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1.
Ned Tijdschr Geneeskd ; 1682024 May 14.
Artigo em Holandês | MEDLINE | ID: mdl-38747614

RESUMO

BACKGROUND: Worldwide, disease in children due to exposure to rats is increasing, also in the Netherlands. Not only the generally known pathogen Leptospira should be considered, also S. moniliformis, Yersinia pestis, Lymphocytic choriomeningitis virus, Hantavirus, Francisella tularensis and Pasteurella multocida are also known rat-associated zoonosis. CASE DESCRIPTION: An 12-year-old boy visited the pediatrician with fever, headache and nausea, followed by generalized erythema and arthritis. The boy had a pet rat. The patient's blood culture was positive for S. moniliformis. The patient was treated with antibiotics and made a full recovery. CONCLUSION: Just like many rat-associated diseases have 'rat-bite fever' caused by S. moniliformis an nonspecific clinical presentation. It is not necessary to have had a rat bite, to develop rat-bite fever. Better awareness and knowledge about rat related diseases should contribute to earlier diagnosis and treatment. Which is of great importance because of increased morbidity and mortality associated to rat related diseases.


Assuntos
Antibacterianos , Febre por Mordedura de Rato , Criança , Masculino , Humanos , Febre por Mordedura de Rato/diagnóstico , Febre por Mordedura de Rato/tratamento farmacológico , Animais , Antibacterianos/uso terapêutico , Ratos , Resultado do Tratamento , Streptobacillus/isolamento & purificação , Zoonoses/diagnóstico
2.
Mov Disord ; 36(12): 2951-2957, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34515380

RESUMO

BACKGROUND: Treatment of animal models with ataxia telangiectasia (A-T) with nicotinamide riboside (NR) improved their neurological outcome and survival. OBJECTIVE: The aim of this study is to investigate the effects of NR in patients with A-T. METHODS: In this open-label, proof-of-concept study, 24 patients with A-T were treated with NR during four consecutive months. The effects of NR on ataxia, dysarthria, quality of life, and laboratory parameters were analyzed. RESULTS: During treatment, ataxia scores improved; mean total Scale for the Assessment and Rating of Ataxia and International Cooperative Ataxia Rating Scale scores decreased to 2.4 and 10.1 points, respectively. After NR withdrawal, ataxia scores worsened. In immunodeficient patients, the mean serum IgG concentration increased substantially until the end of the study period with 0.52 g/L. Untargeted metabolomics analysis revealed increased plasma levels of NR metabolites and purine nucleosides during treatment. Adverse effects did not occur. CONCLUSIONS: Treatment with NR is tolerated well and associated with improvement in ataxia and serum immunoglobulin concentrations in patients with A-T. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.


Assuntos
Ataxia Telangiectasia , Animais , Humanos , Imunoglobulinas , Niacinamida/análogos & derivados , Niacinamida/uso terapêutico , Compostos de Piridínio , Qualidade de Vida
3.
Dev Med Child Neurol ; 63(4): 450-456, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33521952

RESUMO

AIM: To investigate the characteristics and severity of dysarthria in children and adults with ataxia telangiectasia. METHOD: All children and adults with ataxia telangiectasia who visited our multidisciplinary outpatient clinic for ataxia telangiectasia were asked to participate in this study, which took place in March 2019. To evaluate dysarthria, we used the Radboud Dysarthria Assessment in adults (older than 18y) and the paediatric Radboud Dysarthria Assessment in children (5-18y), including the observational tasks 'conversation' and 'reading', and the speech-related maximum performance tasks 'repetition rate', 'phonation time', 'fundamental frequency range', and 'phonation volume'. Speech intelligibility was measured using the Intelligibility in Context Scale. RESULTS: Twenty-two individuals (15 children [5-17y], seven adults [19-47y]; 14 males and eight females; mean age 19y, SD 15y 2mo) participated. Dysarthria was present in all participants and characterized by ataxic components in adults and similar uncontrolled movements in children. In most participants, speech was mildly to mildly/severely affected. Almost all participants had an abnormal score for at least one maximum performance task. INTERPRETATION: Dysarthria in ataxia telangiectasia is characterized by uncontrolled, ataxic, and involuntary movements, resulting in monotonous, unstable, slow, hypernasal, and chanted speech. WHAT THIS PAPER ADDS: Dysarthria in ataxia telangiectasia is characterized by uncontrolled, ataxic, and involuntary movements. Dysarthria in ataxia telangiectasia results in monotonous, unstable, slow, hypernasal, and chanted speech. Dysarthria in ataxia telangiectasia can be assessed using the Radboud Dysarthria Assessment and the paediatric Radboud Dysarthria Assessment.


Assuntos
Ataxia Telangiectasia/complicações , Disartria/etiologia , Movimento/fisiologia , Fala/fisiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inteligibilidade da Fala/fisiologia , Adulto Jovem
4.
EuroIntervention ; 9(3): 373-81, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23872651

RESUMO

AIMS: Long-term health-related quality of life (HRQOL) in the elderly after percutaneous coronary intervention (PCI) is unknown. We 1) compared HRQOL of elderly (≥70 years) with younger patients (<70 years) at 6, 12, 36 months post-PCI, and 2) examined whether predictors of impaired HRQOL 36 months post-PCI differed between older and younger patients. METHODS AND RESULTS: A prospective cohort of 651 PCI patients (26.3% ≥70 years) completed the SF-36 at 6, 12 and 36 months post-PCI. Older patients experienced a poorer physical HRQOL at all time points and worse mental HRQOL with respect to vitality and role emotional functioning (all p-values<0.05). By 36 months, the HRQOL for the older patients worsened in five of the eight subdomains (all p-values<0.05). Younger patients did not experience enduring changes in HRQOL, with the exception of role physical functioning. Predictors of impaired HRQOL were generally different for the elderly (diabetes, previous PCI) compared to younger cohorts (smoking, previous bypass surgery, ACE inhibitors), although poor six-month HRQOL, anxiety and depression were common predictors for both groups. CONCLUSIONS: Elderly PCI patients experience a deteriorating and poorer HRQOL than younger patients across three years. Contrary to younger patients, three-year HRQOL of elderly patients is irrespective of adverse events during outcomes.


Assuntos
Avaliação Geriátrica , Intervenção Coronária Percutânea , Qualidade de Vida , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Emoções , Feminino , Humanos , Modelos Logísticos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Intervenção Coronária Percutânea/efeitos adversos , Estudos Prospectivos , Sistema de Registros , Fatores de Risco , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento
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