scholarly journals The Characteristics of Capnocytophaga Infection: 10 Years of Experience

2021 ◽  
Author(s):  
Supavit Chesdachai ◽  
Don Bambino Geno Tai ◽  
Zachary A Yetmar ◽  
Anisha Misra ◽  
Natalie Ough ◽  
...  
Keyword(s):  
Hematologic Malignancy ◽  
Demographic Data ◽  
Common Species ◽  
Clinical Syndrome ◽  
Human Infection ◽  
Current Data ◽  
Immunocompromised Patients ◽  
Community Onset ◽  
Head And Neck Infections ◽  
Microbiological Data

Abstract Background Capnocytophaga is a Gram-negative, facultative anaerobe. Human infection is rare but can lead to devastating outcomes. C. canimorsus can cause sepsis following an animal bite, whereas human-oral associated Capnocytophaga infections were reported in immunocompromised patients. Current data on these infections is not robust. Our goal is to provide a contemporary description of a unique characteristic of Capnocytophaga infections. Methods We performed a retrospective review of all patients with Capnocytophaga infection from January 2010 to August 2020 at three main hospitals of Mayo Clinic in Rochester, Minnesota, Scottsdale, Arizona, and Florida. We collected baseline demographic data, clinical characteristics, microbiological data, and outcomes of C. canimorsus and human-oral associated Capnocytophaga infection. Results Among 82 patients with Capnocytophaga infection, 46 patients (56.0%) had bacteremia. The most common species identified in this group was C. sputigena (57.9%), followed by C. canimorsus (34.8%). Patients with human-oral associated Capnocytophaga bacteremia were often immunocompromised, presented with neutropenic fever, and had worse six months all-cause mortality compared to C. canimorsus bacteremia (36.4% vs. 6.2%, p=.03). They also had a higher beta-lactamase production rate (36.4% vs. 0.0%, p=.02). Among patients without bacteremia, the main clinical syndrome was polymicrobial head and neck infections (47.2%). Conclusions Human-oral associated Capnocytophaga bacteremia occurs primarily in immunocompromised patients, particularly those with hematologic malignancy. In contrast, C. canimorsus bacteremia is more likely to present with community-onset infection related to zoonotic exposure. Human-oral associated Capnocytophaga infection without bacteremia is frequently isolated in polymicrobial infection; this phenomenon's significance is yet to be fully understood.

scholarly journals Survey of general practitioners' attitudes towards psychiatry

2010 ◽  
Vol 34 (12) ◽  
pp. 525-528 ◽  
Author(s):  
Catherine Thompson ◽  
Nisha Dogra ◽  
Robert McKinley
Keyword(s):  
General Practitioners ◽  
Role Models ◽  
Positive Attitude ◽  
Demographic Data ◽  
Current Data ◽  
Undergraduate Teaching ◽  
Individual Response ◽  
Positive Attitudes ◽  
The Mean ◽  
Teaching Psychiatry

Aims and methodThere is a lack of current data regarding attitudes of doctors towards psychiatry. General practitioners (GPs) are increasingly involved in teaching psychiatry, and their attitudes towards psychiatry may affect their ability to promote psychiatry. The main aim of the study is to inform on current attitudes of GPs towards psychiatry as a discipline. The Attitudes Towards Psychiatry (ATP-30) questionnaire was administered to all GPs within Shropshire.ResultsThe response rate was 61% (n = 145 from N = 239). The mean score for the ATP-30 was 113.9. An association was found between GP trainer status and higher ATP-30 scores. Positive associations were found between demographic data (age, length of career, postgraduate experience of psychiatry, involvement in undergraduate teaching, GP trainer status) and individual response items on the ATP-30 scale.Clinical implicationsGeneral practitioners in Shropshire have a positive attitude towards psychiatry. Associations between demographic data and ATP-30 scores indicate that GPs with more experience of psychiatry and those involved in training may have more positive attitudes. The main limitation of the study is the lack of proven validity of the scale for use in this population. The positive attitude towards psychiatry is consistent with GPs providing the role models needed if they are to be involved to a greater degree with teaching and promoting psychiatry as a career. The need for the development of a more specific tool or an update to the existing tool is discussed.

scholarly journals Automated outbreak detection: a quantitative retrospective analysis

1999 ◽  
Vol 122 (1) ◽  
pp. 103-110 ◽  
Author(s):  
L. STERN ◽  
D. LIGHTFOOT
Keyword(s):  
Warning System ◽  
Normal Incidence ◽  
Human Infection ◽  
Current Data ◽  
Automated System ◽  
Outbreak Detection ◽  
Minimum Threshold ◽  
Quantitative Measurements ◽  
Salmonella Infections ◽  
Past Data

An automated early warning system has been developed and used for detecting clusters of human infection with enteric pathogens. The method used requires no specific disease modelling, and has the potential for extension to other epidemiological applications. A compound smoothing technique is used to determine baseline ‘normal’ incidence of disease from past data, and a warning threshold for current data is produced by combining a statistically determined increment from the baseline with a fixed minimum threshold. A retrospective study of salmonella infections over 3 years has been conducted. Over this period, the automated system achieved >90% sensitivity, with a positive predictive value consistently >50%, demonstrating the effectiveness of the combination of statistical and heuristic methods for cluster detection. We suggest that quantitative measurements are of considerable utility in evaluating the performance of such systems.

scholarly journals Clinical and Microbiological Determinants of Outcome inStaphylococcus aureusBacteraemia

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
James Price ◽  
Gillian Baker ◽  
Ian Heath ◽  
Karen Walker-Bone ◽  
Marc Cubbon ◽  
...  
Keyword(s):  
Methicillin Resistance ◽  
Central Line ◽  
Symptom Duration ◽  
Genetic Lineage ◽  
Metastatic Infection ◽  
Primary Focus ◽  
Definition Of ◽  
Community Onset ◽  
Microbiological Data

Staphylococcus aureusbacteraemia (SAB) is commonly complicated by metastatic infection or relapse after treatment.Objectives. The study aim was to determine the role of bacterial, host, and management factors in development of complicated SAB.Methods. A prospectively-conducted observational study gathered data on predisposition, management and outcome of 100 consecutive SAB cases. Antibiotic susceptibilities and genetic lineage of bacterial isolates were determined. Further clinical and microbiological data were gathered on two retrospective series from 1999–2000 (n=57) and 2004 (n=116).Results. In the prospective cases, 27% met our definition of complicated disease. Expressed as RR and 95% CI, complicated disease was associated with diabetes (1.58, 1.00–2.48), injecting-drug use (5.48, 0.88–33.49), community-onset of symptoms (1.4, 1.02–1.92), and symptom duration≥48hours prior to starting effective antibiotic therapy (2.10, 1.22–3.61). Uncomplicated disease was associated with the presence of a central line (0.69, 0.55–0.88) and prompt removal of a primary focus (0.71, 0.57–0.90). Neither methicillin resistance nor genetic lineage was associated with complicated disease, but methicillin resistance was associated with higher mortality.Conclusions. This study demonstrates that clinical rather than microbial factors are the major determinants of SAB outcome and underscores the importance of early treatment.

The herpetofauna of Kioloa, New South Wales: baseline observational data collected 30 years ago and inspired by R. E. Barwick

2014 ◽  
Vol 62 (1) ◽  
pp. 100 ◽  
Author(s):  
Klaus Henle ◽  
Will Osborne ◽  
Frank Lemckert
Keyword(s):  
New South ◽  
New South Wales ◽  
Common Species ◽  
Current Data ◽  
Eastern Coast ◽  
Field Station ◽  
South Wales ◽  
Anthropogenic Habitat ◽  
Reptile Species ◽  
Frog Species

There is increasing concern about the global decline of amphibians and reptiles. One problem with documenting declines and identifying underlying causes is the absence of historical data to compare to current data. Here we provide historic data for Kioloa on the south-eastern coast of New South Wales. In this region considerable clearing of natural forest and woodland and creation of farmland ponds took place during the second half of the 20th century. The Australian National University has a field station at Kioloa and R.E. Barwick introduced us to the field station and what was known of the herpetofauna in the mid-1980s. We undertook detailed observational surveys of the herpetofauna at this time and we revisited the area at other times, focusing on the coastal habitats. We found 13 species of frogs and 11 species of reptiles. Three further frog species and one reptile species known to occur in the area in the 1980s were not detected by us. More recently, one further frog species and six reptile species were added to the list, raising the total to 17 frog and 18 reptile species. The number and composition was similar to other locations of coastal New South Wales, except for some of the rarely encountered species. No strictly forest-dependent species were observed in the partially cleared survey area and such species presumably had already disappeared from these areas already before we commenced our observations. The frog Pseudophryne bibronii was still common in tall open-forest but was uncommon in partially cleared areas. Six species of frogs and one species of reptile presumably benefited from the anthropogenic habitat modifications. No declines of common species of reptiles occurred between the mid-1980s and 1993 but all species of frogs were very rare in 1993 due to very dry conditions. Litoria aurea, a threatened species of frog that was widespread in the mid-1980s, survives (2012) only at one site in the area.

scholarly journals Primary progressive aphasia: Classification of variants in 100 consecutive Brazilian cases

2013 ◽  
Vol 7 (1) ◽  
pp. 110-121 ◽  
Author(s):  
Mirna Lie Hosogi Senaha ◽  
Paulo Caramelli ◽  
Sonia M.D. Brucki ◽  
Jerusa Smid ◽  
Leonel T. Takada ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Language Impairment ◽  
Demographic Data ◽  
Primary Progressive Aphasia ◽  
Clinical Syndrome ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Diagnosis And Classification ◽  
Consensus Classification

ABSTRACT Primary progressive aphasia (PPA) is a neurodegenerative clinical syndrome characterized primarily by progressive language impairment. Recently, consensus diagnostic criteria were published for the diagnosis and classification of variants of PPA. The currently recognized variants are nonfluent/agrammatic (PPA-G), logopenic (PPA-L) and semantic (PPA-S). Objective: To analyze the demographic data and the clinical classification of 100 PPA cases. Methods: Data from 100 PPA patients who were consecutively evaluated between 1999 and 2012 were analyzed. The patients underwent neurological, cognitive and language evaluation. The cases were classified according to the proposed variants, using predominantly the guidelines proposed in the consensus diagnostic criteria from 2011. Results: The sample consisted of 57 women and 43 men, aged at onset 67.2±8.1 years (range of between 53 and 83 years). Thirty-five patients presented PPA-S, 29 PPA-G and 16 PPA-L. It was not possible to classify 20% of the cases into any one of the proposed variants. Conclusion: It was possible to classify 80% of the sample into one of the three PPA variants proposed. Perhaps the consensus classification requires some adjustments to accommodate cases that do not fit into any of the variants and to avoid overlap where cases fit more than one variant. Nonetheless, the established current guidelines are a useful tool to address the classification and diagnosis of PPA and are also of great value in standardizing terminologies to improve consistency across studies from different research centers.

scholarly journals STUDIES UPON EXPERIMENTAL MEASLES

1922 ◽  
Vol 36 (2) ◽  
pp. 231-238 ◽  
Author(s):  
Charles W. Duval ◽  
Rigney D'Aunoy
Keyword(s):  
Incubation Period ◽  
Temperature Rise ◽  
Early Stage ◽  
Clinical Syndrome ◽  
Human Infection ◽  
Direct Result ◽  
Cutaneous Manifestations ◽  
The Face ◽  
Specific Virus ◽  
Repeated Passage

An active transmissible virus exists in the blood of measles patients during the eruptive stage of the disease. This virus produces in rabbits after intravenous injection a specific reaction analogous in all essential features to that of the human infection. Following a definite incubation period of from 2 to 5 days the animals infected show pyrexial, leucocytic, and cutaneous alterations. Fully 90 per cent of such inoculated rabbits react in a remarkable manner. The earliest constant symptom of the infection is a rise in temperature, which on the average occurs 4 days after inoculation and most probably marks the end of the incubation period. Concomitantly with this temperature rise there is a diminution in the total number of circulating leucocytes. This decrease in the number of white blood elements may be relative or may appear in the form of a well defined leucopenia. The most striking objective signs are the coryza, conjunctival injection, enanthemata, and exanthemata. The mucous membrane lesions are similar in their physical appearance to the so called Koplik spots seen in man. They occur on the buccal side of the oral cavity ranging in number from two to eight discrete hemorrhagic areas with paler centers. They appear as a rule coincidently with the temperature rise or shortly thereafter. The exanthematous lesions though occurring only in about 40 per cent of the infected animals complete the clinical syndrome in this particular experimental host. The rash may appear as early as the 3rd and as late as the 7th day after inoculation. In its early stage it is of the macular variety, appearing as a diffuse eruption which later develops into a more papular type of lesion. At this time the cutaneous manifestations appear as slightly raised, flattened, purplish red, discrete areas in the skin of the face, neck, chest, and abdomen. Repeated passage of the virus of measles through the rabbit seems to increase its virulence. A number of animals infected with such passage virus succumb in the fourth and subsequent generations, undoubtedly as the direct result of the action of the specific excitant, as in none of the animals was there cultural evidence of secondary intercurrent infection. In the animals dying presumably as a result of the specific virus grave nephritic changes were evident. It is a noteworthy fact that the pneumonia so common in fatal cases of human measles was not evident in any of the experimental animals. We believe this to be of considerable significance, especially in elucidating the direct etiological factor of the fatal pneumonias so often present in human measles cases. Apparently such infections in man can be explained purely on the basis of the destruction of normal defense barriers by the specific excitant of the infectious disease, and the lack of host resistance to the ordinary pyogenic microorganism.

Do Many of the Behavioral and Psychological Symptoms of Dementia Constitute a Distinct Clinical Syndrome? Current Evidence Using the BEHAVE-AD

2000 ◽  
Vol 12 (S1) ◽  
pp. 155-164 ◽  
Author(s):  
Barry Reisberg ◽  
Isabel Monteiro ◽  
Istvan Boksay ◽  
Stefanie Auer ◽  
Carol Torossian ◽  
...  
Keyword(s):  
Rating Scale ◽  
Psychological Symptoms ◽  
Clinical Syndrome ◽  
Current Data ◽  
Current Evidence ◽  
Pharmacologic Intervention ◽  
Dementia Patients ◽  
Placebo Intervention ◽  
And Function ◽  
Behavioral And Psychological Symptoms

The Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD) was specifically designed to assess behavioral and psychological symptoms of dementia (BPSD) that would be remediable to both psychologic and pharmacologic intervention. Furthermore, the BEHAVE-AD was designed to assess categories of symptoms that would respond in a cohesive (syndrome) manner in dementia patients, independently of effects of interventions on cognition and functioning. Current data indicate that the BEHAVE-AD does indeed assess a cohesive, cognition- and function independent syndrome in AD and in related dementias that is responsive to psychologic and appropriate pharmacologic intervention. Evidence is also increasing for differential responsiveness of this BPSD syndrome to select pharmacologic agents compared with nonspecific psychologic (placebo) intervention. This article reviews the evidence for this BPSD syndrome in dementia patients, as assessed with the BEHAVE-AD.

scholarly journals Ebola Virus ? A Global Threat

2015 ◽  
Vol 5 (1) ◽  
pp. 44-51
Author(s):  
Mejbah Uddin Ahmed ◽  
Sushmita Roy
Keyword(s):  
Nonhuman Primates ◽  
Ebola Virus ◽  
Rna Virus ◽  
Close Contact ◽  
Multiorgan Failure ◽  
Hemorrhagic Fever ◽  
Human Infection ◽  
Current Data ◽  
Sub Saharan Africa ◽  
Virus Infections

Ebola virus is a filamentous, enveloped, non-segmented, single-stranded, negative-sense RNA virus. It belongs to the Filoviridae and was first recognized near the Ebola River valley in Zaire in 1976. Since then most of the outbreaks have occurred to both human and nonhuman primates in sub-Saharan Africa. Ebola virus causes highly fatal hemorrhagic fever in human and nonhuman primates. In addition to hemorrhagic fever, it could be used as a bioterrorism agent. Although its natural reservoir is yet to be proven, current data suggest that fruit bats are the possibility. Infection has also been documented through the handling of infected chimpanzees, gorillas, monkeys, forest antelope and porcupines. Human infection is caused through close contact with the blood, secretion, organ or other body fluids of infected animal. Human-to-human transmission is also possible. Ebola virus infections are characterized by immune suppression and a systemic inflammatory response that causes impairment of the vascular, coagulation, and immune systems, leading to multiorgan failure and shock. The virus constitutes an important public health threat in Africa and also worldwide as no effective treatment or vaccine is available till now DOI: http://dx.doi.org/10.3329/jemc.v5i1.21497 J Enam Med Col 2015; 5(1): 44-51

scholarly journals The Performance of Sepsis-3 Criteria to Predict Mortality among patients with hematologic malignancy and post-transplant who have Suspected Infection

2021 ◽  
Author(s):  
Oryan Henig ◽  
Rosemary K B Putler ◽  
Owen Albin ◽  
Twisha S Patel ◽  
Daniel Kaul ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Predictive Validity ◽  
Risk Model ◽  
Hematologic Malignancy ◽  
Positive Likelihood Ratio ◽  
Clinical Score ◽  
Baseline Risk ◽  
Immunocompromised Patients ◽  
Suspected Infection ◽  
Dichotomous Variables

Abstract Background Sepsis is a leading cause of death, particularly in immunocompromised people. The revised definition of sepsis (Sepsis-3) uses Sequential Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) to identify patients with sepsis. The aim of this study was to evaluate the performance of SOFA, qSOFA and SIRS (systemic inflammatory response syndrome) in immunocompromised patients. Methods Adult immunocompromised patients admitted to Michigan Medicine between 2012-2018 with suspected infection were included based on criteria adopted from the Sepsis-3 study. Each clinical score (SOFA≥2, qSOFA≥2, SIRS≥2) was added to the baseline risk model as an ordinal as well as dichotomous variables and AUROC values were calculated. In addition, breakpoints of SOFA between 2-10 were assessed to identify the breakpoints with the highest sensitivity and specificity for hospital mortality. The analysis was stratified for intensive care unit (ICU) status. Results Of 2822 immunocompromised patients with a mean age of 56.8±15.6, 213 (7.5%) died during hospitalization. When added to the baseline risk model, SOFA score had the greatest predictive validity for hospital mortality [AUROC=0.802 (95%CI: 0.771-0.832)], followed by qSOFA (AUROC=0.783 (0.754-0.812) and SIRS (AUROC=0.741 (0.708-0.774]). Among SOFA breakpoints that were evaluated, SOFA≥6 had the greatest predictive validity and moderate positive likelihood ratio (2.75) for hospital mortality. Conclusion The predictive validity for hospital mortality of qSOFA was similar among immunocompromised patients to that reported in the Sepsis-3 study. The sensitivity of qSOFA≥2 for hospital mortality was low. SOFA≥6 might be an effective tool to identify immunocompromised patients with suspected infection at high risk for clinical deterioration.

scholarly journals Prevalence of microsporidiosis in human and cattle

2017 ◽  
Vol 40 (2) ◽  
pp. 147-154
Author(s):  
Kadum N. E.
Keyword(s):  
Rural Areas ◽  
Common Species ◽  
Enterocytozoon Bieneusi ◽  
Human Infection ◽  
Urine Samples ◽  
Milk Samples ◽  
Encephalitozoon Intestinalis ◽  
Blue Stain ◽  
Stool Samples ◽  
Apparently Healthy

     In order to identify microsporidia and other fungi  in  stool and  urine samples of human, and in fecal and milk samples of cattle, 100 stool samples with or without diarrhea and 50 urine samples, human fecal and urine samples were obtained from certain Baghdad hospitals and certain rural areas surroundings Baghdad city, in addition to 50 fecal and 56  milk samples  of cattle apparently healthy were collected  from Alshula Slaughter House and  directly from  anal of the animal field  of College of Veterinary Medicine/ Baghdad University. All samples were collected during six months from 1/10/2014 to 1/4/2015. Thin films were formed and stained by Webers Modified Trichrom stain and Modified Trichrom-Ryan Blue stain. The results showed that (23%) 23 out of 100 stool samples of human were positive for Microsporidia spp. and (16%) 8 out of 50 urine samples of human were positive for this fungus. While the result revealed (18%) 9 out of 50 fecal samples and (7.14%) 4 out of 56 milk samples of cattle were positive for Microsporidia spp. The result also explained that (25.3%) 19 cases of patients suffering from diarrhea expressed   Microsporidia spp. after the examination of 75 stool samples, while (16%) 4 persons without diarrhea showed positive Microspordia, through the examination of 25 stool samples. The study explains that the  Enterocytozoon bieneusi is a common species associated with human infection and  Encephalitozoon intestinalis is  a common Microsporidia associated with  cattle infection  whereas Encephalitozoon cuniculi is rarely identified in human  but recorded in cattle.

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