scholarly journals Inflammation and psychopathology in children following PICU admission: an exploratory study

2018 ◽  
Vol 21 (4) ◽  
pp. 139-144 ◽  
Author(s):  
Giorgia Caspani ◽  
Georgina Corbet Burcher ◽  
M Elena Garralda ◽  
Mehrengise Cooper ◽  
Christine M Pierce ◽  
...  
Keyword(s):  
Lymphocyte Count ◽  
Exploratory Study ◽  
Psychiatric Symptoms ◽  
White Cell Count ◽  
Post Traumatic Stress ◽  
Reactive Protein ◽  
Behavioural Difficulties ◽  
And Gender ◽  
Emotional And Behavioural Difficulties

BackgroundSurvivors of critical illness in childhood commonly display subsequent psychiatric symptoms including emotional and behavioural difficulties, and manifestations of post-traumatic stress disorder (PTSD). Anomalies in inflammatory profiles are an established finding in these childhood psychiatric conditions.ObjectiveThis exploratory study aimed to investigate whether abnormal peripheral blood inflammatory markers measured during paediatric intensive care unit (PICU) admission were associated with psychiatric symptoms after discharge.MethodsWe performed a prospective observational cohort study on 71 children with septic illness, meningoencephalitis and other critical disorders admitted to two PICUs between 2007 and 2010. 3–6 months following discharge, subjects were assessed for global psychiatric risk (ie, presence of emotional and behavioural difficulties on the parental Strengths and Difficulties Questionnaire (SDQ)), and for PTSD risk using the child-rated Impact of Events Scale (IES-8). Inflammatory and related biological markers were transcribed from PICU admission notes (white cell count, lymphocytes, neutrophils, C reactive protein (CRP), platelets, fibrinogen and lactate).FindingsGlobal psychiatric risk at follow-up was associated with abnormal lymphocyte count during admission (χ2=6.757, p=0.014, n=48). In children with sepsis, partial correlation analyses controlling for age and gender highlighted associations between (i) SDQ scores and low lymphocyte count (r=−0.712; p=0.009, n=14), and (ii) IES-8 score and high CRP levels (r=0.823; p=0.006, n=11). These associations remained after correction for multiple comparisons.ConclusionThese results support the hypothesis that acute inflammation may play a role in determining the development of psychopathology following PICU admission.Clinical implicationsIf the findings are replicated, they may help to better highlight which children are at risk of post-PICU psychopathology and appropriately target follow-up.

scholarly journals Pyomyositis of the pectineus muscle in an adolescent male

2017 ◽  
Vol 99 (7) ◽  
pp. e216-e218 ◽  
Author(s):  
J Hiddema ◽  
S Hassan ◽  
N Mangat ◽  
N Siddiqui
Keyword(s):  
White Cell Count ◽  
Normal Function ◽  
Adolescent Male ◽  
Reactive Protein ◽  
Intravenous Antibiotics ◽  
Tropical Areas ◽  
Widespread Availability ◽  
Magnetic Resonance Imaging Mri ◽  
Irritable Hip

The ‘irritable hip’ continues to pose a challenge for clinicians. Even with predictive clinical algorithms, decision making can be difficult. Emergency treatment is required if septic arthritis is suspected. Other differential diagnoses such as transient synovitis, pyomyositis of the pelvic girdle muscles and osteomyelitis must be considered in order to help guide appropriate investigations and allow early treatment. We report the case of a 13-year-old boy presenting to our institution with an acutely painful left hip but still able to weight bear. Despite a fever and raised inflammatory markers, the clinical examination did not correspond to that of an infected hip joint. Urgent magnetic resonance imaging (MRI) confirmed pyomyositis of the pectineus muscle. To our knowledge, this is the first reported case in the literature. The child was treated with seven days of intravenous antibiotics. There was a good clinical response as well as normalisation of the C-reactive protein level and white cell count. The patient was discharged home with a further week of oral antibiotics. Follow-up MRI at two weeks demonstrated a dramatic reduction in the inflammation of the pectineus. At the clinic follow-up appointment, the child was asymptomatic and back to normal function. Pyomyositis is typically found in tropical areas but its rates in temperate climates have been rising. It usually affects large groups of muscles such as the quadriceps and gluteal muscles. MRI is the gold standard investigation. If diagnosed early, the condition can be treated successfully with intravenous antibiotics alone. Given the widespread availability of MRI, we recommend its increased use to distinguish between pyomyositis and other paediatric hip pathologies.

scholarly journals Short Term Effects of Mild Severity COVID-19 on Left Ventricular Functions

2021 ◽  
Author(s):  
Osman Bektaş ◽  
Ahmet Karagöz ◽  
Feyza Nur Topçu Yenerçağ ◽  
Seçkin Dereli ◽  
Celali Kurt ◽  
...  
Keyword(s):  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Long Term Effects ◽  
C Reactive Protein ◽  
Short Term ◽  
Reactive Protein ◽  
The Mean ◽  
And Gender

Abstract Purpose: We aimed to evaluate long term effects of COVID-19 disease on left ventricular function using speckle tracking echocardiography. Methods: In our study, 96 non-hospitalized patients who were diagnosed with COVID-19 disease in our center between 15 August 2020 and 01 September 2020 and 96 age and gender matched control subjects were included.Results:The mean follow up duration was 137 ± 7 days. White blood cell, neutrophile and lymphocyte were significantly lower and C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) were significantly higher in the COVID-19 group. (6.6 ± 2.8 vs. 24.4 ± 21.8, p <0.001 and 4.1 ± 2.5 vs. 7.1 ± 4, p <0.001, respectively). LV-GLS and LV-GCS were significantly lower in the COVID-19 group. (-20.1 ± 3.1 vs -15.9 ± 2, p <0.001 and -29.3 ± 2.1 vs -26.3 ± 2.1, p <0.001, respectively). LV-GLS and LV-GCS were found to be negatively correlated with CRP (rs = -0.515, p <0.001 and rs = 0.-466, p <0.001, respectively) and NLR (rs = -0.494, p <0.001 and rs = -434, p <0.001, respectively). Conclusion: Deteriorating effects of COVID-19 disease on both LV-GCS and LV-GLS can be seen even in the short term. These detrimental effects seem to be associated with CRP levels and NLR measured in the course of active infection.

scholarly journals The Promising Role of Dynamic 18F-NaF PET-CT in Diagnosing Symptomatic Joint Prosthesis

2015 ◽  
Vol 1 (2) ◽  
Author(s):  
Olu Adesanya ◽  
Pedro Foguet ◽  
Charles Hutchinson
Keyword(s):  
Cell Count ◽  
White Cell Count ◽  
Joint Prosthesis ◽  
C Reactive Protein ◽  
Septic Loosening ◽  
Reactive Protein ◽  
Pet Ct

Our purpose was to establish proof of principle case study for the use of dynamic 18F-NaF PET-CT in the assessment of knee and hip prostheses. Approval was granted by the research ethics committee and informed<br />consent was obtained. This is a case study investigating the role of dynamic 18F NaF PET-CT in a patient with ilateral knee prostheses (1 symptomatic/painful and 1 asymptomatic). Both knees were studied with dynamic 18F-NaF PET-CT technique to demonstrate the different pattern of uptake in normal/asymptomatic joint as well as painful joints with aseptic loosening. In addition, a knee aspirate was obtained from the symptomatic knee and serum C-reactive protein and erythrocyte sediment rate levels as well as a peripheral white cell count were<br />obtained in addition to 12 month clinical follow up. Images were obtained with multi-sequential dynamic image acquisition in list mode using GE Healthcare® volume imaging protocol (ViP) after an intravenous injection of 250 MBq 18F-NaF. The images were interpreted as normal, loosening or septic loosening based on the graphical pattern of tracer uptake produced at the bone-prosthesis interface. A final diagnosis was made by a combination of joint aspiration microbiology and clinical follow-up for 1 year; in addition to C-reactive protein and erythrocyte sediment rate levels as well as peripheral white cell count. NaF PET results were compared with 3-phase dynamic bone scan results and plain radiographs. The degree of uptake in the symptomatic joint exceeded background<br />levels and also levels of uptake in the asymptomatic knee. The pattern of uptake and curve slope in both the asymptomatic and symptomatic joints matched the pattern of uptake in our hypothesis. Dynamic 18F-NaF PET-CT is a useful imaging modality for assessing painful joint prosthesis. It can differentiate between asymptomatic joints and aseptic loosening. However, more work is required for the detection of septic loosening.

scholarly journals A Follow-Up on Psychiatric Symptoms and Post-Traumatic Stress Disorders in Tuareg Refugees in Burkina Faso

2018 ◽  
Vol 9 ◽  
Author(s):  
Mauro Giovanni Carta ◽  
Daniela Moro ◽  
Fadimata Wallet Oumar ◽  
Maria Francesca Moro ◽  
Mirra Pintus ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Traumatic Stress ◽  
Psychiatric Symptoms ◽  
Stress Disorders ◽  
Post Traumatic Stress ◽  
Traumatic Stress Disorders ◽  
Post Traumatic

scholarly journals Incidence of reactive thrombocytosis in serious bacterial infections in children aged two months to twelve years and its usefulness as a predictor of serious bacterial infections

2020 ◽  
Vol 7 (3) ◽  
pp. 626
Author(s):  
Thahseen Nilofar Sahubar Sadique ◽  
Thrilok Natarajan ◽  
Kabilan Shanmugham ◽  
Suresh Kumar Veluchamy
Keyword(s):  
Bacterial Infections ◽  
White Cell Count ◽  
Reactive Thrombocytosis ◽  
Medical College ◽  
Reactive Protein ◽  
Serious Bacterial Infections ◽  
And Gender ◽  
Madras Medical College ◽  
Tract Infections ◽  
A Prospective Study

Background: The aims of the study were to estimate the incidence of reactive thrombocytosis(RT) among febrile children aged 2 months to 12 years and to identify any differences in age group and gender in mounting thrombocytosis as a response to infection, to identify if thrombocytosis occurred preferentially in any particular group of serious bacterial infections(SBI), to compare thrombocytosis with other parameters like total white cell count, C-reactive protein(CRP), cultures etc. and to assess the utility of platelet count as a potential predictor of serious bacterial infection.Methods: This was a prospective study done in Institute of Child Health and Hospital for children, Madras Medical College from September 2015 to July 2016. Inclusion criteria: Children aged 2 months to 12 years with symptoms of fever less than 6 days admitted in the paediatric wards and those seen at the outpatient department. Exclusion criteria: Children having received parenteral antibiotics.Results: Of the 500 children, 142 (28.4%) had reactive thrombocytosis. RT was mild in 120 children (24%), moderate in 16 children (3.2%), severe in 4(0.8%) and extreme in two children (0.4%). This study showed that 36.48% (85 / 233) of children under 1 year had RT (p = 0.0002).There was no significant sex related difference in mounting RT. Out of 500 children included in the study, serious bacterial infection was diagnosed among 171 children (34.2%).Pneumonia (n=100) was the most common SBI followed by urinary tract infections (n=33), meningitis (n=23), sepsis (n=15). This study showed that RT has a moderate ability to predict serious bacterial infections (AUC=0.78; PPV-75.35%).Conclusions: Incidence of reactive thrombocytosis in febrile children aged 2 months to 12 years is 28.4%. It occurs more frequently in infants and without any sex predilection. RT is associated with leucocytosis, positive CRP, positive Chest X ray findings, positive urine culture and positive CSF findings. This shows that RT has a moderate ability in predicting SBI in children.

scholarly journals EP.FRI.840 Lymphopaenia and laparotomy – a predictor of mortality

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Alasdair Pollock ◽  
Norman Galbraith ◽  
Anna Bleakley ◽  
Isobel Setford ◽  
Elaine Halcrow ◽  
...  
Keyword(s):  
Neutrophil Count ◽  
Immune Checkpoint ◽  
Lymphocyte Count ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
White Cell Count ◽  
Immune Dysfunction ◽  
Emergency Laparotomy ◽  
Reactive Protein ◽  
T Cell Dysfunction

Abstract Aims Immune dysfunction is often seen in patients undergoing emergency laparotomy. Efforts to correct T-cell dysfunction & apoptosis by use of immune checkpoint inhibitors in prospective trials are underway, where lymphopaenia is an indication for therapy. We investigated the association of lymphopaenia in patients undergoing emergency laparotomy as a measure of immune dysfunction and predictor of 30-day mortality.  Methods Retrospective analysis was performed on emergency laparotomies at the Royal Alexandra Hospital using the prospectively maintained Emergency Laparotomy and Laparoscopic Scotland Audit (ELLSA) database. White cell count (WCC), Neutrophil count, Lymphocyte count and C-reactive protein (CRP) were compared between those who died within 30 days and those who survived using Mann-Whitney-U test (p &lt; 0.05). Results Between 2017-2018, 196 cases were analysed for assessed, after 4 patients excluded due to insufficient data. Mean age was 63 years, 86 were male and 108 were female. Eighteen (9.2%) deaths were recorded within 30 days of emergency laparotomy. Non-survivors demonstrated a decreased lymphocyte count on day 3 and 7 following emergency laparotomy when compared to the survivor group (p &lt; 0.05). No significance was found when comparing the WCC, Neutrophil count or CRP of both groups. Conclusions Patients who did not survive emergency laparotomy were found to have decreased lymphocyte counts when compared with survivors.  This may be a surrogate measure of sepsis or trauma-associated immune dysfunction. Further study into immune related mechanisms may lay the foundation for prospective studies using immune checkpoint inhibitors in the emergency laparotomy population.

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