scholarly journals Ischemic Stroke in Infants and Children: Practical Management in Emergency

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Sara Ciccone ◽  
Michela Cappella ◽  
Caterina Borgna-Pignatti
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Rare Disease ◽  
Clinical Picture ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Signs And Symptoms ◽  
The Subject ◽  
Underlying Diseases ◽  
In Infants And Children

Stroke is a rare disease in children, with an estimated incidence 13/100000 and a significant impact on morbidity and mortality. Clinical presentation and risk factors, present in almost half of pediatric patients, are not the same as in adults. The diagnosis of stroke in children is often delayed because signs and symptoms can be subtle and nonspecific. History and clinical examination should exclude underlying diseases or predisposing factors. Neuroimaging is crucial in defining diagnosis. Other tests might be necessary, according to the clinical picture. We present here the most recent practical directions on how to diagnose and manage arterial stroke in children, according to different international guidelines on the subject.

The Diagnostic Assessment of Suspected Pulmonary Embolism on the Acute Medical Take: An Evidence Based Guide

2007 ◽  
Vol 6 (1) ◽  
pp. 20-26
Author(s):  
Alastair Proudfoot ◽  
◽  
Derek Bell ◽  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Clinical Presentation ◽  
Diagnostic Assessment ◽  
Evidence Based ◽  
Suspected Pulmonary Embolism ◽  
The Subject ◽  
Adjusted Incidence ◽  
Age And Sex

Pulmonary Embolism is a common cardiopulmonary illness with an age and sex adjusted incidence of around 117 cases per 100 000 person years. The clinical presentation is extremely heterogeneous and non specific. Risk factors for venous thromboembolism are well established. When combined with presenting features and investigations. a multimodality algorithm has led to significant changes in the diagnostic approach of suspected PE. While the best combination of tests for any individual patient remains the subject of controversy this article aims to rationalise the acute physician’s approach to diagnosis and use of available investigations.

scholarly journals Risk factors, types and outcomes of arterial ischemic stroke in Polish pediatric patients: a retrospective single-center study

2021 ◽  
Vol 17 (1) ◽  
pp. 62-70 ◽  
Author(s):  
Beata Sarecka-Hujar ◽  
Ilona Kopyta ◽  
Dorota Raczkiewicz
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Pediatric Patients ◽  
Age At Onset ◽  
Neurological Complications ◽  
Arterial Ischemic Stroke ◽  
Stroke Subtype ◽  
Anterior Circulation ◽  
Post Stroke ◽  
Normal Outcome

IntroductionVarious neurological complications may occur as a consequence of arterial ischemic stroke (AIS) and have an impact on daily activity of the patients, costs of their medical care and rehabilitation. The aim of this study was to analyze risk factors, stroke symptoms and post-stroke consequences in Polish pediatric patients depending on stroke subtype.Material and methodsWe retrospectively reviewed 77 children under the age of 18 years following their first AIS. Patients were white, Polish Caucasians, recruited in the Department of Pediatric Neurology at the Medical University of Silesia in Katowice (Poland). Statistical analysis was performed using Statistica 12.0.ResultsGender differed significantly between stroke subgroups (p = 0.030). The presence of focal cerebral arteriopathy (FCA) and chronic diseases was associated with type of AIS (p = 0.003 and p = 0.050, respectively). An outcome without neurological deterioration (normal outcome) was observed in 43% of children with lacunar anterior circulation infarct (LACI). Hemiparesis was present in almost all children with total anterior circulation infarct (TACI), in two thirds of children with partial anterior circulation infarct (PACI) and in almost 50% of children with LACI or posterior circulation infarct (POCI). In every child with hemiplegia the stroke symptom evolved into hemiparesis at follow-up. Additionally, patients with a normal outcome were older at the time of AIS than those with at least one neurological consequence (OR = 0.894, p = 0.034).ConclusionsThe presence and number of neurological outcomes depend on stroke subtypes. A relation between the presence of post-stroke deficits and age at onset was observed. The odds of deficit after ischemic stroke decreases by an average of 10.6% if the child is 1 year older at the time of AIS.

scholarly journals Clinical presentation of tubal ectopic pregnancy

2020 ◽  
Vol 9 (3) ◽  
pp. 1148
Author(s):  
Kavitha Garikapati ◽  
M. Parvathi Devi ◽  
N. Alekya Goud
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Uterine Cavity ◽  
Expectant Management ◽  
Signs And Symptoms ◽  
First Trimester ◽  
Child Bearing ◽  
Incidence Risk ◽  
Ectopic Pregnancies

Background: When the fertilized ovum gets implanted at site other than normal position of uterine cavity, it is known as ectopic pregnancy. Incidence of ectopic pregnancy is 1-2% of all reported pregnancies. It is an unmitigated disaster of human production and the most important cause of morbidity and mortality in first trimester with major cause of reduced child bearing potential. It is notorious in its clinical presentation, challenging the attending physician.Methods: women with risk factors, signs and symptoms and with confirmed diagnosis. Women discharged against medical advice. Study population is 50. Retrospective analysis for 3 years (2016-2019). Objectives of this study were to study the incidence, risk factors, clinical presentation, diagnosis and changing trends of modern management. Results analysed after entering the information in the excel sheets using descriptive analysisResults: Out of 4940 deliveries, 50 were tubal ectopic pregnancies 1.012%. Women aged 20-25 years were 52%. In our study, multiparous were 68%. Common symptoms were abdominal pain 80.2%, amenorrhea 72%, urine gravindex test positive 92.8%. Etiology was PID 20%, previous ectopic pregnancy 4%, IUCD 4%, LSCS with tubectomy 16%, most common site is ampulla 82%. About 78% were ruptured. Tubal abortions 4%, salpingectomy done in 82%. Laparotomy in 2.43% in hemodynamically unstable. Medical management 8%. Salpingostomy in 4% and expectant management 2%. Morbidity in the form of blood transfusion 23.48%, DIC with ICU admission 2%. No mortality.Conclusions: A high index of clinical suspicion with underlying risk factors may get us early diagnosis for timely intervention.

Perianal Abscesses and Fistulas in Infants and Children

2020 ◽  
Vol 30 (05) ◽  
pp. 386-390
Author(s):  
Jan-Hendrik Gosemann ◽  
Martin Lacher
Keyword(s):  
Pediatric Patients ◽  
Clinical Presentation ◽  
Perianal Abscess ◽  
Current Evidence ◽  
Surgical Approaches ◽  
Older Children ◽  
Fistula In Ano ◽  
Inflammatory Bowel ◽  
In Infants And Children ◽  
Rule Out

AbstractPerianal abscess (PA) and fistula-in-ano (FIA) are common entities in infancy. Although several hypotheses have been suggested, the pathogenesis of PA/FIA remains elusive. The natural course of these diseases in infancy is self-limiting in the majority of cases whereas older children show similarities to PA/FIA in adults. It is important to rule out rare differential diagnoses of PA/FIA such as inflammatory bowel disease (IBD), surgical complications after colorectal surgery, and immunodeficiencies. Treatment remains empiric, comprises conservative, as well as surgical approaches, and is dependent on the age of the patient. This review summarizes anatomical aspects, current evidence on disease pathogenesis, clinical presentation, and management of pediatric patients with PA and FIA.

scholarly journals Chronic non-communicable diseases in the epidemic (COVID-19): Investigation of risk factors, control and care

2020 ◽  
pp. 449-456
Keyword(s):  
Risk Factors ◽  
Self Care ◽  
Signs And Symptoms ◽  
Communicable Diseases ◽  
Chronic Obstructive ◽  
Negative Consequences ◽  
Obstructive Pulmonary Disease ◽  
Non Communicable Diseases ◽  
Underlying Diseases ◽  
And Control

INTRODUCTION. Chronic non-communicable diseases (NCDs), global health problem and it is a threat to health and the development of countries. Currently, the number of people with COVID-19 as well as the resulting death toll is rising sharply worldwide. People with underlying diseases may be at greater risk. AIM. The purpose of the present study was to investigate the chronic non-communicable diseases in the epidemic (COVID-19): Investigation of risk factors, control and care. METERIALS AND METHODS. To access the articles, including international databases Scopus, PubMed, Web of Science, Embase were searched using the keywords of chronic non-communicable diseases (NCDs), chronic, risk factors, prevention and control, self-efficacy and self-care and their various combinations using AND/OR operators. No language restrictions were applied to the search process. RESULTS. Based on the evidence, NCDs, exacerbate the negative consequences of COVID-19. according to the results of this study, Among the patients admitted with COVID-19, The most common underlying diseases, were in these people, include, cardiovascular disease, hypertension, chronic obstructive pulmonary disease (COPD), smoking, malignancy, chronic kidney disease, and diabetes mellitus. Obesity may be considered as a potential COVID-19 risk factor. CONCLUSIONS. Although lifestyle, nutrition, and medical interventions are important for the early prevention of NCDs, having the tools and resources to use information more effectively is more important One of the determining and effective factors in maintaining health and preventing the aggravation of signs and symptoms of the disease COVID-19, especially in chronic diseases, is to perform self-care behaviors.

scholarly journals Pulmonary Embolism in Ischemic Stroke: Clinical Presentation, Risk Factors, and Outcome

2013 ◽  
Vol 2 (6) ◽  
Author(s):  
Jitphapa Pongmoragot ◽  
Alejandro A. Rabinstein ◽  
Yongchai Nilanont ◽  
Richard H. Swartz ◽  
Limei Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Ischemic Stroke ◽  
Clinical Presentation

scholarly journals Ovarian torsion in a 20-year-old patient

CJEM ◽  
2006 ◽  
Vol 8 (02) ◽  
pp. 126-129 ◽  
Author(s):  
Chris Martin ◽  
Kirk Magee
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Clinical Presentation ◽  
Acute Abdominal Pain ◽  
Signs And Symptoms ◽  
Ovarian Torsion ◽  
High Index ◽  
Reproductive Age ◽  
The Difference ◽  
High Index Of Suspicion

ABSTRACTOvarian torsion is an uncommon gynecological emergency that requires prompt recognition and treatment. It may present with nonspecific signs and symptoms, and should be considered in any female with acute abdominal pain. The diagnosis is based on an awareness of the relevant risk factors, the clinical presentation, and a high index of suspicion. Timely investigation and management can make the difference between ovarian loss and salvage — an outcome of great importance in the population of reproductive age females.

The Lithium Toxic Patient in the Medical Hospital: Diagnostic and Management Dilemmas

1993 ◽  
Vol 23 (1) ◽  
pp. 55-62 ◽  
Author(s):  
Dilip Ramchandani ◽  
Barbara A. Schindler
Keyword(s):  
Risk Factors ◽  
General Hospital ◽  
Clinical Picture ◽  
Hospital Setting ◽  
Signs And Symptoms ◽  
Lithium Toxicity ◽  
Psychiatric Consultation ◽  
Diagnostic Skills ◽  
Increased Risk ◽  
Toxic Reactions

Objective: Patients with lithium toxicity can pose difficulties in diagnosis and management in the general hospital setting. The authors examined patients who were referred to the Psychiatric Consultation-Liaison Service with suspicion of lithium overdose to delineate and characterize medical and psychiatric risk factors for toxicity and to follow the course and resolution of their toxicity. Method: The authors reviewed the charts of patients with lithium levels >1.5 mEq/L who were admitted consecutively to a general hospital over an 18-month period. Results: Of twelve patients, eight were found to have developed lithium toxicity due to incidental and iatrogenic factors. These patients presented with a variety of confusing signs and symptoms. Hypothyroidism and coexisting organic illness contributed to the lack of clarity in their clinical picture. Conclusion: The widening scope of indication for lithium therapy leads to increased risk of toxic reactions which challenge the diagnostic skills of the consulting psychiatrist in a general hospital setting.

Thrombosis in Infants and Children

Hematology ◽  
2006 ◽  
Vol 2006 (1) ◽  
pp. 86-96 ◽  
Author(s):  
Reinhard Schneppenheim ◽  
Jeanette Greiner
Keyword(s):  
Risk Factors ◽  
Clinical Presentation ◽  
Infants And Children ◽  
Therapeutic Interventions ◽  
Older Children ◽  
Thrombotic Risk ◽  
Therapeutic Decisions ◽  
Prophylactic Anticoagulation ◽  
Clinical Conditions ◽  
In Infants And Children

Abstract During the last decade much progress has been made toward better understanding of the underlying reasons causing thromboembolism in children. A considerable number of acquired and hereditary thrombotic risk factors have been identified which may also have an impact on therapeutic decisions and prognosis concerning outcome and the risk of a second event. However, indications for therapeutic interventions, such as thrombolysis and prophylactic anticoagulation with respect to the different clinical conditions and their combination with other risk factors, are not yet well defined. The following article describes the causes, clinical presentation and management of thrombosis in neonates, infants and older children, focusing on the clinically most relevant conditions.

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