scholarly journals COVID‐19 among children seeking primary paediatric care with signs of an acute infection

2021 ◽  
Author(s):  
Sebastian Hoehl ◽  
Felix Schneider ◽  
Martin Eckrich ◽  
Tim Ole Gründler ◽  
Pera Silvija Jerkic ◽  
...  
Keyword(s):  
Acute Infection ◽  
Paediatric Care

Multifactorial analysis of clinical laboratory signs, the levels of IL-17A, IL-23, IL-33, IL-35, and specific antibodies in the serum of patients with Lyme borreliosis without erythema migrans

2020 ◽  
Vol 4 (11) ◽  
pp. 676-681
Author(s):  
V.V. Sapozhnikova ◽  
◽  
A.L. Bondarenko ◽  
Keyword(s):  
Principal Component Analysis ◽  
Lyme Borreliosis ◽  
Clinical Laboratory ◽  
Acute Infection ◽  
Erythema Migrans ◽  
Principal Component ◽  
Component Analysis ◽  
Control Group ◽  
Multifactorial Analysis ◽  
Specific Antibodies

Aim: to determine the association between clinical laboratory parameters, the production of cytokines (IL-17A, -23, -33, -35), and specific IgM and IgG in the serum of patients with Lyme borreliosis without erythema migrans. Patients and Methods: complete blood count, the concentrations of IL-17A, -23, -33, -35, and the levels of specific IgM and IgG were measured during acute infection and convalescence (n=30). The control group included age- and sex-matched healthy individuals (n=30). Statistical analysis was performed using the StatSoft Statistica v 10.0 software (parametric and non-parametric methods and multifactorial analysis, i.e., principal component analysis). Results: most (80%) patients with Lyme borreliosis without erythema migrans are the people of working age. In most patients, the combination of the specific antibodies against Borrelia afzelii and Borrelia garinii (76.7%) and severe intoxication and inflammatory process (100%) were detected. Moderate and severe disease associated with meningism was diagnosed in 90% and 10%, respectively. The mean duration of hectic period was 8.3±1.27 days. Abnormal ECG was reported in 40% of patients, i.e., conduction abnormalities in 20%, sinus bradycardia in 16.7%,and sinus tachycardia in 3.3%. The clinical laboratory signs of hepatitis without jaundice were identified in 26.7%. During treatment, the significant reduction in band and segmented neutrophil counts as well as the significant increase in platelet count were revealed compared to these parameters at admission. Abnormal cytokine levels (i.e., the increase in IL-17A, -23, -33 and the deficiency of IL-35) were detected. Conclusions: multifactorial analysis has demonstrated that the severity of immunological abnormalities in patients with Lyme borreliosis without erythema migrans is associated with fever, cardiac and liver disorders, the high levels of IL-23 and IL-33, and the lack of IL-35 and specific IgM and IgG. KEYWORDS: tick-borne borreliosis, Lyme disease without erythema migrans, clinical laboratory signs, cytokines, specific antibodies, multifactorial analysis, principal component analysis. FOR CITATION: Sapozhnikova V.V., Bondarenko A.L. Multifactorial analysis of clinical laboratory signs, the levels of IL-17A, IL-23, IL-33, IL-35, and specific antibodies in the serum of patients with Lyme borreliosis without erythema migrans. Russian Medical Inquiry. 2020;4(11):676–681. DOI: 10.32364/2587-6821-2020-4-11-676-681.

EPIDEMIC THYROIDITIS

1964 ◽  
Vol 45 (3) ◽  
pp. 381-401 ◽  
Author(s):  
G. Hintze ◽  
P. Fortelius ◽  
J. Railo
Keyword(s):  
Thyroid Gland ◽  
Distribution Pattern ◽  
Needle Biopsy ◽  
Serum Proteins ◽  
Acute Infection ◽  
Thyroid Tissue ◽  
Subacute Thyroiditis ◽  
Present Observation ◽  
Upper Respiratory Tract ◽  
Endemic Goitre

ABSTRACT A type of subacute thyroiditis occurring epidemically in a factory in Helsinki was observed in 44 cases. In every case the thyroiditis followed an acute infection of the upper respiratory tract. The variation in incidence during one and a half years was in good agreement with that of the acute infection. Since Helsinki is in an endemic goitre region, the fact that the disease was of the migrating type was of great diagnostic importance. In all cases but one, the nodules have persisted. One case of asymptomatic thyroiditis was seen. In the majority of the patients the thyroid gland had been carefully palpated before the thyroiditis occurred, and in all cases the condition was followed up by the same investigator. Special attention was paid to changes in the iodine metabolism, the serum cholesterol, the electrophoretic distribution pattern of the serum proteins, and the circulating thyroid auto-antibodies. In many cases needle biopsy of the thyroid gland was performed. Thyroid function invariably returned to normal with time, although one patient remained in a hypothyroid state for about a year. In no cases were thyroid auto-antibodies found. For the beta-globulin fraction, the electrophoretic distribution pattern of the serum proteins gave values which were still not normalized in any case, and only in two cases was the alpha2-fraction normalized. The needle biopsy, when thyroid tissue was obtained, showed almost the same picture as in endemic goitre, but in some specimens nonspecific inflammatory changes were seen. Prednisolone relieved the symptoms, but did not affect the course of the disease. According to the present observation this type of epidemic thyroiditis would seem to represent a form of nonspecific subacute thyroiditis.

Dynamics of T Cells Repertoire During Trypanosoma cruzi Infection and its Post-Treatment Modulation

2019 ◽  
Vol 26 (36) ◽  
pp. 6519-6543 ◽  
Author(s):  
Adriana Egui ◽  
Paola Lasso ◽  
Elena Pérez-Antón ◽  
M. Carmen Thomas ◽  
Manuel Carlos López
Keyword(s):  
Immune Response ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Cardiac Tissue ◽  
Acute Infection ◽  
Clinical Status ◽  
Chronic Phase ◽  
Parasite Load ◽  
Chronic Patients ◽  
Cruzi Infection

Chagas disease courses with different clinical phases and has a variable clinical presentation and progression. The acute infection phase mostly exhibits a non-specific symptomatology. In the absence of treatment, the acute phase is followed by a chronic phase, which is initially asymptomatic. This chronic asymptomatic phase of the disease is characterized by a fragile balance between the host’s immune response and the parasite replication. The loss of this balance is crucial for the progression of the sickness. The virulence and tropism of the T. cruzi infecting strain together to the inflammation processes in the cardiac tissue are the main factors for the establishment and severity of the cardiomyopathy. The efficacy of treatment in chronic Chagas disease patients is controversial. However, several studies carried out in chronic patients demonstrated that antiparasitic treatment reduces parasite load in the bloodstream and leads to an improvement in the immune response against the Trypanosoma cruzi parasite. The present review is mainly focused on the cellular patterns associated to the clinical status and the evolution of the disease in chronic patients, as well as the effectiveness of the treatment related to T. cruzi infection control. Therefore, an emphasis is placed on the dynamics of specific-antigens T cell subpopulations, their memory and activation phenotypes, their functionality and their contribution to pathogenesis or disease control, as well as their association with risk of congenital transmission of the parasite.

A qualitative descriptive inquiry of the influences on nurses’ missed care decision‐making processes in acute hospital paediatric care

2020 ◽  
Vol 28 (8) ◽  
pp. 1929-1939
Author(s):  
Annamaria Bagnasco ◽  
Nicoletta Dasso ◽  
Silvia Rossi ◽  
Fiona Timmins ◽  
Giuseppe Aleo ◽  
...  
Keyword(s):  
Decision Making ◽  
Acute Hospital ◽  
Paediatric Care ◽  
Decision Making Processes ◽  
Qualitative Descriptive ◽  
Missed Care ◽  
Care Decision

scholarly journals 1005 Antibiotic-Impregnated Calcium Sulfate Beads Are Not Effective in the Primary Prevention of Infection in Open Femur and Tibia Fractures

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Fung ◽  
A Ward ◽  
K Patel ◽  
M Krkovic
Keyword(s):  
Primary Prevention ◽  
Infection Rate ◽  
Calcium Sulfate ◽  
Acute Infection ◽  
Open Fractures ◽  
Prevention Of Infection ◽  
Significant Difference ◽  
Tibia Fractures ◽  
Systemic Antibiotics

Abstract Introduction Infection is a major complication of open fractures. Antibiotic-impregnated calcium sulfate (AICS) beads are widely used as an adjuvant to systemic antibiotics. Whilst their efficacy in the secondary prevention of infection is established, we present the first retrospective study evaluating AICS beads in the primary prevention of infection in open fractures. Method 214 open femur and tibia fractures in 207 patients were reviewed over a seven-year period. 148 fractures received only systemic antibiotic prophylaxis. 66 fractures also received AICS beads. The occurrence of acute infection (wound infection and acute osteomyelitis) was recorded, as well as that of long-term complications (chronic osteomyelitis, non-union and death). Results Fractures that received AICS with systemic antibiotics had an overall acute infection rate of 42% (28/66), compared to 43% (63/148) in fractures that received only systemic antibiotics (p > 0.05). There was no significant difference in infection rate even when fractures were stratified by Gustilo-Anderson grade. There was also no significant difference in the rate of long-term complications. Conclusions Our results indicate that the adjuvant use of AICS beads is not effective for the primary prevention of acute infection or long-term complications in open leg fractures. Further research is needed to elucidate the factors influencing the outcomes of AICS use.

scholarly journals Using body temperature and variables commonly available in the EHR to predict acute infection: a proof-of-concept study showing improved pretest probability estimates for acute COVID-19 infection among discharged emergency department patients

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Carl T. Berdahl ◽  
An T. Nguyen ◽  
Marcio A. Diniz ◽  
Andrew J. Henreid ◽  
Teryl K. Nuckols ◽  
...  
Keyword(s):  
Emergency Department ◽  
Body Temperature ◽  
Acute Infection ◽  
Time Of Day ◽  
Pretest Probability ◽  
Absolute Difference ◽  
Proof Of Concept ◽  
Easy Method ◽  
Concept Study ◽  
Probability Estimates

Abstract Objectives Obtaining body temperature is a quick and easy method to screen for acute infection such as COVID-19. Currently, the predictive value of body temperature for acute infection is inhibited by failure to account for other readily available variables that affect temperature values. In this proof-of-concept study, we sought to improve COVID-19 pretest probability estimation by incorporating covariates known to be associated with body temperature, including patient age, sex, comorbidities, month, and time of day. Methods For patients discharged from an academic hospital emergency department after testing for COVID-19 in March and April of 2020, we abstracted clinical data. We reviewed physician documentation to retrospectively generate estimates of pretest probability for COVID-19. Using patients’ COVID-19 PCR test results as a gold standard, we compared AUCs of logistic regression models predicting COVID-19 positivity that used: (1) body temperature alone; (2) body temperature and pretest probability; (3) body temperature, pretest probability, and body temperature-relevant covariates. Calibration plots and bootstrap validation were used to assess predictive performance for model #3. Results Data from 117 patients were included. The models’ AUCs were: (1) 0.69 (2) 0.72, and (3) 0.76, respectively. The absolute difference in AUC was 0.029 (95% CI −0.057 to 0.114, p=0.25) between model 2 and 1 and 0.038 (95% CI −0.021 to 0.097, p=0.10) between model 3 and 2. Conclusions By incorporating covariates known to affect body temperature, we demonstrated improved pretest probability estimates of acute COVID-19 infection. Future work should be undertaken to further develop and validate our model in a larger, multi-institutional sample.

scholarly journals One Health Approach: An Overview of Q Fever in Livestock, Wildlife and Humans in Asturias (Northwestern Spain)

Animals ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 1395
Author(s):  
Alberto Espí ◽  
Ana del Cerro ◽  
Álvaro Oleaga ◽  
Mercedes Rodríguez-Pérez ◽  
Ceferino M. López ◽  
...  
Keyword(s):  
One Health ◽  
Roe Deer ◽  
Q Fever ◽  
Close Contact ◽  
Acute Infection ◽  
Pcr Analysis ◽  
Wild Ungulates ◽  
Domestic Ruminants ◽  
Iberian Red Deer ◽  
Northwestern Spain

This study aimed to investigate the seroprevalence of C. burnetii in domestic ruminants, wild ungulates, as well as the current situation of Q fever in humans in a small region in northwestern Spain where a close contact at the wildlife–livestock–human interface exists, and information on C. burnetii infection is scarce. Seroprevalence of C. burnetii was 8.4% in sheep, 18.4% in cattle, and 24.4% in goats. Real-time PCR analysis of environmental samples collected in 25 livestock farms detected Coxiella DNA in dust and/or aerosols collected in 20 of them. Analysis of sera from 327 wild ungulates revealed lower seroprevalence than that found in domestic ruminants, with 8.4% of Iberian red deer, 7.3% chamois, 6.9% fallow deer, 5.5% European wild boar and 3.5% of roe deer harboring antibodies to C. burnetii. Exposure to the pathogen in humans was determined by IFAT analysis of 1312 blood samples collected from patients admitted at healthcare centers with Q fever compatible symptoms, such as fever and/or pneumonia. Results showed that 15.9% of the patients had IFAT titers ≥ 1/128 suggestive of probable acute infection. This study is an example of a One Health approach with medical and veterinary institutions involved in investigating zoonotic diseases.

scholarly journals What’s going on following acute covid-19? Clinical characteristics of patients in an out-patient rehabilitation program

2021 ◽  
pp. 1-12
Author(s):  
Sergiu Albu ◽  
Nicolas Rivas Zozaya ◽  
Narda Murillo ◽  
Alberto Garcia-Molina ◽  
Cristian Andres Figueroa Chacón ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Acute Infection ◽  
Rehabilitation Program ◽  
Neuropsychological Impairment ◽  
Outpatient Rehabilitation ◽  
Screening Process ◽  
Icu Patients ◽  
Persistent Symptoms

BACKGROUND: Coronavirus disease 2019 (COVID-19) patients present long-lasting physical and neuropsychological impairment, which may require rehabilitation. OBJECTIVES: The current cross-sectional study characterizes post COVID-19 sequelae and persistent symptoms in patients in an outpatient rehabilitation program. METHODS: Thirty patients [16 post-ICU and 14 non-ICU; median age = 54(43.8–62) years; 19 men] presenting sequelae and/or persistent symptoms (>3 months after acute COVID-19) were selected of 41 patients referred for neurorehabilitation. Patients underwent physical, neuropsychological and respiratory evaluation and assessment of impact of fatigue and quality of life. RESULTS: The main reasons for referral to rehabilitation were: fatigue (86.6%), dyspnea (66.7%), subjective cognitive impairment (46.7%) and neurological sequelae (33.3%). Post-ICU patient presented sequelae of critical illness myopathy and polyneuropathy, stroke and encephalopathy and lower forced vital capacity compared to non-ICU patients. Cognitive impairment was found in 63.3% of patients, with a similar profile in both sub-groups. Increased physical fatigue, anxiety and depression and low quality of life were prevalent irrespective of acute COVID-19 severity. CONCLUSIONS: The variability of post COVID-19 physical and neuropsychological impairment requires a complex screening process both in ICU and non-ICU patients. The high impact of persistent symptoms on daily life activities and quality of life, regardless of acute infection severity, indicate need for rehabilitation.

Sign in / Sign up

Export Citation Format

Share Document