Clinical, genetical and microbiological characterization of pediatric patients with Cystic Fibrosis in Ecuador

Abstract Summary Objective To characterize the epidemiology and the clinical, pathological, microbiological and genetical profile of children with cystic fibrosis treated in Ecuador. Methods We conducted a cross-sectional analysis of the pediatric population with a confirmed diagnosis of cystic fibrosis (CF) attending to one of the biggest III-level hospitals in Ecuador. All demographic, clinical and genetical variables were obtained from the electronic medical records (EMR) from 2017-2018. Results 47 patients with CF were observed and followed for more than a year. Gender distribution was similar between male (48.9%, n = 23) and female patients (51.1%, n = 24). The Tiffeneau-Pinelli index (FEV1/FVC) changed significantly after 9 months post-diagnosis (85.55 ± 13.26; p <0.05). The most common pathogenic genetical mutation was F508del, found in 52.78% of the cohort (n = 19); H609R, found in 36.11% (n = 13) and the G85E and the N1303K with 11.11% respectively (n = 3). Finally, there were 14.1% (n = 7) of patients with a mutation g.204099A> C, which has only been reported among Ecuadorians. Conclusions This is the first study carried out in Ecuador exploring the clinical, genetical and bacteriological analysis of patients with CF. Children with CF are often colonized by four species of gram-positive bacteria (S. aureus, Coagulase-Negative Staphylococcus, Streptococcus pneumoniae and M. catarrhalis) were the most predominant this condition atients were hospitalized for complications related to cystic fibrosis, with an average of 19 days of stay.

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Clinical, genetic and microbiological characterization of pediatric patients with Cystic Fibrosis in a Public Hospital in Ecuador

10.21203/rs.2.12767/v4 ◽

2020 ◽

Author(s):

Yazmina Lascano-Vaca ◽

Esteban Ortiz-Prado ◽

Lenin Gomez-Barreno ◽

Katherine Simbaña-Rivera ◽

Eduardo Vasconez ◽

...

Keyword(s):

Cystic Fibrosis ◽

Public Hospital ◽

Pediatric Patients ◽

Pediatric Population ◽

Clinical Genetic ◽

Cross Sectional ◽

Genetic Feature ◽

Bacteriological Profile ◽

Sectional Analysis

Abstract Background: To carry out a complete clinical, pathological, genetic and microbiological characterization of pediatric patients with molecular confirmed cystic fibrosis (CF) attending the Carlos Andrade Marín Hospital (HCAM) within the study period. Methods: A cross-sectional analysis of the pediatric population with a confirmed diagnosis of CF disease who attended HCAM , one of the largest tertiary-level hospitals in Ecuador, between 2017 and 2018 was performed. All demographic, clinical and genetic variables were obtained from the electronic medical records (EMR) stored by the hospital. Results: 47 patients with CF were included in the study. Gender distribution was similar between male (48.9%, n = 23) and female patients (51.1%, n = 24). The Tiffeneau-Pinelli index (FEV 1 /FVC) changed significantly after nine months post-diagnosis (85.55 ± 13.26; p < 0.05). The most common pathogenic genetic variants were F508del, found in 52.78% of the cohort (n = 19); H609R, found in 36.11% (n = 13); g.204099A>C, found in 14.1% (n = 7), followed by G85E and the N1303K with 11.11% (n = 3) each. Conclusions: To our best knowledge, this is the first study exploring the clinical, genetic and bacteriological profile of CF’s patients in Ecuador. Within the cohort of patients, an important and unique genetic feature was characterized by the presence of the g.204099A> C and the c.206359C>A homozygous polymorphism as well as the presence of the H609R variant, a mutation only reported among Ecuadorians.

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Clinical, genetic and microbiological characterization of pediatric patients with Cystic Fibrosis in a Public Hospital in Ecuador

10.21203/rs.2.12767/v2 ◽

2019 ◽

Author(s):

Yazmina Lascano-Vaca ◽

Esteban Ortiz-Prado ◽

Lenin Gomez-Barreno ◽

Katherine Simbaña-Rivera ◽

Eduardo Vasconez ◽

...

Keyword(s):

Cystic Fibrosis ◽

Public Hospital ◽

Pediatric Patients ◽

Pediatric Population ◽

Homozygous Mutation ◽

Clinical Genetic ◽

Cross Sectional ◽

Bacteriological Profile ◽

Sectional Analysis

Abstract Objective: To carry out a complete clinical, pathological, genetic and microbiological characterization of pediatric patients with molecular confirmed CF attending the Carlos Andrade Marín Hospital within the study period. Methods: A cross-sectional analysis of the pediatric population with a confirmed diagnosis of cystic fibrosis (CF) disease, who attended one of the largest tertiary-level hospitals in Ecuador between 2017 and 2018 was conducted. All demographic, clinical and genetic variables were obtained from the electronic medical records (EMR) stored by the hospital. Results: 47 patients with CF were included in the study. Gender distribution was similar between male (48.9%, n = 23) and female patients (51.1%, n = 24). The Tiffeneau-Pinelli index (FEV1/FVC) changed significantly after nine months post-diagnosis (85.55 ± 13.26; p <0.05). The most common pathogenic genetic mutations were F508del, found in 52.78% of the cohort (n = 19); H609R, found in 36.11% (n = 13); g.204099A>C, found in 14.1% (n = 7), followed by G85E and the N1303K with 11.11% (n = 3) each. Conclusions: To our best knowledge, this is the first study exploring the clinical, genetic and bacteriological profile of CF’s patients in Ecuador. Due to the lack of universal screening in the country, a large proportion of individuals are being diagnosed or misdiagnosed later than expected, jeopardizing their treatments and prognosis. It is relevant to establish that the presence of the g.204099A> C and the c.206359C>A homozygous mutation variants have only been reported among Ecuadorians. These patients appear to show a less severe CF disease and a better prognosis.

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Clinical, genetic and microbiological characterization of pediatric patients with Cystic Fibrosis in a Public Hospital in Ecuador

10.21203/rs.2.12767/v3 ◽

2020 ◽

Author(s):

Yazmina Lascano-Vaca ◽

Esteban Ortiz-Prado ◽

Lenin Gomez-Barreno ◽

Katherine Simbaña-Rivera ◽

Eduardo Vasconez ◽

...

Keyword(s):

Cystic Fibrosis ◽

Public Hospital ◽

Pediatric Patients ◽

Pediatric Population ◽

Clinical Genetic ◽

Cross Sectional ◽

Genetic Feature ◽

Bacteriological Profile ◽

Sectional Analysis

Abstract SummaryObjective: To carry out a complete clinical, pathological, genetic and microbiological characterization of pediatric patients with molecular confirmed cystic fibrosis (CF) attending the Carlos Andrade Marín Hospital (HCAM) within the study period.Methods: A cross-sectional analysis of the pediatric population with a confirmed diagnosis of CF disease who attended HCAM, one of the largest tertiary-level hospitals in Ecuador, between 2017 and 2018 was performed. All demographic, clinical and genetic variables were obtained from the electronic medical records (EMR) stored by the hospital. Results: 47 patients with CF were included in the study. Gender distribution was similar between male (48.9%, n = 23) and female patients (51.1%, n = 24). The Tiffeneau-Pinelli index (FEV1/FVC) changed significantly after nine months post-diagnosis (85.55 ± 13.26; p <0.05). The most common pathogenic genetic variants were F508del, found in 52.78% of the cohort (n = 19); H609R, found in 36.11% (n = 13); g.204099A>C, found in 14.1% (n = 7), followed by G85E and the N1303K with 11.11% (n = 3) each. Conclusions: To our best knowledge, this is the first study exploring the clinical, genetic and bacteriological profile of CF’s patients in Ecuador. Within the cohort of patients, an important and unique genetic feature was characterized by the presence of the g.204099A> C and the c.206359C>A homozygous polymorphism as well as the presence of the H609R variant, a mutation only reported among Ecuadorians.

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Clinical Significance of Isolates Known to Be Blood Culture Contaminants in Pediatric Patients

Medicina ◽

10.3390/medicina55100696 ◽

2019 ◽

Vol 55 (10) ◽

pp. 696

Author(s):

Sejong Chun ◽

Cheol-In Kang ◽

Yae-Jean Kim ◽

Nam Yong Lee

Keyword(s):

Blood Culture ◽

Clinical Significance ◽

Medical Records ◽

Pediatric Patients ◽

Blood Stream Infection ◽

Single Case ◽

Pediatric Population ◽

Blood Stream ◽

Coagulase Negative Staphylococcus ◽

Viridans Group Streptococcus

Background and objectives: The objective of this study was to investigate the clinical significance of isolates from blood stream infection known to be blood culture contaminants in pediatric patients. Materials and Methods: Microbiological reports and medical records of all blood culture tests issued from 2002 to 2012 (n = 76,331) were retrospectively reviewed. Evaluation for potential contaminants were done by reviewing medical records of patients with the following isolates: coagulase-negative Staphylococcus, viridans group Streptococcus, Bacillus, Corynebacterium, Micrococcus, Aerococcus, and Proprionibacterium species. Repeated cultures with same isolates were considered as a single case. Cases were evaluated for their status as a pathogen. Results: Coagulase-negative Staphylococcus had clinical significance in 23.8% of all cases. Its rate of being a true pathogen was particularly high in patients with malignancy (43.7%). Viridans group Streptococcus showed clinical significance in 46.2% of all cases. Its rate of being a true pathogen was similar regardless of the underlying morbidity of the patient. The rate of being a true pathogens for remaining isolates was 27.7% for Bacillus and 19.0% for Corynebacterium species. Conclusions: Coagulase-negative Staphylococcus and viridans group Streptococcus isolates showed high probability of being true pathogens in the pediatric population, especially in patients with underlying malignancy.

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Microbial Patterns and Antimicrobial Susceptibility on Pediatric Patients with Pressure Ulcers

Molecular and Cellular Biomedical Sciences ◽

10.21705/mcbs.v3i1.39 ◽

2019 ◽

Vol 3 (1) ◽

pp. 17

Author(s):

Deryne Anggia Paramita ◽

Khairina Nasution ◽

Nova Zairina Lubis

Keyword(s):

Acinetobacter Baumannii ◽

Pressure Ulcer ◽

Antimicrobial Susceptibility ◽

Pediatric Patients ◽

Pediatric Population ◽

Cross Sectional Study ◽

Gram Positive ◽

Cross Sectional ◽

Gram Negative ◽

Gram Positive Bacteria

Background: A pressure ulcer (PU) is localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with sharp surface. Several studies have found that PU is also a common problem in the pediatric population. Infection at PU sites is the most common complication, where PU can host resistant microorganisms and can turn into a local infection that is a source of bacteremia in hospital patients. This study aims to determine the most common bacteria and antimicrobial susceptibility at the site of PU in pediatric patients that serve as baseline data in Haji Adam Malik Hospital.Materials and Methods: A cross-sectional study was carried out in July-December 2017, involving 30 PU pediatric patients. For each subject, swab from ulcers were cultured in microbial laboratory to determine the microbial pattern and antimicrobial susceptibility.Results: The most common age group was 0-3 (53.3%), the highest gender was male (60%), the most common type was type 2 (46.7%), the main location was occipital (30%) and the most common undelying diseases were hydrocephalus (16.6%). The most common microbial pattern in PU pediatric patients is Acinetobacter baumannii (40%). The highest sensitivity is vancomycine for gram positive bacteria and amikacine for gram negative bacteria.Conclusion: The most common microbial pattern in PU pediatric patients in Haji Adam Malik Hospital is Acinetobacter baumannii (40%). The highest sensitivity is vancomycine for gram positive bacteria and amikacine for gram negative bacteria.Keywords: pressure ulcer, pediatric, microbial pattern, antimicrobial susceptibility

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An assessment of the knowledge of medical doctors on Electronic Medical Records in a Tertiary Health Center in Sub-Saharan Africa: A Cross sectional study

Trends in Research ◽

10.15761/tr.1000136 ◽

2019 ◽

Vol 2 (2) ◽

Author(s):

AO Poluyi ◽

OO Onigbogi ◽

EO Poluyi

Keyword(s):

Health Center ◽

Electronic Medical Records ◽

Medical Records ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Medical Doctors ◽

Sectional Study ◽

Cross Sectional ◽

Sub Saharan

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Do Electronic Medical Records Improve Advance Directive Documentation? A Systematic Review

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909118796191 ◽

2018 ◽

Vol 36 (3) ◽

pp. 255-263 ◽

Cited By ~ 2

Author(s):

Christopher Lemon ◽

Michael De Ridder ◽

Mohamed Khadra

Keyword(s):

Systematic Review ◽

Electronic Medical Records ◽

Medical Records ◽

Planning Process ◽

Assessment Tool ◽

Controlled Trial ◽

Decision Aids ◽

Automatic Identification ◽

Cross Sectional ◽

Identification Software

Background: Documentation rates of advance directives (ADs) remain low. Using electronic medical records (EMRs) could help, but a synthesis of evidence is currently lacking. Objectives: To evaluate the evidence for using EMRs in documenting ADs and its implications for overcoming challenges associated with their use. Design: Systematic review of articles in English, published from inception of databases to December 2017. Data Sources: PubMed, PsycINFO, EMBASE, and CINAHL. Methods/Measurements: Four databases were searched from inception to December 2017. Randomized and nonrandomized quantitative studies examining the effects of EMRs on creation, storage, or use of ADs were included. All featured an advance care planning process. Evidence was evaluated using the Cochrane Collaboration’s risk assessment tool. Results: Fifteen studies were included: 1 randomized controlled trial, 1 randomized pilot, 4 pre–post studies, 4 cross-sectional studies, 1 retrospective cohort study, 1 historical control study, 1 retrospective observational study, 1 retrospective review, and 1 evaluation of an EMR feature. Seven studies showed that EMR-based reminders, AD templates, and decision aids can improve AD documentation rates. Three demonstrated that EMR search functions, decision aids, and automatic identification software can help identify patients who have or need ADs according to certain criteria. Five showed EMRs can create documentation challenges, including locating ADs, and making some patients more likely than others to have an AD. Most studies had an unclear or high risk of bias. Conclusions: Limited evidence suggests EMRs could be used to help address AD documentation challenges but may also create additional problems. Stronger evidence is needed to more conclusively determine how EMR may assist in population approaches to improving AD documentation.

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Abstract 372: Electronic Medical Records Can Identify Patients With Persistently Elevated Blood Pressure Without A Prior Diagnosis Of Hypertension.

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.7.suppl_1.372 ◽

2014 ◽

Vol 7 (suppl_1) ◽

Author(s):

Olufunso W Odunukan ◽

Ahmed S Rahman ◽

Daniel Roellinger ◽

Steven Cha ◽

James M Naessens ◽

...

Keyword(s):

Blood Pressure ◽

Electronic Medical Records ◽

Medical Records ◽

Elevated Blood Pressure ◽

Electronic Records ◽

Elevated Blood ◽

Cross Sectional ◽

Outpatient Visits ◽

Cross Sectional Design ◽

Diagnosis Of Hypertension

Background: The diagnosis of hypertension requires systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg on at least 2 different occasions. Therefore, there is the possibility of patients with elevated BP remaining undiagnosed if not seen by the same provider. Purpose: To utilize electronic medical records (EMR) to identify patients not previously diagnosed with hypertension that have elevated blood pressure meeting criteria for a diagnosis of hypertension using a threshold of SBP ≥ 140mmHg or DBP ≥ 90 mmHg (high BP) on 2 or more occasions. Methods: This was a cross sectional design utilizing retrospective multi-year billing and clinical data from a large multi-specialty center in the Midwest. Using electronic records of all outpatient visits in each year from 2009 - 2011, patients with at least 2 visits with SBP ≥ 140mmHg or DBP ≥ 90 mmHg (2HBP) in the measurement year were identified. These patients were compared with previously identified cohorts of known hypertension patients (Known HTN) compiled using the EMR problem list. A sensitivity analysis was done using patients with high BP at 2 consecutive visits (2CHBP) and also those with high BP at 3 consecutive visits (3CHBP). We compared proportions of patients with high BP without a prior diagnosis of hypertension (UDHTN). Results: The proportion of patients with SBP ≥ 140mmHg or DBP ≥ 90 mmHg without a prior diagnosis of hypertension (UDHTN) when compared to the cohort of known patients with a diagnosis of hypertension (Known HTN) was 25% in 2009, 26% in 2010, and 28% in 2011 in the 2CHBP cohort compared to 27% in 2009, 28% in 2010, and 30% in 2011 in the 2HBP cohort and 18% in 2009, 19% in 2010 and 23% in 2011 in the 3CHBP cohort. Conclusion: About a quarter of patients meeting current thresholds on multiple and consecutive visits did not have a known diagnosis of hypertension. The use of EMR can identify these patients for commencement of appropriate management. Table 1

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