Habit cough in children. Specific symptoms and psychotherapy

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.

Download Full-text

Screening Instruments for the Detection of Male-Specific Symptoms of Unipolar Depression – A Critical Overview

10.1055/s-0038-1667808 ◽

2018 ◽

Author(s):

A Zülke ◽

A Kersting ◽

S Dietrich ◽

T Luck ◽

SG Riedel-Heller ◽

...

Keyword(s):

Unipolar Depression ◽

Screening Instruments ◽

Male Specific ◽

Specific Symptoms ◽

Critical Overview

Download Full-text

Ground-Based Medical Services for In-Flight Emergencies

Aerospace Medicine and Human Performance ◽

10.3357/amhp.5431.2020 ◽

2020 ◽

Vol 91 (4) ◽

pp. 348-351

Author(s):

Jung Ha Kim ◽

Smi Choi-Kwon

Keyword(s):

Common Reason ◽

Medical Services ◽

Prescription Medications ◽

Team Leaders ◽

Cabin Crew ◽

Medication Prescription ◽

South Korean ◽

Cardiac Symptoms ◽

Actual Use ◽

Specific Symptoms

BACKGROUND: The aim of this study was to evaluate the use of ground-based medical services (GBMS) by the cabin crew of a major South Korean airline for in-flight medical incidents involving passengers.METHODS: We conducted a survey of cabin crew to identify the anticipated use of GBMS in 2017. We compared the anticipated use to actual use as reported in cabin crew records submitted to the GBMS team and cabin crew logs from May 2013 to April 2016.RESULTS: Among 766 team leaders and assistant leaders, 211 individuals answered the questionnaire. A total of 915 instances of GBMS use were reported during the study period. There were no significant differences between anticipated and actual use in terms of the reasons for needing GBMS, with medication prescription being the most common reason. However, there were significant differences in the specific symptoms that triggered contact with GBMS. Pediatric and digestive symptoms were under-predicted, while neuropsychiatric and cardiac symptoms were over-predicted.DISCUSSION: Cabin crew tended to require GBMS to assist with pediatric and digestive conditions more often than anticipated. Furthermore, digestive and pediatric symptoms often require prescription medications.Kim JH, Choi-Kwon S. Ground-based medical services for in-flight emergencies. Aerosp Med Hum Perform. 2020; 91(4):348–351.

Download Full-text

Natriuretic Peptides – Addressing the Dilemma of Heart Failure Management

European Cardiology Review ◽

10.15420/ecr.2011.7.2.104 ◽

2011 ◽

Vol 7 (2) ◽

pp. 104

Author(s):

Kenneth McDonald ◽

Ulf Dahlström ◽

◽

Keyword(s):

Heart Failure ◽

Physical Examination ◽

Natriuretic Peptides ◽

Normal Values ◽

Outpatient Setting ◽

Heart Failure Management ◽

Effective Screening ◽

Specific Symptoms ◽

Objective Marker

Heart failure (HF) is characterised by non-specific symptoms and unremarkable physical examination; therefore, the need exists for an available objective marker of HF status. Natriuretic peptides (NPs) are a marker that can aid the dilemmas in present-day HF management. More effective screening for clinical deterioration would include changes in brain natriuretic peptide (BNP) levels. Normal values for BNP, <50–100 pg/ml, have excellent negative predictive value (NPV) in excluding HF as a diagnosis. BNP values that are significantly elevated, e.g. >500 pg/ml, make the diagnosis of HF more likely. There are now established and emerging uses for NPs in managing HF in the community. These include the role of NPs at the time of possible new presentation of HF, its role in prognostication and, finally, the increasing interest in using NPs to guide therapy in the outpatient setting.

Download Full-text

Cas de suie de l'érable et de chancre du peuplier dans le canton de Genève

Schweizerische Zeitschrift fur Forstwesen ◽

10.3188/szf.2016.0098 ◽

2016 ◽

Vol 167 (2) ◽

pp. 98-104

Author(s):

Bastien Cochard ◽

François Lefort

Keyword(s):

Internal Transcribed Spacer ◽

Pathogenic Fungi ◽

Fungal Flora ◽

Acer Campestre ◽

Cytospora Chrysosperma ◽

Pure Cultures ◽

Populus X Euramericana ◽

Bark Peeling ◽

Specific Symptoms ◽

First Time

A case of sooty bark disease and Cytospora poplar canker in the Canton of Geneva In summer 2014, a case of sooty bark disease caused by Cryptostroma corticale on an individual field maple (Acer campestre) and two cases of poplar canker due to Cytospora chrysosperma on Populus x euramericana were identified genetically for the first time on the territory of the Canton of Geneva. In both cases, the trees presented signs of very advanced dieback, accompanied by specific symptoms such as bark peeling and sooty plaques for the maple, and loose twisted bark layers and black colouring of the wood in structural branches of the poplars. Sampling was carried out in the symptomatic areas and components of the fungal flora were isolated in pure cultures in order to identify any pathogenic fungi. The molecular analysis of the rDNA internal transcribed spacer (ITS) sequences made it possible to identify precisely all pure isolates obtained. The results showed a majority presence of C. corticale in the maple tree, and of C. chrysosperma in the two poplars. Both these fungi are little known in Switzerland and Europe, and their presence is maybe associated with changes in the climate.

Download Full-text

A Case Study of a Large and Rare Pleomorphic Liposarcoma in The Chest Area

Journal of Internal Medicine and Emergency Research ◽

10.37191/mapsci-2582-7367-1(2)-010 ◽

2020 ◽

Author(s):

Yuanjun Cheng

Keyword(s):

Delayed Diagnosis ◽

Clinical Work ◽

Radical Excision ◽

Pathological Findings ◽

Chest Tightness ◽

Pleomorphic Liposarcoma ◽

Left Chest ◽

Specific Symptoms ◽

Work Up

Pleomorphic liposarcoma rarely develops in the chest area. This report presents a primary pleomorphic liposarcoma that was discovered in the left chest area of a 74-year-old female patient. The patient had presented specific symptoms, including cough, chest tightness and shortness of breath. A radical excision of the tumor was performed. The tumor was extremely large (27 cm - 24 cm- 10 cm) and completely encapsulated. Upon histological examination, it was diagnosed as a giant, pleomorphic liposarcoma. Thereafter, non-specific radiological and endoscopic results during clinical work-up delayed diagnosis until post-operative histology were gathered. In this report, the case-specific clinical and radiological diagnostic challenges are discussed, as well as the relevant surgical and pathological findings.

Download Full-text

Gene Therapy Approaches in an Autoimmune Demyelinating Disease: Multiple Sclerosis

Current Gene Therapy ◽

10.2174/1566523220666200306092556 ◽

2020 ◽

Vol 19 (6) ◽

pp. 376-385

Author(s):

Md. A. Islam ◽

Shoumik Kundu ◽

Rosline Hassan

Keyword(s):

Multiple Sclerosis ◽

Gene Therapy ◽

Disease Progression ◽

Demyelinating Disease ◽

Human Subjects ◽

Mice Model ◽

Focal Lesions ◽

Protective Function ◽

Monocytes And Macrophages ◽

Specific Symptoms

Multiple Sclerosis (MS) is the most common autoimmune demyelinating disease of the Central Nervous System (CNS). It is a multifactorial disease which develops in an immune-mediated way under the influences of both genetic and environmental factors. Demyelination is observed in the brain and spinal cord leading to neuro-axonal damage in patients with MS. Due to the infiltration of different immune cells such as T-cells, B-cells, monocytes and macrophages, focal lesions are observed in MS. Currently available medications treating MS are mainly based on two strategies; i) to ease specific symptoms or ii) to reduce disease progression. However, these medications tend to induce different adverse effects with limited therapeutic efficacy due to the protective function of the blood-brain barrier. Therefore, researchers have been working for the last four decades to discover better solutions by introducing gene therapy approaches in treating MS generally by following three strategies, i) prevention of specific symptoms, ii) halt or reverse disease progression and iii) heal CNS damage by promoting remyelination and axonal repair. In last two decades, there have been some remarkable successes of gene therapy approaches on the experimental mice model of MS - experimental autoimmune encephalomyelitis (EAE) which suggests that it is not far that the gene therapy approaches would start in human subjects ensuring the highest levels of safety and efficacy. In this review, we summarised the gene therapy approaches attempted in different animal models towards treating MS.

Download Full-text

Scrub typhus (Orientia tsutsugamushi), A rapidly spreading epidemic in Chennai - A standalone lab experience

International Journal of Bioassays ◽

10.21746/ijbio.2016.09.0021 ◽

2016 ◽

Vol 5 (09) ◽

pp. 4896

Author(s):

Sripriya C.S.* ◽

Shanthi B. ◽

Arockia Doss S. ◽

Antonie Raj I. ◽

Mohana Priya

Keyword(s):

Scrub Typhus ◽

Clinical Symptoms ◽

Clinical Manifestations ◽

Febrile Illness ◽

Orientia Tsutsugamushi ◽

The Past ◽

Igm Elisa ◽

The Mean ◽

Specific Symptoms ◽

Symptoms And Signs

Scrub typhus (Orientia tsutsugamushi), is a strict intracellular bacterium which is reported to be a recent threat to parts of southern India. There is re-emergence of scrub typhus during the past few years in Chennai. Scrub typhus is an acute febrile illness which generally causes non-specific symptoms and signs. The clinical manifestations of this disease range from sub-clinical disease to organ failure to fatal disease. This study documents our laboratory experience in diagnosis of scrub typhus in patients with fever and suspected clinical symptoms of scrub typhus infection for a period of two years from April 2014 to April 2016 using immunochromatography and IgM ELISA methods. The study was conducted on 648 patients out of whom 188 patients were found to be positive for scrub typhus. Results also showed that pediatric (0 -12 years) and young adults (20 – 39 years) were more exposed to scrub typhus infection and female patients were more infected compared to male. The study also showed that the rate of infection was higher between September to February which also suggested that the infection rate is proportional to the climatic condition. Statistical analysis showed that the mean age of the patients in this study was 37.6, standard deviation was 18.97, CV % was 50.45.

Download Full-text

Bone marrow necrosis and fat embolism syndrome: a near fatal complication in previously undiagnosed sickle beta + thalassaemia

BMJ Case Reports ◽

10.1136/bcr-2020-238317 ◽

2021 ◽

Vol 14 (1) ◽

pp. e238317

Author(s):

Nibash Budhathoki ◽

Sunita Timilsina ◽

Bebu Ram ◽

Douglas Marks

Keyword(s):

Bone Marrow ◽

Multiorgan Failure ◽

Rare Condition ◽

Altered Mental Status ◽

Fat Embolism ◽

Bone Marrow Necrosis ◽

Embolism Syndrome ◽

Hb S ◽

High Index Of Suspicion ◽

Specific Symptoms

Prevalence of haemoglobin sickle-β+ thalassaemia (Hb S/β+thal) is variable with geography ranging from 0.2% to 10% among sickle cell patients. Clinical presentation of Hb S/β+thal patients depends on HbA level, with milder disease often going undiagnosed. However, rarely these patients can present with a fulminant vaso-occlusive crisis (VOC). Given VOC can present with non-specific symptoms, the diagnosis and treatment is often delayed. Here, we present a patient who initially developed altered mental status, pancytopenia and multiorgan failure due a critical VOC resulting in bone marrow necrosis and fat embolism. Subsequent workup confirmed that our patient had Sickle-β+ thalassaemia, which had gone undiagnosed, despite subclinical evidence of haemolysis on routine lab work for years. Following diagnosis and initiation of RBC exchange, he improved significantly and was discharged home. High index of suspicion and bone marrow biopsy is vital for early diagnosis and management of this rare condition.

Download Full-text