Dengue viral infection(DVI)is one of the world’s most significant viral infections spreading.Most of the patients have been asymptomatic,with relatively benign clinical manifestations and outcomes.However,a small num...Dengue viral infection(DVI)is one of the world’s most significant viral infections spreading.Most of the patients have been asymptomatic,with relatively benign clinical manifestations and outcomes.However,a small number of patients have progressed to severe dengue diseases,including hemorrhage,multi-organ impairment,and increased vascular leakage causing hypovolemic shock,which can cause cardiovascular collapse and death.Numerous lines of evidence have demonstrated that DVI could also cause cardiac dysfunction,arrhythmias,and severe myocarditis.The treatment for dengue hemorrhagic fever(DHF)patients remains symptomatic and supportive,with close monitoring of hemodynamic status.The contributory role of cardiac dysfunction in DHF patients has potentially critical implications on the management.This review will address the current knowledge of cardiac involvement in DHF patients and the management strategy to reduce the fatality outcome.展开更多
Primary cardiac involvement, which develops as a direct consequence of systemic sclerosis(SSc), may manifest as myocardial damage, fibrosis of the conduction system, pericardial and, less frequently, as valvular disea...Primary cardiac involvement, which develops as a direct consequence of systemic sclerosis(SSc), may manifest as myocardial damage, fibrosis of the conduction system, pericardial and, less frequently, as valvular disease. In addition, cardiac complications in SSc may develop as a secondary phenomenon due to pulmonary arterial hypertension and kidney pathology. The prevalence of primary cardiac involvement in SSc is variable and difficult to determine because of the diversity of cardiac manifestations, the presence of subclinical periods, the type of diagnostic tools applied, and the diversity of patient populations. When clinically manifested, cardiac involvement is thought to be an important prognostic factor. Profound microvascular disease is a pathognomonic feature of SSc, as both vasospasm and structural alterations are present. Such alterations are thought to predict macrovascular atherosclerosis over time. There are contradictory reports regarding the prevalence of atherosclerosis in SSc. According to some authors, the prevalence of atherosclerosis of the large epicardial coronary arteries is similar to that of the general population, in contrast with other rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. However, the level of inflammation in SSc is inferior. Thus, the atherosclerotic process may not be as aggressive and not easily detectable in smaller studies. Echocardiography(especially tissue Doppler imaging), single-photon emission computed tomography, magnetic resonance imaging and cardiac computed tomography are sensitive techniques for earlier detection of both structural and functional scleroderma-related cardiac pathologies. Screening for subclinical cardiac involvement via modern, sensitive tools provides an opportunity for early diagnosis and treatment, which is of crucial importance for a positive outcome.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)pandemic affects all aspects of our lives,including children.With the advancement of the pandemic,children under five years old are at increased risk of hospitalization...BACKGROUND The coronavirus disease 2019(COVID-19)pandemic affects all aspects of our lives,including children.With the advancement of the pandemic,children under five years old are at increased risk of hospitalization relative to other age groups.This makes it paramount that we develop tools to address the two critical aspects of preserving children's health–new treatment protocols and new predictive models.For those purposes,we need to understand better the effects of COVID-19 on children,and we need to be able to predict the number of affected children as a proportion of the number of infected children.This is why our research focuses on clinical and epidemiological pictures of children with heart damage post-COVID,as a part of the general picture of post-COVID among this age group.AIM To demonstrate the role of children in the COVID-19 spread in Bulgaria and to test the hypothesis that there are no secondary transmissions in schools and from children to adults.METHODS Our modeling and data show with high probability that in Bulgaria,with our current measures,vaccination strategy and contact structure,the pandemic is driven by the children and their contacts in school.RESULTS This makes it paramount that we develop tools to address the two critical aspects of preserving children's health–new treatment protocols and new predictive models.For those purposes,we need to understand better the effects of COVID-19 on children,and we need to be able to predict the number of affected children as a proportion of the number of infected children.This is why our research focuses on clinical and epidemiological pictures of children with heart damage post-COVID,as a part of the general picture of post-Covid among this age group.CONCLUSION Our modeling rejects that hypothesis,and the epidemiological data supports that.We used epidemiological data to support the validity of our modeling.The first summer wave in 2020 from the listed here school proms endorse the idea of transmissions from students to teachers.展开更多
<strong>Background:</strong> Beh<span style="white-space:nowrap;">ç</span>et’s disease (BD) is a multisystemic, chronic inflammatory disorder with a broad range of manifes...<strong>Background:</strong> Beh<span style="white-space:nowrap;">ç</span>et’s disease (BD) is a multisystemic, chronic inflammatory disorder with a broad range of manifestations including within the cardiovascular system. Cardiac involvement like intracardiac thrombus (ICT) and valvular involvement in BD are rarely seen entities and often associated with poor prognosis. <strong>Case Presentation: </strong>We present the case of a young patient with vascular-Beh<span style="white-space:nowrap;">ç</span>et diagnosed by the presence of intracardiac thrombus in the right ventricle, unresponsive to medical treatment. Even though the intracardiac lesion was successfully treated by surgical excision, he presented a severe tricuspid dysfunction some years later due to the extension of fibrosis with no surgical therapeutic option. <strong>Conclusion:</strong> Intracardiac thrombosis is a rare but early manifestation of Beh<span style="white-space:nowrap;">ç</span>et’s disease, which is difficult to diagnose and has a poor prognosis.展开更多
文摘Dengue viral infection(DVI)is one of the world’s most significant viral infections spreading.Most of the patients have been asymptomatic,with relatively benign clinical manifestations and outcomes.However,a small number of patients have progressed to severe dengue diseases,including hemorrhage,multi-organ impairment,and increased vascular leakage causing hypovolemic shock,which can cause cardiovascular collapse and death.Numerous lines of evidence have demonstrated that DVI could also cause cardiac dysfunction,arrhythmias,and severe myocarditis.The treatment for dengue hemorrhagic fever(DHF)patients remains symptomatic and supportive,with close monitoring of hemodynamic status.The contributory role of cardiac dysfunction in DHF patients has potentially critical implications on the management.This review will address the current knowledge of cardiac involvement in DHF patients and the management strategy to reduce the fatality outcome.
文摘Primary cardiac involvement, which develops as a direct consequence of systemic sclerosis(SSc), may manifest as myocardial damage, fibrosis of the conduction system, pericardial and, less frequently, as valvular disease. In addition, cardiac complications in SSc may develop as a secondary phenomenon due to pulmonary arterial hypertension and kidney pathology. The prevalence of primary cardiac involvement in SSc is variable and difficult to determine because of the diversity of cardiac manifestations, the presence of subclinical periods, the type of diagnostic tools applied, and the diversity of patient populations. When clinically manifested, cardiac involvement is thought to be an important prognostic factor. Profound microvascular disease is a pathognomonic feature of SSc, as both vasospasm and structural alterations are present. Such alterations are thought to predict macrovascular atherosclerosis over time. There are contradictory reports regarding the prevalence of atherosclerosis in SSc. According to some authors, the prevalence of atherosclerosis of the large epicardial coronary arteries is similar to that of the general population, in contrast with other rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. However, the level of inflammation in SSc is inferior. Thus, the atherosclerotic process may not be as aggressive and not easily detectable in smaller studies. Echocardiography(especially tissue Doppler imaging), single-photon emission computed tomography, magnetic resonance imaging and cardiac computed tomography are sensitive techniques for earlier detection of both structural and functional scleroderma-related cardiac pathologies. Screening for subclinical cardiac involvement via modern, sensitive tools provides an opportunity for early diagnosis and treatment, which is of crucial importance for a positive outcome.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)pandemic affects all aspects of our lives,including children.With the advancement of the pandemic,children under five years old are at increased risk of hospitalization relative to other age groups.This makes it paramount that we develop tools to address the two critical aspects of preserving children's health–new treatment protocols and new predictive models.For those purposes,we need to understand better the effects of COVID-19 on children,and we need to be able to predict the number of affected children as a proportion of the number of infected children.This is why our research focuses on clinical and epidemiological pictures of children with heart damage post-COVID,as a part of the general picture of post-COVID among this age group.AIM To demonstrate the role of children in the COVID-19 spread in Bulgaria and to test the hypothesis that there are no secondary transmissions in schools and from children to adults.METHODS Our modeling and data show with high probability that in Bulgaria,with our current measures,vaccination strategy and contact structure,the pandemic is driven by the children and their contacts in school.RESULTS This makes it paramount that we develop tools to address the two critical aspects of preserving children's health–new treatment protocols and new predictive models.For those purposes,we need to understand better the effects of COVID-19 on children,and we need to be able to predict the number of affected children as a proportion of the number of infected children.This is why our research focuses on clinical and epidemiological pictures of children with heart damage post-COVID,as a part of the general picture of post-Covid among this age group.CONCLUSION Our modeling rejects that hypothesis,and the epidemiological data supports that.We used epidemiological data to support the validity of our modeling.The first summer wave in 2020 from the listed here school proms endorse the idea of transmissions from students to teachers.
文摘<strong>Background:</strong> Beh<span style="white-space:nowrap;">ç</span>et’s disease (BD) is a multisystemic, chronic inflammatory disorder with a broad range of manifestations including within the cardiovascular system. Cardiac involvement like intracardiac thrombus (ICT) and valvular involvement in BD are rarely seen entities and often associated with poor prognosis. <strong>Case Presentation: </strong>We present the case of a young patient with vascular-Beh<span style="white-space:nowrap;">ç</span>et diagnosed by the presence of intracardiac thrombus in the right ventricle, unresponsive to medical treatment. Even though the intracardiac lesion was successfully treated by surgical excision, he presented a severe tricuspid dysfunction some years later due to the extension of fibrosis with no surgical therapeutic option. <strong>Conclusion:</strong> Intracardiac thrombosis is a rare but early manifestation of Beh<span style="white-space:nowrap;">ç</span>et’s disease, which is difficult to diagnose and has a poor prognosis.
