(s):  
Poornima Shankar ◽  
Shajna Mahamud
Keyword(s):  
Family History ◽  
Febrile Seizure ◽  
Monsoon Season ◽  
Febrile Seizures ◽  
First Episode ◽  
Upper Respiratory Tract ◽  
History Of ◽  
Upper Respiratory ◽  
One Year ◽  
Tract Infections

Background: Febrile seizure is the most common type of seizure disorder that occurs in children aged 6-60 months. Recurrences are common. This study was conducted to evaluate the epidemiology, clinical profile and laboratory parameters of children presenting with febrile seizure in a teaching hospital.Methods: This was a descriptive retrospective study among children presenting with febrile seizure admitted to KIMS, Bengaluru from March (2018-2019). Children between six months to five years were included in the study while patients with prior episodes of afebrile seizures, abnormal neurodevelopment and not meeting the age criteria were excluded. Patient’s demographic and clinical data were collected from the in-patient records and analysed.Results: Among 60 children with febrile seizures were enrolled in our study with highest prevalence in males (58%) and amongst 13-24 months age group (37%). Majority (20%) presented in the monsoon season (June) and in the morning hours (43%). Simple febrile seizures and complex febrile seizures were observed in 60% and 40% respectively. Majority (73%) who developed first episode of seizure were below 24 months ago with mean age of 18.71±11.50 months. 42% had recurrence and was significantly associated with first episode of febrile seizures at age ≤1 year and family history of seizures. Upper respiratory tract infections were the commonest cause of fever. Anaemia and leucocytosis were seen in 72% and 70% cases respectively.Conclusions: Febrile seizure was observed predominantly in children below two years, simple febrile seizure being the commonest. Recurrence was common and significantly associated with the first episode of febrile seizure at the age one year or below and family history. Majority had anaemia which showed that iron deficiency anaemia could be a risk factor. Leucocytosis was present in most which could be either due to underlying infection or due to the stress of seizure itself.

Ostensible Versus Actual Reasons for Seeking Pediatric Attention: Another Look at the Parental Ticket of Admission

PEDIATRICS ◽  
1982 ◽  
Vol 70 (6) ◽  
pp. 870-874
Author(s):  
Lee W. Bass ◽  
Richard L. Cohen
Keyword(s):  
Family History ◽  
Chief Complaint ◽  
Parental Anxiety ◽  
Thought Processes ◽  
Pediatric Practice ◽  
Life Threatening Illness ◽  
Vital Functions ◽  
Sick Patient ◽  
Life Threatening ◽  
History Of

The presentation of parental anxiety that appears excessive in view of the nature of the child's "chief complaint" is a frequent occurrence in pediatric practice. This study reviews 370 sick-patient visits in one pediatric office during a three-month period. Additional questioning in the area of parental anxieties concerning these symptoms revealed that in 125 instances (33.8%), the parent was entertaining unverbalized fears that something much more serious was wrong with the child than could be anticipated from the ostensible reason for seeking assistance. An analysis of the "actual reason for coming" reveals that the child's presenting complaint has become associated for the parent with (1) family history of serious life-threatening illness; (2) fears of loss and separation; (3) death; (4) the fears of another family member who is pressing for "answers" about the problem; (5) fears of loss of vital functions and a variety of other thought processes that have somehow become linked to the child's symptom. Techniques for recognizing and ameliorating this parenting difficulty are discussed.

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