• Title/Summary/Keyword: Clinical presentation

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Characteristics of Respiratory Syncytial Virus Infection in Hospitalized Children Before and During the COVID-19 Pandemic in Thailand

  • Wilawan Chaiut;Ratana Sapbamrer;Sauwaluk Dacha;Tavitiya Sudjaritruk;Ida Parwati;Anton Sumarpo;Rungnapa Malasao
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.3
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    • pp.212-220
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    • 2023
  • Objectives: This study compared the epidemiological and clinical manifestations of patients hospitalized with respiratory syncytial virus (RSV) infection before and during the coronavirus disease 2019 (COVID-19) pandemic at a tertiary care hospital in Chiang Mai Province, Thailand. Methods: This retrospective observational study utilized data from all cases of laboratory-confirmed RSV infection at Maharaj Nakorn Chiang Mai Hospital from January 2016 to December 2021. Differences in the clinical presentation of RSV infection before (2016 to 2019) and during (2020 to 2021) the COVID-19 pandemic were analyzed and compared. Results: In total, 358 patients hospitalized with RSV infections were reported from January 2016 to December 2021. During the COVID-19 pandemic, only 74 cases of hospitalized RSV infection were reported. Compared to pre-pandemic levels, the clinical presentations of RSV infection showed statistically significant decreases in fever on admission (p=0.004), productive cough (p=0.004), sputum (p=0.003), nausea (p=0.03), cyanosis (p=0.004), pallor (p<0.001), diarrhea (p<0.001), and chest pain (p<0.001). Furthermore, vigilant measures to prevent the spread of COVID-19, including lockdowns, also interrupted the RSV season in Thailand from 2020 to 2021. Conclusions: The incidence of RSV infection was affected by the COVID-19 pandemic in Chiang Mai Province, Thailand, which also changed the clinical presentation and seasonal pattern of RSV infection in children.

A Study on the Development of Clinical Workstation (임상용 워크스테이션의 개발에 관한 연구)

  • Park, Kwang-Seok;Lee, Tae-Su;Min, Byeong-Gu
    • Journal of Biomedical Engineering Research
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    • v.11 no.1
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    • pp.141-146
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    • 1990
  • A clinical workstation has been developed for the use in clinical ward. This system is connected to the Picture Archiving and Communication System previously installed. It provides the capabilities of image display, image processing, diagnostic report review, clinical lab data review and analytic diagrams presentation for the hospitalized patients in clinical ward. The performances of this system were evaluated during the 9 months. These results show typical aspects of clinical patterns in data transmissions, image studies and clinical lab data studies. These typical aspects should be counted in the further development of workstation for the clinical use.

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Evaluation of Clinical Competence in Plastic Surgery using OSCE(Objective Structured Clinical Examination): 3-Year Experience (객관구조화진료시험을 이용한 성형외과학 진료능력평가: 3년간의 경험)

  • Hwang, Kun;Lee, Se Il
    • Archives of Plastic Surgery
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    • v.32 no.6
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    • pp.675-682
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    • 2005
  • This is the evaluation report of clinical competence of undergraduate medical students in Plastic Surgery field using OSCE(Objective Structured Clinical Examination) executed in three years. OSCE comprises of assessment of subject, choice of clinical stations sampling, identification of components of clinical competence to be evaluated, the level of performance required, development of specification table, editing of OSCE presentation page and assessment of practicability and results exploitation. About fifty students were examined annually. Seven station stimuli with simulated patient participation were carried out. The mean OSCE score was $82.3{\pm}6.19$. The reliability of the total station was 0.72. The examination shows a positive response to the OSCE. Our experience shows OSCE's feasibility for Plastic Surgery during the initial course of education. Referring to our experiences, the Korean Society of Plastic and Reconstructive Surgeons (KPRS) applied the OSCE test for Korean Plastic Surgery Board Certification

Radiological Apoplexy and Its Correlation with Acute Clinical Presentation, Angiogenesis and Tumor Microvascular Density in Pituitary Adenomas

  • Lee, Jung-Sup;Park, Yong-Sook;Kwon, Jeong-Taik;Nam, Taek-Kyun;Lee, Tae-Jin;Kim, Jae-Kyun
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.281-287
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    • 2011
  • Objective : Pituitary apoplexy is life-threatening clinical syndrome caused by the rapid enlargement of a pituitary tumor due to hemorrhage and/or infarction. The pathogenesis of pituitary apoplexy is not completely understood. We analyzed the magnetic resonance imaging (MRI) of pituitary tumors and subsequently correlated the radiological findings with the clinical presentation. Additionally, immunohistochemistry was also performed to determine whether certain biomarkers are related to radiological apoplexy. Methods : Thirty-four cases of pituitary adenoma were enrolled for retrospective analysis. In this study, the radiological apoplexy was defined as cases where hemorrhage, infarction or cysts were identified on MRI. Acute clinical presentation was defined as the presence of any of the following symptoms: severe sudden onset headache, decreased visual acuity and/or visual field deficit, and acute mental status changes. Angiogenesis was quantified by immunohistochemical expression of fetal liver kinase 1 (Flk-1), neuropilin (NRP) and vascular endothelial growth factor (VEGF) expression, while microvascular density (MVD) was assessed using Endoglin and CD31. Results : Clinically, fourteen patients presented with acute symptoms and 20 for mild or none clinical symptoms. Radiologically, fifteen patients met the criteria for radiological apoplexy. Of the fifteen patients with radiologic apoplexy, 9 patients presented acute symptoms whereas of the 19 patient without radiologic apoplexy, 5 patients presented acute symptoms. Of the five biomarkers tracked, only VEGF was found to be positively correlated with both radiological and nonradiological apoplexy. Conclusion : While pituitary apoplexy is currently defined in cases where clinical symptoms can be histologically confirmed, we contend that cases of radiologically identified pituitary hemorrhages that present with mild or no symptoms should be designated subacute or subclinical apoplexy. VEGF is believed to have a positive correlation with pituitary hemorrhage. Considering the high rate of symptomatic or asymptomatic pituitary tumor hemorrhage, additional studies are needed to detect predictors of the pituitary hemorrhage.

Impact of Bilateral Breast Cancer on Prognosis: Synchronous Versus Metachronous Tumors

  • Ibrahim, Noha Y.;Sroor, Mahmoud Y.;Darwish, Dalia O.
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1007-1010
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    • 2015
  • Background: The clinical significance of bilateral breast cancer is unclear and its influence on prognosis is controversial. Materials and Methods: Between 2005 and 2009 we identified 110 cases of bilateral breast cancer (BBC) ; 49 patients had synchronous (duration between the occurrence of carcinoma in both breasts was less than 12 months) and 61 had metachronous (duration was more than one year with no ipsilateral local recurrence). We compared the patient characteristics including age, menopausal status, clinical stage, tumor size, histological classification, lymph node status, and hormone receptor and Her-2 status. We also compared the treatment given and overall and disease free survival (DFS) of both groups. Results: Synchronous cases tend to present more aggressively than metachronous cases and age at first presentation adversely affects survival. The 5 year overall survival was 78.7% for metachronous and 60% for synchronous. Patients with positive hormonal status had better five year disease free survival in metachronous compared to synchronous cases, at 76% and 63%, respectively. Age at first presentation >45years had better DFS (65%) compared to those with age ${\leq}45$ years (52%) at 5 years follow up. Conclusions: Patients with synchronous breast cancer may have worse prognosis. Young age and hormone receptor negative were risk factors in our study. Close follow up and early detection of contralateral breast cancer is mandatory.

A case of pulmonary thromboembolism in a healthy infant (건강한 영아에서 발생한 폐혈전색전증 1례)

  • Choi, Woo-Yeon;Choi, Young-Seok;Oh, Soo-Min;Cho, Young-Kuk;Ma, Jae-Sook
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.1030-1033
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    • 2007
  • A pulmonary thromboembolism (PTE), which is a sudden blockage in a pulmonary artery, usually due to a blood clot, is rare in children. The clinical presentation is often subtle or masked by the underlying clinical condition and the condition must be suspected during clinical testing. Although the choice of treatment depends on the clinical presentation, anticoagulation is the mainstay of therapy for children with PTE. We report the case of a healthy 1-month-old boy who presented with hemoptysis without hemodynamic instability. He was diagnosed based on chest computed tomography with angiography and 99mTc macroaggregated albumin lung perfusion scintigraphy and treated with low-molecular-weight heparin.

Clinical Experience and Management of Cervico-Thoracic Epidural Hematoma

  • Ahn, Sang-Soak;Song, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.381-384
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    • 2010
  • Spinal epidural hematoma (SEH) causing acute myelopathy is rare. The usual clinical presentation of a SEH is sudden severe neck or back pain that progresses toward paraparesis or quadriparesis, depending on the level of the lesion. Recent studies have shown that early decompressive surgery is very important for patient's recovery. We experienced five patients of cervico-thoracic epidural hematomas associated with neurologic deficits that were treated successfully with surgical intervention.

Adolescent menstrual disorders (청소년의 월경 장애)

  • Hong, Chang-Ho
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1257-1262
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    • 2006
  • The age of puberty represents a very critical time in the life history of every young woman. The menarche stands as primary indicator of the onset of sexual maturation in females. By late adolescence, 75% of girls experience some problem associated with menstruation. Delayed, irregular, painful, and heavy menstrual bleeding are leading reasons for physician office visits by adolescents, and dysmenorrhea is the leading reason for school absenteeism among girls. This article discusses normal menstrual function during adolescence, then reviews the clinical presentation, evaluation, and management of adolescent dysmenorrhea, dysfunctional uterine bleeding, amenorrhea, and polycystic ovary syndrome.

The Role of Intensity Modulated Radiotherapy in Cancer Treatment

  • Cheung, Kin-Yin
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.6-8
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    • 2002
  • Intensity modulated radiotherapy (IMRT) is an advanced but expensive form of 3-dimensional conformal radiation therapy technique. While the initial clinical data appear to be promising for some treatment sites, the cost effectiveness of the treatment modality has yet to be justified by long-term clinical outcome. This presentation reviews the potential efficacy and limitation of IMRT in respect of the practicality, dosimetry, and resource aspects. It tries to explore and draw conclusions on the strategies for using this sophisticated and expensive treatment technique from AFOMP perspective.

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Diffuse Peritonitis with Ruptured Gallbladder in a Dog (담낭파열에 의한 복막염의 일례)

  • Cho Kil-Hyon
    • Journal of Veterinary Clinics
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    • v.1 no.1
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    • pp.63-66
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    • 1984
  • A 6 yers old German Shepherd dog was diagnosed to a ruptured gallbladder subsquently causing a diffuse peritonitis with bile-contaminated ascites. Surgical exploration could not determine its causes of pathogenesis. A marked leukocytosis and increased alkaline phosphotase were the pronounced clinical pathologic features. Delayed surgical exploration was critical therapeutic failure of this particular case. An immediate surgical intervention could be a life saving therapy of choise. The author report an uncommon clinical case presentation of the ruptured gallbladder in a dog and an importance of immediate surgical correction.

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