scholarly journals Clinical Characteristics of Inpatients with Anaphylaxis in China

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Rui Tang ◽  
Han-Yi Xu ◽  
Ju Cao ◽  
Shi Chen ◽  
Jin-Lu Sun ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Multiple Organ ◽  
Female Ratio ◽  
Multisystem Involvement ◽  
Organ Systems ◽  
Number Of Patients ◽  
Male Patients ◽  
Male To Female

Objective.To analyze the clinical characteristics of inpatients with anaphylaxis and the factors that influenced those characteristics.Methods.Using the patient records from 1990 to 2013 from three highly ranked Chinese hospitals, we retrospectively analyzed the characteristics of 108 inpatients with anaphylaxis (not anaphylaxis admitted).Results.The mean patient age was42±20years old and male-to-female ratio was 1 : 1.3. The number of patients with anaphylaxis increased gradually, and cases diagnosed after 2005 accounted for 68.5% of the 108 total cases. The most common trigger was medications. The most common clinical manifestations included cutaneous, nervous, respiratory, circulatory, and digestive signs and symptoms. Male patients were more likely to experience loss of consciousness. Multisystem involvement was more likely to develop in patients with low BP, whereas it was uncommon in those with anaphylaxis induced by antibiotics or anesthetics. Epinephrine was used as the first-line treatment for 56 cases.Conclusions.Inpatient with anaphylaxis was more common in female patients and the number increased gradually during the study period. The most common trigger was medications. Patients with low BP were prone to having multisystem involvement, whereas the cases of anaphylaxis induced by antibiotics and anesthetics were less likely to involve multiple organ systems.

scholarly journals A meta-analysis of 2019 novel corona virus patient clinical characteristics and comorbidities

2020 ◽  
Author(s):  
Subodh Sharma Paudel
Keyword(s):  
High Risk ◽  
Clinical Characteristics ◽  
English Language ◽  
Meta Analysis ◽  
Previous History ◽  
Female Ratio ◽  
Number Of Patients ◽  
New Variant ◽  
History Of ◽  
Male To Female

Abstract IntroductionBeing a new variant of coronavirus, detailed information regarding the virulence, its clinical characters, high risk individuals are yet to be defined. This study was done with the objective of finding out clinical features of corona infection and also studies what are the comorbidities that are associated with it.MethodsThis is a single arm meta-analysis in which relevant data were derived from searches in PubMed. It includes study papers which were written in English language and their completely published article is found. Seven articles published from 24th Jan to 16th March, 2020 are included in this study. ResultsThe total number of patients was 1786 with 1044 males and 742 females with male to female ratio of 1.4:1. The median age of patients was 41 years). Fever was present in 88.8% cases. Dry Cough in 68% followed by fatigue in 33%. Hypertension (15.8%) is the most common comorbidity followed by cardio and cerebrovascular condition (11.7%). ConclusionPatients often presented with symptoms of fever, dry cough, lethargy and fatigue, muscle pain, productive cough. Similarly, patients with previous history of HTN, DM, COPD, cardio and cerebrovascular condition, immune-deficient states are at high risk of developing into the severe COVID-19 infection.

scholarly journals Adrenocortical carcinoma’s incidence and mortality in central Serbia

2017 ◽  
Vol 145 (1-2) ◽  
pp. 38-42
Author(s):  
Milan Jovanovic ◽  
Vladan Zivaljevic ◽  
Aleksandar Diklic ◽  
Nikola Slijepcevic ◽  
Katarina Tausanovic ◽  
...  
Keyword(s):  
Age Groups ◽  
World Population ◽  
Age Group ◽  
Female Ratio ◽  
Number Of Patients ◽  
Incidence And Mortality ◽  
Male Patients ◽  
Adrenocortical Carcinomas ◽  
Male To Female ◽  
Sixth Decade

Introduction/Objective. Adrenocortical carcinomas (ACCs) are very rare tumors with grave prognosis despite multimodal treatment. The aim of our study was to determine the incidence and mortality of ACCs in Central Serbia. Methods. The study period was from 1999 to 2012. We used data from the Cancer Registry of Central Serbia. Incidence and mortality rates were sex- and age-standardized according to Segi?s world population. Results. In the defined period of the study, 128 patients with a diagnosis of ACC were registered and the female-to-male ratio was 1.3:1. The median age of affected individuals was 42.3 years. There were two main age peaks ? one in childhood (0?9 years), and the other in the fifth and sixth decade of life. In this period, the average standardized incidence rate of ACC amounted to two per million people with slightly increasing trend. The largest number of male patients with ACC (22; 39.2%) was registered in the age group of 0?9 years, while the largest number of patients in females was shown to be in the age group of 40?49 years (29; 40.3%). During the study period, there were 35 deaths registered in patients with ACC (mean age of 61.2 years). The average mortality rate of ACC was 0.3 per million people. The male-to-female ratio was 1.5:1. Most fatal outcomes were registered in the age groups of 50?59 and 60?69 years, so 91.4% of all deaths took place in the age groups 50+. Conclusion. ACC is an extremely rare tumor that occurs more often in women than in men. However, fatal outcomes occur more frequently in males.

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 Leukoencephalopathy and cerebral edema as the presenting manifestations of SLE in an ANA-negative adolescent female: A case report and review of literature.

2020 ◽  
Author(s):  
Alexandra Theisen ◽  
Paroma Bose ◽  
Christina Knight ◽  
Melissa Oliver
Keyword(s):  
Cerebral Edema ◽  
Lupus Erythematosus ◽  
Primary Care Physicians ◽  
Neuropsychiatric Symptoms ◽  
Clinical Manifestations ◽  
Central Nervous System Involvement ◽  
Multiple Organ ◽  
Small Subset ◽  
Adolescent Female ◽  
Organ Systems

Abstract Background: Systemic lupus erythematosus (SLE) is an autoimmune disease with various clinical manifestations involving multiple organ systems. Neuropsychiatric manifestations of SLE has been associated with increased morbidity and mortality, thus it is important to recognize and diagnosis the disease entity and treat early. When neuropsychiatric symptoms are involved, typically there are many other systemic features to aid in the diagnosis of SLE. Many autoantibodies have been discovered and are used to help diagnose SLE. The antibody present in most cases of pediatric SLE, as well as in many other rheumatic diseases, is the nonspecific antinuclear antibody (ANA), making it a commonly used screening tool by primary care physicians when evaluating a patient with a possible rheumatic disorder. However, a small subset of SLE patients, 1-5%, present with a negative ANA, and it is important to keep SLE on the differential diagnosis in specific instances when a thorough infectious and neurological workup has been completed and proven to be inconclusive. Case Presentation: This case involves a Hispanic adolescent female with a negative ANA who presented with diffuse cerebral edema secondary to leukoencephalopathy due to SLE with central nervous system involvement. She had an extensive workup while inpatient involving metabolism, infectious disease, rheumatology, and neurology prior to obtaining the diagnosis of SLE. She was treated with both cyclophosphamide and rituximab and showed improvement. Conclusions: A review of the literature revealed 8 cases with SLE presenting with or developing diffuse cerebral edema and/or leukoencephalopathy. Our patient’s case differs in that she was also ANA negative despite other autoantibody positivity. While she did have low complements and transient leukopenia, she did not present with other signs of organ involvement, which made the diagnosis of SLE with neuropsychiatric involvement quite challenging. We discuss the importance of keeping SLE on the differential despite a negative ANA in complex cases without any other cause and to consider initial screening with not only the ANA but also dsDNA and complements to avoid missed diagnoses.

scholarly journals OUTCOME OF DACRYOCYSTORHINOSTOMY WITH OR WITHOUT SILICON INTUBATION IN PRIMARY NASOLACRIMAL DUCT OBSTRUCTION

1969 ◽  
Vol 1 (2) ◽  
pp. 55-59
Author(s):  
Haroon Rashid ◽  
Faizur Rahman ◽  
Abid Naseem ◽  
Arshad Iqbal.
Keyword(s):  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Interventional Study ◽  
Female Ratio ◽  
Duct Obstruction ◽  
Number Of Patients ◽  
Silicon Tube ◽  
Complications Rate ◽  
Age Range ◽  
Male To Female

Objectives: The objective of the study was to compare the outcome of Classical Dacrocystorhinostomy(DCR) alone or with Slicon intubation in patients of primary nasolacrimal duct obstruction.Study design: This is a randomized prospective interventional study performed at Saidu Teaching Hospitalform from 1st January'2006 to 31st December 2006.Material and methods: Diagnosis of nasolacrimal duct obstruction was made on basis of history, clinicalexamination, regurgitation test and syringing of the nasolacrimal passage. Patients were selected byconvenient sampling and were randomized to two groups, for DCR with and without Silicon tube. Silicontube was removed after 4 months of surgery. Patients were followed up to 6 months.Results: Total number of patients was one hundred. Fifty (50%) patients were operated with siliconintubation and 50 (50%) without silicon intubation. Male to female ratio was 1:1.27.Age range was 15 yearsto 80 years. Mean, median and mode ages were 42.54, 47 and 30 years respectively. Eleven patients werelost from the study at various stages and were not included in the results of the study. The complicationsnoted were silicon tube loss in 2 cases, silicon tube displacement in 3 cases and DCR failure in 4 cases.Among the failure, 2 cases belonged to each group with and without silicon intubation.Conclusions: We conclude that the complications rate with and without silicon intubation is the same inprimary nasolacrimal duct obstruction. It is therefore, recommended that silicon intubation may not benecessary in such cases.Key words: DCR, Intubation, NLD Obstruction.

Multicenter Study of 342 Anorectal Malformation Patients: Age, Gender, Krickenbeck Subtypes, and Associated Anomalies

2019 ◽  
Vol 30 (05) ◽  
pp. 447-451
Author(s):  
Tahmina Banu ◽  
Anwarul Karim ◽  
Maryam Ghavami Adel ◽  
Kokila Lakhoo ◽  
Tasmiah Tahera Aziz ◽  
...  
Keyword(s):  
Anorectal Malformations ◽  
Associated Anomalies ◽  
Gender Distribution ◽  
Female Ratio ◽  
Iranian Patient ◽  
Relative Incidence ◽  
Organ Systems ◽  
Rectovesical Fistula ◽  
Global Initiative ◽  
Male To Female

Abstract Introduction Published studies based on Krickenbeck classification of anorectal malformations (ARMs) are still insufficient to assess the global as well as regional relative incidence of different ARM subtypes, gender distribution, and associated anomalies. The primary purpose of this study was to provide an estimate of those in Global Initiative for Children's Surgery (GICS) research group. Materials and Methods We collected ARM data prospectively for 1 year from four institutes of different geographic locations. A total of 342 patients were included in this study (195, 126, 11, and 10 from Bangladesh, Iran, Papua New Guinea, and Oxford, United Kingdom, respectively). Results Overall male to female ratio was 1:1. The most frequent ARM subtype was perineal fistula (23.7% = 81/342). About 48.5% (166/342) patients had at least one associated anomaly. Cardiac and genitourinary systems were the most commonly affected systems, 31.6% (108/342) and 18.4% (63/342), respectively. These organ-systems were followed by anomalies of vertebral/spinal (9.9% = 34/342), musculoskeletal (4.4% = 15/342), and gastrointestinal/abdominal (3.2% = 11/342) systems. Rectovesical fistula had the highest percentage (96.4% = 27/28) of associated anomalies. About 18.1% (62/342) patients had multiple anomalies. ARMs (both isolated and with associated anomalies) occurred equally in males and females. Comparison between patients from Bangladesh and Iran showed differences in relative incidence in ARM subtypes. In addition, Iranian patient group had higher percentage of associated anomalies compared with Bangladeshi (73 vs. 35.4%). Conclusion Our study provides important insights about ARM subtypes, gender distribution and associated anomalies based on Krickenbeck classification especially from Bangladesh and Iran.

scholarly journals Biologics in the Treatment of Lupus Erythematosus: A Critical Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-17 ◽  
Author(s):  
Dominik Samotij ◽  
Adam Reich
Keyword(s):  
Clinical Trials ◽  
Lupus Erythematosus ◽  
Unmet Need ◽  
Clinical Manifestations ◽  
Immunosuppressive Drugs ◽  
Multiple Organ ◽  
Biologic Agents ◽  
Drug Induced ◽  
Treatment Regimes ◽  
Organ Systems

Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease affecting multiple organ systems that runs an unpredictable course and may present with a wide variety of clinical manifestations. Advances in treatment over the last decades, such as use of corticosteroids and conventional immunosuppressive drugs, have improved life expectancy of SLE sufferers. Unfortunately, in many cases effective management of SLE is still related to severe drug-induced toxicity and contributes to organ function deterioration and infective complications, particularly among patients with refractory disease and/or lupus nephritis. Consequently, there is an unmet need for drugs with a better efficacy and safety profile. A range of different biologic agents have been proposed and subjected to clinical trials, particularly dedicated to this subset of patients whose disease is inadequately controlled by conventional treatment regimes. Unfortunately, most of these trials have given unsatisfactory results, with belimumab being the only targeted therapy approved for the treatment of SLE so far. Despite these pitfalls, several novel biologic agents targeting B cells, T cells, or cytokines are constantly being evaluated in clinical trials. It seems that they may enhance the therapeutic efficacy when combined with standard therapies. These efforts raise the hope that novel drugs for patients with refractory SLE may be available in the near future. This article reviews the current biological therapies being tested in the treatment of SLE.

A clinicopathologic correlation of the idiopathic hypereosinophilic syndrome. II. Clinical manifestations

Blood ◽  
1981 ◽  
Vol 58 (5) ◽  
pp. 1021-1026 ◽  
Author(s):  
RT Schooley ◽  
MA Flaum ◽  
HR Gralnick ◽  
AS Fauci
Keyword(s):  
Hypereosinophilic Syndrome ◽  
Clinical Manifestations ◽  
Initial Therapy ◽  
Multiple Organ ◽  
Cytotoxic Agents ◽  
Grading System ◽  
Idiopathic Hypereosinophilic Syndrome ◽  
Splenic Enlargement ◽  
Organ Systems ◽  
Clinical Grading

Abstract The idiopathic hypereosinophilic syndrome, a disorder characterized by peripheral blood and bone marrow eosinophilia associated with single or multiple organ system dysfunction attributable to tissue invasion by eosinophils has, in the past, been associated with an extremely poor prognosis. Recently, we reported the favorable impact of a therapeutic protocol consisting of prednisone and/or hydroxyurea on the morbidity and mortality of this syndrome. We have reviewed the clinical and hematologic features upon admission and the subsequent clinical courses of 32 patients with this disease referred to the NIH between 1965 and 1979 in an effort to determine which features suggest a more rapidly progressive course. A grading system based on 22 clinical features involving the 8 organ systems commonly affected by the illness was devised. The disease followed a more aggressive course in patients with evidence of cardiac or neurologic dysfunction at the time of initial NIH evaluation. Although splenomegaly, in and of itself, caused little morbidity, splenic enlargement at presentation appeared to be a predictor of a more aggressive course. The clinical grading system accurately predicted which patients would require no specific antihypereosinophilic therapy, which patients would respond adequately to corticosteroids, and which patients would require therapy with cytotoxic agents. It is proposed that this clinical grading system, and the hematologic grading system outlined in the accompanying report be used as aids in the selection of initial therapy in this group of patients.

scholarly journals Accuracy of GRK-2200T Auto-refkeratometer in Subjective Acceptance for Refractive Errors

2019 ◽  
Vol 4 (1) ◽  
pp. 645-648
Author(s):  
Bishwa Nath Adhikari ◽  
Pramod Sharma Gautam ◽  
Shishu Upadhyay ◽  
Uday Chandra Prakash
Keyword(s):  
Refractive Errors ◽  
Spherical Equivalent ◽  
Female Ratio ◽  
Medical College ◽  
Spherical Component ◽  
Number Of Patients ◽  
Prospective Comparative Study ◽  
The Mean ◽  
Male To Female ◽  
Day By Day

Introduction: Globally, the most common cause for diminution of vision is refractive errors and the number of patients with refractive errors is increasing day by day. The Auto-refraction (AR) is quick and patient friendly procedure as compared to retinoscopy and subjective refraction in finding out refractive errors. Hence, the accuracy of Auto-refractometer in terms of subjective acceptance (SA) should be taken into account before prescribing optical correction based on findings of that particular model of Auto-refractometer. So, this study is directed towards analysis of the accuracy of GRK-2200T Auto-retieratometer in terms of acceptance by comparing findings of AR with that of SC. Objectives: The aim of this study was to assess the refractive status of patient's eyes using auto refractometer (GRK-2200T auto-retierato meter) and to estimate the agreement of it in terms of accuracy in acceptance of subjective correction by the patient. Methodology: A hospital based prospective comparative study conducted on 226 eyes of 113 patients who visited out-patient department (OPD) of Ophthalmology at Nobel Medical College and Teaching Hospital (NoMCTH), Biratnagar diagnosed with Myopia, Hyperopia and Astigmatism. Duration of study was 4 months from 2nd October, 2018 to 2nd February, 2019. All data thus collected was subjected to statistical analysis by using SPSS version 22. Result The mean age of the study subjects was 26.91±7.79 years with male to female ratio of 0.47. When spherical power, cylindrical power and the axis are taken into consideration together, only 13.3% of the total tested eyes subjectively accepted the AR values unchanged. On subjective correction, 32.7% of the tested eyes accepted spherical power while 46.5% accepted cylindrical power and 50.9% accepted axis of AR unchanged. About 52.2% of the total eyes examined fall within the deviation of spherical equivalent (SE) of ±o.25D and up to 67.3% of them fall within the deviation of ±o.50D. Conclusion The auto refraction by GRK-2200T auto-retieratometer was found to be satisfactory for a preliminary refraction but not satisfactory as substitutes for conventional subjective refraction. However, auto refraction values obtained by GRK-2200T auto-retieratometer could be important in order to accurately prescribe the cylindrical power as well as its axis than the spherical component.

scholarly journals Consensus guidelines for the diagnosis and clinical management of Erdheim-Chester disease

Blood ◽  
2014 ◽  
Vol 124 (4) ◽  
pp. 483-492 ◽  
Author(s):  
Eli L. Diamond ◽  
Lorenzo Dagna ◽  
David M. Hyman ◽  
Giulio Cavalli ◽  
Filip Janku ◽  
...  
Keyword(s):  
Clinical Management ◽  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Multiple Organ ◽  
Future Research ◽  
Consensus Guidelines ◽  
Erdheim Chester Disease ◽  
Organ Systems ◽  
Erdheim Chester ◽  
Chester Disease

Abstract Erdheim-Chester disease (ECD) is a rare, non-Langerhans histiocytosis. Recent findings suggest that ECD is a clonal disorder, marked by recurrent BRAFV600E mutations in >50% of patients, in which chronic uncontrolled inflammation is an important mediator of disease pathogenesis. Although ∼500 to 550 cases have been described in the literature to date, increased physician awareness has driven a dramatic increase in ECD diagnoses over the last decade. ECD frequently involves multiple organ systems and has historically lacked effective therapies. Given the protean clinical manifestations and the lack of a consensus-derived approach for the management of ECD, we provide here the first multidisciplinary consensus guidelines for the clinical management of ECD. These recommendations were outlined at the First International Medical Symposium for ECD, comprised of a comprehensive group of international academicians with expertise in the pathophysiology and therapy of ECD. Detailed recommendations on the initial clinical, laboratory, and radiographic assessment of ECD patients are presented in addition to treatment recommendations based on critical appraisal of the literature and clinical experience. These formalized consensus descriptions will hopefully facilitate ongoing and future research efforts in this disorder.

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