scholarly journals Should We Care About Plasmodium Vivax and HIV Coinfection? A Systematic Review and a Cases Series From the Brazilian Amazon

2020 ◽  
Author(s):  
Paola López Del-Tejo ◽  
Nadia Cubas-Vega ◽  
Cecilia Caraballo-Guerra ◽  
Bernardo Maia da Silva ◽  
Jefferson da Silva Valente ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plasmodium Vivax ◽  
Severe Malaria ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Brazilian Amazon ◽  
African Region ◽  
Cross Sectional ◽  
Hiv Coinfection

Abstract Background. Malaria and HIV are two important public health issues. However, data on HIV-Plasmodium vivax co-infection (HIV/PvCo) is scarce, with most of the available data related to P. falciparum in the African region. It is unclear whether HIV can change the clinical course of Plasmodium vivax (Pv) malaria, and thereby increase the risk of complications. In this study, a systematic review of the HIV/PvCo is presented, including new cases from the Brazilian Amazon. Methods. Medical records from a tertiary care center in the Western Brazilian Amazon (2009 to 2018) were reviewed to identify HIV/PvCo hospitalized patients. Demographic, clinical and laboratory characteristics, and outcomes are reported. We also performed a systematic review of published studies on HIV/PvCo. Metadata, number of HIV/PvCo cases, demographic, clinical, and outcome data were extracted if available. Results. A total of 1048 vivax malaria patients were hospitalized in the 10-year period; 21 (2.0%) were HIV/PvCo cases, of which nine (42.9%) had AIDS-defining illnesses. For eleven (52.4%) patients, this was their first malaria infection. Seven (33.3%) patients were unaware of their HIV status and were diagnosed at hospitalization. Severe malaria criteria were found in 5 (23.8%) patients. One patient died. The systematic review provided 17 articles (12 cross-sectional or longitudinal studies and 5 case report studies). A higher prevalence of studies involved cases in African and Asian countries (35.3% and 29.4%, respectively), and the prevalence of reported co-infections ranged from 0.1 to 60%. Cases of severe malaria-HIV coinfection were not reported. Conclusion. Reports of HIV/PvCo are scarce in the literature, with only a few studies describing clinical and laboratory outcomes. Systematic screening for both co-infections are not performed, and therefore, a realistic prevalence of HIV/PvCo is absent. This study showed a low prevalence of HIV/PvCo, despite local malaria and HIV high prevalence. Even though relatively small, this is the largest case series to describe HIV/PvCo.

scholarly journals Should we care about Plasmodium vivax and HIV coinfection? A systematic review and a cases series from the Brazilian Amazon

2020 ◽  
Author(s):  
Paola López Del-Tejo ◽  
Nadia Cubas-Vega ◽  
Cecilia Caraballo-Guerra ◽  
Bernardo Maia da Silva ◽  
Jefferson da Silva Valente ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plasmodium Vivax ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Brazilian Amazon ◽  
Outcome Data ◽  
Malaria Episode ◽  
Cross Sectional ◽  
Systematic Screening

Abstract Background. Malaria and HIV are two important public health issues. However, evidence on HIV-Plasmodium vivax co-infection (HIV/PvCo) is scarce, with most of the available information related to P. falciparum on the African continent. It is unclear whether HIV can change the clinical course of Plasmodium vivax (Pv) malaria, and increase the risk of complications. In this study, we present a systematic review of the HIV/PvCo, and include recent cases from the Brazilian Amazon. Methods. Medical records from a tertiary care center in the Western Brazilian Amazon (2009 - 2018) were reviewed to identify HIV/PvCo hospitalized patients. Demographic, clinical and laboratory characteristics and outcomes are reported. We also performed a systematic review of published studies on HIV/PvCo. Metadata, number of HIV/PvCo cases, demographic, clinical, and outcome data were extracted. Results. A total of 1048 vivax malaria patients were hospitalized in the 10-year period; 21 (2.0%) were HIV/PvCo cases, of which nine (42.9%) had AIDS-defining illnesses. This was the first malaria episode in eleven (52.4%) patients. Seven (33.3%) patients were unaware of their HIV status and were diagnosed on hospitalization. Severe malaria was diagnosed in 5 (23.8%) patients. One patient died. The systematic review search provided 17 articles (12 cross-sectional or longitudinal studies and 5 case report studies). A higher prevalence of studies involved cases in African and Asian countries (35.3% and 29.4%, respectively), and the prevalence of reported co-infections ranged from 0.1 to 60%. Conclusion. Reports of HIV/PvCo are scarce in the literature, with only a few studies describing clinical and laboratory outcomes. Systematic screening for both co-infections is not routinely performed, and therefore, the real prevalence of HIV/PvCo is unknown. This study showed a low prevalence of HIV/PvCo, despite the high prevalence of malaria and HIV locally. Even though relatively small, this is the largest case series to describe HIV/PvCo.

scholarly journals Should we care about Plasmodium vivax and HIV co-infection? A systematic review and a cases series from the Brazilian Amazon

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Paola López Del-Tejo ◽  
Nadia Cubas-Vega ◽  
Cecilia Caraballo-Guerra ◽  
Bernardo Maia da Silva ◽  
Jefferson da Silva Valente ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plasmodium Vivax ◽  
Vivax Malaria ◽  
Tertiary Care ◽  
Case Series ◽  
Brazilian Amazon ◽  
Outcome Data ◽  
Malaria Episode ◽  
Tertiary Care Centre ◽  
Cross Sectional

Abstract Background Malaria and HIV are two important public health issues. However, evidence on HIV-Plasmodium vivax co-infection (HIV/PvCo) is scarce, with most of the available information related to Plasmodium falciparum on the African continent. It is unclear whether HIV can change the clinical course of vivax malaria and increase the risk of complications. In this study, a systematic review of HIV/PvCo studies was performed, and recent cases from the Brazilian Amazon were included. Methods Medical records from a tertiary care centre in the Western Brazilian Amazon (2009–2018) were reviewed to identify HIV/PvCo hospitalized patients. Demographic, clinical and laboratory characteristics and outcomes are reported. Also, a systematic review of published studies on HIV/PvCo was conducted. Metadata, number of HIV/PvCo cases, demographic, clinical, and outcome data were extracted. Results A total of 1,048 vivax malaria patients were hospitalized in the 10-year period; 21 (2.0%) were HIV/PvCo cases, of which 9 (42.9%) had AIDS-defining illnesses. This was the first malaria episode in 11 (52.4%) patients. Seven (33.3%) patients were unaware of their HIV status and were diagnosed on hospitalization. Severe malaria was diagnosed in 5 (23.8%) patients. One patient died. The systematic review search provided 17 articles (12 cross-sectional or longitudinal studies and 5 case report studies). A higher prevalence of studies involved cases in African and Asian countries (35.3 and 29.4%, respectively), and the prevalence of reported co-infections ranged from 0.1 to 60%. Conclusion Reports of HIV/PvCo are scarce in the literature, with only a few studies describing clinical and laboratory outcomes. Systematic screening for both co-infections is not routinely performed, and therefore the real prevalence of HIV/PvCo is unknown. This study showed a low prevalence of HIV/PvCo despite the high prevalence of malaria and HIV locally. Even though relatively small, this is the largest case series to describe HIV/PvCo.

scholarly journals Should we care about Plasmodium vivax and HIV co-infection? A systematic review and a cases series from the Brazilian Amazon

2020 ◽  
Author(s):  
Paola López Del-Tejo ◽  
Nadia Cubas-Vega ◽  
Cecilia Caraballo-Guerra ◽  
Bernardo Maia da Silva ◽  
Jefferson da Silva Valente ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plasmodium Vivax ◽  
Vivax Malaria ◽  
Tertiary Care ◽  
Case Series ◽  
Brazilian Amazon ◽  
Outcome Data ◽  
Malaria Episode ◽  
Tertiary Care Centre ◽  
Cross Sectional

Abstract Background Malaria and HIV are two important public health issues. However, evidence on HIV-Plasmodium vivax co-infection (HIV/PvCo) is scarce, with most of the available information related to Plasmodium falciparum on the African continent. It is unclear whether HIV can change the clinical course of vivax malaria and increase the risk of complications. In this study, a systematic review of HIV/PvCo studies was performed, and recent cases from the Brazilian Amazon were included. Methods Medical records from a tertiary care centre in the Western Brazilian Amazon (2009-2018) were reviewed to identify HIV/PvCo hospitalized patients. Demographic, clinical and laboratory characteristics and outcomes are reported. Also, a systematic review of published studies on HIV/PvCo was conducted. Metadata, number of HIV/PvCo cases, demographic, clinical, and outcome data were extracted. Results A total of 1,048 vivax malaria patients were hospitalized in the 10-year period; 21 (2.0%) were HIV/PvCo cases, of which 9 (42.9%) had AIDS-defining illnesses. This was the first malaria episode in 11 (52.4%) patients. Seven (33.3%) patients were unaware of their HIV status and were diagnosed on hospitalization. Severe malaria was diagnosed in 5 (23.8%) patients. One patient died. The systematic review search provided 17 articles (12 cross-sectional or longitudinal studies and 5 case report studies). A higher prevalence of studies involved cases in African and Asian countries (35.3 and 29.4%, respectively), and the prevalence of reported co-infections ranged from 0.1 to 60%. Conclusion Reports of HIV/PvCo are scarce in the literature, with only a few studies describing clinical and laboratory outcomes. Systematic screening for both co-infections is not routinely performed, and therefore the real prevalence of HIV/PvCo is unknown. This study showed a low prevalence of HIV/PvCo despite the high prevalence of malaria and HIV locally. Even though relatively small, this is the largest case series to describe HIV/PvCo.

Prehospital Intubations Are Associated with Elevated Endotracheal Tube Cuff Pressures: A Cross-Sectional Study Characterizing ETT Cuff Pressures at a Tertiary Care Emergency Department

2021 ◽  
pp. 1-4
Author(s):  
Ruo S. Chen ◽  
Laurel O’Connor ◽  
Matthew R. Rebesco ◽  
Kara L. LaBarge ◽  
Edgar J. Remotti ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Cuff Pressure ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Endotracheal Tube Cuff ◽  
Cross Sectional ◽  
Tube Cuff ◽  
Respiratory Therapists ◽  
Significant Difference

Abstract Introduction: Emergency Medical Services (EMS) providers are trained to place endotracheal tubes (ETTs) in the prehospital setting when indicated. Endotracheal tube cuffs are traditionally inflated with 10cc of air to provide adequate seal against the tracheal lumen. There is literature suggesting that many ETTs are inflated well beyond the accepted safe pressures of 20-30cmH2O, leading to potential complications including ischemia, necrosis, scarring, and stenosis of the tracheal wall. Currently, EMS providers do not routinely check ETT cuff pressures. It was hypothesized that the average ETT cuff pressure of patients arriving at the study site who were intubated by EMS exceeds the safe pressure range of 20-30cmH2O. Objectives: While ETT cuff inflation is necessary to close the respiratory system, thus preventing air leaks and aspiration, there is evidence to suggest that over-inflated ETT cuffs can cause long-term complications. The purpose of this study is to characterize the cuff pressures of ETTs placed by EMS providers. Methods: This project was a single center, prospective observational study. Endotracheal tube cuff pressures were measured and recorded for adult patients intubated by EMS providers prior to arrival at a large, urban, tertiary care center over a nine-month period. All data were collected by respiratory therapists utilizing a cuff pressure measurement device which had a detectable range of 0-100cmH2O and was designed as a syringe. Results including basic patient demographics, cuff pressure, tube size, and EMS service were recorded. Results: In total, 45 measurements from six EMS services were included with ETT sizes ranging from 6.5-8.0mm. Mean patient age was 52.2 years (67.7% male). Mean cuff pressure was 81.8cmH2O with a range of 15 to 100 and a median of 100. The mode was 100cmH2O; 40 out of 45 (88.9%) cuff pressures were above 30cmH2O. Linear regression showed no correlation between age and ETT cuff pressure or between ETT size and cuff pressure. Two-tailed T tests did not show a significant difference in the mean cuff pressure between female versus male patients. Conclusion: An overwhelming majority of prehospital intubations are associated with elevated cuff pressures, and cuff pressure monitoring education is indicated to address this phenomenon.

scholarly journals Vitamin C Deficiency in Inflammatory Bowel Disease: The Forgotten Micronutrient

2021 ◽  
Author(s):  
Katie A Dunleavy ◽  
Ryan C Ungaro ◽  
Laura Manning ◽  
Stephanie Gold ◽  
Joshua Novak ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Vitamin C ◽  
Bowel Disease ◽  
Fruits And Vegetables ◽  
Nutritional Assessment ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Vitamin C Deficiency ◽  
Inflammatory Bowel

Abstract Background Micronutrient deficiencies are common in patients with inflammatory bowel disease (IBD). To date, the literature has focused on vitamin D, vitamin B12, and iron deficiencies. Methods We report a case series of 20 patients with IBD and vitamin C deficiency treated at a single tertiary care center. Results Sixteen (80%) patients had symptoms of clinical scurvy, including arthralgia, dry brittle hair, pigmented rash, gingivitis, easy bruising and/or brittle nails. Eighteen patients underwent a nutritional assessment, 10 (56%) patients reported complete avoidance of fruits and vegetables, and 3 (17%) reported reduced intake of fruits and vegetables. Conclusions Vitamin C deficiency should be considered in IBD patients, particularly those with reduced fruit/vegetable intake, as it can lead to significant signs and symptoms.

A Comparison of Falls and Dizziness Handicap by Vestibular Diagnosis

2021 ◽  
pp. 1-10
Author(s):  
Ryan J. Huang ◽  
Sherri L. Smith ◽  
Libor Brezina ◽  
Kristal M. Riska
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Vestibular Migraine ◽  
Cross Sectional ◽  
Positional Vertigo ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Paroxysmal Positional Vertigo

Purpose There is a paucity of data that directly compares the falls rate and dizziness handicap of different vestibular diagnoses. The purpose of this study is to compare the falls rate and dizziness handicap of common vestibular diagnoses encountered among a cohort of vestibular patients at a single institution. Method We conducted a retrospective cross-sectional study of patients evaluated for dizziness at a tertiary care center vestibular clinic between August 1, 2017, and March 19, 2019. Vestibular diagnosis, demographic variables, comorbidities, falls status, and Dizziness Handicap Inventory (DHI) were extracted from the medical record for analysis. Associations between vestibular diagnosis and falls history or DHI were evaluated using multivariate logistic and linear regression, respectively. Results A total of 283 patients met our inclusion criteria with the following diagnoses: benign paroxysmal positional vertigo (BPPV; n = 55), acoustic neuroma ( n = 30), Ménière's disease ( n = 28), multiple vestibular diagnoses ( n = 15), vestibular migraine ( n = 135), or vestibular neuritis ( n = 20). After adjusting for age, sex, race, medications, and comorbidities, the odds of falling was 2.47 times greater (95% CI [1.08, 6.06], p = .039) and the DHI score was 11.66 points higher (95% CI [4.99, 18.33], p < .001) in those with vestibular migraine compared to those with BPPV. Other diagnoses were comparable to BPPV with respect to odds of falling and dizziness handicap. Conclusions Patients with vestibular migraine may suffer an increased risk of falls and dizziness handicap compared to patients with BPPV. Our findings highlight the need for timely evaluation and treatment of all patients with vestibular disease.

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

scholarly journals Clinico-epidemiological profile of patients admitted with Plasmodium vivax malaria in a tertiary care hospital, Delhi

2018 ◽  
Vol 5 (12) ◽  
pp. 5420 ◽  
Author(s):  
Geeta Yadav ◽  
Geeta Pardeshi ◽  
Neelam Roy
Keyword(s):  
Plasmodium Vivax ◽  
Severe Malaria ◽  
Vivax Malaria ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Fatality ◽  
Care Hospital ◽  
Who Criteria ◽  
Epidemiological Profile ◽  
Safdarjung Hospital

Background: Malaria is an important public health problem in India. Severe and complicated forms of malaria are usually associated with Plasmodium falciparum species. But recently published literature suggests that Plasmodium vivax infection also presents as severe malaria. The objective was to study clinical and epidemiological profile of patients with P. vivax malaria admitted in Safdarjung hospital.Methods: A record based retrospective study was conducted in Vardhman Mahavir Medical College & Safdarjung Hospital, a tertiary care hospital in Delhi. Data were collected from all case records with ICD 10 codes for Malaria (B50-B54) for the year 2011 obtained from Medical Records Department, Safdarjung Hospital and analyzed using SPSS 21.0.Results: A total of 147 case records which had information about the test results for type of malaria infection were reviewed. Out of 147, 89 (60.5%) had P. vivax malaria. Of the 89 patients with P. vivax malaria, 47 (53%) were children and 63 (70.7%) were males. A peak in the number of inpatients was seen in September with median duration of hospital stay of 4 days and case fatality rate of 9%. A total of 56 (63%) patients had one or more severe manifestations of malaria as per WHO criteria. The most common severe manifestation was bleeding 27 (30%) followed by impaired consciousness 18 (20%).Conclusions: In more than half of the malaria patients admitted at the tertiary care centre the diagnosis was P. vivax malaria. Of them 63% patients had severe malaria as per WHO criteria.

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