scholarly journals Asymptomatic COVID-19 or are we missing something?

2020 ◽  
Vol 44 ◽  
Author(s):  
Jazmin K Daniells ◽  
Helen L MacCallum ◽  
David N Durrheim
Keyword(s):  
New England ◽  
National Guidelines ◽  
Asymptomatic Patients ◽  
History Of ◽  
Symptom History ◽  
Clinical Records ◽  
Pandemic Wave

A closer review of the asymptomatic COVID-19 cases recorded during the first pandemic wave in the Hunter New England area found that seven of the 26 ‘asymptomatic’ patients actually had experienced COVID-19-like symptoms, with five reporting symptoms prior to testing on review of all available clinical records. There is a need to delve deeper into the symptom history of ‘asymptomatic’ cases than initially recommended in national guidelines.

scholarly journals Filum terminale lipomas: imaging prevalence, natural history, and conus position

2014 ◽  
Vol 13 (5) ◽  
pp. 559-567 ◽  
Author(s):  
Michael J. Cools ◽  
Wajd N. Al-Holou ◽  
William R. Stetler ◽  
Thomas J. Wilson ◽  
Karin M. Muraszko ◽  
...  
Keyword(s):  
Natural History ◽  
Incidental Finding ◽  
Tethered Cord ◽  
Filum Terminale ◽  
Presenting Symptoms ◽  
Asymptomatic Patients ◽  
History Analysis ◽  
History Of ◽  
Clinical Records

Object Filum terminale lipomas (FTLs) are being identified with increasing frequency due to the increasing utilization of MRI. Although an FTL may be associated with tethered cord syndrome (TCS), in many cases FTLs are diagnosed incidentally in patients without any symptoms of TCS. The natural history of FTLs is not well defined. Methods The authors searched the clinical and imaging records at a single institution over a 14-year interval to identify patients with FTLs. For patients with an FTL, the clinical records were reviewed for indication for imaging, presenting symptoms, perceived need for surgery, and clinical outcome. A natural history analysis was performed using all patients with more than 6 months of clinical follow-up. Results A total of 436 patients with FTL were identified. There were 217 males and 219 females. Of these patients, 282 (65%) were adults and 154 (35%) were children. Symptoms of TCS were present in 22 patients (5%). Fifty-two patients underwent surgery for FTL (12%). Sixty-four patients (15%) had a low-lying conus and 21 (5%) had a syrinx. The natural history analysis included 249 patients with a mean follow-up time of 3.5 years. In the follow-up period, only 1 patient developed new symptoms. Conclusions Filum terminale lipomas are a common incidental finding on spinal MRI, and most patients present without associated symptoms. The untreated natural history is generally benign for asymptomatic patients.

scholarly journals The City-State of Boston: The Rise and Fall of an Atlantic Power, 1630–1865

2020 ◽  
Vol 94 (3) ◽  
pp. 631-636
Author(s):  
Noam Maggor
Keyword(s):  
New England ◽  
British Empire ◽  
American Revolution ◽  
Regional Autonomy ◽  
Atlantic Trade ◽  
History Of ◽  
British Colonial ◽  
City State ◽  
The City ◽  
American Nation

Mark Peterson's The City-State of Boston is a formidable work of history—prodigiously researched, lucidly written, immense in scope, and yet scrupulously detailed. A meticulous history of New England over more than two centuries, the book argues that Boston and its hinterland emerged as a city-state, a “self-governing republic” that was committed first and foremost to its own regional autonomy (p. 6). Rather than as a British colonial outpost or the birthplace of the American Revolution—the site of a nationalist struggle for independence—the book recovers Boston's long-lost tradition as a “polity in its own right,” a fervently independent hub of Atlantic trade whose true identity placed it in tension with the overtures of both the British Empire and, later, the American nation-state (p. 631).

CLINICAL CONFERENCE

PEDIATRICS ◽  
1958 ◽  
Vol 22 (5) ◽  
pp. 1016-1022
Author(s):  
Saul Krugman ◽  
Robert Ward
Keyword(s):  
England Journal ◽  
New England ◽  
Gamma Globulin ◽  
Infectious Hepatitis ◽  
Progress Report ◽  
State School ◽  
Staten Island ◽  
Active Immunity ◽  
History Of ◽  
Time Of Admission

Dr. Krugman: Since 1953 approximately 400 cases of infectious hepatitis with jaundice have been observed at the Willowbrook State School on Staten Island. The studies to be described were carried out in collaboration with Dr. Robert Ward and Dr. Joan Giles of our staff, Dr. A. Milton Jacobs of Willowbrook State School and Dr. Oscar Bodansky of Sloan-Kettering Institute. I should like to present a progress report of our investigations which have been concerned with the prevention and natural history of infectious hepatitis at Willowbrook. (A report of these studies has recently appeared in the New England Journal of Medicine (248:407, 1958) to which the reader may refer for further details.) It had been previously reported by Stokes and associates that the administration of gamma-globulin was followed by not only a lower incidence of hepatitis but also a prolongation of the protective effect. Stokes postulated that "passive-active" immunity was responsible for this phenomenon. The epidemic of hepatitis at Willowbrook provided us with an opportunity to test this hypothesis. Effect of Gamma-globulin on the Frequency of Infectious Hepatitis. Figure 1 illustrates the course of the outbreak at Willowbrook beginning in January, 1955. As can be seen, hepatitis continued to occur at a rate of about two to three cases per week. The cases, predominantly in children, occurred in 18 buildings in the institution. In June of 1956 gamma-globulin, 0.01 ml/lb, was administered to approximately a third of the inmates of each building. The control and inoculated groups were comparable as to age and time of admission to Willowbrook.

Sudden cardiac arrest in 15-year-old girl. Could it be avoided?

2018 ◽  
Vol 1 (46) ◽  
pp. 43-48
Author(s):  
Maria Posadowska ◽  
Maria Miszczak-Knecht ◽  
Alicja Mirecka-Rola ◽  
Katarzyna Bieganowska
Keyword(s):  
Cardiac Arrest ◽  
Hypertrophic Cardiomyopathy ◽  
Cardiac Death ◽  
Sudden Cardiac Arrest ◽  
Postmortem Examination ◽  
Cardiac Care ◽  
Related Family ◽  
Asymptomatic Patients ◽  
History Of ◽  
Genetically Determined

We present a case of a 15-year-old girl after sudden cardiac arrest because of ventricular fibrillation. Hypertrophic cardiomyopathy was diagnosed. Family history of patient was positive – her uncle (mother’s brother) died suddenly at the age of 21, postmortem examination showed hypertrophic cardiomyopathy. The deceased man’s family was not under cardiac care. The presented case proves, that due to genetically determined cardiac diseases such as cardiomyopathies and channelopathies, all related family members should be examined cardiologically. Diagnosis of the disease in asymptomatic patients would allow the implementation of treatment and reduce the risk of a sudden cardiac arrest / sudden cardiac death.

Abstract P47: Predicting Death and Stroke After Carotid Endarterectomy in Asymptomatic Patients: A Clinical Prediction Model

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Linda Calvillo-King ◽  
Song Zhang ◽  
Lei Xuan ◽  
Ethan A Halm
Keyword(s):  
Carotid Endarterectomy ◽  
Risk Score ◽  
Prediction Rule ◽  
Severe Disability ◽  
Clinical Prediction ◽  
Imaging Data ◽  
Final Model ◽  
Complication Risk ◽  
Asymptomatic Patients ◽  
History Of

Background and Purpose: National AHA guidelines on carotid endarterectomy (CEA) for asymptomatic patients (Pts) stipulate that the long term benefit of surgery is dependent on having a ≤ 3% risk of perioperative death or stroke (D/S) due to the procedure. We developed and validated a multivariate model of risk of D/S within 30 days of CEA for asymptomatic disease and a clinical prediction rule based on the final model. Methods: We analyzed data from 6553 asymptomatic cases in the New York Carotid Artery Surgery (NYCAS) study, a population-based cohort of all Medicare beneficiaries having CEA in NY State from 1/98 to 6/99. Medical records were abstracted for: sociodemographics, neurological history, carotid imaging data, comorbidities, and D/S within 30 days. All events were adjudicated. Multivariate logistic regression with GEE was used to identify independent predictors of combined D/S. The final model was cross-validated with100 random splits. A CEA-8 Clinical Risk Score assigned 1 point to each risk factor except for disability which got 2 points. Results: The 6553 CEAs were performed by 435 surgeons in 157 hospitals. Mean age was 74 years, 3655 were male, 4152 had coronary artery disease (CAD), 873 valvular disease, 611 congestive heart failure (CHF), 1453 history of distant stroke or TIA, and 93 severe disability. Nearly all (6413) had 70-90% ipsilateral stenosis, and 2469 had ≥ 50% contralateral stenosis. The combined 30 day D/S rate was 3.0% (198 of 6553). Multivariable predictors of perioperative D/S were: female (OR, 1.5; 95% CI, 1.1-1.9), non-white (OR, 1.8; 1.1-2.9), severe disability (OR, 3.7; 1.8-7.7), CHF (OR, 1.6; 1.1-2.4), CAD (OR, 1.6; 1.2- 2.2), valvular heart disease (OR, 1.5; 1.1-2.3), distant history of stroke/TIA (OR, 1.5; 1.1- 2.0), and non-operated stenosis ≥50% (OR, 1.8; 1.3-2.3). The CEA-8 Risk Score stratified Pts from a D/S rate of 0.6% (3 of 509) to 10% (16 of 159). Conclusions: Several sociodemographic, neuroseverity, and comorbidity factors predicted risk of D/S in asymptomatic patients having CEA. A CEA-8 Risk Score of ≥ 4 identifies high risk Pts (predicted D/S rate of >7.5%) with 2.5 times the AHA guideline acceptable complication risk in asymptomatic Pts (≤ 3%).

Badania przesiewowe w profilaktyce raka jelita grubego

2018 ◽  
Vol 21 (3) ◽  
Author(s):  
Marta Musińska ◽  
Marta Minkiewicz ◽  
Justyna Wasielica-Berger ◽  
Krystian Kidrycki ◽  
Krzysztof Kurek
Keyword(s):  
Colorectal Cancer ◽  
Screening Program ◽  
Single Step ◽  
Preventive Action ◽  
Asymptomatic Patients ◽  
Oncological Diseases ◽  
History Of ◽  
Genetic And Environmental Factors ◽  
Therapeutic Tools

Colorectal cancer is the second most frequently diagnosed cancer in Poland as well as in the world. In addition, this cancer is the second cause of death among oncological diseases. Genetic and environmental factors with a documented impact on the development and progression of colorectal cancer have been thoroughly investigated. Every case of colorectal cancer begins with the stage of a nonmalignant polyp, whose progression to invasive malignant tumor lasts about 10 years. This period is long enough to implement appropriate preventive action that allow early detection and treatment of pre-cancerous lesions. Colorectal cancer screening is the process of detecting polypoid lesions in asymptomatic patients with no history of cancers. Colonoscopy has the benefit of diagnostic and therapeutic tools, which allows to detect and remove of premalignant polyps in a single step approach. The aim of this work is to present the role of a screening program in the prevention of colorectal cancer.

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