The Frequency of Pericardial Effusions in Bacterial Meningitis

PEDIATRICS ◽  
1979 ◽  
Vol 63 (5) ◽  
pp. 764-770
Author(s):  
W. Pennock Laird ◽  
John D. Nelson ◽  
F. Douglas Huffines
Keyword(s):  
Risk Factors ◽  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Significant Risk ◽  
Literature Survey ◽  
The Other ◽  
Purulent Pericarditis ◽  
Pericardial Effusions ◽  
In Series ◽  
A Prospective Study

Because of our experience with four cases of purulent pericarditis complicating bacterial meningitis during a 13-month period, we performed a prospective study to determine the frequency of this complication. Echocardiograms were done on 100 patients with bacterial meningitis. Small or moderate pericardial effusions were detected in 19 patients, but none had symptoms or signs related to the effusion. Pericardiocentesis was done in one infant; all the other effusions resolved spontaneously. Patients with effusion were significantly younger than those without this complication, but no other significant risk factors were identified. A literature survey indicated that symptomatic pericarditis occurs in fewer than 1% of patients with meningitis. Conversely, in series of cases of purulent pericarditis, associated meningitis was reported in 12% of patients. We concluded that pericardial infection is common in patients with meningitis but that it is usually of no clinical significance and resolves with antibiotic therapy.

scholarly journals 186. Risk Factors for Extended Spectrum β-Lactamase Bacteremia and External Application of a Clinical Prediction Tool

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S113-S114
Author(s):  
Jacqueline Burnell ◽  
Rebecca Fallis ◽  
Peter Axelrod ◽  
Daniel Mueller
Keyword(s):  
Risk Factors ◽  
Antibiotic Therapy ◽  
Klebsiella Oxytoca ◽  
Significant Risk ◽  
University Hospital ◽  
Prediction Tool ◽  
External Application ◽  
The Past ◽  
Extended Spectrum ◽  
History Of

Abstract Background Extended spectrum β-lactamase (ESBL) bacteria are resistant to many antibiotics, which increases the risk of inadequate early antibiotic therapy. A previous single-center study had created a prediction tool to assist clinicians in identifying patients at risk for ESBL bloodstream infections. The purpose of our research project was to assess validity of this tool while also identifying risk factors for ESBL bacteremia within our own institution, which would allow for assessment of alternative prediction tools. Methods We performed a retrospective chart review of adult patients admitted to an urban university hospital who were found to have bacteremia with Escherichia coli, Klebsiella pneumoniae, and/or Klebsiella oxytoca between October 2016 and April 2018. Demographics and comorbidities were assessed, along with other potential risk factors including exposure to antibiotics and hospitalizations within the past 6 months. Results A total of 214 instances of bacteremia were identified and 14% were due to ESBL organisms. Risk factors for ESBL bacteremia in our cohort included history of positive culture for ESBL (RR = 5.9) or MRSA (RR = 3.5) and antibiotic usage in the past 6 months (RR = 2.3). Patients with ESBL bacteremia were hospitalized longer (mean 16 days vs. 6 days for non-ESBL), received longer durations of antibiotic therapy (11.7 days vs. 5.3 days), and were exposed to greater numbers of different antibiotics (1.9 vs. 0.7) in the previous 6 months. Multivariate logistic regression showed that history of prior ESBL infection (OR 14.7, CI 1.8–120) and increasing number of different antibiotic classes administered in the prior 6 months (OR 4.3, CI 1.7–11.2) were significant risk factors for ESBL bacteremia. The previously created prediction tool did not sufficiently differentiate higher and lower risk for ESBL bacteremia in our cohort. Conclusion Although risk factors were similar, the previously derived stepwise prediction tool did not predict ESBL bacteremia in our external cohort. Point-based prediction modeling might better assess risk across institutions. Additionally, the number of different antibiotics received was associated with risk for ESBL bacteremia and should be investigated further. Disclosures All authors: No reported disclosures.

scholarly journals Early Postoperative Arrhythmias after Paediatric Cardiac Surgery

2018 ◽  
Vol 6 (1) ◽  
pp. 22-28
Author(s):  
Kazi Zahidul Hoque ◽  
Akhand Tanzih Sultana ◽  
Mamun Mia ◽  
Masumul Gani Chowdhury ◽  
Makbul Hossein
Keyword(s):  
Risk Factors ◽  
Body Weight ◽  
Cardiac Surgery ◽  
Postoperative Period ◽  
Significant Risk ◽  
Radical Change ◽  
Paediatric Cardiac Surgery ◽  
Number Of Patients ◽  
Paediatric Age ◽  
A Prospective Study

Background: The radical change in techniques in paediatric cardiac surgery has dramatically reduced the morbidity and mortality. The different varieties of arrhythmia that are frequently observed in postoperative period in our country are still not well documented.Objectives: To determine the incidence and risk factors of arrhythmia immediately after cardiac surgery in paediatric age group.Materials and method: It was a prospective study. A total of 100 paediatric patients (age <18 years) who underwent cardiac surgery at Dhaka Shishu Hospital between 2013 and 2016 were selected purposivelyResults: Out of 100 patients maximum 41% were from 13-72 months age group. The mean age was 49.73±37.17 months with range of 0.5-231 months, 58% patients were male and rest were female. Postoperatively 31% subjects were arrhythmic and of these the highest number of patients suffered from junctional ectopic tachycardia. Out of these 100 patients, 39% were diagnosed as VSD followed by TOF (35%). Among 31 arrhythmic patients 59.83%, 41.93% and 3.22% manifested onset of arrhythmia at 1st, 1st to 2nd and 2nd to 7th postoperative period respectively. In this study age, body weight, cyanosis, CPB time, postoperative acidosis, ventilation support days, hypertension on arrival in ICU as well as ICU stay days were recognized as significant risk factors (p <0.05).Conclusion: Proper and careful monitoring of younger patient with lower body weight undergoing corrective cardiac surgery with long cardiopulmonary bypass (CPB) time may reduce the episodes of post operative arrhythmia. These patients may require high inotropic support post operatively. So, medical prevention and early diagnosis as well as proper management may improve the operative outcome.Delta Med Col J. Jan 2018 6(1): 22-28

Abstract 2634: A Prospective Study Of Asymptomatic Intracranial Arterial Stenosis In Japanese Healthy Subjects

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Ryukichi Matsui ◽  
Hiroaki Oguro ◽  
Nagai Atsushi ◽  
Hirokazu Bokura ◽  
Keiichi Onoda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Healthy Subjects ◽  
Significant Risk ◽  
Stroke Onset ◽  
Arterial Stenosis ◽  
Intracranial Arterial Stenosis ◽  
A Prospective Study ◽  
Age And Sex

Background and purpose: Atherosclerotic stenosis of major intracranial arteries accounts for 5 to 10% of all causes of stroke. The Warfarin versus Aspirin Symptomatic Intracranial Disease (WASID) Study has demonstrated stroke onset in 5 among 100 patients with asymptomatic intracranial arterial stenosis (AIAS) during the follow-up period of 1.8 years. However, there are no prospective studies of intracranial stenosis in healthy subjects with a longer follow-up period. We conducted a 7-years longitudinal study in healthy subjects with AIAS to examine its risk factors and prognosis. Methods: We performed a prospective study on 3,155 neurologically normal subjects without history of stroke (1724 men, 1431 woman, mean age of 59). They were followed up with the mean interval of 83 months to obtain information about their stroke event with a questionnaire by mail or telephone interview and inquiry to the relevant medical facilities. AIAS were assessed on MRA at the time of first visit for all subjects. Result: AIAS was detected in 323 subjects (10.2%; AIAS group) at the initial examination. Significant risk factors for AIAS were older age, female, hypertension, high values of fasting blood glucose and HbA1c. During the follow-up stroke occurred in 77 subjects (2.7%) from the no-AIAS group and 14 subjects (4.3%) from the AIAS group (p = 0.07). Age and sex affected the stroke onset. The Cox's proportional-Hazards regression model after adjustment of age and sex revealed the significant contribution of AIAS on stroke onset (OR 1.9; 95% CI 1.03-3.4, p = 0.039). The stroke types were 11 ischemic and 3 hemorrhagic in the AIAS group. Conclusions: AIAS is a significant risk factor for future stroke even in healthy subjects. Intense management of blood pressure and glucose level might be crucial for preventing asymptomatic intracranial atherosclerotic disease.

scholarly journals Risk Factors Associated With 55 1 In Elective Gastrointestinal Surgery: A Prospective Study In A Specialized Surgical Centre

2019 ◽  
Vol 16 (2) ◽  
pp. 71-75
Author(s):  
Aminul Islam Joarder ◽  
Mohammad Salahuddin Faruque ◽  
M Nur E Elahi ◽  
Ishrat Jahan ◽  
Omar Siddiqui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Smoking Habit ◽  
Gastrointestinal Surgery ◽  
Significant Risk ◽  
Operation Time ◽  
Drain Tube ◽  
Site Infection ◽  
A Prospective Study ◽  
Surgery Department

Background: Understanding SSI and providing feedback to the surgical team has been shown to reduce the incidence of surgical site infection and the cost incurred due to it. Objective: To assess the risk factors of surgical site infection (SSI) in elective gastrointestinal surgery. Methods: prospective data were collected on 1122 surgical patients admitted in the surgery department in BSMMU from January 201 0 to July 201 2. All preoperative risk factors were evaluated .Patients operated were followed in the post operative period and if any wound infection noted, swab from the site of infection was sent for culture and sensitivity and antibiotics were given accordingly. Results: The incidence of SSI was 1 83(1 6.31 %).Out of this 1 83 cases 65.6% had BMI <25. Anaemia was present in 45.90% cases, bronchopulomnary disease was present in 1 1 .5% cases and DM & jaundice was present in 8.1 9% and 28.9% cases accordingly. 69(37.7%) cases were habitual smoker.SSI rate progressively increased with rate of contamination and maximum infection occurred in lower GIT surgery which was 144(1 7.84%). SSI developed more, in 1 02 (55.74 %) cases when duration of peration was more th ;1 1 1;1.2 hours. In 73.8% cases of SSI drain tube was used. Statistically significant risk factors for SS were found to be smoking habit, BMI <25, preoperative anaemia and duration of operation more than two hours. Conclusion: Specific optimization of the patients' preoperative condition is essential to reduce the risk of SSI following elective gastrointestinal surgery. Surveillance should be conducted and maintained in all hospitals to promote better surgical outcomes. Cessation of smoking, optimization of nutritional status, correction of anaemia and reduction of operation time should be associated with a lower incidence of SSI. Journal of Surgical Sciences (2012) Vol. 16 (2) : 71-75

SFO-1 and DHA-1 genes Detection in β-lactamases-producing Klebsiella pneumoniae Causing Blood Stream Infections Acquired in Intensive Care Units in Mansoura University Hospitals

2021 ◽  
Vol 30 (3) ◽  
pp. 43-51
Author(s):  
Nermeen Nassar ◽  
Mohammad Badr ◽  
Nehad Nasef ◽  
Ghada Barakat
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Blood Stream ◽  
Clinical Samples ◽  
University Hospitals ◽  
Blood Stream Infections ◽  
Significant Difference ◽  
Synergy Test ◽  
A Prospective Study ◽  
Low Prevalence

Objectives: The study aimed to detect SFO-1 and DHA-1 genes and to differentiate AmpC with overlapped ESBL isolates. Also, it identified the risk factors aiding in emergence the ESBL producing K.pneumoniae causing blood stream infections in ICUs of Mansoura University Hospitals (MUHs). Methodology: This is a prospective study that enrolled 520 blood samples. Double disk synergy test (DDST) and Modified threedimensional test were performed. Genotypic detection of SFO-1, Class A ESBL, and DHA-1, AmpC β-lactamase was done. Results: 520 septicemic patients were enrolled with significant correlation for adults’ acquisition of infection. The main bacteria isolates causing nosocomial infection in septicemic patients admitted to ICU were S. aureus, E. coli and K. pneumoniae. A significant difference in distribution of ESBL and AmpC β-lactamases was detected with significant association between impenem resistance and prevalence of ESBL in those patients. There was a low-occurrence of ESBL SFO-1 and DHA-1 detected in clinical samples. Surgical intervention and CVC were the significant risk factors for presence of ESBL but previous antibiotics and hospital stay were non-significant effectors for presence of ESBL. Conclusion: Though SFO-1 is a low-prevalence ESBL, it has been taken by a plasmid with many other multiple resistance determinants including many related genes, and go together with by a large DHA-1- plasmid.

Pericardial Effusions in Bacterial Meningitis Are Not Common

PEDIATRICS ◽  
1980 ◽  
Vol 65 (5) ◽  
pp. 1052-1052
Author(s):  
John L. Bass ◽  
Edward L. Kaplan
Keyword(s):  
Pericardial Effusion ◽  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Clinical Significance ◽  
Pericardial Effusions ◽  
Sensitive Method

We read with interest the paper entitled "The Frequency of Pericardial Effusions in Bacterial Meningitis" by Laird and colleagues (Pediatrics 63:764-770, 1979). In our view, the authors' conclusions that "pericardial infection is common in patients with meningitis, but that it is usually of no clinical significance and resolves with antibiotic therapy" are unjustified from the evidence presented. It is well recognized that echocardiography is a sensitive method for detecting the presence of a pericardial effusion, but unfortunately, there are no echocardiographic features which define the etiology of the effusion.

scholarly journals Hyperglycemia but not Glycated Albumin, is Linked to Retinopathy of Prematurity

2020 ◽  
Author(s):  
Ana C Almeida ◽  
Gabriela A Silva ◽  
Gabriele Santini ◽  
Margarida Brízido ◽  
Miguel Correia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Risk Factor ◽  
Retinopathy Of Prematurity ◽  
Glycated Albumin ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The Other ◽  
Reference Ranges ◽  
Extremely Preterm

Abstract Background: Retinopathy of prematurity (ROP) is a neovascular disorder of the immature retina. Neonatal hyperglycemia is a common problem in extremely preterm infants. Several studies have also reported an association between hyperglycemia and ROPPurpose: Our goal was to determine the association between hyperglycemia, glycated albumin (GlyA) and retinopathy of prematurity (ROP).Methods: Prospective study of all infants under ROP screening from March 2017 to July 2019. All demographic, clinical and laboratory data were collected. Glucose was measured at birth and every 8h for the first week and serum GlyA was evaluated at birth, 1st, 2nd and 4th weeks after birth. Reference range for GlyA was obtained according to the CLSI EP28-A3C. Univariate logistic regression was used to examine risk factors for ROP followed by multivariate regression.Results: A total of 152 infants were included in the study. Median gestational age was 30 weeks and median birth weight 1,240g. Thirty-three infants (21,7%) had ROP. Hyperglycemia was present in 24 (72,7%) infants diagnosed with any ROP versus 6 (0,05%) in those without ROP. Median GlyA at birth, 1st, 2nd and 4th and respective reference ranges were 8.50% (6.00-12.65), 8.20% (5.32-11.67), 8.00% (5.32-10.00) and 7.90% (5.30-9-00) respectively. After multivariate logistic regression, hyperglycemia but not GlyA, remained a significant risk factor for ROP overpowering the other recognized risk factors (Exp (B)28.062, 95%CI for Exp(B) 7.881 - 99.924 p <0.001)Conclusions: In our cohort, hyperglycemia but not GlyA, remained a significant risk factor for ROP overpowering the other recognized risk factors.

Risk factors in dropping out from in-patient treatment of substance abuse

2002 ◽  
Vol 19 (3) ◽  
pp. 193-201
Author(s):  
Pekka Saarnio ◽  
Vesa Knuuttila
Keyword(s):  
Risk Factors ◽  
Substance Abuse ◽  
Positive Attitude ◽  
Significant Risk ◽  
The Other ◽  
Patient Treatment ◽  
Dropping Out ◽  
The Subject ◽  
The One

The purpose of the study was to identify risk factors in dropping out from in-patient treatment of substance abuse. Such information is needed in order to target interventions aimed at improving the continuity of treatment. The subjects (N=114) were clients of a Finnish treatment institution. The results indicated that significant risk factors for dropping out included the age of the subject, contemplation of change and attitude toward AA/NA. Continuity of treatment improved with age, and also with improved contemplation. Subjects with an extremely positive attitude toward AA/NA dropped out infrequently. Younger clients were more positively disposed to AA/NA than were older clients. The findings suggest that interventions to prevent dropping out should be aimed on the one hand at younger clients who are not positively disposed to AA/NA and on the other at older clients with an inadequate contemplation of change.

scholarly journals Factors predicting difficult laparoscopic cholecystectomy: a single institution experience

2017 ◽  
Vol 4 (5) ◽  
pp. 1743
Author(s):  
Shiv K. Bunkar ◽  
Sushil Yadav ◽  
Amit Singh ◽  
Kalpana Agarwal ◽  
Preeti Singh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Tertiary Care ◽  
Significant Risk ◽  
General Surgeon ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
College Hospital ◽  
Symptomatic Gallstones ◽  
A Prospective Study

Background: Laparoscopic cholecystectomy is one of the most common operations performed by general surgeon. This study was performed to evaluate pre-operative factors predicting difficult laparoscopic cholecystectomy.Methods: A prospective study was carried out at Jawaharlal Nehru Medical College Hospital, Ajmer, a tertiary care centre in Middle East Rajasthan, India. In present study we included 100 patients diagnosed with symptomatic gallstones disease on the basis of history, clinical examinations and USG findings and underwent laparoscopic cholecystectomy in our hospital by a single surgeon during the period of July 2014 to July 2016. These all patients were evaluated for a group of risk factors and preoperatively these risk factors were given a score between 0-5 labeled as easy, 5-10 as difficult and 11-15 as very difficult. Statistical analysis was done by Fischer’s test and chi square test.Results: BMI >30, previous medical disease like DM, palpable gall bladder, prior hospitalization pericholecystic collection and impacted stone are significant risk factors to predict difficult laparoscopic cholecystectomy.Conclusions: The studied scoring system had a positive prediction value for easy prediction of 94% and for difficult prediction of 100%.

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