229 research outputs found
Kawasaki disease: report of two cases
Kawasaki hastalıgı sistemik bir vaskülittir. En çok orta boy arterleri tutar. Gelismis ülkelerde çocuklarda edinsel
kalp hastalıklarının en sık nedenidir. Halen etiolojisi ve patogenezi tam aydınlatılmamıstır. Koroner arter
etkilenmesine baglı ani ölüm ve kronik hastalık riski intravenöz immünglobulin tedavisi sonrası belirgin
azalmaktadır. Bu nedenle erken ve dogru tanı prognoz açısından çok önemlidir.
Kawasaki hastalıgı tanısı konan iki olgumuzun birinde ekokardiyogramda sol ana koroner arterde dilatasyon
saptandı. Diger olguda kardiyak lezyon yoktu. Koroner arter ektazisi izlemde geriledi. Bu makalede, iki olgu
nedeniyle Kawasaki hastalıgı'nın tanısı, tedavi ve izlem ilkeleri tartısılmıstır.Kawasaki disease is a systemic vasculitis. It affects medium-sized arteries most commonly. In developed
countries, it is the most common reason for acquired cardiac diseases in children. Etiology and pathogenesis of
the disease have not yet been completely clarified. Risk of sudden death or chronic cardiac disease due to
coronary artery lesions are highly decreased after intravenous immunoglobulin therapy. Thus, early and correct
diagnosis is of utmost importance for favorable outcome.
In one of the two cases with Kawasaki disease, left main coronary artery was dilated on the echocardiogram. The
other patient had no cardiac lesion. Coronary artery ectasia was observed to be regressed. In this paper, due to the
two cases, diagnosis, treatment and follow-up principles of Kawasaki disease were discussed
Two patientswith aseptic meningitis and immune trombocytopenic purpura following chickenpox
Suçiçeği, Varicella Zoster virüsünün (VZV) primer enfeksiyonudur. VZV viremisine bağlı olarak iç organ ve
santral sinir sistemi tutulumu gözlenebilir. Nörolojik komplikasyonlar, suçiçeği enfeksiyonu geçiren çocukların
hastaneye en sık yatış endikasyonları arasındadır. Üstelik tipik deri döküntüsü olmadan da görülebilirler.
Suçiçeğinin hemorajik komplikasyonları çocuklukta nadirdir. İmmün yetmezliklilerde trombositopeniyle
birlikte yaygın hemorajik döküntülere yol açabilir. Trombositopeni suçiçeğini izleyen 1-2 hafta içinde
gözlenebileceği gibi daha geç de ortaya çıkabilir.
Bu makalede, suçiçeği enfeksiyonundan sonra gelişmiş aseptik menenjitli 7 yaşında erkek olgu ile immun
trombositopenik purpuralı (İTP) 6 yaşında erkek olgu sunulmuştur. Her iki olguda da iyileşen suçiçeği
döküntüleri vardı. Aseptik menenjitli olgu spontan iyileşirken, İTP'li olgu metil prednizolon tedavisine yanıt
verdi. Bu iki olgu nedeniyle suçiçeğinin komplikasyonlu seyredebileceği ve aşı ile korunmanın önemi
vurgulanmıştır.Chickenpox is the primary infection of varicella zoster virus. The viscera and central nervous system can be
affected due to viremia of VZV. Neurologic complications are among the most frequent indications for
hospitalization of children with varicella. Furthermore, they can be seen in the absence of characteristic
cutaneous rash. Haemorrhagic complications of varicella are rare in childhood. Varicella can cause
trombocytopenia and disseminated hemorrhagic lesions in immunocompromised children. Trombocytopenia
maybegin 1to 2weeks ormore after varicella.
In this paper,a sevenyear oldmalewith asepticmeningitis and a six year oldmalewithimmune trombocytopenic
purpura (ITP) following varicella are presented. Both of them had resolving cutaneous rashes of varicella. The
patient with aseptic meningitis recovered spontaneously; on the otherhand, the patient with ITP responded to
metil prednisolone treatment.Due to these two cases, it is stressed that varicella can be complicated and it can be
prevented withvaccine
Prevalence of Hypertension among High School Students in a Middle Anatolian Province of Turkey
Hypertension may lead to irreversible damages in vital organs, such as
heart, brain, and kidney, and may cause death in children if treatments
are not given despite early diagnosis. This cross-sectional
epidemiological study was conducted during 1 January-31 March 2004 to
investigate the prevalence of hypertension among high school students.
The study cohort included 1,041 students of six high schools, who were
selected from among 14,789 students of 26 high schools in Sivas
province of Turkey, using the cluster-sampling method. A questionnaire
was used for collecting information from students on age, gender,
smoking, and whether they or their families have any diseases. Blood
pressure, height, and weight of the participitants were determined by
the research group. Students whose repeated systolic or diastolic blood
pressures were higher than the 95th percentile were considered to be
hypertensive patients. Hypertension was prevalent among 4.4% (n=45) of
the students. There was a significant correlation between prevalence of
hypertension and body mass index. No significant correlation was found
between prevalence of hypertension and other variables, such as
smoking, age, gender, and family history of diabetes. The results
suggest that hypertension is an important public-health problem among
high school students. The results also showed that the body mass index
was an important parameter in hypertension in such a study group.
Researchers should consider overweight a causative risk factor for
development of hypertension in early-onset groups
Large-scale adverse effects related to treatment evidence standardization (LAERTES): an open scalable system for linking pharmacovigilance evidence sources with clinical data
Patients with primary immunodeficiencies are a reservoir of poliovirus and a risk to polio eradication
ABSTARCT: Immunodeficiency-associated vaccine-derived polioviruses (iVDPVs) have been isolated from primary immunodeficiency (PID) patients exposed to oral poliovirus vaccine (OPV). Patients may excrete poliovirus strains for months or years; the excreted viruses are frequently highly divergent from the parental OPV and have been shown to be as neurovirulent as wild virus. Thus, these patients represent a potential reservoir for transmission of neurovirulent polioviruses in the post-eradication era. In support of WHO recommendations to better estimate the prevalence of poliovirus excreters among PIDs and characterize genetic evolution of these strains, 635 patients including 570 with primary antibody deficiencies and 65 combined immunodeficiencies were studied from 13 OPV-using countries. Two stool samples were collected over 4 days, tested for enterovirus, and the poliovirus positive samples were sequenced. Thirteen patients (2%) excreted polioviruses, most for less than 2 months following identification of infection. Five (0.8%) were classified as iVDPVs (only in combined immunodeficiencies and mostly poliovirus serotype 2). Non-polio enteroviruses were detected in 30 patients (4.7%). Patients with combined immunodeficiencies had increased risk of delayed poliovirus clearance compared to primary antibody deficiencies. Usually, iVDPV was detected in subjects with combined immunodeficiencies in a short period of time after OPV exposure, most for less than 6 months. Surveillance for poliovirus excretion among PID patients should be reinforced until polio eradication is certified and the use of OPV is stopped. Survival rates among PID patients are improving in lower and middle income countries, and iVDPV excreters are identified more frequently. Antivirals or enhanced immunotherapies presently in development represent the only potential means to manage the treatment of prolonged excreters and the risk they present to the polio endgame. Keywords: Poliovirus eradication, Immunodeficiency-associated vaccine-derived polioviruses, Oral poliovirus vaccine, Humoral immunodeficiency, Combined immunodeficiency, Primary immunodeficienc
Characteristics of specialists treating hypothyroid patients: the “THESIS” collaborative
Copyright \ua9 2023 Žarković, Attanasio, Nagy, Negro, Papini, Perros, Cohen, Akarsu, Alevizaki, Ayvaz, Bednarczuk, Berta, Bodor, Borissova, Boyanov, Buffet, Burlacu, Ćirić, D\uedez, Dobnig, Fadeyev, Field, Fliers, Fr\uf8lich, F\ufchrer, Galofr\ue9, Hakala, Jiskra, Kopp, Krebs, Kršek, Kužma, Lantz, Laz\ufarov\ue1, Leenhardt, Luchytskiy, McGowan, Melo, Metso, Moran, Morgunova, Mykola, Beleslin, Niculescu, Perić, Planck, Poiana, Puga, Robenshtok, Rosselet, Ruchala, Riis, Shepelkevich, Unuane, Vardarli, Visser, Vrionidou, Younes, Yurenya and Heged\ufcs.Introduction: Thyroid specialists influence how hypothyroid patients are treated, including patients managed in primary care. Given that physician characteristics influence patient care, this study aimed to explore thyroid specialist profiles and associations with geo-economic factors. Methods: Thyroid specialists from 28 countries were invited to respond to a questionnaire, Treatment of Hypothyroidism in Europe by Specialists: an International Survey (THESIS). Geographic regions were defined according to the United Nations Statistics Division. The national economic status was estimated using World Bank data on the gross national income per capita (GNI per capita). Results: 5,695 valid responses were received (response rate 33\ub70%). The mean age was 49 years, and 65\ub70% were female. The proportion of female respondents was lowest in Northern (45\ub76%) and highest in Eastern Europe (77\ub72%) (p <0\ub7001). Respondent work volume, university affiliation and private practice differed significantly between countries (p<0\ub7001). Age and GNI per capita were correlated inversely with the proportion of female respondents (p<0\ub701). GNI per capita was inversely related to the proportion of respondents working exclusively in private practice (p<0\ub7011) and the proportion of respondents who treated >100 patients annually (p<0\ub701). Discussion: THESIS has demonstrated differences in characteristics of thyroid specialists at national and regional levels, strongly associated with GNI per capita. Hypothyroid patients in middle-income countries are more likely to encounter female thyroid specialists working in private practice, with a high workload, compared to high-income countries. Whether these differences influence the quality of care and patient satisfaction is unknown, but merits further study
Surgical and conservative treatment of patients with congenital scoliosis: α search for long-term results
<p>Abstract</p> <p>Background</p> <p>In view of the limited data available on the conservative treatment of patients with congenital scoliosis (CS), early surgery is suggested in mild cases with formation failures. Patients with segmentation failures will not benefit from conservative treatment. The purpose of this review is to identify the mid- or long-term results of spinal fusion surgery in patients with congenital scoliosis.</p> <p>Methods</p> <p>Retrospective and prospective studies were included, reporting on the outcome of surgery in patients with congenital scoliosis. Studies concerning a small numbers of cases treated conservatively were included too. We analyzed mid-term (5 to 7 years) and long-term results (7 years or more), both as regards the maintenance of the correction of scoliosis and the safety of instrumentation, the early and late complications of surgery and their effect on quality of life.</p> <p>Results</p> <p>A small number of studies of surgically treated patients were found, contained follow-up periods of 4-6 years that in the most cases, skeletal maturity was not yet reached, and few with follow-up of 36-44 years. The results of bracing in children with congenital scoliosis, mainly in cases with failure of formation, were also studied.</p> <p>Discussion</p> <p>Spinal surgery in patients with congenital scoliosis is regarded in short as a safe procedure and should be performed. On the other hand, early and late complications are also described, concerning not only intraoperative and immediate postoperative problems, but also the safety and efficacy of the spinal instrumentation and the possibility of developing neurological disorders and the long-term effect these may have on both lung function and the quality of life of children.</p> <p>Conclusions</p> <p>Few cases indicate the long-term results of surgical techniques, in the natural progression of scoliosis. Similarly, few cases have been reported on the influence of conservative treatment.</p> <p>In conclusion, patients with segmentation failures should be treated surgically early, according to the rate of deformity formation and certainly before the pubertal growth spurt to try to avoid cor- pulmonale, even though there is lack of evidence for that in the long-term. Furthermore, in patients with formation failures, further investigation is needed to document where a conservative approach would be necessary.</p
A framework for human microbiome research
A variety of microbial communities and their genes (the microbiome) exist throughout the human body, with fundamental roles in human health and disease. The National Institutes of Health (NIH)-funded Human Microbiome Project Consortium has established a population-scale framework to develop metagenomic protocols, resulting in a broad range of quality-controlled resources and data including standardized methods for creating, processing and interpreting distinct types of high-throughput metagenomic data available to the scientific community. Here we present resources from a population of 242 healthy adults sampled at 15 or 18 body sites up to three times, which have generated 5,177 microbial taxonomic profiles from 16S ribosomal RNA genes and over 3.5 terabases of metagenomic sequence so far. In parallel, approximately 800 reference strains isolated from the human body have been sequenced. Collectively, these data represent the largest resource describing the abundance and variety of the human microbiome, while providing a framework for current and future studies
Structure, function and diversity of the healthy human microbiome
Author Posting. © The Authors, 2012. This article is posted here by permission of Nature Publishing Group. The definitive version was published in Nature 486 (2012): 207-214, doi:10.1038/nature11234.Studies of the human microbiome have revealed that even healthy individuals differ remarkably in the microbes that occupy habitats such as the gut, skin and vagina. Much of this diversity remains unexplained, although diet, environment, host genetics and early microbial exposure have all been implicated. Accordingly, to characterize the ecology of human-associated microbial communities, the Human Microbiome Project has analysed the largest cohort and set of distinct, clinically relevant body habitats so far. We found the diversity and abundance of each habitat’s signature microbes to vary widely even among healthy subjects, with strong niche specialization both within and among individuals. The project encountered an estimated 81–99% of the genera, enzyme families and community configurations occupied by the healthy Western microbiome. Metagenomic carriage of metabolic pathways was stable among individuals despite variation in community structure, and ethnic/racial background proved to be one of the strongest associations of both pathways and microbes with clinical metadata. These results thus delineate the range of structural and functional configurations normal in the microbial communities of a healthy population, enabling future characterization of the epidemiology, ecology and translational applications of the human microbiome.This research was supported in
part by National Institutes of Health grants U54HG004969 to B.W.B.; U54HG003273
to R.A.G.; U54HG004973 to R.A.G., S.K.H. and J.F.P.; U54HG003067 to E.S.Lander;
U54AI084844 to K.E.N.; N01AI30071 to R.L.Strausberg; U54HG004968 to G.M.W.;
U01HG004866 to O.R.W.; U54HG003079 to R.K.W.; R01HG005969 to C.H.;
R01HG004872 to R.K.; R01HG004885 to M.P.; R01HG005975 to P.D.S.;
R01HG004908 to Y.Y.; R01HG004900 to M.K.Cho and P. Sankar; R01HG005171 to
D.E.H.; R01HG004853 to A.L.M.; R01HG004856 to R.R.; R01HG004877 to R.R.S. and
R.F.; R01HG005172 to P. Spicer.; R01HG004857 to M.P.; R01HG004906 to T.M.S.;
R21HG005811 to E.A.V.; M.J.B. was supported by UH2AR057506; G.A.B. was
supported by UH2AI083263 and UH3AI083263 (G.A.B., C. N. Cornelissen, L. K. Eaves
and J. F. Strauss); S.M.H. was supported by UH3DK083993 (V. B. Young, E. B. Chang,
F. Meyer, T. M. S., M. L. Sogin, J. M. Tiedje); K.P.R. was supported by UH2DK083990 (J.
V.); J.A.S. and H.H.K. were supported by UH2AR057504 and UH3AR057504 (J.A.S.);
DP2OD001500 to K.M.A.; N01HG62088 to the Coriell Institute for Medical Research;
U01DE016937 to F.E.D.; S.K.H. was supported by RC1DE0202098 and
R01DE021574 (S.K.H. and H. Li); J.I. was supported by R21CA139193 (J.I. and
D. S. Michaud); K.P.L. was supported by P30DE020751 (D. J. Smith); Army Research
Office grant W911NF-11-1-0473 to C.H.; National Science Foundation grants NSF
DBI-1053486 to C.H. and NSF IIS-0812111 to M.P.; The Office of Science of the US
Department of Energy under Contract No. DE-AC02-05CH11231 for P.S. C.; LANL
Laboratory-Directed Research and Development grant 20100034DR and the US
Defense Threat Reduction Agency grants B104153I and B084531I to P.S.C.; Research
Foundation - Flanders (FWO) grant to K.F. and J.Raes; R.K. is an HHMI Early Career
Scientist; Gordon&BettyMoore Foundation funding and institutional funding fromthe
J. David Gladstone Institutes to K.S.P.; A.M.S. was supported by fellowships provided by
the Rackham Graduate School and the NIH Molecular Mechanisms in Microbial
Pathogenesis Training Grant T32AI007528; a Crohn’s and Colitis Foundation of
Canada Grant in Aid of Research to E.A.V.; 2010 IBM Faculty Award to K.C.W.; analysis
of the HMPdata was performed using National Energy Research Scientific Computing
resources, the BluBioU Computational Resource at Rice University
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