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      Association of Kawasaki disease with tropospheric wind patterns

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          Abstract

          The causal agent of Kawasaki disease (KD) remains unknown after more than 40 years of intensive research. The number of cases continues to rise in many parts of the world and KD is the most common cause of acquired heart disease in childhood in developed countries. Analyses of the three major KD epidemics in Japan, major non-epidemic interannual fluctuations of KD cases in Japan and San Diego, and the seasonal variation of KD in Japan, Hawaii, and San Diego, reveals a consistent pattern wherein KD cases are often linked to large-scale wind currents originating in central Asia and traversing the north Pacific. Results suggest that the environmental trigger for KD could be wind-borne. Efforts to isolate the causative agent of KD should focus on the microbiology of aerosols.

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          The NCEP/NCAR 40-Year Reanalysis Project

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            Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association

            Kawasaki disease is an acute self-limited vasculitis of childhood that is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develop in approximately 15% to 25% of untreated children and may lead to ischemic heart disease or sudden death. A multidisciplinary committee of experts was convened to revise the American Heart Association recommendations for diagnosis, treatment, and long-term management of Kawasaki disease. The writing group proposes a new algorithm to aid clinicians in deciding which children with fever for > or =5 days and < or =4 classic criteria should undergo echocardiography, receive intravenous gamma globulin (IVIG) treatment, or both for Kawasaki disease. The writing group reviews the available data regarding the initial treatment for children with acute Kawasaki disease, as well for those who have persistent or recrudescent fever despite initial therapy with IVIG, including IVIG retreatment and treatment with corticosteroids, tumor necrosis factor-alpha antagonists, and abciximab. Long-term management of patients with Kawasaki disease is tailored to the degree of coronary involvement; recommendations regarding antiplatelet and anticoagulant therapy, physical activity, follow-up assessment, and the appropriate diagnostic procedures to evaluate cardiac disease are classified according to risk strata. Recommendations for the initial evaluation, treatment in the acute phase, and long-term management of patients with Kawasaki disease are intended to assist physicians in understanding the range of acceptable approaches for caring for patients with Kawasaki disease. The ultimate decisions for case management must be made by physicians in light of the particular conditions presented by individual patients.
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              Kawasaki syndrome.

              Kawasaki syndrome is an acute, self-limited vasculitis that occurs in children of all ages and presents a challenge for the clinician: the disorder can be difficult to recognise; there is no diagnostic laboratory test; there is an extremely effective therapy; and there is a 25% chance of serious cardiovascular damage if the treatment is not given early in the course of the disease. This review includes discussion of the history of the syndrome, the diagnostic challenges, epidemiology, aetiology, pathology, immunopathogenesis, therapy, genetic influences, and the long-term cardiovascular sequelae.
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                Author and article information

                Journal
                Sci Rep
                Scientific Reports
                Nature Publishing Group
                2045-2322
                10 November 2011
                2011
                : 1
                : 152
                Affiliations
                [1 ]simpleInstitut Català de Ciències del Clima (IC3) , Barcelona, Catalonia, Spain
                [2 ]simpleInstitució Catalana de Recerca i Estudis Avançats (ICREA) , Barcelona, Catalonia, Spain
                [3 ]simpleClimate, Atmospheric Science, and Physical Oceanography, Scripps Institution of Oceanography , UCSD and Water Resources Discipline, US Geological Survey, La Jolla, CA
                [4 ]simpleDept. of Pediatrics, John A. Burns School of Medicine, Univ. of Hawaii, Kapiolani Medical Center , Honolulu, HI
                [5 ]simpleDepartment of Public Health, Jichi Medical University , Tochigi, Japan
                [6 ]simpleDept. of Pediatrics, Rady Children's Hospital San Diego and UCSD , La Jolla, CA
                [7 ]These authors contributed equally to this work.
                Author notes
                Article
                srep00152
                10.1038/srep00152
                3240972
                22355668
                fb19c1f2-208d-4133-a45a-f10c70d5c2bc
                Copyright © 2011, Macmillan Publishers Limited. All rights reserved

                This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/

                History
                : 15 June 2011
                : 17 October 2011
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