Notes

Risk factors connected with tension signs or symptoms during pregnancy and postpartum: integrative literature review.
Moreover, eosinophilia, bronchial asthma, lung infiltration, acute kidney injury and positive perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) test implied Churg Strauss syndrome. Eosinophil infiltrate with fibrin thrombus was revealed by endomyocardial biopsy. The patient was diagnosed of cardiac involvement of CSS and recovered after immunosuppressive and anticoagulant treatments.

Loeffler's endocarditis should be suspected when physicians encounter restrictive cardiomyopathy accompanied by mural thrombus in a patient with eosinophilia. Prompt immunosuppressive and anticoagulant medication can bring the disease under control.
Loeffler's endocarditis should be suspected when physicians encounter restrictive cardiomyopathy accompanied by mural thrombus in a patient with eosinophilia. Prompt immunosuppressive and anticoagulant medication can bring the disease under control.
Loss of consciousness in children can be caused by a wide spectrum of factors, including infection, metabolic disorders, trauma, and poisoning which requires timely and accurate evaluation.

In this paper, we introduce a three-year-old boy who was first referred to the Emergency ward of Mashhad Imam Reza Hospital due to unconsciousness. Having spent a few days in a hotel, this boy, who was a visitor to Mashhad, lost consciousness. During evaluations, hypotension and severe high anion gap metabolic acidosis was observed. Finally, the patient was diagnosed with ethylene glycol poisoning.

Poisoning should be considered as one of the most likely diagnoses in children with loss of consciousness. The identification of the clinical symptoms and the use of appropriate diagnostic algorithms is essential for timely diagnosis and appropriate treatment of specific cases of toxicity.
Poisoning should be considered as one of the most likely diagnoses in children with loss of consciousness. The identification of the clinical symptoms and the use of appropriate diagnostic algorithms is essential for timely diagnosis and appropriate treatment of specific cases of toxicity.
It has been confirmed that incidental silent cerebral infarctions (SCIs) found in healthy people may be risk factors for cerebrovascular diseases such as strokes and vascular dementia. The prospective study aimed to determine the utility of baseline serum white blood cell (WBC) counts to predict the emergence of new SCI after intracranial hemorrhage (ICH).

This is a prospective study. From January 2016 to December 2017, we recruited 171 patients admitted to the neurology department of the Affiliated Shuyang Hospital of Xuzhou Medical University with a first episode of ICH. Serum WBC count was measured on admission. SCI was detected by cranial magnetic resonance imaging (MRI) 14 days after the onset of the ICH. Receiver operating characteristic curve analysis was used to calculate the most appropriate cut-off values of the WBC count for differentiating patients with and without SCI at the end of the study period.

New SCIs were detected in 28.07% of patients by cranial MRI. Multivariate logistic regression analysis showed that cerebral microbleeds (CMBs), raised WBC counts, and leukoaraiosis were independent risk factors for SCI. The most appropriate cut-off WBC count differentiating the two groups was 7.65×10
/L (sensitivity 77.08%, specificity 63.41%).

Elevated levels of serum WBC counts in patients with ICH are associated with SCI. There is potential value in using serum WBC counts to predict new SCI after an acute hemorrhagic stroke.
Elevated levels of serum WBC counts in patients with ICH are associated with SCI. There is potential value in using serum WBC counts to predict new SCI after an acute hemorrhagic stroke.
Cow's milk intolerance canlead to chronic constipation in children. The present study seeks to determine the effect ofcow's milk-free diet (CMFD) on chronic constipation in children who are not responding to laxatives.

Seventy children suffering from chronic constipation (described as the Rome III criteria) were enrolled in an open-label randomized clinical study. Each group included 35 children aged 4-14 years treated with laxatives for at least three months with no improvements. The intervention group received CMFD plus calcium supplements for four weeks and the control group did not have any restrictions in consuming cow's milk and dairy products. GW9662 Also, both groups received polyethylene glycol (PEG; 1 gr/kg/day) and high-fiber foods (at least 10 gr/day) for four weeks. Responsiveness was described as a reduction in symptoms and signs according to the Rome III criteria after four weeks.

After four weeks, 25 (71.4%) children in the CMFD group responded to the treatment compared to four (11.4%) children in the control group (P<0.001). Significant differences were found between the CMFD and control groups in terms of the seven Rome III criteria post-intervention; history of large stools (25% vs. 53.6%), large fecal mass in the rectum during examination (17.1% vs. 50%), history of painful defecation (18.2% vs. 55.6%), history of retentive posturing (10% vs. 46%), ≥1 episode/week of incontinence (25 % vs. 50%, P=0.001), ≤ 2 defecations/week (17.4% vs. 52.3%) and history of thick stool with toilet obstruction (22.2% vs. 52.3%).

This study showed that children with functional constipation with no response to laxatives could benefit from a cow's milk-free and dairy-free diet.
This study showed that children with functional constipation with no response to laxatives could benefit from a cow's milk-free and dairy-free diet.
Coronary Artery Disease is one of the leading causes of death in the world. CAD usually progresses slowly during time and patients with normal or near-normal coronary arteries are also at risk of developing CAD. It is now believed that even mild atherosclerosis can increase the rate of CAD.

This is a retrospective, descriptive and analytic study. We selected patients who had undergone at least two diagnostic coronary angiographies at Tehran Heart Center and had normal coronary structure or mild CAD in initial angiography. The data was obtained from the Tehran Heart Center Angiography Databank. Predicting factors in the development of CAD were determined.

Data on 556 patients were reviewed. The median interval between the initial and final coronary catheterization was 37.6 months. On the final evaluation, 216 patients (38.8%) found to have developed some degrees of coronary artery disease. Based on the multivariate analysis, age, hematocrit, cigarette smoking, hypertension, and initial presentation with stable and unstable angina were found to be independent predictors of progression to CAD in patients.
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