scholarly journals Viral and bacterial infection elicit distinct changes in plasma lipids in febrile children

2019 ◽  
Author(s):  
Xinzhu Wang ◽  
Ruud Nijman ◽  
Stephane Camuzeaux ◽  
Caroline Sands ◽  
Heather Jackson ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Viral Infection ◽  
Bacterial Infections ◽  
Plasma Lipids ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cholesterol Sulfate ◽  
Inappropriate Use ◽  
Clinical Signs And Symptoms ◽  
The Uk

AbstractFever is the most common reason that children present to Emergency Departments in the UK. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. As a result, many children are prescribed antibiotics often unnecessarily, while others with life-threatening bacterial infections can remain untreated. The ‘omics’ approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n=20) and confirmed viral infection (n=20). We show for the first time that bacterial and viral infection elicit distinct changes in the host lipidome. Glycerophosphoinositol, sphingomyelin, lysophosphotidylcholine and cholesterol sulfate were increased in the confirmed virus infected group, while fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were increased in cases with confirmed bacterial infection. A combination of three lipids achieved the area under the receiver operating characteristic (ROC) curve of 0.918 (95% CI 0.835 to 1). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics.

scholarly journals Plasma lipid profiles discriminate bacterial from viral infection in febrile children

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Xinzhu Wang ◽  
◽  
Ruud Nijman ◽  
Stephane Camuzeaux ◽  
Caroline Sands ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Viral Infection ◽  
Clinical Signs ◽  
Plasma Lipid ◽  
Signs And Symptoms ◽  
Infected Group ◽  
Cholesterol Sulfate ◽  
Inappropriate Use ◽  
Clinical Signs And Symptoms ◽  
Metabolic Biomarkers

AbstractFever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The ‘omics’ approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics.

scholarly journals Assessment of the utility of Yale observation scale as a predictor of bacteremia in children aged 3 months to 36 months

2019 ◽  
Vol 6 (2) ◽  
pp. 559
Author(s):  
P. Sudhakar ◽  
P. Ajitha
Keyword(s):  
Bacterial Infections ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Roc Curves ◽  
Operating Characteristics ◽  
Good Tool ◽  
Early Management ◽  
Observation Scale ◽  
Clinical Signs And Symptoms ◽  
Yale Observation Scale

Background: The Yale observation scale (YOS) is an illness severity helps to diagnose bacteremia based on simple noninvasive clinical signs and symptoms. The aim of the present study was to assess the utility of YOS as a predictor of bacterial infection in febrile children aged 3 to 36 months.Methods: This prospective observational study was conducted on 200 children aged 3 to 36 months presenting with fever, at the Institute of Child Health and Hospital for Children during the period from April 2016 to September 2016. Rectal temperature was taken for all children. Clinical examination was done as required based on the YOS and scores were given accordingly at the time of initial presentation of the child before invasive investigations. All the observation was assessed statistically and receiver operating characteristics (ROC) curve was performed to analyze the sensitivity of the YOS.Results: Highly significant correlation (p=0.0001) was found to exist between the age of the child, duration of the fever, higher body temperature >104, WBC count, ANC and improved condition of patient with higher YOS. ROC curves showed that the sensitivity and specificity of YOS at the best cut off value of 14.5 was found to be 97% and 79.6% respectively.Conclusions: YOS is very good tool for predicting bacteremia in young febrile children based on simple non-invasive clinical signs and symptoms. The findings ruled out by YOS aids in the immediate and early management of bacterial infections before the arrival of the results of the biochemical diagnostic tests.

scholarly journals Microbial and Molecular Screening of Swimmers Associated with Conjunctivitis from Public Swimming Pools in Erbil Province

2020 ◽  
Vol 31 (4) ◽  
pp. 36
Author(s):  
Sazan Q. Maulud ◽  
Lawin A. Omar ◽  
Ahmed Nawzad Hassan ◽  
Rastee H. Saeed
Keyword(s):  
Bacterial Infection ◽  
Viral Infection ◽  
Bacterial Infections ◽  
Signs And Symptoms ◽  
Swimming Pool ◽  
Infection Frequency ◽  
Swimming Pools ◽  
Microbial Infection ◽  
Safe Place ◽  
Microbial Agents

Public swimming pools, if not treated well could work as a reservoir of many microorganisms that cause infections among swimmers. Conjunctivitis is one of those common infections that resulted from microbial and non-microbial agents, microbial conjunctivitis caused by viral (mainly Human adenovirus HAdVs) and bacterial infections. This study aims to investigate the prevalence of microbial causative agents of swimming pool conjunctivitis and evaluating the swimming pools in terms of health and the extent of contamination in Erbil province. Eighty-eight specimens were isolated and identified from the swimmers showing signs and symptoms of swimming pool conjunctivitis from different public swimming pools in Erbil city from January to the end of February 2020. Sample identified using bacteriological methods, serology test, and nested PCR for detection of HAdVs. The swimmers samples consisted of 60 males and 28 females, and they were aged between 16-56 years. The obtained results showed that, out of 88 samples, 36 (40.91%) detected as a viral infection and 29 (32.95%) as bacterial infection, while, 23 (26.13%) showed no growth (non-microbial infection). Frequency of swimming pool conjunctivitis among male and female was 60 (68.2%) and 28 (31.8%) respectively. Depending on the obtained results, it can be concluded that conjunctivitis could result from viral, bacterial, and non-microbial agents, a viral infection is the main cause followed by a bacterial infection, also public swimming pools are not a safe place and swimmers are subjected to infection by different pathogens.

scholarly journals A Review of Hantavirus Research in Indonesia: Prevalence in Humans and Rodents, and the Discovery of Serang Virus

Viruses ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 698
Author(s):  
Lukman ◽  
Kosasih ◽  
Ibrahim ◽  
Pradana ◽  
Neal ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Clinical Signs ◽  
Febrile Illness ◽  
Signs And Symptoms ◽  
Molecular Evidence ◽  
Rt Pcr ◽  
Seoul Virus ◽  
Seroprevalence Data ◽  
Clinical Signs And Symptoms ◽  
Almost All

Dengue and other common tropical infectious diseases of similar clinical presentation are endemic in Indonesia, which may lead to an underestimation of the prevalence of hantavirus (HTV) infection in the country. To better understand the current burden of HTV infection, this study aimed to both identify acute HTV infection among hospitalized patients with fever and to determine the overall seroprevalence of HTV. These results were further considered within the context of previously reported HTV infection in humans and animals in Indonesia by conducting a review of published literature. As part of an observational cohort study of acute febrile illness, this sub-study retrospectively analyzed blood specimens obtained during admission, during the 2–4-week convalescent period, and three months after admission. Convalescent specimens from patients with clinical signs and symptoms of HTV infection were first screened for HTV IgG. When positive, convalescent specimens and paired acute specimens were screened for HTV IgM, and paired acute specimens were tested for HTV by Reverse Transcription Polymerase Chain Reaction (RT-PCR). A literature review of HTV in Indonesia was conducted on manuscripts manually reviewed for relevance after identification from a search using the terms “hantavirus/Seoul virus” and “Indonesia”. From patients at eight hospitals in seven provincial capitals, HTV IgG seroprevalence was 11.6% (38/327), with the highest being in Denpasar (16.3%, 7/43) and the lowest being in Yogyakarta (3.4%, 1/31). Anti-HTV IgG was most prevalent in adults (13.5%, 33/244) and males (15.6%, 29/186). Acute HTV infections were identified in two subjects, both of whom had Seoul virus. In Indonesia, HTVs have been studied in humans and animals since 1984. Over the past 35 years, the reported seroprevalences in rodents ranged from 0% to 34%, and in humans from 0% to 13%. Fourteen acute infections have been reported, including one in a tourist returning to Germany, but only two have been confirmed by RT-PCR. Almost all rodent and human surveillance results demonstrated serological and molecular evidence of Seoul virus infection. However, in Semarang, anti-Puumala virus IgM has been detected in humans and Puumala RNA in one rodent. In Serang, a new virus named Serang virus was identified due to its differences from Seoul virus. In Maumere, HTV and Leptospira spp. were identified simultaneously in rodents. The burden of HTV infection in Indonesia is underestimated, and additional studies are needed to understand the true prevalence. Seroprevalence data reported here, previous observations of HTV co-infections in rodents, and the prevalence of rodent-borne bacterial infections in Indonesia suggest that the population may be routinely encountering HTVs. While Seoul virus appears to be the most prevalent HTV in the country, further studies are needed to understand which HTVs are circulating.

scholarly journals Confidence and willingness among laypersons in the UK to act in a head injury situation: a qualitative focus group study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033531
Author(s):  
Stefan Tino Kulnik ◽  
Mary Halter ◽  
Ann Hilton ◽  
Aidan Baron ◽  
Stuart Garner ◽  
...  
Keyword(s):  
Decision Making ◽  
Head Injury ◽  
Focus Group ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
First Aid ◽  
Snowball Sampling ◽  
Focus Group Study ◽  
Clinical Signs And Symptoms ◽  
The Uk

ObjectivesTo explore factors influencing confidence and willingness among laypersons in the UK to act in a head injury situation, in order to inform first aid education offered by the British Red Cross.DesignQualitative focus group study.SettingSouth East England.ParticipantsForty-four laypersons (37 women, 7 men) were purposively recruited from the general public using snowball sampling, into one focus group each for six population groups: parents of young children (n=8), informal carers of older adults (n=7), school staff (n=7), sports coaches (n=2), young adults (n=9) and ‘other’ adults (n=11). The median (range) age group across the sample was 25–34 years (18–24, 84–95). Participants were from Asian (n=6), Black (n=6), Mixed (n=2) and White (n=30) ethnic backgrounds.ResultsThe majority of participants described being confident and willing to act in a head injury scenario if that meant calling for assistance, but did not feel sufficiently confident or knowledgeable to assist or make decisions in a more involved way. Individuals’ confidence and willingness presented as fluid and dependent on an interplay of situational and contextual considerations, which strongly impacted decision-making: prior knowledge and experience, characteristics of the injured person, un/observed head injury, and location and environment. These considerations may be framed as enablers or barriers to helping behaviour, impacting decision-making to the same extent as—or even more so than—the clinical signs and symptoms of head injury. An individual conceptual model is proposed to illustrate inter-relationships between these factors.ConclusionsOur findings show that confidence and willingness to act in a head injury scenario are dependent on several contextual and situational factors. It is important to address such factors, in addition to knowledge of clinical signs and symptoms, in first aid education and training to improve confidence and willingness to act.

scholarly journals Comparative analysis of COVID-19 guidelines from six countries: A qualitative study on the US, China, South Korea, the UK, Brazil and Haiti

2020 ◽  
Author(s):  
JI YOUN YOO ◽  
Samia Valeria Ozorio Dutra ◽  
Dany Fanfan ◽  
Sarah Sniffen ◽  
Hao Wang ◽  
...  
Keyword(s):  
Qualitative Study ◽  
South Korea ◽  
Healthcare Professionals ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Healthcare Systems ◽  
Contact Tracing ◽  
Clinical Signs And Symptoms ◽  
The Government ◽  
The Uk

Abstract Background: In late January, a worldwide crisis known as COVID-19 was declared a Public Health Emergency of International Concern by the WHO. Within only a few weeks, the outbreak took on pandemic proportions, affecting over 100 countries. It was a significant issue to prevent and control COVID-19 on both national and global scales due to the dramatic increase in confirmed cases worldwide. Government guidelines provide a fundamental resource for communities, as they guide citizens on how to protect themselves against COVID-19, however, they also provide critical guidance for policy makers and healthcare professionals on how to take action to decrease the spread of COVID-19. We aimed to identify the differences and similarities between six different countries' (US, China, South Korea, UK, Brazil and Haiti) government-provided community and healthcare system guidelines, and to explore the relationship between guideline issue dates and the prevalence/incidence of COVID-19 cases.Methods: To make these comparisons, this exploratory qualitative study used document analysis of government guidelines issued to the general public and to healthcare professionals. Documents were purposively sampled (N=55) and analyzed using content analysis.Results: The major differences in the evaluation and testing criteria in the guidelines across the six countries centered around the priority of testing for COVID-19 in the general population, which was strongly dependent on each country’s healthcare capacity. However, the most similar guidelines pertained to the clinical signs and symptoms of COVID-19, and methods to prevent its contraction.Conclusion: In the initial stages of the outbreak, certain strategies were universally employed to control the deadly virus’s spread, including quarantining the sick, contact tracing, and social distancing. However, each country dealt with differing healthcare capacities, risks, threats, political and socioeconomic challenges, and distinct healthcare systems and infrastructure. Acknowledging these differences highlights the importance of examining the various countries’ response to the COVID-19 pandemic with a nuanced view, as each of these factors shaped the government guidelines distributed to each country’s communities and healthcare systems.

scholarly journals Comparative analysis of COVID-19 guidelines from six countries: a qualitative study on the US, China, South Korea, the UK, Brazil, and Haiti

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ji Youn Yoo ◽  
Samia Valeria Ozorio Dutra ◽  
Dany Fanfan ◽  
Sarah Sniffen ◽  
Hao Wang ◽  
...  
Keyword(s):  
Qualitative Study ◽  
South Korea ◽  
Healthcare Professionals ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Healthcare Systems ◽  
Contact Tracing ◽  
Clinical Signs And Symptoms ◽  
The Government ◽  
The Uk

Abstract Background In late January, a worldwide crisis known as COVID-19 was declared a Public Health Emergency of International Concern by the WHO. Within only a few weeks, the outbreak took on pandemic proportions, affecting over 100 countries. It was a significant issue to prevent and control COVID-19 on both national and global scales due to the dramatic increase in confirmed cases worldwide. Government guidelines provide a fundamental resource for communities, as they guide citizens on how to protect themselves against COVID-19, however, they also provide critical guidance for policy makers and healthcare professionals on how to take action to decrease the spread of COVID-19. We aimed to identify the differences and similarities between six different countries’ (US, China, South Korea, UK, Brazil and Haiti) government-provided community and healthcare system guidelines, and to explore the relationship between guideline issue dates and the prevalence/incidence of COVID-19 cases. Methods To make these comparisons, this exploratory qualitative study used document analysis of government guidelines issued to the general public and to healthcare professionals. Documents were purposively sampled (N = 55) and analyzed using content analysis. Results The major differences in the evaluation and testing criteria in the guidelines across the six countries centered around the priority of testing for COVID-19 in the general population, which was strongly dependent on each country’s healthcare capacity. However, the most similar guidelines pertained to the clinical signs and symptoms of COVID-19, and methods to prevent its contraction. Conclusion In the initial stages of the outbreak, certain strategies were universally employed to control the deadly virus’s spread, including quarantining the sick, contact tracing, and social distancing. However, each country dealt with differing healthcare capacities, risks, threats, political and socioeconomic challenges, and distinct healthcare systems and infrastructure. Acknowledging these differences highlights the importance of examining the various countries’ response to the COVID-19 pandemic with a nuanced view, as each of these factors shaped the government guidelines distributed to each country’s communities and healthcare systems.

Coronary heart disease

2014 ◽  
pp. 109-118
Keyword(s):  
Coronary Arteries ◽  
Stable Angina ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Premature Death ◽  
Common Symptom ◽  
Acute Mi ◽  
Coronary Syndromes ◽  
Clinical Signs And Symptoms ◽  
The Uk

CHD remains one of the largest causes of premature death in the UK. Angina is the most common symptom of CHD. It is usually described as a central, retrosternal pain or ache that is crushing or choking in nature. Pain may radiate down the left arm and/or up into the neck and is often accompanied by shortness of breath and sweating. Some patients may describe it as chest discomfort. The presentation of CHD, however, covers a broad spectrum of clinical signs and symptoms that vary in severity. An individual may be asymptomatic despite disease within the coronary arteries; may present with gradually worsening symptoms of angina; or the first presentation may be death following an acute MI. The progress of the disease is variable, depending on the individual’s risk factors and the coronary arteries affected. Terminology varies but, generally speaking, CHD is divided into two subtypes: stable angina—with reversible ischaemia, and acute coronary syndromes—which is an umbrella term that includes unstable angina and MI. This chapter outlines the pathophysiology and clinical management of stable angina.

Coronary heart disease: stable angina

2020 ◽  
pp. 129-140
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Stable Angina ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Premature Death ◽  
Common Symptom ◽  
Retrosternal Pain ◽  
Clinical Signs And Symptoms ◽  
The Uk

Although rates of premature death from coronary heart disease (CHD) have fallen 80% over the past 40 years, it is still a significant cause of premature death in the UK. Angina is the most common symptom of CHD. It is usually described as a central, retrosternal pain or ache that is crushing or choking in nature. Pain may radiate down the left arm and/or up into the neck and is often accompanied by shortness of breath (SOB) and sweating. Some patients may describe it as chest discomfort. The presentation of CHD, however, covers a broad spectrum of clinical signs and symptoms that vary in severity. An individual may be asymptomatic despite disease within the coronary arteries; may present with gradually worsening symptoms of angina; or the first presentation may be death following an acute myocardial infarction (MI). This chapter outlines the pathophysiology and clinical management of stable angina.

Fatal Necrotizing Fasciitis as a Consequence of Blunt Trauma: A Case Report

2021 ◽  
Vol 11 (3) ◽  
pp. 170-173
Author(s):  
Chandrakanth HV ◽  
Hemanth Kumar RG ◽  
Smitha Rani
Keyword(s):  
Case Report ◽  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Necrotizing Fasciitis ◽  
Subcutaneous Tissue ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Clinical Signs And Symptoms ◽  
Medicolegal Issues ◽  
Early Debridement

Necrotizing fasciitis is an uncommon lethal bacterial infection that involves the subcutaneous tissue and fascia. It can be mono or polymicrobial infection. The diagnosis is mainly dependent on clinical signs and symptoms. Trauma is the commonest cause for it. The early signs and symptoms may mimic cellulitis. We present a case of necrotizing fasciitis following an assault. The patient was received in a state of shock. Despite all measures, the patient could not be saved. Early debridement and antibiotic therapy have a key role in the prognosis of the disease. Medicolegal issues can arise when the disease develops post-assault because of the vague and unpredictable nature of the disease and its challenging prognosis.

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