scholarly journals The index case of COVID-19 in Northeastern Iran

2020 ◽  
Vol 90 (4) ◽  
Author(s):  
Khadijeh Kalan Farmanfarma ◽  
Alireza Moslem ◽  
Fereshteh Ghorat ◽  
Mohammad Nematshahi ◽  
Azam Moslem ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Clinical Symptoms ◽  
Index Case ◽  
Family Members ◽  
Complete Recovery ◽  
Laboratory Diagnosis ◽  
Neurological Illness ◽  
History Of

The index case of COVID-19 in Sabzevar, Khorasan Razavi Province in northeastern Iran, was an 80-year-old man with a history of psycho-neurological illness and acute respiratory clinical symptoms, and a history of travel to areas with confirmed COVID-19 cases in Gorgan City. He was identified on February 16, 2020, and his laboratory diagnosis was made on February 26, 2020. The patient was hospitalized and discharged after complete recovery. The contacts of the patient were traced, revealing the infection of his 30-year-old son with milder symptoms of COVID-19, which was confirmed through a laboratory test on April 4, 2020 and was recommended for home quarantine. Other family members had no signs of COVID-19.

scholarly journals HTLV-1 infection is associated with a history of active tuberculosis among family members of HTLV-1-infected patients in Peru

2007 ◽  
Vol 136 (8) ◽  
pp. 1076-1083 ◽  
Author(s):  
K. VERDONCK ◽  
E. GONZÁLEZ ◽  
W. SCHROOTEN ◽  
G. VANHAM ◽  
E. GOTUZZO
Keyword(s):  
Multivariate Analysis ◽  
Index Case ◽  
Family Members ◽  
Active Tuberculosis ◽  
T Lymphotropic Virus ◽  
Lifetime History ◽  
History Of ◽  
Index Cases

SUMMARYThe purpose of this study was to assess the association between human T-lymphotropic virus 1 (HTLV-1) and a lifetime history of active tuberculosis (TB) among relatives of HTLV-1-infected patients. We reviewed clinical charts of all relatives of HTLV-1-infected index cases who attended our institute in Lima from 1990–2004. The data of 1233 relatives was analysed; 394 (32·0%) were HTLV-1 positive. Eighty-one subjects (6·6%) had a history of active TB, including 45/394 (11·4%) HTLV-1-positive and 36/839 (4·3%) HTLV-1-negative relatives (P<0·001). On multivariate analysis, three factors were associated with TB history: HTLV-1 infection (adjusted OR 2·5, 95% CI 1·6–3·9), age (adjusted OR 1·3, 95% CI 1·1–1·5 per 10-year age increase) and relation to the index case (adjusted OR 2·6, 95% CI 1·3–5·1, for siblingsvs. spouses of index cases). In conclusion, HTLV-1 infection may increase the susceptibility to active TB. In populations where both infections are frequent, such an association could affect the dynamics of TB.

scholarly journals Familial Autoimmune Myasthenia Gravis: Four Patients Involving Three Generations

2000 ◽  
Vol 27 (4) ◽  
pp. 307-310 ◽  
Author(s):  
R.A. Marrie ◽  
D.J. Sahlas ◽  
G.M. Bray
Keyword(s):  
Myasthenia Gravis ◽  
Medical Records ◽  
Index Case ◽  
Family Members ◽  
Monozygotic Twins ◽  
Bulbar Symptoms ◽  
History Of ◽  
Autoimmune Myasthenia ◽  
Successive Generations ◽  
Receptor Antibodies

Background:Familial autoimmune myasthenia gravis (MG) is rare, although a genetic role for the development of autoimmune MG is suggested by concordance in monozygotic twins and the increased frequency of other autoimmune diseases in family members of myasthenics.Methods:A patient with a family history of MG was evaluated in hospital. Relatives were interviewed and medical records examined for details regarding the diagnosis of MG in three other family members.Results:The index case first experienced symptoms of MG at age 75 years. She developed generalized MG and required corticosteroids and immunosuppressive therapy to control her disease. Her father developed predominantly bulbar symptoms of MG at age 75 years. He died of complications experienced following a gastrostomy placed for continued difficulty swallowing. His brother developed similar symptoms of MG in his early 60s and died shortly after thymectomy. A 46-year-old nephew of the index case is also beginning to exhibit signs of generalized MG. Acetylcholine receptor antibodies were strongly positive in the index case and her nephew. (The assay was not available for her father and uncle).Conclusion:Four individuals in three successive generations had diagnoses of autoimmune MG. Study of familial cases such as these may clarify the contribution of genetic factors to the development of this disease.

Time to recovery predicted by the severity of postoperative C5 palsy

2020 ◽  
Vol 32 (2) ◽  
pp. 191-199 ◽  
Author(s):  
Zach Pennington ◽  
Daniel Lubelski ◽  
Erick M. Westbroek ◽  
A. Karim Ahmed ◽  
Jeff Ehresman ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Complete Recovery ◽  
Radicular Pain ◽  
Tertiary Referral Center ◽  
C5 Palsy ◽  
Kaplan Meier ◽  
History Of ◽  
The Mean ◽  
Grade 3 ◽  
Degenerative Cervical Spine

OBJECTIVEPostoperative C5 palsy affects 7%–12% of patients who undergo posterior cervical decompression for degenerative cervical spine pathologies. Minimal evidence exists regarding the natural history of expected recovery and variables that affect palsy recovery. The authors investigated pre- and postoperative variables that predict recovery and recovery time among patients with postoperative C5 palsy.METHODSThe authors included patients who underwent posterior cervical decompression at a tertiary referral center between 2004 and 2018 and who experienced postoperative C5 palsy. All patients had preoperative MR images and full records, including operative note, postoperative course, and clinical presentation. Kaplan-Meier survival analysis was used to evaluate both times to complete recovery and to new neurological baseline—defined by deltoid strength on manual motor testing of the affected side—as a function of clinical symptoms, surgical maneuvers, and the severity of postoperative deficits.RESULTSSeventy-seven patients were included, with an average age of 64 years. The mean follow-up period was 17.7 months. The mean postoperative C5 strength was grade 2.7/5, and the mean time to first motor examination with documented C5 palsy was 3.5 days. Sixteen patients (21%) had bilateral deficits, and 9 (12%) had new-onset biceps weakness; 36% of patients had undergone C4–5 foraminotomy of the affected root, and 17% had presented with radicular pain in the dermatome of the affected root. On univariable analysis, patients’ reporting of numbness or tingling (p = 0.02) and a baseline deficit (p < 0.001) were the only predictors of time to recovery. Patients with grade 4+/5 weakness had significantly shorter times to recovery than patients with grade 4/5 weakness (p = 0.001) or ≤ grade 3/5 weakness (p < 0.001). There was no difference between those with grade 4/5 weakness and those with ≤ grade 3/5 weakness. Patients with postoperative strength < grade 3/5 had a < 50% chance of achieving complete recovery.CONCLUSIONSThe timing and odds of recovery following C5 palsy were best predicted by the magnitude of the postoperative deficit. The use of C4–5 foraminotomy did not predict the time to or likelihood of recovery.

scholarly journals Familial Thrombosis Due to Antithrombin III Deficiency

Blood ◽  
1974 ◽  
Vol 43 (2) ◽  
pp. 219-231 ◽  
Author(s):  
Ewa Marciniak ◽  
Claude H. Farley ◽  
Philip A. DeSimone
Keyword(s):  
Antithrombin Iii ◽  
Clinical Symptoms ◽  
Oral Anticoagulants ◽  
Laboratory Diagnosis ◽  
Blood Component ◽  
History Of ◽  
Antithrombin Iii Deficiency ◽  
Recurrent Venous Thrombosis

Abstract A large kindred from eastern Kentucky, with extensive history of recurrent venous thrombosis and pulmonary embolism, was studied. Low antithrombin III titers, ranging from 26% to 49% of normal values, were found in plasma of nine members in three consecutive generations; another five members, four of whom were not available for study, are suspected of having the biochemical defect. There was a good correlation between clinical symptoms and antithrombin III deficiency, although three of the younger members with the defect still remained free of thrombosis. In serum of the affected subjects antithrombin III was almost completely utilized, which indicates that stoichiometric binding to coagulation enzymes dominates under biological conditions. Antithrombin and antifactor Xa activities residing in the macroglobulin region of plasma and serum remained unchanged. The responsiveness to heparin in vitro and in vivo confirmed the evidence that antithrombin III is the sole blood component through which heparin exerts its anticoagulant effect. In five affected members therapy with oral anticoagulants increased very significantly the level of antithrombin III in plasma and contributed to a remarkable increase of residual antithrombin III in serum. This objective improvement after warfarin therapy may create significant difficulties in the laboratory diagnosis of antithrombin III deficiency.

scholarly journals LAMINOPLASTY AND CORPECTOMY IN THE TREATMENT OF CERVICAL SPONDYLOTIC MYELOPATHY

2018 ◽  
Vol 17 (3) ◽  
pp. 174-179
Author(s):  
Dreval’ Maxim Dmitrievich ◽  
Arestov Sergey Olegovich ◽  
Petrosyan David Vazgenovich ◽  
Kashcheev Alexey Alexeevich ◽  
Vershinin Andrey Vyacheslavovich ◽  
...  
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Clinical Symptoms ◽  
Complete Recovery ◽  
Neurological Dysfunction ◽  
Level Of Evidence ◽  
Segmental Instability ◽  
History Of ◽  
Prospective Comparative Study ◽  
Initial Severity ◽  
Significant Regression

ABSTRACT Introduction: Cervical Spondylotic myelopathy (CSM) is a disabling manifestation of extended cervical stenosis characterized by pronounced neurological dysfunction. Decompressive interventions contribute to significant regression of symptoms and, in some cases, complete recovery can be achieved. Objective: To explore the potential of laminoplasty in patients with extended cervical spondylotic stenoses complicated by myelopathy, and to develop approaches for surgical intervention in these patients. Methods: Fifty-six patients were included in the study. Laminoplasty was performed in 34 patients. Corpectomy was performed in 22 patients who made up the comparison group. The frequency and initial severity of concomitant non-neurological disorders in both groups were comparable. Results: Indications for laminoplasty were determined. They include: symptoms of spondylotic myelopathy, three or more levels of compression, preservation of lordosis, absence of signs of segmental instability, inability to perform anterior decompression, and age over 55 years. The presence of signs of segmental instability, kyphotic deformation, and history of mental disorders may be considered as contraindications for this surgery. Conclusions: Due to a number of advantages, laminoplasty is the treatment of choice for extended cervical spondylotic stenosis. Adequate selection of patients based on the evaluation of clinical symptoms, extension of stenosis, neurological signs and neuroimaging features enable excellent results to be achieved. Level of Evidence: II. Type of Study: Prospective comparative study.

scholarly journals Episodic Hematuria in a Young Boy - Do Not Miss Familial Idiopathic Hypercalciuria

2019 ◽  
Vol I (1) ◽  
pp. 1-2
Author(s):  
Vinay Rathore
Keyword(s):  
Family History ◽  
Renal Tubular Acidosis ◽  
Renal Pelvis ◽  
Index Case ◽  
Family Members ◽  
Renal Stones ◽  
Idiopathic Hypercalciuria ◽  
Adequate Hydration ◽  
History Of ◽  
Renal Tubular

Familial hypercalcemia is an important cause of episodic hematuria in children and can lead to nephrolithiasis if untreated. Elucidation of proper family history and screening of family members can help in clinching the diagnosis. An 8-year-old boy presented with episodic painless hematuria for 3 years, with a history of small renal stones in parents, which was managed conservatively. Ultrasound showed concretions in the renal pelvis, and urinalysis revealed hypercalciuria in the absence of renal tubular acidosis in index case as well as parents. He was started on thiazides, oral citrate supplementation, and adequate hydration, following which he became asymptomatic.

scholarly journals Spectrum of Hemoglobin E Disorder in a Family

KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 653-655
Author(s):  
Nazma Akter ◽  
Md Azizul Hoque ◽  
Ataur Rahman Choudhury
Keyword(s):  
Index Case ◽  
Family Members ◽  
Clinical Problem ◽  
Laboratory Diagnosis ◽  
Hemoglobin E ◽  
Her Family ◽  
Family Pedigree ◽  
The Family ◽  
Hb E ◽  
Family Case

We report a Bangladeshi family case of Hemoglobin E (Hb E) disorder. A 50 years old female and three of her family members had hemoglobin E disorder. Which was an incidental findings with nonspecific clinical problem and finally discovered the family pedigree of hemoglobin E disorder in asymptomatic other family members. Herein, we present the laboratory diagnosis and comparative data of the spectrum of Hb E disorders (i.e., heterozygous Hb E trait, homozygous Hb E disease) that was found in our index case and her offspring. Finally, genetic counseling & proper education gave to prevent the transmission of the abnormal gene in their progeny.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 653-655

scholarly journals Formation of a cohort of anticovid plasma donors with high-titer antibodies neutralizing SARS-CoV-2

2020 ◽  
Vol 65 (3) ◽  
pp. 242-250
Author(s):  
I. B. Simarova ◽  
A. I. Kostin ◽  
Ju. V. Smirnova ◽  
E. A. Ladygina ◽  
D. Yu. Logunov ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
High Titer ◽  
Disease Onset ◽  
Temperature Response ◽  
Complete Recovery ◽  
Pilot Project ◽  
Time Interval ◽  
Potential Donor ◽  
History Of ◽  
Polymerase Chain

Background. The application of convalescent plasma (CP) is currently seen as a feasible therapeutic approach in the treatment of COVID-19.Aim. To analyze the experience of recruiting a donor cohort from COVID-19 convalescents for banking of CP as part of a pilot project at the Moscow Healthcare Department.Materials and methods. A retrospective research included 493 COVID-19 convalescents as potential CP donors, all examined at the Sklifosovsky Research Institute for Emergency Medicine. CP was banked using the plasmapheresis method. Only those donors with a documented medical history of COVID-19, which was confi rmed by polymerase chain reaction of SARS-CoV-2 RNA in pharyngeal swabs, and no sooner than 14 days after complete recovery were eligible for donation. Viral neutralizing activity (VNA) was chosen as the key characteristic of the immunological viability of CP. All the donors having VNA titers were characterized in terms of gender, age, time interval since the disease onset, regression of clinical symptoms and clinical features of the COVID 19 course.Results. Effective (1:160 or more) and acceptable (1:80) VNA titers were found in 21.1 % and 24.75 % of donors, respectively. Signifi cant predictors for a donor having a high VNA titer included: male sex, age over 36 years and verifi ed viral pneumonia. The absence of a signifi cant body temperature response (38.5 °С) can be considered as a negative marker of a potential donor.

Screening for haemorrhagic disorders in paediatric patients by means of a questionnaire

2009 ◽  
Vol 29 (S 01) ◽  
pp. S87-S89 ◽  
Author(s):  
I. Music ◽  
M. Novak ◽  
B. Acham-Roschitz ◽  
W. Muntean
Keyword(s):  
Predictive Value ◽  
Laboratory Diagnosis ◽  
Von Willebrand Disease ◽  
Control Group ◽  
Older Children ◽  
Mild Disease ◽  
History Of ◽  
Von Willebrand ◽  
Specific Symptoms ◽  
Infants And Young Children

SummaryAim: In children, screening for haemorrhagic disorders is further complicated by the fact that infants and young children with mild disease in many cases most likely will not have a significant history of easy bruising or bleeding making the efficacy of a questionnaire even more questionable. Patients, methods: We compared the questionnaires of a group of 88 children in whom a haemorrhagic disorder was ruled out by rigorous laboratory investigation to a group of 38 children with mild von Willebrand disease (VWD). Questionnaires about child, mother and father were obtained prior to the laboratory diagnosis on the occasion of routine preoperative screening. Results: 23/38 children with mild VWD showed at least one positive question in the questionnaire, while 21/88 without laboratory signs showed at least one positive question. There was a trend to more specific symptoms in older children. Three or more positive questions were found only in VWD patients, but only in a few of the control group. The question about menstrual bleeding in mothers did not differ significantly. Sensitivity of the questionnaire for a hemostatic disorder was 0.60, while specifity was 0.76. The negative predictive value was 0.82, but the positive predictive value was only 0.52. Conclusions: Our small study shows, that a questionnaire yields good results to exclude a haemostatic disorder, but is not a sensitive tool to identify such a disorder.

New Families with Hereditary Hemorrhagic Trait due to Deficiency of Fibrin Stabilizing Factor (F. XIII)

1968 ◽  
Vol 20 (03/04) ◽  
pp. 534-541 ◽  
Author(s):  
O Egeberg
Keyword(s):  
Factor Xiii ◽  
Family Members ◽  
Recessive Inheritance ◽  
Factor Xiii Deficiency ◽  
History Of ◽  
Congenital Factor

SummarySevere hemorrhagic disorder due to congenital factor XIII deficiency is described in two unrelated Norwegian girls.Plasma cephalin time was for both patients extraordinarily short during episodes of bleeding and hematomas. No such hyperactivity reaction was demonstrable in unaffected condition some months later.Estimations of blood factor XIII levels revealed a partial defect in the parents of both children, and also in some other family members, consistent with an autosomal incompletely recessive inheritance of the defect. Some of the presumptive heterozygotes had a history of light bleeding phenomenons; whether this was related to their partial lack of factor XIII is so far uncertain.

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