scholarly journals PERANAN PROKALSITONIN PADA PNEUMONIA KOMUNITAS

2017 ◽  
Vol 2 (2) ◽  
pp. 33
Author(s):  
Mirza Purwitasari ◽  
Erlina Burhan ◽  
Priyanti Z. Soepandi
Keyword(s):  
Bacterial Infections ◽  
Respiratory Infections ◽  
Protein A ◽  
Clinical Signs ◽  
Public Health Problem ◽  
Clinical Information ◽  
Signs And Symptoms ◽  
Inflammatory Biomarker ◽  
Therapeutic Decisions ◽  
Clinical Signs And Symptoms

Abstrak : Keterbatasan dalam mendiagnosis infeksi respirasi dari klinis, gejala penyakit dan pemeriksaan mikrobiologis, keberadaan biomarker dapat dijadikan informasi tambahan dalam meningkatkan diagnosis dan prognosis yang membantu dalam keputusan pemberian terapi. Penggunaan prokalsitonin dapat membantu diagnosis membedakan dari infeksi yang disebabkan oleh virus, menilai derajat risiko pasien dan keputusan pemberian, penghentian dan durasi antibiotik yang optimal. Pneumonia komunitas masih menjadi masalah kesehatan. Prokalsitonin pada akhir-akhir ini menjadi perhatian prognosis pada pneumonia komunitas. , baik yang diakibatkan oleh bakter iatau pun bukan. Prokalsitonin juga mempunyai kemampuan yang lebih baik dari pada C-reaktif protein sebagai biomarker petanda inflamasi dan mempunyai hubungan yang signifikan dengan skor sistem yang menilai klinis dan angka kematian. Kata kunci: Pneumonia komunitas, prokalsitoninAbstract : In light of the limitations of clinical signs and symptoms and traditional microbiologic diagnostic for respiratory infections, blood biomarkers that correlate with the presence and extent of bacterial infections may provide additional useful information to improve diagnostic and prognostic efforts and help with therapeutic decisions in individual patients. A growing body of evidence support the use of procalcitonin (PCT) to differentiate bacterial from viral respiratory diagnoses, to help risk stratify patients, and to guide antibiotic therapy decisions about initial need for, and optimal duration of, therapy.Communityacquired peneumonia (CAP) is a significant clinical and public health problem. Recently, attention has been paid to the potential for procalcitonin (PCT) both to differentiate the diagnosis and to indicate the prognosis of pneumonia. Procalsitonin has the ability to supplement clinical information to determine whether or not the cause of the inection is likely to be bacterial. In addition, PCT seems to be superior to the most prevalent inflammatory biomarker C-reactive protein a

Bias and `Overcall' in Interpreting Chest Radiographs in Young Febrile Children

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 11-13
Author(s):  
Michael S. Kramer ◽  
Renée Roberts-Bräuer ◽  
Robert L. Williams
Keyword(s):  
Gold Standard ◽  
Clinical Signs ◽  
Clinical Information ◽  
Signs And Symptoms ◽  
Chest Radiographs ◽  
Pediatric Radiologist ◽  
Diagnostic Validity ◽  
Kappa Index ◽  
Hospital Emergency ◽  
Clinical Signs And Symptoms

Few studies have examined the diagnostic validity of the examining physician's interpretation of chest radiographs in young febrile children, and none (to our knowledge) the extent to which the "official" (ie, the radiologist's) reading may be biased by access to the examining physician's reading and to other clinical information. The authors studied 287 consecutive chest radiographs obtained in 286 febrile children 3 to 24 months of age without chronic cardiopulmonary disease or known asthma who presented to a children's hospital emergency department between March 1989 and August 1990. The readings by treating pediatricians, official pediatric radiologists, and a "blind" pediatric radiologist were compared. Official radiologists had access to the treating pediatricians' readings and the clinical information provided on the radiography requisition. The blind radiologist knew only that each child was 3 to 24 months of age and febrile, and he was asked to judge the presence or absence of pneumonia. Using the blind radiologist's reading as the "gold standard" for judging validity of the treating physicians' and official radiologists' readings, sensitivity (.677 vs .647), specificity (.828 vs .849), positive predictive value (PPV, .537 vs .571), and kappa index (κ, .462 vs .475) were quite similar. By contrast, agreement by the treating physicians was considerably higher with the official radiologists' readings as gold standard: sensitivity = .756, specificity = .922, PPV = .795, and κ = .688. When the treating physician's reading was positive, the official radiologists' positivity rate was much higher than the blind radiologist's (74.4% vs 51.8%, P < .005), sensitivity was high (.884) but specificity was low (.436), PPV was .663, and κ was .326. When the treating physicians' reading was negative, however, the pattern was reversed: positivity = 8.5% vs 12.8% (P not significant), sensitivity = .240, specificity = .937, PPV = .353, and κ = .205. Surprisingly, none of the three sets of readings appeared to be influenced by the reporting of clinical signs and symptoms on the radiography requisition. These results indicate that official radiologists are strongly biased by the treating physician's reading. Since such a bias can lead to unnecessary antibiotic treatment and hospital admission, strategies to reduce it should receive high priority.

scholarly journals A CRITICAL REVIEW ARTICLE ON PANDU W.S.R. ANAEMIA

2021 ◽  
Vol 9 (9) ◽  
pp. 2144-2150
Author(s):  
Shivam Kumar Nigam ◽  
Rita Singh ◽  
Sanjay Srivastava
Keyword(s):  
Medical Science ◽  
Clinical Signs ◽  
Public Health Problem ◽  
Signs And Symptoms ◽  
Modern Medicine ◽  
Review Article ◽  
Global Public Health ◽  
The World ◽  
Clinical Signs And Symptoms ◽  
Global Public Health Problem

Pandu Roga is one of the diseases mentioned in Ayurveda characterized by the changes in the skin colour to white (Shweta), yellowish (Peeta), greenish (Harita) etc. which is one of the “Varnopalakshita Roga" i.e., a disease characterized by the change in the colour. The clinical condition of Pandu in Ayurveda can be co-related with Anaemia described in Modern Medical Science, due to the resemblance in the clinical signs and symptoms. In Modern Medicine, Pandu is a pale appearance which may be due to the decreased blood supply to the skin or de- creased visibility of oxyhemoglobin. Anaemia is a major global public health problem and the most prevalent nu- tritional deficiency disorder in the world. This article presents the Ayurvedic concept of Pandu Roga (Anaemia). Keywords: Pandu, Vyadhi, Srotas, Anaemia, Pallor,

scholarly journals Assessment of the utility of Yale observation scale as a predictor of bacteremia in children aged 3 months to 36 months

2019 ◽  
Vol 6 (2) ◽  
pp. 559
Author(s):  
P. Sudhakar ◽  
P. Ajitha
Keyword(s):  
Bacterial Infections ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Roc Curves ◽  
Operating Characteristics ◽  
Good Tool ◽  
Early Management ◽  
Observation Scale ◽  
Clinical Signs And Symptoms ◽  
Yale Observation Scale

Background: The Yale observation scale (YOS) is an illness severity helps to diagnose bacteremia based on simple noninvasive clinical signs and symptoms. The aim of the present study was to assess the utility of YOS as a predictor of bacterial infection in febrile children aged 3 to 36 months.Methods: This prospective observational study was conducted on 200 children aged 3 to 36 months presenting with fever, at the Institute of Child Health and Hospital for Children during the period from April 2016 to September 2016. Rectal temperature was taken for all children. Clinical examination was done as required based on the YOS and scores were given accordingly at the time of initial presentation of the child before invasive investigations. All the observation was assessed statistically and receiver operating characteristics (ROC) curve was performed to analyze the sensitivity of the YOS.Results: Highly significant correlation (p=0.0001) was found to exist between the age of the child, duration of the fever, higher body temperature >104, WBC count, ANC and improved condition of patient with higher YOS. ROC curves showed that the sensitivity and specificity of YOS at the best cut off value of 14.5 was found to be 97% and 79.6% respectively.Conclusions: YOS is very good tool for predicting bacteremia in young febrile children based on simple non-invasive clinical signs and symptoms. The findings ruled out by YOS aids in the immediate and early management of bacterial infections before the arrival of the results of the biochemical diagnostic tests.

scholarly journals Viral and bacterial infection elicit distinct changes in plasma lipids in febrile children

2019 ◽  
Author(s):  
Xinzhu Wang ◽  
Ruud Nijman ◽  
Stephane Camuzeaux ◽  
Caroline Sands ◽  
Heather Jackson ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Viral Infection ◽  
Bacterial Infections ◽  
Plasma Lipids ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cholesterol Sulfate ◽  
Inappropriate Use ◽  
Clinical Signs And Symptoms ◽  
The Uk

AbstractFever is the most common reason that children present to Emergency Departments in the UK. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. As a result, many children are prescribed antibiotics often unnecessarily, while others with life-threatening bacterial infections can remain untreated. The ‘omics’ approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n=20) and confirmed viral infection (n=20). We show for the first time that bacterial and viral infection elicit distinct changes in the host lipidome. Glycerophosphoinositol, sphingomyelin, lysophosphotidylcholine and cholesterol sulfate were increased in the confirmed virus infected group, while fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were increased in cases with confirmed bacterial infection. A combination of three lipids achieved the area under the receiver operating characteristic (ROC) curve of 0.918 (95% CI 0.835 to 1). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics.

scholarly journals Infectious Diarrhea, as Public Health Problem, in Romania

2021 ◽  
Vol 6 (3) ◽  
Keyword(s):  
Public Health ◽  
Acute Diarrhea ◽  
Content Volume ◽  
Clinical Signs ◽  
Public Health Problem ◽  
Signs And Symptoms ◽  
Point Of View ◽  
Public Health Issue ◽  
Family Doctors ◽  
Clinical Signs And Symptoms

From medical point of view, “Diarrhea” is an alteration in a normal bowel movement characterized by an increase in the water content, volume, or frequency of stools. Acute diarrhea of infec¬tious etiology, often referred to as gastroenteri¬tis and is typically associated with clinical signs and symptoms including: nausea, vomiting, abdomi¬nal pain and cramps, bloating, flatulence, fever, passage of bloody stools, tenesmus, and fecal ur¬gency. Infectious diarrheal diseases are the second leading cause of morbidity and mortality worldwide. It is the diarrhea we have also found out, during a large 3 yeas study 2017-2020 in Transylvania – Romania. 3577 number of cases were transmitted during this time, to our Public Health Center, by 12 district Sanitary Polices. These were mostly diagnosed by the territorial family doctors and more then 50%, have need hospitalization, for several days because of the mentioned disease disorders. The detected infectious etiology, were determined in authorized laboratories in which it was identified: Shigella, Salmonella, Campylobacter, and Yersinia, Rotavirus, Giardia. Most number of cases appeared in children, followed by elderly or adult people, as quantified number of determination. In light of these data, acute diarrheal illness had to be considered a major public health issue against which control efforts are needed. Public health surveillance and response in the field of infectious acute diarrhea include obligatory strategies of infection control.

scholarly journals A Review of Hantavirus Research in Indonesia: Prevalence in Humans and Rodents, and the Discovery of Serang Virus

Viruses ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 698
Author(s):  
Lukman ◽  
Kosasih ◽  
Ibrahim ◽  
Pradana ◽  
Neal ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Clinical Signs ◽  
Febrile Illness ◽  
Signs And Symptoms ◽  
Molecular Evidence ◽  
Rt Pcr ◽  
Seoul Virus ◽  
Seroprevalence Data ◽  
Clinical Signs And Symptoms ◽  
Almost All

Dengue and other common tropical infectious diseases of similar clinical presentation are endemic in Indonesia, which may lead to an underestimation of the prevalence of hantavirus (HTV) infection in the country. To better understand the current burden of HTV infection, this study aimed to both identify acute HTV infection among hospitalized patients with fever and to determine the overall seroprevalence of HTV. These results were further considered within the context of previously reported HTV infection in humans and animals in Indonesia by conducting a review of published literature. As part of an observational cohort study of acute febrile illness, this sub-study retrospectively analyzed blood specimens obtained during admission, during the 2–4-week convalescent period, and three months after admission. Convalescent specimens from patients with clinical signs and symptoms of HTV infection were first screened for HTV IgG. When positive, convalescent specimens and paired acute specimens were screened for HTV IgM, and paired acute specimens were tested for HTV by Reverse Transcription Polymerase Chain Reaction (RT-PCR). A literature review of HTV in Indonesia was conducted on manuscripts manually reviewed for relevance after identification from a search using the terms “hantavirus/Seoul virus” and “Indonesia”. From patients at eight hospitals in seven provincial capitals, HTV IgG seroprevalence was 11.6% (38/327), with the highest being in Denpasar (16.3%, 7/43) and the lowest being in Yogyakarta (3.4%, 1/31). Anti-HTV IgG was most prevalent in adults (13.5%, 33/244) and males (15.6%, 29/186). Acute HTV infections were identified in two subjects, both of whom had Seoul virus. In Indonesia, HTVs have been studied in humans and animals since 1984. Over the past 35 years, the reported seroprevalences in rodents ranged from 0% to 34%, and in humans from 0% to 13%. Fourteen acute infections have been reported, including one in a tourist returning to Germany, but only two have been confirmed by RT-PCR. Almost all rodent and human surveillance results demonstrated serological and molecular evidence of Seoul virus infection. However, in Semarang, anti-Puumala virus IgM has been detected in humans and Puumala RNA in one rodent. In Serang, a new virus named Serang virus was identified due to its differences from Seoul virus. In Maumere, HTV and Leptospira spp. were identified simultaneously in rodents. The burden of HTV infection in Indonesia is underestimated, and additional studies are needed to understand the true prevalence. Seroprevalence data reported here, previous observations of HTV co-infections in rodents, and the prevalence of rodent-borne bacterial infections in Indonesia suggest that the population may be routinely encountering HTVs. While Seoul virus appears to be the most prevalent HTV in the country, further studies are needed to understand which HTVs are circulating.

scholarly journals Infectious diarrhea, as public health problem, in Romania

2021 ◽  
Vol 3 (3) ◽  
pp. 01-04
Author(s):  
Liana Deac
Keyword(s):  
Public Health ◽  
Acute Diarrhea ◽  
Content Volume ◽  
Clinical Signs ◽  
Public Health Problem ◽  
Signs And Symptoms ◽  
Point Of View ◽  
Public Health Issue ◽  
Family Doctors ◽  
Clinical Signs And Symptoms

From medical point of view, “Diarrhea” is an alteration in a normal bowel movement characterized by an increase in the water content, volume, or frequency of stools. Acute diarrhea of infec­tious etiology, often referred to as gastroenteri­tis and is typically associated with clinical signs and symptoms including: nausea, vomiting, abdomi­nal pain and cramps, bloating, flatulence, fever, passage of bloody stools, tenesmus, and fecal ur­gency. Infectious diarrheal diseases are the second leading cause of morbidity and mortality worldwide. It is the diarrhea we have also found out, during a large 3 yeas study 2017-2020 in Transylvania – Romania. 3577 number of cases were transmitted during this time, to our Public Health Center, by 12 district Sanitary Polices. These were mostly diagnosed by the territorial family doctors and more than 50%, have need hospitalization, for several days because of the mentioned disease disorders. The detected infectious etiology, were determined in authorized laboratories in which it was identified: Shigella, Salmonella, Campylobacter, and Yersinia, Rotavirus, Giardia. Most number of cases appeared in children, followed by elderly or adult people, as quantified number of determination. In light of these data, acute diarrheal illness had to be considered a major public health issue against which control efforts are needed. Public health surveillance and response in the field of infectious acute diarrhea include obligatory strategies of infection control.

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

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

scholarly journals Maintaining Optimum Health Requires Longer-Term Stable Vitamin D Concentrations

2020 ◽  
pp. 1-5
Author(s):  
Sunil Wimalawansa ◽  
Sunil Wimalawansa
Keyword(s):  
Vitamin D ◽  
Immune System ◽  
Respiratory Infections ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Healthy Person ◽  
Immune Defense ◽  
The Body ◽  
Steady Level ◽  
Clinical Signs And Symptoms

Humans are constantly invaded by environmental microbes. The body is protected from pathogen attacks by the immune defense system. In 99.8% of the time, our innate immune system is capable of getting rid of these organisms without before these can cause harm. Those who are with weaker immune systems constantly get infections and having chronic diseases. Among many factors contributing to maintaining a robust immune system, vitamin D has the highest impact. It has a major protective effect against acute respiratory infections and subduing both communicable and non-communicable diseases. A healthy person with stronger immunity may not manifest clinical signs and symptoms of COVID-19-silent, asymptomatic carriers of the virus and can be infectious. Whereas not all PCR positive persons are infectious. A rapid response occurs through the innate system that is followed by the adaptive response that lasts a longer period. Vitamin D kick starts both systems. However, the protective immune and other functions are damped in the presence of hypovitaminosis and also when the levels are fluctuating. Thus, the importance of maintaining serum 25(OH)D at a steady level above 30 ng/mL. When maintaining such, among all nutrients vitamin D has the widest benefits to multiple body systems. Thus, this sunshine vitamin (a steroid hormone) has been modulated through evolution to emerge as a key survival mechanism in humans. Nevertheless, vitamin D is not a panacea.

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