scholarly journals Clinical Surveillance of Candidemia at Our Hospital

2021 ◽  
Vol 62 (2) ◽  
pp. 29-34
Author(s):  
Akihiko Sano ◽  
Yoshifumi Nishi ◽  
Shota Yonetani ◽  
Hiroaki Yoshida ◽  
Hiroko Kawai ◽  
...  
Keyword(s):  
Clinical Surveillance

scholarly journals A cohort study of survival following discharge from hospital in rural Tanzanian children using linked data of admissions with community-based demographic surveillance

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Oscar Mukasa ◽  
Honorati Masanja ◽  
Don DeSavigny ◽  
Joanna Schellenberg
Keyword(s):  
Linked Data ◽  
Cox Regression ◽  
District Hospital ◽  
Rural Setting ◽  
Post Discharge ◽  
Community Based ◽  
Related Data ◽  
Clinical Surveillance ◽  
Additional Support ◽  
Discharge From Hospital

Abstract Background To illustrate the public health potential of linking individual bedside data with community-based household data in a poor rural setting, we estimated excess pediatric mortality risk after discharge from St Francis Designated District Hospital in Ifakara, Tanzania. Methods Linked data from demographic and clinical surveillance were used to describe post-discharge mortality and survival probability in children aged < 5 years, by age group and cause of admission. Cox regression models were developed to identify risk factors. Results Between March 2003 and March 2007, demographic surveillance included 28,910 children aged 0 to 5 years and among them 831 (3%) were admitted at least once to the district hospital. From all the children under the demographic surveillance 57,880 person years and 1381 deaths were observed in 24 months of follow up. Survivors of hospital discharge aged 0–5 years were almost two times more likely to die than children of the same age in the community who had not been admitted (RR = 1.9, P < 0.01, 95% CI 1.6, 2.4). Amongst children who had been admitted, mortality rate within a year was highest in infants (93 per 1000 person years) and amongst those admitted due to pneumonia and diarrhoea (97 and 85 per 1000 person years respectively). Those who lived 75 km or further from the district hospital, amongst children who were admitted and survived discharge from hospital, had a three times greater chance of dying within one year compared to those living within 25 km (adjusted HR 3.23, 95% CI 1.54,6.75). The probability of surviving the first 30 days post hospitalization was 94.4% [95% CI 94.4, 94.9], compared to 98.8% [95% CI 97.199.5] in non-hospitalized children of the same age in the commuity. Conclusion This study illustrates the potential of linking health related data from facility and household levels. Our results suggest that families may need additional support post hospitalization.

scholarly journals MONITORING OF PARTICLE ENVIRONMENTAL POLLUTION AND FUNGAL ISOLATIONS DURING HOSPITAL BUILDING-WORK ACTIVITIES IN A HEMATOLOGY WARD.

2019 ◽  
Vol 11 (1) ◽  
pp. e2019062 ◽  
Author(s):  
Fabio Pattavina ◽  
Daniele Ignazio La Milia ◽  
Sara Vincenti ◽  
Barbara Fiori ◽  
Riccardo Torelli ◽  
...  
Keyword(s):  
Invasive Aspergillosis ◽  
Fungal Spores ◽  
Antigen Test ◽  
Building Site ◽  
Work Activities ◽  
Significant Difference ◽  
Before And After ◽  
Containment Measures ◽  
Clinical Surveillance ◽  
Galactomannan Antigen

Building-work activities could cause dust contamination and dissemination of fungal spores. Significant relationship was found between building-work activities and the incidence of invasive aspergillosis, in highly immunocompromised patients. Renovation-works activities were carried out by four building sites of the hematology ward in a Teaching Hospital without the interruption of clinical activities. These sites were monitored by environmental sampling to determine the particles and fungi count. Clinical surveillance were made using galactomannan antigen test as a proxy for invasive aspergillosis diagnosis. The galactomannan antigen test showed no significant difference between presence (3,85%) or absence (5,76%)  of renovation work activities (p=0,497). The particle counts showed higher values of small and big-diameter particles before the renovation works if compared to the end of the activities. It was probably due to the containment measures implemented during and immediately after the final phases of the building site. The Fungi counts showed no particular differences between the phase before and after of the renovation activities. Our finding show that is possible to perform renovation work, during clinical activities, by increasing the clinical and the environmental surveillance.

scholarly journals Distinct genetic pathways define pre-malignant versus compensatory clonal hematopoiesis in Shwachman-Diamond syndrome

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Alyssa L. Kennedy ◽  
Kasiani C. Myers ◽  
James Bowman ◽  
Christopher J. Gibson ◽  
Nicholas D. Camarda ◽  
...  
Keyword(s):  
Somatic Mutations ◽  
Bone Marrow Failure ◽  
Subsequent Development ◽  
Genetic Constraints ◽  
Clonal Hematopoiesis ◽  
Clinical Surveillance ◽  
Clinical Consequences ◽  
Shwachman Diamond Syndrome ◽  
Mechanistic Basis ◽  
Selection Of

AbstractTo understand the mechanisms that mediate germline genetic leukemia predisposition, we studied the inherited ribosomopathy Shwachman-Diamond syndrome (SDS), a bone marrow failure disorder with high risk of myeloid malignancies at an early age. To define the mechanistic basis of clonal hematopoiesis in SDS, we investigate somatic mutations acquired by patients with SDS followed longitudinally. Here we report that multiple independent somatic hematopoietic clones arise early in life, most commonly harboring heterozygous mutations in EIF6 or TP53. We show that germline SBDS deficiency establishes a fitness constraint that drives selection of somatic clones via two distinct mechanisms with different clinical consequences. EIF6 inactivation mediates a compensatory pathway with limited leukemic potential by ameliorating the underlying SDS ribosome defect and enhancing clone fitness. TP53 mutations define a maladaptive pathway with enhanced leukemic potential by inactivating tumor suppressor checkpoints without correcting the ribosome defect. Subsequent development of leukemia was associated with acquisition of biallelic TP53 alterations. These results mechanistically link leukemia predisposition to germline genetic constraints on cellular fitness, and provide a rational framework for clinical surveillance strategies.

Duplex Ultrasound Versus Clinical Surveillance in the Prediction of TIPS Malfunction Placed for Refractory Ascites: Is Ultrasound Surveillance Useful?

2017 ◽  
Vol 40 (12) ◽  
pp. 1861-1865 ◽  
Author(s):  
Shamar Young ◽  
Patrick Scanlon ◽  
Prashant Sherestha ◽  
Jafar Golzarian ◽  
Tina Sanghvi
Keyword(s):  
Duplex Ultrasound ◽  
Refractory Ascites ◽  
Clinical Surveillance ◽  
Ultrasound Surveillance

Outcomes of radiocephalic arteriovenous fistula in octogenarians

2021 ◽  
pp. 112972982110154
Author(s):  
Raffaella Mauro ◽  
Alessia Pini ◽  
Rodolfo Pini ◽  
Mohammad Abualhin ◽  
Chiara Mascoli ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Previous History ◽  
Venous Catheter ◽  
Dialysis Session ◽  
Old Patients ◽  
Younger Patients ◽  
First Choice ◽  
Clinical Surveillance ◽  
History Of ◽  
The Impact

Background: Current guidelines recommend radiocephalic arteriovenous fistula (RCAVF) as a first choice access for hemodialysis, without specific indication for octogenarians .This study was undertaken to assess the efficacy of RCAVF in octogenarians compared with younger patients. Material and methods: All patients treated by RCAVF from January 2013 to December 2017 were included in a prospective database for a retrospective analysis. Patient demographics, comorbidities, and dialytic treatment data were collected prospectively and compared in patients <80 year-old and ⩾80 years-old. Clinical surveillance was performed during each dialysis session. The main endpoints were primary (PP) and assisted patency (AP). Results: Within the study period, a total of 294 RCAVF were analyzed: 245 (83.3%) RCAVF were performed in <80 year-old and 49 (16.7%) ⩾80 years old. The overall PP and AP at 2-year was 69% ± 2% and 73% ± 3%, respectively. Patients ⩾ 80 years-old had a significantly reduced 2-year PP, AP of RCAVF compared with the younger patients: 50% ± 8% and 62% ± 7% versus 73% ± 3% and 75% ± 3%, p = 0.01 and p = 0.03, respectively. The analysis for possible risk factors for reduction of PP in patients ⩾80 years identified in the central venous catheter(CVC) a predictor of earlier RCAVF failure: HR 3.03(95% CI 1.29–7.13), p = 0.01.Kaplan–Meier curve confirms the reduction of PP in ⩾80 years old patients at 2-year follow-up with previous CVC compared patients without history of CVC: 59% ± 10% versus 24% ± 11%, p = 0.01. A comparison between the two groups was made in order to evaluate the impact of previous history of CVC .In absence of a history of CVC use older patients had a similar 2-year PP compared with younger patients: 59% ± 10% versus 72% ± 4%, p = 0.46. Otherwise, the history of a previous CVC reduced significantly the 2-year PP in ⩾80 years old patients compared the younger: 24% ± 12% versus 75% ± 5%, p = 0.0001. Conclusions: Despite lower overall primary and primary assisted patency, RCAVF are associated with satisfactory results also in octogenarians if performed in absence of history of CVC. Under these circumstances RCAVF can be considered a first choice treatment.

scholarly journals Genetics of multiple endocrine neoplasia type 1 syndrome: what's new and what's old

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 73 ◽  
Author(s):  
Alberto Falchetti
Keyword(s):  
Multiple Endocrine Neoplasia ◽  
Multiple Endocrine Neoplasia Type ◽  
Hot Spot ◽  
Gene Mutations ◽  
Causative Gene ◽  
Endocrine Neoplasia ◽  
Endocrine Neoplasia Type ◽  
Main Gene ◽  
Clinical Surveillance

Despite its identification in 1997, the functions of the MEN1 gene—the main gene underlying multiple endocrine neoplasia type 1 syndrome—are not yet fully understood. In addition, unlike the RET—MEN2 causative gene—no hot-spot mutational areas or genotype–phenotype correlations have been identified. More than 1,300 MEN1 gene mutations have been reported and are mostly "private” (family specific). Even when mutations are shared at an intra- or inter-familial level, the spectrum of clinical presentation is highly variable, even in identical twins. Despite these inherent limitations for genetic counseling, identifying MEN1 mutations in individual carriers offers them the opportunity to have lifelong clinical surveillance schemes aimed at revealing MEN1-associated tumors and lesions, dictates the timing and scope of surgical procedures, and facilitates specific mutation analysis of relatives to define presymptomatic carriers.

scholarly journals Australian National Enterovirus Reference Laboratory annual report, 2017

2020 ◽  
Vol 44 ◽  
Author(s):  
Jason A Roberts ◽  
Linda K Hobday ◽  
Aishah Ibrahim ◽  
Bruce R Thorley
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Performance Criterion ◽  
World Health ◽  
Reference Laboratory ◽  
Surveillance Systems ◽  
Disease Surveillance System ◽  
Enterovirus A71 ◽  
Clinical Surveillance ◽  
Health Organization

Australia monitors its polio-free status by conducting surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age, as recommended by the World Health Organization (WHO). Cases of AFP in children are notified to the Australian Paediatric Surveillance Unit or the Paediatric Active Enhanced Disease Surveillance System and faecal specimens are referred for virological investigation to the National Enterovirus Reference Laboratory. In 2017, no cases of poliomyelitis were reported from clinical surveillance and Australia reported 1.33 non-polio AFP cases per 100,000 children, meeting the WHO performance criterion for a sensitive surveillance system. Three non-polio enteroviruses, coxsackievirus B1, echovirus 11 and enterovirus A71, were identified from clinical specimens collected from AFP cases. Australia established enterovirus and environmental surveillance systems to complement the clinical system focussed on children and an ambiguous vaccine-derived poliovirus type 2 was isolated from sewage in Melbourne. In 2017, 22 cases of wild polio were reported with three countries remaining endemic: Afghanistan, Nigeria and Pakistan.

scholarly journals Antibiotics in acute appendicitis. When and how? A general review

2019 ◽  
Vol 6 (1) ◽  
pp. 30-33
Author(s):  
L. Alecu ◽  
C. Niţipir ◽  
Iulian Slavu ◽  
V. Braga ◽  
D. Mihăilă ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Antibiotic Treatment ◽  
Complication Rate ◽  
Acquired Resistance ◽  
Perforated Appendicitis ◽  
Interval Appendectomy ◽  
Bacterial Proliferation ◽  
Long Period ◽  
Clinical Surveillance ◽  
Relapse Rates

Introduction: An increasing interest exits towards the use of antibiotics in the treatment of uncomplicated acute appendicitis.Discussion: For a long period of time, surgery was the only treatment for acute appendicitis. Due to recent research in the etiology of acute appendicitis which seems to be driven by intraluminal bacterial proliferation, new data suggests that for non-perforated appendicitis confirmed with the help of CT, antibiotics may play a central role in the treatment. As relapse rates amount in some cases to only 5% after antibiotic treament, a discussion is required regarding the risks of interval appendectomy and its use. The debate regarding the optimal antibiotic course is on-going as some surgeons advocate for amoxicillin/clavulanic while others, due to acquired resistance recommend Ertapenem.Conclusion:  Selective antibiotic treatment for selected forms of acute appendicitis, uncomplicated without perforation is safe and has a relatively low complication rate. However, certain mentions must be made:  surgery must not be delayed if failure of antibiotics exists as it can lead to higher rates of peritonitis. Close clinical surveillance is of utmost importance

scholarly journals Unlocking the Predictive Power of Heterogeneous Data to Build an Operational Dengue Forecasting System

2020 ◽  
Author(s):  
Carrie Manore ◽  
Geoffrey Fairchild ◽  
Amanda Ziemann ◽  
Nidhi Parikh ◽  
Katherine Kempfert ◽  
...  
Keyword(s):  
Satellite Imagery ◽  
Data Streams ◽  
Cumulative Risk ◽  
State Level ◽  
Heterogeneous Data ◽  
Data Sources ◽  
Global Dynamics ◽  
Flexible System ◽  
Clinical Surveillance ◽  
Spatio Temporal

ABSTRACTPredicting an infectious disease can help reduce its impact by advising public health interventions and personal preventive measures. While availability of heterogeneous data streams and sensors such as satellite imagery and the Internet have increased the opportunity to indirectly measure, understand, and predict global dynamics, the data may be prohibitively large and/or require intensive data management while also requiring subject matter experts to properly exploit the data sources (e.g., deriving features from fundamentally different data sets). Few efforts have quantitatively assessed the predictive benefit of novel data streams in comparison to more traditional data sources, especially at fine spatio-temporal resolutions. We have combined multiple traditional and non-traditional data streams (satellite imagery, Internet, weather, census, and clinical surveillance data) and assessed their combined ability to predict dengue in Brazil’s 27 states on a weekly and yearly basis over seven years. For each state, we nowcast dengue based on several time series models, which vary in complexity and inclusion of exogenous data. We also predict yearly cumulative risk by municipality and state. The top-performing model and utility of predictive data varies by state, implying that forecasting and nowcasting efforts in the future may be made more robust by and benefit from the use of multiple data streams and models. One size does not fit all, particularly when considering state-level predictions as opposed to the whole country. Our first-of-its-kind high resolution flexible system for predicting dengue incidence with heterogeneous (and still sometimes sparse) data can be extended to multiple applications and regions.

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