scholarly journals Cardiac Manifestations of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with SARS-CoV-2 Infection

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Alireza Ghodsi ◽  
Elnaz Mahmoudabadi ◽  
Sara Ghahremani ◽  
Abdolreza Malek
Keyword(s):  
Cardiac Involvement ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Signs And Symptoms ◽  
Multiple Organs ◽  
Clinical Signs And Symptoms ◽  
Cardiac Manifestations ◽  
Inflammatory Syndrome

Context: Multisystem inflammatory syndrome in children (MIS-C) is an emerging condition after the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, termed COVID-19. This study aimed to describe the cardiac manifestations of children diagnosed with MIS-C. Evidence Acquisition: This narrative review was conducted by searching the PubMed, Scopus, and Google Scholar databases to review MIS-C cardiac manifestations up to September 30, 2020. The demographic features, past medical history, clinical signs and symptoms, cardiac involvement, and the type of COVID-19 diagnosis confirmation were extracted. Results: In many children, MIS-C seems to be a post-infectious complication of the COVID-19 infection. This syndrome affects multiple organs and has various clinical manifestations mimicking Kawasaki disease. Patients frequently present with persistent fever, kidney injury, gastrointestinal (GI) problems, neurologic symptoms, mucosal changes, conjunctivitis, and cardiac involvement. Children with MIS are more likely to present with hypotension, shock, and cardiac dysfunction, rather than coronary artery abnormalities and arrhythmia. Children with MIS need close observation; some need to be hospitalized, and a few may need a Pediatric Intensive Care Unit (PICU) admission. Treatment currently includes anticoagulants, IV immunoglobulin, and anti-inflammatory drugs. Conclusions: As a novel syndrome associated with SARS-CoV-2 infection, MIS-C is potentially lethal. Cardiac manifestations, including coronary and myocardial involvement, are common and should be carefully identified. With prompt diagnosis and proper treatment, most children will survive, but the outcomes of the disease are unknown, so long-term follow-ups are required.

An Update of Gorlin-Goltz Syndrome

2018 ◽  
Vol 7 (3) ◽  
pp. 38-41 ◽  
Author(s):  
Aliya Hasan ◽  
Dapo Akintola ◽  
Aliya Hasan ◽  
Dapo Akintola
Keyword(s):  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Oral Manifestations ◽  
Early Referral ◽  
Goltz Syndrome ◽  
Dental Practitioners ◽  
Wide Range ◽  
Risk Of Malignancy ◽  
Clinical Signs And Symptoms

Gorlin-Goltz syndrome encompasses a variety of clinical signs and symptoms including important oral manifestations which general dental practitioners should be aware of. In light of the risk of malignancy it is important to be aware of this syndrome and recognise the need for early referral for multidisciplinary management. This paper aims to discuss Gorlin-Goltz syndrome, the pathophysiology of the condition and address the wide range of clinical manifestations. The author will pay particular attention to the oral manifestations of the condition and the management of such anomalies.

scholarly journals Phosphodiesterase Inhibitors: Could They Be Beneficial for the Treatment of COVID-19?

2020 ◽  
Vol 21 (15) ◽  
pp. 5338 ◽  
Author(s):  
Mauro Giorgi ◽  
Silvia Cardarelli ◽  
Federica Ragusa ◽  
Michele Saliola ◽  
Stefano Biagioni ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Clinical Manifestations ◽  
Phosphodiesterase Inhibitors ◽  
Signs And Symptoms ◽  
World Health ◽  
Pde Inhibitors ◽  
Clinical Signs And Symptoms ◽  
Hydrolyzing Enzymes ◽  
Health Organization ◽  
Restrictive Measures

In March 2020, the World Health Organization declared the severe acute respiratory syndrome corona virus 2 (SARS-CoV2) infection to be a pandemic disease. SARS-CoV2 was first identified in China and, despite the restrictive measures adopted, the epidemic has spread globally, becoming a pandemic in a very short time. Though there is growing knowledge of the SARS-CoV2 infection and its clinical manifestations, an effective cure to limit its acute symptoms and its severe complications has not yet been found. Given the worldwide health and economic emergency issues accompanying this pandemic, there is an absolute urgency to identify effective treatments and reduce the post infection outcomes. In this context, phosphodiesterases (PDEs), evolutionarily conserved cyclic nucleotide (cAMP/cGMP) hydrolyzing enzymes, could emerge as new potential targets. Given their extended distribution and modulating role in nearly all organs and cellular environments, a large number of drugs (PDE inhibitors) have been developed to control the specific functions of each PDE family. These PDE inhibitors have already been used in the treatment of pathologies that show clinical signs and symptoms completely or partially overlapping with post-COVID-19 conditions (e.g., thrombosis, inflammation, fibrosis), while new PDE-selective or pan-selective inhibitors are currently under study. This review discusses the state of the art of the different pathologies currently treated with phosphodiesterase inhibitors, highlighting the numerous similarities with the disorders linked to SARS-CoV2 infection, to support the hypothesis that PDE inhibitors, alone or in combination with other drugs, could be beneficial for the treatment of COVID-19.

scholarly journals Clinical characteristics of COVID-19 in children compared with adults in Shandong, China

2020 ◽  
Author(s):  
Wenjun Du ◽  
Jinhong Yu ◽  
Hui Wang ◽  
Xiaoguo Zhang ◽  
Shouwei Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Health Workers ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Case Series ◽  
Signs And Symptoms ◽  
Asymptomatic Patients ◽  
Positive Indicators ◽  
Clinical Signs And Symptoms

Abstract Aims & Background: The COVID-19 outbreak spread in China and is a threat to the world. We reported on the epidemiological, clinical, laboratory, and radiological characteristics of children cases to help health workers better understand and provide timely diagnosis and treatment.Methods: Retrospectively, two research centers’ case series of 67 consecutive hospitalized cases including 14 children cases with COVID-19 between 23 Jan 2020 to 15 Feb 2020 from Jinan and Rizhao were enrolled in this study. Epidemiological, clinical, laboratory, and radiological characteristics of children and adults were analyzed and compared.Results: Most cases in children were mild(21.4%) and conventional cases(78.6%), with mild clinical signs and symptoms, and all cases were of family clusters. Fever (35.7%) and dry cough(21.4%) were described as clinical manifestations in children cases. Dry cough and phlegm were not the most common symptoms in children compared with adults(p=0.03). In the early stages of the disease, lymphocyte counts did not significantly decline but neutrophils counts did in children compared with adults(p=0.00).There was an elevated level of LDH(p=0.01) and a lower level of CRP(p=0.00)and IL-6(p=0.01) in children compared with adults. There were 8 (57.1%)asymptomatic cases and 6 (42.9%)symptomatic cases among the 14 children cases. The age of asymptomatic patients was younger than that of symptomatic patients(p=0.03). Even among asymptomatic patients, 5(62.5%)cases had pneumonia including 3 (60%) cases with bilateral pneumonia, which was not different compared with that of asymptomatic cases(p=0.58, p=0.74).Conclusions: The clinical symptoms of children are mild, and the positive indicators of laboratory tests are rare, which may easily cause clinical misdiagnoses.

scholarly journals Clinical manifestations of cow milk protein intolerance in infants

2005 ◽  
Vol 133 (7-8) ◽  
pp. 348-352
Author(s):  
Marija Mladenovic ◽  
Nedeljko Radlovic ◽  
Zoran Lekovic ◽  
Dragana Ristic ◽  
Dragana Zivanovic ◽  
...  
Keyword(s):  
Milk Protein ◽  
Wide Spectrum ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Cow Milk ◽  
Type I ◽  
Digestive Disorders ◽  
Clinical Signs And Symptoms ◽  
Protein Intolerance

Introduction. The disorder of cow milk protein intolerance is characterized by a wide spectrum of clinical manifestations caused by hypersensitivity of type I, II, or IV, and occurs in 2-3% of children, mostly infants. Objective. The aim of this study was to present our experiences and observations of clinical signs and symptoms of cow milk protein intolerance in infants aged below 12 months. Method. The investigation was carried out on a sample of 55 infants, aged between 1.5-9 months (x=4.2l?1.25), who had cow milk protein intolerance. Diagnosis of illness was based on characteristic anamnestic, clinical, and laboratory parameters, as well as on an adequate patient's response to antigen elimination. Results. The clinical presentation of cow milk protein intolerance was dominated by cutaneous problems, found in 40/55 (72.73%) infants, followed by digestive disorders, found in 31 (56.36%), while respiratory tract disorders were observed least frequently (14.55%). None of the patients developed anaphylactic shock. Changes involving only one system were found in 35 (63.64%) patients; of these 20 (36.36%) were cutaneous and 15 (27.27%) digestive. Twenty (36.36%) infants displayed multisystemic changes; of these 12 were cutaneus with digestive, 4 were cutaneus with respiratory, while 4 infants had cutaneous, digestive, and respiratory disorders. Of the 55 infants with cow milk protein intolerance, 26 (47.27%) had urticaria, 22 (40.00%) perioral erythema, 21 (38.18%) diarrhoea (15 haemorrhagic, 6 non-haemorrhagic), 13 (23.64%) vomiting, 12 (21.82%) Quincke's oedema, 12 (21.82%) eczema, 5 (9.09%) obstructive bronchitis, while 3 (5.45%) infants had laryngitis. In 5 (9.09%) patients we found a significant body weight deficit and in 3 (5.45%), sideropenic anaemia, while longitudinal growth retardation was not registered in any of the patients. Conclusion. Our study showed that the disorder of cow milk protein intolerance predominantly involved cutaneous disorders as well as combinations of cutaneous and digestive disorders, while respiratory system disorders proved to be relatively rare.

scholarly journals Differentiating multisystem inflammatory syndrome in children: a single-centre retrospective cohort study

2021 ◽  
pp. archdischild-2021-322290
Author(s):  
Jordan E Roberts ◽  
Jeffrey I Campbell ◽  
Kimberlee Gauvreau ◽  
Gabriella S Lamb ◽  
Jane Newburger ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Oral Mucosa ◽  
Multivariable Analysis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Laboratory Findings ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Clinical Signs And Symptoms ◽  
Inflammatory Syndrome

ObjectiveFeatures of multisystem inflammatory syndrome in children (MIS-C) overlap with other febrile illnesses, hindering prompt and accurate diagnosis. The objectives of this study were to identify clinical and laboratory findings that distinguished MIS-C from febrile illnesses in which MIS-C was considered but ultimately excluded, and to examine the diseases that most often mimicked MIS-C in a tertiary medical centre.Study designWe identified all children hospitalised with fever who were evaluated for MIS-C at our centre and compared clinical signs and symptoms, SARS-CoV-2 status and laboratory studies between those with and without MIS-C. Multivariable logistic LASSO (least absolute shrinkage and selection operator) regression was used to identify the most discriminative presenting features of MIS-C.ResultsWe identified 50 confirmed MIS-C cases (MIS-C+) and 68 children evaluated for, but ultimately not diagnosed with, MIS-C (MIS-C-). In univariable analysis, conjunctivitis, abdominal pain, fatigue, hypoxaemia, tachypnoea and hypotension at presentation were significantly more common among MIS-C+ patients. MIS-C+ and MIS-C- patients had similar elevations in C-reactive protein (CRP), but were differentiated by thrombocytopenia, lymphopenia, and elevated ferritin, neutrophil/lymphocyte ratio, BNP and troponin. In multivariable analysis, predictors of MIS-C included age, neutrophil/lymphocyte ratio, platelets, conjunctivitis, oral mucosa changes, abdominal pain and hypotension.ConclusionsAmong hospitalised children undergoing evaluation for MIS-C, children with MIS-C were older, more likely to present with conjunctivitis, oral mucosa changes, abdominal pain and hypotension, and had higher neutrophil/lymphocyte ratios and lower platelet counts. These data may be helpful for discrimination of MIS-C from other febrile illnesses, including bacterial lymphadenitis and acute viral infection, with overlapping features.

scholarly journals The value of histopathological diagnosis in rupoid psoriasis accompanied by fever. A case report and a review of the literature

2014 ◽  
Vol 60 (6) ◽  
pp. 282-284
Author(s):  
S.H. Morariu ◽  
M.A. Badea ◽  
M.D. Vartolomei ◽  
Iudita Maria Badea ◽  
O.S. Cotoi
Keyword(s):  
Clinical Signs ◽  
Clinical Manifestations ◽  
Local Therapy ◽  
Signs And Symptoms ◽  
Daily Practice ◽  
Sudden Onset ◽  
Histopathological Diagnosis ◽  
Intermittent Fever ◽  
Immunosuppressed Patients ◽  
Clinical Signs And Symptoms

Abstract Psoriasis is a common dermatosis, however the rupoid type is considered as an exceptional form of this disease. Rupoid scabs are very rare in dermatological daily practice, usually being seen as secondary to syphilis in immunosuppressed patients. Rupoid psoriasis is characterized by thick and multilayered crusts that are resistant to local therapy and present a sudden onset. Severe arthropathy is a common manifestation. We did not found in literature any association of rupoid psoriasis with intermittent fever. We present the case of a patient who exhibited a rush of rupoid boards with severe arthralgia accompanied by intermittent fever. The suspicion of malignant syphilis was raised considering the clinical signs and symptoms and the specific social context of STDs. This suspicion was unconfirmed by TPHA negative reaction and histopathological appearance that showed changes typical of psoriasis. Clinical manifestations were successfully controlled with methotrexate.

scholarly journals A Brief Review on Covid-19 Effects in Children and Treatment Methods

2021 ◽  
Vol 70 (1) ◽  
Author(s):  
Vaishnavi Tammishetty ◽  
Sravika Nagamalla ◽  
Pravalika Sakilam ◽  
Hyma Ponnaganti
Keyword(s):  
Clinical Signs ◽  
Clinical Manifestations ◽  
Medical Practitioner ◽  
Signs And Symptoms ◽  
Limited Data ◽  
Laboratory Findings ◽  
Gi Symptoms ◽  
Review Study ◽  
Clinical Signs And Symptoms ◽  
Inflammatory System

As there is an outbreak of novel corona virus in 2019 it has spread globally that resulted in severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) pandemic and mostly there is limited data provided on children. The main aim of this review is to provide a knowledge on introduction, epidemiology, pathogenesis, transmission, clinical manifestations, laboratory findings, treatment of COVID-19 in children. And it also includes latest statistical data of children prone to COVID-19. Besides respiratory and GI symptoms atypical features such as chilblains and multi-inflammatory system are also reported. pathophysiology gives information regarding the life cycle of virus in hostcell and epidemiology explains the different types of viruses affecting the respiratory system. The clinical signs and symptoms are almost similar to the adults but they are in mild, and most of the children affected with Covid-19 are asymptomatic. This review study makes a medical practitioner to have a quick, practical approach to the disease to use in different scopes, especially in pediatric medicine.

scholarly journals Clinical Manifestations and Associated Complications of Scrub Typhus in Odisha, India

2020 ◽  
Author(s):  
Lalatendu Mohanty ◽  
Aditya Dhanawat ◽  
Partisha Gupta ◽  
Guncha Maheshwari
Keyword(s):  
Rural Areas ◽  
Scrub Typhus ◽  
Early Recognition ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Kidney Injury ◽  
Signs And Symptoms ◽  
Multiple Organ ◽  
Care Physician ◽  
Organ Systems

Introduction: Scrub typhus is a re-emerging illness in the South-East Asia and other parts of the world caused by Orientia tsutsugamushi, which is a mite-borne bacterium belonging to the Rickettsiaceae family. It has varied clinical manifestations and affects multiple organ systems. In Asia, about 1 million new cases are identified annually. Aim: The aim was to conduct a retrospective study to observe the clinical profile and complications of scrub typhus in South-Eastern India. Materials and Methods: Clinical data of 240 patients who were 18 years of age or above, admitted in the Department of Internal Medicine and diagnosed with scrub typhus by means of IgM Enzyme-linked Immune Sorbent Assay (ELISA) was collected. Demographic profile, clinical signs and symptoms, laboratory parameters, co-infections and complications were reviewed. Statistical analyses were performed using Chi-square test. Results: Majority of the patients were males, between the age of 18-29 years and lived in rural areas. Forty-three (17.9%) patients were admitted in the ICU and the remaining in wards. Sixty-nine (28.8%) patients had consolidation and 11 (4.6%) had Acute Respiratory Distress Syndrome (ARDS). Twenty-one (8.8%) patients had jaundice and 76 (31.7) had hepatomegaly. Twenty-one (8.8%) patients had meningo-encephalitis and 18 (7.5%) had acute kidney injury. Twelve (5%) patients had co-infection with dengue and 8 (3.3%) had malaria. Conclusion: This study shows wide and varied presentation of scrub typhus infection along with the course of the disease and response to the treatment. The diagnostic clues such as fever, eschar, rashes, lymphadenopathy should be kept in mind by a primary care physician as early recognition and treatment can prevent its dangerous complications and reduce the mortality due to the disease. Occurrence of co-infections should also be kept in mind for better management of the patient.

scholarly journals Gestational trophoblastic disease: Literature review

2011 ◽  
Vol 64 (3-4) ◽  
pp. 188-193 ◽  
Author(s):  
Vera Milenkovic ◽  
Biljana Lazovic
Keyword(s):  
Hydatidiform Mole ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Gestational Trophoblastic Disease ◽  
Modern Technology ◽  
Diagnostic Methods ◽  
Trophoblastic Disease ◽  
Gestational Trophoblastic Diseases ◽  
Clinical Signs And Symptoms

Gestational trophoblastic disease is characterized by abnormal proliferation of pregnancy-associated trophoblastic tissue with malignant potential. Gestational trophoblastic disease covers a spectrum of conditions including hydatidiform mole, invasive mole, choriocarcinoma and placental site trophoblastic tumour. It is very important to understand the pathophysiology and natural history of the disease in order to achieve faster recognition and effective treatment. The presence and course of the disease can be monitored with quantitative levels of human chorionic gonadotrophin in all cases. Clinical signs and symptoms are usually insufficient to diagnose and predict the extent of disease. Nowadays, gestational trophoblastic diseases are the best treated gynaecological malignancy thanks to modern technology. This review covers various aspects of gestational trophoblastic disease: its development, epidemiology, aetiology and pathogenesis, as well as its classification, clinical manifestations and diagnostic methods.

Primer on Multiple Sclerosis

2016 ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Professionals ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Diagnostic Strategies ◽  
History Of ◽  
Clinical Signs And Symptoms ◽  
Nursing Health

Primer on Multiple Sclerosis, second edition is designed to be a practical guide to the basic science and clinical manifestations of multiple sclerosis. It is intended primarily for neurologists and other health care professionals who treat persons with this disease. The book starts with a review of the history of multiple sclerosis and the basic genetics, immunology, electrophysiology, and pathophysiology that are central to the disease. It then reviews the common and uncommon clinical signs and symptoms of multiple sclerosis and the management of these conditions. The latest diagnostic strategies are presented. There is extensive coverage of approved and experimental disease-modifying therapies, including algorithms to assist clincians in choosing these therapies. Complementary and alternative therapies that are popular among persons with multiple sclerosis are examined. New additions to this edition include a chapter for nursing health care professionals, and updates on therapeutics. Unique to this book are the chapters on the legal, psychosocial, and vocational issues that often present challenges for person with multiple sclerosis, topics that typically are not covered in standard texts.

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