scholarly journals Birdshot retinochoroiditis in Brazil: a multicenter review of 40 patients

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Maria Luisa Gois da Fonsêca ◽  
Raul N. G. Vianna ◽  
Anna C. H. Rocha ◽  
Antonio M. B. Casella ◽  
Arnaldo Cialdini ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Clinical Course ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Clinical Findings ◽  
Birdshot Retinochoroiditis ◽  
Hispanic Patients ◽  
The Mean ◽  
Clinical Signs And Symptoms ◽  
Few Data

Abstract Background Birdshot retinochoroiditis (BRC) is a rare and chronic bilateral uveitis mostly found in Caucasians. As few data are available about the clinical course of BRC in Hispanic patients, we aimed to report the clinical findings and the evolution of BRC in Brazilian patients. Methods This retrospective cohort multicenter nationwide study was performed by analyzing the records of patients with BRC diagnoses from Brazilian ophthalmological centers from April 1995 to May 2020. Results Forty patients (80 eyes) with a diagnosis of BRC were evaluated. The mean age was 53 years, and there was no sex predominance. All tested patients (34/40) were positive for HLA-A29. The diagnosis of BRC was made following the Levinson et al. criteria, and all ancillary tests were performed to exclude differential diagnoses. Clinical signs and symptoms, such as complications and treatment, were described. Conclusions BRC evolution in Brazilian patients seems to have some peculiarities that diverge from the published literature available about Caucasians, as AS inflammation is higher in this population.

scholarly journals Successful Modified Therapy in a Patient with Probable Infection-Associated Hemophagocytic Lymphohistiocytosis

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Carl L. Kay ◽  
Matthew J. Rendo ◽  
Paul Gonzales ◽  
Sead G. Beganovic ◽  
Magdalena Czader
Keyword(s):  
Hemophagocytic Lymphohistiocytosis ◽  
Clinical Course ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Good Patient ◽  
Good Patient Outcome ◽  
Distributive Shock ◽  
Probable Infection ◽  
Clinical Signs And Symptoms ◽  
Baseline Renal Function

Hemophagocytic lymphohistiocytosis (HLH) is a rare, hyperinflammatory syndrome characterized by clinical signs and symptoms of extreme inflammation. In adults, HLH is typically a complication of infections, autoimmune diseases, and malignancies. While the disease is often fatal, classic management of HLH revolves around early diagnosis and initiation of protocolized therapy. We present a case of a previously healthy 56-year-old female who developed distributive shock requiring intubation, vasopressors, and continuous venovenous hemofiltration. In the setting of multiple infectious syndromes, severe cytopenias, and rising direct hyperbilirubinemia, her diagnosis of HLH was confirmed. Therapy was initiated with dexamethasone and two doses of reduced-intensity etoposide based on the patient’s clinical course. Over the next few weeks, she continued to improve on dexamethasone monotherapy and has maintained remission up to the present with complete resolution of her cytopenias and return of baseline renal function. Our case highlights the variability in the management of probable infection-associated HLH (IHLH) with a good patient outcome. We demonstrate the potential to treat IHLH with partial protocols and minimal chemotherapeutics.

scholarly journals Postnatally Acquired Zika Virus Disease Among Children, United States, 2016–2017

2019 ◽  
Vol 70 (2) ◽  
pp. 227-231 ◽  
Author(s):  
Nicole P Lindsey ◽  
Charsey C Porse ◽  
Emily Potts ◽  
Judie Hyun ◽  
Kayleigh Sandhu ◽  
...  
Keyword(s):  
Zika Virus ◽  
Virus Disease ◽  
Healthcare Providers ◽  
Clinical Signs ◽  
Virus Transmission ◽  
Signs And Symptoms ◽  
Clinical Findings ◽  
Case Definition ◽  
Illness Onset ◽  
Clinical Signs And Symptoms

Abstract Background The clinical findings among children with postnatally acquired Zika virus disease are not well characterized. We describe and compare clinical signs and symptoms for children aged <18 years. Methods Zika virus disease cases were included if they met the national surveillance case definition, had illness onset in 2016 or 2017, resided in a participating state, and were reported to the Centers for Disease Control and Prevention. Pediatric cases were aged <18 years; congenital and perinatal infections were excluded. Pediatric cases were matched to adult cases (18‒49 years). Clinical information was compared between younger and older pediatric cases and between children and adults. Results A total of 141 pediatric Zika virus disease cases were identified; none experienced neurologic disease. Overall, 28 (20%) were treated in an emergency department, 1 (<1%) was hospitalized; none died. Of the 4 primary clinical signs and symptoms associated with Zika virus disease, 133 (94%) children had rash, 104 (74%) fever, 67 (48%) arthralgia, and 51 (36%) conjunctivitis. Fever, arthralgia, and myalgia were more common in older children (12‒17 years) than younger children (1‒11 years). Arthralgia, arthritis, edema, and myalgia were more common in adults compared to children. Conclusions This report supports previous findings that Zika virus disease is generally mild in children. The most common symptoms are similar to other childhood infections, and clinical findings and outcomes are similar to those in adults. Healthcare providers should consider a diagnosis of Zika virus infection in children with fever, rash, arthralgia, or conjunctivitis, who reside in or have traveled to an area where Zika virus transmission is occurring.

scholarly journals Specific clinical signs and symptoms are predictive of clinical course in sporadic Creutzfeldt−Jakob disease

2016 ◽  
Vol 23 (9) ◽  
pp. 1455-1462 ◽  
Author(s):  
E. Nakatani ◽  
Y. Kanatani ◽  
H. Kaneda ◽  
Y. Nagai ◽  
S. Teramukai ◽  
...  
Keyword(s):  
Clinical Course ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Jakob Disease ◽  
Clinical Signs And Symptoms

Association Rate between Incisional and Pelvic Endometriosis

2011 ◽  
Vol 3 (4) ◽  
pp. 183-187 ◽  
Author(s):  
Saeed Alborzi ◽  
Bahareh Hamedi ◽  
Sedigheh Abbasi ◽  
Mohammad Ebrahim Parsanejad ◽  
Jaleh Zolghadri
Keyword(s):  
Abdominal Wall ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Pelvic Cavity ◽  
Pelvic Endometriosis ◽  
Association Rate ◽  
Abdominal Wall Endometriosis ◽  
The Mean ◽  
Clinical Signs And Symptoms ◽  
Wall Mass

Purpose To investigate the association rate between abdominal wall and pelvic endometriosis in a population of Iranian patients, in University and private hospitals of Shiraz University of Medical Sciences. Methods 30 women were diagnosed as abdominal wall endometriosis according to the clinical signs and symptoms (dysmenorrhea, dyspauronia and pelvic pain) and the sonographic findings. The mean age of the patients was 30.5 ±3.3 (range 21–35) years. All the patients underwent resection of abdominal wall mass and investigation of the pelvic cavity for detecting pelvic endometriosis by laparoscopy. The pelvic endometriosis was scored and the stage was determined. Results 28 (93.3%) patients were found to have concomitant pelvic endometriosis. The mean score of pelvic endometriosis was 9.3 ± 6.6 (range 3–33). Of the patients, 10 (33.3%) suffered from stage I endometriosis, 16 (53.3%) from stage II, and 2 (6.7%) from stage III. Only 2 (6.7%) patients did not have concomitant pelvic endometriosis. The abdominal wall mass was successfully excised in all the cases. The histopathology diagnosis was confirmed in all the cases. Conclusions The association rate between abdominal wall and pelvic endometriosis is higher than that previously reported, up to 90%. Thus, routine investigation of the pelvic cavity is recommended in all the patients with abdominal wall endometriosis.

scholarly journals AB1092 ULTRASOUND EXAMINATION OF JOINTS AND PERIARTICULAR TISSUES IN PATIENTS WITH INFLAMMATORY BOWEL DISEASES.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1835.2-1835
Author(s):  
G. Gainullina ◽  
E. Kirillova ◽  
A. Odincova ◽  
E. Belousova ◽  
D. Abdulganieva
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Ultrasound Examination ◽  
Power Doppler ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Clinical Findings ◽  
Extraintestinal Manifestation ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
The Mean

Background:Joints and entheseal involvement is a common extraintestinal manifestation in inflammatory bowel diseases (IBD) [1]. Recent studies have shown the superiority of ultrasound over clinical findings in the evaluation of joints and periarticular tissues.Objectives:To assess of joint and entheseal involvement in IBD patients using ultrasound with Power Doppler, their correlation with IBD clinical variables and the difference between Crohn’s disease (CD) and ulcerative colitis (UC).Methods:We prospectively included 38 IBD patients into the study. Disease activity was evaluated in CD by Harvey Bradshaw, in UC - Mayo Index. Peripheral joints and entheses were imaged by ultrasound, using Samsung Accuvix A30 5-13 MHz linear array transducer. Ultrasound examination of 14 peripheral joints (hip, knee, ankle, shoulder, acromioclavicular, elbow, wrist) and 35 entheses was performed. Vascularization on them was assessed with Power Doppler (PD). Entheseal abnormalities were scored with US according to indices GUESS, MASEI and BUSES [2]. Statistical analysis was done by Mann-Whitney test and Spearman criteria by “Statistica” software.Results:In 38 patients UC was in 22 (58%), CD - in 16 (42%). The mean age of UC patients was 28 (23; 35) years, in CD - 33 (27; 36) years. The mean duration of UC was 24 (10; 48) months; CD - 66 (24; 114) months. The majority of patients had highly active disease: in UC - moderate and severe attacks in 16 pts (72%), in CD out of 16 patients, moderate and severe activity was observed in 9 (56%).Synovitis were found in 19 patients (50%), 8 patients with UC (36%), and 10 patients with CD (62%), synovitis with vascularization was detected in 7 patients (18%), five with CD (13%), two with UC (9%).Enthesitis (echogenicity reduction and thickening) was detected in 30 patients (79%), 8 (50%) pts with CD and 17 (77%) pts with UC, enthesitis with vascularization (PD) in 13 pts (34 %), 5 (31%) pts with CD and 8 (36%) pts with UC. Tenosynovitis was observed in 11 pts (29%), three (19%) with CD and 8 (36%) pts - UC, tenosynovitis with vascularization in two patients (5%), one with UC and one with CD. Structure damage (erosion, enthesophytis) were found in 23 patients (61%), 12 patients (75%) with CD and 11 (50%) patients with UC.There were no significant differences in ultrasound signs of joint and entheses damage between patients with UC and CD.We found an association between the clinical characteristics of IBD and the ultrasound signs of entheses damage: duration of the disease has a direct moderate correlation with the number of enthesitis (SR = 0.36; p = 0.026) and GUESS (SR = 0.37; p = 0.022).There was no statistically significant relationship between the severity of the attack and damage to the joints and entheses.Conclusion:The severity of joint and periarticular tissues damage is significantly correlated with the duration of the index disease and are independent of IBD activity.References:[1]The First European Evidence-based Consensus on Extra-Intestinal Manifestations in IBD // JCC. — 2016. —V. 10, № 3. — Р. 239-254.[2] Bandinelli F, Milla M, Genise S et al. Ultrasound discloses entheseal involvement in inactive and low active inflammatory bowel disease without clinical signs and symptoms of spondyloarthropathy. Rheumatology (Oxford). 2011 Jul; 50 (7): 1275-1279.Disclosure of Interests:None declared

scholarly journals Correlation Between Clinical Findings of Temporomandibular Disorders and MRI Characteristics of Disc Displacement

2015 ◽  
Vol 9 (1) ◽  
pp. 273-281 ◽  
Author(s):  
Raman Kumar ◽  
Shambulingappa Pallagatti ◽  
Soheyl Sheikh ◽  
Amit Mittal ◽  
Deepak Gupta ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Temporomandibular Disorders ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Clinical Findings ◽  
Disc Displacement ◽  
Disk Displacement ◽  
Anterior Disc Displacement ◽  
Group 2 ◽  
Clinical Signs And Symptoms

Objectives: Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The first step in MR imaging of the TMJ is to evaluate the articular disk, or meniscus, in terms of its morphologic features and its location relative to the condyle in both closed- and open-mouth positions. Disk location is of prime importance because the presence of a displaced disk is a critical sign of TMJ dysfunction. However, disk displacement is also frequently seen in asymptomatic volunteers. It is important for the maxillofacial radiologist to detect early MR imaging signs of dysfunction, thereby avoiding the evolution of this condition to its advanced and irreversible phase which is characterized by osteoarthritic changes such as condylar flattening or osteophytes. Further the MR imaging techniques will allow a better understanding of the sources of TMJ pain and of any discrepancy between imaging findings and patient symptoms. Henceforth, the aim of the study was to evaluate whether MRI findings of various degrees of disk displacement could be correlated with the presence or absence of clinical signs and symptoms of temporomandibular disorders in symptomatic and asymptomatic subjects.Materials and Methods:In this clinical study, 44 patients (88 TMJs) were examined clinically and divided into two groups. Group 1 consisted of 22 patients with clinical signs and symptoms of TMDs either unilaterally or bilaterally and considered as study group. Group 2 consisted of 22 patients with no signs and symptoms of TMDs and considered as control group. MRI was done for both the TMJs of each patient. Displacement of the posterior band of articular disc in relation to the condyle was quantified as anterior disc displacement with reduction (ADDR), anterior disc displacement without reduction (ADDWR), posterior disc displacement (PDD).Results:Disk displacement was found in 18 (81.8%) patients of 22 symptomatic subjects in Group 1 on MRI and 4 (18.1%) were diagnosed normal with no disc displacement. In Group 2, 2 (9.1%) of 22 asymptomatic patients were diagnosed with disc displacement while 20 (90.1%) were normal. Sensitivity and Specificity tests were applied in both the groups to correlate clinical findings of TMD and MRI characterstics of disc displacement and results showed Sensitivity of 90% and Specificity of 83.3%.Conclusion:Disk displacement on MRI correlated well with presence or absence of clinical signs and symptoms of temporomandibular disorders with high Sensitivity and Specificity of 90% and 83.3% respectively.

scholarly journals Unified Staging System for Lewy Body Disorders: Clinicopathologic Correlations and Comparison to Braak Staging

2019 ◽  
Vol 78 (10) ◽  
pp. 891-899 ◽  
Author(s):  
Charles H Adler ◽  
Thomas G Beach ◽  
Nan Zhang ◽  
Holly A Shill ◽  
Erika Driver-Dunckley ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Lewy Body ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Staging System ◽  
Clinical Findings ◽  
Cognitively Normal ◽  
Braak Staging ◽  
Younger Age ◽  
Clinical Signs And Symptoms

Abstract This study was designed to correlate clinical findings with the extent of pathologic a-synuclein (aSyn) in the brain using the Unified Staging System for Lewy Body disorders (USSLB). Data from 280 cases from the Arizona Study of Aging and Neurodegenerative Disorders are presented. Each case had a complete USSLB staging and at least 1 full research clinical assessment, including subspecialty neurologist-administered movement and cognitive evaluation. Of the 280, 25.7% were cognitively normal, 8.6% had mild cognitive impairment, and 65.7% had dementia. All cases could be categorized into 1 of 5 USSLB stages (8.6% stage I—olfactory bulb only; 15.4% IIa—brainstem predominant; 13.6% IIb—limbic predominant; 31.8% III—brainstem and limbic; and 30.7% IV—neocortical) yet using the Braak staging system 70 cases (25.3%) could not be classified. Those with USSLB stages III and IV died at a younger age. Multiple measures of motor parkinsonism, cognitive impairment, hyposmia, and probable RBD were significantly correlated with increasing USSLB stage. We conclude that the USSLB is the most comprehensive staging system for all Lewy body disorders and allows for categorization and ranking of all brains with significant correlations to many motor and nonmotor clinical signs and symptoms.

scholarly journals Chemical angioplasty for cerebral vasospasm in patients with subarachnoid hemorrhage

2019 ◽  
Vol 7 (4S) ◽  
pp. 47-53
Author(s):  
A. A. Shilov ◽  
A. V. Mironov ◽  
E. G. Uchasova ◽  
D. Yu. Naumov ◽  
P. A. Shuspannikov ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Vasospasm ◽  
Clinical Signs ◽  
Artery Aneurysm ◽  
Signs And Symptoms ◽  
Non Invasive ◽  
Aneurysm Clipping ◽  
The Mean ◽  
Clinical Signs And Symptoms ◽  
Cerebral Artery Aneurysm

Aim. To evaluate the hospital outcomes of chemical angioplasty in patients with vasospasm secondary to the clipping of the ruptured cerebral artery aneurysm.Methods. 18 patients who underwent chemical angioplasty were included in the study. Patients’ age ranged from 24 to 66 years old, the mean age was 46.6±13.2 years. Indications for chemical angioplasty and the criteria for its termination were determined by the neurosurgeon based on clinical signs and symptoms, and the data of the non-invasive examination.Results.The sessions of chemical angioplasty were performed an average of 4.7±2.3 days after the aneurysm clipping and 6.5±3 days after the onset of subarachnoid hemorrhage. The number of sessions was 4.8±2.2 and varied from 1 to 9 sessions. The baseline Lindergard index was 3.82±0.6. Three patients (16.6%) died in the in-hospital period. The Lindergard index after the end of chemical angioplasty was 2.75±0.84, which is unreliably lower (p = 0.31) than that at the baseline.Conclusion. Timely chemical angioplasty can reduce the development of significant vasospasm complications, particularly ischemic neurologic deficit.

scholarly journals Frequency of Parechovirus Serotype 1 Among Young Infants With Sepsis

2020 ◽  
Author(s):  
Manoochehr Makvandi ◽  
Chiman Karami ◽  
Rooya Pirmoradi ◽  
Ali Timori ◽  
Ahmad Shamsizadeh
Keyword(s):  
Clinical Signs ◽  
Signs And Symptoms ◽  
Human Parechovirus ◽  
Chi Square ◽  
Young Infants ◽  
Serotype 1 ◽  
Duration Of Hospitalization ◽  
The Mean ◽  
Clinical Signs And Symptoms ◽  
Low Prevalence

Abstract Background: Human parechovirus (HPeV) is recognized as a potentially severe viral infection such as gastrointestinal , respiratory and sepsis disease.In neonates and young infants. HPeV-1 is the most prevalent genotype and most commonly causes sepsis in young infants. The aim of study was to determine the prevalence of HPeV in hospitalized young infants with sepsis.Methods: The sera of 100 samples were collected from young infants [46 (46%) females and 54(54%) males < below 90 days] with clinical signs and symptoms of sepsis. The total RNA was extracted, cDNA was synthesized. The Nested PCR was carried out for detection of HPeV. The mean , chi square tests were used for distributions of HPeV genotypes among the gender, age group and season.Results: 5/100 (5%) of patients including 2/46(2%) females and 3/54(3%) males showed positive for HPeV (P=0.85). The results of sequencing and phylogenetic tree revealed that the isolated HPeV were genotype 1.Conclusion: Low prevalence of 5% HPeV were detected. HPeV was dominant in this region. The screening HPeV RNA in patients with sepsis may reduce the use of antibiotics and shorten the duration of hospitalization.

Respiratory morbidities among working children of gem polishing industries, India

2009 ◽  
Vol 25 (1) ◽  
pp. 81-84 ◽  
Author(s):  
RR Tiwari ◽  
A Saha ◽  
JR Parikh
Keyword(s):  
Chest Radiography ◽  
Clinical Signs ◽  
Working Hours ◽  
Signs And Symptoms ◽  
Female Child ◽  
Respiratory Morbidity ◽  
Occupational Hazards ◽  
Working Children ◽  
The Mean ◽  
Clinical Signs And Symptoms

There are millions of working children worldwide. In gem polishing industry, exposure to occupational hazards of dust and chemicals used in polishing of gemstone may result in respiratory symptoms and respiratory disorders. The present study included 586 exposed and 569 comparison group subjects. Data was collected through personal interview, clinical examination, and chest radiography. The respiratory morbidity was diagnosed on the basis of clinical signs and symptoms and chest radiography. The study variables included age, sex, daily working hours, and duration of exposure. The mean age of the child laborers was 11.31 ± 5.34 years. Prevalence of respiratory morbidity was significantly high in the female child laborers. The other study variables namely age, duration of exposure, and daily working hours were found to be statistically non-significant. The prevalence of respiratory morbidity among child laborers of gem polishing industry in Jaipur was found to be 7%.

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