History Of Viral Diseases Research Articles

Determination of Minimum Data Set for Designing a Diagnosis Decision Support System and Medication Follow-Up for Multiple Sclerosis

Background and Purpose: Diagnosis of multiple sclerosis (MS) is complicated because of the lack of definite factor. Decision support systems are expert systems which help physicians in decision-making process. First step in designing the system is identification of a minimum dataset (MDS). This study aimed to determine minimum dataset required to design diagnosis decision support system.Materials and Methods: This research was a descriptive cross-sectional study. Data were gathered from medical guideline approved by Ministry of Health, Treatment and Medical Training, Multiple Sclerosis diagnosis, international guideline of Royal college of England, and McDonald Diagnostic criteria. Data collection tool was a designed checklist consisting of 100 items provided to 25 neurologists and MS fellowships of medical universities and private clinics in Iran.Results: Out of 100 designed information’s items, 10 items were omitted due to CVR less than 0.49. Employment status items, history of MS in 3rd grade relatives, history of viral diseases, orbital MRI, optical coherence tomography, brain CT-scan, ESR, CRP, visually evoked potentials, delay duration of P100 for each eyes are all examples of information elements that have been omitted.Conclusion: Determining the minimum dataset related to MS is an important step in designing diagnosis decision support system and medication follow-up. Therefore, MDSs can help those responsible for gathering standard information of patients with Multiple Sclerosis (MS), and causes improvement in management of information for this disease.

Neurological impairment of the monozygotic twins with congenital infection presumed by Zika virus: Case report

Abstract Introduction: the increase in the incidence of congenital microcephaly in Brazil has been associated to the Zika virus outbreak. This case report aimed to describe the neurological impairment of monozygotic twins presumably due to an intrauterine infection by Zika virus during the Brazilian outbreak in 2015. Case description: The monozygotic twins born at term with severe congenital microcephaly were taken to the Outpatient Pediatric Service of a University Hospital. The 17-yearold mother, primigravida, lives in the Northeast region of Brazil, has a normal body mass index, no family history of microcephaly, no clinical history of viral diseases, or exposure to drugs and/or radiation during pregnancy. Serological tests for toxoplasmosis, rubella, syphilis, cytomegalovirus and HIV were negative at the prenatal evaluation and the obstetrical ultrasounds showed a monochorionic, diamniotic twin pregnancy without any evidence of neurological abnormalities. In the post-natal, the imaging of the skull, was evidenced of a great neurological impairment in one of the twins, who, in addition to presenting cerebral calcifications, gliosis and subependymal cysts, also had ventriculomegaly with hydrocephalus of supratentorial predominance and more pronounced cerebral atrophy compared to the other twin. Both presented delayed neuropsychomotor development. Discussion: distinct neurological alterations in the monochorionic twins with an infection presumed by Zika virus may raise the hypothesis of the existence of predisposing factors or protection against this viral agent.

Dilated cardiomyopathy in childhood: prognostic features and outcome

The natural history of dilated cardiomyopathy in children is difficult to predict due to the heterogeneous character of the disease. The outcome in infants and children is highly variable from complete recovery to death.In this study, 40 children diagnosed with dilated cardiomyopathy between 1995 and 2004 in our paediatric cardiology unit were reviewed with respect to clinical course and outcome, retrospectively. The medical history of these patients with dilated cardiomyopathy was reviewed to determine age, gender, family history, preceding viral illness, duration of symptoms before the diagnosis, symptoms and signs at presentation, treatment and outcome. The diagnosis was made on the basis of cardiomegaly and evidence of poor left ventricular function by echocardiography.Median age at diagnosis was 14 months, ranging from 2 months to 8 years. At presentation, 28 patients (70%) were under and twelve (30%) were above the age of two years.Twenty-eight (70%) patients had signs of congestive heart failure. Mean duration of follow-up was 40 ± 24 months (ranging from 6 months to 9 years), 21 patients (52.5%) recovered, 17 patients (42.5%) had residual disease and two (5%) died. The cause of death in both patients was progressive cardiac failure. Sixteen of 28 patients (57%) who were below the age of two years and five of 12 patients (42%) who were above the age of two years at presentation recovered.The rate of recovery was significantly different between the two age groups (p < 0.05). Seventeen of 21 (81%) patients with a history of recent viral illness at presentation recovered. The mean duration of the disease among those who recovered was 11 ± 8.3 months. Five of 19 (26%) patients without recent viral illness recovered.The mean duration of the disease in this group was 22 ± 12 months.There was a significant difference between the two groups with respect to recovery and recovery time (p < 0.05). During the first 6 months after diagnosis, there was a significant difference between the patients who recovered and the patients who had residual disease with respect to improvement in the left ventricular FS (22 ± 3.5%, 15.2 ± 2.8%, respectively) (p < 0.05).In conclusion, in this study, the rate of recovery and survival is higher than in previous studies. A good outcome is related to age at presentation (≤ two years old), a history of viral disease within three months of presentation and improvement in ventricular function during the first 6 months after diagnosis. Intractable heart failure has an adverse effect on the outcome.

Genetic epidemiology of persistent islet cell antibodies among IDDM patients.

The persistence of cytoplasmic islet cell antibodies (ICA) more than a year after diagnosis of insulin-dependent diabetes mellitus (IDDM) was investigated in 43 families with at least two children with IDDM. The prevalence of persistent ICA among IDDM patients was 16%. Persistence of ICA appeared to be familial in that siblings with IDDM were significantly more concordant for the presence or for the absence of ICA than expected by chance (P = 0.04). Patients with persistent ICA were older on average at onset of IDDM than patients without persistent ICA after adjusting for duration of disease (P = 0.004). Persistence of ICA was not significantly associated with HLA DR type, immunoglobulin genotype, insulin allele class, sex, history of viral diseases, or prior vaccinations.