scholarly journals Pregnancy-Associated Listeriosis in a Tertiary Hospital in Ningbo, Zhejiang, China: A Retrospective Study

2021 ◽  
Author(s):  
Yefang Ke ◽  
Lina Ye ◽  
Pan Zhu ◽  
Ying Sun ◽  
Zhe Zhu
Keyword(s):  
Infectious Disease ◽  
Differential Diagnosis ◽  
Retrospective Study ◽  
Birth Weight ◽  
Clinical Characteristics ◽  
Late Onset ◽  
Mortality Rates ◽  
Tertiary Hospital ◽  
Limited Information ◽  
First Line

Abstract Background Pregnancy-associated listeriosis is a severe infectious disease and potentially leading to fetal/neonatal fatal. Limited information on pregnancy-associated listeriosis is available in China. Methods We performed a retrospective study on maternal and neonatal patients with pregnancy-associated listeriosis. The clinical characteristics of pregnancy-associated listeriosis were studied, and the outcome determinants of neonatal listeriosis were explored. Results 14 cases of pregnancy-associated listeriosis were identified. The incidence of pregnancy-associated listeriosis in our hospital was 16.69/100,000 births. All of the 14 maternal patients eventually recovered after delivery shortly with no sequelae. None of the 12 mothers who delivered in this hospital received antepartum first-line empirical treatment. Among the 14 neonatal cases, 1 was late onset listeriosis and 13 were early onset cases; 11 survived and 3 died. Fatality rates were significantly higher in outborn neonates (P=0.005). Besides, higher mortality rates were observed in neonates with lower birth weight (P=0.038), gestational age<28 weeks (P=0.056), and Apgar score (5th min) <5 (P=0.056), with marginally significant differences. Conclusions There is a neglected burden of pregnancy-associated listeriosis in our hospital. Timely and optimal resuscitative measures are considered to be important to reduce mortality of neonatal listeriosis. Listeriosis should be considered in the differential diagnosis of pregnancy-associated infections.

scholarly journals Clinical Characteristics, Maternal and Neonatal Outcomes of COVID-19 Positive Pregnant Mothers at a Tertiary Hospital in Johannesburg, South Africa

2021 ◽  
Author(s):  
Tanusha Devi Ramdin ◽  
Rossella Marina Bandini ◽  
Robin Terance Saggers ◽  
Michael Radomsky ◽  
Mphelekedzeni Mulaudzi ◽  
...  
Keyword(s):  
Birth Weight ◽  
Respiratory Distress ◽  
Clinical Characteristics ◽  
Tertiary Hospital ◽  
Neonatal Outcomes ◽  
Common Symptom ◽  
Middle Income ◽  
Symptomatic Disease ◽  
Novel Coronavirus ◽  
Pregnant Mothers

Abstract Background: The global spread of the novel coronavirus 2019 (COVID-19) has been sudden shock to the world and resulted in many questions that remain unanswered. Limited data has been published in low-middle-income country settings (LMICS) Objectives: To describe the clinical characteristics and outcome of mothers and neonates delivered from COVID-19 positive mothers, and to identify the incidence of COVID-19 positive neonates.Methods: A prospective, descriptive study, from 1 August 2020 to 31 March 2021 conducted at a tertiary hospital, in JohannesburgAll neonates born to mothers that were COVID-19 positive and that required admission to the neonatal unit were included. Informed consent was obtained from mothers prior to enrolment.Results: A total of 111 COVID-19 positive pregnant women delivered neonates at the tertiary hospital. In this study, only 28 of the 111 (25%) neonates born to COVID-19 positive mothers were admitted. The majority of the COVID-19 pregnant mothers were asymptomatic or had mild symptomatic disease (80%). Two (2/111 (2%) mothers required ICU admission and three (3/111 (3%) of them demised. In relation to neonatal outcomes, the majority of the neonates were delivered at a gestational age of 35 weeks with a birth weight of 2400 grams .The most common symptom was respiratory distress (89 %). The one (3%) neonate that tested positive for COVID-19 was born moderately preterm with a low birth weight and respiratory distress syndrome. Two (2/28 (7%) neonates demised, however the cause of death was not related to COVID-19. All the remaining (26/28 (93%) neonates were discharged and were well on follow up. Conclusion: Our study has shown that the risk of neonatal transmission from pregnant COVID-19 mothers is relatively low, and the majority of neonatal disease ranged from asymptomatic to mildly symptomatic disease. Further research efforts are essential to improve neonatal care in LMICS.

scholarly journals Endometriosis is an important cause of pelvic pain in adolescence

2014 ◽  
Vol 60 (6) ◽  
pp. 560-564 ◽  
Author(s):  
Marina de Paula Andres ◽  
Sergio Podgaec ◽  
Karina Belickas Carreiro ◽  
Edmund Chada Baracat
Keyword(s):  
Differential Diagnosis ◽  
Pelvic Pain ◽  
Clinical Characteristics ◽  
Chronic Pelvic Pain ◽  
Conventional Treatment ◽  
Tertiary Hospital ◽  
Ovarian Cysts ◽  
Common Disease ◽  
Important Differential Diagnosis ◽  
The University

Objective: despite endometriosis being a common disease, where early detection is key to preventing its progression, it is a condition often overlooked in adolescents. The aim of this study was to report the clinical characteristics of adolescent patients with endometriosis monitored in a tertiary hospital. Methods: a retrospective study of 394 patients undergoing surgery with a histological diagnosis of endometriosis at the Endometriosis Division of the Gynecology Department at the Hospital das Clínicas of the University of São Paulo Medical School from 2008 to 2013. 21 adolescents were included (aged under 21 years). Results: the age ranged from 17.95 ± 1.48 years, the average time for diagnostic confirmation was 2.96 ± 2.93 years, and the age at the onset of symptoms was 15.28 ± 3.03 years on average. The sites affected were ovarian (38%), peritoneal (47.6%) and retrocervical (23.8%). Dysmenorrhea was found in 80.9 % of adolescents (severe in 33.3% of cases) and chronic pelvic pain in 66.6%. Conclusion: endometriosis in adolescents is an important differential diagnosis from pelvic pain and ovarian cysts, mainly among those with no response to conventional treatment. The main forms of involvement are peritoneal and ovarian. Despite the onset of symptoms in adolescence and advances in imaging methods, the diagnosis of this disease is still delayed.

scholarly journals Prediction of late-onset fetal growth restriction using a combined first- and second-trimester screening model in South Chinese infants: a retrospective study

2019 ◽  
Author(s):  
Haiqing Zheng ◽  
Yan Feng ◽  
Jiexin Zhang ◽  
Kuanrong Li ◽  
Huiying Liang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Birth Weight ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Detection Rate ◽  
Prediction Models ◽  
Late Onset ◽  
Growth Restriction ◽  
Abdominal Circumference ◽  
Second Trimester

Abstract Background Prediction models for early and late fetal growth restriction (FGR) have been established in many high-income countries. However, prediction models for late FGR in China are limited. This study aimed to develop a simple combined first- and second-trimester prediction model for screening late-onset FGR in South Chinese infants.Methods This retrospective study included 2258 women who had singleton pregnancies and received routine ultrasound scans. Late-onset FGR was defined as a birth weight < the 10th percentile plus abnormal Doppler indices and/or a birth weight below the 3rd percentile after 32 weeks, regardless of the Doppler status. Multivariate logistic regression was used to develop a prediction model.Results Ninety-three fetuses were identified as late-onset FGR. The significant predictors for late-onset FGR were maternal age, height, weight, and medical history; the second-trimester head circumference (HC)/abdominal circumference (AC) ratio; and the estimated fetal weight (EFW). This model achieved a detection rate (DR) of 52.6% for late-onset FGR at a 10% false positive rate (FPR) (area under the curve (AUC): 0.80, 95%CI 0.76-0.85).Conclusions A multivariate model combining first- and second-trimester default tests can detect 52.6% of cases of late-onset FGR. Further studies with more screening markers are needed to improve the detection rate.

scholarly journals Prediction of late-onset fetal growth restriction using a combined first- and second-trimester screening model in South Chinese infants: a retrospective study

2020 ◽  
Author(s):  
Haiqing Zheng ◽  
Yan Feng ◽  
Jiexin Zhang ◽  
Kuanrong Li ◽  
Huiying Liang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Birth Weight ◽  
Prediction Model ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Detection Rate ◽  
Prediction Models ◽  
Late Onset ◽  
Validation Dataset ◽  
Second Trimester

Abstract Background: Prediction models for early and late fetal growth restriction (FGR) have been established in many high-income countries. However, prediction models for late FGR in China are limited. This study aimed to develop a simple combined first- and second-trimester prediction model for screening late-onset FGR in South Chinese infants. Methods: This retrospective study included 2258 women who had singleton pregnancies and received routine ultrasound scans as training dataset. A validation dataset including 565 pregnant women was used to evaluate the model in order to enable an unbiased estimation. Late-onset FGR was defined as a birth weight < the 10th percentile plus abnormal Doppler indices and/or a birth weight below the 3rd percentile after 32 weeks, regardless of the Doppler status. Multivariate logistic regression was used to develop a prediction model. The model included the a priori risk (maternal characteristics), the second-trimester head circumference (HC/AC) / abdomen circumference (HC) ratio and estimated fetal weight (EFW). Results: Ninety-three fetuses were identified as late-onset FGR. The significant predictors for late-onset FGR were maternal age, height, weight, and medical history; the second-trimester HC/ AC ratio; and the EFW. This model achieved a detection rate (DR) of 52.6% for late-onset FGR at a 10% false positive rate (FPR) (area under the curve (AUC): 0.80, 95%CI 0.76-0.85). The AUC of the validation dataset was 0.65 (95%CI 0.54-0.78). Conclusions: A multivariate model combining first- and second-trimester default tests can detect 52.6% of cases of late-onset FGR at a 10% FPR. Further studies with more screening markers are needed to improve the detection rate.

Infectious Disease-Related Deaths of Low Birth Weight Infants, United States, 1968 to 1982

PEDIATRICS ◽  
1989 ◽  
Vol 84 (2) ◽  
pp. 296-303
Author(s):  
Janine M. Jason
Keyword(s):  
Infectious Disease ◽  
United States ◽  
Birth Weight ◽  
Infant Mortality ◽  
Low Birth Weight ◽  
Infectious Diseases ◽  
The United States ◽  
Mortality Rates ◽  
Mortality Data ◽  
Tract Infections

Infant mortality rates in the United States are higher than in any other developed country. Low birth weight (LBW) is the primary determinant of infant mortality. Despite city, state, and federal programs to prevent LBW, decreases in infant mortality in the 1980s appear to be largely secondary to improved survival of LBW infants rather than to a decline in the rate of LBW births. Because prevention of mortality due to infectious disease is feasible, it was of interest to examine the role of infectious diseases in LBW infant mortality. US vital statistics mortality data for 1968 through 1982 were analyzed in terms of LBW infant mortality associated with infectious and noninfectious diseases. These analyses indicated that the rates of infectious disease-associated early neonatal and postneonatal LBW mortality increased during this time; late neonatal rates did not decline appreciably. Infectious diseases were associated with 4% of all LBW infant deaths in 1968; this had increased to 10% by 1982. Although LBW infant mortality rates associated with noninfectious diseases did not differ for white and black populations, infectious disease-associated mortality rates were consistently higher for blacks than whites in both metropolitan and nonmetropolitan areas. Chorioamnionitis was involved in 28% of infectious disease-associated early neonatal LBW deaths. Sepsis was an increasingly listed cause of death in all infant age periods, whereas respiratory tract infections were decreasingly listed. Necrotizing enterocolitis increased as a cause of late neonatal mortality. These data suggest that infectious diseases are an increasing cause of LBW infant mortality and these deaths occur more frequently in the black population targeted by prevention programs. More research concerning specific causes and prevention of infections in the LBW infant may help reduce US infant mortality.

scholarly journals Pattern, Clinical Characteristics, and Outcome of Meningitis among HIV-Infected Adults Admitted in a Tertiary Hospital in North Western Tanzania: A Cross-Sectional Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Matobogolo M. Boaz ◽  
Samuel Kalluvya ◽  
Jennifer A. Downs ◽  
Bonaventura C. T. Mpondo ◽  
Stephen E. Mshana
Keyword(s):  
Mortality Rate ◽  
Clinical Characteristics ◽  
Clinical Information ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Limited Information ◽  
Cross Sectional ◽  
Diagnostic Capacity ◽  
Medical Wards ◽  
Western Tanzania

Background.Limited information exists on the etiologies, clinical characteristics, and outcomes of meningitis among HIV-infected patients in Africa. We conducted a study to determine the etiology, clinical characteristics, and outcomes of meningitis among HIV-infected adults.Methods.A prospective cross-sectional hospital based study was conducted among HIV-infected patients aged ≥18 years admitted to the medical wards with symptoms and signs of meningitis. Sociodemographic and clinical information were collected using a standardized data collection tool. Lumbar puncture was performed to all patients; cerebrospinal fluid samples were sent for analysis.Results.Among 60 HIV-infected adults clinically diagnosed to have meningitis, 55 had CSF profiles consistent with meningitis. Of these, 14 (25.5%) had a laboratory-confirmed etiology while 41 (74.5%) had no isolate identified.Cryptococcus neoformanswas the commonest cause of meningitis occurring in 11 (18.3%) of patients followed byMycobacterium tuberculosis(6.7%). The in-hospital mortality was 20/55 (36.4%). Independent predictors of mortality were low baseline CD4 count and turbid CSF appearance.Conclusion.Cryptococcal meningitis is the most prevalent laboratory-confirmed etiological agent among adult HIV-infected patients with suspected meningitis admitted to medical wards in Western Tanzania. Mortality rate in this population remains unacceptably high. Improving diagnostic capacity and early treatment may help to decrease the mortality rate.

scholarly journals Anti-cyclic-citrullinated-protein-antibodies in psoriatic arthritis patients: how autoimmune dysregulation could affect clinical characteristics, retention rate of methotrexate monotherapy and first line biotechnological drug survival. A single center retrospective study.

2021 ◽  
Vol 12 ◽  
pp. 204062232098672
Author(s):  
Cinzia Rotondo ◽  
Addolorata Corrado ◽  
Daniela Cici ◽  
Stefano Berardi ◽  
Francesco Paolo Cantatore
Keyword(s):  
Retrospective Study ◽  
Psoriatic Arthritis ◽  
Clinical Characteristics ◽  
Retention Rate ◽  
Statistical Significance ◽  
Severe Disease ◽  
First Line ◽  
Drug Survival ◽  
Biotechnological Drugs ◽  
Citrullinated Protein

Aim: Occasional findings of anti-cyclic-citrullinated-protein-antibodies (anti-CCP) were rarely observed in psoriatic arthritis (PsA). The aim of our study is to evaluate whether the presence of anti-CCP can determine different clinical subsets and influence methotrexate monotherapy survival, and biotechnological drug retention rate. Methods: We conducted a retrospective study on PsA patients. All patients were required to fulfill the CASPAR criteria for PsA, and to present juxta-articular osteo-proliferative signs at X-ray. The exclusion criteria were age less than 18 years old, satisfaction of rheumatoid arthritis classification criteria, and seropositivity for rheumatoid factor. Clinical characteristics, anti-CCP titer, drug survival and comorbidities information were recorded for each patient. Statistical significance was set at p ⩽ 0.05. Results: Of 407 patients with PsA screened 113 were recruited. Twelve patients were anti-CCP positive. Methotrexate monotherapy survival was shorter in patients with anti-CCP (150 ± 48.3 weeks versus 535.3 ± 65.3 weeks; p = 0.026) [discontinuation risk hazard ratio (HR) = 2.389, 95% confidence interval (CI) 1.043, 5.473; p = 0.039] than those without. Significant shorter survival of first-line biotechnological drugs (b-DMARDs) was observed in the anti-CCP positive group than in that without (102.05 ± 24.4 weeks versus 271.6 ± 41.7 weeks; p = 0.005) with higher discontinuation risk (HR = 3.230, 95% CI 1.299, 8.028; p = 0.012). A significant higher rate of multi-failure (more than second-line b-DMARDs) was found in anti-CCP positive patients than in those without (50% versus 14%, p = 0.035). Conclusion: Anti-CCP in PsA could be suggestive of more severe disease, with worse drug survival of both methotrexate monotherapy and first-line b-DMARDs, and higher chance to be b-DMARDs multi-failure. So, they can be considered for more intensive clinical management of these patients.

scholarly journals A Standardized Implementation of Multicenter Quality Improvement Program of Very Low Birth Weight Newborns Could Significantly Reduce Admission Hypothermia and Improve Outcomes Within a Certain Region in China

2021 ◽  
Author(s):  
Shu-yu Bi ◽  
Yong-hui Yu ◽  
Cong Li ◽  
Ping Xu ◽  
Hai-yan Xu ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Birth Weight ◽  
Clinical Data ◽  
Gestational Age ◽  
Clinical Characteristics ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Improvement Program ◽  
Two Phases ◽  
The Impact

Abstract Background: Admission hypothermia (AH, <36.5℃) remains a major challenge for global neonate survival, especially in China. Due to high incidence of reginal AH, we developed a prospective multicenter quality improvement (QI) initiative to reduce regional AH and evaluate the impact on outcome among VLBW neonates.Methods: The study used sequential Plan - Do - Study - Act (PDSA) approach. Clinical data were collected prospectively with 5 NICUs from Sino-Northern Neonatal Network (SNN) in China. Bundle come into practice since January 1, 2019. The clinical data in pre-QI phase (January 1, 2018– December 31, 2018) were compared with post-QI phase (January 1, 2019–December 31, 2020). Clinical characteristics and outcomes data were analysed.Results: A total of 750 in-born VLBW infants were enrolled in the study, 270 in pre-QI period and 480 in post- QI period, respectively. There had no significant differences in clinical characteristics in two phases. Compared with pre-QI period, the percentage of AH decreased in the QI period (95.9 %vs 71.3%, P < 0.01). Admission mod-severe hypothermia (AMSH) was improved significantly, reduced by 38.5% after QI (68.5 %vs 30%, P < 0.01). Average admission temperature improved after QI [36.0 ˚C（35.8˚C，36.5˚C）vs 35.5 ˚C（35.2 ˚C，36.0 ˚C）, P < 0.01 ]. No significant increase in AH rate and thermal burns (0.4%VS 0%). Risks of mortality and late-onset neonatal sepsis (LOS) were significantly lower in post-QI period as compared to pre-QI period (aRR 0.19, 95% CI 0.09–0.39; aRR 0.55, 95% CI 0.41–0.80) whether adjusting for birth weight (BW), gestational age (GA)，small for gestational age (SGA), Apgar score at 5 min < 7.Conclusion：Implementation of multicenter thermoregulatory QI help in significant reduction of AH and AMSH of VLBW neonates within a certain area, which in turn can help to improve reginal neonatal outcomes. We gained a lot from QI, learned and explored a suitable method to continuous QI, this may provide reference for similar developing countries.

scholarly journals Differences in clinical characteristics of early- and late-onset neonatal sepsis caused by Klebsiella pneumoniae

2020 ◽  
Vol 34 ◽  
pp. 205873842095058
Author(s):  
Ting You ◽  
Han Zhang ◽  
Lu Guo ◽  
Ke-Ran Ling ◽  
Xiao-Yu Hu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Klebsiella Pneumoniae ◽  
Parenteral Nutrition ◽  
Exposure Time ◽  
Gestational Age ◽  
Clinical Characteristics ◽  
Late Onset ◽  
Univariate Analysis ◽  
Antibiotic Exposure

To identify differences in the clinical characteristics of early- and late-onset sepsis (EOS and LOS) caused by Klebsiella pneumoniae ( K. pneumoniae) and to describe the risk factors for multidrug-resistant K. pneumoniae (MDR-KP) infection. Infants with K. pneumoniae-induced sepsis who were admitted to a children’s Hospital between Jan 2000 and Dec 2019 were included. All infants were divided into EOS and LOS groups, as well as MDR-KP and non-MDR-KP groups. Demographics, clinical characteristics, and risk factors were compared between the two groups. One hundred eighty infants (66 with EOS and 114 with LOS) were further analyzed, accounting for 36.8% of sepsis cases caused by MDR-KP. The frequency of respiratory failure, bronchopulmonary dysplasia, and intraventricular hemorrhage were more common in the LOS group and a higher rate of acute respiratory distress syndrome was more common in infants in the EOS group ( P < 0.05). K. pneumoniae showed a low sensitivity to penicillin, beta-lactams and cephalosporins, and it showed a high sensitivity to levofloxacin, ciprofloxacin, and amikacin. Prematurity, low birth weight, longer antibiotic exposure time, long duration of peripheral catheter insertion, long mechanical ventilation time, and long parenteral nutrition time were associated with an increased rate of MDR-KP infection by univariate analysis ( P < 0.05). The regression analysis identified a long antibiotic exposure time (OR = 1.37, 95% CI: 1.01–1.89) and long parenteral nutrition time (OR = 1.39, 95% CI: 1.01–1.89) as independent risk factors for a MDR-KP infection, and a greater gestational age and birth weight were associated with a lower risk of MDR-KP infection (OR = 0.57, 95% CI: 0.40–0.79). LOS caused by K. pneumoniae may lead to a higher frequency of complications. The risk factors for MDR-KP infection were longer duration of antibiotic exposure and parenteral nutrition. A greater gestational age and larger birth weight may decrease the risk of MDR-KP infection.

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