scholarly journals 477. Increased Referrals for New PFAPA (Aphthous Stomatitis, Pharyngitis, Adenitis) Diagnosis During the COVID-19 Pandemic

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S340-S341
Author(s):  
Bessey Geevarghese ◽  
Shan Sun ◽  
Ravi Jhaveri
Keyword(s):  
Infection Prevention ◽  
Periodic Fever ◽  
Diagnosis Code ◽  
Prevention Strategies ◽  
Health Crisis ◽  
Health Measures ◽  
Number Of Patients ◽  
Lead Investigator ◽  
Fever Syndromes ◽  
Monthly Distribution

Abstract Background COVID-19 pandemic caused by SARS-CoV-2 resulted in a global health crisis in 2020. Quarantining, wearing masks and physical distancing- key infection prevention strategies implemented to stop the spread of COVID-19, also led to dramatic decreases in rates of common respiratory viral infection seen in young children. Due to lack of school and daycare exposure, we evaluated a larger than usual number of patients with periodic fevers without any known infectious contacts. Based on this observation, we conducted an analysis of all suspected cases of periodic fevers seen at our institution during the COVID-19 lockdown compared to prior seasons. Methods The clinical charts were queried for all patients presenting to any Lurie Children’s Hospital outpatient specialty clinic or laboratory with ICD diagnosis code of MO4.1 and MO4.8 (all recurrent and periodic fever syndromes) from June 1, 2020 through September 30, 2020, and compared to similar months the previous 2 years (2018 and 2019). Each patient chart was reviewed by the lead investigator to verify all new diagnoses of PFAPA. The number of new patients with PFAPA diagnosis were tallied and analyzed. Statistical comparisons were made using Kruskal-Wallis tests for monthly distributions in different years. Results We noted a significant increase in patients with new PFAPA diagnosis between June through August 2020 compared to similar months in 2018 and 2019 (Figure1). Experienced pediatric infectious disease physicians and rheumatologists diagnosed majority of the cases. During these months, a monthly median (IQR) of 13 (11.5, 14.5) patients were diagnosed among different Lurie specialty clinics, which is more than 2.5 folds increase in new PFAPA patients from the previous two years which were about 5 (3.5, 6) (Figure 2). Number of Patients with New PFAPA Diagnosis There was a significant increase in number of new patients diagnosed with PFAPA between June through August 2020 compared to similar months in 2018 and 2019. Monthly Distribution Summary for New PFAPA Diagnosis Statistical comparisons were made using Kruskal- Wallis tests for monthly distributions in different years Conclusion We observed a significant increase in PFAPA patients referred to our institution soon after introduction of public health measures to slow spread of COVID-19. Given that most children were not in daycare, schools, or camps, we suspect that parents and pediatricians were able to recognize patterns of periodic fevers in children much quicker than preceding years, when fevers would typically be attributed to an infectious process. Disclosures Ravi Jhaveri, MD, AstraZeneca (Consultant)Dynavax (Consultant)Elsevier (Other Financial or Material Support, Editorial Stipend as Co-editor in Chief, Clinical Therapeutics)Seqirus (Consultant)

scholarly journals Healthcare Outbreaks Associated With a Water Reservoir and Infection Prevention Strategies

2016 ◽  
Vol 62 (11) ◽  
pp. 1423-1435 ◽  
Author(s):  
Hajime Kanamori ◽  
David J. Weber ◽  
William A. Rutala
Keyword(s):  
Infection Prevention ◽  
Water Reservoir ◽  
Prevention Strategies

The Past, Present, and Future of Healthcare-Associated Infection Prevention in Pediatrics: Catheter-Associated Bloodstream Infections

2010 ◽  
Vol 31 (S1) ◽  
pp. S27-S31 ◽  
Author(s):  
Kristina A. Bryant ◽  
Danielle M. Zerr ◽  
W. Charles Huskins ◽  
Aaron M. Milstone
Keyword(s):  
Infection Prevention ◽  
Bloodstream Infections ◽  
Central Line ◽  
Morbidity And Mortality ◽  
Prevention Strategies ◽  
Healthcare Associated Infection ◽  
Research Topics ◽  
The Past ◽  
Healthcare Associated ◽  
Current Practices

Central line–associated bloodstream infections cause morbidity and mortality in children. We explore the evidence for prevention of central line–associated bloodstream infections in children, assess current practices, and propose research topics to improve prevention strategies.

Targeted Surveillance to Identify Children Colonized with Vancomycin-Resistant Enterococcus in the Pediatric Intensive Care Unit

2010 ◽  
Vol 31 (1) ◽  
pp. 95-98 ◽  
Author(s):  
Aaron M. Milstone ◽  
Lisa L. Maragakis ◽  
Karen C. Carroll ◽  
Trish M. Perl
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Infection Prevention ◽  
Pediatric Intensive Care ◽  
Vancomycin Resistant Enterococcus ◽  
Prevention Strategies ◽  
Asymptomatic Patients ◽  
Vancomycin Resistant ◽  
Pediatric Infection

Performing admission surveillance cultures is a resource-intensive strategy to identify asymptomatic patients with vancomycin-resistant Enterococcus (VRE) colonization. We measured VRE prevalence among children admitted to the pediatric intensive care unit. Targeted surveillance captured 94% of VRE-colonized children and may be an effective strategy to identify VRE carriers and facilitate pediatric infection prevention strategies.

scholarly journals Cost-effectiveness analysis of SARS-CoV-2 infection prevention strategies including pre-endoscopic virus testing and use of high risk personal protective equipment

Endoscopy ◽  
2020 ◽  
Author(s):  
Alanna Ebigbo ◽  
Christoph Römmele ◽  
Christina Bartenschlager ◽  
Selin Temizel ◽  
Elisabeth Kling ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
High Risk ◽  
Personal Protective Equipment ◽  
Infection Prevention ◽  
High Volume ◽  
Protective Equipment ◽  
Prevalence Rates ◽  
Prevention Strategies ◽  
Universal Testing ◽  
Asymptomatic Patients

Abstract Background Infection prevention strategies to protect healthcare workers in endoscopy units during the post-peak phase of the COVID-19 pandemic are currently under intense discussion. In this paper, the cost-effectiveness of routine pre-endoscopy testing and high risk personal protective equipment (PPE) is addressed. Method A model based on theoretical assumptions of 10 000 asymptomatic patients presenting to a high volume center was created. Incremental cost-effectiveness ratios (ICERs) and absolute costs per endoscopy were calculated using a Monte Carlo simulation. Results ICER values for universal testing decreased with increasing prevalence rates. For higher prevalence rates (≥ 1 %), ICER values were lowest for routine pre-endoscopy testing coupled with use of high risk PPE, while cost per endoscopy was lowest for routine use of high risk PPE without universal testing. Conclusion In general, routine pre-endoscopy testing combined with high risk PPE becomes more cost-effective with rising prevalence rates of COVID-19.

scholarly journals MO961KIDNEY TRANSPLANTATION AS A TREATMENT OF CHOICE FOR AA AMYLOIDOSIS DUE TO PERIODIC FEVER SYNDROME

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ivana Dedinska ◽  
Karol Graňák ◽  
Matej Vnučák
Keyword(s):  
Early Childhood ◽  
Kidney Transplantation ◽  
Clinical Course ◽  
Periodic Fever ◽  
Periodic Fever Syndrome ◽  
Aa Amyloidosis ◽  
Periodic Fever Syndromes ◽  
Post Transplant ◽  
Fever Syndromes ◽  
End Stage

Abstract Background and Aims Renal AA amyloidosis is the most serious complication of periodic fever syndrome, which, inadequate suppression, due to persistent inflammation, leads to nephrotic syndrome and renal failure over several years. In most cases, periodic fever syndromes begin to manifest clinically in early childhood. Occurrence in adulthood is considered rare and is associated with a poorer clinical course. Kidney transplantation is an effective and safe treatment for end-stage chronic kidney disease (CKD) based on AA amyloidosis. Method We present cases of two patients after deceased donor kidney transplantation, who have been diagnosed with adult periodic fever syndrome. Conclusion Periodic fever syndromes are diseases beginning to manifest clinically in early childhood in 60–90% of cases, most often in the case of familial Mediterranean fever around 4 years of age, in the case of CAPS usually only a few months after birth. Occurrence in adulthood is considered rare and is associated with a poorer clinical course. Kidney transplantation is an effective and safe treatment of end-stage CKD based on AA amyloidosis associated with periodic fever syndrome. Adequate targeted treatment against IL-1 or TNF is important and appears to be safe during the post-transplant period, with regular monitoring of renal function, acute phase inflammatory reactants, and histological findings by protocol graft biopsies. It will be important and necessary to assess the development of diseases in the post-transplant period in the long term.

scholarly journals AN INSIGHT INTO AYURVEDIC VIEW OF SARS -COVID – 19

2020 ◽  
Vol 8 (7) ◽  
pp. 3925-3929
Author(s):  
Sreelakshmi S ◽  
Varghese Jibi ◽  
Manna Mathew ◽  
Priyanka Yadav
Keyword(s):  
Standard Treatment ◽  
Lifestyle Changes ◽  
Personal Hygiene ◽  
Treatment Modalities ◽  
Effective Management ◽  
Treatment Protocols ◽  
Health Crisis ◽  
Health Measures ◽  
Care Health ◽  
Insight Into

The Covid - 19 pandemic is defining the global health crisis of our time and occurs to be the greatest chal-lenge. The number of people getting affected and deaths are raising daily throughout the world. COVID-19 is the infectious disease caused by the most recently discovered Corona virus. The situation is much more than a health crisis with a potential to create devastating situations at social, economic, and political levels. Till date, no effective management to address this infection has been identified and attempts are being made to integrate a few traditional interventions along with standard treatment protocols of COVID-19. Ayurveda’s extensive knowledge is based on preventive care, health measures and boosting immunity. Contribution of Ayurveda in the management of various communicable and non-communicable diseases cannot be undermined. Through its wider concepts and treatment modalities, it has greater potential to ad-dress such situations. Awareness about the mode of spread of this disease is recommended highly to pre-vent oneself from falling prey to the disease. The large resource of time-tested traditional knowledge has to be used for the benefit of mankind. In addition to the personal hygiene and social distancing measures, it is of immense importance to improve individual’s natural defence system (immunity). Ayurveda can play a major role in mitigating the spread of COVID -19 by implementing some lifestyle changes along with sim-ple herbal medications and procedures by properly classifying and distinguishing the stage of the disease.

scholarly journals Clinical spectrum, geographical variability of COVID-19 and its implications

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Md. Hasanul Banna Siam ◽  
Abdullah Al Mosabbir ◽  
Nahida Hannan Nishat ◽  
Ahsan Ahmed ◽  
Mohammad Sorowar Hossain
Keyword(s):  
Coming Out ◽  
Clinical Manifestations ◽  
Vital Role ◽  
Clinical Spectrum ◽  
Surveillance Strategy ◽  
Health Crisis ◽  
Atypical Symptoms ◽  
Public Health Crisis ◽  
Number Of Patients ◽  
The Common

: The coronavirus disease 2019 (COVID-19) pandemic has triggered a worldwide unprecedented public health crisis. Initially, COVID-19 was considered as a disease of the respiratory system as fever and at least one respiratory symptom was used to identify a suspected COVID-19 case. But there are now numerous reports of COVID-19 patients presenting with myriads of extrapulmonary symptoms and a substantial number of patients are asymptomatic as well. Additionally, there are significant clinical and epidemiological variations of severe acute respiratory syndrome coronavirus 2 (SARSCOV-2) infection across different geographical locations. The updated research thus challenges the existing surveillance system that is mainly based on fever and respiratory symptoms. As countries are coming out of lockdown to save economic fallout, a revised surveillance strategy is required to effectively identify and isolate the correct patients. Besides, since developing countries are becoming the new epicenters of pandemic and there are limited resources for RT-PCR based tests, so documenting the clinical spectrum can play a vital role in the syndromic clinical diagnosis of COVID-19. A plethora of atypical symptoms also aids in guiding better treatment and remains as a source for further research. It is therefore crucial to understand the common and uncommon clinical manifestations of SARS-COV-2 infection and its variability across different geographic regions.

Hereditary periodic fever syndromes

2020 ◽  
pp. 2207-2218
Author(s):  
Helen J. Lachmann ◽  
Stefan Berg ◽  
Philip N. Hawkins
Keyword(s):  
Clinical Features ◽  
Periodic Fever ◽  
Mevalonate Kinase ◽  
Tnf Receptor ◽  
Aa Amyloidosis ◽  
Periodic Fever Syndromes ◽  
Hereditary Periodic Fever Syndromes ◽  
Hereditary Periodic Fever ◽  
Fever Syndromes ◽  
Wells Syndrome

The hereditary periodic fever syndromes or hereditary autoinflammatory diseases are disorders of innate immunity that mostly present in childhood and are characterized by recurrent, self-limiting, seemingly unprovoked episodes of fever and systemic inflammation that occur in the absence of autoantibody production or identifiable infection. Disorders include (1) familial Mediterranean fever (FMF), due to mutations in the gene encoding pyrin; (2) tumour necrosis factor (TNF) receptor-associated periodic syndrome (TRAPS), due to mutations in a gene for a TNF receptor; (3) mevalonate kinase deficiency and period fever (MKD), caused by mutations in the mevalonate kinase gene; and (4) the cryopyrin-associated periodic syndromes (CAPS), which include (a) familial cold urticarial syndrome, (b) Muckle–Wells syndrome, and (c) chronic infantile neurological, cutaneous, and articular syndrome. With advances in genetics, further syndromes are continually being recognized. These are all extremely rare and in the majority are only known to affect a handful of kindred or individuals. Diagnosis relies on recognition of suggestive clinical features that are almost always accompanied by a substantial acute phase response, and is supported by genetic testing. With the exception of FMF, which is a common disease in certain geographic areas, hereditary periodic fever syndromes are rare and easily overlooked in the differential diagnosis of recurrent fevers. Clinical features and management—attacks can be mild to debilitating and short to prolonged, while their most feared complication is AA amyloidosis. Effective therapies are available for some syndromes, for example: (1) FMF—daily prophylactic colchicine prevents clinical attacks and susceptibility to AA amyloidosis, (2) CAPS—treatment with anti-IL-1 agents produces rapid and often complete clinical and serological remission, and (3) TRAPS—anti-IL therapies are extremely effective.

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