A Wide Database for Future Studies Aimed at Improving Early Recognition of Candidemia

Invasive candidiasis is associated with high morbidity and mortality in critically ill patients, i.e. patients admitted to Intensive Care Units (ICUs) or in surgical wards. There are no clinical signs or specific symptoms and even though early diagnosis risk scores and rapid tests are available, none of such strategies has an equally-optimal level of sensitivity and specificity. In the era of Electronic Health Records (EHRs), several clinical studies exploited Machine Learning (ML) models and large database of features to improve the diagnosis accuracy. The main aim of this work is to build a wide dataset which can be exploited to apply ML models to further improve the early recognition of candidemia at the bedside of patients with compatible signs and symptoms.

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Incidence, Pathogenesis, and Management of Sepsis

AACN Advanced Critical Care ◽

10.4037/15597768-2006-4005 ◽

2006 ◽

Vol 17 (4) ◽

pp. 385-393 ◽

Cited By ~ 1

Author(s):

Ruth M. Kleinpell ◽

Brian T. Graves ◽

Michael H. Ackerman

Keyword(s):

Severe Sepsis ◽

Nursing Care ◽

Early Recognition ◽

Clinical Signs ◽

Signs And Symptoms ◽

High Morbidity ◽

Assessment And Monitoring ◽

Clinical Signs And Symptoms ◽

Evidence Based Guidelines ◽

Sepsis Care

Sepsis is a complex condition that occurs as a result of the systemic manifestation of infection. It is associated with high morbidity and mortality risks for critically ill patients. Assessment and monitoring aimed at early recognition and treatment, on the basis of evidence-based guidelines, are advocated for optimizing outcomes for patients with severe sepsis. Awareness of the risk factors, clinical signs and symptoms, pathophysiology, and updates in the management of sepsis can enhance the nursing care for patients with severe sepsis to promote best practices for sepsis care in the intensive care unit. This article reviews the incidence and pathophysiology of sepsis, highlighting updates in treatment and implications for nursing care.

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Clinico-epidemiological features of Japanese encephalitis patients hospitalized in a tertiary care center

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20184008 ◽

2018 ◽

Vol 5 (10) ◽

pp. 4548

Author(s):

Abu Hasan Sarkar ◽

Bishnu Ram Das

Keyword(s):

Japanese Encephalitis ◽

Care Center ◽

Tertiary Care ◽

Clinical Signs ◽

Signs And Symptoms ◽

Complete Recovery ◽

High Morbidity ◽

Medical College ◽

Clinical Signs And Symptoms ◽

One Year

Background: Japanese encephalitis (JE) is of particular interest as it has a high morbidity and mortality. Neurological sequale is the most dreaded damage caused by JE. It is a preventable disease with specific interventions. The objective of the study was to study the demography, clinical profile and outcome of patients with Japanese Encephalitis admitted to the wards of Internal Medicine and Pediatrics at Jorhat Medical College Hospital.Methods: Hospital based observational study for one year in Jorhat Medical College, Jorhat, Assam.Results: The mean age for JE was 32.25±27 years for male, 27.47±22 years for female and 29.94±24 years overall. Assessment of clinical signs and symptoms showed that fever and change in mental status were present in 100% of JE cases followed by neck rigidity in 79.3% and headache in 68.9%. 44.8% of JE cases had history of seizure, 37.9% had vomiting, 34.5% had irritability, 13.8% were unconscious. The peak of JE incidence occurred in the month of July (77.6%). Complete recovery was seen in 39.2%, followed by death in 32.6% and recovery with neurological sequalae in 28.2% at the time of discharge.Conclusions: Vigorous awareness activities should be carried out to sensitize people on prevention of JE.

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Machine learning model for predicting severity prognosis in patients infected with COVID-19: Study protocol from COVID-AI Brasil

PLoS ONE ◽

10.1371/journal.pone.0245384 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0245384

Author(s):

Flávia Paiva Proença Lobo Lopes ◽

Felipe Campos Kitamura ◽

Gustavo Faibischew Prado ◽

Paulo Eduardo de Aguiar Kuriki ◽

Marcio Ricardo Taveira Garcia ◽

...

Keyword(s):

Machine Learning ◽

Alternative Hypothesis ◽

Clinical Signs ◽

Signs And Symptoms ◽

Learning Model ◽

Chest Ct ◽

Secondary Outcome ◽

Convenience Sample ◽

Machine Learning Model ◽

Short Period

The new coronavirus, which began to be called SARS-CoV-2, is a single-stranded RNA beta coronavirus, initially identified in Wuhan (Hubei province, China) and currently spreading across six continents causing a considerable harm to patients, with no specific tools until now to provide prognostic outcomes. Thus, the aim of this study is to evaluate possible findings on chest CT of patients with signs and symptoms of respiratory syndromes and positive epidemiological factors for COVID-19 infection and to correlate them with the course of the disease. In this sense, it is also expected to develop specific machine learning algorithm for this purpose, through pulmonary segmentation, which can predict possible prognostic factors, through more accurate results. Our alternative hypothesis is that the machine learning model based on clinical, radiological and epidemiological data will be able to predict the severity prognosis of patients infected with COVID-19. We will perform a multicenter retrospective longitudinal study to obtain a large number of cases in a short period of time, for better study validation. Our convenience sample (at least 20 cases for each outcome) will be collected in each center considering the inclusion and exclusion criteria. We will evaluate patients who enter the hospital with clinical signs and symptoms of acute respiratory syndrome, from March to May 2020. We will include individuals with signs and symptoms of acute respiratory syndrome, with positive epidemiological history for COVID-19, who have performed a chest computed tomography. We will assess chest CT of these patients and to correlate them with the course of the disease. Primary outcomes:1) Time to hospital discharge; 2) Length of stay in the ICU; 3) orotracheal intubation;4) Development of Acute Respiratory Discomfort Syndrome. Secondary outcomes:1) Sepsis; 2) Hypotension or cardiocirculatory dysfunction requiring the prescription of vasopressors or inotropes; 3) Coagulopathy; 4) Acute Myocardial Infarction; 5) Acute Renal Insufficiency; 6) Death. We will use the AUC and F1-score of these algorithms as the main metrics, and we hope to identify algorithms capable of generalizing their results for each specified primary and secondary outcome.

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Posterior nutcracker syndrome – a systematic review

VASA ◽

10.1024/0301-1526/a000670 ◽

2018 ◽

Vol 47 (1) ◽

pp. 23-29 ◽

Cited By ~ 4

Author(s):

Jae Hyon Park ◽

Gi Hoon Lee ◽

Seul Mi Lee ◽

Michael Eisenhut ◽

Andreas Kronbichler ◽

...

Keyword(s):

Renal Vein ◽

Left Renal Vein ◽

Clinical Signs ◽

Signs And Symptoms ◽

Final Analysis ◽

Evidence Base ◽

High Morbidity ◽

Nutcracker Syndrome ◽

Paediatric Age ◽

Posterior Nutcracker Syndrome

Abstract. Posterior nutcracker syndrome (PNCS) is the entrapment of the left renal vein between the aorta and the vertebral column. Although uncommon, it is still an important diagnosis due to the high morbidity associated with the risk of secondary anaemia from haematuria, from long-term left renal vein hypertension, vascular thrombosis, and even blood clots in the urinary system. A literature search of PubMed and EMBASE databases was performed and 27 publications containing 27 cases were included for the final analysis. The following frequency of clinical signs and symptoms was noted: twenty-five patients had haematuria, 13 patients had flank pain, and two had hypertension. Overall, male-female distribution was balanced and there were more adult than paediatric (age < 18 years) patients. All symptoms of patients with conservative treatment were either well-controlled or under spontaneous resolution. Conservative management instead of surgical treatment should be preferred in most cases. Taken together, despite the low incidence of PNCS, its recognition and management are highly important. This systematic study explores the evidence base for conservative and medical options.

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Characteristics of Children with Diabetic Ketoacidosis Treated in Pediatric Intensive Care Unit: Two-Center Cross-Sectional Study in Croatia

Medicina ◽

10.3390/medicina55070362 ◽

2019 ◽

Vol 55 (7) ◽

pp. 362 ◽

Cited By ~ 2

Author(s):

Burcul ◽

Arambasic ◽

Polic ◽

Kovacevic ◽

Bartulovic ◽

...

Keyword(s):

Intensive Care ◽

Diabetic Ketoacidosis ◽

Cerebral Edema ◽

Early Recognition ◽

Laboratory Data ◽

Clinical Signs ◽

Pediatric Intensive Care ◽

Signs And Symptoms ◽

Laboratory Parameters ◽

Significant Difference

Background and objective: There is an increasing risk of type 1 diabetes mellitus (T1D) among children in Croatia. Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with T1D, with cerebral edema as the most severe complication. Since early recognition of cerebral edema leads to a better outcome, it is important that patients with moderate or severe DKA are closely monitored and treated in pediatric intensive care units (PICUs). The aim of this study is to investigate clinical and laboratory parameters, as well as complications in children treated in PICUs because of DKA. Materials and methods: Patients treated due to DKA in the PICU of the University Hospitals of Split and Osijek from 2013 to 2017 were included in this study. Retrospectively collected data included age, gender, clinical signs and symptoms, and various laboratory parameters. After dividing subjects into two groups: Newly diagnosed with T1D (NT1D) and previously diagnosed with T1D (PT1D), collected data were compared between the two groups. Results: A total of 82 patients were enrolled. Those with NT1D were more often treated in the PICU, with two of them developing cerebral edema. Dehydration was the most frequent clinical sign, found in 95% of patients at admission. Decreased consciousness level was found in 41.5% of patients, with majority of them being somnolent. No difference was found between NT1D and PT1D. Additionally, there was no significant difference regarding laboratory data at admission. Conclusions: More children with NT1D required treatment in the PICU due to DKA with two of them developing cerebral edema. Since cerebral edema is a life-threatening condition, treatment of patients with moderate or severe DKA in PICUs will provide necessary monitoring enabling early recognition, treatment, and better treatment outcome. To minimize the incidence of DKA among patients with NT1D, it is important to continuously carry out public health education programs aimed at early identification of signs and symptoms of T1D.

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Right Cerebellar Tuberculosis with Cranial Nerve Palsy in Pulmonary Tuberculosis Patient

Jurnal Respirasi ◽

10.20473/jr.v7-i.2.2021.65-69 ◽

2021 ◽

Vol 7 (2) ◽

pp. 65

Author(s):

I Komang Rusgi Yandi ◽

Isnin Anang Marhana

Keyword(s):

Young Adult ◽

Clinical Signs ◽

Clinical Manifestations ◽

Signs And Symptoms ◽

Tuberculosis Patient ◽

Public Health Issue ◽

High Morbidity ◽

Radiological Findings ◽

Blurred Vision ◽

History Of

Introduction: Tuberculosis (TB) is a major public health issue. The most devastating clinical manifestations of TB is Central nervous system (CNS) TB. CNS TB is found approximately in 1% of all patients with active TB, and cerebellar TB is rarely reported. CNS TB can present as meningitis, arachnoiditis, tuberculomas, or the uncommon forms of tuberculous subdural empyema and brain abscess.Case: A 23-year-old patient was reported in October 2018 with signs and symptoms of 2-month history of vertigo, headache, vomiting, weakness, fever, blurred vision, lingual palsy, dysmetria, and decrease of consciousness. The patient had a few months of history of cough, contact with a TB patient, his father, and loss of body weight. On admission, the patient had fever (38.50 C) and Glasgow coma score of 13.Discussion: CNS TB can occur in an immunocompromised patient with malnutrition, whether a child or young adult. The patient in this case had risk factors because he is a young adult and had contact with a patient of TB, his father. Based on epidemiology, clinical signs and symptoms, radiological findings, and the result of AFB-stained sputum, the patient was diagnosed with right cerebellar TB and PTB.Conclusion: The high morbidity and mortality characteristics of CNS TB are very important to note, thus the prompt diagnosis and therapy should be done. The specific therapy of ATD combined with surgery seems to provide a good result. The clinical and radiological findings were used as the evaluation of the medication.

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Machine Learning Methods to Predict Acute Respiratory Failure and Acute Respiratory Distress Syndrome

Frontiers in Big Data ◽

10.3389/fdata.2020.579774 ◽

2020 ◽

Vol 3 ◽

Author(s):

An-Kwok Ian Wong ◽

Patricia C. Cheung ◽

Rishikesan Kamaleswaran ◽

Greg S. Martin ◽

Andre L. Holder

Keyword(s):

Machine Learning ◽

Respiratory Failure ◽

Acute Respiratory Failure ◽

Early Recognition ◽

Disease Process ◽

High Morbidity ◽

Learning Tools ◽

Machine Learning Methods ◽

Improve Patient

Acute respiratory failure (ARF) is a common problem in medicine that utilizes significant healthcare resources and is associated with high morbidity and mortality. Classification of acute respiratory failure is complicated, and it is often determined by the level of mechanical support that is required, or the discrepancy between oxygen supply and uptake. These phenotypes make acute respiratory failure a continuum of syndromes, rather than one homogenous disease process. Early recognition of the risk factors for new or worsening acute respiratory failure may prevent that process from occurring. Predictive analytical methods using machine learning leverage clinical data to provide an early warning for impending acute respiratory failure or its sequelae. The aims of this review are to summarize the current literature on ARF prediction, to describe accepted procedures and common machine learning tools for predictive tasks through the lens of ARF prediction, and to demonstrate the challenges and potential solutions for ARF prediction that can improve patient outcomes.

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Prevalence of Schistosoma haematobium among Qur’anic School Pupils in Zaria, Kaduna State

UMYU Journal of Microbiology Research (UJMR) ◽

10.47430/ujmr.2052.012 ◽

2020 ◽

pp. 92-97

Author(s):

Anchau Z.G. ◽

Keyword(s):

Schistosoma Haematobium ◽

Clinical Signs ◽

Public Health Problem ◽

Signs And Symptoms ◽

High Morbidity ◽

Major Public Health Problem ◽

Community Based ◽

Urinary Schistosomiasis ◽

Clinical Signs And Symptoms ◽

Age Range

Urinary schistosomiasis is a major public health problem particularly in developing countries and is associated with high morbidity. The study aimed at determining the prevalence of urinary schistosomiasis among Qur’anic school pupils in Zaria, Kaduna State. One hundred and fifty-five (155) urine samples were collected from Qur’anic school pupils in Zaria. The samples were immediately transported to the laboratory of the Department of Microbiology, Ahmadu Bello University (A.B.U), Zaria and processed using sedimentation technique. The ova of Schistosoma haematobium were detected in fifty-eight (58) samples giving a prevalence of 37.4%. The infection was highest in age group 10-12 years with 41.9%, followed by those in age range 13-15years (41.0%) while the least was observed among pupils between the ages of7- 9years (27.5%). Risk factors observed to be associated with schistosomiasis include; swimming in river or dam, fishing and place of laundry. The infection was associated with clinical signs and symptoms including abdominal pain, haematuria, painful and frequent urination. Regular community-based treatment should be conducted using anti-helminthic drugs to reduce urinary schistosomiasis. Key words: Prevalence, Schistosoma haematobium, Qur’anic school pupils, Zaria, Kaduna State

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Clinical Manifestations and Associated Complications of Scrub Typhus in Odisha, India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/44908.13941 ◽

2020 ◽

Author(s):

Lalatendu Mohanty ◽

Aditya Dhanawat ◽

Partisha Gupta ◽

Guncha Maheshwari

Keyword(s):

Rural Areas ◽

Scrub Typhus ◽

Early Recognition ◽

Clinical Signs ◽

Clinical Manifestations ◽

Kidney Injury ◽

Signs And Symptoms ◽

Multiple Organ ◽

Care Physician ◽

Organ Systems

Introduction: Scrub typhus is a re-emerging illness in the South-East Asia and other parts of the world caused by Orientia tsutsugamushi, which is a mite-borne bacterium belonging to the Rickettsiaceae family. It has varied clinical manifestations and affects multiple organ systems. In Asia, about 1 million new cases are identified annually. Aim: The aim was to conduct a retrospective study to observe the clinical profile and complications of scrub typhus in South-Eastern India. Materials and Methods: Clinical data of 240 patients who were 18 years of age or above, admitted in the Department of Internal Medicine and diagnosed with scrub typhus by means of IgM Enzyme-linked Immune Sorbent Assay (ELISA) was collected. Demographic profile, clinical signs and symptoms, laboratory parameters, co-infections and complications were reviewed. Statistical analyses were performed using Chi-square test. Results: Majority of the patients were males, between the age of 18-29 years and lived in rural areas. Forty-three (17.9%) patients were admitted in the ICU and the remaining in wards. Sixty-nine (28.8%) patients had consolidation and 11 (4.6%) had Acute Respiratory Distress Syndrome (ARDS). Twenty-one (8.8%) patients had jaundice and 76 (31.7) had hepatomegaly. Twenty-one (8.8%) patients had meningo-encephalitis and 18 (7.5%) had acute kidney injury. Twelve (5%) patients had co-infection with dengue and 8 (3.3%) had malaria. Conclusion: This study shows wide and varied presentation of scrub typhus infection along with the course of the disease and response to the treatment. The diagnostic clues such as fever, eschar, rashes, lymphadenopathy should be kept in mind by a primary care physician as early recognition and treatment can prevent its dangerous complications and reduce the mortality due to the disease. Occurrence of co-infections should also be kept in mind for better management of the patient.

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Clinical validation of an open-access SARS-COV-2 antigen detection lateral flow assay, compared to commercially available assays

PLoS ONE ◽

10.1371/journal.pone.0256352 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0256352

Author(s):

Christine M. Bachman ◽

Benjamin D. Grant ◽

Caitlin E. Anderson ◽

Luis F. Alonzo ◽

Spencer Garing ◽

...

Keyword(s):

Open Access ◽

Clinical Signs ◽

Rapid Test ◽

Signs And Symptoms ◽

Lateral Flow ◽

Lateral Flow Assay ◽

Clinical Validation ◽

Product Profile ◽

Rapid Tests ◽

Clinical Signs And Symptoms

Rapid tests for SARS-COV-2 infection are important tools for pandemic control, but current rapid tests are based on proprietary designs and reagents. We report clinical validation results of an open-access lateral flow assay (OA-LFA) design using commercially available materials and reagents, along with RT-qPCR and commercially available comparators (BinaxNOW® and Sofia®). Adult patients with suspected COVID-19 based on clinical signs and symptoms, and with symptoms ≤7 days duration, underwent anterior nares (AN) sampling for the OA-LFA, Sofia®, BinaxNOW ™, and RT-qPCR, along with nasopharyngeal (NP) RT-qPCR. Results indicate a positive predictive agreement with NP sampling as 69% (60% -78%) OA-LFA, 74% (64% - 82%) Sofia®, and 82% (73% - 88%) BinaxNOW™. The implication for these results is that we provide an open-access LFA design that meets the minimum WHO target product profile for a rapid test, that virtually any diagnostic manufacturer could produce.

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