Procalcitonin and White Blood Cells as an Infection Marker in Children with Diabetic Ketoacidosis

2021 ◽  
Vol 70 (12) ◽  
pp. 260-264
Author(s):  
Nur Rochmah ◽  
Muhammad Faizi ◽  
Yudhi Kurniawan ◽  
Latifatu Choirunisa ◽  
Anang Endaryanto ◽  
...  
Keyword(s):  
Diabetic Ketoacidosis ◽  
Blood Cells ◽  
Characteristic Curve ◽  
White Blood Cells ◽  
Insulin Dependent Diabetes Mellitus ◽  
Cross Sectional Study ◽  
Dependent Diabetes Mellitus ◽  
Cross Sectional ◽  
Insulin Dependent ◽  
Infection Marker

Introduction: Diabetic ketoacidosis (DKA), an acute complication of type 1 (insulin dependent) diabetes mellitus (T1DM), can be precipitated by infection. Procalcitonin (PCT) is an accurate marker of bacteremia, sepsis, and inflammation, however white blood cells (WBC) are still often used by clinicians. We aimed to analyze PCT levels and WBC counts in children with DKA.Methods: A cross-sectional study was conducted in Dr. Soetomo General Hospital, Surabaya, Indonesia, between 2015 and 2019. T1DM and DKA diagnosis was based on the International Society for Pediatric and Adolescent Diabetes. PCT levels and WBC counts were measured in samples from patients with and without DKA, and were compared using the Mann-Whitney test.Results: A total of 41 samples were included, with 15 samples (36.6%) from children with DKA, and 26 (63.4%) from children without DKA. PCT levels and WBC counts were significantly higher in those with DKA (p<0.001). The receiver operating characteristic curve analysis of WBC was lower than PCT (0.849 vs. 0.982). PCT had a higher sensitivity and spesificity as an infection marker than WBC (93.3 vs. 86.7; 92.3 vs. 88.5, respectively).Conclusion: PCT is a better infection marker in children with DKA than WBC  

The situation of antibiotic use for diarrhea treatment on pediatric inpatient at Pediatrics - Kien Giang General Hospital in 2019-2020

2020 ◽  
pp. 15-24
Author(s):  
Nhon Tran Van ◽  
Mai Do Van ◽  
Hien Ha Minh
Keyword(s):  
General Hospital ◽  
Blood Cells ◽  
Antibiotic Prescription ◽  
White Blood Cells ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Loose Stool ◽  
Cross Sectional ◽  
Watery Stool ◽  
Pediatric Inpatient

Background: To survey for evaluation the use of antibiotic for diarrhea treatment on pediatric inpatient in compliance with MOH, WHO or treatment regimen. Objectives: (1) To describe the situation of antibiotic use for diarrhea treatment and (2) to determine factors that affected on indication of antibiotic for pediatric inpatient under 15 years at Kien Giang General Hospital in 2019. Subjects and methods: A cross-sectional study on 251 medical records of pediatric inpatients who treated by one of any drug from 01/2019 to 12/2019. Results: one antibiotic was prescribed in 71.7% in comparison with 17.1% on two antibiotics. The antibiotic prescription was based on the results of blood test including examinations of white blood cells (WBC), the percentage of neutrophils (Neu%) and/or C-reactive protein (CRP) (59.4%), stool with white blood cells and/or red blood cells (1.6%), high fever without causes (27.9%), watery stool (86.3%), loose stool with blood (100%), loose stool (97.9%). The most used antibiotics are ceftriaxone (53.4%), ciprofloxacin (12.4%). Duration of antibiotic use is 5 days in median. Conclusion: The rate of antibiotic prescription that met MOH and WHO guidelines was 88.3% in comparison with 11.7% of non-conformance. The compliance prescriptions based on antibiogram were 77.8%, non-compliance were 22.5%. The compliance dosage refered to guideline was 86.4%, non-conpliance was 2.4%. The duration of hospitalization and neutrophil are factors that affected the use of antibiotics (p < 0.05). Keywords: diarrhea, pediatric inpatient, antibiotic, Pediatrics-Kien Giang General Hospital

Diabetic Ketoacidosis in Children and the Role of Outpatient Management

1990 ◽  
Vol 11 (10) ◽  
pp. 297-304 ◽  
Author(s):  
H. Peter Chase ◽  
Satish K. Garg ◽  
David H. Jelley
Keyword(s):  
Diabetic Ketoacidosis ◽  
Hospital Admissions ◽  
Insulin Dependent Diabetes Mellitus ◽  
The United States ◽  
Absolute Number ◽  
Dependent Diabetes Mellitus ◽  
National Commission ◽  
Diabetic Patients ◽  
Intravenous Insulin ◽  
Insulin Dependent

Diabetic ketoacidosis (DKA) is a common complication among children with diabetes, accounting for 14% to 31% of all diabetes-related hospital admissions.1,2 Extrapolation of data from the National Commission on Diabetes3 suggests that there are approximately 160 000 admissions to private hospitals each year in the United States for DKA. The cost of hospitalizations for DKA is over one billion dollars annually. Sixty-five percent of all patients admitted are less than 19 years of age. The incidence of DKA is believed to be declining. However, because the numbers of subjects with insulin-dependent diabetes mellitus is increasing, the absolute number of hospitalizations for DKA is still increasing. It is the single most common cause of death in diabetic patients under 24 years of age.2 The treatment of DKA has changed in recent years, particularly with the use of low-dose continuous intravenous insulin infusion and with the availability of blood pH levels. Severe DKA has been defined as "a state of ketoacidosis with serum bicarbonate decreased to 10 mmol/L or less," or more recently, as a "pH of 7.1 or less."4 The mortality from DKA has been reported to be in the range of 0.5 to 15.4%.3,5 Previous mortality figures were as high as 38%.2

scholarly journals Myocardial dysfunction associated with diabetic ketoacidosis in a 5-year-old girl

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984779 ◽  
Author(s):  
Amjad Halloum ◽  
Shaikha Al Neyadi
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Brain Edema ◽  
Myocardial Dysfunction ◽  
Insulin Dependent Diabetes Mellitus ◽  
Inotropic Support ◽  
Insulin Dependent Diabetes ◽  
Dependent Diabetes Mellitus ◽  
Insulin Dependent ◽  
New Onset

In this study, we report a case of a 5-year-old girl with new onset of insulin-dependent diabetes mellitus, who presented with severe diabetic ketoacidosis associated with brain edema and severe myocardial dysfunction, needing intubation and inotropic support. To our knowledge, this is the youngest reported case with severe diabetic ketoacidosis complicated with myocardial dysfunction.

Associations between white blood cells count and obesity in apparently healthy young adults

2020 ◽  
Vol 50 (6) ◽  
pp. 1013-1019
Author(s):  
Fatemeh Ghannadiasl
Keyword(s):  
Young Adults ◽  
Cardiovascular Diseases ◽  
Blood Cells ◽  
White Blood Cells ◽  
Cross Sectional Study ◽  
The Body ◽  
Sectional Study ◽  
Cross Sectional ◽  
Content Type ◽  
Apparently Healthy

Purpose The elevated white blood cells (WBCs) count has been reported to be a predictor of cardiovascular diseases, diabetes, hypertension and metabolic syndrome. This study aims to determine the associations between WBCs count and obesity in apparently healthy young adults. Design/methodology/approach In this cross-sectional study, the authors evaluated the body mass index (BMI) in 392 apparently healthy young adults of both sexes. The WBCs count was measured using standard counter techniques. The inclusion criteria were the agreement to participate in the study, between 18 and 25 years of age, lack of self-reported diseases such as cardiovascular diseases, hypertension, kidney and infectious diseases. Findings According to the BMI classification, underweight and overweight or obesity were observed in 14.58 and 11.48 per cent of young adults, respectively. The mean WBC was 6.5 ± 1.5 (×10³ cells/µL). Higher values of WBCs were found in women than in men (p = 0.02). The young adults with higher BMI had a higher WBCs count. There was a positive correlation between WBCs count and weight and BMI (r = 0.19 and r = 0.22, p < 0.001, respectively). Research limitations/implications This research was a cross-sectional study. Future studies are suggested using longitudinal studies to examine more relationships between obesity and WBCs count in apparently healthy young adults. Practical implications The results of this study provide evidence for weight management in this age group to reduce diseases associated with increased WBCs count. Originality/value The WBCs count was related to increasing levels of BMI per cent 2 C even in the normal range.

scholarly journals STAT3 methylation in white blood cells as a novel sensitive biomarker for the toxic effect of low-dose benzene exposure

2016 ◽  
Vol 5 (3) ◽  
pp. 800-807 ◽  
Author(s):  
Di Liu ◽  
Yujiao Chen ◽  
Pengling Sun ◽  
Wenlin Bai ◽  
Ai Gao
Keyword(s):  
Dna Methylation ◽  
Toxic Effect ◽  
Health Effects ◽  
Blood Cells ◽  
Low Dose ◽  
White Blood Cells ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Benzene Exposure

A cross-sectional study was conducted in a sample of 571 workers to explore the toxic effect and early sensitive biomarker of the health effects of low-dose benzene exposure (LDBE), as well as the correlation between DNA methylation and the toxic effect of LDBE.

scholarly journals Evaluation of Endocrine Complications in Beta-Thalassemia Intermedia Patients: A Cross Sectional Multi-Center Study

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2343-2343
Author(s):  
Mehran Karimi ◽  
Tahereh Zarei ◽  
Sezaneh Haghpanah ◽  
Azita Azarkeivan ◽  
Christos Kattamis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Transfusion ◽  
Insulin Dependent Diabetes Mellitus ◽  
Dependent Diabetes Mellitus ◽  
Beta Thalassemia ◽  
Endocrine Disorders ◽  
Thalassemia Intermedia ◽  
Cross Sectional ◽  
Insulin Dependent ◽  
Endocrine Complications

Abstract The diagnosis of beta thalassemia intermedia (BTI) is mainly based on the severity of clinical phenotype. It is associated with a wide range of specific complications including extramedullary hematopoiesis, leg ulcers, gallstones, hypercoagulable state, pulmonary hypertension (PHT), endocrine disorders and osteoporosis. The commonest endocrine complication in beta thalassemia major (TM) patients is hypogonadism followed by hypothyroidism and diabetes but the data on endocrine disorders in BTI patients are scarce. The aim of this study is to determine the prevalence of endocrine complications in a large series of BTI patients. Methods: In this multi-countries cross-sectional study, all BTI patients registered at 12 thalassemic treatment centers in Iran (2 Centers), Italy (2 Centers), Greece, Turkey (2 centers), Oman, Qatar, Jordan, Cyprus and United Kingdom were enrolled during 2017. Non transfusion- dependent beta-thalassemia patients or those who received blood transfusion 3-4 times or less annually, were evaluated. Required information was collected from medical records using a designed questionnaire. Demographic data, clinical characteristics and laboratory data included age, sex, splenectomy, type of treatment (blood transfusion, iron chelation, hydroxyurea), hormonal assays, bone mineral density, calcium -phosphorous metabolism, serum ferritin, liver function tests, fetal and total hemoglobin levels,, platelet and nucleated red blood cell counts, were collected. Results: A total of 721 BTI patients were enrolled in the survey from 9 countries. The most prevalent disease-related complications were osteoporosis (21.6%) and hypogonadism (12.6%) followed by: central hypothyroidism (8.3%), non-insulin-dependent diabetes mellitus (7.8%), primary hypothyroidism (5.5%), insulin-dependent diabetes mellitus (4.2%), hypoparathyroidism (2.2%), growth hormone deficiency (1.1%), adrenal mass (1%) and thyroid cancer (0.5%). Conclusion: This study evaluated the largest cohort of BTI patients with endocrine disorders. Although BTI patients are non-transfusion dependent or only occasionally transfused, iron-overload due to increased intestinal iron absorption and enhanced bone marrow activity cause endocrine disorders and osteoporosis. This study demonstrate that although endocrine complications are less common in patients with BTI compared to data reported in literature in TM patients , a regular monitoring with timely diagnosis and proper management underscoring on osteoporosis and gonadal disorders are crucial to prevent endocrine complications in these patients. Disclosures No relevant conflicts of interest to declare.

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