scholarly journals Dengue Lurks During Coronavirus Disease-19 Pandemic in Indonesia: A Narrative Review

2020 ◽  
Vol 8 (T1) ◽  
pp. 391-398
Author(s):  
Wienta Diarsvitri ◽  
Retno Budiarti ◽  
Pramita Anindya Nugraheni ◽  
M. Fathi Ilmawan ◽  
Verna Biutifasari
Keyword(s):  
Secondary Infection ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Clinical Pathology ◽  
Organ Damage ◽  
Careful Consideration ◽  
Narrative Review ◽  
Antigenic Structure ◽  
Serological Tests ◽  
Laboratory Findings

BACKGROUND: Most attention and healthcare resources in Indonesia have been geared toward battling the coronavirus (CoV) disease (COVID)-19 pandemic, and less overture has been given to the looming risks of dengue that has been endemic in many areas of Indonesia. Despite related constraints, the Primary Health Cares (PHC) in Indonesia plays an important role in the face of emergency situations. AIM: This study aimed to review the dengue and COVID-19 infection, clinical manifestations in children and adults, clinical pathology findings, as well as the prevention strategies that could be applied in PHC. METHODS: This study is a narrative review based on the research articles and reports that were published between 2010 and 2020. A total of 70 articles and reports were obtained and after careful consideration, 58 articles and reports were used as references of this study. RESULTS: Both dengue virus (DENV) and severe acute respiratory syndrome-CoV (SARS-CoV-2) share the similarity of antigenic structure, common symptoms, and laboratory findings. The immune response in SARS-CoV-2 may cause a cytokine storm, which can increase vascular permeability and organ damage. Secondary infection of DENV with different strains may allow the occurrence of antibody-dependent enhancement. The cross-reactions between SARS-CoV-2 antibodies and DENV antigens may cause false positive on rapid dengue infection serological tests. CONCLUSION: PHC as the front line of health services has a fundamental role in the crisis situation. The prevention and control of DENV and SARS-CoV-2 infections are based on the mode of transmission and need compliance to the related health protocols.

scholarly journals FCγII (CD32) MONOSIT DI INFEKSI DENGUE PRIMER DAN SEKUNDER {FcγRII (CD32) Monocytes in Primary and Secondary Dengue Infection}

2018 ◽  
Vol 22 (1) ◽  
pp. 42
Author(s):  
Umi S. Intansari ◽  
Usi Sukorini ◽  
Shanti Ika Sari
Keyword(s):  
Neutralizing Antibodies ◽  
Secondary Infection ◽  
Dengue Infection ◽  
Density Ratio ◽  
Clinical Manifestations ◽  
Dengue Shock Syndrome ◽  
Cross Sectional ◽  
Major Health Problem ◽  
Secondary Infections ◽  
Capture Method

Dengue infection is a major health problem in the world, including Indonesia. Clinical manifestations of dengue infection varywidely, from asymptomatic until dengue shock syndrome (DSS). Antibody Dependent Enhancement (ADE) hypothesis that states thatnon-neutralizing antibodies in secondary dengue infection may enhance dengue infection via Fcγ receptors is still controversial. Clinicalresearch shows that not all secondary infections manifest as DHF/DSS, but nearly all DHF/DSS cases are caused by secondary infection.Allegedly, the expression of Fcγ has an effect on this incident. This study is an observational analytical study with a cross sectional designto determine the expression of FcγRII (CD32) monocytes in patients with primary and secondary dengue infection. CD32 of monocyteswas measured using FACS Calibur with lyse no wash technique. Primary and secondary dengue infection were determined by IgM/IgGoptical density ratio using ELISA capture method. The ratio of IgM/IgG ≥1.2 was considered as primary infection, while the ratio <1.2was considered as secondary infection. Twenty primary and 32 secondary dengue infection patients in acute phase of dengue infectionpartisipated in this study. Expressions of Fcγ RII (CD32) monocytes were significantly lower in primary than secondary dengue infection(187.825±31.584 vs 218.598±43.414 MFI; p=0.008). CD32 expressions were higher in day 3 compared to day 4 of fever.

scholarly journals Clinical and laboratory findings in patients with dengue associated with hepatopathy

2011 ◽  
Vol 44 (6) ◽  
pp. 674-677 ◽  
Author(s):  
Delso do Nascimento ◽  
Ana Rita Coimbra Motta de Castro ◽  
Íris Bucker Froes ◽  
Gláucia Bigaton ◽  
Éveny Cristine Luna de Oliveira ◽  
...  
Keyword(s):  
Low Income ◽  
Clinical Symptoms ◽  
Statistical Significance ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Laboratory Findings ◽  
Mato Grosso ◽  
Mortality And Morbidity ◽  
Average Value ◽  
Grade Ii

INTRODUCTION: Hepatic disorders caused by dengue infection may progress to severe manifestations, including mortality and morbidity. Cytokines are involved in it, such as the migration inhibitory factor of macrophages (MIF), tumor necrosis factor (TNF), natural killer cells (NK), B lymphocytes, and macrophages. METHODS: This study was carried out from January to April 2007 at a public hospital from the Federal University of Mato Grosso do Sul, Campo Grande, Brazil. Sixty-eight patients were studied concerning hepatic alterations, with 56 reported having classic dengue, 6 with hemorrhagic dengue grade I, and 6 with hemorrhagic dengue grade II. RESULTS: Among the 56 with classic dengue, 83.3% had aspartate aminotransferase (AST) alterations, and 69.6% had altered alanine aminotransferase (ALT). For those with hemorrhagic dengue grade I, 100% had AST alterations, and 83.3% had altered ALT. All the patients with hemorrhagic dengue grade II had AST and ALT alterations. AST variations reached 22.0 and 907.0, with an average value of 164.6. For ALT, we found variations between 25.0 and 867.0, with an average value of 166.07. There had been statistical significance between dengue clinical shapes and hepatic function markers. CONCLUSIONS: We conclude that the infection was predominant in adults, females, and in those with low income and education. The liver enzymes were of larger amount in hemorrhagic dengue, but there was weak statistical evidence of the clinical manifestations and transaminases. Major signs and clinical symptoms were fever, headache, myalgia, arthralgia, weakness, severe pain behind the eyes, and rashes.

The Role of Hyperleukocytosis in Predicting the Severity of Pertussis

2020 ◽  
Author(s):  
Xiao-Ying Wu ◽  
chuan gan
Keyword(s):  
Heart Rate ◽  
Respiratory Rate ◽  
Bacterial Infections ◽  
Clinical Manifestations ◽  
Organ Damage ◽  
Clinical Analysis ◽  
Laboratory Findings ◽  
Wbc Count ◽  
The Relationship

Abstract Background: Few reports have described the relationship between WBC count and the severity of pertussis or the timing of ET in patients with hyperleukocytosis.Methods: A retrospective clinical analysis of infants with pertussis and a WBC exceeding 30*10^9/L was performed.Results: A total of 158 patients were enrolled in the study. There were significant differences in the clinical manifestations of cyanosis, fever, highest respiratory rate, and highest heart rate. There were significant differences in all complications except for pulmonary hypertension. In laboratory findings, there were significant differences in organ damage (myocardial markers, ALT), increased inflammation indicators (CRP, PCT), and the incidence of combined bacterial infections. There were significant differences in ICU stay length, mechanical ventilation use, days hospitalized, days until cough relief and days until the WBC fell below 25*10^9/L. A WBC count >55.38 *10^9/L was calculated as the cutoff value with 88.2% sensitivity and 23.4% specificity in predicting ET. A respiratory rate of 59 breaths/min had 94.1% sensitivity and 36.7% specificity in predicting ET. A heart rate of 159 beats/min had 100% sensitivity and 38.1% specificity in predicting ET.Conclusion: WBC count is related to the severity of pertussis. We recommend that ET is considered when the patient’s WBC count exceeds 55*10^9/L, breathing exceeds 60 breaths/min, and/or heart rate exceeds 160 beats/min.

SAT0179 ADHERENCE TO HYDROXYCHLOROQUINE INFLUENCES THE INCIDENCE OF ORGAN DAMAGE DURING FOLLOW-UP IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1031.1-1031
Author(s):  
J. H. Kang ◽  
S. E. Choi ◽  
H. Xu ◽  
D. J. Park ◽  
S. S. Lee
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Damage Index ◽  
Clinical Manifestations ◽  
Medication Possession Ratio ◽  
Organ Damage ◽  
Systemic Lupus ◽  
Laboratory Findings ◽  
The Impact

Background:Objectives:Hydroxychloroquine (HCQ) is a cornerstone drug in patients with systemic lupus erythematosus (SLE), decreasing the risk of flares and comorbidities and improving survival. This study investigated the effects of HCQ adherence on clinical manifestations, disease activity, and organ damage in Korean patients with SLE.Methods:Data on 299 SLE patients were obtained from the Korean Lupus Network registry. Demographic variables, clinical manifestations, laboratory findings, PGA, and SLEDAI-2000 and SLICC damage index scores were recorded at the time of enrollment and repeated annually for 4 consecutive years. Patients were divided into two groups according to the level of HCQ adherence. Adherence was defined by the medication possession ratio and dichotomized as ≤ 80% vs. > 80%. Univariate and multivariate analyses were performed to assess the impact of adherence to HCQ on clinical outcomes.Results:Of the 299 patients, 31 (10.4%) showed poor drug adherence during the follow-up period. Patients with poor HCQ adherence were older (P=0.011), less insured (P=0.024), experienced lower employment (P=0.033), and had a higher rate of comorbidities such as hypertension (P=0.048) and depression (P<0.001). The non-adherent group had higher mean and changed SLICC damage index scores than the adherent group across all 4 years. In the multivariate analysis, HCQ non-adherence was significantly associated with older age (OR, 1.043; 95% CI, 1.006–1.081; P=0.021), depression (OR, 11.98; 95% CI, 1.099–130.6; P=0.042), and an annual increase in the SLICC damage index score (OR, 2.275; 95% CI, 1.369–3.779; P=0.002).Conclusion:HCQ adherence might be influenced by age and depressive mood. Additionally, the poor adherence to HCQ in SLE patients was correlated with higher cumulative organ damage. Therefore, patients with SLE should be educated to take HCQ appropriately to improve their clinical outcome in clinical practice.Disclosure of Interests:None declared

scholarly journals Karakteristik Klinis dan Virologis Penderita Demam Berdarah Dengue di Kota Bandar Lampung

2020 ◽  
Vol 12 (2) ◽  
pp. 85-92
Author(s):  
Nurminha Nurminha ◽  
Tori Rihiantoro ◽  
Mara Ipa
Keyword(s):  
Dengue Virus ◽  
Clinical Symptoms ◽  
Serological Test ◽  
Secondary Infection ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Denv Infection ◽  
Severe Dengue ◽  
Virus Serotype ◽  
Degree Of Severity

Abstract. Clinical symptoms of dengue virus (DENV) infection range from asymptomatic mild dengue fever(DF), more severe dengue hemorrhagic fever (DHF) up to dengue shock syndrome. One of the determinantsof dengue infection severity was virus virulence. This study aimed to determine the clinical and virologicalcharacteristics of dengue virus infection patients based on the severity degree. A cross-sectional study wasconducted in RSUD Dr. H. Abdul Moeloek, Lampung Province between July-November 2016 with 56 denguepatients as samples selected using purposive sampling. The serological test was done using a rapiddiagnostic test. Blood samples for DENV serotype identification were examined using reverse-transcriptionpolymerase chain reaction. Classification of DENV infection severity was obtained from the patient’s medicalrecord. The results showed that the most common clinical manifestations were fever, headache, and retroorbitalpain, appearing in all patients from every degree of severity. There were Grade I DHF patients whoexperienced Myalgia (15.6%) and petechiae (22.2%). Laboratory results showed that thrombocytopeniaappeared in every grade, even though 13.3% of grade I patients did not experience it. Secondary infectionwas found in 92.9% of samples, and all DENV serotype can be detected in 39.2%samples: DENV-1 (46.7%),DENV-2 (6.7%), DENV-3 (26.7%), and DENV-4 (20%). This study concluded that the majority of clinicalcharacteristics in DHF patients are in line with the degree of severity, with the bleeding as the dominantmanifestation in patients with grade II-IV. Virological characteristics of DENV-1 are dominant in all patientswith DHF grade I-IV.Keywords: dengue virus, serotype, severity, secondary infection, Bandar Lampung

Etiology and clinical features of epididymo-orchitis: A single-center study in Tehran, Iran

2020 ◽  
Vol 20 ◽  
Author(s):  
Sara Abolghasemi ◽  
Mohammad Alizadeh ◽  
Ali Hashemi ◽  
Shabnam Tehrani
Keyword(s):  
Chlamydia Trachomatis ◽  
Clinical Symptoms ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
Urinary Frequency ◽  
Serological Tests ◽  
Duration Of Symptoms ◽  
Two Samples ◽  
History Of ◽  
Tract Infections

Introduction: Epididymo-orchitis is a common urological disease among men. Little is known about the clinical and epidemiological aspects of the disease in Iran. Thus, the present study was aimed to investigate the etiology, clinical sequelae and risk factors of patients with epididymo-orchitis in Tehran, Iran. Materials and Methods: Patients presenting with epididymo-orchitis were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, molecular and serological tests were undertaken to look for Chlamydia trachomatis, Neisseria gonorrhoeae, Brucella spp., Mycoplasma spp, and other bacteria. Results: Fifty patients with epididymo-orchitis were evaluated according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The mean age of the patients was 53 years. Fever, dysuria, pain in the flanks, urinary frequency and discharges occurred in 58.0%, 50.0%, 50.0%, 28.0% and 6.0%, respectively. Bacterial pathogen was identified in 26% (13/50) of patients by urine culture. Escherichia coli was the etiological agent in 11/13 patients (84.6%). Two out of 50 patients (4.0%) were also positive for Chlamydia trachomatis. Two samples were serologically positive for Brucella spp. High Mean age, fever, urinary frequency, history of the underlying disease and history of urinary tract infections were found to have a significant association with the positive bacteriologic urine culture (P<0.05). Conclusions: The most common clinical manifestations were fever, dysuria, and abdominal pain. E. coli and C. trachomatis were the major causative agents. Use of a set of diagnostic approaches including clinical symptoms, urine culture and more precise techniques such as PCR should be taken into consideration for the definitive diagnosis.

scholarly journals The Quality of Life Definition: Where Are We Going?

Uro ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 14-22
Author(s):  
Tommaso Cai ◽  
Paolo Verze ◽  
Truls E. Bjerklund Johansen
Keyword(s):  
Quality Of Life ◽  
Extra Dimension ◽  
Sexual Partner ◽  
Therapeutic Approach ◽  
Well Being ◽  
Narrative Review ◽  
Laboratory Findings

The quality of life (QoL) concept now includes new aspects related to patients’ well-being because QoL has become more of a personal perception than an an objective and measurable entity. Here, we discuss the principal aspects of QoL-related aspects in urology and andrology by using a narrative review. Some aspects concerning the QoL are essential when managing uro-andrological patients. The aim of treatments should not only include the absence of disease or symptoms relief but also the improvement of a patient’s QoL with regard to his/her internal status and relationship with others. In this sense, any therapeutic approach should be based on the patient’s perspectives and not only on the instrumental and laboratory findings. Finally, we discussed the role of a patient’s sexual partner adding an extra dimension to the patient-centerd approach as part of the QoL concept in andrology.

scholarly journals Clinical presentations and long term prognosis of childhood onset polyarteritis nodosa in single centre of Korea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeong-Seon Lee ◽  
Joong-Gon Kim ◽  
Soyoung Lee
Keyword(s):  
Polyarteritis Nodosa ◽  
Clinical Manifestations ◽  
Long Term Outcomes ◽  
Childhood Onset ◽  
Laboratory Findings ◽  
Clinical Presentations ◽  
Long Term Prognosis ◽  
Digital Amputation

AbstractChildhood-onset polyarteritis nodosa (PAN) is a rare and systemic necrotising vasculitis in children affecting small- to medium-sized arteries. To date, there have been only a few reports because of its rarity. Thus, we aimed to investigate the clinical manifestations, laboratory findings, treatment, and long-term outcomes in patients with childhood-onset PAN and to evaluate the usefulness of the paediatric vasculitis activity score (PVAS). We retrospectively analysed the data of nine patients with childhood-onset PAN from March 2003 to February 2020. The median ages at symptom onset, diagnosis, and follow-up duration were 7.6 (3–17.5), 7.7 (3.5–17.6), and 7.0 (1.6–16.3) years, respectively. All patients had constitutional symptoms and skin manifestations, while five exhibited Raynaud’s phenomenon. Organ involvement was observed in one patient. The median PVAS at diagnosis was 7 (range: 2–32). Prednisolone was initially used for induction in all patients, and other drugs were added in cases refractory to prednisolone. All patients survived, but three patients with high PVAS at diagnosis experienced irreversible sequelae, including intracranial haemorrhage and digital amputation. In conclusion, early diagnosis and treatment may minimise sequelae in patients with childhood-onset PAN. This study suggests that high PVAS score at diagnosis may be associated with poor prognosis.

scholarly journals Increased levels of pentraxins protein and cytokines bear good association in patients with severe dengue infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Goutam Patra ◽  
Bibhuti Saha ◽  
Sumi Mukhopadhyay
Keyword(s):  
Dengue Infection ◽  
Clinical Manifestations ◽  
Blood Parameters ◽  
Warning Signs ◽  
Severe Dengue ◽  
Disease Manifestation ◽  
Mild Disease ◽  
Tnf Α ◽  
The Status ◽  
The Tropics

AbstractDengue is an arboviral infection with high rates of morbidity and mortality throughout the tropics and sub-tropics. This work studied the status of pentraxin (CRP/SAP) protein, ferritin, TNF-α and IL-1β levels in Dengue patients of different pathophysiological manifestations. Accordingly, clinically confirmed Dengue cases (n = 97) were enrolled and subsequently blood parameters were studied by Haematology cell counter and Biochemistry Autoanalyser. CRP, SAP, ferritin, TNF-α and IL-1β ELISA were done in all the samples by using standard ELISA kits. Statistical Analysis was done in all the experiments. The levels of CRP (p < 0.0001), SAP (p < 0.0001), ferritin (p < 0.0001), TNF-α (p < 0.0001) and IL-1β (p < 0.0001) were high in patients with Severe Dengue as compared to Dengue without warning signs. High levels of SGOT, SGPT and decreased platelet counts were found in severe patients as compared to Healthy donor. CRP/SAP as well as TNF-α/IL-1β were independently associated with both dengue severity and overall disease manifestation. Statistically significant increased CRP, SAP, ferritin, TNF-α and IL-1β titres were correlated in patients with severe clinical manifestations as compared to mild disease forms of dengue. Elevated levels of pentraxin, TNF-α/IL-1β in blood during dengue infection could act as an early predictor in Severe Dengue infection.

scholarly journals Acute confusional state as a prognostic sign of COVID-19 large-vessel occlusion (LVO)

2021 ◽  
Vol 14 (2) ◽  
pp. e240536
Author(s):  
Smit Sunil Deliwala ◽  
Murtaza Hussain ◽  
Anoosha Ponnapalli ◽  
Dominic Awuah ◽  
Thair Dawood ◽  
...  
Keyword(s):  
De Novo ◽  
Stroke Care ◽  
Organ Damage ◽  
Large Vessel ◽  
Antigenic Structure ◽  
Left Internal Carotid Artery ◽  
Care Pathways ◽  
Acute Confusional State ◽  
Confusional State ◽  
Vessel Occlusion

COVID-19 is well known for its respiratory symptoms, but severe presentations can alter haemostasis, causing acute end-organ damage with poor outcomes. Among its various neurological presentations, cerebrovascular events often present as small-vessel strokes. Although uncommon, in predisposed individuals, large-vessel occlusions (LVOs) can occur as a possible consequence of direct viral action (viral burden or antigenic structure) or virus-induced cytokine storm. Subtle presentations and complicated stroke care pathways continue to exist, delaying timely care. We present a unique case of COVID-19 LVO manifesting as an acute confusional state in an elderly man in April 2020. CT angiography revealed 'de novo' occlusions of the left internal carotid artery and proximal right vertebral artery, effectively blocking anterior and posterior circulations. Delirium can lead to inaccurate stroke scale assessments and prolong initiation of COVID-19 stroke care pathways. Future studies are needed to look into the temporal relationship between confusion and neurological manifestations.

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