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Sample records for acute febrile stage

  1. Effect of Taurine on Febrile Episodes in Acute Lymphoblastic Leukemia

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    Mina Islambulchilar

    2015-03-01

    Full Text Available Purpose: The purpose of our study was to evaluate the effect of oral taurine on the incidence of febrile episodes during chemotherapy in young adults with acute lymphoblastic leukemia. Methods: Forty young adults with acute lymphoblastic leukemia, at the beginning of maintenance course of their chemotherapy, were eligible for this study. The study population was randomized in a double blind manner to receive either taurine or placebo (2 gram per day orally. Life quality and side effects including febrile episodes were assessed using questionnaire. Data were analyzed using Pearson’s Chi square test. Results: Of total forty participants, 43.8% were female and 56.3 % were male. The mean age was 19.16±1.95 years (ranges: 16-23 years. The results indicated that the levels of white blood cells are significantly (P<0.05 increased in taurine treated group. There was no elevation in blasts count. A total of 70 febrile episodes were observed during study, febrile episodes were significantly (P<0.05 lower in taurine patients in comparison to the control ones. Conclusion: The overall incidence of febrile episodes and infectious complications in acute lymphoblastic leukemia patients receiving taurine was lower than placebo group. Taurine’s ability to increase leukocyte count may result in lower febrile episodes.

  2. Mayaro Virus in Child with Acute Febrile Illness, Haiti, 2015.

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    Lednicky, John; De Rochars, Valery Madsen Beau; Elbadry, Maha; Loeb, Julia; Telisma, Taina; Chavannes, Sonese; Anilis, Gina; Cella, Eleonora; Ciccozzi, Massinno; Okech, Bernard; Salemi, Marco; Morris, J Glenn

    2016-11-01

    Mayaro virus has been associated with small outbreaks in northern South America. We isolated this virus from a child with acute febrile illness in rural Haiti, confirming its role as a cause of mosquitoborne illness in the Caribbean region. The clinical presentation can mimic that of chikungunya, dengue, and Zika virus infections.

  3. Acute febrile encephalopathy in adults from Northwest India

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    Bhalla Ashish

    2010-01-01

    Full Text Available Background : Acute onset fever with altered mentation is a common problem encountered by the physician practicing in tropical countries. Central nervous system (CNS infections are the most common cause resulting in fever with altered mentation in children. Aim : In this study, we have tried to analyze the cause of encephalopathy following short febrile illness in adults presenting to a tertiary care center in Northwestern part of India. Setting and Design : A prospective observational study carried out in a tertiary care center in the Northwestern India over a period of 1 year. Material and Methods : A total of 127 patients with fever of less than 2 weeks duration along with alteration in mentation were studied prospectively over a period of 12 months. The demographic variables were recorded in detail. In addition to routine investigations, cerebrospinal fluid analysis, noncontrast- and contrast-enhanced computed tomography, along with magnetic resonance imaging were performed in all the subjects. Statistical Analysis : The results were analyzed using SPSS statistical software. The values were expressed as mean with standard deviation for contiguous variable as percentage for the others. Results and Conclusion : Out of these, 70% had primary CNS infection as the etiology. A total of 33% patients had meningitis, 29.9% had evidence of meningoencephalitis, and 12.7% were diagnosed as sepsis-associated encephalopathy. These were followed by cerebral malaria, leptospirosis, and brain abscess as the cause of febrile encephalopathy in adults. Among the noninfectious causes, acute disseminated encephalomyelitis, cortical venous thrombosis, and neuroleptic malignant syndrome were documented in 2.36% each. In 11% of the patients, the final diagnosis could not be made in spite of the extensive investigations. Our study demonstrates that acute febrile encephalopathy in adults is a heterogeneous syndrome with primary CNS infections being the commonest

  4. Febrile neutropenia in children with acute lymphoblastic leukemia: single center experience

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    Özdemir, Nihal; Tüysüz, Gülen; Çelik, Nigar; Yantri, Leman; Erginöz, Ethem; Apak, Hilmi; Özkan, Alp; Yıldız, İnci; Celkan, Tiraje

    2016-01-01

    Aim: An important life-threatening complication of intensive chemotherapy administered in children with leukemia is febrile neutropenia. The objective of this study was to evaluate the clinical features and consequences of febrile neutropenia attacks in children who were treated for acute lymphoblastic leukemia. Material and Methods: Nighty-six children who received chemotherapy for acute lymphoblastic leukemia in our center between January 1995 and December 2010 were included in the study. The data related to demographic characteristics, treatment features, relapse and febrile neutropenia incidences, risk factors, culture results and prognosis were retrospectively evaluated from the patients’ files. Results: A total of two hundred-ninety nine febrile neutropenia attacks observed in the patients during initial treatment and relapse treatment were evaluated. When the incidence of febrile neutropenia was evaluated by years, it was observed that the patients treated after year 2000 had statistically significantly more febrile neutopenia attacks compared to the patients treated before year 2000. When the incidences of febrile neutropenia during initial treatment and during relapse treatment were compared, it was observed that more febrile neutropenia attacks occured during relapse treatment. Fifty-nine percent of all febrile neutropenia attacks were fever of unknown origin. Eighty microorganisms grew in cultures during febrile neutropenia throughout treatment in 75 patients; 86% were bacterial infections (50% gram positive and 50% gram negative), 8% were viral infections and 6% were fungal infections. Coagulase negative staphylococcus (n=17) was the most frequent gram positive pathogen; E. Coli (n=17) was the most commonly grown gram negative pathogen. Conclusions: In this study, it was found that an increase in the incidence of febrile neutropenia occured in years. Increments in treatment intensities increase the incidence of febrile neutropenia while improving

  5. CONTINUOUS-INFUSION OF CEFTAZIDIME IN FEBRILE NEUTROPENIC PATIENTS WITH ACUTE MYELOID-LEUKEMIA

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    DAENEN, S; ERJAVEC, Z; UGES, DRA; DEVRIESHOSPERS, HG; DEJONGE, P; HALIE, MR

    1995-01-01

    Twelve febrile patients with severe neutropenia, who had undergone aggressive chemotherapy for acute myeloid leukemia, were treated empirically with a continuous infusion of ceftazidime 100 mg/kg/day after a 500 mg loading dose, in order to study the pharmacokinetics of ceftazidime after continuous

  6. [Esophageal aspergillosis in a patient with acute myelogenous leukemia and febrile neutropenia].

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    Besa, Santiago; Kattan, Eduardo; Cid, Ximena; Claro, Juan C

    2014-04-01

    Aspergillosis usually compromises the respiratory system, but can also affect others. We report a 46 yo female with acute myeloid leukemia, developed febrile neutropenia and dysphagia. Endoscopy revealed esophageal cytomegalovirus-like ulcers, but biopsies showed Aspergillus spp. It's important to consider aspergillosis in the differential diagnosis of esophageal lesions in high-risk patients.

  7. An analysis of autopsy cases of non-Hodgkin lymphoma-with special reference to those masquerading as acute febrile illness

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    Sonali Rajesh Saraf

    2016-01-01

    Conclusion: As NHL present with nonspecific symptoms, these tumours may not be detected in early stages and hence may not be treated appropriately. These patients have weakened immunity and hence are prone to infection and sepsis which can be a major cause of mortality. This autopsy study experience has shown that NHL can masquerade as acute febrile illness which if not detected early and treated adequately can turn fatal.

  8. Arboviral etiologies of acute febrile illnesses in Western South America, 2000-2007.

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    Brett M Forshey

    Full Text Available BACKGROUND: Arthropod-borne viruses (arboviruses are among the most common agents of human febrile illness worldwide and the most important emerging pathogens, causing multiple notable epidemics of human disease over recent decades. Despite the public health relevance, little is know about the geographic distribution, relative impact, and risk factors for arbovirus infection in many regions of the world. Our objectives were to describe the arboviruses associated with acute undifferentiated febrile illness in participating clinics in four countries in South America and to provide detailed epidemiological analysis of arbovirus infection in Iquitos, Peru, where more extensive monitoring was conducted. METHODOLOGY/FINDINGS: A clinic-based syndromic surveillance system was implemented in 13 locations in Ecuador, Peru, Bolivia, and Paraguay. Serum samples and demographic information were collected from febrile participants reporting to local health clinics or hospitals. Acute-phase sera were tested for viral infection by immunofluorescence assay or RT-PCR, while acute- and convalescent-phase sera were tested for pathogen-specific IgM by ELISA. Between May 2000 and December 2007, 20,880 participants were included in the study, with evidence for recent arbovirus infection detected for 6,793 (32.5%. Dengue viruses (Flavivirus were the most common arbovirus infections, totaling 26.0% of febrile episodes, with DENV-3 as the most common serotype. Alphavirus (Venezuelan equine encephalitis virus [VEEV] and Mayaro virus [MAYV] and Orthobunyavirus (Oropouche virus [OROV], Group C viruses, and Guaroa virus infections were both observed in approximately 3% of febrile episodes. In Iquitos, risk factors for VEEV and MAYV infection included being male and reporting to a rural (vs urban clinic. In contrast, OROV infection was similar between sexes and type of clinic. CONCLUSIONS/SIGNIFICANCE: Our data provide a better understanding of the geographic range of

  9. Arboviral Etiologies of Acute Febrile Illnesses in Western South America, 2000–2007

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    Forshey, Brett M.; Guevara, Carolina; Laguna-Torres, V. Alberto; Cespedes, Manuel; Vargas, Jorge; Gianella, Alberto; Vallejo, Efrain; Madrid, César; Aguayo, Nicolas; Gotuzzo, Eduardo; Suarez, Victor; Morales, Ana Maria; Beingolea, Luis; Reyes, Nora; Perez, Juan; Negrete, Monica; Rocha, Claudio; Morrison, Amy C.; Russell, Kevin L.; J. Blair, Patrick; Olson, James G.; Kochel, Tadeusz J.

    2010-01-01

    Background Arthropod-borne viruses (arboviruses) are among the most common agents of human febrile illness worldwide and the most important emerging pathogens, causing multiple notable epidemics of human disease over recent decades. Despite the public health relevance, little is know about the geographic distribution, relative impact, and risk factors for arbovirus infection in many regions of the world. Our objectives were to describe the arboviruses associated with acute undifferentiated febrile illness in participating clinics in four countries in South America and to provide detailed epidemiological analysis of arbovirus infection in Iquitos, Peru, where more extensive monitoring was conducted. Methodology/Findings A clinic-based syndromic surveillance system was implemented in 13 locations in Ecuador, Peru, Bolivia, and Paraguay. Serum samples and demographic information were collected from febrile participants reporting to local health clinics or hospitals. Acute-phase sera were tested for viral infection by immunofluorescence assay or RT-PCR, while acute- and convalescent-phase sera were tested for pathogen-specific IgM by ELISA. Between May 2000 and December 2007, 20,880 participants were included in the study, with evidence for recent arbovirus infection detected for 6,793 (32.5%). Dengue viruses (Flavivirus) were the most common arbovirus infections, totaling 26.0% of febrile episodes, with DENV-3 as the most common serotype. Alphavirus (Venezuelan equine encephalitis virus [VEEV] and Mayaro virus [MAYV]) and Orthobunyavirus (Oropouche virus [OROV], Group C viruses, and Guaroa virus) infections were both observed in approximately 3% of febrile episodes. In Iquitos, risk factors for VEEV and MAYV infection included being male and reporting to a rural (vs urban) clinic. In contrast, OROV infection was similar between sexes and type of clinic. Conclusions/Significance Our data provide a better understanding of the geographic range of arboviruses in South

  10. Bartonella henselae as a cause of acute-onset febrile illness in cats

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    Edward B Breitschwerdt

    2015-08-01

    Full Text Available Case series summary At different time points spanning 6 months, three adopted feral flea-infested cats, residing in the household of a veterinary technician, became acutely anorexic, lethargic and febrile. Enrichment blood culture/PCR using Bartonella alpha Proteobacteria growth medium (BAPGM confirmed initial infection with the same Bartonella henselae genotype in all three cases. With the exception of anemia and neutropenia, complete blood counts, serum biochemical profiles and urinalysis results were within reference intervals. Also, tests for feline leukemia virus, feline immunodeficiency virus, Toxoplasma gondii and feline coronavirus antibodies were negative. Serial daily temperature monitoring in one case confirmed a cyclic, relapsing febrile temperature pattern during 1 month, with resolution during and after treatment with azithromycin. Bartonella henselae Western immunoblot (WB results did not consistently correlate with BAPGM enrichment blood culture/PCR results or B henselae indirect fluorescent antibody (IFA titers, and WB titration results were not informative for establishing antibiotic treatment failure. During the respective follow-up periods, no illnesses or additional febrile episodes were reported, despite repeat documentation of B henselae bacteremia in two cats available for follow-up (one with the same genotype and the other with a different B henselae genotype; one cat was, unfortunately, killed by dogs before follow-up testing. Relevance and novel information We conclude that microbiological diagnosis and treatment of B henselae infection in cats can be challenging, that antibody titration results and resolution of clinical abnormalities may not correlate with a therapeutic cure, and that fever and potentially neutropenia should be differential diagnostic considerations for young cats with suspected bartonellosis.

  11. Dengue fever causing febrile neutropenia in children with acute lymphoblastic leukemia: an unknown entity.

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    Ramzan, Mohammed; Yadav, Satya Prakash; Dinand, Veronique; Sachdeva, Anupam

    2013-06-01

    Dengue fever is endemic in many parts of the world but it has not been described as a cause of febrile neutropenia. We describe here clinical features, laboratory values and outcome in 10 children with acute lymphoblastic leukemia (ALL) and with dengue fever as a cause of febrile neutropenia. These data are compared to an age-matched control population of 22 children with proven dengue infection without ALL. Except for fever in all patients and plethoric face in one patient, typical symptoms of dengue such as abdominal pain, myalgias, and headaches, were absent. Mean duration of hospital stay was 6.3±2.0 days in ALL patients vs. 5.0±2.0 in controls (p=0.096). Median platelet count was 13,000/cmm (range 1000-28,000) in cases vs. 31,500 (range 13,000-150,000) in controls (p=0.018). Mean time for recovery for platelet was 6.0±1.3days in ALL patients vs. 2.5±0.9days in controls (pfebrile neutropenia although typical symptoms may be lacking. Platelet recovery may be significantly delayed.

  12. Dengue and other common causes of acute febrile illness in Asia: an active surveillance study in children.

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    Maria Rosario Capeding

    Full Text Available BACKGROUND: Common causes of acute febrile illness in tropical countries have similar symptoms, which often mimic those of dengue. Accurate clinical diagnosis can be difficult without laboratory confirmation and disease burden is generally under-reported. Accurate, population-based, laboratory-confirmed incidence data on dengue and other causes of acute fever in dengue-endemic Asian countries are needed. METHODS AND PRINCIPAL FINDINGS: This prospective, multicenter, active fever surveillance, cohort study was conducted in selected centers in Indonesia, Malaysia, Philippines, Thailand and Vietnam to determine the incidence density of acute febrile episodes (≥ 38 °C for ≥ 2 days in 1,500 healthy children aged 2-14 years, followed for a mean 237 days. Causes of fever were assessed by testing acute and convalescent sera from febrile participants for dengue, chikungunya, hepatitis A, influenza A, leptospirosis, rickettsia, and Salmonella Typhi. Overall, 289 participants had acute fever, an incidence density of 33.6 per 100 person-years (95% CI: 30.0; 37.8; 57% were IgM-positive for at least one of these diseases. The most common causes of fever by IgM ELISA were chikungunya (in 35.0% of in febrile participants and S. Typhi (in 29.4%. The overall incidence density of dengue per 100 person-years was 3.4 by nonstructural protein 1 (NS1 antigen positivity (95% CI: 2.4; 4.8 and 7.3 (95% CI: 5.7; 9.2 by serology. Dengue was diagnosed in 11.4% (95% CI: 8.0; 15.7 and 23.9% (95% CI: 19.1; 29.2 of febrile participants by NS1 positivity and serology, respectively. Of the febrile episodes not clinically diagnosed as dengue, 5.3% were dengue-positive by NS1 antigen testing and 16.0% were dengue-positive by serology. CONCLUSIONS: During the study period, the most common identified causes of pediatric acute febrile illness among the seven tested for were chikungunya, S. Typhi and dengue. Not all dengue cases were clinically diagnosed; laboratory confirmation

  13. Joint effects of febrile acute infection and an interferon-γ polymorphism on breast cancer risk.

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    Yi Su

    Full Text Available BACKGROUND: There is an inverse relationship between febrile infection and the risk of malignancies. Interferon gamma (IFN-γ plays an important role in fever induction and its expression increases with incubation at fever-range temperatures. Therefore, the genetic polymorphism of IFN-γ may modify the association of febrile infection with breast cancer risk. METHODOLOGY AND PRINCIPAL FINDINGS: Information on potential breast cancer risk factors, history of fever during the last 10 years, and blood specimens were collected from 839 incident breast cancer cases and 863 age-matched controls between October 2008 and June 2010 in Guangzhou, China. IFN-γ (rs2069705 was genotyped using a matrix-assisted laser desorption/ionization time-of-flight mass spectrometry platform. Odds ratios (OR and 95% confidence intervals (CIs were calculated using multivariate logistic regression. We found that women who had experienced ≥1 fever per year had a decreased risk of breast cancer [ORs and 95% CI: 0.77 (0.61-0.99] compared to those with less than one fever a year. This association only occurred in women with CT/TT genotypes [0.54 (0.37-0.77] but not in those with the CC genotype [1.09 (0.77-1.55]. The association of IFN-γ rs2069705 with the risk of breast cancer was not significant among all participants, while the CT/TT genotypes were significantly related to an elevated risk of breast cancer [1.32 (1.03-1.70] among the women with <1 fever per year and to a reduced risk of breast cancer [0.63 (0.40-0.99] among women with ≥1 fever per year compared to the CC genotype. A marked interaction between fever frequencies and the IFN-γ genotypes was observed (P for multiplicative and additive interactions were 0.005 and 0.058, respectively. CONCLUSIONS: Our findings indicate a possible link between febrile acute infection and a decreased risk of breast cancer, and this association was modified by IFN-γ rs2069705.

  14. Diagnostic Algorithm in the Management of Acute Febrile Abdomen in Patients with Autosomal Dominant Polycystic Kidney Disease

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    Neuville, Marie; Hustinx, Roland; Jacques, Jessica; Krzesinski, Jean-Marie; Jouret, François

    2016-01-01

    Background Acute febrile abdomen represents a diagnostic challenge in patients with autosomal dominant polycystic kidney disease (ADPKD). Although criteria have been proposed for cyst infection (CyI) and hemorrhage (CyH), there is a lack of comparative assessments. Furthermore, distinguishing cystic from non-cystic complications remains problematic. Design ADPKD patients presenting with abdominal pain and/or fever between 01/2005 and 06/2015 were retrospectively identified in a systematic com...

  15. Ocular involvement in acute febrile neutrophilic dermatosis (Sweet syndrome): new cases and review of the literature.

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    Gottlieb, Chloe C; Mishra, Aditya; Belliveau, Dan; Green, Peter; Heathcote, J Godfrey

    2008-01-01

    Sweet syndrome (acute febrile neutrophilic dermatosis) is a dermatologic disorder with accompanying features of systemic inflammation. It is commonly associated with conjunctivitis, but a variety of types of ocular inflammation have been reported. The ocular manifestations of Sweet syndrome include periorbital and orbital inflammation, dacryoadenitis, conjunctivitis, episcleritis, scleritis, limbal nodules, peripheral ulcerative keratitis, iritis, glaucoma, and choroiditis. The ocular inflammation appears concurrently with skin lesions. An overview of Sweet syndrome is presented with a review of cases in the literature describing ocular involvement. We report two additional cases of ocular involvement, one with conjunctivitis and a second with iritis, peripheral ulcerative keratitis, and episcleritis. Of the 20 cases, half were bilateral. Thirteen cases occurred in the setting of classical or idiopathic Sweet syndrome and seven in association with malignancy. Biopsies of ocular tissue were infrequent, but, in the seven cases where ocular tissue was analyzed, the histopathology was similar to that of the cutaneous lesions. The ocular complications of Sweet syndrome resolved with systemic administration of corticosteroid or cyclosporine. Topical ocular steroid treatment was frequently used in conjunction with oral steroid but may not have been valuable.

  16. Sweet's syndrome – a comprehensive review of an acute febrile neutrophilic dermatosis

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    Cohen Philip R

    2007-07-01

    Full Text Available Abstract Sweet's syndrome (the eponym for acute febrile neutrophilic dermatosis is characterized by a constellation of clinical symptoms, physical features, and pathologic findings which include fever, neutrophilia, tender erythematous skin lesions (papules, nodules, and plaques, and a diffuse infiltrate consisting predominantly of mature neutrophils that are typically located in the upper dermis. Several hundreds cases of Sweet's syndrome have been published. Sweet's syndrome presents in three clinical settings: classical (or idiopathic, malignancy-associated, and drug-induced. Classical Sweet's syndrome (CSS usually presents in women between the age of 30 to 50 years, it is often preceded by an upper respiratory tract infection and may be associated with inflammatory bowel disease and pregnancy. Approximately one-third of patients with CSS experience recurrence of the dermatosis. The malignancy-associated Sweet's syndrome (MASS can occur as a paraneoplastic syndrome in patients with an established cancer or individuals whose Sweet's syndrome-related hematologic dyscrasia or solid tumor was previously undiscovered; MASS is most commonly related to acute myelogenous leukemia. The dermatosis can precede, follow, or appear concurrent with the diagnosis of the patient's cancer. Hence, MASS can be the cutaneous harbinger of either an undiagnosed visceral malignancy in a previously cancer-free individual or an unsuspected cancer recurrence in an oncology patient. Drug-induced Sweet's syndrome (DISS most commonly occurs in patients who have been treated with granulocyte-colony stimulating factor, however, other medications may also be associated with DISS. The pathogenesis of Sweet's syndrome may be multifactorial and still remains to be definitively established. Clinical and laboratory evidence suggests that cytokines have an etiologic role. Systemic corticosteroids are the therapeutic gold standard for Sweet's syndrome. After initiation of treatment

  17. ACUTE UNDIFFERENTIATED FEBRILE ILLNESS AMONG ADULTS – A HOSPITAL BASED OBSERVATIONAL STUDY

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    Shivkumar

    2013-04-01

    Full Text Available ABSTRACT. BACKGROUND: Fever is a burning issue in the tropics and the mos t common cause of morbidity. Quite frequently this fever goes undi agnosed because of many reasons like the lack of diagnostic facilities, insufficient epidemi ological data available on causes of fever, and so on. This research study was aimed to find out the e tiology and clinical markers of Acute Undifferentiated Febrile Illness [AUFI] among the r ural population of Southern India. METHODOLOGY: This prospective, observational study was conducted at Government Villupuram Medical College and Hospital, a rural ter tiary care centre in Tamil Nadu, India. Consecutive hospitalised adult patients [>16 years] with AUFI[5-14 days fever] were enrolled into the study from August 2010 to February 2012 [1 8 months].Upon enrollment, detailed history was recorded, physical examination done and basic blood tests including biochemical examination, smear study for malaria, blood culture s and serology for the commonly encountered infections were done according to study protocol. The patients were followed up until clinical recovery and convalescence. The data were entered in MS excel and analyzed using Epi-info software 2008 version. RESULTS: A total of 403 patients were included in the study . The distribution of AUFI included Malaria 133[33%], Typhoid 83[20.59%], Dengue 42[10.4%], Leptospirosis 25[6.2%], and other causes 36[8.9%] and unknown cause 84[20.84%]. Malaria patients were significantly associated with jaundice , altered mentation, travel outside the district, elevated AST/ALT levels, thrombocytopenia and splenomegaly. Typhoid fever was associated with longer fever duration, abdominal pai n, coated tongue, relative bradycardia, normal platelet counts and low leucocyte count. Deng ue fever could be predicted by rash, pruritis, petechiae ,retro-orbital pain and low platele t counts. Leptospirosis patients showed significant association with conjunctival suffusion , muscle

  18. Possible Role of Rickettsia felis in Acute Febrile Illness among Children in Gabon.

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    Mourembou, Gaël; Lekana-Douki, Jean Bernard; Mediannikov, Oleg; Nzondo, Sydney Maghendji; Kouna, Lady Charlene; Essone, Jean Claude Biteghe Bi; Fenollar, Florence; Raoult, Didier

    2015-10-01

    Rickettsia felis has been reported to be a cause of fever in sub-Saharan Africa, but this association has been poorly evaluated in Gabon. We assessed the prevalence of this bacterium among children Gabon; the locations were in urban, semiurban, and rural areas. DNA samples from 410 febrile children and 60 afebrile children were analyzed by quantitative PCR. Overall, the prevalence of R. felis among febrile and afebrile children was 10.2% (42/410 children) and 3.3% (2/60 children), respectively. Prevalence differed among febrile children living in areas that are urban (Franceville, 1.3% [1/77]), semiurban (Koulamoutou, 2.1% [3/141]), and rural (Lastourville, 11.2% [15/134]; Fougamou, 39.7% [23/58]). Furthermore, in a rural area (Fougamou), R. felis was significantly more prevalent in febrile (39.7% [23/58]) than afebrile children (5.0% [1/20]). Additional studies are needed to better understand the pathogenic role of R. felis in this part of the world.

  19. Imaging in adult patients with acute febrile encephalopathy:What is better, computerized tomography (CT) or magnetic resonance imaging (MRI)?

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    Bhalla A; Suri V; Singh P; Varma S; Khandelwal NK

    2012-01-01

    Objective: To compare the efficacy of cranial imaging techniques in adult patients with acute febrile encephalopathy. Methods: We enrolled one hundred and two patients presenting to the emergency with fever of shorter than 15-day duration and altered sensorium. All the patients were subjected to routine investigations, detailed cerebrospinal fluid analysis, computerized tomograms (Non contrast followed by contrast enhanced) and Magnetic resonance imaging of the brain. Final diagnosis was reached after considering the clinical, biochemical findings, imaging results and response to therapy. The positive yield of radiological investigations was compared against the final diagnosis. Results: The patients were divided into three groups. Of these patients, 48 had evidence of meningoencephalitis, 22 patients had pyogenic meningitis, and 20 were combined together in others group. In other 12 patients, a definitive diagnosis could not be made. Only 37% patients were detected to have abnormal computerized tomograms and the commonest abnormality was diffuse edema, which failed to point to an etiological diagnosis. Magnetic resonance imaging was abnormal in 62.75% cases and was able to suggest an etiological diagnosis in 100% cases of cerebral venous thrombosis, tubercular meningitis, 95% cases of meningoencephalitis and 45% with meningitis. Conclusions: Magnetic resonance imaging provides better information than computerized tomography in adult patients with acute febrile encephalopathy.

  20. Dengue and Chikungunya Virus Infections among Young Febrile Adults Evaluated for Acute HIV-1 Infection in Coastal Kenya

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    Ngoi, Carolyne N.; Price, Matt A.; Fields, Barry; Bonventure, Juma; Ochieng, Caroline; Mwashigadi, Grace; Hassan, Amin S.; Thiong’o, Alexander N.; Micheni, Murugi; Mugo, Peter; Graham, Susan; Sanders, Eduard J.

    2016-01-01

    Background Fever is common among patients seeking care in sub-Saharan Africa (sSA), but causes other than malaria are rarely diagnosed. We assessed dengue and chikungunya virus infections among young febrile adults evaluated for acute HIV infection (AHI) and malaria in coastal Kenya. Methods We tested plasma samples obtained in a cross-sectional study from febrile adult patients aged 18–35 years evaluated for AHI and malaria at urgent care seeking at seven health facilities in coastal Kenya in 2014–2015. Dengue virus (DENV) and chikungunya virus (CHIKV) were amplified using quantitative real-time reverse-transcription polymerase chain reaction. We conducted logistic regression analyses to determine independent predictors of dengue virus infection. Results 489 samples that were negative for both AHI and malaria were tested, of which 43 (8.8%, 95% confidence interval [CI]: 6.4–11.7) were positive for DENV infection. No participant was positive for CHIKV infection. DENV infections were associated with clinic visits in the rainy season (adjusted odds ratio (AOR) = 3.0, 95% CI: 1.3–6.5) and evaluation at a private health facility (AOR 5.2, 95% CI: 2.0–13.1) or research health facility (AOR = 25.6, 95% CI: 8.9–73.2) instead of a public health facility. Conclusion A high prevalence of DENV infections was found in febrile young adult patients evaluated for AHI. Our data suggests that DENV, along with AHI and malaria, should be considered in the differential diagnosis of the adult patient seeking care for fever in coastal Kenya. PMID:27942016

  1. Acute Febrile Illness Surveillance in a Tertiary Hospital Emergency Department: Comparison of Influenza and Dengue Virus Infections

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    Lorenzi, Olga D.; Gregory, Christopher J.; Santiago, Luis Manuel; Acosta, Héctor; Galarza, Ivonne E.; Hunsperger, Elizabeth; Muñoz, Jorge; Bui, Duy M.; Oberste, M. Steven; Peñaranda, Silvia; García-Gubern, Carlos; Tomashek, Kay M.

    2013-01-01

    In 2009, an increased proportion of suspected dengue cases reported to the surveillance system in Puerto Rico were laboratory negative. As a result, enhanced acute febrile illness (AFI) surveillance was initiated in a tertiary care hospital. Patients with fever of unknown origin for 2–7 days duration were tested for Leptospira, enteroviruses, influenza, and dengue virus. Among the 284 enrolled patients, 31 dengue, 136 influenza, and 3 enterovirus cases were confirmed. Nearly half (48%) of the confirmed dengue cases met clinical criteria for influenza. Dengue patients were more likely than influenza patients to have hemorrhage (81% versus 26%), rash (39% versus 9%), and a positive tourniquet test (52% versus 18%). Mean platelet and white blood cell count were lower among dengue patients. Clinical diagnosis can be particularly difficult when outbreaks of other AFI occur during dengue season. A complete blood count and tourniquet test may be useful to differentiate dengue from other AFIs. PMID:23382160

  2. Likely health outcomes for untreated acute febrile illness in the tropics in decision and economic models; a Delphi survey.

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    Yoel Lubell

    Full Text Available BACKGROUND: Modelling is widely used to inform decisions about management of malaria and acute febrile illnesses. Most models depend on estimates of the probability that untreated patients with malaria or bacterial illnesses will progress to severe disease or death. However, data on these key parameters are lacking and assumptions are frequently made based on expert opinion. Widely diverse opinions can lead to conflicting outcomes in models they inform. METHODS AND FINDINGS: A Delphi survey was conducted with malaria experts aiming to reach consensus on key parameters for public health and economic models, relating to the outcome of untreated febrile illnesses. Survey questions were stratified by malaria transmission intensity, patient age, and HIV prevalence. The impact of the variability in opinion on decision models is illustrated with a model previously used to assess the cost-effectiveness of malaria rapid diagnostic tests. Some consensus was reached around the probability that patients from higher transmission settings with untreated malaria would progress to severe disease (median 3%, inter-quartile range (IQR 1-5%, and the probability that a non-malaria illness required antibiotics in areas of low HIV prevalence (median 20%. Children living in low transmission areas were considered to be at higher risk of progressing to severe malaria (median 30%, IQR 10-58% than those from higher transmission areas (median 13%, IQR 7-30%. Estimates of the probability of dying from severe malaria were high in all settings (medians 60-73%. However, opinions varied widely for most parameters, and did not converge on resurveying. CONCLUSIONS: This study highlights the uncertainty around potential consequences of untreated malaria and bacterial illnesses. The lack of consensus on most parameters, the wide range of estimates, and the impact of variability in estimates on model outputs, demonstrate the importance of sensitivity analysis for decision models

  3. The Relationship between Poverty and Healthcare Seeking among Patients Hospitalized with Acute Febrile Illnesses in Chittagong, Bangladesh.

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    M Trent Herdman

    Full Text Available Delays in seeking appropriate healthcare can increase the case fatality of acute febrile illnesses, and circuitous routes of care-seeking can have a catastrophic financial impact upon patients in low-income settings. To investigate the relationship between poverty and pre-hospital delays for patients with acute febrile illnesses, we recruited a cross-sectional, convenience sample of 527 acutely ill adults and children aged over 6 months, with a documented fever ≥38.0 °C and symptoms of up to 14 days' duration, presenting to a tertiary referral hospital in Chittagong, Bangladesh, over the course of one year from September 2011 to September 2012. Participants were classified according to the socioeconomic status of their households, defined by the Oxford Poverty and Human Development Initiative's multidimensional poverty index (MPI. 51% of participants were classified as multidimensionally poor (MPI>0.33. Median time from onset of any symptoms to arrival at hospital was 22 hours longer for MPI poor adults compared to non-poor adults (123 vs. 101 hours rising to a difference of 26 hours with adjustment in a multivariate regression model (95% confidence interval 7 to 46 hours; P = 0.009. There was no difference in delays for children from poor and non-poor households (97 vs. 119 hours; P = 0.394. Case fatality was 5.9% vs. 0.8% in poor and non-poor individuals respectively (P = 0.001-5.1% vs. 0.0% for poor and non-poor adults (P = 0.010 and 6.4% vs. 1.8% for poor and non-poor children (P = 0.083. Deaths were attributed to central nervous system infection (11, malaria (3, urinary tract infection (2, gastrointestinal infection (1 and undifferentiated sepsis (1. Both poor and non-poor households relied predominantly upon the (often informal private sector for medical advice before reaching the referral hospital, but MPI poor participants were less likely to have consulted a qualified doctor. Poor participants were more likely to attribute delays in

  4. The Relationship between Poverty and Healthcare Seeking among Patients Hospitalized with Acute Febrile Illnesses in Chittagong, Bangladesh.

    Science.gov (United States)

    Herdman, M Trent; Maude, Richard James; Chowdhury, Md Safiqul; Kingston, Hugh W F; Jeeyapant, Atthanee; Samad, Rasheda; Karim, Rezaul; Dondorp, Arjen M; Hossain, Md Amir

    2016-01-01

    Delays in seeking appropriate healthcare can increase the case fatality of acute febrile illnesses, and circuitous routes of care-seeking can have a catastrophic financial impact upon patients in low-income settings. To investigate the relationship between poverty and pre-hospital delays for patients with acute febrile illnesses, we recruited a cross-sectional, convenience sample of 527 acutely ill adults and children aged over 6 months, with a documented fever ≥38.0 °C and symptoms of up to 14 days' duration, presenting to a tertiary referral hospital in Chittagong, Bangladesh, over the course of one year from September 2011 to September 2012. Participants were classified according to the socioeconomic status of their households, defined by the Oxford Poverty and Human Development Initiative's multidimensional poverty index (MPI). 51% of participants were classified as multidimensionally poor (MPI>0.33). Median time from onset of any symptoms to arrival at hospital was 22 hours longer for MPI poor adults compared to non-poor adults (123 vs. 101 hours) rising to a difference of 26 hours with adjustment in a multivariate regression model (95% confidence interval 7 to 46 hours; P = 0.009). There was no difference in delays for children from poor and non-poor households (97 vs. 119 hours; P = 0.394). Case fatality was 5.9% vs. 0.8% in poor and non-poor individuals respectively (P = 0.001)-5.1% vs. 0.0% for poor and non-poor adults (P = 0.010) and 6.4% vs. 1.8% for poor and non-poor children (P = 0.083). Deaths were attributed to central nervous system infection (11), malaria (3), urinary tract infection (2), gastrointestinal infection (1) and undifferentiated sepsis (1). Both poor and non-poor households relied predominantly upon the (often informal) private sector for medical advice before reaching the referral hospital, but MPI poor participants were less likely to have consulted a qualified doctor. Poor participants were more likely to attribute delays in

  5. Prevalence and characteristics of dengue and chikungunya infections among acute febrile patients in Nong Khai Province, Thailand.

    Science.gov (United States)

    Lertanekawattana, Sujet; Anantapreecha, Surapee; Jiraphongsa, Chuleeporn; Duan-ngern, Pawinee; Potjalongsin, Sathit; Wiittayabamrung, Wisanu; Daroon, Pamol; Techolarn, Meta

    2013-09-01

    We conducted a cross sectional study at three hospitals of Nong Khai Province, Thailand to determine the prevalence and characteristics of dengue and chikungunya infection among patients who sought care. The study population was acute febrile patients who visited these hospitals during 1 August -31 October, 2010 who were aged 2-60 years and had clinical symptoms compatible with the case definition. Dengue and chikungunya cases were confirmed by an ELISA IgM titer or RT-PCR. We also reviewed surveillance data of dengue and chikungunya infections from 2003-2009. Of the 200 participants recruited into the study, 103 patients (51.5%) were confirmed to have acute dengue infection; dengue serotype 2 was the most prevalence serotype. The ages of confirmed dengue cases ranged from 2-37 years old. The distribution of cases showed that dengue morbidity tended to be clustered in adjacent areas, particularly in Mueang District. Only a small proportion of the patients uses mosquito repellant and had screens on their windows. One patient (0.5%) had laboratory confirmed chikungunya infection. She was from Rattanawapi District, an area where no chikungunya had been reported before. Since the disease varies by age and geographic location, increased awareness of health care workers and public health officers about the diseases in the area is needed for early detection of cases and to promote early prevention and control measures.

  6. Acute Uncomplicated Febrile Illness in Children Aged 2-59 months in Zanzibar - Aetiologies, Antibiotic Treatment and Outcome.

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    Kristina Elfving

    Full Text Available Despite the fact that a large proportion of children with fever in Africa present at primary health care facilities, few studies have been designed to specifically study the causes of uncomplicated childhood febrile illness at this level of care, especially in areas like Zanzibar that has recently undergone a dramatic change from high to low malaria transmission.We prospectively studied the aetiology of febrile illness in 677 children aged 2-59 months with acute uncomplicated fever managed by IMCI (Integrated Management of Childhood Illness guidelines in Zanzibar, using point-of-care tests, urine culture, blood-PCR, chest X-ray (CXR of IMCI-pneumonia classified patients, and multiple quantitative (qPCR investigations of nasopharyngeal (NPH (all patients and rectal (GE swabs (diarrhoea patients. For comparison, we also performed NPH and GE qPCR analyses in 167 healthy community controls. Final fever diagnoses were retrospectively established based on all clinical and laboratory data. Clinical outcome was assessed during a 14-day follow-up. The utility of IMCI for identifying infections presumed to require antibiotics was evaluated.NPH-qPCR and GE-qPCR detected ≥1 pathogen in 657/672 (98% and 153/164 (93% of patients and 158/166 (95% and 144/165 (87% of controls, respectively. Overall, 57% (387/677 had IMCI-pneumonia, but only 12% (42/342 had CXR-confirmed pneumonia. Two patients were positive for Plasmodium falciparum. Respiratory syncytial virus (24.5%, influenza A/B (22.3%, rhinovirus (10.5% and group-A streptococci (6.4%, CXR-confirmed pneumonia (6.2%, Shigella (4.3% were the most common viral and bacterial fever diagnoses, respectively. Blood-PCR conducted in a sub-group of patients (n = 83 without defined fever diagnosis was negative for rickettsiae, chikungunya, dengue, Rift Valley fever and West Nile viruses. Antibiotics were prescribed to 500 (74% patients, but only 152 (22% had an infection retrospectively considered to require

  7. Acute Uncomplicated Febrile Illness in Children Aged 2-59 months in Zanzibar – Aetiologies, Antibiotic Treatment and Outcome

    Science.gov (United States)

    Elfving, Kristina; Shakely, Deler; Andersson, Maria; Baltzell, Kimberly; Ali, Abdullah S.; Bachelard, Marc; Falk, Kerstin I.; Ljung, Annika; Msellem, Mwinyi I.; Omar, Rahila S.; Parola, Philippe; Xu, Weiping; Petzold, Max; Trollfors, Birger; Björkman, Anders; Lindh, Magnus; Mårtensson, Andreas

    2016-01-01

    Background Despite the fact that a large proportion of children with fever in Africa present at primary health care facilities, few studies have been designed to specifically study the causes of uncomplicated childhood febrile illness at this level of care, especially in areas like Zanzibar that has recently undergone a dramatic change from high to low malaria transmission. Methods We prospectively studied the aetiology of febrile illness in 677 children aged 2–59 months with acute uncomplicated fever managed by IMCI (Integrated Management of Childhood Illness) guidelines in Zanzibar, using point-of-care tests, urine culture, blood-PCR, chest X-ray (CXR) of IMCI-pneumonia classified patients, and multiple quantitative (q)PCR investigations of nasopharyngeal (NPH) (all patients) and rectal (GE) swabs (diarrhoea patients). For comparison, we also performed NPH and GE qPCR analyses in 167 healthy community controls. Final fever diagnoses were retrospectively established based on all clinical and laboratory data. Clinical outcome was assessed during a 14-day follow-up. The utility of IMCI for identifying infections presumed to require antibiotics was evaluated. Findings NPH-qPCR and GE-qPCR detected ≥1 pathogen in 657/672 (98%) and 153/164 (93%) of patients and 158/166 (95%) and 144/165 (87%) of controls, respectively. Overall, 57% (387/677) had IMCI-pneumonia, but only 12% (42/342) had CXR-confirmed pneumonia. Two patients were positive for Plasmodium falciparum. Respiratory syncytial virus (24.5%), influenza A/B (22.3%), rhinovirus (10.5%) and group-A streptococci (6.4%), CXR-confirmed pneumonia (6.2%), Shigella (4.3%) were the most common viral and bacterial fever diagnoses, respectively. Blood-PCR conducted in a sub-group of patients (n = 83) without defined fever diagnosis was negative for rickettsiae, chikungunya, dengue, Rift Valley fever and West Nile viruses. Antibiotics were prescribed to 500 (74%) patients, but only 152 (22%) had an infection

  8. Proton pump inhibitor-induced Sweet’s syndrome: report of acute febrile neutrophilic dermatosis in a woman with recurrent breast cancer

    OpenAIRE

    Cohen, Philip R.

    2015-01-01

    Background: Sweet’s syndrome, also referred to as acute febrile neutrophilic dermatosis, can either occur as an idiopathic disorder or associated with another condition, including cancer, or induced by exposure to a drug. Proton pump inhibitors selectively inhibit gastric parietal cell H+-K+-adenosine triphosphatase and are most commonly used for the treatment of gastroesophageal reflux disease. Purpose: Proton pump inhibitor-associated Sweet’s syndrome is described in a woman with recurrent ...

  9. Human Herpesvirus 6 Infection Presenting as an Acute Febrile Illness Associated with Thrombocytopenia and Leukopenia

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    Maja Arnež

    2016-01-01

    Full Text Available We present an infant with acute fever, thrombocytopenia, and leukopenia, coming from an endemic region for tick-borne encephalitis, human granulocytic anaplasmosis, and hantavirus infection. The primary human herpesvirus 6 infection was diagnosed by seroconversion of specific IgM and IgG and by identification of viral DNA in the acute patient’s serum. The patient did not show skin rash suggestive of exanthema subitum during the course of illness.

  10. Acute febrile neutrophilic dermatosis (Sweet's syndrome in a child, associated with a rotavirus infection: a case report

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    Makis Alexandros

    2010-08-01

    Full Text Available Abstract Introduction Sweet's syndrome characterized by fever, blood neutrophilia and inflammatory skin lesions, is rarely diagnosed in children. It presents in three clinical settings: classical Sweet's syndrome, usually after a respiratory tract infection; malignancy-associated, frequently related to acute myelogeneous leukemia; and drug-induced. We present, to the best of our knowledge, the first case of a rotavirus -infection-related Sweet's syndrome. Case presentation An 18-month-old boy of Hellenic origin was referred to us with diarrhea, fever, neutrophilia, typical skin lesions, asymmetrical hip arthritis and oropharyngeal involvement. A skin biopsy confirmed the diagnosis. Thorough screening did not reveal any underlying systemic illness, except for the confirmation of an overt rotavirus infection. The syndrome responded promptly upon corticosteroid administration; no recurrence was observed. Conclusion Besides describing the connection of Sweet's syndrome to a rotavirus infection, this case report is also a reminder that in a child presenting with a febrile papulo-nodular rash with neutrophilia Sweet's syndrome should be included in the differential.

  11. Convulsiones febriles

    OpenAIRE

    Matilde Ruiz-García

    2015-01-01

    La Liga Internacional de Lucha contra la Epilepsia y la Organización Mundial de la Salud consideran a las convulsiones febriles como eventos comunes y benignos de la etapa infantil. Las convulsiones febriles son la forma más frecuente de crisis convulsiva en la infancia y afectan de 2 a 4% de los menores de 5 años en Estados Unidos y Europa, de 9 a 10% en Japón y hasta a 14% en Guam.

  12. Convulsiones febriles

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    Matilde Ruiz-García

    2015-10-01

    Full Text Available La Liga Internacional de Lucha contra la Epilepsia y la Organización Mundial de la Salud consideran a las convulsiones febriles como eventos comunes y benignos de la etapa infantil. Las convulsiones febriles son la forma más frecuente de crisis convulsiva en la infancia y afectan de 2 a 4% de los menores de 5 años en Estados Unidos y Europa, de 9 a 10% en Japón y hasta a 14% en Guam.

  13. Febrile Seizures

    Science.gov (United States)

    ... it occasionally can cause drowsiness, a lack of coordination, or hyperactivity. Children vary widely in their susceptibility to such side ... determine the impact of these seizures on the development of epilepsy and memory. Children who have experienced prolonged febrile seizures are more ...

  14. Convulsiones febriles

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    Martha L. Vélez

    1990-03-01

    Full Text Available e revisaron las historias clínicas de 118 niños con diagnóstico de convulsión febril, que acudieron a la consulta externa de lactantes del Hospital Infantil (Hospital Universitario San vicente de Paúl de Medellín.

  15. Validation of a case definition for leptospirosis diagnosis in patients with acute severe febrile disease admitted in reference hospitals at the State of Pernambuco, Brazil

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    Alfredo Pereira Leite de Albuquerque Filho

    2011-12-01

    Full Text Available INTRODUCTION: Leptospirosis is often mistaken for other acute febrile illnesses because of its nonspecific presentation. Bacteriologic, serologic, and molecular methods have several limitations for early diagnosis: technical complexity, low availability, low sensitivity in early disease, or high cost. This study aimed to validate a case definition, based on simple clinical and laboratory tests, that is intended for bedside diagnosis of leptospirosis among hospitalized patients. METHODS: Adult patients, admitted to two reference hospitals in Recife, Brazil, with a febrile illness of less than 21 days and with a clinical suspicion of leptospirosis, were included to test a case definition comprising ten clinical and laboratory criteria. Leptospirosis was confirmed or excluded by a composite reference standard (microscopic agglutination test, ELISA, and blood culture. Test properties were determined for each cutoff number of the criteria from the case definition. RESULTS: Ninety seven patients were included; 75 had confirmed leptospirosis and 22 did not. Mean number of criteria from the case definition that were fulfilled was 7.8±1.2 for confirmed leptospirosis and 5.9±1.5 for non-leptospirosis patients (p<0.0001. Best sensitivity (85.3% and specificity (68.2% combination was found with a cutoff of 7 or more criteria, reaching positive and negative predictive values of 90.1% and 57.7%, respectively; accuracy was 81.4%. CONCLUSIONS: The case definition, for a cutoff of at least 7 criteria, reached average sensitivity and specificity, but with a high positive predictive value. Its simplicity and low cost make it useful for rapid bedside leptospirosis diagnosis in Brazilian hospitalized patients with acute severe febrile disease.

  16. Fluid therapy for severe acute pancreatitis in acute response stage

    Institute of Scientific and Technical Information of China (English)

    MAO En-qiang; TANG Yao-qing; FEI Jian; QIN Shuai; WU Jun; LI Lei; MIN Dong; ZHANG Sheng-dao

    2009-01-01

    Background Fluid therapy for severe acute pancreatitis (SAP) should not only resolve deficiency of blood volume, but also prevent fluid sequestration in acute response stage. Up to date, there has not a strategy for fluid therapy dedicated to SAP. So, this study was aimed to investigate the effects of fluid therapy treatment on prognosis of SAP. Methods Seventy-six patients were admitted prospectively according to the criteria within 72 hours of SAP onset. They were randomly assigned to a rapid fluid expansion group (Group I, n=36) and a controlled fluid expansion group (Group Ⅱ, n=40). Hemodynamic disorders were either quickly (fluid infusion rate was 10-15 ml·kg-1·h-1, Group Ⅰ) or gradually improved (fluid infusion rate was 5-10 ml·kg-1·h-1, Group Ⅱ) through controlling the rate of fluid infusion. Parameters of fluid expansion, blood lactate concentration were obtained when meeting the criteria for fluid expansion. And APACHE Ⅱ scores were obtained serially for 72 hours. Rate of mechanical ventilation, incidence of abdominal compartment syndrome (ACS), sepsis, and survival rate were obtained. Results The two groups had statistically different (P 0.05). Total amount of fluid sequestration within 4 days was higher in Group Ⅰ ((5378±2751)ml) than in Group Ⅱ ((4215±1998)ml, P<0.05). APACHE Ⅱ scores were higher in Group Ⅰ on days 1,2, and 3 (P<0.05). Rate of mechanical ventilation was higher in group Ⅰ (94.4%) than in group Ⅱ (65%, P<0.05). The incidences of abdominal compartment syndrome (ACS) and sepsis were significantly lower in Group Ⅱ (P <0.05). Survival rate was remarkably lower in Group Ⅰ (69.4%) than in Group Ⅱ (90%, P <0.05). Conclusions Controlled fluid resuscitation offers better prognosis in patients with severe volume deficit within 72 hours of SAP onset.

  17. Molecular Characterisation of Chikungunya Virus Infections in Trinidad and Comparison of Clinical and Laboratory Features with Dengue and Other Acute Febrile Cases.

    Science.gov (United States)

    Sahadeo, Nikita; Mohammed, Hamish; Allicock, Orchid M; Auguste, Albert J; Widen, Steven G; Badal, Kimberly; Pulchan, Krishna; Foster, Jerome E; Weaver, Scott C; Carrington, Christine V F

    2015-11-01

    Local transmission of Chikungunya virus (CHIKV) was first documented in Trinidad and Tobago (T&T) in July 2014 preceding a large epidemic. At initial presentation, it is difficult to distinguish chikungunya fever (CHIKF) from other acute undifferentiated febrile illnesses (AUFIs), including life-threatening dengue disease. We characterised and compared dengue virus (DENV) and CHIKV infections in 158 patients presenting with suspected dengue fever (DF) and CHIKF at a major hospital in T&T, and performed phylogenetic analyses on CHIKV genomic sequences recovered from 8 individuals. The characteristics of patients with and without PCR-confirmed CHIKV were compared using Pearson's χ2 and student's t-tests, and adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were determined using logistic regression. We then compared signs and symptoms of people with RT-qPCR-confirmed CHIKV and DENV infections using the Mann-Whitney U, Pearson's χ2 and Fisher's exact tests. Among the 158 persons there were 8 (6%) RT-qPCR-confirmed DENV and 30 (22%) RT-qPCR-confirmed CHIKV infections. Phylogenetic analyses showed that the CHIKV strains belonged to the Asian genotype and were most closely related to a British Virgin Islands strain isolated at the beginning of the 2013/14 outbreak in the Americas. Compared to persons who were RT-qPCR-negative for CHIKV, RT-qPCR-positive individuals were significantly more likely to have joint pain (aOR: 4.52 [95% CI: 1.28-16.00]), less likely to be interviewed at a later stage of illness (days post onset of fever--aOR: 0.56 [0.40-0.78]) and had a lower white blood cell count (aOR: 0.83 [0.71-0.96]). Among the 38 patients with RT-qPCR-confirmed CHIKV or DENV, there were no significant differences in symptomatic presentation. However when individuals with serological evidence of recent DENV or CHIKV infection were included in the analyses, there were key differences in clinical presentation between CHIKF and other AUFIs including DF, which

  18. Utility of the tourniquet test and the white blood cell count to differentiate dengue among acute febrile illnesses in the emergency room.

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    Christopher J Gregory

    2011-12-01

    Full Text Available Dengue often presents with non-specific clinical signs, and given the current paucity of accurate, rapid diagnostic laboratory tests, identifying easily obtainable bedside markers of dengue remains a priority. Previous studies in febrile Asian children have suggested that the combination of a positive tourniquet test (TT and leucopenia can distinguish dengue from other febrile illnesses, but little data exists on the usefulness of these tests in adults or in the Americas. We evaluated the diagnostic accuracy of the TT and leucopenia (white blood cell count <5000/mm(3 in identifying dengue as part of an acute febrile illness (AFI surveillance study conducted in the Emergency Department of Saint Luke's Hospital in Ponce, Puerto Rico. From September to December 2009, 284 patients presenting to the ED with fever for 2-7 days and no identified source were enrolled. Participants were tested for influenza, dengue, leptospirosis and enteroviruses. Thirty-three (12% patients were confirmed as having dengue; 2 had dengue co-infection with influenza and leptospirosis, respectively. An infectious etiology was determined for 141 others (136 influenza, 3 enterovirus, 2 urinary tract infections, and 110 patients had no infectious etiology identified. Fifty-two percent of laboratory-positive dengue cases had a positive TT versus 18% of patients without dengue (P<0.001, 87% of dengue cases compared to 28% of non-dengue cases had leucopenia (P<0.001. The presence of either a positive TT or leucopenia correctly identified 94% of dengue patients. The specificity and positive predictive values of these tests was significantly higher in the subset of patients without pandemic influenza A H1N1, suggesting improved discriminatory performance of these tests in the absence of concurrent dengue and influenza outbreaks. However, even during simultaneous AFI outbreaks, the absence of leucopenia combined with a negative tourniquet test may be useful to rule out dengue.

  19. The Role of Human Coronaviruses in Children Hospitalized for Acute Bronchiolitis, Acute Gastroenteritis, and Febrile Seizures: A 2-Year Prospective Study.

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    Monika Jevšnik

    Full Text Available Human coronaviruses (HCoVs are associated with a variety of clinical presentations in children, but their role in disease remains uncertain. The objective of our prospective study was to investigate HCoVs associations with various clinical presentations in hospitalized children up to 6 years of age. Children hospitalized with acute bronchiolitis (AB, acute gastroenteritis (AGE, or febrile seizures (FS, and children admitted for elective surgical procedures (healthy controls were included in the study. In patients with AB, AGE, and FS, a nasopharyngeal (NP swab and blood sample were obtained upon admission and the follow-up visit 14 days later, whereas in children with AGE a stool sample was also acquired upon admission; in healthy controls a NP swab and stool sample were taken upon admission. Amplification of polymerase 1b gene was used to detect HCoVs in the specimens. HCoVs-positive specimens were also examined for the presence of several other viruses. HCoVs were most often detected in children with FS (19/192, 9.9%, 95% CI: 6-15%, followed by children with AGE (19/218, 8.7%, 95% CI: 5.3-13.3% and AB (20/308, 6.5%, 95% CI: 4.0-9.8%. The presence of other viruses was a common finding, most frequent in the group of children with AB (19/20, 95%, 95% CI: 75.1-99.8%, followed by FS (10/19, 52.6%, 95% CI: 28.9-75.6% and AGE (7/19, 36.8%, 95% CI: 16.3-61.6%. In healthy control children HCoVs were detected in 3/156 (1.9%, 95% CI: 0.4-5.5% NP swabs and 1/150 (0.7%, 95% CI: 0.02-3.3% stool samples. It seems that an etiological role of HCoVs is most likely in children with FS, considering that they had a higher proportion of positive HCoVs results than patients with AB and those with AGE, and had the highest viral load; however, the co-detection of other viruses was 52.6%.ClinicalTrials.gov NCT00987519.

  20. Prevalence of patients with acute febrile illnesses and positive dengue NS1 tests in a tertiary hospital in Papua New Guinea.

    Science.gov (United States)

    Asigau, Viola; Lavu, Evelyn K; McBride, William J H; Biloh, Eric; Naroi, Francis; Koana, Egi; Ferguson, John K; Laman, Moses

    2015-01-01

    Because the prevalence of dengue fever in urban settings in Papua New Guinea is unknown, we investigated the presence of dengue using the NS1 antigen test in an outpatient-based prospective observational study at Port Moresby General Hospital. Of 140 patients with acute febrile illnesses, dengue fever was diagnosed in 14.9% (20 of 134; 95% confidence interval [95% CI] = 9.6-22.4). Malaria (2 of 137; 1.5%; 95% CI = 0.3-5.7), chikungunya (3 of 140; 2.1%; 95% CI = 0.6-6.6), and bacterial bloodstream infections (0 of 80; 0%; 95% CI = 0-5.7) were uncommon. Dengue fever should no longer be considered rare in Papua New Guinea.

  1. Elaboration of a clinical and paraclinical score to estimate the probability of herpes simplex virus encephalitis in patients with febrile, acute neurologic impairment.

    Science.gov (United States)

    Gennai, S; Rallo, A; Keil, D; Seigneurin, A; Germi, R; Epaulard, O

    2016-06-01

    Herpes simplex virus (HSV) encephalitis is associated with a high risk of mortality and sequelae, and early diagnosis and treatment in the emergency department are necessary. However, most patients present with non-specific febrile, acute neurologic impairment; this may lead clinicians to overlook the diagnosis of HSV encephalitis. We aimed to identify which data collected in the first hours in a medical setting were associated with the diagnosis of HSV encephalitis. We conducted a multicenter retrospective case-control study in four French public hospitals from 2007 to 2013. The cases were the adult patients who received a confirmed diagnosis of HSV encephalitis. The controls were all the patients who attended the emergency department of Grenoble hospital with a febrile acute neurologic impairment, without HSV detection by polymerase chain reaction (PCR) in the cerebrospinal fluid (CSF), in 2012 and 2013. A multivariable logistic model was elaborated to estimate factors significantly associated with HSV encephalitis. Finally, an HSV probability score was derived from the logistic model. We identified 36 cases and 103 controls. Factors independently associated with HSV encephalitis were the absence of past neurological history (odds ratio [OR] 6.25 [95 % confidence interval (CI): 2.22-16.7]), the occurrence of seizure (OR 8.09 [95 % CI: 2.73-23.94]), a systolic blood pressure ≥140 mmHg (OR 5.11 [95 % CI: 1.77-14.77]), and a C-reactive protein probability score was calculated summing the value attributed to each independent factor. HSV encephalitis diagnosis may benefit from the use of this score based upon some easily accessible data. However, diagnostic evocation and probabilistic treatment must remain the rule.

  2. Prevalence of malaria among acute febrile patients clinically suspected of having malaria in the Zeway Health Center, Ethiopia.

    Science.gov (United States)

    Feleke, Sendeaw M; Animut, Abebe; Belay, Mulugeta

    2015-01-01

    Malaria diagnosis is a common challenge in developing countries with limited diagnostic services. Common febrile illnesses were assessed in 280 malaria-suspected patients, and each case was subjected to clinical and laboratory examinations for malaria, relapsing fever, typhoid fever, typhus, and brucellosis. Data were entered and analyzed using Epi Info version 3.1 software. Malaria accounted for 17% (CI, 12.6-21.4%) of febrile illnesses. The remaining cases were associated with typhoid fever (18.5%; CI, 13.95-23.05%), typhus (17.8%; CI, 13.32-22.28%), brucellosis (1%; CI, -0.17-2.17%), relapsing fever (2%; CI, 0.36-3.64%), and unknown causes (44%). Approximately 7% of patients had coinfections, and 2% of patients treated as monoinfections. Approximately 1.4% of the nonmalarial patients received antimalarial treatment. The sensitivity and specificity of the CareStart Pf/pan rapid diagnostic tests in comparison with those of microscopy were 100% and 91%, respectively, with positive- and negative-predictive values of 94% and 100%, respectively. Compared with microscopy, the positive-predictive value of each malaria symptom was much lower than that of the symptoms combined: fever, 17%; sweating, 30%; headache, 18%; general body ache, 22%; loss of appetite, 21%. The study findings revealed a high proportion of nonmalarial illnesses were clinically categorized as malaria. Parasite-based diagnosis is recommended for the management of malarial and nonmalarial cases.

  3. Retrospective survey and evaluation of first-line antibiotics for chemotherapy-induced febrile neutropenia in patients with acute myeloid leukemia

    Science.gov (United States)

    Mukoyama, Naoki; Nakashima, Marie; Miyamura, Koichi; Yoshimi, Akira; Noda, Yukihiro; Mori, Kazuhiro

    2017-01-01

    ABSTRACT Patients with acute leukemia are susceptible to chemotherapy-induced severe myelosuppression, and therefore are at a high risk for febrile neutropenia (FN). In such cases, the use of broad-spectrum antibiotics such as fourth-generation cephalosporins and carbapenems is recommended as first-line antimicrobial treatment; however, the effectiveness of these agents in patients with acute myeloid leukemia (AML) has not been investigated in detail. We retrospectively examined and evaluated the effectiveness of first-line antibiotic treatment regimens for chemotherapy-induced FN in patients with AML in Japanese Red Cross Nagoya Daiichi Hospital. The evaluated first-line treatment regimens were as follows: cefozopran (CZOP) + amikacin (AMK) in 38 cases, cefepime (CFPM) alone in 2 cases, CFPM + AMK in 2 cases, piperacillin (PIPC) + AMK in 2 cases, and CZOP alone in 1 case. Additionally, prophylactic antifungal agents were administered in all cases. Markedly effective, effective, moderately effective, and ineffective responses occurred in 31.1%, 8.9%, 8.9%, and 51.1%, respectively, of the treated cases. The response rate, defined as the combination of markedly effective and effective outcomes, was 40.0%. In 11 cases, impairment of renal functions were observed, and they were associated with combination treatments including AMK; nine of these were associated with a glycopeptide. The combination of CZOP with AMK (84.4%) was the most commonly used first-line treatment for FN in patients with AML; carbapenem or tazobactam/PIPC has never been used for treatment of such cases. Our findings demonstrate that fourth-generation cephems will be an effective first-line treatment for FN in patients with AML in our hospital. PMID:28303057

  4. Pancreatic Perfusion CT in Early Stage of Severe Acute Pancreatitis

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    Yoshihisa Tsuji

    2012-01-01

    Full Text Available Early intensive care for severe acute pancreatitis is essential for improving SAP mortality rates. However, intensive therapies for SAP are often delayed because there is no ideal way to accurately evaluate severity in the early stages. Currently, perfusion CT has been shown useful to predict prognosis of SAP in the early stage. In this presented paper, we would like to review the clinical usefulness and limitations of perfusion CT for evaluation of local and systemic complications in early stage of SAP.

  5. Recognition and management of febrile convulsion in children.

    Science.gov (United States)

    Paul, Siba Prosad; Kirkham, Emily Natasha; Shirt, Bethany

    2015-08-26

    Febrile convulsion is characterised by convulsion associated with fever in an infant or child aged between six months and six years. The febrile illness causing the convulsion should not be secondary to an intracranial infection (meningitis or encephalitis) or acute electrolyte imbalance. Most cases of febrile convulsion are short lived and self-terminating. However, a few cases of prolonged febrile convulsion may need anticonvulsant medication to stop the seizure. Management is mainly symptomatic, although anticonvulsants may have a role in a small number of children with complex or recurrent febrile convulsion. Referral to paediatric neurologists may be necessary in cases of complex or recurrent febrile convulsion, or in those where a pre-existing neurological disorder exists. One third of children will develop a further febrile convulsion during subsequent febrile illness. Nurses have a vital role in managing children with febrile convulsion, educating parents about the condition and dispelling myths. This article outlines the presentation, management, investigations and prognosis for febrile convulsion, indicating how nurses working in different clinical areas can help to manage this common childhood condition.

  6. Association between pneumonia in acute stroke stage and 3-year mortality in patients with acute first-ever ischemic stroke.

    Science.gov (United States)

    Yu, Yi-Jing; Weng, Wei-Chieh; Su, Feng-Chieh; Peng, Tsung-I; Chien, Yu-Yi; Wu, Chia-Lun; Lee, Kuang-Yung; Wei, Yi-Chia; Lin, Shun-Wen; Zhu, Jun-Xiao; Huang, Wen-Yi

    2016-11-01

    The influence of pneumonia in acute stroke stage on the clinical presentation and long-term outcomes of patients with acute ischemic stroke is still controversial. We investigate the influence of pneumonia in acute stroke stage on the 3-year outcomes of patients with acute first-ever ischemic stroke. Nine-hundred and thirty-four patients with acute first-ever ischemic stroke were enrolled and had been followed for 3years. Patients were divided into two groups according to whether pneumonia occurred during acute stroke stage or not. Clinical presentations, risk factors for stroke, laboratory data, co-morbidities, and outcomes were recorded. The result showed that a total of 100 patients (10.7%) had pneumonia in acute stroke stage. The prevalence of older age, atrial fibrillation was significantly higher in patients with pneumonia in acute stroke stage. Total anterior circulation syndrome and posterior circulation syndrome occurred more frequently among patients with pneumonia in acute stroke stage (Ppneumonia in acute stroke stage is a significant predictor of 3-year mortality (hazard ratio=6.39, 95% confidence interval=4.03-10.11, Ppneumonia during the acute stroke stage is associated with increased risk of 3-year mortality. Interventions to prevent pneumonia in acute stroke stage might improve ischemic stroke outcome.

  7. Febrile Seizure: Demographic Features and Causative Factors

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    Hamed ESMAILI GOURABI

    2013-01-01

    parental knowledge, attitudes, concerns and practices. J Formos Med Assoc. 2006 Jan;105(1:38-48. Vaswani RK, Dharaskar PG, Kulkarni S, Ghosh K. Iron deficiency as a risk factor for first febrile seizure. Indian Pediatr. 2010 May;47(5:437-9.Sadleir LG, Scheffer IE. Febrile seizures. BMJ. 2007 Feb;334(7588:307-11.Mohebbi MR, Holden KR, Butler IJ. FIRST: a practical approach to the causes and management of febrile seizures. J Child Neurol. 2008 Dec;23(12:1484-9.Salehi Omran M, Khalilian E, Mehdipour E et al. Febrile seizures in North Iranian children: Epidemiology and clinical feature. J Pediatr Neurol. 2008;6(1:39-42.Bidabadi E, Mashouf M. Association between iron deficiency anemia and first febrile convulsion. A case-control study. Seizure. 2009 Jun;18(5:347-51.Vahidnia F, Eskenazi B, Jewell N. Maternal smoking, alcohol drinking, and febrile convulsion. Seizure. 2008 Jun;17(4:320-6.Ashrafzade F, Hashemzadeh A, Malek A. Acute otitis Media in Children with Febrile Convulsion. Iran J Otorhinolaryngol. 2002;16(35:33-9.Millichap JJ, Gordon Millichap J. Methods of investigation and management of infections causing febrile seizures. Pediatr Neurol. 2008 Dec;39(6:381-6.Hosseini Nasab A, Dai pariz M, Alidousti K. Demographic characteristics and predisposing factors of febrile seizures in children admitted to Hospital No. 1 of Kerman University of Medical Sciences. J Med Counc Islam Repub Iran. 2006;24(2:107-12.Keller A, Saucier D, Sheerin A, Yager J. Febrile convulsions affect ultrasonic vocalizations in the rat pup. Epilepsy Behav. 2004 Oct;5(5:649-54.Ogihara M, Shirakawa S, Miyajima T, Takekuma K, Hoshika A. Diurnal variation in febrile convulsions. Pediatr Neurol. 2010 Jun;42(6:409-12.Fallah R, Akhavan S, Mir Sadat Nasseri F. Clinical and demographic characteristics of first febrile seizure in children. J Shaeed Sdoughi Uni Med Sci Yazd. 2009;16(5:61-5.Khodapanahande F, VahidHarandi N, Esmaeli F. Evaluation of seasonal variation and circadian rhythm of febrile seizures in

  8. Miliaria-rash after neutropenic fever and induction chemotherapy for acute myelogenous leukemia Miliária 'rash' após neutropenia febril e quimioterapia de indução para a leucemia mielóide aguda

    Directory of Open Access Journals (Sweden)

    Tuyet A Nguyen

    2011-08-01

    Full Text Available Miliaria is a disorder of the eccrine sweat glands which occurs in conditions of increased heat and humidity. It can be associated with persistent febrile states as well as with certain drugs. We presented a 40 year-old female with myelodysplastic syndrome and progression to acute myelogenous leukemia who was admitted to the hospital for chemotherapy induction. The patient was treated with idarubicin and cytarabine. She became pancytopenic and developed neutropenic fever and was started on vancomycin and cefepime, but was persistently febrile with night sweats. Five days into her fevers, she developed diffuse, nonpruritic and fragile vesicles together with drenching nightsweats. The patient's exanthem was diagnosed as Miliaria crystallina, most probably induced by neutropenic fever and idarubucin exposureMiliária é uma desordem das glândulas sudoríparas écrinas, que ocorre em condições de aumento de calor e umidade. Miliária pode ser associada com estados febris persistentes bem como com certos medicamentos. Apresentamos o caso de uma mulher de 40 anos com síndrome mielodisplásica e progressão para leucemia mielóide aguda que foi admitida no hospital para quimioterapia de indução. A paciente foi tratada com idarrubicina e citarabina. Ela se tornou pancitopênica e desenvolveu neutropenia febril. Iniciou tratamento com vancomicina e cefepime, mas a febre com sudorese noturna continou. Cinco dias depois a paciente desenvolveu vesículas difusas, não pruríticas e frágeis juntamente com a persistência de sudorese noturna. O exantema do paciente foi diagnosticado como Miliária cristalina, provavelmente induzida por neutropenia febril e exposição a idarubucin

  9. Diazepam for Febrile Seizures

    OpenAIRE

    1990-01-01

    The efficacy and side effects of intermittent oral diazepam for the prevention of febrile seizure recurrence were investigated in the Departments of Clinical Pharmacology, Neurosurgery, and Biostatistics, University of Tours, France.

  10. Febrile seizures in Kaduna, north western Nigeria

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    E E Eseigbe

    2012-01-01

    Full Text Available Background: Febrile seizure is the most common seizure of childhood and has a good prognosis. However its presentation is fraught with poor management, with grave consequences, in our environment. Thus a review of its current status is important. Objective: To review the status of febrile seizures in Kaduna metropolis. Materials and Methods: A review of cases seen in the Department of Paediatrics, 44 Nigeria Army Reference Hospital, Kaduna between June 2008 and June 2010. Results: Out of the 635 cases admitted in the department 17 (2.7% fulfilled the criteria for febrile seizures. There were 11 Males and 6 Females (M: F, 1.8:1. Age range was from 9 months to 5 years with a mean of 2.2 years ± 1.1 and peak age of 3 years. Twelve (70.6% were in the upper social classes (I-III. Fever, convulsion, catarrh and cough were major presenting symptoms. Incidence of convulsion was least on the 1st day of complaint. Fourteen (82.4% of the cases were simple febrile seizures while 3 were complex. There was a positive family history in 5 (29.4% of the cases. Eleven (64.7% had orthodox medication at home, before presentation, 5 (29.4% consulted patient medicine sellers and 7 (41.7% received traditional medication as part of home management. Malaria and acute respiratory infections were the identifiable causes. Standard anti-malaria and anti-biotic therapy were instituted, where indicated. All recovered and were discharged. Conclusion: There was a low prevalence of febrile seizures among the hospitalized children and a poor pre-hospitalization management of cases. It highlighted the need for improved community awareness on the prevention and management of febrile seizures.

  11. Febrile Seizures: Controversy and Consensus

    Science.gov (United States)

    Doiron, Omer A.

    1983-01-01

    Although febrile convulsions are a relatively common complaint, the approach to their management is far from uniform and highly controversial. This article reviews the consensus statement on febrile convulsions arrived at by the Consensus Development Conference held in 1980 by the National Institutes of Health, together with other literature of interest to family physicians. Guidelines are given for the assessment, diagnosis and emergency treatment of febrile seizures. Epilepsy and atypical febrile convulsions are distinguished from simple febrile seizures. Prognosis, prevention, and the importance of counselling parents are discussed, as well as the controversial issue of prophylactic treatment. PMID:21286583

  12. The risk of febrile neutropenia and need for G-CSF primary prophylaxis with the docetaxel and cyclophosphamide regimen in early-stage breast cancer patients: a meta-analysis.

    Science.gov (United States)

    Do, Tran; Medhekar, Rohan; Bhat, Raksha; Chen, Hua; Niravath, Polly; Trivedi, Meghana V

    2015-10-01

    The febrile neutropenia (FN) rates reported with the docetaxel 75 mg/m(2) plus cyclophosphamide 600 mg/m(2) (TC) regimen given every 3 weeks vary from 4 to 69 % in early-stage breast cancer (ESBC) patients. This creates uncertainty as to whether patients receiving the TC regimen should also receive granulocyte colony-stimulating factor primary prophylaxis (G-CSFpp), which is recommended when chemotherapy regimens have ≥20 % FN rate. We conducted a meta-analysis of published studies to determine FN rate with the TC regimen, its dependence on patients' age, and the efficacy of G-CSFpp in reducing it in ESBC patients. We systematically searched the literature via PUBMED using the following terms: 'docetaxel', 'cyclophosphamide', 'febrile neutropenia', and 'breast cancer'. Inclusion criteria were full text peer-reviewed clinical studies in English reporting FN rates with TC regimen in relationship to G-CSFpp. Comprehensive meta-analysis software was used for all statistical analyses. Eight studies (N = 1542 patients) were included in our meta-analysis. The pooled mean FN rate was 23.2 % (95 % confidence interval (CI) 6.9-55.2 %; Q = 218.17, I (2) = 97.7). The FN risk in <65 years old patients was lower by 67.7 % compared to that in patients ≥65 years old (pooled odds ratio (OR) 0.323; 95 % CI 0.127-0.820; P = 0.017). The FN risk was reduced by 92.3 % with G-CSFpp (pooled OR 0.077; 95 % CI 0.013-0.460; P = 0.005). Our meta-analysis demonstrated that TC regimen was associated with ≥20 % FN risk, which was significantly higher in patients ≥65 years old and improved with G-CSFpp. G-CSFpp should be considered for all ESBC patients receiving TC regimen, especially those ≥65 years old.

  13. Fever, febrile seizures and epilepsy

    OpenAIRE

    2007-01-01

    Seizures induced by fever (febrile seizures) are the most common type of pathological brain activity in infants and children. These febrile seizures and their potential contribution to the mechanisms of limbic (temporal lobe) epilepsy have been a topic of major clinical and scientific interest. Key questions include the mechanisms by which fever generates seizures, the effects of long febrile seizures on neuronal function and the potential contribution of these seizures to epilepsy. This revi...

  14. Febrile and other occasional seizures.

    Science.gov (United States)

    Bast, T; Carmant, L

    2013-01-01

    Seizures with fever that result from encephalitis or meningitis usually occur late in the course of febrile illness, and are focal and prolonged. Febrile seizures are by far the most common affecting 5% of the population, followed by posttraumatic seizures and those observed in the setting of a toxic, infectious, or metabolic encephalopathy. This chapter reviews the clinical presentation of the three most common forms, due to fever, trauma, and intoxication. Febrile seizures carry no cognitive or mortality risk. Recurrence risk is increased by young age, namely before 1 year of age. Febrile seizures that persist after the age of 6 years are usually part of the syndrome of Generalized epilepsy febrile seizures plus. These febrile seizures have a strong link with epilepsy since non-febrile seizures may occur later in the same patient and in other members of the same family with an autosomal dominant transmission. Complex febrile seizures, i.e., with focal or prolonged manifestations or followed by focal defect, are related to later mesial temporal epilepsy with hippocampal sclerosis; risk factors are seizure duration and brain malformation. Prophylactic treatment is usually not required in febrile seizures. Early onset of complex seizures is the main indication for AED prophylaxis. Early posttraumatic seizures, i.e., within the first week, are often focal and indicate brain trauma: contusion, hematoma, 24 hours amnesia, and depressed skull fracture are major factors of posttraumatic epilepsy. Prophylaxis with antiepileptic drugs is not effective. Various psychotropic drugs, including antiepileptics, may cause seizures.

  15. Causes of Infectious Diseases Which Tend to Get Into Febrile Convulsion

    OpenAIRE

    Blouki Moghaddam; Bidabadi; Hassanzadeh Rad; Dalili

    2015-01-01

    Background Febrile convulsions are seizures associated with fever during childhood. They generally have excellent prognosis. However, as they may signify a serious underlying acute infectious disease, each case must be carefully examined and appropriately investigated. Objectives The aim of this study was to investigate the causes of infectious diseases, which tend to get into febrile convulsion in patients hospitalized in 17th Sh...

  16. Clinical and radiological features of pandemic H1N1 2009 influenza virus infection manifesting as acute febrile respiratory illness at their initial presentations: comparison with contemporaneous non-H1N1 patients

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Tae Jin (Dept. of Radiology, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of); Dept. of Radiology, Seoul National Univ. Hospital, Seoul (Korea, Republic of)); Park, Chang Min; Choi, Seung Hong; Lee, Hyun Ju; Goo, Jin Mo (Dept. of Radiology, Seoul National Univ. Hospital, Seoul (Korea, Republic of)), email: cmpark@radiol.snu.ac.kr; Kwon, Gu Jin (Dept. of Family Medicine, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of); Dept. of Family Medicine, Gangneung Asan Hospital, Gangneung (Korea, Republic of)); Woo, Sung Koo (Dept. of Radiology, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of)); Park, Seung Hoon (Dept. of Internal Medicine, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of))

    2011-05-15

    Background Since the first outbreak caused by the pandemic H1N1 2009 influenza in Mexico, the virus has spread widely across the world with meaningful morbidity and mortality. However, there are few data on the comparative investigations to assess the clinical and radiological features between the H1N1 patient and non-H1N1 patients. Purpose To assess the clinical and radiological features of patients infected by the pandemic H1N1 2009 flu virus at their initial presentation and to compare them with contemporaneous non-H1N1 patients with acute febrile respiratory illness. Material and Methods This retrospective study was approved by the ethics committee of the Armed Forces Medical Command, South Korea. From August to September 2009, 337 consecutive patients presented with an acute febrile respiratory illness in a tertiary military hospital. Reverse-transcriptase polymerase-chain-reaction tests were performed in 62 of these patients under the impression of H1N1 infection. Clinical and radiological features at their initial presentation were described for the H1N1 group (n = 35) and non-H1N1 group (n = 27) and compared between the two groups. Results Increased C-reactive protein level (97%) without leukocytosis (9%) or increased erythrocyte sedimentation rate (0%) was common in the H1N1 group at their initial presentation. On chest radiographs, 12 of 35 (34%) H1N1 patients had abnormal findings; nodules in 10 patients (83%) and consolidations in two (17%). Of the 28 H1N1 patients who underwent thin-section CT 16 patients (57%) showed abnormal findings; ground-glass opacities (GGOs) in 15 (94%), and nodules in 13 (81%). However, there were no significant differences between the H1N1 group and non-H1N1 group in terms of symptoms, laboratory results, or radiological findings (P > 0.05). Conclusion Patients with H1N1 infection show consistent clinical and radiological features at their initial presentation, however, clinical and radiological features of the H1N1 group are

  17. Febrile Seizures: Four Steps Algorithmic Clinical Approach

    Directory of Open Access Journals (Sweden)

    Mahmoud Mohammadi

    2010-03-01

    Full Text Available Febrile seizures (FS are the most common form of convulsive phenomena in human being and affect 2% to 14% of children. It is the most common type of seizures that every pediatrician is dealing with. It is the most benign type of all seizures occurring in childhood. There are many debates on how to approach to febrile seizures in pediatric neurology and there are many possible malpractices in this field. Some of the most common frequent queries are -How could we differentiate FS from seizures and fever associated with serious infections involving the central nervous system? - When should we refer the affected child for further investigations such as lumbar puncture, EEG, neuroimaging, and routine biochemical studies? - How should we treat FS in its acute phase? - How could we assess the risk for further recurrences as well as other risks threatening the childs health in future? - How could we select the patients for treatment or prophylaxis? - Which medication(s should be selected for treatment or prophylaxis? Trying to answer the above-mentioned questions, this review article will present a four steps algorithmic clinical approach model to a child with febrile seizures based on the current medical literature.

  18. Successful staged operation for acute type A aortic dissection with paraplegia.

    Science.gov (United States)

    Ando, Takashi; Abe, Hiroyuki; Nagata, Tokuichiro; Makuuchi, Haruo

    2013-06-01

    A 75-year-old man presented with both paraplegia and acute occlusion of the abdominal aorta at onset. Extraanatomical bypass was performed following spinal drainage. After 3 days, the ascending aorta replaced under cardiopulmonary bypass using the extraanatomical bypass graft for arterial cannulation. The abdominal aorta was replaced after 6 months. A staged operation is one of the options for acute aortic dissection with paraplegia and acute occlusion of the abdominal aorta.

  19. Zinc supplementation prolongs the latency of hyperthermia-induced febrile seizures in rats.

    Science.gov (United States)

    Aydın, L; Erdem, S R; Yazıcı, C

    2016-03-01

    Some studies have shown a relationship between febrile seizures and zinc levels. The lowest dose zinc supplementation in pentylenetetrazole seizure model has a protective effect. But, zinc pretreatment has no effect in maximal electroshock model. However, it is unclear how zinc supplementation affects hyperthermia-induced febrile seizures. The aim of the present study was to investigate the effects of zinc supplementation on febrile seizures in male Sprague-Dawley rats. The rats were randomly assigned to four groups. Zinc supplementation was commenced 5 days prior to febrile seizure induction by placing the animals in a water bath at 45°C. We measured the rectal temperature and determined the febrile seizure latency, duration, and stage. In the zinc-supplemented group, both the seizure latency and the rectal temperature triggering seizure initiation were significantly higher than in the other groups. We suggest that zinc supplementation can positively modulate febrile seizure pathogenesis in rats.

  20. 骨髓增生异常综合征并发急性发热性嗜中性皮病一例%Myelodysplastic syndrome complicated with acute febrile neutrophilic dermatosis:one case report

    Institute of Scientific and Technical Information of China (English)

    曾芸馨; 李旭东; 张競文; 林东军

    2014-01-01

    骨髓增生异常综合征(MDS)是一种异质性克隆性造血干细胞疾病,少部分MDS患者可并发急性发热性嗜中性皮病(SWEET综合征,SS),其皮肤改变主要为不对称性疼痛性红色丘疹、结节和斑块,后期可进展为脓疱,同时伴发热、白细胞升高及ESR增快,皮肤病理活组织检查(活检)以弥漫分布于真皮浅层的成熟中性粒细胞浸润为特征,糖皮质激素治疗有效而抗感染治疗无效,合并SS的MDS容易进展为急性髓系白血病,预后不佳。该文报道1例接受皮下输液港植入化学治疗后继发SS的MDS患者,患者化学治疗过程顺利,但其皮下输液港植入部位发生胸壁皮肤感染,伴有持续高热,胸壁皮肤切口部位上方有疼痛性红色丘疹,经抗感染治疗无效,皮肤活检结果示真皮浅层中性粒细胞浸润,诊断为MDS并发SS,予糖皮质激素治疗后体温降至正常,皮损愈合,随访示MDS处于完全缓解状态。因此,临床上对于存在发热、痛性红色丘疹且抗感染治疗无效的MDS患者需警惕SS的可能,应及早完善皮肤活检以便早诊断、早治疗。%Myelodysplastic syndrome (MDS )is a type of heterogeneous clonal hematopoiefic stem cell disease. A minority of MDS patients could be complicated with acute febrile neutrophilic dermatosis (Sweet's syndrome,SS),mainly characterized by asymmetric painful red papula,node and plaque,andpro-gresses into pustule during the advanced stage. Meanwhile,signs of fever,leukocytosis and accelerated eryth-rocyte sedimentation could occur. Skin pathological biopsy revealed infiltrated matureneutrophilic leukocytes scattering across superficial dermal layer. Glucocorticoid treatment was effective whereas anti-infectious therapy yielded no efficacy. MDS complicated with SS is likely to progress into acute myeloid leukemia with poor prog-nosis. In this article,we reported one MDS case complicated with SS after

  1. Acute Septal Panniculitis. A Cutaneous Marker of a Very Early Stage of Pancreatic Panniculitis Indicating Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Surendran E

    2005-07-01

    Full Text Available CONTEXT: Pancreatitis may occasionally be complicated by panniculitis as a result of the release of pancreatic enzymes. Pancreatic panniculitis is rare, occurring in 2-3% of all patients with pancreatic disorders, with a higher incidence among alcoholic males. CASE REPORT: A 29-year-old male was admitted to our Department with acute abdominal pain one day following alcohol consumption. On physical examination, tender erythematous plaques and nodules were present on the left ankle and the pretibial regions of both lower legs, a clinical sign of panniculitis indicating acute pancreatitis common in alcoholic patients. Abdominal ultrasonography showed a diffusely edematous pancreas suggestive of acute pancreatitis. Abdominal contrast enhanced computerized tomography revealed features suggestive of severe acute pancreatitis with pancreatic necrosis. A skin biopsy confirmed the diagnosis of septal panniculitis without vasculitis or fat necrosis, which is indicative of a very early stage of pancreatic panniculitis suggesting acute alcoholic pancreatitis. CONCLUSION: Septal panniculitis without vasculitis or fat necrosis is a cutaneous clinical marker which denotes a very early stage of pancreatic panniculitis associated with acute alcoholic pancreatitis. The treatment of pancreatic panniculitis is primarily supportive and depends on the underlying pancreatic pathology which may include surgery or endoscopic management.

  2. [An unusual cause of febrile neutropenia: brucellosis].

    Science.gov (United States)

    Solmaz, Soner; Asma, Süheyl; Ozdoğu, Hakan; Yeral, Mahmut; Turunç, Tuba

    2014-10-01

    Febrile neutropenia which is a common complication of cancer treatment, is one of the major causes of morbidity and mortality. Several gram-negative and gram-positive bacteria are responsible for infections in neutropenic patients, however the most common microorganisms are Escherichia coli and coagulase-negative staphylococci, in decreasing order. Although Brucella spp. infections are endemic in Turkey, brucellosis-related febrile neutropenia has only rarely been reported. In this report, a case of brucellosis-related febrile neutropenia in a patient with acute myeloblastic leukemia (AML) was presented. A 56-year-old male patient presenting with fever, petechiae/purpura, leukocytosis, thrombocytopenia, and anemia was admitted to our hospital. Laboratory studies revealed a hemoglobin level of 8.27 g/dl, leukocyte count of 77.100 k/ml, absolute neutrophil count of 200 k/ml, and platelets at 94.200 k/ml. The patient was diagnosed as AML-M1 and piperacillin/tazobactam was started as the first-line antibiotic therapy due to the febrile neutropenia. On admission, blood and urine cultures were negative. Once the fever was controlled, remission/induction chemotherapy was initiated. However, fever developed again on the eight day, and vancomycin was added to the therapy. Since the fever persisted, the antibiotic therapy was gradually replaced with meropenem and linezolid. However, fever continued and the patient's general condition deteriorated. Subsequently performed Brucella tube agglutination test revealed positivity at 1/320 titer and the microorganism grown in blood culture (Bactec 9050; BD, USA) was identified as B.melitensis by conventional methods. Rifampicin and doxycycline therapy was started immediately, however, the patient died due to septic shock. If the tests for brucellosis were performed earlier when response to second step antibiotic therapy lacked in this patient, it was assumed that mortality could be prevented by the prompt initiation of the

  3. MMR Vaccination and Febrile Seizures

    DEFF Research Database (Denmark)

    Vestergaard, Mogens; Hviid, Anders; Madsen, Kreesten Meldgaard

    2004-01-01

    CONTEXT: The rate of febrile seizures increases following measles, mumps, and rubella (MMR) vaccination but it is unknown whether the rate varies according to personal or family history of seizures, perinatal factors, or socioeconomic status. Furthermore, little is known about the long-term outcome...... of febrile seizures increased during the 2 weeks following MMR vaccination (2.75; 95% confidence interval [CI], 2.55-2.97), and thereafter was close to the observed RR for nonvaccinated children. The RR did not vary significantly in the subgroups of children that had been defined by their family history...... of seizures, perinatal factors, or socioeconomic status. At 15 to 17 months, the risk difference of febrile seizures within 2 weeks following MMR vaccination was 1.56 per 1000 children overall (95% CI, 1.44-1.68), 3.97 per 1000 (95% CI, 2.90-5.40) for siblings of children with a history of febrile seizures...

  4. Nitroheterocyclic drugs cure experimental Trypanosoma cruzi infections more effectively in the chronic stage than in the acute stage

    Science.gov (United States)

    Francisco, Amanda Fortes; Jayawardhana, Shiromani; Lewis, Michael D.; White, Karen L.; Shackleford, David M.; Chen, Gong; Saunders, Jessica; Osuna-Cabello, Maria; Read, Kevin D.; Charman, Susan A.; Chatelain, Eric; Kelly, John M.

    2016-01-01

    The insect-transmitted protozoan parasite Trypanosoma cruzi is the causative agent of Chagas disease, and infects 5–8 million people in Latin America. Chagas disease is characterised by an acute phase, which is partially resolved by the immune system, but then develops as a chronic life-long infection. There is a consensus that the front-line drugs benznidazole and nifurtimox are more effective against the acute stage in both clinical and experimental settings. However, confirmative studies have been restricted by difficulties in demonstrating sterile parasitological cure. Here, we describe a systematic study of nitroheterocyclic drug efficacy using highly sensitive bioluminescence imaging of murine infections. Unexpectedly, we find both drugs are more effective at curing chronic infections, judged by treatment duration and therapeutic dose. This was not associated with factors that differentially influence plasma drug concentrations in the two disease stages. We also observed that fexinidazole and fexinidazole sulfone are more effective than benznidazole and nifurtimox as curative treatments, particularly for acute stage infections, most likely as a result of the higher and more prolonged exposure of the sulfone derivative. If these findings are translatable to human patients, they will have important implications for treatment strategies. PMID:27748443

  5. rCBF to distant areas in the acute and chronic stages of unilateral cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Onoda, Toru; Tamada, Tsutomu; Gyoten, Masayuki; Imai, Shigeki; Kajihara, Yasumasa [Kawasaki Medical School, Kurashiki, Okayama (Japan). School of Medicine; Fukuda, Atsuhiro [Kawasaki Medical School, Kurashiki, Okayama (Japan). Clinical Care Center; Miyanoki, Syo [Kobe Univ. (Japan). School of Medicine

    2002-09-01

    In 14 patients with unilateral cerebrovascular disease, regional cerebral blood flow (CBF) to distant areas in the acute and chronic stages was evaluated by SPECT with {sup 123}I-IMP. In the acute stage, rCBF in distant areas was decreased in all patients. In the chronic stage, a decrease in rCBF was observed in the contralateral cerebellar hemisphere in 50% of unilateral cerebral hemispheric lesions, in the ipsilateral thalamus in 42.9% of cerebral cortical lesions, and in the ipsilateral cortex in 57.1% of subcortical lesions. The decreased rCBF in distant areas even in the chronic stage suggested the involvement of organic changes in the pathologic condition in this stage. (author)

  6. [Prehospital stage of medical aid to patients with acute coronary syndrome and elevated ST segment].

    Science.gov (United States)

    Vertkin, A L; Morozov, S N; Fedorov, A I

    2013-01-01

    We studied effect of time on the outcome of acute coronary syndrome and elevated ST segment at the prehospital stage. Logistic regression analysis revealed two time-dependent predictors: "symptom-needle" time and total call service time. In patients undergoing prehospital thrombolysis, these indices (88 and 85 min respectively) reliably predicted the probability of fatal outcome. Their values of 71 and 77 min respectively predicted the risk of unfavourable outcome. The total call service time may serve as an indicator of the quality of work of an ambulance crew at the prehospital stage of management of acute coronary syndrome with elevated ST segment.

  7. Metoprolol in acute myocardial infarction reduces ventricular arrhythmias both in the early stage and after the acute event.

    Science.gov (United States)

    Rehnqvist, N; Olsson, G; Erhardt, L; Ekman, A M

    1987-06-01

    Fifty three of the 5778 patients included in the MIAMI (Metoprolol in Acute Myocardial Infarction) trial were investigated with long-term ECG recordings in order to evaluate the effect of acute beta-blockade on premature ventricular complexes in and after acute myocardial infarction. Twenty five patients were given placebo and 28 metoprolol in a double-blind randomized fashion for 15 days. After this period the patients were put on open beta-blockade without breaking individual study codes. The mean number of premature ventricular complexes during the inclusion day (day 0) was the same in the two groups. The median numbers were also similar in the two groups: 190 and 154 in the placebo and metoprolol groups, respectively. Metoprolol significantly reduced the median number of premature ventricular complexes in the randomized period. The median numbers on days 1, 2 and 15 were 146, 101, 84 in the placebo group and 73, 59 and 10 in the metoprolol group, respectively (P less than 0.05). Also during the further follow-up, when investigated 1, 3 and 6 months after the infarction, the median number of premature ventricular complexes was lower in the metoprolol group (74, 257, 142 in the placebo group and 7, 5 and 11 in the metoprolol group, P less than 0.05). This indicates that metoprolol treatment in the acute phase of myocardial infarction reduces ventricular arrhythmias both in the early stage and also after the acute event.

  8. Family history and recurrence of febrile seizures.

    OpenAIRE

    1994-01-01

    To determine the value of a detailed family history for the assessment of the risk of recurrence of febrile seizures, 115 children who visited the emergency room of an academic children's hospital were studied prospectively. The recurrence risk of febrile seizures was analysed in relation to the child's family history and the proportion of relatives affected by febrile seizures using Kaplan-Meier estimates and Cox proportional hazard models. A first degree family history positive for febrile ...

  9. Dose Supplemental Zinc Prevent Recurrence of Febrile Seizures?

    Directory of Open Access Journals (Sweden)

    Siamak SHIVA

    2011-12-01

    , Salomon ME, et al. Predictors of recurrent febrile seizures. A prospective cohort study. Arch Pediatr Adolesc Med 1997;151(4:371-8.El-Radhi AS. Lower degree of fever at the initial febrile convulsion is associated with increased risk of subsequent convulsions. Eur J Paediatr Neurol 1998;2(2:91-6.Barzegar Mohammad SB, Alizadeh M, Jouyban AA, Ghafari S. Preventive Effect of Phenobarbital on Seizure Recurrence in Acute Phase of Febrile Seizure in Children. Med J Tabriz Univ Med Sci 2009;31(3:13-7.Mahyar A, Rezaee M. Ferritin Level in Children with and Without Febrile Convulsion. Behbood 2006;10(3(30:204-9.Razieh F, Akhavan Karbasi S. The relationship between paraclinical findings of first febrile seizure and recurrence biological basis of altered resistance to infection. Am J clin nutr. 1998;68(2:447S.Papierkowski A, Mroczkowska - Juchkiewicz A. Magnesium and zinc levels in blood serum and cerebrospinal fluid in children with febrile convulsions]. Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 1999;6(33:138.Mahyar A, Ayazi P, Fallahi M, Javadi A. Correlation between serum selenium level and febrile seizures. Pediatr Neurol 2010;43(5:331-4.Tütüncüolu S, Kütükçüler N, Kepe L, Coker C, Berdeli A, Tekgül H. Proinflammatory cytokines, prostaglandins and zinc in febrile convulsions. Pediatr Int 2001;43(3:235-9.Mollah MA, Dey PR, Tarafdar SA, Akhter S, Ahmed S, Hassan T, et al. Zinc in CSF of patients with febrile convulsion. Indian J Pediatr 2002;69(10:859-61.Kumar L, Chaurasiya OS, Gupta AH. Prospective Study of Level of Serum Zinc In Patients of Febrile Seizures,Idiopathic Epilepsy and CNS Infections. People J Sci Res 2011; 4(2:1-4.Schmiegelow K, Johnsen AH, Ebbesen F, Mortensen T, Berg AM, Thorn I, et al. Gamma-aminobutyric acid concentration in lumbar cerebrospinal fluid from patients with febrile convulsions and controls. Acta Paediatr Scand 1990;79(11:1092-8.Audenaert D, Schwartz E, Claeys KG, Claes L, Deprez L, Suls A, et al. A novel GABRG2

  10. Seizure-Induced Neuronal Injury: Vulnerability to Febrile Seizures in an Immature Rat Model

    OpenAIRE

    Toth, Zsolt; Yan, Xiao-Xin; Haftoglou, Suzie; Ribak, Charles E.; Tallie Z. Baram

    1998-01-01

    Febrile seizures are the most common seizure type in young children. Whether they induce death of hippocampal and amygdala neurons and consequent limbic (temporal lobe) epilepsy has remained controversial, with conflicting data from prospective and retrospective studies. Using an appropriate-age rat model of febrile seizures, we investigated the acute and chronic effects of hyperthermic seizures on neuronal integrity and survival in the hippocampus and amygdala via molecular and neuroanatomic...

  11. Febrile convulsions and sudden infant death syndrome

    DEFF Research Database (Denmark)

    Vestergaard, Mogens; Basso, Olga; Henriksen, Tine Brink

    2002-01-01

    It has been suggested that sudden infant death syndrome (SIDS) and febrile convulsions are related aetiologically. We compared the risk of SIDS in 9877 siblings of children who had had febrile convulsions with that of 20.177 siblings of children who had never had febrile convulsions. We found...

  12. Hippocampal Sclerosis After Febrile Status Epilepticus: The FEBSTAT Study

    Science.gov (United States)

    Lewis, Darrell V.; Shinnar, Shlomo; Hesdorffer, Dale C.; Bagiella, Emilia; Bello, Jacqueline A.; Chan, Stephen; Xu, Yuan; MacFall, James; Gomes, William A.; Moshé, Solomon L.; Mathern, Gary W.; Pellock, John M.; Nordli, Douglas R.; Frank, L. Matthew; Provenzale, James; Shinnar, Ruth C.; Epstein, Leon G.; Masur, David; Litherland, Claire; Sun, Shumei

    2014-01-01

    Objective Whether febrile status epilepticus (FSE) produces hippocampal sclerosis (HS) and temporal lobe epilepsy (TLE) has long been debated. Our objective is to determine if FSE produces acute hippocampal injury that evolves to HS. Methods FEBSTAT and two affiliated studies prospectively recruited 226 children aged 1 month to 6 years with FSE and controls with simple febrile seizures. All had acute MRIs and follow-up MRIs were obtained at approximately 1 year later in the majority. Visual interpretation by two neuroradiologists informed only of subject age was augmented by hippocampal volumetrics, analysis of the intra-hippocampal distribution of T2 signal, and apparent diffusion coefficients. Results Hippocampal T2 hyperintensity, maximum in Sommer's sector, occurred acutely after FSE in 22 of 226 children in association with increased volume. Follow-up MRIs obtained on 14 of the 22 with acute T2 hyperintensity showed HS in 10 and reduced hippocampal volume in 12. In contrast, follow-up of 116 children without acute hyperintensity showed abnormal T2 signal in only 1 (following another episode of FSE). Furthermore, compared to controls with simple febrile seizures, FSE subjects with normal acute MRIs had abnormally low right to left hippocampal volume ratios, smaller hippocampi initially and reduced hippocampal growth. Interpretation Hippocampal T2 hyperintensity after FSE represents acute injury often evolving to a radiological appearance of HS after one year. Furthermore, impaired growth of normal appearing hippocampi after FSE suggests subtle injury even in the absence of T2 hyperintensity. Longer follow-up is needed to determine the relationship of these findings to TLE. PMID:24318290

  13. Correlation of Serum Zinc Level with Simple Febrile Seizures: A Hospital based Prospective Case Control Study

    Directory of Open Access Journals (Sweden)

    Imran Gattoo

    2015-04-01

    Full Text Available Background: Febrile seizures are one of the most common neurological conditions of childhood. It seems that zinc deficiency is associated with increased risk of febrile seizures.Aim: To estimate the serum Zinc level in children with simple Febrile seizures and to find the correlation between serum zinc level and simple Febrile seizures.Materials and Methods: The proposed study was a hospital based prospective case control study which included infants and children aged between 6 months to 5 years, at Post Graduate Department of Pediatrics, (SMGS Hospital, GMC Jammu, northern India. A total of 200 infants and children fulfilling the inclusion criteria were included. Patients were divided into 100(cases in Group A with simple febrile seizure and 100(controls in Group B of children with acute febrile illness without seizure. All patients were subjected to detailed history and thorough clinical examination followed by relevant investigations.Results: Our study had slight male prepondance of 62% in cases and 58% in controls . Mean serum zinc level in cases was 61.53±15.87 ugm/dl and in controls it was 71.90+18.50 ugm/dl .Serum zinc level was found significantly low in cases of simple febrile seizures as compaired to controls ,with p value of

  14. Undiagnosed Acute Viral Febrile Illnesses, Sierra Leone

    Science.gov (United States)

    2014-07-01

    yellow fever , Rift Valley fever , chikungunya, Ebola, and Marburg viruses but not to Crimean-Congo hemorrhagic...Lassa fever . We tested for IgM to dengue virus (DENV), West Nile vi- rus (WNV), yellow fever virus (YFV), Rift Valley fever virus (RVFV), chikungunya...total (%) Dengue 11/253 (4.3) 6/250 (2.4) West Nile 7/253 (2.8) 3/250 (1.2) Yellow fever 5/201 (2.5) 5/201 (2.5) Rift Valley fever 5/253 (2.0)

  15. Detection and significance of inflammatory factors and immunoglobulin in acute stage patients with infantile pneumonia

    Institute of Scientific and Technical Information of China (English)

    Xiao-Zheng Meng; Liang Qiao

    2016-01-01

    Objective:To investigate the detection and significance of inflammatory factors and immunoglobulin in acute stage patients with infantile pneumonia.Methods:A total of 80 cases of acute stage patients with infantile pneumonia were divided into mild group (n=33) and severe group (n=47) according to illness degrees, and 40 cases of healthy children were selected as control group. Serum CRP, Ig A, Ig G and Ig M levels were detected by nephelometry, IL-6 levels were detected by enzyme-linked immunosorbent assay. The levels of inflammatory factors (CRP, IL-6) and immunoglobulin indexes (Ig A, Ig G and Ig M) were compared among 3 groups.Results: The inflammatory factors (CRP, IL-6) in mild and severe group increased significantly compared with control group, CRP and IL-6 levels in severe group were were significantly higher than that in mild group (P<0.05). The levels of Ig A in mild and severe group decreased significantly compared with control group, Ig A level in severe group was significantly lower than that in mild group (P<0.05), the levels of Ig G and Ig M in mild and severe group increased significantly compared with control group, the levels of Ig G and Ig M in severe group were significantly higher than that in mild group (P<0.05). Conclusions:The levels of inflammatory factors are increased while immune function is decreased in acute stage patients with infantile pneumonia. Inflammation is stronger and immune function is worse with the severity of the disease. Detection of inflammatory factors and immunoglobulin levels is helpful to diagnose and treatment of acute stage patients with infantile pneumonia.

  16. Secondary Infections in Cancer Patients with Febrile Neutropenia

    Directory of Open Access Journals (Sweden)

    Alpay Azap

    2012-09-01

    Full Text Available OBJECTIVE: Patients with neutropenia due to cancer chemotherapy are prone to severe infections. Cancer patients can experience >1 infectious episode during the same period of neutropenia. This study aimed to determine the etiological and clinical characteristics of secondary infectious episodes in cancer patients with febrile neutropenia and to identify the factors associated with the risk of secondary infectious episodes. METHODS: All cancer patients that received antineoplastic chemotherapy at Ankara University, School of Medicine, Department of Hematology between May 2004 and May 2005 and developed neutropenia were included in the study. Data were collected using survey forms that were completed during routine infectious diseases consultation visits. Categorical data were analyzed using the chi-square test, whereas Student’s t-test was used for continuous variables. Multivariate logistic regression analysis was performed to identify independent predictors of secondary infections (SIs. RESULTS: SIs were observed during 138 (53% of 259 febrile neutropenic episodes. Of the 138 episodes, 89 (64.5% occurred in male patients with a mean age of 40.9 years (range: 17-76 years. In total, 80% of the SIs were clinically or microbiologically documented. Factors on d 4 of the initial febrile episode were analyzed via a logistic regression model. The presence of a central intravenous catheter (OR: 3.01; P < 0.001, acute myeloid leukemia (AML as the underlying disease (OR: 2.12; P = 0.008, diarrhea (OR: 4.59; P = 0.005, and invasive aspergillosis (IA during the initial febrile episode (OR: 3.96; P = 0.009 were statistically significant risk factors for SIs. CONCLUSION: Among the cancer patients with neutropenia in the present study, AML as the underlying disease, the presence of a central venous catheter, diarrhea, and IA during the initial febrile episode were risk factors for the development of SIs.

  17. Acute oral toxicity of chemicals in terrestrial life stages of amphibians: Comparisons to birds and mammals.

    Science.gov (United States)

    Crane, Mark; Finnegan, Meaghean; Weltje, Lennart; Kosmala-Grzechnik, Sylwia; Gross, Melanie; Wheeler, James R

    2016-10-01

    Amphibians are currently the most threatened and rapidly declining group of vertebrates and this has raised concerns about their potential sensitivity and exposure to plant protection products and other chemicals. Current environmental risk assessment procedures rely on surrogate species (e.g. fish and birds) to cover the risk to aquatic and terrestrial life stages of amphibians, respectively. Whilst a recent meta-analysis has shown that in most cases amphibian aquatic life stages are less sensitive to chemicals than fish, little research has been conducted on the comparative sensitivity of terrestrial amphibian life stages. Therefore, in this paper we address the questions "What is the relative sensitivity of terrestrial amphibian life stages to acute chemical oral exposure when compared with mammals and birds?" and "Are there correlations between oral toxicity data for amphibians and data for mammals or birds?" Identifying a relationship between these data may help to avoid additional vertebrate testing. Acute oral amphibian toxicity data collected from the scientific literature and ecotoxicological databases were compared with toxicity data for mammals and birds. Toxicity data for terrestrial amphibian life stages are generally sparse, as noted in previous reviews. Single-dose oral toxicity data for terrestrial amphibian life stages were available for 26 chemicals and these were positively correlated with LD50 values for mammals, while no correlation was found for birds. Further, the data suggest that oral toxicity to terrestrial amphibian life stages is similar to or lower than that for mammals and birds, with a few exceptions. Thus, mammals or birds are considered adequate toxicity surrogates for use in the assessment of the oral exposure route in amphibians. However, there is a need for further data on a wider range of chemicals to explore the wider applicability of the current analyses and recommendations.

  18. Febrile cholestatic disease as an initial presentation of nodular lymphocyte-predominant Hodgkin lymphoma

    Institute of Scientific and Technical Information of China (English)

    Anna; Mrzljak; Slavko; Gasparov; Ika; Kardum-Skelin; Vesna; Colic-Cvrlje; Slobodanka; Ostojic; Kolonic

    2010-01-01

    Febrile cholestatic liver disease is an extremely unusual presentation of Hodgkin lymphoma(HL).The liver biopsy of a 40-year-old man with febrile episodes and cholestatic laboratory pattern disclosed an uncommon subtype of HL,a nodular lymphocyte-predominant HL(NLPHL).Liver involvement in the early stage of the usually indolent NLPHL's clinical course suggests an aggressiveness and unfavorable outcome.Emphasizing a liver biopsy early in the diagnostic algorithm enables accurate diagnosis and appropriate tre...

  19. Evaluation of febrile neutropenic patients hospitalized in a hematology clinic

    Institute of Scientific and Technical Information of China (English)

    M ucahit Goruk; Mehmet Sinan Dal; Tuba Dal; Abdullah Karakus; Recep Tekin; Nida Ozcan; Orhan Ayyildiz

    2015-01-01

    Objective: To evaluate the febrile neutropenic patients with hematological malignancies hospitalized in hematology clinic with poor hygiene standards. Methods: A total of 124 patients with hematological malignancies (69 male, 55 female) hospitalized in hematology clinic with poor hygiene conditions depending on hospital conditions, between January 2007 and December 2010, were evaluated, retrospectively. Results: In this study, 250 febrile neutropenia episodes developing in 124 hospitalized patients were evaluated. Of the patients, 69 were men (56%) and 55 women (44%). A total of 40 patients (32%) had acute myeloid leukemia, 25 (20%) acute lymphoblastic leukemia, 19 (15%) non-Hodgkin's lymphoma, 10 (8%) multiple myeloma, and 8 (8%) chronic myeloid leukemia. In our study, 56 patients (22%) were diagnosed as pneumonia, 38 (15%) invasive aspergillosis, 38 (15%) sepsis, 16 (6%) typhlitis, 9 (4%) mucormy-cosis, and 4 (2%) urinary tract infection. Gram-positive cocci were isolated from 52%(n = 20), while Gram-negative bacilli 42%(n = 16) and yeasts from 6% (n = 2) of the sepsis patients, respectively. The most frequently isolated Gram-positive bacteria were methicillin-resistant coagulase-negative staphylococci (n=18), while the most frequently isolated Gram-negative bacteria was Escherichia coli (n=10). Conclusions: Febrile neutropenia is still a problem in patients with hematological ma-lignancies. The documentation of the flora and detection of causative agents of infections in each unit would help to decide appropriate empirical therapy. Infection control pro-cedures should be applied for preventing infections and transmissions.

  20. Febrile neutropenia in haematological malignancies

    Directory of Open Access Journals (Sweden)

    Sharma A

    2005-01-01

    Full Text Available Fever is the principle sign of infection in neutropenic patient and frequently may be the only evidence of infection. The pattern of fever in neutropenia is non-specific and not pathognomonic of any type of infections or non-infectious process and can be suppressed by the antipyretic effects of drugs such as corticosteroids. Neutropenia, resulting from cytotoxic chemotherapy is the most common risk factor for severe infections in hematological malignancies. The duration of neutropenia also contributes significantly to the risk of serious infections. This risk is significantly greater a lower neutrophil counts, such that 100% patients with ANC < 100 cells/µl lasting 3 weeks or more develop documented infections. The prompt initiation of empirical antibiotics in febrile neutropenia has been the most important advance in the management of the immunocompromised host. The initial empirical antibiotic regimen started at presentation of the febrile episode frequently requires modifications especially in high-risk febrile neutropenia. Neutropenic patients who remain febrile despite 4-7 days of broad spectrum antibacterial therapy are at a high risk of invasive fungal infection. Empirical antifungal therapy with Amphotericin B in persistently febrile neutropenic patients and other high risk patients has shown to reduce the risk of invasive fungal infection by 50-80% and the risk of fungal infection related mortality by 23-45% in 1980′s. The IDSA has recommended that amphotericin B at 0.5-0.7 mg/kg/day be administered till marrow recovery. This approach is limited however by the adverse effects caused by drug infusion (fever, chills, myalgias, nausea, hypotension and bronchospasm. Lipid formulations which improve the therapeutic ratio of the traditional formulation are available. The safety and efficacy of these formulations is well established. These formulations have comparable efficacy and are less nephrotoxic than conventional amphotericin B

  1. Febrile seizures: A review for family physicians

    OpenAIRE

    2007-01-01

    Febrile seizures are the most common cause of convulsions in children. Most are simple in nature, although those with focal onset, prolonged duration (³15 min) or those that recur within 24 h or within the same febrile illness are considered complex. Diagnosis of this condition is essentially clinical and based on its description provided by parents. Its pathophysiology remains unclear, but genetics plays a major role in conferring susceptibility. Although most febrile seizures are ben...

  2. Acute paretic syndrome in juvenile White Leghorn chickens resembles late stages of acute inflammatory demyelinating polyneuropathies in humans

    Directory of Open Access Journals (Sweden)

    Preisinger Rudolf

    2010-01-01

    Full Text Available Abstract Background Sudden limb paresis is a common problem in White Leghorn flocks, affecting about 1% of the chicken population before achievement of sexual maturity. Previously, a similar clinical syndrome has been reported as being caused by inflammatory demyelination of peripheral nerve fibres. Here, we investigated in detail the immunopathology of this paretic syndrome and its possible resemblance to human neuropathies. Methods Neurologically affected chickens and control animals from one single flock underwent clinical and neuropathological examination. Peripheral nervous system (PNS alterations were characterised using standard morphological techniques, including nerve fibre teasing and transmission electron microscopy. Infiltrating cells were phenotyped immunohistologically and quantified by flow cytometry. The cytokine expression pattern was assessed by quantitative real-time PCR (qRT-PCR. These investigations were accomplished by MHC genotyping and a PCR screen for Marek's disease virus (MDV. Results Spontaneous paresis of White Leghorns is caused by cell-mediated, inflammatory demyelination affecting multiple cranial and spinal nerves and nerve roots with a proximodistal tapering. Clinical manifestation coincides with the employment of humoral immune mechanisms, enrolling plasma cell recruitment, deposition of myelin-bound IgG and antibody-dependent macrophageal myelin-stripping. Disease development was significantly linked to a 539 bp microsatellite in MHC locus LEI0258. An aetiological role for MDV was excluded. Conclusions The paretic phase of avian inflammatory demyelinating polyradiculoneuritis immunobiologically resembles the late-acute disease stages of human acute inflammatory demyelinating polyneuropathy, and is characterised by a Th1-to-Th2 shift.

  3. IMPORTANCE OF SERUM PROCALCITONIN IN FEBRILE NEUTROPENIA

    Directory of Open Access Journals (Sweden)

    Mohd. Riyaz

    2014-07-01

    Full Text Available Febrile neutropenia is defined as a fever >101°F for 1 hour, with an absolute neutrophil count of ≤500 cells/microliter, or an ANC of ≤1000 cells/microliter with a projected nadir of ≤500 cells/microliter. In haematological malignancies it is the common complication and requires broad-spectrum antibacterial therapy. Clinical examination and cultures fail to detect a pathogen or an infectious focus in 25–50%, which are classified as pyrexia of unknown origin (PUO. Patient with pyrexia of unknown origin may receive long duration of antibiotic treatment as the cause is unclear of being infective or not. Febrile neutropenia is a common complication of many chemotherapeutic regimens for all types of cancers. Mortality and Morbidity is high particularly in elderly, immuno-compromised. Approximately 20- 40 % of patients with severe sepsis and 45-60% patients with septic shock die within 15-20 days. This study was done to know the sources of infection and to assess the diagnostic value of serum Procalcitonin and its relation with mortality in various stages of sepsis. Sepsis incidence was more in patient age more than 55yrs. the most common source of sepsis was respiratory tract infection. Serum PCT proved to be an indicator of sepsis in ill patients, with sensitivity of 91%. Presence of both persistent and profound neutropenia was associated with a much higher mortality. The occurrence of infection is directly proportional to the degree of neutropenia, at the onset of fever the PCT levels will not be helpful for the decision to start or stop the antibacterial therapy, and a PCT value higher than 0.5ng/ml in pyrexia of unknown origin might suggest a possibility of occult infection, i.e. with lacking microbiological and clinical documentation. A delayed PCT peak higher than0.5ng/ml contributes to the early diagnosis of fungal disease.

  4. Acute Fetal Anemia Diagnosed by Middle Cerebral Artery Doppler Velocimetry in Stage V Twin–Twin Transfusion Syndrome

    Directory of Open Access Journals (Sweden)

    Jennifer Salcedo

    2011-12-01

    Full Text Available In stage V twin–twin transfusion syndrome (TTTS, up to 50% of surviving twins die or experience permanent disabilities, likely due to acute intertwin hemorrhage resulting in sudden severe anemia of the survivor. Although fetal middle cerebral artery (MCA Doppler studies demonstrate strong correlation with fetal hemoglobin values, acute hemorrhagic events are more difficult to diagnose, and optimal timing of delivery of the survivor poses an obstetric dilemma. We report a case of newly diagnosed stage V TTTS at 28 weeks gestation, complicated by acute severe anemia diagnosed by significantly abnormal fetal MCA Doppler studies. The anemic twin was urgently delivered and is doing well without significant sequelae.

  5. Febrile seizures and risk of schizophrenia

    DEFF Research Database (Denmark)

    Vestergaard, Mogens; Pedersen, Carsten Bøcker; Christensen, Jakob;

    2005-01-01

    BACKGROUND: Febrile seizure is a benign condition for most children, but experiments in animals and neuroimaging studies in humans suggest that some febrile seizures may damage the hippocampus, a brain area of possible importance in schizophrenia. METHODS: A population-based cohort of all children...... with schizophrenia. A history of febrile seizures was associated with a 44% increased risk of schizophrenia [relative risk (RR)=1.44; 95% confidence interval (CI), 1.07-1.95] after adjusting for confounding factors. The association between febrile seizures and schizophrenia remained virtually unchanged when...... restricting the analyses to people with no history of epilepsy. A history of both febrile seizures and epilepsy was associated with a 204% increased risk of schizophrenia (RR=3.04; 95% CI, 1.36-6.79) as compared with people with no such history. CONCLUSIONS: We found a slightly increased risk of schizophrenia...

  6. Management of febrile convulsion in children.

    Science.gov (United States)

    Paul, Siba Prosad; Rogers, Eleanor; Wilkinson, Rachel; Paul, Biswajit

    2015-05-01

    The causes of febrile convulsions are usually benign. Such convulsions are common in children and their long-term consequences are rare. However, other causes of seizures, such as intracranial infections, must be excluded before diagnosis, especially in infants and younger children. Diagnosis is based mainly on history taking, and further investigations into the condition are not generally needed in fully immunised children presenting with simple febrile convulsions. Treatment involves symptom control and treating the cause of the fever. Nevertheless, febrile convulsions in children can be distressing for parents, who should be supported and kept informed by experienced emergency department (ED) nurses. This article discusses the aetiology, clinical presentation, diagnosis and management of children with febrile convulsion, and best practice for care in EDs. It also includes a reflective case study to highlight the challenges faced by healthcare professionals who manage children who present with febrile convulsion.

  7. S100B proteins in febrile seizures

    DEFF Research Database (Denmark)

    Mikkonen, Kirsi; Pekkala, Niina; Pokka, Tytti

    2011-01-01

    S100B protein concentrations correlate with the severity and outcome of brain damage after brain injuries, and have been shown to be markers of blood-brain barrier damage. In children elevated S100B values are seen as a marker of damage to astrocytes even after mild head injuries. S100B proteins...... may also give an indication of an ongoing pathological process in the brain with respect to febrile seizures (FS) and the likelihood of their recurrence. To evaluate this, we measured S100B protein concentrations in serum and cerebrospinal fluid from 103 children after their first FS. 33 children...... with acute infection without FS served as controls for the serum concentrations. In the FS patients the mean S100B concentration in the cerebrospinal fluid samples was 0.21μg/L and that in the serum samples 0.12μg/L. The mean serum concentration in the controls was 0.11μg/L (difference 0.01μg/L, 95...

  8. S100B proteins in febrile seizures

    DEFF Research Database (Denmark)

    Mikkonen, Kirsi; Pekkala, Niina; Pokka, Tytti

    2011-01-01

    S100B protein concentrations correlate with the severity and outcome of brain damage after brain injuries, and have been shown to be markers of blood-brain barrier damage. In children elevated S100B values are seen as a marker of damage to astrocytes even after mild head injuries. S100B proteins...... may also give an indication of an ongoing pathological process in the brain with respect to febrile seizures (FS) and the likelihood of their recurrence. To evaluate this, we measured S100B protein concentrations in serum and cerebrospinal fluid from 103 children after their first FS. 33 children...... with acute infection without FS served as controls for the serum concentrations. In the FS patients the mean S100B concentration in the cerebrospinal fluid samples was 0.21µg/L and that in the serum samples 0.12µg/L. The mean serum concentration in the controls was 0.11µg/L (difference 0.01µg/L, 95...

  9. Febrile Seizure: Demographic Features and Causative Factors

    OpenAIRE

    2012-01-01

    How to cite this article: Esmaili Gourabi H, Bidabadi E, Cheraghalipour  F, Aarabi  Y, Salamat F. Febrile Seizure: Demographic Features and Causative Factors. Iran J Child Neurol Autumn 2012; 6(4):33-37.Abstract Objective Because of geographical and periodical variation, we prompted to determine the demographic features and causative factors for febrile seizure in Rasht. Materials & Methods In this cross-sectional study, all 6–month- to 6-year-old children with the diagnosis of febrile s...

  10. Successful renal transplantation after recovery from acute disseminated encephalomyelitis in a child with end-stage renal disease

    Directory of Open Access Journals (Sweden)

    Bhosale Guruprasad

    2010-01-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM, seen mostly in children, is an acute demyelinating disease, affecting mainly the white matter of brain and spinal cord. We report an unusual case of ADEM in an 11-year old boy with end-stage renal disease, who underwent hemopoietic stem cell transplantation prior to renal transplantation. He needed admission to the intensive care unit and required mechanical ventilation. He responded to intravenous injection of steroids and upon recovery, underwent renal transplantation successfully.

  11. Sorbents in acute renal failure and end-stage renal disease: middle molecule and cytokine removal.

    Science.gov (United States)

    Winchester, James F; Silberzweig, Jeffrey; Ronco, Claudio; Kuntsevich, Viktoria; Levine, Daniel; Parker, Tom; Kellum, John A; Salsberg, Jamie A; Quartararo, Peter; Levin, Nathan W

    2004-01-01

    Renal replacement therapy in acute renal failure (ARF) and chronic renal failure (end-stage renal disease; ESRD) has been based on the use of modifications of dialysis (continuous arteriovenous hemofiltration and hemodiafiltration) to remove middle-molecular-weight toxins, consisting of low-molecular-weight proteins and peptides (LMWP) and cytokines involved in inflammation. High-flux dialyzers are not efficient at removing LMWP, and for this reason, sorbents have been studied to augment or replace dialysis. Removal of LMWP such as beta2-microglobulin, leptin, complement factor D, angiogenin and cytokines such as interleukin (IL)-1, IL-6, IL-10, IL-18 and tumor necrosis factor-alpha has been established in animal models of sepsis and in ESRD patients using sorbents. Sorbent devices added to hemodialysis, or the use of such devices alone in inflammatory states, including sepsis, ARF, cardiopulmonary bypass, pre-explantation of donor organs and ESRD, are being studied.

  12. Computed tomography in suppurative meningitis. CT and clinical findings in the acute stage

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Akira; Fujiwara, Katsuhiko; Iino, Shigeru (Kyoto Prefectural Univ. of Medicine (Japan))

    1982-06-01

    Computed tomography abnormalities revealed in 18 of 29 patients (62%) with infantile supprative meningitis. The abnormalities included ventricular dilatation (12 cases), subdural edema (8), cerebral infarction (4), cerebral atrophy (3), encephalitis (2), and cerebral herniation (1). The comparative study of CT pictures and clinical findings in the acute stage of the disease showed that the high incidence of these abnormalities occurred in the following conditions: 1) The age was less than 1 year, 2) establishment of the diagnosis took more than 5 days, 3) glucose of the cerebrospinal fluid was less than 200 mg/dl, 4) protein of the cerebrospinal fluid was more than 200 mg/dl, and 5) convulsion occurred 24 hrs after institution of the treatment.

  13. [Operations on carotid arteries in an acute stage of ischaemic stroke].

    Science.gov (United States)

    Ignat'ev, I M

    2011-01-01

    presenting in an acute stage of ischaemic stroke, with appropriate observance of the strict indications for the intervention.

  14. Improved accuracy of acute graft-versus-host disease staging among multiple centers.

    Science.gov (United States)

    Levine, John E; Hogan, William J; Harris, Andrew C; Litzow, Mark R; Efebera, Yvonne A; Devine, Steven M; Reshef, Ran; Ferrara, James L M

    2014-01-01

    The clinical staging of acute graft-versus-host disease (GVHD) varies significantly among bone marrow transplant (BMT) centers, but adherence to long-standing practices poses formidable barriers to standardization among centers. We have analyzed the sources of variability and developed a web-based remote data entry system that can be used by multiple centers simultaneously and that standardizes data collection in key areas. This user-friendly, intuitive interface resembles an online shopping site and eliminates error-prone entry of free text with drop-down menus and pop-up detailed guidance available at the point of data entry. Standardized documentation of symptoms and therapeutic response reduces errors in grade assignment and allows creation of confidence levels regarding the diagnosis. Early review and adjudication of borderline cases improves consistency of grading and further enhances consistency among centers. If this system achieves widespread use it may enhance the quality of data in multicenter trials to prevent and treat acute GVHD.

  15. Evaluation of febrile neutropenic patients hospitalized in a hematology clinic

    Institute of Scientific and Technical Information of China (English)

    Mcahit; Grk; Mehmet; Sinan; Dal; Tuba; Dal; Abdullah; Karakus; Recep; Tekin; Nida; zcan; Orhan; Ayyildiz

    2015-01-01

    Objective:To evaluate the febrile neutropenic patients with hematological malignancies hospitalized in hematology clinic with poor hygiene standards.Methods:A total of 124 patients with hematological malignancies(69 male,55 female)hospitalized in hematology clinic with poor hygiene conditions depending on hospital conditions,between January 2007 and December 2010,were evaluated,retrospectively.Results:In this study,250 febrile neutropenia episodes developing in 124 hospitalized patients were evaluated.Of the patients,69 were men(56%)and 55 women(44%).A total of 40 patients(32%)had acute myeloid leukemia,25(20%)acute lymphoblastic leukemia,19(15%)non-Hodgkin’s lymphoma,10(8%)multiple myeloma,and 8(8%)chronic myeloid leukemia.In our study,56 patients(22%)were diagnosed as pneumonia,38(15%)invasive aspergillosis,38(15%)sepsis,16(6%)typhlitis,9(4%)mucormycosis,and 4(2%)urinary tract infection.Gram-positive cocci were isolated from 52%(n=20),while Gram-negative bacilli 42%(n=16)and yeasts from 6%(n=2)of the sepsis patients,respectively.The most frequently isolated Gram-positive bacteria were methicillin-resistant coagulase-negative staphylococci(n=18),while the most frequently isolated Gram-negative bacteria was Escherichia coli(n=10).Conclusions:Febrile neutropenia is still a problem in patients with hematological malignancies.The documentation of the flora and detection of causative agents of infections in each unit would help to decide appropriate empirical therapy.Infection control procedures should be applied for preventing infections and transmissions.

  16. Hypothermia induced by adenosine 5'-monophosphate attenuates early stage injury in an acute gouty arthritis rat model.

    Science.gov (United States)

    Miao, Zhimin; Guo, Weiting; Lu, Shulai; Lv, Wenshan; Li, Changgui; Wang, Yangang; Zhao, Shihua; Yan, Shengli; Tao, Zhenyin; Wang, Yunlong

    2013-08-01

    To investigate whether the hypothermia induced by Adenosine 5'-Monophosphate (5'-AMP) could attenuate early stage injury in a rat acute gouty arthritis model. Ankle joint injection with monosodium urate monohydrate crystals (MSU crystals) in hypothermia rat model which was induced by 5'-AMP and then observe whether hypothermia induced by 5'-AMP could be effectively inhibit the inflammation on acute gouty arthritis in rats. AMP-induced hypothermia has protective effects on our acute gouty arthritis, which was demonstrated by the following criteria: (1) a significant reduction in the ankle swelling (p gouty arthritis model.

  17. Temperature, age, and recurrence of febrile seizure

    NARCIS (Netherlands)

    M. van Stuijvenberg (Margriet); E.W. Steyerberg (Ewout); G. Derksen-Lubsen (Gerarda); H.A. Moll (Henriëtte)

    1998-01-01

    textabstractOBJECTIVE: Prediction of a recurrent febrile seizure during subsequent episodes of fever. DESIGN: Study of the data of the temperatures, seizure recurrences, and baseline patient characteristics that were collected at a randomized placebo controlled trial of ibuprofen s

  18. Febrile seizures: A review for family physicians

    Directory of Open Access Journals (Sweden)

    Karande Sunil

    2007-03-01

    Full Text Available Febrile seizures are the most common cause of convulsions in children. Most are simple in nature, although those with focal onset, prolonged duration (³15 min or those that recur within 24 h or within the same febrile illness are considered complex. Diagnosis of this condition is essentially clinical and based on its description provided by parents. Its pathophysiology remains unclear, but genetics plays a major role in conferring susceptibility. Although most febrile seizures are benign and associated with minor viral illnesses, it is critical that the child be evaluated immediately to reduce parental anxiety and to identify the cause of the fever. It is essential to exclude underlying pyogenic meningitis, either clinically or, if any doubt remains, by lumbar puncture. The risk of pyogenic meningitis is as low (< 1.3% as the risk in a febrile child without seizures. After an initial febrile seizure (simple or complex, 3-12% of children develop epilepsy by adolescence. However, the risk of developing epilepsy after an initial simple febrile seizure is low (1.5-2.4%. Since the vast majority of children have a normal long-term outcome, antiepileptic medication is not recommended to prevent recurrence of febrile seizures. Oral diazepam or clobazam, given only when fever is present, is an effective means of reducing the risk of recurrence. The family physician can play an important role in counseling the parents that most febrile seizures are brief, do not require any specific treatment or extensive work-up, the probability of frequent or possibly threatening recurrences is low and the long-term prognosis is excellent.

  19. Macular Hole Associated with Vogt-Koyanagi-Harada Disease at the Acute Uveitic Stage

    Directory of Open Access Journals (Sweden)

    Masaharu Mizuno

    2015-09-01

    Full Text Available We describe a case with macular hole (MH associated with Vogt-Koyanagi-Harada (VKH disease. A 71-year-old Japanese woman presented with visual loss and headaches. The best-corrected visual acuity (BCVA was 0.02 in the right eye (RE and 0.1 in the left eye (LE. The patient was diagnosed with VKH based on circumferential choroidal detachments, multiple serous retinal detachments, and optic disc hyperemia. The multiple serous retinal detachments improved with high-dose corticosteroid therapy and gradual tapering. The BCVA was recovered to 1.2/0.7 in the RE/LE. Six weeks after the initial administration of steroid, vitreomacular traction was found by optical coherence tomography in the LE, which progressed to stage 4 MH with the BCVA of 0.2 in the LE. Twenty-three weeks after the initial treatment, vitrectomy was performed with the standard surgical procedures, including inner limiting membrane peeling around the fovea and air tamponade. The MH was closed successfully and the BCVA was 0.4 in the LE 5 weeks after the vitrectomy. This is the first report of a case with MH secondary to the acute uveitic stage of VKH. Successful closure of MH was achieved with the standard surgical intervention for an idiopathic MH. To conclude, at the early stage of VKH, there is a possibility of MH formation due to the rapid progress of vitreous traction following the inflammation, and the surgical procedure could be effective to resolve this secondary disorder.

  20. Iron-deficiency Anemia in Children with Febrile Seizure: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Fateme GHASEMI

    2014-04-01

    Neurol 2010;14(1:27-30.16. Bidabadi E, Mashouf M. Association between Iron Deficiency Anemia and First Febrile Convulsion: A Case–control Study. Seizure 2009;18:347-51.17. Oski FA, Brugnara C, Nathan DG. A Diagnostic Approach to the Anemic Patients. In: Nathan DG, Orkin SH, editors. Nathan and Oski’s Hematology of Infancy and Childhood. 7th ed. Philadelphia: WB Saunders Company; 2008. Appendix 11.18. Vaswani RK, Dharaskar PG, Kulkarni S, Ghosh K. Iron Deficiency as a Risk Factor for First Febrile Seizure. Indian Pediatr 2009;47(5:437-9.19. Sadeghzadeh M, Khoshnevis P, Mahboubi E. Iron Status and Febrile Seizure- A Case Control Study in Children Less Than 3 Years. Iran J Child Neurol 2012;6(4:27-31.20. Idro R, Gwer S, Williams TN, Otieno T, Uyoga S, Fegan G, et al. Iron Deficiency and Acute Seizures: Results from Children Living in Rural Kenya and a Metaanalysis. PLoS One 2010;5(11:e14001.21. Auvichayapat P, Auvichayapat N, Jedsrisuparp A, Thinkhamrop B, Sriroj S, Piyakulmala T, et al. Incidence of Febrile Seizures in Thalassemic Patients. J Med Assoc Thai 2004:87(8:970-3. 

  1. Histopathological Findings in Brains of Patients Who Died in the Acute Stage of Poor-grade Subarachnoid Hemorrhage

    Science.gov (United States)

    SATOMI, Junichiro; HADEISHI, Hiromu; YOSHIDA, Yasuji; SUZUKI, Akifumi; NAGAHIRO, Shinji

    2016-01-01

    Patients with poor-grade aneurysmal subarachnoid hemorrhage (SAH) are likely to die due to irreversible acute-stage primary brain damage. However, the mechanism(s) and pathology responsible for their high mortality rate remain unclear. We report our findings on the brains of individuals who died in the acute stage of SAH. An autopsy was performed on the brains of 11 SAH patients (World Federation of Neurosurgical Societies grade 5) who died within 3 days of admission and who did not receive respiratory assistance. All brains were free of intracranial hematoma and hydrocephalus; all harbored ruptured aneurysms. In all brains, multiple infarcts with perifocal edema were scattered throughout the cortex and subcortical white matter of the whole brain. Infarcts with a patchy – were more often seen than infarcts with a wedge-shaped pattern. Microscopic examination revealed multiple areas with cytotoxic edema and neuronal death indicative of acute ischemic changes. Edema and congestion were more obvious in areas where the subarachnoid clot tightly adhered to the pia mater. Pathologically, the brains of deceased patients with acute poor-grade SAH were characterized by edema and multifocal infarcts spread throughout the whole brain; they were thought to be attributable to venous ischemia. Diffuse disturbance in venous drainage attributable to an abrupt increase in the intracranial pressure and focal disturbances due to tight adhesion of the subarachnoid clot to the pia mater, may contribute strongly to irreversible brain damage in the acute stage of SAH. PMID:27357086

  2. Oxidative stress and Kawasaki disease: how is oxidative stress involved from the acute stage to the chronic stage?

    Science.gov (United States)

    Yahata, Tomoyo; Hamaoka, Kenji

    2017-01-01

    Inflammation and oxidative stress are closely related. Further, oxidative stress plays an important role in the pathology of inflammation-based Kawasaki disease. An excessive in vivo production of reactive oxygen species increases oxidative stress in the body, which triggers an endless vicious spiral of inflammation reactions and reactive oxygen metabolites. This presumably forms diffuse vasculitis in the acute phase. Acute inflammation and oxidative stress can be rapidly controlled by treatments; however, they may remain for a long time. This has recently been identified as a problem in the chronic phase of Kawasaki disease. Generally, the presence of vascular inflammation and oxidative stress impairs blood vessels, leading to the onset of atherosclerosis, which is a widely recognized risk. The current discussion focuses on whether the same is valid for blood vessels in the chronic phase of Kawasaki disease.

  3. The specific features and pattern of febrile infection-related epilepsy syndrome (FIRES in children

    Directory of Open Access Journals (Sweden)

    L. V. Shalkevich

    2014-01-01

    Full Text Available The paper considers the etiology, pathogenesis, clinical presentations, diagnosis and treatment in children with febrile infection-related epilepsy syndrome (FIRES and the aspects of identifying this disease as an individual nosological entity. It details a study of the possible etiological factors of FIRES, such as metabolic, genetic, and immunological disorders, aseptic inflammatory processes, as well as a search for a certain infectious agent by inoculations of different biological environments of the body and by polymerase chain reaction; the diagnostic characteristics of FIRES at the present stage, including the use of electroencephalography, positron emission tomography, and magnetic resonance imaging; different approaches to drug therapy for FIRES at the onset stages of its clinical manifestations, protracted status epilepticus, and drugresistant epilepsy. The issues of the predictable outcome of this disease, including survival and the probability of further development of epilepsy and maintenance of cognitive functions, are also viewed. Diagnostic criteria for the syndrome, such as age at its onset 3 to 15 years in previously healthy children; acute onset as fever to develop high-frequency focal seizures several days later; the absence of the identified disease pathogen detected by the examinations of cerebrospinal fluid, serum, and other environments of the body; the development of drug-resistant epilepsy and severe permanent cognitive and motor deficits after the completion of an acute period in most cases are presented. The paper is clinically exemplified by the authors’ observation of an 11-year-old boy who meets the above criteria for the syndrome, but has a relatively favorable course, without developing severe drug-resistant epilepsy.

  4. {sup 1}H-MRS for the diagnosis of acute disseminated encephalomyelitis: insight into the acute-disease stage

    Energy Technology Data Exchange (ETDEWEB)

    Ben Sira, Liat; Miller, Elka [Tel Aviv Sourasky Medical Center, Department of Radiology, Tel-Aviv (Israel); Artzi, Moran [Tel Aviv Sourasky Medical Center, Functional Brain Imaging Center, Tel-Aviv (Israel); Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Fattal-Valevski, Aviva; Constantini, Shlomi [Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Tel Aviv Medical Center, Paediatric Neurology Unit, The Paediatric Neurosurgery Department, Tel Aviv (Israel); Ben Bashat, Dafna [Tel Aviv Sourasky Medical Center, Functional Brain Imaging Center, Tel-Aviv (Israel)

    2010-01-15

    Acute disseminated encephalomyelitis (ADEM) is a demyelinating disorder of the central nervous system (CNS). Differentiating ADEM from other inflammatory disorders, such as multiple sclerosis, is not always conclusive using conventional MRI. To evaluate longitudinal magnetic resonance spectroscopy (MRS) changes that distinguish ADEM from other inflammatory disorders. MRI/MRS scans were performed in seven patients with ADEM during the acute and chronic phases of the disease. Partial recovery was detected between the acute and chronic phases in choline/creatine ratio. Major elevation of lipids and reduction in myo-inositol/creatine ratio was detected in all patients during the acute phase, followed by a reduction in lipids peak and elevation above normal in myo-inositol/creatine ratio during the chronic phase. Consistent and unique MRS changes in metabolite ratios between the acute and chronic presentations of the disease were found. To the best of our knowledge, these patterns have not been described in other inflammatory disorders and might assist in the early diagnosis of ADEM. (orig.)

  5. Four-Stage Audit Demonstrating Increased Uptake of HIV Testing in Acute Neurology Admissions Using Staged Practical Interventions.

    Directory of Open Access Journals (Sweden)

    Dilraj Singh Sokhi

    Full Text Available UK National Guidelines (UKNG advise HIV testing in clinically indicated neurological presentations. We audited the impact of our practical strategies to increase uptake of HIV testing at a regional acute neurology admissions unit.We audited HIV testing in 4 periods over 2 years: before we designed a UKNG-based "HIV testing in Neurology" protocol ("pre-protocol"; after dissemination of the protocol alone ("post-protocol"; post-protocol dissemination combined with both a tailored departmental admissions clerking proforma to prompt for HIV testing & consenting, and regular focussed tutorials to doctors on HIV testing in neurological patients ("post-proforma"; and finally one year after the post-proforma period ("+1 year". We also looked at the total number of HIV tests sent from the unit during the two-year period. We assessed significance using Fisher's exact test.47.8% of all acute neurology non-stroke admissions were eligible for HIV testing during all the audit periods. Testing rates were as follows: pre-protocol 21.9%; post-protocol 36.6%; post-proforma 83.3%; and at +1 year 65.4% (p<0.05 for both post-protocol and +1 year when compared to pre-protocol. Documentation of consent for HIV testing improved from 25% to 67.6% with the HIV-tailored clerking proforma. The total number of HIV tests requested from the unit doubled in the post-proforma period compared to pre-protocol (p<0.05.the combination of an HIV testing protocol, a tailored departmental clerking proforma and regular focussed teaching to doctors on indications for HIV testing led to a sustained increase in HIV testing uptake in our regional acute neurology admissions unit.

  6. Mycoplasma pneumoniae pneumonia in hospitalized children diagnosed at acute stage by paired sera

    Institute of Scientific and Technical Information of China (English)

    LIU Chun-ling; WEI Ming; LIU Zhen-ye; WANG Gui-qiang; ZHANG Bo; XU Hua; HU Liang-ping; HE Xiao-feng; WANG Jun-hua; ZHANG Jun-hong; LIU Xiao-yu

    2010-01-01

    Background Mycoplasma pneumoniae (M. pneumoniae) is a frequent cause of respiratory tract infections. However,there is deficient knowledge about the clinical manifestations of M. pneumoniae infection. We described the clinical and laboratory findings of M. pneumoniae pneumonia in hospitalized children who were all diagnosed by a ≥ fourfold increase in antibody titer.Methods M. pneumoniae antibodies were routinely detected in children admitted with acute respiratory infection during a one-year period. The medical history was re-collected from children whose M. pneumoniae antibody titer increased≥fourfold at the bedside by a single person, and their frozen paired serum samples were measured again for the M.pneumoniae antibody titer.Results Of the 635 children whose sera were detected for the M. pneumoniae antibody, paired sera were obtained from 82 and 29.3% (24/82) showed a ≥ fourfold increase in antibody titer. There were 24 cases, nine boys and 15 girls, aged from two to 14 years, whose second serum samples were taken on day 9 at the earliest after symptom onset; the shortest interval was three days. All children presented with a high fever (≥38.5℃) and coughing. Twenty-one had no nasal obstruction or a runny nose, and five had mild headaches which all were associated with the high fever. The disease was comparatively severe if the peak temperature was >39.5℃. All were diagnosed as having pneumonia through chest X-rays. Four had bilateral or multilobar involvement and their peak temperatures were all ≤ 39.5℃. None of the children had difficulty in breathing and all showed no signs of wheezing.Conclusions The second serum sample could be taken on day 9 at the earliest after symptom onset meant that paired sera could be used for the clinical diagnosis of M. pneumoniae pneumonia in children at the acute stage. M. pneumoniae is a lower respiratory tract pathogen. Extrapulmonary complications were rare and minor in our study. High peak temperature (

  7. A study of'febrile illnesses on the Thai-Myanmar border: predictive factors of rickettsioses.

    Science.gov (United States)

    PicKard, Amy L; McDaniel, Philip; Miller, R Scott; Uthaimongkol, Nichapat; Buathong, Nillawan; Murray, Clinton K; Telford, Sam R; Parola, Philippe; Wongsrichanalai, Chansuda

    2004-09-01

    We have performed a case-control analysis to determine the significance of clinical, laboratory and epidemiological features as predictive factors of rickettsioses among patients in Sangkhla Buri, Thailand (Thai-Myanmar border). Fifteen serologically-confirmed rickettsiosis patients including Spotted Fever Group (SFG) rickettsioses, scrub typhus, and murine typhus were classified as 'cases'; one hundred and sixty-three acutely febrile patients presenting to the same hospital during the same time period, who had no serological evidence of acute rickettsiosis, were classified as 'controls'. Patients' report of rash/arthropod bite [Odds ratio (OR) 22.90, 95% CI (confidence interval) 6.23, 84.13] and history of jungle trips (OR 5.30, 95% CI 1.69-16.62) were significant risk factors. Elevated ALT (OR 3.04, 95% CI 1.04, 8.88) and depressed platelet count (OR 3.38, 95% CI 1.13, 10.10) were also useful differentiating markers of rickettsioses in this population. Definitive diagnosis of rickettsioses is difficult without specialized diagnostic capabilities that are rarely available in remote areas such as Sangkhla Buri, where other acute febrile illnesses with similar presentation are commonly found. The relative importance of predictive factors presented here may provide clinicians with some useful guidance in distinguishing rickettsioses from other acute febrile illnesses. Timely administration of empiric treatment in highly suspicious cases can deter potential morbidity from these arthropod-borne infections.

  8. History of febrile illness and variation in semen quality

    DEFF Research Database (Denmark)

    Carlsen, Elisabeth; Andersson, Anna-Maria; Petersen, Jørgen Holm

    2003-01-01

    The purpose of this study was to analyse the effect of a history of febrile illness on semen quality.......The purpose of this study was to analyse the effect of a history of febrile illness on semen quality....

  9. Scrub typhus presenting as an acute abdomen

    Directory of Open Access Journals (Sweden)

    PP Abhilash Kundavaram

    2014-01-01

    Full Text Available Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, which presents as an acute febrile illness with headache, myalgia, breathlessness, and an eschar, a pathognomonic sign, in a varying proportion of patients. However, this illness can present unusually with fever and severe abdominal pain mimicking acute abdomen. A careful search for an eschar in all patients with an acute febrile illness would provide a valuable diagnostic clue and avoid unnecessary investigations and surgical exploration.

  10. Scrub typhus presenting as an acute abdomen

    OpenAIRE

    PP Abhilash Kundavaram; Sohini Das; M Varghese George

    2014-01-01

    Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, which presents as an acute febrile illness with headache, myalgia, breathlessness, and an eschar, a pathognomonic sign, in a varying proportion of patients. However, this illness can present unusually with fever and severe abdominal pain mimicking acute abdomen. A careful search for an eschar in all patients with an acute febrile illness would provide a valuable diagnostic clue and avoid unnecessary investigatio...

  11. Scrub typhus presenting as an acute abdomen.

    Science.gov (United States)

    Kundavaram, Abhilash Pp; Das, Sohini; George, Varghese M

    2014-01-01

    Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, which presents as an acute febrile illness with headache, myalgia, breathlessness, and an eschar, a pathognomonic sign, in a varying proportion of patients. However, this illness can present unusually with fever and severe abdominal pain mimicking acute abdomen. A careful search for an eschar in all patients with an acute febrile illness would provide a valuable diagnostic clue and avoid unnecessary investigations and surgical exploration.

  12. MRI findings in acute stage after head trauma and intellectual outcome

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Shingo; Hashimoto, Kunio; Yatsushige, Hiroshi; Kubota, Yoshihiro; Tabata, Hitoshi [Tsuchiura Kyodo General Hospital, Ibaraki (Japan)

    1998-12-01

    Disturbance of mental function, as a sequela of head trauma, occurred not only after severe head injury, but after mild to moderate head injury. Although initial Glasgow Coma Scale (GCS) score and its chronological change have been shown as good predictive indices of functional outcome in severely head injured patients, a useful predictive index has not been established in cases with mild to moderate head injury. In this study, MRI and CT image findings of acute stage in 17 head injured cases with initial GCS score 9 or more were analyzed and compared with intellectual outcome. MRI findings which suggest diffuse axonal injury (DAI findings) were seen in 7 out of 17, focal cerebral contusion of eloquent area in 6, and lesions of medial temporal lobe in 9. Medial temporal lobe lesions (MTL) were demonstrated as hyperintensity area in proton density weighted image (PDWI) within 3 days and in T2 weighted image more than 7 days after injury, and were not seen in CT or T1WI in most cases. All cases with MTL of dominant side failed in returning to pre-injury work or position. Comparison with MRI findings and WAIS-R 3 months after injury showed statistically significant correlation of MTL with impaired IQ, although DAI findings could not have significant correlation with poor functional coutcome. Etiology of MTL might be primary brain damage caused by collision of temporal lobe against basal dura or shearing force, rather than secondary changes following ischemia or deafferentation. These results suggest the importance of MRI examination (PDWI) to disclose post-traumatic changes and to predict intellectual outcome. (author)

  13. Febrile Convulsions: Their Significance for Later Intellectual Development and Behaviour.

    Science.gov (United States)

    Wallace, S.J.

    1984-01-01

    Concludes that intellectual and behavioral outcomes in children who have had febrile convulsions are dependent on preseizure status, unilaterality of the initial fit, recurrent febrile seizures, continued neurological abnormalities, the advent of fits when afebrile, and socioeconomic status. Suggests that a febrile convulsion should be followed up…

  14. Standardizing acute toxicity data for use in ecotoxicology models: influence of test type, life stage, and concentration reporting.

    Science.gov (United States)

    Raimondo, Sandy; Vivian, Deborah N; Barron, Mace G

    2009-10-01

    Ecotoxicological models generally have large data requirements and are frequently based on existing information from diverse sources. Standardizing data for toxicological models may be necessary to reduce extraneous variation and to ensure models reflect intrinsic relationships. However, the extent to which data standardization is necessary remains unclear, particularly when data transformations are used in model development. An extensive acute toxicity database was compiled for aquatic species to comprehensively assess the variation associated with acute toxicity test type (e.g., flow-through, static), reporting concentrations as nominal or measured, and organism life stage. Three approaches were used to assess the influence of these factors on log-transformed acute toxicity: toxicity ratios, log-linear models of factor groups, and comparison of interspecies correlation estimation (ICE) models developed using either standardized test types or reported concentration type. In general, median ratios were generally less than 2.0, the slopes of log-linear models were approximately one for well-represented comparisons, and ICE models developed using data from standardized test types or reported concentrations did not differ substantially. These results indicate that standardizing test data by acute test type, reported concentration type, or life stage may not be critical for developing ecotoxicological models using large datasets of log-transformed values.

  15. Febrile Seizures: Etiology, Prevalence, and Geographical Variation

    Directory of Open Access Journals (Sweden)

    Ali DELPISHEH

    2014-07-01

    Full Text Available How to Cite This Article: Delpisheh A, Veisani Y, Sayehmiri K, Fayyazi A. Febrile Seizures: Etiology, Prevalence, and Geographical Variation. Iran J Child Neurol. 2014 Summer; 8(3:30-37. AbstractObjectiveFebrile seizures (FSs are the most common neurological disorder observed in the pediatric age group. The present study provides information about epidemiological and clinical characteristics as well as risk factors associated with FS among Iranian children.Materials & MethodsOn the computerized literature valid databases, the FS prevalence and 95% confidence intervals were calculated using a random effects model. A metaregression analysis was introduced to explore heterogeneity between studies. Data manipulation and statistical analyses were performed using Stata10.ResultsThe important viral or bacterial infection causes of FSs were; recent upper respiratory infection 42.3% (95% CI: 37.2%–47.4%, gastroenteritis21.5% (95% CI: 13.6%–29.4%, and otitis media infections15.2% (95% CI: 9.8%- 20.7% respectively. The pooled prevalence rate of FS among other childhood convulsions was 47.9% (95% CI: 38.8–59.9%. The meta–regression analysis showed that the sample size does not significantly affect heterogeneity for the factor ‘prevalence FS’.ConclusionsAlmost half of all childhood convulsions among Iranian children are associated with Febrile seizure. ReferencesFelipe L, Siqueira M. febrile seizures: update on diagnosis and management. Siqueira LFM. 2010;56 (4:489–92.Oka E, Ishida S, Ohtsuka Y, Ohtahara S. Neuroepidemiological Study of Childhood Epilepsy by Application of International Classification of Epilepsies and Epileptic Syndromes (ILAE, 1989. Epilepsia. 1995;36 (7:658–61.Shi X, Lin Z, Ye X, Hu Y, Zheng F, Hu H. An epidemiological survey of febrile convulsions among pupils in the Wenzhou region. Zhongguo Dang Dai Er Ke Za Zhi. 2012 Feb;14 (2:128–30.Waruiru C, Appleton R. Febrile seizures: an update. Arch Dis Child

  16. Syndromic surveillance: etiologic study of acute febrile illness in dengue suspicious cases with negative serology. Brazil, Federal District, 2008 Vigilância sindrômica: estudo etiológico de doenças febris agudas a partir dos casos suspeitos de dengue com sorologia não reagente. Distrito Federal, Brasil, 2008

    Directory of Open Access Journals (Sweden)

    Ailton Domicio da Silva

    2010-10-01

    Full Text Available With the aim of identifying the etiology of acute febrile illness in patients suspected of having dengue, yet with non reagent serum, a descriptive study was conducted with 144 people using secondary serum samples collected during convalescence. The study was conducted between January and May of 2008. All the exams were re-tested for dengue, which was confirmed in 11.8% (n = 17; the samples that remained negative for dengue (n = 127 were tested for rubella, with 3.9% (n = 5 positive results. Among those non reactive for rubella (n = 122, tests were made for leptospirosis and hantavirus. Positive tests for leptospirosis were 13.9% (n = 17 and none for hantavirus. Non reactive results (70.8% were considered as Indefinite Febrile Illness (IFI. Low schooling was statistically associated with dengue, rubella and leptospirosis (p = 0.009, dyspnea was statistically associated with dengue and leptospirosis (p = 0.012, and exanthem/petechia with dengue and rubella (p = 0.001. Among those with leptospirosis, activities in empty or vacant lots showed statistical association with the disease (p = 0.013. Syndromic surveillance was shown to be an important tool in the etiologic identification of IFI in the Federal District of Brazil.Com o objetivo de identificar a etiologia de doenças febris agudas, em suspeitos de dengue com sorologia não reagente, realizou-se estudo descritivo com 144 pessoas utilizando amostras de soro coletados na convalescença, entre janeiro e março de 2008. Todos os exames foram re-testados para dengue, sendo as amostras negativas, processadas para rubéola (n = 127. Dentre as não reagentes para rubéola, submeteu-se ao teste para leptospirose (n = 122, e em se permanecendo sem diagnóstico, testou-se para hantavirose. Confirmou-se dengue em 11,8% (n = 17, rubéola em 3,9% (n = 5 e leptospirose em 13,9% (n = 17. Os resultados não reagentes foram considerados como doença febril aguda indiferenciada (DFI em 70.8% dos casos

  17. Triagem para o tratamento ambulatorial da neutropenia febril Screening for the outpatient treatment of febrile neutropenia

    Directory of Open Access Journals (Sweden)

    Marcelo Bellesso

    2010-01-01

    Full Text Available A neutropenia febril (NF é uma complicação frequente e potencialmente fatal nos pacientes em tratamento quimioterápico. Entendemos hoje que a neutropenia febril é considerada uma emergência clínica e que a administração de antibióticos de amplo espectro diminui drasticamente a mortalidade. Estudos sugerem que a neutropenia febril compreende um grupo extremamente heterogêneo e que dados clínicos como febre domiciliar, ausência de hipotensão, ausência de desidratação, ausência de doença pulmonar obstrutiva crônica, ausência de outros sintomas, ausência de infecção fúngica prévia e idade Febrile neutropenia is a frequent and potentially fatal adverse event of chemotherapy. Nowadays, febrile neutropenia is considered an emergency and it is known that prompt infusion of antibiotics decreases mortality. Several studies demonstrated that febrile neutropenia is a heterogeneous group of diseases and that factors such as outpatient status, no hypotension, no dehydration, no chronic obstructive pulmonary disease, no symptoms, no previous fungal infection and age < 60 years are protective factors against serious complications as demonstrated by the Multinational Association for Supportive Care in Cancer (MASCC. These data show that outpatient treatment and early discharge is safer and much research has shown lower costs for outpatient treatment in low-risk patients with febrile neutropenia. The aim of this work is to review and discuss tools (in particular the MASCC index for safe screening of febrile neutropenia for outpatient treatment in addition to demonstrate results of research.

  18. Diagnosing Febrile Illness in a Returned Traveler

    Centers for Disease Control (CDC) Podcasts

    2012-03-01

    This podcast will assist health care providers in diagnosing febrile illness in patients returning from a tropical or developing country.  Created: 3/1/2012 by National Center for Enteric, Zoonotic, and Infectious Diseases (NCEZID).   Date Released: 3/1/2012.

  19. Febrile Seizures: clinical and genetic studies

    NARCIS (Netherlands)

    M. van Stuijvenberg (Margriet)

    1998-01-01

    textabstractFebrile seizures are described as a temporary seizure disorder of childhood; the attacks occur by definition in association with fever and are usually accompanied by sudden tonic-clonic muscle contractions and reduced consciousness, usually lasting not longer than 5 to 10 minutes. Accord

  20. Treatment of febrile seizures with intermittent clobazam.

    Science.gov (United States)

    Manreza, M L; Gherpelli, J L; Machado-Haertel, L R; Pedreira, C C; Heise, C O; Diament, A

    1997-12-01

    Fifty children, 24 female and 26 male, with ages varying from 6 to 72 months (mean = 23.7 m.) that experienced at least one febrile seizure (FS) entered a prospective study of intermittent therapy with clobazam. Cases with severe neurological abnormalities, progressive neurological disease, afebrile seizures, symptomatic seizures of other nature, or seizures during a central nervous system infection were excluded. Seizures were of the simple type in 25 patients, complex in 20 and unclassified in 5. The mean follow-up period was 7.9 months (range = 1 to 23 m.), and the age at the first seizure varied from 5 to 42 months (mean = 16.8 m.). Clobazam was administered orally during the febrile episode according to the child's weight: up to 5 kg, 5 mg/day; from 5 to 10 kg, 10 mg/day; from 11 to 15 kg, 15 mg/day, and over 15 kg, 20 mg/day. There were 219 febrile episodes, with temperature above 37.8 degrees C, in 40 children during the study period. Twelve children never received clobazam and 28 received the drug at least once. Drug efficacy was measured by comparing FS recurrence in the febrile episodes that were treated with clobazam with those in which only antipyretic measures were taken. Ten children (20%) experienced a FS during the study period. Of the 171 febrile episodes treated with clobazam there were only 3 recurrences (1.7%), while of the 48 episodes treated only with antipyretic measures there were 11 recurrences (22.9%), a difference highly significant (p diazepam in the intermittent treatment of FS recurrence.

  1. FEBRILE SEIZURE: RECURRENCE AND RISK FACTORS

    Directory of Open Access Journals (Sweden)

    A. TALEBIAN

    2006-06-01

    Full Text Available Background:Febrile Convulsion is the most common convulsive disorder in children,occurring in 2 to 4% of the pediatric population and recurring in 30-50% of cases. Considering the varying recurrence rates reported, thisstudy was conducted at the pediatric ward of the Shaheed BeheshtiGeneral Hospital, between 2000-2001 to determine the frequencyof recurrence and related risk factors in children presenting with theirfirst episode of febrile convulsionMaterials & Methods:A two–year cohort study was performed on 50 children presentingwith the first attack of febrile convulsion. Patient demographic dataincluding age, sex, type and duration of seizure, family history offebrile seizure or epilepsy and the interval between fever onset andoccurrence of seizure were recorded in questionnaires. Those patients,for whom prophylactic medication was not administered, werefollowed at three–month intervals for up to one year. Findings werestatistically analyzed using Fisher’s exact testResults:Recurrence was observed in twelve children (24% out of the fifty,being most common in patients aged less than one year (54.4%.Recurrence rates among children with a positive family history offebrile convulsion, presence of complex febrile seizure and positivefamily history of epilepsy were 42.1%, 42.8% and 25% respectively.From among those children with a “less than one hour” intervalbetween fever onset and occurrence of seizure, recurrence occurredin 43-7% of cases, while in those with a “more than one hourinterval”, 14.7% experienced recurrence.Conclusion:Recurrence rates are increased by certain factors including age-belowone year-, positive family history of febrile convulsion, and a “lessthan one hour” interval between time of fever onset and seizureoccurrence.

  2. Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage

    Institute of Scientific and Technical Information of China (English)

    Hong Chen; Fei Li; Jia-Bang Sun; Jian-Guo Jia

    2008-01-01

    AIM: To study retrospectively the influence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in patients with early acute pancreatitis (AP) (during the first week after admission) on physiological functions, and the association of the presence of LAH/ACS and outcome.METHODS: Patients (n=74) with AP recruited in this study were divided into two groups according to intra-abdominal pressure (IAP) determined by indirect measurement using the transvesical route via Foley bladder catheter during the first week after admission. Patients (n=44) with IAP≥12 mmHg were assigned in IAH group, and the remaining patients (n=30) with IAP<12mmHg in normal IAP group. For analysis of the influence of IAH/ACS on organ function and outcome, the physiological parameters and the occurrence of organ dysfunction during intensive care unit (ICU) stay were recorded, as were the incidences of pancreatic infection and in-hospital mortality.RESULTS: LAH within the first week after admission was found in 44 patients (59.46%). Although the APACHE Ⅱ scores on admission and the Ranson scores within 48h after hospitalization were elevated in IAH patients in early stage, they did not show the statistically significant differences from patients with normal IAP within a week after admission (16.18±3.90 vs 15.70±4.25, P=0.616; 3.70±0.93 vs 3.47±0.94, P=0.285, respectively). ACS in early AP was recorded in 20 patients (27.03%). During any 24-h period of the first week after admission, the recorded mean IAP correlated significantly with the Marshall score calculated at the same time interval in IAH group (r=0.635, P<0.001). Although ACS patients had obvious amelioration in physiological variables within 24h after decompression, the incidences of pancreatitic infection, septic shock, multiple organ dysfunction syndrome (MODS) and death in the patients with ACS were significantly higher than that in other patients without ACS (pancreatitic infection: 60.0% vs 7.4%, P<0

  3. MRI findings of acute cerebral swelling and brain edema in the acute stage. A report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Oki, Hideo; Ueda, Shin; Matsumoto, Keizo; Kashihara, Michiharu; Furuichi, Masashi.

    1988-08-01

    We report two cases, one of acute cerebral swelling and the other with a major stroke, whose MRI has shown very interesting findings. Case 1, a 32-year-old male, was admitted to our service because of a lowering of his consciousness immediately after a head injury. On admission, the patient was semicomatous (E/sub 1/M/sub 2/V/sub 1/, with anisocoria (R > L). His plain skull X-ray was normal. A CT scan, however, demonstrated right isodensity hemispheric swelling associated with a subarachnoid hemorrhage in the right Sylvian fissure. A right carotid angiogram showed no vascular disorders. MR imaging of the spin density demonstrated a hyperintensitive thickening of the gray matter in the whole right hemisphere. Case 2, a 58-year-old female, was admitted because of a sudden onset of loss of consciousness, with right hemiparesis and dysarthria. On admission, her consciousness was semicomatous (E/sub 1/M/sub 3/V/sub 1/), and it deteriorated to a deep coma 1 hour later. A CT scan demonstrated a diffuse left hemispheric low density, with a finding of hemorrhagic infarction in the basal ganglia. MR imaging of the spin density showed a hyperintensitive thickening of the gray matter resembling that of Case 1. The findings of the spin-echo images of our two cases showed a hyperintensitive thickening of the gray matter in both. The hyperintensity and thickening of the gray matter apparently indicated a sort of hyperemia and brain edema. These findings led us to suspect that the hyperemia associated with acute cerebral swelling and ischemic brain edema of our two cases originated in the gray matter, although it has been considered that the pathogenesis of acute cerebral swelling is not known and that brain edema, especially vasogenic edema, will mostly develop in the white matter rather than in the gray matter.

  4. Renal Function in Children with Febrile Convulsions

    Directory of Open Access Journals (Sweden)

    Ladan AFSHARKHAS

    2014-12-01

    Full Text Available How to Cite This Article: Afsharkhas L, Tavasoli A. Renal Function in Children with Febrile Convulsions.Iran J Child Neurol. 2014 Autumn;8(4:57-61.AbstractObjectiveFebrile convulsions (FC are the most frequent seizure disorder in children.Some studies have detected serum electrolyte disturbances in patients with FC.This study determines serum electrolytes, renal function tests, and frequency of urinary tract infection in hospitalized children with FC.Materials & MethodsIn this descriptive, cross sectional study, we evaluated 291 children with FC admitted to the Neurology ward of Ali-Asghar Children’s Hospital from 2008–2013. Data was recorded on age, sex, type (simple, complex, and recurrence of seizures, family history of FC and epilepsy, serum electrolytes, renal function tests, and urinary tract infections.ResultsA total of 291 patients with diagnosis of FC were admitted to our center. Of these 291 patients, 181 (62.2% were male. The mean age was 24.4 ± 14.6 months.There were simple, complex, and recurrent FCs in 215 (73.9%, 76 (26.1% and 61 (21% of patients, respectively. Urinary tract infections (UTI were found in 13 (4.5% patients, more present in females (p-value = 0.03 and under 12 months of age (p-value = 0.003. Hyponatremia, hypocalcemia, and hypokalemia was detected in 32 (11%, 16 (5.5%, and 4 (1.4% of cases, respectively. Twentyfour (8.2% patients had a glomerular filtration rate less than 60 ml/min/1.73m2.There were no abnormalities in serum magnesium, BUN, and creatinine levels.ConclusionDuring FCs, mild changes may occur in renal function but a serum electrolyte evaluation is not necessary unless patients are dehydrated. In children with FC, urinary tract infections should be ruled out. ReferencesGhofrani M. Febrile Convulsion: Another look at an old subject. Iran J Child Neurology 2006 June:1(1:5-9.Swaiman K, Ashwal S, Ferriero D, Schor N. Swaiman’s Pediatric Neurology: Principles and Practice. 5th edition

  5. Long term end-stage renal disease and death following acute renal replacement therapy in the ICU

    DEFF Research Database (Denmark)

    Lohse, R.; Damholt, M. B.; Wiis, J.

    2016-01-01

    INTRODUCTION: In ICU the need for acute renal replacement therapy (RRT) associates with high mortality and risk of end-stage renal disease (ESRD), but there are limited long-term data. We investigated these outcomes and their risk factors. METHODS: Retrospective analysis of all adult patients...... admitted to a general, university hospital ICU 2005-2012, excluding chronic dialysis patients. ESRD was defined as need of RRT > 90 days or kidney transplant. RESULTS: Of 5766 patients included, 1004 (16%) received acute RRT; their 30-day mortality was 42% vs. 16% for those not requiring acute RRT...... (adjusted hazard ratio (HR) 1.13 (0.96-1.32)). The 90-day mortality was 55% for patients receiving acute RRT vs. 22% for those who did not (adjusted HR 1.32 (1.15-1.51)) and 1-year mortality was 63% vs. 30%, respectively, (adjusted HR 1.31 (1.16-1.48)). The 7-year risk of ESRD for ICU patients surviving 90...

  6. Papilloedema and MRI enhancement of the prechiasmal optic nerve at the acute stage of Leber hereditary optic neuropathy.

    Science.gov (United States)

    Lamirel, Cédric; Cassereau, Julien; Cochereau, Isabelle; Vignal-Clermont, Catherine; Pajot, Olivier; Tanguy, Jean-Yves; Zanlonghi, Xavier; Reynier, Pascal; Amati-Bonneau, Patrizia; Dubas, Frédéric; Bonneau, Dominique; Verny, Christophe

    2010-05-01

    The authors report a case of one patient from a family carrying the homoplasmic Leber hereditary optic neuropathy (LHON) G11778A mitochondrial DNA mutation with papilloedema 9 months prior to the acute stage of LHON and still present at the onset of visual loss. During the vision loss, the MRI demonstrated a T2 hyperintensity and an enhancement of the prechiasmal left optic nerve, suggesting the existence of an inflammatory mechanism. A retrospective review of the chart of two others members of the same family, with bilateral optic disc oedema at onset of the vision loss, suggests that the relationship of papilloedema and acute phase of LHON may not be just a coincidence, at least in this family. The visual loss related to LHON could have been triggered in the setting of the chronic papilloedema, associated with the intracranial hypertension.

  7. Treatment of febrile seizures with intermittent clobazam

    OpenAIRE

    1997-01-01

    Fifty children, 24 female and 26 male, with ages varying from 6 to 72 months (mean=23.7 m.) that experienced at least one febrile seizure (FS) entered a prospective study of intermittent therapy with clobazam. Cases with severe neurological abnormalities, progressive neurological disease, afebrile seizures, symptomatic seizures of other nature, or seizures during a central nervous system infection were excluded. Seizures were of the simple type in 25 patients, complex in 20 and unclassified i...

  8. Treatment Duration of Febrile Urinary Tract Infections

    OpenAIRE

    van der Starre, Willize E.; van Dissel, Jaap T.; Nieuwkoop, Cees

    2011-01-01

    Although febrile urinary tract infections (UTIs) are relatively common in adults, data on optimal treatment duration are limited. Randomized controlled trials specifically addressing the elderly and patients with comorbidities have not been performed. This review highlights current available evidence. Premenopausal, non-pregnant women without comorbidities can be treated with a 5–7 day regimen of fluoroquinolones in countries with low levels of fluoroquinolone resistance, or, if proven suscep...

  9. [Epidemiological surveillance of febrile rash illness].

    Science.gov (United States)

    Pérez-Pérez, Gabriela Fidela; Rojas-Mendoza, Teresita; Cabrera-Gaytán, David Alejandro; Grajales-Muñiz, Concepción; Maldonado-Burgos, Martha Alejandra

    2015-01-01

    Introducción: en 2011 se detectaron tres casos importados de sarampión, por lo que se intensificó la vigilancia epidemiológica con emisión de alertas epidemiológicas. El objetivo de este estudio es describir el fenómeno de la intensificación de la vigilancia epidemiológica de enfermedad febril exantemática ante la importación de casos confirmados de sarampión en el territorio nacional en el Instituto Mexicano del Seguro Social. Métodos: se obtuvieron los casos del sistema especial de vigilancia epidemiológica de 2011, se compararon con el año previo. Se determinó t de Student para diferencia de medias, prueba de Wilson para proporciones; ambas con un valor alfa del 0.05. Resultados: en 2011 se notificaron 2786 casos de enfermedad febril exantemática, 51.2 % más casos que el año anterior; el número de casos reportados con relación a los esperados aumentó en 29 de las 35 Delegaciones del IMSS con un incremento en el promedio de casos notificados a partir de la semana 26. El 67.4 % de los casos notificados se concentró en los menores de 5 años de edad. Conclusiones: se apreció un incremento importante de casos notificados de enfermedad febril exantemática en comparación con el año previo. El Instituto cuenta con un sistema de vigilancia epidemiológica de enfermedad febril exantemática robusto y flexible, que ha permitido identificar riesgos a la población.

  10. [Acute rheumatic fever].

    Science.gov (United States)

    Maier, Alexander; Kommer, Vera

    2016-03-01

    We report on a young women with acute rheumatic fever. Acute rheumatic fever has become a rare disease in Germany, especially in adults. This carries the risk that it can be missed in the differential diagnostic considerations of acute rheumatic disorders and febrile status. If rheumatic fever is not diagnosed and treated correctly, there is a considerable risk for rheumatic valvular heart disease. In this article diagnosis, differential diagnosis and therapy of rheumatic fever are discussed extensively.

  11. Treatment Result in the Initial Stage of Kanazawa Mobile Embolectomy Team for Acute Ischemic Stroke

    Science.gov (United States)

    UCHIYAMA, Naoyuki; MISAKI, Kouichi; MOHRI, Masanao; KAMIDE, Tomoya; HIROTA, Yuichi; HIGASHI, Ryo; MINAMIDE, Hisato; KOHDA, Yukihiko; ASAHI, Takashi; SHOIN, Katsuo; IWATO, Masayuki; KITA, Daisuke; HAMADA, Yoshitaka; YOSHIDA, Yuya; NAKADA, Mitsutoshi

    2016-01-01

    Five recent multicenter randomized controlled trials (RCTs) have clearly shown the superiority of mechanical thrombectomy in large vessel occlusion acute ischemic stroke compared to systemic thrombolysis. Although 14 hospitals in Ishikawa prefecture have uninterrupted availability of systemic thrombolysis, mechanical thrombectomy is not available at all of these hospitals. Therefore, we established a Kanazawa mobile embolectomy team (KMET), which could travel to these hospitals and perform the acute reperfusion therapy. In this article, we report early treatment outcomes and validate the effectiveness of a network between affiliated hospitals and KMET. Between January 2014 and December 2015, 48 patients, aged 45–92 years (mean: 73.0 years), underwent acute reperfusion therapy provided by KMET in 10 affiliated hospitals of Kanazawa University Hospital. The pre-treatment NIHSS scores ranged from 5 to 39 (mean: 19.1). ASPECTS+W ranged from 1 to 11 (mean: 7.3). Successful revascularization, defined as thrombolysis in cerebral infarction (TICI) 2b or 3, was achieved in 38/48 cases (80%), and a good outcome, defined as modified Rankin Scale (mRS) score from 0 to 2 at 90 days after the treatment, was achieved in 24/48 cases (50%). There were two cases of intracranial bleeding (4%). Mean time from onset to recanalization was 297 min. These results, which are similar to those of five previous RCTs, suggest that a collaborative network between affiliated hospitals and KMET is effective for acute reperfusion therapy in local areas wherein experienced neuroendovascular specialists are insufficient. PMID:27725522

  12. SERUM ZINC LEVEL IN PATIENTS WITH SIMPLE FEBRILE SEIZURE

    Directory of Open Access Journals (Sweden)

    Farhad HEYDARIAN

    2010-10-01

    Full Text Available ObjectiveTo evaluate the serum zinc level of the patients with simple febrile seizure and compare them with febrile children without seizure.Materials & MethodsThis prospective case - control study was performed on 60 patients aged 6 months to 6 years from Apr. 2009 to Jan.2010 in Ghaem, Imam Reza and Dr. Sheikh Hospitals in Mashhad. The serum zinc level was assessed and compared between the cases (30 individuals who suffered from simple febrile seizure and the controls (30 individuals who had fever without seizure.ResultsMean serum zinc level was 663.7 µg /l and 758.33  µg /l in the case group and the control group, respectively (PConclusionIt was revealed that the serum level of zinc was significantly lower in children with simple febrile seizure in comparison with febrile children without seizure.Keywords: Simple febrile seizure, children, zinc, CSF (cerebrospinal fluid

  13. Food-borne bacteremic illnesses in febrile neutropenic children.

    Science.gov (United States)

    Lee, Anselm Chi-Wai; Siao-Ping Ong, Nellie Dawn

    2011-08-31

    Bacteremia following febrile neutropenia is a serious complication in children with malignancies. Preventive measures are currently targeted at antimicrobial prophylaxis, amelioration of drug-induced neutropenia, and nosocomial spread of pathogens, with little attention to community-acquired infections. A retrospective study was conducted at a pediatric oncology center during a 3-year period to identify probable cases of food-borne infections with bacteremia. Twenty-one bacteremic illnesses affecting 15 children receiving chemotherapy or hematopoietic stem cell transplantation were reviewed. Three (14%) episodes were highly suspected of a food-borne origin: a 17-year-old boy with osteosarcoma contracted Sphingomonas paucimobilis septicemia after consuming nasi lemak bought from a street hawker; a 2-year-old boy with acute lymphoblastic leukemia developed Chryseobacterium meningosepticum septicemia after a sushi dinner; a 2-year-old girl was diagnosed with acute lymphoblastic leukemia and Lactobacillus bacteremia suspected to be of probiotic origin. All of them were neutropenic at the time of the infections and the bacteremias were cleared with antibiotic treatment. Food-borne sepsis may be an important, but readily preventable, cause of bloodstream infections in pediatric oncology patients, especially in tropical countries with an abundance of culinary outlets.

  14. Food-borne bacteremic illnesses in febrile neutropenic children

    Directory of Open Access Journals (Sweden)

    Anselm Chi-wai Lee

    2011-08-01

    Full Text Available Bacteremia following febrile neutropenia is a serious complication in children with malignancies. Preventive measures are currently targeted at antimicrobial prophylaxis, amelioration of drug-induced neutropenia, and nosocomial spread of pathogens, with little attention to community-acquired infections. A retrospective study was conducted at a pediatric oncology center during a 3-year period to identify probable cases of food-borne infections with bacteremia. Twenty-one bacteremic illnesses affecting 15 children receiving chemotherapy or hematopoietic stem cell transplantation were reviewed. Three (14% episodes were highly suspected of a food-borne origin: a 17-year-old boy with osteosarcoma contracted Sphingomonas paucimobilis septicemia after consuming nasi lemak bought from a street hawker; a 2-year-old boy with acute lymphoblastic leukemia developed Chryseobacterium meningosepticum septicemia after a sushi dinner; a 2-year-old girl was diagnosed with acute lymphoblastic leukemia and Lactobacillus bacteremia suspected to be of probiotic origin. All of them were neutropenic at the time of the infections and the bacteremias were cleared with antibiotic treatment. Food-borne sepsis may be an important, but readily preventable, cause of bloodstream infections in pediatric oncology patients, especially in tropical countries with an abundance of culinary outlets.

  15. Improved early diagnosis of acute inflammatory skeletal-articular diseases in children: A two-radiopharmaceutical approach

    Energy Technology Data Exchange (ETDEWEB)

    Handmaker, H.; Giammona, S.T.

    1984-05-01

    The febrile child with a painful bone or joint still presents a difficult pediatric diagnostic problem. Acute hematogenous osteomyelitis, septic arthritis, and cellulitis are the most common causes of this symptom. Thirty-seven patients with these disorders were studied. Because findings from technetium-99m phosphate bone scans and roentgenograms are often normal in patients in the early stages of acute hematogenous osteomyelitis, children suspected of having this disorder were tested using gallium-67 citrate scans in addition to the other diagnostic procedures. The increased diagnostic accuracy of this approach over that of bone scan and roentgenogram studies alone was observed in the children with fever and bone or joint pain.

  16. Serum endocan levels in children with febrile neutropenia

    Directory of Open Access Journals (Sweden)

    Eylem Kiral

    2016-03-01

    Full Text Available Endocan is an endotelial cell specific molecule; previous studies have shown that serum endocan levels increased in cancer and sepsis and are also related to the severity of sepsis. There are no clinical study about serum endocan levels in children with febrile neutropenia. The aim of this study was to evaluate serum endocan levels in pediatric leukemia patients with febrile neutropenia (n=33 and compare them with children with leukemia without fever (n=33 and also with healthy children (n=24. The median serum endocan level in the first group (children with febrile neutropenia was statistically significantly higher compared to the leukemic children without febrile neutropenia and also control group (P<0.01 for both. No difference was determined between the serum endocan levels of the leukaemia patients without febrile neutropenia and the healthy control group (P>0.05. Serum endocan levels were also similar with febrile neutropenia due to bacterial causes comparing with the idiopathic febril neutropenia. The results of this study showed increased serum endocan in children with leukemia during the febrile neutropenia episode, and no changes of serum endocan levels in children without leukemia without infection/fever. The monitoring of a series of serum endocan levels would be helpful for the course of febrile neutropenia.

  17. Iron Status and Febrile Seizure- A Case Control Study in Children Less Than 3 Years

    Directory of Open Access Journals (Sweden)

    Mansour SADEGHZADEH

    2013-01-01

    febrile convulsions: case-control study in children under 2 years. BMJ. 1996 Aug;313(7053:343.Yadav D, Chandra J. Iron deficiency: beyond anemia. Indian J Pediatr. 2011 Jan;78(1:65-72.Sherjil A, us Saeed Z, Shehzad S, Amjad R. Iron deficiency anaemia-a risk factor for febrile seizures in children. J Ayub Med Coll Abbottabad. 2010 Jul-Sep;22(3:71-3.Erikson KM, Jones BC, Hess EJ, Zhang Q, Beard JL. Iron deficiency decreases dopamine D1 and D2 receptors in rat brain. Pharmacol Biochem Behav. 2001 Jul-Aug;69(3-4:409-18.Beard JL, Chen Q, Connor J, Jones BC. Altered monoamine metabolism in caudate-putamen of iron-deficient rats. Pharmacol Biochem Behav. 1994 Jul;48(3:621-4.Chen Q, Beard JL, Jones BC. Abnormal rat brain monoamine metabolism in iron deficiency anemia. J Nutr Biochem. 1995;6(9:486-93.Youdim MB, Ben-Shachar D, Yehuda S. Putative biological mechanisms of the effect of iron deficiency on brain biochemistry and behavior. Am J Clin Nutr. 1989 Sep;50(3 Suppl:607-15.Felt BT, Beard JL, Schallert T, Shao J, Aldridge JW, Connor JR et al. Persistent12.  neurochemical and behavioral abnormalities in adulthood despite early iron supplementation for perinatal iron deficiency anemia in rats. Brain Behav Res. 2006 Aug;171(2:261-70.Beard JL, Felt B, Schallert T, Burhans M, Connor JR, Georgieff MK. Moderate iron deficiency in infancy: biology and behavior in young rats. Behav Brain Res. 2006 Jun 30;170(2:224-32.Beard JL, Connor JR. Iron status and neural functioning. Ann Rev Nutr. 2003;23:41-58.Johnston MV. Iron deficiency, febrile seizures and brain development. Indian Pediatr. 2012;49(16:13-4.Lozoff B, Georgieff MK. Iron deficiency and brain development. Semin Pediatr Neurol. 2006 Sep;13(3:158-65.Idro R, Gwer S, Williams TN, Otieno T, Uyoga S, Fegan G et al. Iron deficiency and acute seizures: results from children living in rural Kenya and a meta-analysis. PLoS One. 2010 Nov 16;5(11:e14001Salehi Omran MR, Tamaddoni A, Nasehi MM, Babazadeh H, Alizadeh navaei R. Iron status in

  18. Patients' and relatives' experience of difficulties following severe traumatic brain injury: the sub-acute stage

    DEFF Research Database (Denmark)

    Holm, Sara; Schönberger, Michael; Poulsen, Ingrid;

    2008-01-01

    The present study aimed to (1) identify the difficulties most frequently reported by individuals with severe traumatic brain injury (TBI) at the time of discharge from a sub-acute rehabilitation brain injury unit as well as difficulties reported by their relatives, (2) compare patients......' and relatives' reports of patient difficulties, and (3) explore the role of injury severity, disability and other factors on subjective experience of difficulties. The primary measure was the European Brain Injury Questionnaire (EBIQ) administered to patients and to one of their close relatives at discharge...

  19. Febrile Seizure: Demographic Features and Causative Factors

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    Hamed ESMAILI GOURABI

    2012-10-01

    Full Text Available ObjectiveBecause of geographical and periodical variation, we prompted to determine the demographic features and causative factors for febrile seizure in Rasht.Materials & MethodsIn this cross-sectional study, all 6–month- to 6-year-old children with the diagnosis of febrile seizure admitted to 17 Shahrivar hospital in Rasht, from August, 2009 to August, 2010 were studied. Age, sex, family history of the disease, seizure types, body temperature upon admission and infectious causes of the fever were recorded. All statistical analysis was performed with SPSS software, version 16.ResultsOf the 214 children (mean age, 25.24±15.40 months, 124 were boys and 109 had a positive family history. Complex seizures were seen in 39 cases. In patients with a complex febrile seizure, 59% had the repetitive type, 20.5% had the focal type and 20.5% had more than 15 minutes duration of seizures. Most of the repetitive seizures (78.3% occurred in patients under 2 years old; the difference between under and over 2-year-old patients was statistically significant (P=0.02. Study results did not show significant differences between the two genders for simple or complex seizures. The mean body temperature upon admission was 38.2±1.32◦C (38.31±0.82 degrees in boys and 38.04±1.78 in girls. Upper respiratory infections were seen in most patients (74.29%. All cases of lower respiratory infections were boys. There was a statistically significant difference between boys and girls in causes of fever.ConclusionMost of the children had a positive family history and the most common causative factor was upper respiratory infection.

  20. Las convulsiones febriles en la infancia

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    Pertejo García, Alicia

    2013-01-01

    Las convulsiones febriles conforman la patología convulsiva más frecuente en la infancia, generan mucha ansiedad y temor en los padres debido a que aparenta más gravedad de la que realmente tiene. Se muestra una visión global de esta patología y los procedimientos a seguir por los profesionales de enfermería. También se hace hincapié en la educación sanitaria que hay que llevar a cabo

  1. Non-Steroid Anti-Inflammatory Drugs Are Better than Acetaminophen on Fever Control at Acute Stage of Fracture.

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    Kuang-Ting Yeh

    Full Text Available In addition to adequate surgical fixation and an aggressive rehabilitation program, pain relief is one of the most critical factors in the acute stage of fracture treatment. The most common analgesics are nonsteroid anti-inflammatory drugs and Acetaminophen, both of which relieve pain and reduce body temperature. In clinical experiences, they exhibit effective pain control; however, their influence on body temperature remains controversial. This study is aimed at determining the effects of analgesics at the acute stage of traumatic fracture by performing a clinical retrospective study of patients with fractures and a fracture animal model. The retrospective study revealed that, in the acetaminophen group, the mean value of postmedication body temperature (BT was significantly higher than that of the premedication BT. The change in BT was highly related with the medication rather than other risk factors. Forty eight 12-week-old male Wistar rats were divided into 6 groups: a control group, fracture group, fracture-Acetaminophen group, Acetaminophen group, fracture-Arcoxia group, and Arcoxia group. Fracture rats were prepared by breaking their unilateral tibia and fibula. Their inflammation conditions were evaluated by measuring their serum cytokine level and their physiological status was evaluated by estimating their central temperature, heart rate, and mean blood pressure. The hepatic adverse effects were assessed by measuring the serum levels of aspartate aminotransferase (sGOT and alanine aminotransferase (sGPT. The central temperature in the fracture-Acetaminophen group exceeded that in the groups fed normal saline water or Arcoxia. Accumulated hepatic injury was presented as steadily ascending curves of sGOT and sGPT. Inflammation-related cytokine levels were not higher in the Acetaminophen fracture group and were significantly lower in the fracture-Arcoxia group. Fever appeared to be aggravated by acetaminophen and more related to the

  2. Non-Steroid Anti-Inflammatory Drugs Are Better than Acetaminophen on Fever Control at Acute Stage of Fracture.

    Science.gov (United States)

    Yeh, Kuang-Ting; Wu, Wen-Tien; Subeq, Yi-Maun; Niu, Chi-Chien; Liao, Kuang-Wen; Chen, Ing-Ho; Wang, Jen-Hung; Lee, Ru-Ping

    2015-01-01

    In addition to adequate surgical fixation and an aggressive rehabilitation program, pain relief is one of the most critical factors in the acute stage of fracture treatment. The most common analgesics are nonsteroid anti-inflammatory drugs and Acetaminophen, both of which relieve pain and reduce body temperature. In clinical experiences, they exhibit effective pain control; however, their influence on body temperature remains controversial. This study is aimed at determining the effects of analgesics at the acute stage of traumatic fracture by performing a clinical retrospective study of patients with fractures and a fracture animal model. The retrospective study revealed that, in the acetaminophen group, the mean value of postmedication body temperature (BT) was significantly higher than that of the premedication BT. The change in BT was highly related with the medication rather than other risk factors. Forty eight 12-week-old male Wistar rats were divided into 6 groups: a control group, fracture group, fracture-Acetaminophen group, Acetaminophen group, fracture-Arcoxia group, and Arcoxia group. Fracture rats were prepared by breaking their unilateral tibia and fibula. Their inflammation conditions were evaluated by measuring their serum cytokine level and their physiological status was evaluated by estimating their central temperature, heart rate, and mean blood pressure. The hepatic adverse effects were assessed by measuring the serum levels of aspartate aminotransferase (sGOT) and alanine aminotransferase (sGPT). The central temperature in the fracture-Acetaminophen group exceeded that in the groups fed normal saline water or Arcoxia. Accumulated hepatic injury was presented as steadily ascending curves of sGOT and sGPT. Inflammation-related cytokine levels were not higher in the Acetaminophen fracture group and were significantly lower in the fracture-Arcoxia group. Fever appeared to be aggravated by acetaminophen and more related to the elevation of hepatic

  3. Serum Endocan Levels in Children with Febrile Neutropenia.

    Science.gov (United States)

    Kiral, Eylem; Dinleyici, Ener Cagri; Bozkurt-Turhan, Ayse; Bor, Ozcan; Akgun, Yurdanur; Akgun, Necat Akdeniz

    2016-03-17

    Endocan is an endotelial cell specific molecule; previous studies have shown that serum endocan levels increased in cancer and sepsis and are also related to the severity of sepsis. There are no clinical study about serum endocan levels in children with febrile neutropenia. The aim of this study was to evaluate serum endocan levels in pediatric leukemia patients with febrile neutropenia (n=33) and compare them with children with leukemia without fever (n=33) and also with healthy children (n=24). The median serum endocan level in the first group (children with febrile neutropenia) was statistically significantly higher compared to the leukemic children without febrile neutropenia and also control group (Pfebrile neutropenia and the healthy control group (P>0.05). Serum endocan levels were also similar with febrile neutropenia due to bacterial causes comparing with the idiopathic febril neutropenia. The results of this study showed increased serum endocan in children with leukemia during the febrile neutropenia episode, and no changes of serum endocan levels in children without leukemia without infection/fever. The monitoring of a series of serum endocan levels would be helpful for the course of febrile neutropenia.

  4. Twist2 Is Upregulated in Early Stages of Repair Following Acute Kidney Injury

    Science.gov (United States)

    Grunz-Borgmann, Elizabeth A.; Nichols, LaNita A.; Wang, Xinhui; Parrish, Alan R.

    2017-01-01

    The aging kidney is a marked by a number of structural and functional changes, including an increased susceptibility to acute kidney injury (AKI). Previous studies from our laboratory have shown that aging male Fischer 344 rats (24 month) are more susceptible to apoptosis-mediated injury than young counterparts. In the current studies, we examined the initial injury and early recovery phases of mercuric chloride-induced AKI. Interestingly, the aging kidney had decreased serum creatinine compared to young controls 1 day following mercuric chloride injury, but by day 4, serum creatinine was significantly elevated, suggesting that the aging kidney did not recover from injury. This conclusion is supported by the findings that serum creatinine and kidney injury molecule-1 (Kim-1) gene expression remain elevated compared to young controls at 10 days post-injury. To begin to elucidate mechanism(s) underlying dysrepair in the aging kidney, we examined the expression of Twist2, a helix-loop-helix transcription factor that may mediate renal fibrosis. Interestingly, Twist2 gene expression was elevated following injury in both young and aged rats, and Twist2 protein expression is elevated by mercuric chloride in vitro. PMID:28208580

  5. Murine Typhus: An Important Consideration for the Nonspecific Febrile Illness

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    Gurjot Basra

    2012-01-01

    Full Text Available Murine typhus is a widely distributed flea-borne infection caused by Rickettsia typhi. Symptoms of murine typhus are nonspecific and mimic a variety of other infectious diseases. We herein report a case of murine typhus in an area where the broad use of DDT in the mid-20th century has now made it a rare disease. The patient described presented with headache, fever, and a faint macular rash. Initial laboratory studies revealed a slight transaminase elevation. Further questioning revealed exposure to opossums, prompting the consideration of murine typhus as a diagnosis. Although typhus group antibodies were not present during the patient’s acute illness, empiric therapy with doxycycline was initiated, and the patient defervesced. One month after convalescence, the patient returned to clinic with serum that contained typhus group antibodies with an IgG titer of 1 : 1024. Murine typhus is an important consideration during the workup of a patient with a nonspecific febrile illness. Exposure to reservoir hosts and the flea vector place humans at risk for this disease. Clinician recognition of this entity is required for diagnosis and effective therapy.

  6. Brucellosis is not a major cause of febrile illness in patients at public health care facilities in Binh Thuan Province, Vietnam

    NARCIS (Netherlands)

    T.T.T. Nga; P.J. de Vries; T.H. Abdoel; H.L. Smits

    2006-01-01

    Objective: To determine the presence of brucellosis among patients with acute febrile illness at health care facilities in Binh Thuan province, Vietnam. Method: A retrospective seroepidemiological study on serum samples collected at 13 not adjacent health care facilities using the Rose Bengal test a

  7. Profilaxia intermitente na convulsão febril com diazepam via oral Intermittent prophylaxis in febrile seizures with oral diazepam

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    Marilisa M. Guerreiro

    1992-06-01

    Full Text Available Apresentamos a profilaxia intermitente com diazepam via oral como opção de tratamento para convulsão febril. Justificamos essa proposta diante dos importantes efeitos colaterais que ocorrem com as duas medicações classicamente usadas na profilaxia contínua (fenobarbital e valproato. Foram tratados 19 pacientes. Obtivemos resultados favoráveis, pois apenas um caso apresentou recorrência de convulsão febril em vigência de dose adequada do diazepam. Houve efeitos colaterais transitórios em 36,8% da nossa casuística.Intermittent prophylaxis with oral diazepam is presented as an optional treatment for febrile seizures. This proposition is justified by the severe side effects of the currently used chronic anticonvulsant drug therapy in febrile seizures (phenobarbital and valproate. Nineteen patients aged between 3 months and 5 years were treated. They had either simple or complex febrile seizures. Sixteen patients, had at least one prognostic factor for recurrence of febrile seizures: first febrile seizure before 15 months of age, positive family history for epilepsy or febrile seizures, occurrence of a complex febrile seizure or abnormal neurological examination. Three patients had none, (cases 8, 12 and 13. We recommended 2.5mg b.i.d. for children younger than 12 months, 5mg b.i.d. for children older than 12 months and younger than 3 years, and 7.5 b.i.d. for children older than 3 years. The results showed that only one patient had febrile convulsions while taking adequate diazepam dosage. Transient side effects occurred in 36.8% of the cases.

  8. The effect of antiemetics and reduced radiation fields on acute gastrointestinal morbidity of adjuvant radiotherapy in Stage I seminoma of the testis: a randomized pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Khoo, V.S.; Rainford, K.; Horwich, A.; Dearnaley, D.P. [Royal Marsden NHS Trust, Sutton (United Kingdom)

    1997-12-31

    The purpose of this pilot study was to evaluate the acute gastrointestinal morbidity of adjuvant radiotherapy (RT) for Stage I seminoma of the testis. Ten Stage I patients receiving para-aortic and ipsilateral pelvic nodal (dog-leg) RT provided a toxicity baseline (group A). Twenty Stage I patients randomized to dog-let RT or para-aortic RT (10 per group) were further randomized to received prophylactic ondansetron or expectant therapy with metoclopramide (group B). Daily patient-completed questionnaires evaluated acute toxicity. Dog-leg RT for Stage I seminomas is associated with readily demonstrable gastrointestinal tract (GIT) toxicity. The number of patients in this study is too small to produce definitive results, but there appears to be reduced GIT toxicity with prophylactic antiemetics. The effect of reduced RT fields has been assessed further in the MRC randomized tiral of field sizes (TE10). (Author).

  9. Song practice promotes acute vocal variability at a key stage of sensorimotor learning.

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    Julie E Miller

    Full Text Available BACKGROUND: Trial by trial variability during motor learning is a feature encoded by the basal ganglia of both humans and songbirds, and is important for reinforcement of optimal motor patterns, including those that produce speech and birdsong. Given the many parallels between these behaviors, songbirds provide a useful model to investigate neural mechanisms underlying vocal learning. In juvenile and adult male zebra finches, endogenous levels of FoxP2, a molecule critical for language, decrease two hours after morning song onset within area X, part of the basal ganglia-forebrain pathway dedicated to song. In juveniles, experimental 'knockdown' of area X FoxP2 results in abnormally variable song in adulthood. These findings motivated our hypothesis that low FoxP2 levels increase vocal variability, enabling vocal motor exploration in normal birds. METHODOLOGY/PRINCIPAL FINDINGS: After two hours in either singing or non-singing conditions (previously shown to produce differential area X FoxP2 levels, phonological and sequential features of the subsequent songs were compared across conditions in the same bird. In line with our prediction, analysis of songs sung by 75 day (75d birds revealed that syllable structure was more variable and sequence stereotypy was reduced following two hours of continuous practice compared to these features following two hours of non-singing. Similar trends in song were observed in these birds at 65d, despite higher overall within-condition variability at this age. CONCLUSIONS/SIGNIFICANCE: Together with previous work, these findings point to the importance of behaviorally-driven acute periods during song learning that allow for both refinement and reinforcement of motor patterns. Future work is aimed at testing the observation that not only does vocal practice influence expression of molecular networks, but that these networks then influence subsequent variability in these skills.

  10. Are Surrogate Assumptions and Use of Diuretics Associated with Diagnosis and Staging of Acute Kidney Injury after Cardiac Surgery?

    Science.gov (United States)

    Hussein, Hayder K.; Prabhu, Mahesh; Kanagasundaram, N. Suren

    2012-01-01

    Summary Background and objectives This study measured the association between the Acute Kidney Injury Network (AKIN) diagnostic and staging criteria and surrogates for baseline serum creatinine (SCr) and body weight, compared urine output (UO) with SCr criteria, and assessed the relationships between use of diuretics and calibration between criteria and prediction of outcomes. Design, setting, participants, & measurements This was a retrospective cohort study using prospective measurements of SCr, hourly UO, body weight, and drug administration records from 5701 patients admitted, after cardiac surgery, to a cardiac intensive care unit between 1995 and 2006. Results More patients (n=2424, 42.5%) met SCr diagnostic criteria with calculated SCr assuming a baseline estimated GFR of 75 ml/min per 1.73 m2 than with known baseline SCr (n=1043, 18.3%). Fewer patients (n=484, 8.5%) met UO diagnostic criteria with assumed body weight (70 kg) than with known weight (n=624, 10.9%). Agreement between SCr and UO criteria was fair (κ=0.28; 95% confidence interval 0.25–0.31). UO diagnostic criteria were specific (0.95; 0.94–0.95) but insensitive (0.36; 0.33–0.39) compared with SCr. Intravenous diuretics were associated with higher probability of falling below the UO diagnostic threshold compared with SCr, higher 30-day mortality (relative risk, 2.27; 1.08–4.76), and the need for renal support (4.35; 1.82–10.4) compared with no diuretics. Conclusions Common surrogates for baseline estimated GFR and body weight were associated with misclassification of AKIN stage. UO criteria were insensitive compared with SCr. Intravenous diuretic use further reduced agreement and confounded association between AKIN stage and 30-day mortality or need for renal support. PMID:22246280

  11. Acute toxicity of Roundup® herbicide to three life stages of the freshwater shrimp Caridina nilotica (Decapoda: Atyidae)

    Science.gov (United States)

    Mensah, P. K.; Muller, W. J.; Palmer, C. G.

    Glyphosate based herbicides, including Roundup®, are frequently used in the chemical control of weeds and invading alien plant species in South Africa. These herbicides ultimately get into water courses directly or indirectly through processes such as drifting, leaching, surface runoff and foliar spray of aquatic nuisance plants. Despite their widespread use, no water quality guideline exists to protect indigenous South African freshwater organisms from the toxic effects of these herbicides. The toxicity of the herbicide Roundup® was assessed using three different life stages of the freshwater shrimp Caridina nilotica, a prevalent species in South African freshwater ecosystems. Neonate (7 dph and 40 dph) shrimps were exposed to varying concentrations (1.5-50 mg/L acid equivalence (a.e.)) of the herbicide in 48 and 96 h acute toxicity tests in order to determine the most sensitive life-stage. The results showed neonates to be more sensitive to Roundup® than both juveniles and adults with mean 96 h LC 50 values of 2.5, 7.0 and 25.3 mg/L a.e. respectively. The estimated 96 h LC 50 of neonates is much lower than the application rate (20-30 mg/L a.e.), although the application’s impact will depend on the dilution rate of the applied concentration in the environment. All three life-stages of unexposed animals exhibited active and coordinated movement but exposed shrimps were erratic and slow in their movements, with neonates showing most of these behavioral irregularities. This study shows that low levels of the herbicide Roundup® may adversely affect C. nilotica health and survival. Thus, the herbicide should be carefully managed to minimize any negative impact on non-target freshwater organisms.

  12. MRI abnormalities following febrile status epilepticus in children

    Science.gov (United States)

    Bello, Jacqueline A.; Chan, Stephen; Hesdorffer, Dale C.; Lewis, Darrell V.; MacFall, James; Pellock, John M.; Nordli, Douglas R.; Frank, L. Matthew; Moshe, Solomon L.; Gomes, William; Shinnar, Ruth C.; Sun, Shumei

    2012-01-01

    Objective: The FEBSTAT study is a prospective study that seeks to determine the acute and long-term consequences of febrile status epilepticus (FSE) in childhood. Methods: From 2003 to 2010, 199 children age 1 month to 5 years presenting with FSE (>30 minutes) were enrolled in FEBSTAT within 72 hours of the FSE episode. Of these, 191 had imaging with emphasis on the hippocampus. All MRIs were reviewed by 2 neuroradiologists blinded to clinical details. A group of 96 children with first simple FS who were imaged using a similar protocol served as controls. Results: A total of 22 (11.5%) children had definitely abnormal (n = 17) or equivocal (n = 5) increased T2 signal in the hippocampus following FSE compared with none in the control group (p < 0.0001). Developmental abnormalities of the hippocampus were more common in the FSE group (n = 20, 10.5%) than in controls (n = 2, 2.1%) (p = 0.0097) with hippocampal malrotation being the most common (15 cases and 2 controls). Extrahippocampal imaging abnormalities were present in 15.7% of the FSE group and 15.6% of the controls. However, extrahippocampal imaging abnormalities of the temporal lobe were more common in the FSE group (7.9%) than in controls (1.0%) (p = 0.015). Conclusions: This prospective study demonstrates that children with FSE are at risk for acute hippocampal injury and that a substantial number also have abnormalities in hippocampal development. Follow-up studies are in progress to determine the long-term outcomes in these children. PMID:22843278

  13. Relationship between iron deficiency anemia and febrile convulsion in infants

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    Youn Soo Jun

    2010-03-01

    Full Text Available Purpose : The association between iron deficiency anemia and febrile convulsion in infants has been examined in several studies with conflicting results. Therefore, the authors aimed to evaluate the precise relationship involved. Methods : In this case-control study, the authors assessed 100 children with a diagnosis of febrile convulsion, aged between 9 months and 2 years, during January 2007 to July 2009. The control group consisted of 100 febrile children without convulsion; controls were closely matched to the cases by age, gender, and underlying disease. Results : The mean ages of the febrile convulsion and control group were 16.3¡?#?.4 ;and 15.8¡?#?.1 ;months, respectively, and the two groups had no differences in clinical features. Iron deficiency anemia (Hb &lt;10.5 gm/dL was more frequent in the febrile convulsion group than in the control group, although there was no statistical significance. Unexpectably, the RDW (red blood cell distribution width was significantly lower and the MCNC (mean corpuscular hemoglobin concentration was significantly higher among seizure cases than among the controls (P&lt;0.05. There is no statistical difference between simple and complex febrile groups in the clinical and laboratory profiles. On multiple logistic regression analysis, iron deficiency anemia was more frequent, but the RDW was lower, among the cases with febrile convulsion, compared with the controls. Conclusions : Our study suggests that the iron deficiency anemia is associated with febrile convulsion, and screening for iron deficiency anemia should be considered in children with febrile convulsions.

  14. Extremely high ferritin level after an acute myocardial infarction in an end stage renal disease patient.

    Science.gov (United States)

    Sandhu, Gagangeet; Mankal, Pavan; Gupta, Isha; Tagani, Adrian; Ranade, Aditi; Jones, James; Bansal, Anip

    2014-07-01

    We present here a case of an asymptomatic end-stage renal disease (ESRD) patient, who had an unexplained persistent mild leukocytosis in the setting of an extremely high ferritin level (8,997 ng/ml; reference range: 12 - 300 ng/ml) 3 weeks after she suffered from a myocardial infarction (MI). Infection as the cause of these laboratory abnormalities was ruled out. A week later, the patient was noted to have asymptomatic hypotension (100/60 mmHg; her baseline blood pressure was 120/70 mmHg) during a maintenance hemodialysis session. An echocardiography revealed an interval development of moderate pericardial effusion when compared to her previous echocardiography 4 weeks before. In the setting of a recent MI with other laboratory markers suggesting an ongoing inflammatory process, a tentative diagnosis of Dressler's syndrome was made. A pericardial tap yielded exudative (bloody) fluid, thus, confirming our suspicion. Dressler's syndrome results from an inflammation of the pericardium as a consequence of an underlying autoimmune process few weeks to months after a myocardial infarction or post-cardiac surgery. Although it typically presents with pleuritic chest pain, fever, leukocytosis, and a friction rub; our case illustrates that the initial presentation may be asymptomatic in ESRD patients. For the same reason, it is likely an under-recognized entity in such patients. An unexplained elevated ferritin in an ESRD patient with recent history of MI should prompt an investigation for Dressler's syndrome. In those with associated significant pericardial effusion, daily HD should be initiated and anticoagulation should be avoided. Unlike other ESRD associated pericarditis, steroids and NSAIDs should be avoided in Dressler's syndrome as they may hamper cardiac remodeling in the immediate post-MI period. Colchicine may offer some benefit in patients with associated chest pain. For those failing medical management or manifesting overt signs of tamponade, surgical drainage

  15. Use of a custom RT-PCR array to analyze toxicity pathways at different life stages in Brown Norway Rat Brain following acute Toluene exposure.

    Science.gov (United States)

    To investigate the contribution of different life stages on response to toxicants, we utilized a custom designed RT-PCR array to examine the effects of acute exposure by oral gavage of the volatile organic solvent toluene (0.00, 0.65 or 1.0 glkg) in the brains of ma1e Brown Norwa...

  16. Assessing variability in chemical acute toxicity of unionid mussels: Influence of intra- and inter-laboratory testing, life stage, and species - SETAC Abstract

    Science.gov (United States)

    We developed a toxicity database for unionid mussels to examine the extent of intra- and inter-laboratory variability in acute toxicity tests with mussel larvae (glochidia) and juveniles; the extent of differential sensitivity of the two life stages; and the variation in sensitiv...

  17. Assessing variability in chemical acute toxicity of unionid mussels: Influence of intra- and inter-laboratory testing, life stage, and species

    Science.gov (United States)

    The authors developed a toxicity database for unionid mussels to examine the extent of intra- and interlaboratory variability in acute toxicity tests with mussel larvae (glochidia) and juveniles; the extent of differential sensitivity of the 2 life stages; and the variation in se...

  18. Evaluation of Regional Myocardial Systolic Function in the Early Stage of Acute Myocardial Infarction by Strain Rate Imaging

    Directory of Open Access Journals (Sweden)

    M Esmaeilzadeh

    2009-12-01

    Full Text Available Background: We sought to evaluate the impact of different therapeutic strategies on longitudinal regional myocardial systolic function in the early phase of acute myocardial infarction using strain rate imaging.Methods: A total of 38 patients (34 males, with first acute myocardial infarction (AMI were evaluated. Our patients were divided into 3 groups according to the kind of therapy. The mean age of the patients was 55 ± 9.4 years (range: 39- 75 years. Mean left ventricular ejection fraction (LVEF in the patients was 41 ± 10.7%. Primary percutaneous coronary intervention (PCI was performed in 10 patients. Sixteen patients were treated by thrombolytic therapy using streptokinase (SK and 12 were followed-up conservatively. All patients underwent a comprehensive echocardiography study including SR imaging within 3- 5 days after AMI. The parameters measured included peak systolic strain (peakε and strain rate (SRs, end-systolic strain (εes, post systolic shortening (PSS, time to peak systolic strain rate (tSRs, time to end of shortening (teSRs, post systolic strain (PSε, post-systolic strain index (PSI, PSS ratio (PSS/ εMax and peak postsystolic strain rate (SRPSS. Results: There was not any association either between WMSI and tå (P=0.4, or MI location and PSS ratio (P=0.13. But there was an inverse relationship between WMSI and mean SRS, especially when WMSI was more pronounced. A significant relationship was found between tε and teSRs with the kind of therapy (shorter in PCI group (P= 0.04. Using a simple linear regression model, no association was found between PSS ratio and SRs (â=0.056, P =0.70, PSI and teSRs (β= -0.772, P=0.12. Simple linear regression model showed a weak but significant relationship between PSI and Median tε (β = -0.851, P =0.04; r =0.33.Conclusion: Our study showed that PCI resulted in early recovery of regional systolic function of infarcted myocardium during the early stage of acute myocardial infarction.

  19. The Value of C-Reactive Protein and Procalcitonin in Febrile Neutropenia

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    Solmaz Çelebi

    2009-06-01

    Full Text Available Aim: Febrile neutropenia is the major cause of mortality and morbidity in cancer patients. For this reason, early diagnosis of severe infections and appropriate antimicrobial therapy are very important. The aim of this study was to investigate the difference between C-reactive protein (CRP and procalcitonin in determining the sepsis and its severity. Materials and Method: A total of 30 children (35 episodes with febrile neutropenia who were hospitalized in the Uludag University, Pediatric Hematology and Oncology Unit were included in this prospective study. The blood samples for CRP and procalcitonin were collected daily between 0 to 5th days. Serum CRP and procalcitonin levels were compared with culture positivity, prolonged fever, mucositis and absolute granulosit count (AGC. Results: A total of 16 patients (56% diagnosed with acute leukemia and, 14 patients (46% having solid tumours were evaluated. In sequential analysis of febrile episodes, both the median of procalcitonin and the CRP concentrations showed the same tendency and there was no significant correlation between them (r=0.2, p>0.05. There was no significant association between CRP and procalcitonin among those having positive culture and mucositis. However, CRP values at the 3rd, 4th and 5th days were significantly higher in the patients with AGC100/mm3. Similarly, CRP values were significantly higher at the 1st, 2nd, 3rd and 4th days among the patients having prolonged fever. Conclusion: Our study suggests that there is no difference between CRP and procalcitonin in determining sepsis and its severity. Although procalcitonin is a valuable acute phase reactant in non-neutropenic patients, larger prospective investigations are needed to show the prognostic value of procalcitonin in neutropenic patients. (Journal of Current Pediatrics 2009; 7: 7-12

  20. Effect of Acetaminophen Ingestion on Thermoregulation of Normothermic, Non-Febrile Humans.

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    Josh eFoster

    2016-03-01

    Full Text Available In non-febrile mouse models, high dose acetaminophen administration causes profound hypothermia. However, this potentially hazardous side-effect has not been confirmed in non-febrile humans. Thus, we sought to ascertain whether an acute therapeutic dose (20 mg·kg lean body mass of acetaminophen would reduce non-febrile human core temperature in a sub-neutral environment. Ten apparently healthy (normal core temperature, no musculoskeletal injury, no evidence of acute illness Caucasian males participated in a preliminary study (Study one to determine plasma acetaminophen concentration following oral ingestion of 20 mg·kg lean body mass acetaminophen. Plasma samples (every 20 minutes up to 2-hours post ingestion were analysed via enzyme linked immunosorbent assay. Thirteen (eight recruited from Study one apparently healthy Caucasian males participated in Study two, and were passively exposed to 20°C, 40% r.h. for 120 minutes on two occasions in a randomised, repeated measures, crossover design. In a double blind manner, participants ingested acetaminophen (20 mg·kg lean body mass or a placebo (dextrose immediately prior to entering the environmental chamber. Rectal temperature, skin temperature, heart rate, and thermal sensation were monitored continuously and recorded every ten minutes. In Study one, the peak concentration of acetaminophen (14 ± 4 µg/ml in plasma arose between 80 and 100 minutes following oral ingestion. In Study two, acetaminophen ingestion reduced the core temperature of all participants, whereas there was no significant change in core temperature over time in the placebo trial. Mean core temperature was significantly lower in the acetaminophen trial compared with that of a placebo (p 0.05. The results indicate oral acetaminophen reduces core temperature of humans exposed to an environment beneath the thermal neutral zone. These results suggest that acetaminophen may inhibit the thermogenic mechanisms required to regulate

  1. Crisis febriles simples y complejas, epilepsia generalizada con crisis febriles plus, FIRES y nuevos síndromes

    OpenAIRE

    Noris Moreno de Flagge

    2013-01-01

    Las convulsiones febriles representan la mayoría de las convulsiones en el niño. Se ha descrito que 2-5% de los niños experimentan convulsiones febriles antes de los 5 años de edad, aunque en algunas poblaciones se ha descrito hasta un 15%. Es una causa común de admisión en pediatría y de preocupación de los padres. Puede ser la primera manifestación de una epilepsia. Un 13% de pacientes que desarrollan epilepsia tienen antecedente de convulsiones febriles y 30% de estos pacientes se presenta...

  2. Acute Kidney Injury: Tubular Markers and Risk for Chronic Kidney Disease and End-Stage Kidney Failure.

    Science.gov (United States)

    Tan, Hon Liang; Yap, John Q; Qian, Qi

    2016-01-01

    Acute kidney injury (AKI) is a common clinical syndrome directly related to patient short-term and long-term morbidity and mortality. Over the last decade, the occurrence rate of AKI has been increasing, and there has also been a growing epidemic of chronic kidney diseases (CKD) and end-stage kidney disease (ESRD) linked to severe and repeated episodes of AKIs. The detection and management of AKI are currently far from satisfactory. A large proportion of AKI patients, especially those with preexisting CKD, are at an increased risk of non-resolving AKI and progressing to CKD and ESRD. Proposed pathological processes that contribute to the transition of AKI to CKD and ESRD include severity and frequency of kidney injury, alterations of tubular cell phenotype with cells predominantly in the G2/M phase, interstitial fibrosis and microvascular rarification related to loss of endothelial-pericyte interactions and pericyte dedifferentiation. Innate immune responses, especially dendritic cell responses related to inadequate adenosine receptor (2a)-mediated signals, autophagic insufficiency and renin-angiotensin system activation have also been implicated in the progression of AKI and transitions from AKI to CKD and ESRD. Although promising advances have been made in understanding the pathophysiology of AKI and AKI consequences, much more work needs to be done in developing biomarkers for detecting early kidney injury, prognosticating kidney disease progression and developing strategies to effectively treat AKI and to minimize AKI progression to CKD and ESRD.

  3. Ambulatory monitoring of activity levels of individuals in the sub-acute stage following stroke: a case series

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    Zabjek Karl F

    2007-10-01

    Full Text Available Abstract Background There is an important need to better understand the activities of individual patients with stroke outside of structured therapy since this activity is likely to have a profound influence on recovery. A case-study approach was used to examine the activity levels and associated physiological load of patients with stroke throughout a day. Methods Activities and physiologic measures were recorded during a continuous 8 hour period from 4 individuals in the sub-acute stage following stroke (ranging from 49 to 80 years old; 4 to 8 weeks post-stroke in an in-patient rehabilitation hospital. Results Both heart rate (p = 0.0207 and ventilation rate (p Conclusion Activity levels of individuals with stroke during the day were generally low, though task-related changes in physiologic measures were observed. Large variability in the physiological response to even the activities deemed to be greatest intensity suggests that inclusion of such extended measurement of physiologic measures may improve understanding of physiological profile that could guide elements of the physical therapy prescription.

  4. Regulation of ω-3 Fish Oil Emulsion on the SIRS during the Initial Stage of Severe Acute Pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Jiongxin XIONG; Shikai ZHU; Yu ZHOU; Heshui WU; Chunyou WANG

    2009-01-01

    The aim of this study was to explore the effects of parenteral supplementation with ω-3 fish oil emulsion (Omegaven ) on systemic inflammatory response syndrome (SIRS) during the ini-tial stage of severe acute pancreatitis (SAP).In a prospective,randomized and controlled trial,60 pa-tients with SAP were randomized either to treat with conventional therapy (Con group,n=30) or conventional therapy plus intravenous supplementation with 0-3 fish oil emulsion 0.2 g/kg every day (FO group,n=30).The effects were analyzed by the SIRS-related indexes.The results showed that APACHE-II scores in FO group were significantly lower,and the gap increased much farther after the 4th day than those in Con group (P<0.05).Fluid equilibrium time became shorter markedly in FO group than in Con group (5.1±9.2 days vs 8.4±2.3 days).In FO group,SIRS scores were markedly duced,while IL-10 decreased markedly,most prominently between the 4th and 7th day,and the ratio euteral supplementation with ω-3 fish oil emulsion could efficiently lower the magnitude and persis-tence time of the SIRS,markedly retrieve the unbalance of the pro-/anti-inflammatory cytokines,im-prove severe condition of illness and may provide a new way to regulate the SIRS.

  5. Histoplasmosis among hospitalized febrile patients in northern Tanzania

    OpenAIRE

    Lofgren, Sarah M.; Kirsch, Emily J.; Maro, Venance P.; Morrissey, Anne B.; Msuya, Levina J; Kinabo, Grace D; Saganda, Wilbrod; Diefenthal, Helmut C.; Ramadhani, Habib O.; Wheat, L. Joseph; Crump, John A.

    2012-01-01

    Histoplasmosis may be common in East Africa but the diagnosis is rarely confirmed. We report 9 (0.9%) cases of probable histoplasmosis retrospectively identified among 970 febrile inpatients studied in northern Tanzania. Median (range) age was 31 (6, 44) years, 6 (66.7%) were female, 6 (66.7%) HIV-infected; 7 (77.8%) were clinically diagnosed with tuberculosis or bacterial pneumonia. Histoplasmosis is an important cause of febrile illness in Tanzania but is rarely considered in the differenti...

  6. Serological response to Bartonella species in febrile patients from Nepal.

    Science.gov (United States)

    Myint, Khin Saw Aye; Gibbons, Robert V; Iverson, Jennifer; Shrestha, Sanjaya K; Pavlin, Julie A; Mongkolsirichaikul, Duangrat; Kosoy, Michael Y

    2011-12-01

    The Bartonella-associated illnesses are spread world-wide and involve a broad spectrum of signs and symptoms in humans. Several Bartonella species have been shown to be responsible for cases of febrile illnesses. Little information exists on distribution of Bartonella species and their role in human diseases in Nepal. Our preliminary study, a retrospective serological survey of archived specimens, suggests that Bartonella antibodies are prevalent among febrile patients in the Kathmandu Valley of Nepal.

  7. INTERMITTENT CLONAZEPAM IN THE PREVENTION OF RECURRENT FEBRILE SEIZURES

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    Touran MAHMOUDIAN

    2010-10-01

    Full Text Available ObjectiveTo evaluate the efficacy and common side effects of intermittent clonazepam in febrile  seizures.Materials & MethodsThis study was an experimental trial designed to determine the efficacy of intermittent clonazepam in febrile seizures .Thirty patients with an age range of 6 months to 5 years (60% male, 40% female were studied. Children with a history of psychomotor delay, abnormal  neurological examination, a history of antiepileptic drug consumption, and afebrile seizures were excluded from the study. Patients received a single dose of prophylactic Clonazepam (0.05 mg/kg/ day on the first day of febrile illness and twice daily during the course of fever.An antipyretic medication (Acetaminophen was advised if fever exceeded 38oC. Patients were followed up for one year after the study inclusion date.ResultsThree patients were excluded from study since they didnot follow the tritment and three patients experienced afebrile seizures. Twenty four patients had 162 febrile episodes during the course of the study and all patients were seizure-free after 1 year.ConclusionClonazepam was 100% effective but lethargy and ataxia were common side effects in patients. Fortunately, their parents continued treatment because they had prior awareness of the  possible side effects of clonazepam. Clonazepam is efficacious as an intermittent therapy for febrile seizures if parents are informed of its side effects.Keywords: recurrent febrile seizures, clonazepam, intermittent prophylaxis

  8. MALARIA TYPHOID CO - INFECTION AMONG FEBRILE PATIENTS

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    Samatha

    2015-08-01

    Full Text Available Malaria and typhoid fevers, caused by different organisms are major public health problems in developing countries. People in endemic areas are at risk of both infections concurrently. These are the important cause of fevers in many endemic areas especially during rainy season. Each of these diseases can substantially contribute to mortality if not diagnosed and treated early. The present study was designed to find the Sero prevalence of Malaria, Typhoid and Typho malarial co - infections in febrile patients. METHODS: A cross sectional study was conducted from June 2014 to May 2015. A total of five hundred and eighty two subjects were screened for Malaria and Typhoid is included in study irrespective of their age & sex. Data was analysed on the basis of Demographic factors & Serological results. The results were analysed statistically. RESULTS: The seroprevalence of malarial infection was found to be 58.41% , Typhoid as 1.8 % whereas, True Typho Malarial co - infection was seen in 0.7%. CONCLUSION: The present study reports the Prevalence of Malaria, Typhoid and Typho Malarial Co - infection which are important when planning large scale vaccine trials as well as making health policies and a Protocol is required to treat these infections to limit the mortality and morbidity.

  9. Febrile neutropenia in children treated for malignancy.

    Science.gov (United States)

    Barton, Chris D; Waugh, Lucy K; Nielsen, Maryke J; Paulus, Stéphane

    2015-06-01

    Febrile neutropenia (FN) in children treated for malignancy is a common and direct sequela of chemotherapy. Episodes of FN can be life-threatening, and demand prompt recognition, assessment and treatment with broad spectrum antibiotics. While in the majority of episodes no causal infection is identified, 10-20% are secondary to a bloodstream infection (BSI). A reduction in episodes of BSI could be achieved through robust infection prevention strategies, such as CVL care bundles. Alongside good antimicrobial stewardship, these strategies could reduce the risk of emergent, multi-drug resistant (MDR) infections. Emerging bacterial pathogens in BSI include Viridans Group Streptococci (VGS) and Enterobacteriaceae such as Klebsiella spp. which are known for their ability to carry MDR genes. There is also increased recognition of the role of invasive fungal infection (IFI) in FN, in particular with Aspergillus spp. Novel diagnostics, including multiplex blood and respiratory polymerase chain reaction assays can identify infections early in FN, facilitating targeted therapy, and reducing unnecessary antimicrobial exposure. Given appropriate, and sensitive rapid diagnostics, potential also exists to safely inform the risk assessment of patients with FN, identifying those at low risk of complication, who could be treated in the out-patient setting. Several clinical decision rules (CDR) have now been developed and validated in defined populations, for the risk assessment of children being treated for cancer. Future research is needed to develop a universal CDR to improve the management of children with FN.

  10. Association of Serum Soluble Triggering Receptor Expressed on Myeloid Cells Levels in Malignancy Febrile Neutropenic Patients with Bacteremia and Fungemia

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    Ahmad-Reza Shamshiri

    2011-09-01

    Full Text Available Objective:Infections are the major cause of morbidity and mortality in febrile neutropenic patients with malignancy. Rapid diagnostic tests are needed for prompt diagnosis and early treatment which is crucial for optimal management. We assessed the utility of soluble triggering receptor expressed on myeloid cells (sTREM-1 in the diagnosis of bacteremia and fungemia in febrile neutropenic patients. Methods:Sixty-five febrile neutropenic children with malignancy hospitalized in Mofid Children's Hospital during a period of one year from January 2007 were recruited for this cross sectional study (mean age 66.2± 37 months; 35 females and 30 males. Thirty patients (46.2% had acute lymphoblastic leukemia, 2 (3.1% acute myeloid leukemia, one (1.5% lymphoma and 32 (49.2% were under treatment for solid tumors. Simultaneous blood samples were collected for measurement of serum sTREM-1 levels and for blood cultures which were grown in BACTEC media. Gold standard for the presence of infection was a positive BACTEC culture as a more sensitive method compared to current blood culture techniques. Findings Blood cultures with BACTEC system were positive in 13(20% patients (12 bacterial and one fungal culture. The mean serum sTREM-1 level in BACTEC positive patients was 948.2±592.9 pg/ml but in BACTEC negative cases it was 76.3±118.8 pg/ml (P<0.001. The optimal cut-off point of sTREM-1 for detecting patients with positive result of BACTEC was 525 pg/ml with sensitivity and specificity of 84.6% and 100%, respectively. Conclusion:Our study revealed a significant association between serum sTREM-1 level and bacteremia and fungemia in febrile neutropenic patients suffering malignancy with acceptable sensitivity and specificity.

  11. Induction of immunomodulatory miR-146a and miR-155 in small intestinal epithelium of Vibrio cholerae infected patients at acute stage of cholera

    Science.gov (United States)

    Melgar, Silvia; Aung, Kyaw Min; Rahman, Arman; Qadri, Firdausi; Wai, Sun Nyunt; Shirin, Tahmina

    2017-01-01

    The potential immunomodulatory role of microRNAs in small intestine of patients with acute watery diarrhea caused by Vibrio cholerae O1 or enterotoxigenic Escherichia coli (ETEC) infection was investigated. Duodenal biopsies were obtained from study-participants at the acute (day 2) and convalescent (day 21) stages of disease, and from healthy individuals. Levels of miR-146a, miR-155 and miR-375 and target gene (IRAK1, TRAF6, CARD10) and 11 cytokine mRNAs were determined by qRT-PCR. The cellular source of microRNAs in biopsies was analyzed by in situ hybridization. The ability of V. cholerae bacteria and their secreted products to cause changes in microRNA- and mRNA levels in polarized tight monolayers of intestinal epithelial cells was investigated. miR-146a and miR-155 were expressed at significantly elevated levels at acute stage of V. cholerae infection and declined to normal at convalescent stage (Pcholerae O1 strain C6706 and clinical isolates from two study-participants, caused significant increase in miR-155 and miR-146a by the strain C6706 (Pcholera. The inducer is probably the V. cholerae bacterium. By inducing microRNAs the bacterium can limit the innate immune response of the host, including inflammation evoked by its own secreted factors, thereby decreasing the risk of being eliminated. PMID:28319200

  12. Febrile illness experience among Nigerian nomads

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    Akogun Oladele B

    2012-01-01

    Full Text Available Abstract Background An understanding of the febrile illness experience of Nigerian nomadic Fulani is necessary for developing an appropriate strategy for extending malaria intervention services to them. An exploratory study of their malaria illness experience was carried out in Northern Nigeria preparatory to promoting malaria intervention among them. Methods Ethnographic tools including interviews, group discussions, informal conversations and living-in-camp observations were used for collecting information on local knowledge, perceived cause, severity and health seeking behaviour of nomadic Fulani in their dry season camps at the Gongola-Benue valley in Northeastern Nigeria. Results Nomadic Fulani regarded pabboje (a type of "fever" that is distinct from other fevers because it "comes today, goes tomorrow, returns the next" as their commonest health problem. Pabboje is associated with early rains, ripening corn and brightly coloured flora. Pabboje is inherent in all nomadic Fulani for which treatment is therefore unnecessary despite its interference with performance of duty such as herding. Traditional medicines are used to reduce the severity, and rituals carried out to make it permanently inactive or to divert its recurrence. Although modern antimalaria may make the severity of subsequent pabboje episodes worse, nomads seek treatment in private health facilities against fevers that are persistent using antimalarial medicines. The consent of the household head was essential for a sick child to be treated outside the camp. The most important issues in health service utilization among nomads are the belief that fever is a Fulani illness that needs no cure until a particular period, preference for private medicine vendors and the avoidance of health facilities. Conclusions Understanding nomadic Fulani beliefs about pabboje is useful for planning an acceptable community participatory fever management among them.

  13. Lymphocytes subsets in children with febrile convulsions.

    Science.gov (United States)

    Tuncer, Oğuz; Karaman, Sait; Caksen, Hüseyin; Oner, Ahmet Faik; Odabas, Dursun; Yilmaz, Cahide; Atas, Bülent

    2007-07-01

    In this study, lymphocytes subsets including blood CD3, CD4, CD8, CD16, CD19, and CD56 values were analyzed in children with febrile convulsion (FC) to determine whether there was the association of lymphocytes subsets in the pathogenesis of FC. The study includes 48 children with FC, and 55 healthy age matched control subjects, followed in Yüzüncü Yil University, Faculty of Medicine, Department of Pediatrics between October 2003 and June 2004. Blood CD3, CD4, CD8, CD16, CD19, and CD56 values were examined in the study and control groups. The analyses were performed in the Hematology Laboratory, Yüzüncü Yil University Faculty of Medicine, with flow cytometer device (Coulter Epics XL2, Flow Cytometer). A total of 48 children [17 girls (35.5%) and 31 boys (64.5%)], aged 6 months to 60 months (mean 22.20 +/- 13.75 months) with FC and 55 healthy children [28 girls (51%) and 27 boys (49%)], aged 6 months to 60 months (mean 28.87 +/- 17.04 months) were included in the study. When compared with the control group, the study found significantly decreased blood CD3 and CD4 values in the study group (p .05). When comparing the children with and without positive family history for FC, the study did not find any difference for all CD values between the groups (p >.05). Similarly, there was not significant difference in CD values between the children with simple and complex FC (p >.05). The findings suggested that decreased blood CD3 and CD4 values might be responsible for the infections connected with FC or that they might be related to the pathogenesis of FC in some children.

  14. Crisis febriles simples y complejas, epilepsia generalizada con crisis febriles plus, FIRES y nuevos síndromes

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    Noris Moreno de Flagge

    2013-09-01

    Full Text Available Las convulsiones febriles representan la mayoría de las convulsiones en el niño. Se ha descrito que 2-5% de los niños experimentan convulsiones febriles antes de los 5 años de edad, aunque en algunas poblaciones se ha descrito hasta un 15%. Es una causa común de admisión en pediatría y de preocupación de los padres. Puede ser la primera manifestación de una epilepsia. Un 13% de pacientes que desarrollan epilepsia tienen antecedente de convulsiones febriles y 30% de estos pacientes se presentan con convulsiones recurrentes. Sus características fenotípicas nos permiten, en su gran mayoría, clasificarlas, tomar una actitud terapéutica y elaborar un pronóstico. Se puede describir un espectro de su gravedad desde las convulsiones febriles simples hasta las más complejas como las convulsiones febriles plus que comprenden los síndromes de Dravet y FIRES. En los últimos años se han hecho descubrimientos importantes que definen su carácter genético, entrelazándose cada vez más con diferentes afecciones de tipo epiléptico que nos obliga a un seguimiento neurológico más estrecho de muchos de estos niños con convulsiones febriles. Hacemos una revisión bibliográfica con el objetivo de actualizar los conocimientos sobre las convulsiones febriles, su pronóstico y su relación con los nuevos síndromes epilépticos.

  15. INTERMITTENT CLONAZEPAM IN THE PREVENTION OF RECURRENT FEBRILE SEIZURES

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    BAJOGHLI Shirin MD

    2010-09-01

    Full Text Available ObjectiveTo evaluate the efficacy and common side effects of intermittent clonazepamin febrile seizures.Materials & MethodsThis study was an experimental trial designed to determine the efficacy ofintermittent clonazepam in febrile seizures .Thirty patients with an age rangeof 6 months to 5 years (60% male, 40% female were studied. Children with ahistory of psychomotor delay, abnormal neurological examination, a history ofantiepileptic drug consumption, and afebrile seizures were excluded from thestudy. Patients received a single dose of prophylactic Clonazepam (0.05 mg/kg/day on the first day of febrile illness and twice daily during the course of fever.An antipyretic medication (Acetaminophen was advised if fever exceeded38oC. Patients were followed up for one year after the study inclusion date.ResultsThree patients were excluded from study since they didnot follow the tritmentand three patients experienced afebrile seizures. Twenty four patients had 162febrile episodes during the course of the study and all patients were seizure-freeafter 1 year.ConclusionClonazepam was 100% effective but lethargy and ataxia were common sideeffects in patients. Fortunately, their parents continued treatment because theyhad prior awareness of the possible side effects of clonazepam. Clonazepam isefficacious as an intermittent therapy for febrile seizures if parents are informedof its side effects.

  16. The Best Time for EEG Recording in Febrile Seizure

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    Parvaneh KARIMZADEH

    2014-01-01

    Full Text Available How to Cite This Article: Karimzadeh P, Rezayi A, Togha M, Ahmadabadi F, Derakhshanfar H, Azargashb E, Khodaei F. The Best Time for EEG Recording in Febrile Seizure. Iran J Child Neurol. 2014 Winter; 8(1:20-25.ObjectiveSome studies suggest that detection of epileptic discharge is unusual during the first postictal week of febrile seizure and others believe that EEGs carried out on the day of the seizure are abnormal in as many as 88% of the patients. In thisstudy, we intend to compare early and late EEG abnormalities in febrile seizure.Materials & Methods EEG was recorded during daytime sleep, 24-48 hours (early EEG and 2 weeks (late EEG after the seizure in 36 children with febrile seizure (FS, aged between 3 months and 6 years. EEGs that showed generalized or focal spikes, sharp, spike wave complex, and slowing were considered as abnormal EEG.Abnormalities of the first EEG were compared with those of second EEG.ResultsThe most common abnormal epileptiform discharges recorded in the early EEG were slow waves (27.6% and sharp waves in late EEG (36%. Distribution of abnormalities in early and late EEG showed no significant statistical difference.ConclusionThe early and late EEG recording had the same results in patient with febrile seizure. Reference:Hauser WA, Kurland LT. The epidemiology of epilepsy in Rochester, Minnesota, 1935 through 1967. Epilepsia 1975;16(1:1-66.Freeman JM. Febrile seizures: a consensus of their significance, evaluation, and treatment. Pediatrics 1980;66(6:1009.Waruiru C, Appleton R. Febrile seizures: an update. Arch Dis Child 2004;89(8:751-6.ILAE. Guidelines for epidemiologic studies on epilepsy, International League against Epilepsy. Epilepsia 1993;34(4:592-6.Annegers JF, Hauser WA, Shirts SB, Kurland LT. Factors prognostic of unprovoked seizures after febrile convulsions. N Engl J Med 1987;316(9:493-8.Berg AT, Shinnar S, Darefsky AS, Holford TR, Shapiro ED, Salomon ME, et al. Predictors of recurrent febrile

  17. Acute Toxicity Profile and Compliance to Accelerated Radiotherapy Plus Carbogen and Nicotinamide for Clinical Stage T2-4 Laryngeal Cancer: Results of a Phase III Randomized Trial

    Energy Technology Data Exchange (ETDEWEB)

    Janssens, Geert O., E-mail: g.janssens@rther.umcn.nl [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Terhaard, Chris H. [Department of Radiation Oncology, University Medical Center Utrecht, Utrecht (Netherlands); Doornaert, Patricia A. [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands); Bijl, Hendrik P. [Department of Radiation Oncology, University Medical Center Groningen, Groningen (Netherlands); Ende, Piet van den [Department of Radiation Oncology, Maastricht University Medical Centre, Maastricht (Netherlands); Chin, Alim [Department of Clinical Oncology, Leiden University Medical Centre, Leiden (Netherlands); Pop, Lucas A.; Kaanders, Johannes H. [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)

    2012-02-01

    Purpose: To report the acute toxicity profile and compliance from a randomized Phase III trial comparing accelerated radiotherapy (AR) with accelerated radiotherapy plus carbogen and nicotinamide (ARCON) in laryngeal cancer. Methods and Materials: From April 2001 to February 2008, 345 patients with cT2-4 squamous cell laryngeal cancer were randomized to AR (n = 174) and ARCON (n = 171). Acute toxicity was scored weekly until Week 8 and every 2-4 weeks thereafter. Compliance to carbogen and nicotinamide was reported. Results: Between both treatment arms (AR vs. ARCON) no statistically significant difference was observed for incidence of acute skin reactions (moist desquamation: 56% vs. 58%, p = 0.80), acute mucosal reactions (confluent mucositis: 79% vs. 85%, p = 0.14), and symptoms related to acute mucositis (severe pain on swallowing: 53% vs. 58%, p = 0.37; nasogastric tube feeding: 28% vs. 28%, p = 0.98; narcotic medicines required: 58% vs. 58%, p = 0.97). There was a statistically significant difference in median duration of confluent mucositis in favor of AR (2.0 vs 3.0 weeks, p = 0.01). There was full compliance with carbogen breathing and nicotinamide in 86% and 80% of the patients, with discontinuation in 6% and 12%, respectively. Adjustment of antiemesis prophylaxis was needed in 42% of patients. Conclusion: With the exception of a slight increase in median duration of acute confluent mucositis, the present data reveal a similar acute toxicity profile between both regimens and a good compliance with ARCON for clinical stage T2-4 laryngeal cancers. Treatment outcome and late morbidity will determine the real therapeutic benefit.

  18. Tratamiento ambulatorio del paciente con neutropenia febril Outpatient therapy in patients with febrile neutropenia

    Directory of Open Access Journals (Sweden)

    Andrés Londoño Gallo

    2008-01-01

    Full Text Available

    El tratamiento de los pacientes con neoplasia y neutropenia febril plantea muchas dudas. Una de ellas, que genera ansiedad en el personal de la salud, el paciente y sus familiares, es la necesidad de hospitalización porque ésta implica exponer a gérmenes intrahospitalarios potencialmente resistentes a un paciente cuyo sistema inmune puede no estar en las mejores condiciones; incluso con un aislamiento óptimo existe el riesgo de adquirir una infección nosocomial. Muchos estudios han tratado de validar métodos para clasificar a los pacientes con fiebre y neutropenia en grupos de diferente riesgo, como fundamento para implementar estrategias de tratamiento selectivo; así se ha abierto la posibilidad de utilizar medidas más conservadoras para el tratamiento de los episodios de bajo riesgo, entre ellas la administración de regímenes orales ambulatorios de antibióticos de amplio espectro; ello sin demeritar la necesidad de aplicar un juicio clínico adecuado, hacer un buen seguimiento y tener acceso a la atención médica inmediata. La neutropenia es una de las consecuencias graves de la quimioterapia para el cáncer, y se ha demostrado que el tratamiento del paciente neutropénico febril con antibióticos intravenosos reduce la mortalidad. La terapia oral podría ser una alternativa aceptable para pacientes bien seleccionados. Ella puede mejorar la calidad de vida de los pacientes con cáncer, evitar las complicaciones asociadas con la terapia intravenosa y disminuir los costos del tratamiento.

    Treatment of patients with neoplasia and febrile neutropenia, as a consequence of chemotherapy, poses many doubts, among them the need for hospitalization, since this implies exposure to potentially resistant nosocomial microorganisms. Even under the best isolation techniques, there may

  19. ERITEMA NODOSO Y SINDROME FEBRIL PROLONGADO ASOCIADOS A HIPERPARATIROIDISMO SECUNDARIO

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    Enz P

    2005-06-01

    Full Text Available El hiperparatiroidismo secundario es uno de los principales disturbios causados por la insuficiencia renal crónica, y la paratohormona es considerada una de las toxinas del sindrome urémico. El sindrome febril prolongado secundario a hiperparatiroidismo primario ya ha sido descripto en la literatura, aunque no lo ha sido aun el inducido por hiperparatiroidismo secundario. En el presente reporte se presenta un caso de eritema nodoso y sindrome febril prolongado asociado a hiperparatiroidismo secundario y que resolvió luego de efectuada una paratiroidectomía subtotal.

  20. Comparison of acute versus convalescent stage high-sensitivity C-Reactive protein level in predicting clinical outcome after acute ischemic stroke and impact of erythropoietin

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    Yeh Kuo-Ho

    2012-01-01

    Full Text Available Abstract Background and Aim Currently, no data on the optimal time point after acute ischemic stroke (IS at which high-sensitivity C-reactive protein (hs-CRP level is most predictive of unfavorable outcome. We tested the hypothesis that hs-CRP levels during both acute (48 h after IS and convalescent (21 days after IS phases are equally important in predicting 90-day clinical outcome after acute IS. We further evaluated the impact of erythropoietin (EPO, an anti-inflammatory agent, on level of hs-CRP after acute IS. Methods Totally 160 patients were prospectively randomized to receive either EPO therapy (group 1, n = 80 (5,000 IU each time, subcutaneously at 48 h and 72 h after acute IS, or placebo (group 2, n = 80. Serum level of hs-CRP was determined using ELISA at 48 h and on day 21 after IS and once in 60 healthy volunteers. Results Serum level of hs-CRP was substantially higher in all patients with IS than in healthy controls at 48 h and day 21 after IS (all p 0.5. Multivariate analysis showed that hs-CRP levels (at 48 h and day 21 were independently predictive of 90-day major adverse neurological event (MANE (defined as recurrent stroke, NIHSS≥8, or death (all p Conclusion EPO therapy which was independently predictive of freedom from 90-day MANE did not alter the crucial role of hs-CRP levels measured at 48 h and 21-day in predicting unfavorable clinical outcome after IS.

  1. Expression Profiling after Prolonged Experimental Febrile Seizures in Mice Suggests Structural Remodeling in the Hippocampus

    NARCIS (Netherlands)

    Jongbloets, Bart C; van Gassen, Koen L I; Kan, Anne A; Olde Engberink, Anneke H O; de Wit, Marina; Wolterink-Donselaar, Inge G; Groot Koerkamp, Marian J A; van Nieuwenhuizen, Onno; Holstege, Frank C P; de Graan, Pierre N E

    2015-01-01

    Febrile seizures are the most prevalent type of seizures among children up to 5 years of age (2-4% of Western-European children). Complex febrile seizures are associated with an increased risk to develop temporal lobe epilepsy. To investigate short- and long-term effects of experimental febrile seiz

  2. Influences of early rehabilitation training on treating effects of acute stroke during the recovery stage%早期康复训练对急性脑卒中恢复期疗效的影响

    Institute of Scientific and Technical Information of China (English)

    马旭升

    2001-01-01

    @@Background:To apply early rehabilitation exercises on patients of acute stroke may effectively decrease incidence of convulsion of limbs,enhance the speech and mobility function,increase living qualities of patients and decreases incidents of sequelae and disabilities of patients. Objective:To observe the treating effects of early rehabilitation exercises on patients of acute stroke during recovery stage.

  3. Measurements of procalcitonin facilitate targeting of endotoxin adsorption treatment in febrile neutropenic patients suffering from shock.

    Science.gov (United States)

    Hara, Masaki; Tsuchiya, Ken; Nitta, Kosaku; Ando, Minoru

    2014-01-01

    Immediate initiation of hemoperfusion treatment with polymixin B immobilized fiber (PMX-DHP) is a potent strategy to improve hemodynamics in septic patients with critical circulatory failure. However, it is often difficult to accurately and rapidly differentiate between bacterial infections and non-infectious causes of shock in acutely critically-ill patients. Procalcitonin (PCT) measurements may assist in the early identification of bacterial infection/sepsis and determination of severity in such patients. We present two febrile neutropenic (FN) patients who developed severe shock after chemotherapy for hematological malignancies. PCT levels were markedly elevated in both patients (≥ 10 ng/ml), suggesting a high likelihood of bacterial infectious etiology as the cause of their shock, and thus they were promptly treated with PMX-DHP. Measurements of PCT may facilitate targeting of PMX-DHP treatment among FN patients suffering from shock, which may lead to better prognosis.

  4. Limitations of indium-111 leukocyte scanning in febrile renal transplant patients

    Energy Technology Data Exchange (ETDEWEB)

    Sebrechts, C.; Biberstein, M.; Klein, J.L.; Witztum, K.F.

    1986-04-01

    Indium-111-labeled leukocyte scanning was evaluated as a technique for investigating possible abscess as the cause of fever in 10 renal allograft recipients under therapy for rejection, acute tubular necrosis, or urinary infection. The usefulness of the method in this setting was found to be limited by marked nonspecificity of renal, pulmonary, and other focal leukocyte accumulation. Although wound infections were correctly identified, false-positive scans resulted in multiple nonproductive consultations and radiologic procedures (some invasive) and contributed to the decision to perform one negative exploratory laparotomy. Such generalized nonspecificity in this patient population is in distinct contrast to the experience with this diagnostic test in nontransplant patients, and has not previously been reported. Possible explanations and implications of these findings are discussed. Consequently, great caution is recommended in the use of indium-111 leukocyte scans to diagnose infection in febrile renal transplant patients who present in a similar clinical setting.

  5. Simple Prognostic Criteria can Definitively Identify Patients who Develop Severe Versus Non-Severe Dengue Disease, or Have Other Febrile Illnesses

    OpenAIRE

    Falconar, Andrew K. I.; Romero-Vivas, Claudia M. E.

    2012-01-01

    Background Severe dengue disease (SDD) (DHF/DSS: dengue hemorrhagic fever/dengue shock syndrome) results from either primary or secondary dengue virus (DENV) infections, which occur 4 - 6 days after the onset of fever. As yet, there are no definitive clinical or hematological criteria that can specifically identify SDD patients during the early acute febrile-phase of disease (day 0 - 3: < 72 hours). This study was performed during a SDD (DHF/DSS) epidemic to: 1) identify the DENV serotypes th...

  6. Treatment response for acute depression is not associated with number of previous episodes: lack of evidence for a clinical staging model for major depressive disorder.

    Science.gov (United States)

    Dodd, Seetal; Berk, Michael; Kelin, Katarina; Mancini, Michele; Schacht, Alexander

    2013-09-05

    Mental illness has been observed to follow a neuroprogressive course, commencing with prodrome, then onset, recurrence and finally chronic illness. In bipolar disorder and schizophrenia responsiveness to treatment mirrors these stages of illness progression, with greater response to treatment in the earlier stages of illness and greater treatment resistance in chronic late stage illness. Using data from 5627 participants in 15 controlled trials of duloxetine, comparator arm (paroxetine, venlafaxine, escitalopram) or placebo for the treatment of an acute depressive episode, the relationship between treatment response and number of previous depressive episodes was determined. Data was dichotomised for comparisons between participants who had >3 previous episodes (n=1697) or ≤3 previous episodes (n=3930), and additionally for no previous episodes (n=1381) or at least one previous episode (n=4246). Analyses were conducted by study arm for each clinical trial, and results were then pooled. There was no significant difference between treatment response and number of previous depressive episodes. This unexpected finding suggests that treatments to reduce symptoms of depression during acute illness do not lose efficacy for patients with a longer history of illness.

  7. Identification of Srp9 as a febrile seizure susceptibility gene

    NARCIS (Netherlands)

    Hessel, Ellen V S; de Wit, Marina; Wolterink-Donselaar, Inge G; Karst, Henk; de Graaff, Esther; van Lith, Hein A; de Bruijn, Ewart; de Sonnaville, Sophietje; Verbeek, Nienke E; Lindhout, Dick; de Kovel, Carolien G F; Koeleman, Bobby P C; van Kempen, Marjan; Brilstra, Eva; Cuppen, Edwin; Loos, Maarten; Spijker, Sabine S; Kan, Anne A; Baars, Susanne E; van Rijen, Peter C; Gosselaar, Peter H; Groot Koerkamp, Marian J A; Holstege, Frank C P; van Duijn, Cornelia; Vergeer, Jeanette; Moll, Henriette A; Taubøll, Erik; Heuser, Kjell; Ramakers, Geert M J; Pasterkamp, R Jeroen; van Nieuwenhuizen, Onno; Hoogenraad, Casper C; Kas, Martien J H; de Graan, Pierre N E

    2014-01-01

    OBJECTIVE: Febrile seizures (FS) are the most common seizure type in young children. Complex FS are a risk factor for mesial temporal lobe epilepsy (mTLE). To identify new FS susceptibility genes we used a forward genetic strategy in mice and subsequently analyzed candidate genes in humans. METHODS:

  8. Dravet syndrome or genetic (generalized) epilepsy with febrile seizures plus?

    NARCIS (Netherlands)

    Scheffer, Ingrid E.; Zhang, Yue-Hua; Jansen, Floor E.; Dibbens, Leanne

    2009-01-01

    Dravet syndrome and genetic epilepsy with febrile seizures plus (GEFS+) can both arise due 10 mutations of SCN1A. the gene encoding the alpha 1 pore-forming subunit of the sodium channel. GEFS+ refers to a familial epilepsy syndrome where at least two family members have phenotypes that fit within t

  9. Histamine H1 antagonists and clinical characteristics of febrile seizures

    Directory of Open Access Journals (Sweden)

    Zolaly MA

    2012-03-01

    Full Text Available Mohammed A ZolalyDepartment of Pediatrics, College of Medicine, Taibah University, Al-Madinah Al-Munawarah, Kingdom of Saudi ArabiaBackground: The purpose of this study was to determine whether seizure susceptibility due to antihistamines is provoked in patients with febrile seizures.Methods: The current descriptive study was carried out from April 2009 to February 2011 in 250 infants and children who visited the Madinah Maternity and Children's Hospital as a result of febrile convulsions. They were divided into two groups according to administration of antihistamines at the onset of fever.Results: Detailed clinical manifestations were compared between patients with and without administration of antihistamines. The time from fever detection to seizure onset was significantly shorter in the antihistamine group than that in the nonantihistamine group, and the duration of seizures was significantly longer in the antihistamine group than in the nonantihistamine group. No significant difference was found in time from fever detection to seizure onset or seizure duration between patients who received a first-generation antihistamine and those who received a second-generation antihistamine.Conclusion: Due to their central nervous system effects, H1 antagonists should not be administered to patients with febrile seizures and epilepsy. Caution should be exercised regarding the use of histamine H1 antagonists in young infants, because these drugs could potentially disturb the anticonvulsive central histaminergic system.Keywords: antihistamine, nonantihistamine, histamine H1 antagonist, febrile seizures

  10. Evaluation of febrile neutropenic patients hospitalized in a hematology clinic

    Directory of Open Access Journals (Sweden)

    Mücahit Görük

    2015-12-01

    Conclusions: Febrile neutropenia is still a problem in patients with hematological malignancies. The documentation of the flora and detection of causative agents of infections in each unit would help to decide appropriate empirical therapy. Infection control procedures should be applied for preventing infections and transmissions.

  11. The Long-term Risk of Epilepsy after Febrile Seizures in susceptible subgroups

    DEFF Research Database (Denmark)

    Vestergaard, Mogens; Pedersen, Carsten Bøcker; Sidenius, Per Christian

    2007-01-01

    A family history of seizures, preexisting brain damage, or birth complications may modify the long-term risk of epilepsy after febrile seizures. The authors evaluated the association between febrile seizures and epilepsy in a population-based cohort of 1.54 million persons born in Denmark (1978......-up but was particularly high shortly after the first febrile seizure, especially in children who experienced early (late (>3 years of age) onset of febrile seizures. At 23 years of follow-up, the overall cumulative incidence of epilepsy after febrile seizures was 6.9% (95% confidence interval: 6.5, 7......, or low Apgar scores at 5 minutes....

  12. Clinical profile and treatment outcome of febrile infection-related epilepsy syndrome in South Indian children

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    Sandeep B Patil

    2016-01-01

    Full Text Available Purpose: To describe the clinical features and outcome of febrile infection-related epilepsy syndrome (FIRES, a catastrophic epileptic encephalopathy, in a cohort of South Indian children. Materials and Methods: We performed a retrospective chart review of a cohort of children with previously normal development who presented with status epilepticus or encephalopathy with recurrent seizures following a nonspecific febrile illness during the period between January 2007 and January 2012. They were divided into two groups super refractory status epilepticus (SRSE and refractory status epilepticus (RSE depending on the duration and severity of the seizures. Key Findings: Fifteen children who met the inclusion criteria were included for the final analysis. The age of the children at presentation ranged 3-15 years (median 6.3 years. All the children presented with prolonged or recurrent seizures occurring 1-12 days (median 4 days after the onset of fever. Eight children had SRSE while seven children had refractory seizures with encephalopathy. Cerebrospinal fluid (CSF analysis was done in all the children in the acute phase, and the cell count ranged 0-12 cells/μL (median 2 cells/μL with normal sugar and protein levels. Initial neuroimaging done in all children (MRI in 10 and CT in 5, and it was normal in 13 children. Treatment modalities included multiple antiepileptic drugs (AEDs (4-9 drugs (median 5 drugs. Midazolam (MDZ infusion was administered in seven patients. Eight patients required barbiturate coma to suppress the seizure activity. The duration of the barbiturate coma ranged 2-90 days (median 3 days. Steroids were used in 14 children and intravenous immunoglobulin (2 g/kg in 7 children. Three children died in the acute phase. All children were maintained on multiple AEDs till the last follow-up, the number of AEDs ranged 1-6 (median 5 AEDs. The patients with super refractory status in the acute phase were found to be more severely disabled

  13. Lower-limb MRI in the staging and re-staging of osteonecrosis in paediatric patients affected by acute lymphoblastic leukaemia after therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ippolito, D.; Masetto, A.; Franzesi, C.T.; Bonaffini, P.A.; Sironi, S. [University of Milano-Bicocca Milan, School of Medicine, Monza (Italy); Department of Diagnostic Radiology, H. San Gerardo, Monza (Italy); Sala, A.; Biondi, A. [University of Milano-Bicocca Milan, School of Medicine, Monza (Italy); H. San Gerardo, Department of Paediatric Haematology, Monza (Italy)

    2016-04-15

    To assess the diagnostic value of MRI examination in detecting and monitoring osteonecrotic lesions (ON) in childhood acute lymphoblastic leukaemia (ALL) after chemotherapy (CHT) and/or bone marrow transplantation (BMT). Seventy-three patients (37 males, mean age 12.4 years old) with ALL after treatment underwent a lower-limb MR examination between November 2006 and March 2012. In 47 there was clinical suspicion of ON, 26 were asymptomatic. Studies were performed with a 1 T and a 1.5 T scanner, acquiring short tau inversion recovery (STIR) and T1-weighted sequences in coronal plane from the hips to the ankles. The average acquisition time was 18 min. Considering baseline and follow-up examinations, the overall number of MRI studies was 195. Fifty-four of 73 patients showed ON at MRI study, with an overall number of 323 ON (89 involving articular surface, 24 with joint deformity, JD). Twenty-five of 47 symptomatic patients showed subchondral ON lesions, 11 developed JD. Three of 26 asymptomatic patients showed subchondral bone ON at baseline examination but no JD at follow-up. Twenty-two of 28 BMT, 32/45 CHT patients developed ON. Our MRI protocol proved to be feasible in evaluating ON in paediatric patients. Studies should be addressed only to symptomatic patients. (orig.)

  14. Neurodiagnostic Evaluation of a Child with First Complex Febrile Seizure

    Directory of Open Access Journals (Sweden)

    Arpita S Thakker

    2016-04-01

    Full Text Available Background: Febrile seizure is the most common type of childhood seizure and complex febrile seizure has been associated with the risk of epilepsy. The neurodiagnostic evaluation of a child with first CFS is still unclear. Aim & Objective: To assess the clinical characteristics and diagnostic evaluation of children aged 1 month to 5 years presenting with first Complex Febrile Seizure (CFS and to determine the utility of various investigations in a case of first CFS. Material and Methods: A prospective study was conducted in the pediatric department of a tertiary hospital. Fortynine children aged 1 month-5 years with first CFS fulfilling the inclusion criteria were enrolled in the study over duration of 8-months. All the cases were evaluated with complete blood count, serum calcium, serum electrolytes, Electroencephalography (EEG, CT/MRI and lumbar puncture. Results: The investigation results were analyzed with respect to different CFS parameter like type of seizure (focal or generalized and duration of seizure(less than or more than 15 minutes. Upper respiratory tract infection is the main cause of febrile seizure. The duration of CFS did not vary according to the underlying cause. Serum calcium levels are found to be lower in children with complex febrile seizure. All children with CFS, whether focal or multiple generalized, whether of long or short duration, had a normal EEG. Children who had prolonged focal and multiple generalized seizures had abnormal neuroimaging but it was not statistically significant. Conclusion: We conclude from our study that a child with first CFS may not need EEG and neuroimaging as a diagnostic evaluation test. Hypocalcemia can be identified in these children and can be corrected to stop the seizure. Further studies are needed on a large series of children with first CFS to form guidelines for their neurodiagnostic evaluation.

  15. Subperiosteal hematoma of the iliac bone: imaging features of acute and chronic stages with emphasis on pathophysiology

    Energy Technology Data Exchange (ETDEWEB)

    Guillin, Raphael [Rennes University Hospital, Department of Musculoskeletal Imaging, Rennes Cedex 2 (France); Moser, Thomas [Montreal University Hospital, Department of Musculoskeletal Imaging, Montreal (Canada); Koob, Meriam [Strasbourg University Hospital, Department of Pediatric Imaging, Strasbourg (France); Khoury, Viviane [Mc Gill University Health center, Department of Radiology, Montreal (Canada); Chapuis, Madeleine [Rennes University Hospital, Department of Pediatric Orthopedic Surgery, Rennes (France); Ropars, Mickael [Rennes University Hospital, Department of orthopedic surgery, Rennes (France); Cardinal, Etienne [Radiologie Laennec, Montreal (Canada)

    2012-06-15

    The goal of this work is to describe the radiological appearance and clinical presentation of subperiosteal iliac hematoma and present a review of the literature. We retrospectively reviewed the radiological and clinical files of 19 patients (age range: 12-75; mean: 47) who presented with acute or chronic subperiosteal iliac hematomas. Imaging findings and relevant clinical information were recorded. A thorough literature search was performed to find additional cases of this rare condition. Three young patients presented with acute subperiosteal iliac hematoma following a fall. Clinical presentation was characterized by pain and gait disturbance presumed to result from crural nerve compression. Unilateral or bilateral lenticular hematomas deep in the iliacus muscle were demonstrated by CT for all patients while MRI was also available for two of them. In 16 asymptomatic patients, chronic ossified subperiosteal iliac hematomas were incidentally detected by CT. Progressive ossification of acute hematoma was demonstrated at follow-up in two patients. Subperiosteal iliac hematoma is rare but has typical imaging findings that may present acutely in adolescents or chronically in asymptomatic adults. (orig.)

  16. Evaluation of Serum Sodium Levels in Simple, Multiple and Recurrent Febrile Convulsions

    Directory of Open Access Journals (Sweden)

    Fallah Razieh

    2009-10-01

    Full Text Available Febrile seizure is the most common form of childhood seizures that occur in 2-5% of them. The purpose of this study was to compare serum sodium level in first simple, multiple and recurrent febrile con-vulsions to answer whether serum sodium levels can predict febrile seizure recurrence in 24 hours and in other febrile episodes? In a retrospective study, sodium serum levels of all children aged 6 months to 6 years with final diagnosis of first febrile seizure admitted between March 2004 and August 2005 to Yazd Shaheed Sadoughi Hospital, were compared in simple, multiple and recurrence febrile convulsions. 139 cases with final diagnosis of first febrile seizure found among whom serum sodium checked in 112.54 girls and 58 boys with mean age of 2.01 ± 1.2 years evaluated. Type of febrile convulsions was complex in 36.6% of them. 18% had multiple (occurrence of more than one seizure during the febrile illness seizures and 35.7% showed seizure recurrence in other fever episodes among whom 88% occurred in first year. Mean survival recurrence rate was 6.7 ± 5.9 months. There is no significant differences in age and serum sodium level among the three groups. Association of relative hyponatremia and febrile seizure recurrence was not confirmed. These findings reaffirm the recommendation of the American Academy of Pediatrics to not routinely obtain electrolytes in febrile convulsion unless clinically indicated.

  17. Myocardial T1 maps reflect histological findings in acute and chronic stages of myocarditis in a rat model

    DEFF Research Database (Denmark)

    Jeuthe, Sarah; Wassilew, Katharina; O H-Ici, Darach;

    2016-01-01

    BACKGROUND: Cardiovascular magnetic resonance offers both diagnostic and prognostic information in myocarditis. Using an established animal model of myocarditis, the aim of this study was to measure myocardial T1 before the onset, in the acute and in the chronic phases of the disease and to compare...... conventional histology (HE and Sirius-Red staining) and immunohistochemistry (CD 68) investigations. RESULTS: All immunized rats developed myocarditis (morbidity 100%). Histologically we observed increased wall thickness with biventricular macrophage-rich mixed inflammatory infiltrates. All rats...... with a histologically severe myocarditis showed increased native T1 and decreased post-contrast T1 of the myocardium. CONCLUSIONS: The assessment of native T1 and post-contrast T1 allows accurate differentiation between healthy myocardium and myocardium with inflammation and also between the acute and chronic phases...

  18. Improving the diagnostic accuracy of acute myocardial infarction with the use of high-sensitive cardiac troponin T in different chronic kidney disease stages

    Science.gov (United States)

    Yang, Hongliu; Liu, Jing; Luo, Han; Zeng, Xiaoxi; Tang, Xi; Ma, Liang; Mai, Hongxia; Gou, Shenju; Liu, Fang; Fu, Ping

    2017-01-01

    High-sensitive cardiac troponin T (hs-TnT) is a critical biomarker in diagnosis of acute myocardial infarction (AMI). However, CKD individuals usually have elevated hs-TnT even in the absence of AMI. Our study aimed to explore the optimal cutoff-value of hs-TnT and further to improve diagnostic accuracy of AMI in CKD patients. Clinical data of 489 patients were collected from the maintained database between September 2010 and June 2014. CKD patients with AMI were assigned to CKD+AMI group and CKD patients without AMI were assigned to CKD group. Receiver operating characteristic curves were utilized to derive the optimal cutoff-value. In CKD+STEMI and CKD group, hs-TnT was increased with descending eGFR. In CKD+NSTEMI group, hs-TnT showed an upward trend with increasing SYNTAX Score. In patients with CKD+STEMI, hs-TnT was significantly correlated with SYNTAX Score in CKD stage 2, stage 4 and in total. In CKD patients, the optimal cutoff-value of hs-TnT for diagnosis of AMI was 129.45 ng/l with 75.2% sensitivity and 83.2% specificity. The cutoff-value appeared to be hs-TnT level of 99.55ng/l in CKD stage 3, 129.45 ng/l in CKD stage 4, 105.50 ng/l in CKD stage 5 and 149.35 ng/l in dialysis patients, respectively. In different stages of CKD, eGFR-range-specific optimal cutoff-values should be considered. PMID:28145489

  19. Human T cell recognition of the blood stage antigen Plasmodium hypoxanthine guanine xanthine phosphoribosyl transferase (HGXPRT in acute malaria

    Directory of Open Access Journals (Sweden)

    Woodberry Tonia

    2009-06-01

    Full Text Available Abstract Background The Plasmodium purine salvage enzyme, hypoxanthine guanine xanthine phosphoribosyl transferase (HGXPRT can protect mice against Plasmodium yoelii pRBC challenge in a T cell-dependent manner and has, therefore, been proposed as a novel vaccine candidate. It is not known whether natural exposure to Plasmodium falciparum stimulates HGXPRT T cell reactivity in humans. Methods PBMC and plasma collected from malaria-exposed Indonesians during infection and 7–28 days after anti-malarial therapy, were assessed for HGXPRT recognition using CFSE proliferation, IFNγ ELISPOT assay and ELISA. Results HGXPRT-specific T cell proliferation was found in 44% of patients during acute infection; in 80% of responders both CD4+ and CD8+ T cell subsets proliferated. Antigen-specific T cell proliferation was largely lost within 28 days of parasite clearance. HGXPRT-specific IFN-γ production was more frequent 28 days after treatment than during acute infection. HGXPRT-specific plasma IgG was undetectable even in individuals exposed to malaria for at least two years. Conclusion The prevalence of acute proliferative and convalescent IFNγ responses to HGXPRT demonstrates cellular immunogenicity in humans. Further studies to determine minimal HGXPRT epitopes, the specificity of responses for Plasmodia and associations with protection are required. Frequent and robust T cell proliferation, high sequence conservation among Plasmodium species and absent IgG responses distinguish HGXPRT from other malaria antigens.

  20. Intermittent prophylaxis of recurrent febrile seizures with clobazam versus diazepam.

    Science.gov (United States)

    Sattar, S; Saha, S K; Parveen, F; Banu, L A; Momen, A; Ahmed, A U; Quddush, M R; Karim, M M; Begum, S A; Haque, M A; Hoque, M R

    2014-10-01

    Febrile seizures are the most common type of seizure among children that can be prevented by using prophylactic drugs like Clobazam and Diazepam. The present prospective study was conducted in the Department of Pediatrics, Mymensingh Medical College Hospital and Community Based Medical College Hospital, Bangladesh over a period of 1 year from July 2012 to June 2013 to compare the effectiveness of intermittent Clobazam versus Diazepam therapy in preventing the recurrence of febrile seizures and assessed adverse effects of each drug. A total of 65 patients (32 children administered Clobazam and rest 33 children received Diazepam) of simple and complex febrile seizures aged 6 months to 5 years of both sexes were the study population. Data were collected by interview of the patients, clinical examination and laboratory investigations using the research instrument. Data were analyzed by using Chi-square (χ2) Test, Student's 't' Test and Fisher's Exact Test. For all analytical tests, the level of significance was set at 0.05 and pClobazam and Diazepam groups. Over 31% of patients in Clobazam group who experienced episode of fever within 3 months, 40.6% within 6 months and 9.4% within 9 months compared to 36.4% in Diazepam group within 3 months, 45.5% within 6 months & 12.1% within 9 months after discharge from the hospital. Three (9.4%) patients in Clobazam group and 7(21.3%) in Diazepam group who experienced febrile convulsion during the follow up period. From the data adverse effects within 3 and 6 months experienced by the patient's drowsiness, sedation and ataxia were higher in Diazepam group than those in Clobazam group. However, within 9 months lethargy and irritability were somewhat higher in Clobazam group than those in Diazepam group. The mean duration of hospitalization was significantly higher in Diazepam group compared to Clobazam group (6.0±1.0 vs. 4.6±0.08 days, PDiazepam group had a history of recurrent seizures, whereas 3(9.4%) of 32 children in the

  1. A retrospective study using the pressure ulcer scale for healing (PUSH) tool to examine factors affecting stage II pressure ulcer healing in a Korean acute care hospital.

    Science.gov (United States)

    Park, Kyung Hee

    2014-09-01

    Stage II pressure ulcers (PUs) should be managed promptly and appropriately in order to prevent complications. To identify the factors affecting Stage II PU healing and optimize care, the electronic medical records of patients with a Stage II PU in an acute care hospital were examined. Patient and ulcer characteristics as well as nutritional assessment variables were retrieved, and ulcer variables were used to calculate Pressure Ulcer Scale for Healing (PUSH) scores. The effect of all variables on healing status (healed versus nonhealed) and change in PUSH score for healing rate were compared. Records of 309 Stage II PUs from 155 patients (mean age 61.2 ± 15.2 [range 5-89] years, 182 [58.9%] male) were retrieved and analyzed. Of those, 221 healed and 88 were documented as not healed at the end of the study. The variables that were significantly different between patients with PUs that did and did not heal were: major diagnosis (P = 0.001), peripheral arterial disease (P = 0.007), smoking (P = 0.048), serum albumin ( Braden scale score (P = 0.003), and mean arterial pressure (MAP, mm Hg) (P = 0.026). The Cox proportional hazard model showed a significant positive difference in PUSH score change -indicative of healing - when pressure-redistribution surfaces were used (P <0.001, HR = 2.317), PU size was small (≤3.0 cm2, P = 0.006, HR = 1.670), MAP (within a range of 52-112 mm Hg) was higher P = 0.010, HR = 1.016), and patients were provided multivitamins (P = 0.037, HR=1.431). The results of this study suggest strategies for healing Stage II PUs in the acute care setting should include early recognition of lower-stage PUs, the provision of static pressure-redistribution surfaces and multivitamins, and maintaining higher MAP may facilitate healing and prevent deterioration. Further prospective research is warranted to verify the effect of these interventions.

  2. Dose Supplemental Zinc Prevent Recurrence of Febrile Seizures?

    Directory of Open Access Journals (Sweden)

    Siamak SHIVA

    2011-09-01

    Full Text Available ObjectiveFebrile seizures (FS are the most common form of seizures in children. Previous studies have suggested that zinc may play a role in the prevention of FS. However, there is limited information on the preventative effects of zinc against FS. This study aimed to determine whether prescribing zinc supplements could prevent FS.Materials & MethodsIn a randomized, placebo-controlled trial, 100 children who had experienced simple FS for the first time were recruited. Children in the case group (50 patients were orally administered1mg/kg/day zinc sulfate for 1 year, and children in the control group (50 patients received a placebo. Serum zinc levels in both the control and case groups were measured at the start and at the end of the study,and recurrent cases of FS were recorded.ResultsThe case group consisted of 29 boys (58% and 21 girls (42% with a mean age of 2.06 ± 0.83, and the control group consisted of 31 boys (62% and 19 girls (38% with a mean age of 2.22 ± 1.04 years. An inverse relationship was found between febrile diseases and serum zinc levels. In other words, the occurrence of febrile diseases decreased with an increase in serum zinc levels.Eight children (16% in the case group and 8 in the control group experienced recurrent FS within a year.ConclusionSupplemental doses of zinc (1mg/kg/day reduced the rate of febrile illnesses,but did not prevent the recurrence of FS.

  3. [Complex febrile crises: should we change the way we act?].

    Science.gov (United States)

    Martinez-Cayuelas, E; Herraiz-Martinez, M; Villacieros-Hernandez, L; Cean-Cabrera, L; Martinez-Salcedo, E; Alarcon-Martinez, H; Domingo-Jimenez, R; Perez-Fernandez, V

    2014-11-16

    Introduccion. Las convulsiones febriles son una de las causas mas frecuentes de consulta. Hasta ahora, los pacientes con convulsiones febriles complejas (CFC) deben ingresar, dado el mayor porcentaje de epilepsia y complicaciones agudas descrito clasicamente. En la actualidad hay estudios que apoyan ser menos invasivos en el abordaje de estos pacientes. Objetivo. Describir las caracteristicas de los pacientes ingresados por CFC y proponer un nuevo protocolo de actuacion. Pacientes y metodos. Analisis retrospectivo de historias clinicas de ingresados por CFC (enero de 2010-diciembre de 2013). Se ofrecen datos epidemiologicos, clinicos, pruebas complementarias y evolucion. Resultados. Las CFC suponian un 4,2% de los ingresos de neuropediatria (n = 67). Edad media al evento: 25 meses. El 47% tenia antecedentes familiares patologicos, y el 31%, antecedentes personales de convulsion febril previa. En el 54% de los pacientes, la CFC duro menos de cinco minutos; hubo recurrencia, la mayoria con un total de dos crisis y durante el primer dia (las CFC por recurrencia son las mas frecuentes). De las pruebas complementarias realizadas, ninguna de ellas sirvio como apoyo diagnostico en el momento agudo. Durante su seguimiento, cinco pacientes presentaron complicaciones. Los pacientes con antecedentes familiares de convulsiones febriles presentan mayor riesgo de epilepsia o recurrencia (p = 0,02), sin diferencias significativas respecto a la edad, numero de crisis, intervalo de fiebre, estado epileptico o tipo de CFC. Conclusiones. Las CFC no asocian mayores complicaciones agudas; las exploraciones complementarias no permiten discriminar precozmente a los pacientes de riesgo. Su ingreso podria evitarse en ausencia de otros signos clinicos y limitarse a casos seleccionados.

  4. IL-1β: an important cytokine associated with febrile seizures?

    Institute of Scientific and Technical Information of China (English)

    Hong-Mei Yu; Wan-Hong Liu; Xiao-Hua He; Bi-Wen Peng

    2012-01-01

    Febrile seizures (FSs) are the most common convulsions in childhood.Studies have demonstrated a significant relationship between a history of prolonged FSs during early childhood and temporal sclerosis,which is responsible for intractable mesial temporal lobe epilepsy.It has been shown that interleukin-1β (IL-1β) is intrinsically involved in the febrile response in children and in the generation of FSs.We summarize the gene polymorphisms,changes of IL-1β levels and the putative role of IL-1 β in the generation of FSs.IL-1β could play a role either in enhancing or in reducing neural excitability.If the enhancing and reducing effects are balanced,an FS does not occur.When the enhancing effect plays the leading role,an FS is generated.A mild imbalance can cause simple FSs while a severe imbalance can cause complex FSs and febrile status epilepticus.Therefore,anti-IL-1 β therapy may help to treat FSs.

  5. Determination of acute and early life stage toxicity of fat-plant effluent using zebrafish (Danio rerio).

    Science.gov (United States)

    Sişman, Turgay; Incekara, Umit; Yildiz, Yalçin Sevki

    2008-08-01

    The present study examines the effects of an effluent from a fat plant (FP) on zebrafish (Danio rerio) embryos and larvae using the whole effluent toxicity testing methods (WET). The method is based on acute toxicity using 96-h larval mortality and chronic toxicity using endpoints such as the time to hatch, hatching success, deformity, growth rate, swim-up failure, accumulative mortality, and sex ratio. On the basis of larval mortality the 96-h LC(50) (the concentration was lethal to 50% of newly hatching zebrafish larvae) was 68.9%. In chronic toxicity test, newly fertilized embryos (effluent concentrations in a 24-h static renewal system at (27 +/- 0.5) degrees C until 15-day posthatch. The results showed that all chronic endpoints were significantly different from the control at 50% dilution. Embryos began to show lesions on third day at higher concentrations (12, 25, 50% FP effluent concentrations). Treatment group of 25% dilution showed delayed time to hatch. Morphological abnormalities were observed in newly hatched larvae at 25 and 50% FP effluent concentrations. At 25% dilution, sex ratio of larvae was alternated and there was feminization phenomenon. On the basis of the study, the FP effluent tested here may cause increasing embryotoxicity in the zebrafish embryos. We conclude that the test using zebrafish is feasible to evaluate both acute and chronic toxicities of industrial effluents.

  6. Spontaneous Hemocholecyst in an End-Stage Renal Failure Patient on Low Molecular Weight Heparin Hemodialysis

    Directory of Open Access Journals (Sweden)

    Konstantinos Blouhos

    2012-01-01

    Full Text Available The present paper describes a case of spontaneous hemocholecyst in a patient with end-stage renal failure on low molecular weight heparin hemodialysis. The patient presented with acute right upper quadrant pain. An initial ultrasound scan demonstrated a distended gallbladder containing echogenic bile without stones. During hospitalization the patient became febrile, and jaundiced, developed leukocytosis, and had an elevation in serum bilirubin, transaminases, and alkaline phosphatase. A new ultrasound demonstrated a thick-walled gallbladder containing echogenic bile and pericholecystic fluid. MRI depicted a distended gallbladder containing material of mixed signal intensity and a normal biliary tract. Open cholecystectomy revealed a gallbladder filled with blood and clots, and transcystic common bile duct exploration flushed blood clots out of the bile duct. To our knowledge this is the second case of spontaneous hemocholecyst reported in the literature as a consequence of uremic bleeding and LMWH hemodialysis in the absence of other pathology.

  7. Non increased neuron-specific enolase concentration in cerebrospinal fluid during first febrile seizures and a year follow-up in pediatric patients No incrementos en la concentración de enolasa específica de neurona en el líquido cefalorraquídeo durante el primer ataque febril y al año en pacientes pediátricos

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    ALBERTO J. DORTA-CONTRERAS

    1998-09-01

    Full Text Available Febrile seizures are the commonest acute neurological disorder of early childhood. Studies suggested that febrile seizures are previous acute events from a more serious neurological problem. Due to neuron-specific enolase is generally accepted as a marker for neuropathological processes in the brain, 16 pediatric patients were studied during their first seizures and a year after it. Neuron-specific enolase in cerebrospinal fluid and blood were analysed by an immune enzyme assay. Non pathological neuron-specific enolase values were obtained in both periods in the group of patients. There were no significative differences when paired series statistics test was performed with 95% of confidence. Neuron-specific enolase appears not to be a marker for febrile seizures because its concentration not be increased in cerebrospinal fluid in this group of patients.Los ataques febriles constituyen el trastorno neurológico agudo más común en la infancia temprana. Existen estudios que sugieren que los ataques febriles son eventos agudos previos a problemas neurológicos más severos. Debido a que la enolasa específica de neurona está aceptada generalmente como marcador de procesos neuropatológicos en el cerebro, se estudiaran 16 pacientes pediátricos durante su primer ataque y al año de este. La enolasa específica de neurona en el líquido cefalorraquídeo y sangre fue analizada por una prueba inmunoenzimática. No se obtuvieron valores patológicos de enolasa específica de neurona en ambos períodos en el grupo de pacientes. No hubo diferencias significativas al aplicar el test de series apareadas con un 95% de confianza. La enolasa específica de neurona parece no ser un marcador para ataques febriles porque su concentración no se incrementa en este grupo de pacientes.

  8. Effects of acupuncture therapy on plasma neuropeptide Y levels and resuscitation in patients with very early stage acute cerebral infarction A randomized controlled study

    Institute of Scientific and Technical Information of China (English)

    Guozhong Zhang; Lina Ning; Sujuan Gao

    2009-01-01

    BACKGROUND: It is known that acupuncture therapy can decrease plasma neuropeptide Y (NPY) levels in patients with cerebral infarction, but different types of acupuncture therapy used in various stages of cerebral infarction have not been evaluated.OBJECTIVE: To explore the effect of acupuncture therapy on resuscitation (Xingnao Kaicliao) and plasma NPY levels in patients with very early stage acute cerebral infarction.DESIGN, TIME AND SETTING: This case-controlled study was performed at the Affiliated Hospital of the Medical College of the Chinese People's Armed Police Force between September 2004 and October 2005.PARTICIPANTS: Sixty patients with acute cerebral infarction of ≤ 6 hours were used in this study. Patients were randomly divided into an acupuncture therapy group (n = 30) and a routine treatment group (n = 30). Another 30 healthy subjects were used as the control group.METHODS: The acupuncture therapy of Xingnao Kaiqiao used in the acupuncture therapy group was based on routine western medical treatment and was performed at bilateral Neiguan (PC6) using the twirling, reinforcing-reducing method, Renzhong (DU26) using heavy bird-pecking needling, Sanyinjiao (SP6) using reinforcing and reducing by lifting and thrusting the needle, Jiquan (HT1), Weizhong (BL40) and Chize (LU5) using reinforcing and reducing by lifting and thrusting the needle. The acupuncture lasted for 14 days. Patients in the routine treatment group underwent routine medical treatment and no intervention was given to subjects in the control group.MAIN OUTCOME MEASURES: A 4 mL venous blood sample was obtained at different time points, I.e., immediately after hospitalization, the next morning, 7 and 14 days after treatment, to measure plasma NPY levels pre- and post-treatment using the radio-immunity method.RESULTS: The plasma NPY levels were significantly higher in both the routine treatment group and the acupuncture therapy group than in the control group pre- and post-treatment (P < 0

  9. The Role of Seizure-Related SEZ6 as a Susceptibility Gene in Febrile Seizures

    Directory of Open Access Journals (Sweden)

    John C. Mulley

    2011-01-01

    Full Text Available Sixty cases of febrile seizures from a Chinese cohort had previously been reported with a strong association between variants in the seizure-related (SEZ 6 gene and febrile seizures. They found a striking lack of genetic variation in their controls. We found genetic variation in SEZ6 at similar levels at the same DNA sequence positions in our 94 febrile seizure cases as in our 96 unaffected controls. Two of our febrile seizure cases carried rare variants predicted to have damaging consequences. Combined with some of the variants from the Chinese cohort, these data are compatible with a role for SEZ6 as a susceptibility gene for febrile seizures. However, the polygenic determinants underlying most cases of febrile seizures with complex inheritance remain to be determined.

  10. [Effect of complications in the acute period of myocardial infarction on physical exertion tolerance at the hospital stage of rehabilitation].

    Science.gov (United States)

    Al'khimovich, V M; Golubev, V G; Rudina, M D; Rusetskaia, V G

    1988-11-01

    Physical stress tolerance and its hemodynamic support were examined in 95 patients with early myocardial infarction, 50 normal subjects and 25 coronary patients. It is suggested that the stress tolerance test is advisable at an early stage of complicated macrofocal myocardial infarction. The safety of the test improves considerably where it is performed under continuous electrocardiographic and chest-rheographic control. An abnormal diastolic impedance wave, emerging during exercise, may serve an additional diagnostic indicator of stress intolerance.

  11. Increase in Antibiotic-Resistant Gram-Negative Bacterial Infections in Febrile Neutropenic Children

    OpenAIRE

    Lee, Joon Hee; Kim, Seul-Ki; Kim, Seong Koo; Han, Seung Beom; Lee, Jae Wook; Lee, Dong-Gun; Chung, Nack-Gyun; Cho, Bin; Jeong, Dae Chul; Kang, Jin Han; Kim, Hack-Ki

    2016-01-01

    Background The incidence of bacteremia caused by Gram-negative bacteria has increased recently in febrile neutropenic patients with the increase of antibiotic-resistant Gram-negative bacterial infections. This study aimed to identify the distribution of causative bacteria and the proportion of antibiotic-resistant bacteria in bacteremia diagnosed in febrile neutropenic children. Materials and Methods The medical records of febrile neutropenic children diagnosed with bacteremia between 2010 an...

  12. Clinical Observation in 45 Cases of Hemorrhagic Apoplexy of the Acute Stage Treated by Promoting Blood Circulation and Removing Blood Stasis

    Institute of Scientific and Technical Information of China (English)

    孙国柱

    2003-01-01

    To explore the therapeutic effects of the method of promoting blood circulation and removing blood stasis on hemorrhagic apoplexy of acute stage, 45 cases were treated by the method and observed for their conscious state and motor function, which were compared with 40 cases treated with regular western drugs. The results showed that the effective rate in the treated group was 82.2% and that in control group 60% with a significant difference (P<0.05) between the two groups. In the treated group, the scores of the conscious state and the motor function after treatment were elevated dramatically (P<0.01), indicating a much better effect in the treated group than in the control group.

  13. 特发性面神经麻痹急性期的综合治疗%Comprehensive treatment for idiopathic facial paralysis at acute stage

    Institute of Scientific and Technical Information of China (English)

    江伟; 何传斌; 周俊明

    2012-01-01

    目的 观察特发性面神经麻痹急性期患者综合治疗的效果.方法 综合运用药物治疗、物理疗法、康复治疗和心理治疗的方法治疗35例特发性面神经麻痹急性期患者,并观察疗效.结果 35例患者经10 d治疗后,痊愈14例,显效15例,好转4例,无效2例,显效率达82.9%.1个月后随访,痊愈25例,显效8例,好转2例.显效率达94.3%.结论 运用综合方法治疗特发性面神经麻痹急性期患者,临床疗效显著.%Objective To study the effect of combined treatment in 35 cases of idiopathic facial paralysis at acute stage. Methods The integrated application of drug medication, physical therapy, therapeutic rehabilitation and psychological treatment was applied in these patients. Results After treatment for10 days, 14 cases were cured, 15 cases with much improvement, 4 cases with amelioration and 2 cases with failure, and the markedly effective rate was 82.9%. After follow - up for 1 month, 25 patients cured, marked effectiveness in 8 and improvement in 2 cases. The markedly effective rate was 94.3%. Conclusion The efficacy of comprehensive treatment for patients with idiopathic facial paralysis at acute stage is significant .

  14. EEG disorder in patients with complex febrile convulsion and underlying risk factors

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    Mitra Hemmati

    2014-08-01

    Full Text Available Background: Febrile seizures are the most common convulsion disorder in childhood. The possible risk of developing epilepsy in febrile seizures is about 2-10%. EEG is helpful to diagnose epilepsy; however, there are controversies about the abnormal EEG and associated risk factors .The aim of this study was to determine EEG abnormality and effective risk factors in patients with complex febrile seizures. Methods: This study was conducted on the patients with complex febrile seizures in 2009-2010.EEG was performed on all children 6 to 10 days after seizure and reported by a neurologist. Demographic data and risk factors, including age, sex, family history of epilepsy and febrile convulsions, presentation of seizure, postictal neurological disorder were documented by a checklist and their association with EEG was analyzed. Results: 111 patients with complex febrile seizure, 70 girls and 41 boys, with the mean age of 3.4±20 months were studied. EEG was abnormal in 37.8% of patients, 9% were epileptic form abnormality and 28.8% were nonspecific abnormal. There was a statistically significant association between EEG abnormality in patients with focal seizures, family history of febrile seizures and postictal neurologic disorder (p<0.05. Conclusion: The results of this study showed abnormality of EEG in complex febrile convulsions in 37.8% of patients, which was significantly higher in patients with postictal neurological disorder, focal seizures and family history of febrile seizure.

  15. Relationship between bulbocavernosus reflex, patellar reflex and rehabilitation during acute stage of cervical spinal injury%颈髓损伤急性期球海绵体反射、膝反射与康复的关系

    Institute of Scientific and Technical Information of China (English)

    杨茂伟; 朱悦; 吕刚; 范广宇; 薛明

    2003-01-01

    AIM: To investigate the relationship between bulbocavemous refiex(BTR),patallar reflex(PTR) and rehabilitation during acute stage of cervical spinalinjury. METHODS: 73 cases of a class frankel cervical spinal injury patientswere examined with BTR and PTR and recorded the time of the two reflexes,then follow-up after 6 months to monitor recovery situation. RESUULTS: Therewere 28 cases of positive BCR within the first 72 h (38%), 7 cases of improvedcondifions(25% ); there were 13 cases of PTR positive (17%), 13 cases ofimproved status(100% ). CONCLUSION: BCR and PTR are the sign of ima-proved status and better rehabilitation during the acute stage.

  16. Effect of Astragalus Injection on Left Ventricular Remodeling in Aged Patients with Acute Early-stage Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jin-guo (张金国); LIU Ya-jie(刘雅洁); GAO Dong-sheng (高东升); YANG Na (杨娜); LIU Li-xin (刘立新); HE Hua (何华); DONG Hai-xin (董海新); LIU Xue-ling (刘雪玲); CHEN Ting (陈廷); WANG Xue-zhong (王学忠)

    2003-01-01

    Objective: To observe the effect of Astragalus Injection (AI) on left ventricular remodeling in aged patients with acute myocardial infarction (AMI).Methods: Patients with AMI were randomly divided into the AI group (46 cases) treated with AI and the control group (46 cases) treated conventionally. Left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), anterior endocardial segmental length (ASL) and posterior endocardial segmental length (PSL) were all assessed by echocardiogram after 1 week and 4 weeks treatment. The cardiac systolic and diastolic functions were detected by nuclide gating cardiac blood pool imaging at the 4th week. Results: After four weeks' treatment, no obvious change of LVEDVI, LVESVI and ASL in the AI group was found, but these indexes increased significantly in the control group, with significant difference shown between the two groups (P<0.05). As compared with the control group, the left ventricular ejection fraction (LVEF), left ventricular peak ejecting rate (LVPER) and left ventricular peak filling rate (LVPFR) were heightened, the time for peak filling rate (LVTPFR) in the left ventricle was shortened in the AI group.Conclusion: AI is one of the effective drugs in reversing left ventricular remodeling in aged patients with AMI.

  17. Heart Rate Variability in Patients with Acute Ischemic Stroke at Different Stages of Renal Dysfunction: A Cross-sectional Observational Study

    Science.gov (United States)

    Wei, Lin; Zhao, Wen-Bo; Ye, Huan-Wen; Chen, Yan-Hua; Zhang, Xiao-Pei; Huang, Yan; Cai, Ye-Feng; Chen, Quan-Fu; Pan, Su-Yue

    2017-01-01

    , and LF; the Oxfordshire Community Stroke Project (t = −2.38, P = 0.018) was related to the SDANN index. Conclusions: Autonomic dysfunction is aggravated with the progression of eGFR stage in patients with acute ischemic stroke; the eGFR is an independent factor of LF/HF in the adjusted models. Stroke severity and a history of diabetes are more significantly associated with HRV in patients with acute ischemic stroke at different stages of renal dysfunction. PMID:28303846

  18. Acute toxicity of three fire-retardant and two fire-suppressant foam formulations to the early life stages of rainbow trout (Oncorhynchus mykiss)

    Science.gov (United States)

    Gaikowski, Mark P.; Hamilton, Steven J.; Buhl, Kevin J.; McDonald, Susan F.; Summers, Cliff H.; Linder, G.; Krest, S.; Sparling, D.; Little, E.

    1996-01-01

    Laboratory studies were conducted with five early life stages of rainbow trout, Oncorhynchus mykiss, to determine the acute toxicities of five fire-fighting chemical formulations in standardized soft and hard water. Eyed egg, embryo–larvae, swim-up fry, and 60- and 90-d posthatch juveniles were exposed to three fire retardants (Fire-Trol LCG-R, Fire-Trol GTS-R, and Phos-Chek D75-F) and two fire-suppressant foams (Phos-Chek WD-881 and Silv-Ex). Swim-up fry were generally the most sensitive life stage, whereas the eyed-egg was the least sensitive. Toxicity of fire-fighting formulations was greater in hard water than in soft water for all life stages tested with Fire-Trol GTS-R and Silv-Ex and for 90-d-old juveniles tested with Fire-Trol LCG-R. The fire-suppressant foams were more toxic than the fire retardants. The 96-h median lethal concentrations (LC50s) were ranked from the most toxic to the least toxic formulation as follows (ranges are the lowest and highest 96-h LC50 calculated for each formulation): Phos-Chek WD-881 (11–44 mg/L), Silv-Ex (11–78 mg/L), Phos-Chek D75-F (218–>3,600 mg/L), Fire-Trol GTS-R (207–>6,000 mg/L), and Fire-Trol LCG-R (872–>10,000 mg/L). Toxicity values suggest that accidental entry of fire-fighting chemicals into aquatic environments could adversely affect fish populations.

  19. Prophylactic drug management for febrile seizures in children

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    Martin Offringa

    Full Text Available BACKGROUND Febrile seizures occurring in a child older than one month during an episode of fever affect 2% to 4% of children in Great Britain and the United States and recur in 30%. Rapid-acting antiepileptics and antipyretics given during subsequent fever episodes have been used to avoid the adverse effects of continuous antiepileptic drugs. OBJECTIVE To evaluate the effectiveness and safety of antiepileptic and antipyretic drugs used prophylactically to treat children with febrile seizures. METHODS Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL (The Cochrane Library 2011. Issue 3; MEDLINE (1966 to May 2011; EMBASE (1966 to May 2011; Database of Abstracts of Reviews of Effectiveness (DARE (May 2011. No language restrictions were imposed. We also contacted researchers in the field to identify continuing or unpublished studies. Selection criteria: Trials using randomized or quasi-randomized patient allocation that compared the use of antiepileptic or antipyretic agents with each other, placebo or no treatment. Data collection and analysis: Two review authors (RN and MO independently applied pre-defined criteria to select trials for inclusion and extracted the pre-defined relevant data, recording methods for randomization, blinding and exclusions. Outcomes assessed were seizure recurrence at 6, 12, 18, 24, 36 months and at age 5 to 6 years in the intervention and non-intervention groups, and adverse medication effects. The presence of publication bias was assessed using funnel plots. MAIN RESULTS Thirty-six articles describing 26 randomized trials with 2740 randomized participants were included. Thirteen interventions of continuous or intermittent prophylaxis and their control treatments were analyzed. Methodological quality was moderate to poor in most studies. We could not do a meta-analysis for 8 of the 13 comparisons due to insufficient numbers of trials. No significant benefit for valproate, pyridoxine

  20. Prevention of febrile nonhemolytic transfusion reaction with leucocyte filtrated concentrates

    Institute of Scientific and Technical Information of China (English)

    ZHAO Shu-ming; XIANG Guo-chun; ZHANG Jia-si; CHENG Xiao-ling; LI Ru-qing

    2002-01-01

    Objective: To assess the clinical efficiency of the transfusion of leucocyte filtrated RBC concentrates to prevent febrile nonhemolytic transfusion reactions (FNHTRs). Methods: One hundred patients with liver cirrhosis, gastric ulcer or cancer were subjected to receive RBC concentrates after leucocyte filtration.Another 50 patients with similar diseases were selected to receive non-filtrated RBC concentrates. The incidence of FNHTRs in all patients was investigated. Results: There was no FNHTR in 100 transfusions with leucocyte filtrated RBC concentrates, while FNHTRs occurred in 8 of 50 patients with non-filtrated RBC concentrates, with the incidence of 160%. Conclusion: FNHTRs to RBC transfusion can be prevented with leucocyte filtration.

  1. Assessment of early life stage mahi-mahi windows of sensitivity during acute exposures to Deepwater Horizon crude oil.

    Science.gov (United States)

    Mager, Edward M; Pasparakis, Christina; Schlenker, Lela S; Yao, Zongli; Bodinier, Charlotte; Stieglitz, John D; Hoenig, Ronald; Morris, Jeffrey M; Benetti, Daniel D; Grosell, Martin

    2017-01-27

    Windows of exposure to a weathered Deepwater Horizon oil sample (slick A) were examined for early life stage mahi-mahi (Coryphaena hippurus) to determine whether there are developmental periods of enhanced sensitivity during the course of a standard 96-h bioassay. Survival was assessed at 96 h following oil exposures ranging from 2 h to 96 h and targeting 3 general periods of development, namely the prehatch phase, the period surrounding hatch, and the posthatch phase. In addition, 3 different oil preparations were used: high- and low-energy water accommodated fractions of oil and very thin surface slicks of oil (∼1 μm). The latter 2 were used to distinguish between effects due to direct contact with the slick itself and the water underlying the slick. Considering the data from all 3 exposure regimes, it was determined that the period near or including hatch was likely the most sensitive. Furthermore, toxicity was not enhanced by direct contact with slick oil. These findings are environmentally relevant given that the concentrations of polycyclic aromatic hydrocarbons eliciting mortality from exposures during the sensitive periods of development were below or near concentrations measured during the active spill phase. Environ Toxicol Chem 2016;9999:1-9. © 2016 SETAC.

  2. Treatment of febrile neutropenia and prophylaxis in hematologic malignancies: a critical review and update.

    Science.gov (United States)

    Villafuerte-Gutierrez, Paola; Villalon, Lucia; Losa, Juan E; Henriquez-Camacho, Cesar

    2014-01-01

    Febrile neutropenia is one of the most serious complications in patients with haematological malignancies and chemotherapy. A prompt identification of infection and empirical antibiotic therapy can prolong survival. This paper reviews the guidelines about febrile neutropenia in the setting of hematologic malignancies, providing an overview of the definition of fever and neutropenia, and categories of risk assessment, management of infections, and prophylaxis.

  3. Triage of febrile children at a GP cooperative : determinants of a consultation

    NARCIS (Netherlands)

    Monteny, Miriam; Berger, Marjolein Y.; van der Wouden, Johannes C.; Broekman, Berth J.; Koes, Bart W.

    2008-01-01

    Background Most febrile children contacting a GP cooperative are seen by a GP, although the incidence of serious illness is low. The guidelines for triage might not be suitable in primary care. Aim To investigate the determinants related to the outcome of triage in febrile children. Design of study

  4. Pediatric febrile urinary tract infections: the current state of play

    Directory of Open Access Journals (Sweden)

    Hewitt Ian K

    2011-11-01

    Full Text Available Abstract Studies undertaken in recent years have improved our understanding regarding the consequences and management of febrile urinary tract infections (UTIs, which are amongst the most common serious bacterial infections in childhood, with renal scarring a frequent outcome. In the past pyelonephritic scarring of the kidney, often associated with vesico-ureteral reflux (reflux nephropathy was considered a frequent cause of chronic renal insufficiency in children. Increasing recognition as a consequence of improved antenatal ultrasound, that the majority of these children had congenital renal hypo-dysplasia, has resulted in a number of studies examining treatment strategies and outcomes following UTI. In recent years there is a developing consensus regarding the need for a less aggressive therapeutic approach with oral as opposed to intravenous antibiotics, and less invasive investigations, cystourethrography in particular, following an uncomplicated first febrile UTI. There does remain a concern that with this newer approach we may be missing a small subgroup of children more prone to develop severe kidney damage as a consequence of pyelonephritis, and in whom some form of intervention may prove beneficial. These concerns have meant that development of a universally accepted diagnostic protocol remains elusive.

  5. Efficacy of non-invasive positive pressure ventilation in the treatment of respiratory failure in patients with COPD at the acute exacerbation stage

    Institute of Scientific and Technical Information of China (English)

    De-Peng Li

    2016-01-01

    Objective:To observe the efficacy of non-invasive positive pressure ventilation (NIPPV) in the treatment of respiratory failure in patients with COPD at the acute exacerbation stage. Methods:A total of 38 COPD patients at the acute exacerbation stage with respiratory failure who were admitted in our hospital from January, 2012 to January, 2013 with complete medical materials were included in the study and divided into the observation group and the control group according to different treatment methods. On admission, the patients in the two groups were given oxygen inhalation, positive infection control, and drugs that could improve the respiratory function. On the basis, the patients in the observation group were given additional NIPPV. The improvement of blood gas indicators 4, 24, 72 d after admission, and 5, 30 d after discharge in the two groups was compared. The hospitalization time and the number of second hospitalization within 3 months in the two groups were compared.Results: In the observation group, pH value after 4 h ventilation was significantly elevated, and maintained at a stable state after 24 h ventilation, while in the control group, the change of pH value was not statistically significant, and after 5 d treatment, pH value was yet low. In the observation group, PaCO2 was significantly reduced in a short ventilation time, while in the control group, the descending range was small. The comparison of pH and PaCO2 4 h, 24 h, 72 h, and 5 d after treatment between the two groups was statistically significant, but PaCO2 in the two groups could not reduce to the normal level. PaO2 after treatment in the two groups was improved, but the improved degree in the observation degree was significantly superior to that in the control group. The comparison of blood gas indicators 30 d after discharge between the two groups was not statistically significant. The hospitalization time in the observation group was shortened, and the number of second hospitalization

  6. Dynamic changes in spectral and spatial signatures of high frequency oscillations in rat hippocampi during epileptogenesis in acute and chronic stages

    Directory of Open Access Journals (Sweden)

    Pan-Pan Song

    2016-11-01

    Full Text Available Objective: To analyze spectral and spatial signatures of high frequency oscillations (HFOs, which include ripples and fast ripples (FRs, > 200 Hz by quantitatively assessing average and peak spectral power in a rat model of different stages of epileptogenesis.Methods: The lithium–pilocarpine model of temporal lobe epilepsy was used. The acute phase of epilepsy was assessed by recording intracranial electroencephalography (EEG activity for 1 day after status epilepticus (SE. The chronic phase of epilepsy, including spontaneous recurrent seizures (SRSs, was assessed by recording EEG activity for 28 days after SE. Average and peak spectral power of five frequency bands of EEG signals in CA1, CA3 and DG regions of the hippocampus were analyzed with wavelet and digital filter.Results: FRs occurred in the hippocampus in the animal model. Significant dynamic changes in the spectral power of FRS were identified in CA1 and CA3. The average spectral power of ripples increased at 20 min before SE (p < 0.05, peaked at 10 min before diazepam injection. It decreased at 10 min after diazepam (p < 0.05 and returned to baseline after 1 hour (h. The average spectral power of FRs increased at 30 min before SE (p < 0.05 and peaked at 10 min before diazepam. It decreased at 10 min after diazepam (p < 0.05 and returned to baseline at 2 h after injection. The dynamic changes were similar between average and peak spectral power of FRs. Average and peak spectral power of both ripples and FRs in the chronic phase showed a gradual downward trend compared with normal rats 14 days after SE.Significance: The spectral power of HFOs may be utilized to distinguish between normal and pathologic HFOs. Ictal average and peak spectral power of FRs were two parameters for predicting acute epileptic seizures, which could be used as a new quantitative biomarker and early warning marker of seizure. Changes in interictal HFOs power in the hippocampus at the chronic stage may be not

  7. Are febrile seizures an indication for intermittent benzodiazepine treatment, and if so, in which cases?

    Science.gov (United States)

    Camfield, Peter; Camfield, Carol

    2014-10-09

    Febrile seizures occur in ∼4% of children. After a first febrile seizure, the risk of recurrence is ∼40%, but excellent studies document that febrile seizures do not cause brain damage or deficits in cognition or behaviour. The risk of subsequent epilepsy is 2-4%. Prolonged febrile seizures are of concern because a child may later develop mesial temporal sclerosis and intractable epilepsy in rare cases. Most prolonged febrile seizures represent the first febrile seizure and cannot be anticipated. A first prolonged febrile seizure does not increase the risk of recurrence, but if there is a recurrence, it is more likely to be prolonged. Prevention of recurrent febrile seizures is difficult. Antipyretics are ineffective. Daily AED treatment is not often justified. Intermittent oral diazepam at the time of illness is not very successful and has significant side effects. The most optimistic study found that the number of subjects required to treat in order to prevent one recurrence was 14. Intermittent clobazam has fewer side effects than diazepam and may be somewhat effective. Rescue benzodiazepines given outside health care facilities may be effective in selected patients to prevent prolonged recurrences, although this has not been proven with rectal diazepam which has been more extensively studied than buccal or nasal midazolam. Currently, we suggest that, for children with febrile seizures, candidates for consideration for rescue benzodiazepines are those with a prolonged febrile seizure or poor access to medical care. It is possible that the use of a rescue benzodiazepine may alleviate severe parental anxiety, but this remains to be established.

  8. Prophylaxis against febrile neutropenia with pegfilgrastim in Italy: a budget impact analysis

    Directory of Open Access Journals (Sweden)

    Giovanni Rosti

    2011-09-01

    Full Text Available Introduction: prophylaxis with granulocyte colony-stimulating factors (G-CSF is indicated for reduction in the duration of neutropenia and the incidence of febrile neutropenia in patients treated with cytotoxic chemotherapy for malignancy.
Objective: to evaluate the budgetary impact for the Italian NHS.
Design: a decision-analytic model has been developed to analyze the budget impact from the national health care system perspective. Costs include direct healthcare costs to the public payer of G-CSFs as well as their administration costs and costs of FN-related events. The comparison has been done using prophylaxis with G‑CSF (filgrastim for 11 days, pegfilgrastim, lenograstim for 11 days and antibiotics.
Patients and participants: The population of interest for the analysis were patients with breast cancer in stage II and III and patients with non-Hodgkin’s lymphoma (NHL.
Main outcome measures and results: for all the three patients group (NHL, Breast II and III, and for all the chemotherapy regimens (CHOP 21 and R-CHOP 21 for NHL, AC-T, TAC and TC for Breast stage II and III the budget impact analyses shows a cost reduction for the Italian NHS, as a result of an increase of the use of pegfilgrastim.
Conclusions: in Italy, a treatment strategy including pegfilgrastim as either primary or secondary prophylaxis provides value for money.


  9. Melatonin’s Effect in Febrile Seizures and Epilepsy

    Directory of Open Access Journals (Sweden)

    Abolfazl MAHYAR

    2014-07-01

    Full Text Available Normal 0 false false false EN-US X-NONE FA How to Cite This Article: Mahyar A, Ayazi P, Dalirani R, Gholami N, Daneshi-Kohan MM, Mohammadi N, Ahmadi MM, Sahmani AA. Melatonin’s Effect in Febrile Seizures and Epilepsy Iran J Child Neurol. 2014 Summer;8(3: 24-29. AbstractObjectiveRecognition of risk factors for febrile seizures (FS and epilepsy is essential. Studies regarding the role of melatonin in these convulsive disorders are limited.This study determines the relationship between serum melatonin levels and FS and epilepsy in children.Materials & MethodsA population of 111 children with simple FS, complex FS, and epilepsy (37 children per group, respectively were included as case groups. In addition, 37 febrile children without seizures comprised the control group. Serum melatonin levels were measured and compared between all groups.ResultsThe serum melatonin levels in the simple, complex FSs, and epilepsy groups were 2, 2.4, and 2 pg/ml, respectively. The serum melatonin level in the control group was 2.1pg/ml.Moreover, there were no significant differences observed while comparing the case groups.ConclusionThe present study reveals that there is no association between serum melatonin level and simple or complex FS and epilepsy. It appears that melatonin plays no significant role in these convulsive disorders. ReferencesBanerjee TK, Hazra A, Biswas A, Ray Jet al. Neurological disorders in children and adolescents. Indian J Pediatr2009; 76:139-46.Salehi Omran MR, Khalilian E, Mehdipour E, Ghabeli JA. Febrile seizures in North Iranian children: Epidemiology and clinical feature, Journal of Pediatric Neurology2008, 6: 39-43.Shinnar S, O’Dell C. Febrile Seizures, Pediatr Ann 2004, 33: 394-402.Millar JS. The child with febrile seizure, Pediatrics for parents 2006.24:12-14.Fetvei A. Assessment of febrile seizures in children, Eur J Pediatr2008, 167:17-27.Mikati MA. Seizures in Childhood In: Kliegman RM, Stanton BF, Schor NF, St

  10. The testis and epididymis are productively infected by SIV and SHIV in juvenile macaques during the post-acute stage of infection

    Directory of Open Access Journals (Sweden)

    Van der Meulen Joel

    2007-01-01

    Full Text Available Abstract Background Little is known about the progression and pathogenesis of HIV-1 infection within the male genital tract (MGT, particularly during the early stages of infection. Results To study HIV pathogenesis in the testis and epididymis, 12 juvenile monkeys (Macacca nemestrina, 4–4.5 years old were infected with Simian Immunodeficiency Virus mac 251 (SIVmac251 (n = 6 or Simian/Human Immunodeficiency Virus (SHIVmn229 (n = 6. Testes and epididymides were collected and examined by light microscopy and electron microscopy, at weeks 11–13 (SHIV and 23 (SIV following infection. Differences were found in the maturation status of the MGT of the monkeys, ranging from prepubertal (lacking post-meiotic germ cells to post-pubertal (having mature sperm in the epididymal duct. Variable levels of viral RNA were identified in the lymph node, epididymis and testis following infection with both SHIVmn229 and SIVmac251. Viral protein was detected via immunofluorescence histochemistry using specific antibodies to SIV (anti-gp41 and HIV-1 (capsid/p24 protein. SIV and SHIV infected macrophages, potentially dendritic cells and T cells in the testicular interstitial tissue were identified by co-localisation studies using antibodies to CD68, DC-SIGN, αβTCR. Infection of spermatogonia, but not more mature spermatogenic cells, was also observed. Leukocytic infiltrates were observed within the epididymal stroma of the infected animals. Conclusion These data show that the testis and epididymis of juvenile macaques are a target for SIV and SHIV during the post-acute stage of infection and represent a potential model for studying HIV-1 pathogenesis and its effect on spermatogenesis and the MGT in general.

  11. Comorbidities among patients with cancer who do and do not develop febrile neutropenia during the first chemotherapy cycle.

    Science.gov (United States)

    Li, Xiaoyan; Luthra, Rakesh; Morrow, Phuong K; Fisher, Maxine D; Reiner, Maureen; Barron, Richard L; Langeberg, Wendy J

    2016-10-01

    Patients receiving myelosuppressive chemotherapy with certain comorbidities are at increased risk of febrile neutropenia. A comprehensive evaluation of febrile neutropenia-related comorbidities across cancers is needed. This study compared comorbidity prevalence among patients with cancer who did and did not develop febrile neutropenia during the first chemotherapy cycle. This case-control study used administrative claims from adult patients with non-Hodgkin lymphoma or breast, lung, colorectal, ovarian, or gastric cancer who received chemotherapy between 2007 and 2012. Each patient who developed febrile neutropenia (case) was matched with up to four patients without febrile neutropenia (controls) by cancer type, metastasis, chemotherapy regimen, age group, and sex. For each comorbidity (identified in the year before chemotherapy began), the adjusted odds ratio (aOR) for febrile neutropenia by cancer type was evaluated using conditional logistic regression models adjusted for potential confounding factors. Of 31,331 eligible patients, 672 developed febrile neutropenia in the first chemotherapy cycle. A total of 3312 febrile neutropenia cases and matched controls were analyzed. Across tumor types, comorbidity prevalence was higher in patients who developed febrile neutropenia than in those without febrile neutropenia. Among patients with breast cancer, osteoarthritis was more prevalent in patients with febrile neutropenia (aOR, 1.85; 95% CI, 1.07 to 3.18). Among patients with non-Hodgkin lymphoma, renal disease was more prevalent in patients with febrile neutropenia (aOR, 2.25; 95% CI, 1.23 to 4.11). Patients who developed febrile neutropenia in the first chemotherapy cycle presented with comorbidities more often than otherwise similar patients who did not develop febrile neutropenia. These findings warrant further investigation and support the inclusion of comorbidities into febrile neutropenia risk models.

  12. Myeloid Sarcoma and Acute Myelomonocytic Leukemia in an Adolescent with Tetrasomy 8: Staging With {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Makis, William [Brandon Regional Health Centre, Brandon (Canada); Rakheja, Rajan; Lavoie, Josee; Marc Hickeson [McGill Univ. Health Centre, Brandon (Canada)

    2012-06-15

    Tetrasomy 8 is a relatively rare chromosomal abnormality that has been reported in only 33 cases in hematologic disorders, It is known for its association with aggressive acute myeloid leukemia (AML) and myeloid sarcoma and is considered a very poor prognostic factor. Myeloid sarcoma is a rare hematologic malignancy characterized by tumor masses consisting of immature myeloid cells, presenting at an extramedullary site. We present a case of a 17-year-old boy referred for an {sup 18}F-FDG PET/CT for the evaluation of pleural masses and spinal bone lesions seen on CT, after presenting with a 4 month history of chest pain. The PET/CT revealed extensive FDG-avid extrame-dullary disease in the soft tissues of the chest, abdomen, and pelvis, which were biopsy-proven to be myeloid sarcoma, as well as extensive intramedullary disease biopsy proven to be AML. This is the first report of the use of {sup 18}F-FDG PET/CT to stage a subset of aggressive AML and myeloid sarcoma in a patient with an associated chromosomal abnormality (tatrasomy 8)

  13. Prognosis of acute kidney injury in dogs using RIFLE (Risk, Injury, Failure, Loss and End-stage renal failure)-like criteria.

    Science.gov (United States)

    Lee, Y-J; Chang, C-C; Chan, J P-W; Hsu, W-L; Lin, K-W; Wong, M-L

    2011-03-12

    A retrospective case-series study evaluated the prognosis of 853 dogs with acute kidney injury (AKI) based on the RIFLE (Risk, Injury, Failure, Loss and End-stage renal failure) criteria, derived from human medicine. The 30-day mortality of dogs with AKI in each class was found to be 23.8 per cent (40 of 168) dogs for Risk, 41.0 per cent (107 of 261) dogs for Injury and 78.5 per cent (333 of 424) dogs for Failure. Using the dogs in the Risk class as the reference, the mortality of dogs in either the Injury or Failure class was significantly higher than that of dogs in the Risk class (PFailure class (three days). Using a multiple logistic regression model, a new score that simultaneously considered RIFLE class, diarrhoea status and serum phosphorus level was calculated to predict prognosis. Evaluation using the area under the receiver-operating characteristic curve (AUROC) indicated that the new scoring method (AUROC 0.80) was a better prognostic indicator than using RIFLE criteria alone (AUROC 0.73).

  14. [Changes of EEG power spectrum in response to the emotional auditory stimuli in patients in acute and recovery stages of TBI (traumatic brain injury)].

    Science.gov (United States)

    2013-01-01

    We investigated variability of responses to emotionally important auditory stimulation in different groups of TBI (Traumatic Brain Injury) in acute state or recovery. The patients sampling consisted of three different groups: patients in coma or vegetative state, patients with Severe and Moderate TBI in recovery period. Subjects were stimulated with auditory stimuli containing important physiological sounds (coughing, vomiting), emotional sounds (laughing, crying), nature sounds (bird song, barking), unpleasant household sounds (nails scratching the glass), natural sounds (sea, rain, fire) and neutral sounds (white noise). The background encephalographic activity was registered during at least 7 minutes. EEG was recorded while using portable device "Entsefalan". Significant differences of power of the rhythmic activity registered during the presentation of different types of stimuli were analyzed using Mathlab and Statistica 6.0. Results showed that EEG-response to the emotional stimuli differed depending on consciousness level, stimuli type, severity of TBI. Most valuable changes in EEG spectrum power for a patient with TBI were found for unpleasant auditory stimulation. Responsiveness to the pleasant stimulation could be registered in later stages of coming out of coma than to unpleasant stimulation. Alpha-activity is reducing in patients with TBI: the alpha rhythm depression is most evident in the control group, less in group after moderate TBI, and even less in group after severe TBI. Patients in coma or vegetative state didn't show any response in rhythmic power in the frequency of alpha rhythm.

  15. Acute Myocardial Infarction in Puerperium Stage. A Case Presentation Infarto agudo del miocardio en el puerperio . Presentación de un caso

    Directory of Open Access Journals (Sweden)

    Israel Sotolongo Castro

    Full Text Available

    A 38 year-old hypertensive, smoker female patient was presented. She suferred from an acute myocardial infarction in the mediate puerperium stage of an normal deliver. She was assisted in the Heart intensive care unit taking into consideration the basic care principles for this kind of patient. The infarct was diagnosed due to the clinical picture, and the electrographic alterations as well as the enzimatic alterations. The case is presented because it is a low frequency complication and it is not too much registered in the the medical literature revised.

    Se presenta el caso de una paciente de 38 años de edad, con antecedentes de padecer de hipertensión y ser fumadora, a la que se le presenta un infarto agudo del miocardio en el puerperio mediato de un parto eutócico. Fue atendida en la Unidad de Cuidados Intensivos Coronarios respetando los principios de los cuidados básicos para estas pacientes. Se diagnosticó el infarto por el cuadro clínico, las alteraciones electrocardiográficas y enzimáticas. Se presenta el caso por ser una complicación poco frecuente y no muy reportada en la literatura revisada.

  16. Use of a histidine-rich protein 2-based rapid diagnostic test for malaria by health personnel during routine consultation of febrile outpatients in a peripheral health facility in Yaounde, Cameroon.

    Science.gov (United States)

    Sayang, Collins; Soula, Georges; Tahar, Rachida; Basco, Leonardo K; Gazin, Pierre; Moyou-Somo, Roger; Delmont, Jean

    2009-08-01

    The role of a rapid diagnostic test (RDT) in the case management of Plasmodium falciparum malaria infections has not been determined in Africa. Our study was conducted during November 2007-January 2008 to assess test accuracy of an RDT in the management of febrile outpatients in a peripheral urban health facility in Cameroon. We found the overall sensitivity to be 71.4% and a specificity of 82.2%; the positive predictive value and negative predictive value were 73.8% and 80.4%, respectively. False-negative and false-positive cases represented 11.8% and 10.5% of all febrile patients. Malaria alone (31.3%) was the first cause of fever; 33.5% of fever cases were of unknown origin. Acute respiratory infections were common among children 0-2 years of age (25.5%) and decreased with age. The risk of having a clinical failure with the presumptive treatment of febrile children was seven times greater than that of the RDT-oriented management (relative risk = 6.8, 95% confidence interval = 0.88-53.4, P = 0.03) because of the delay of appropriate treatment of non-malarial febrile illness. Our results suggest that the RDT may be of limited utility for children greater than five years of age and adults and that diagnosis based on microscopic examination of blood smears should be recommended for these patient populations, as well as in areas of low transmission.

  17. PRRT2 Mutations Are Related to Febrile Seizures in Epileptic Patients

    Directory of Open Access Journals (Sweden)

    Zheng-Wen He

    2014-12-01

    Full Text Available Previous studies reported that the proline-rich transmembrane protein 2 (PRRT2 gene was identified to be related to paroxysmal kinesigenic dyskinesia (PKD, infantile convulsions with PKD, PKD with migraine and benign familial infantile epilepsy (BFIE. The present study explores whether the PRRT2 mutation is a potential cause of febrile seizures, including febrile seizures plus (FS+, generalized epilepsy with febrile seizures plus (GEFS+ and Dravet syndrome (DS; thus, it may provide a new drug target for personalized medicine for febrile seizure patients. We screened PRRT2 exons in a cohort of 136 epileptic patients with febrile seizures, including FS+, GEFS+ and DS. PRRT2 genetic mutations were identified in 25 out of 136 (18.4% febrile seizures in epileptic patients. Five loss-of-function and coding missense mutations were identified: c.649delC (p.R217Efs*12, c.649_650insC (p.R217Pfs*8, c.412C>G (p.Pro138Ala, c.439G>C (p.Asp147His and c.623C>A (p.Ser208Tyr. PRRT2 variants were probably involved in the etiology of febrile seizures in epileptic patients.

  18. Variation in Rates of Diagnosis of Acute Otitis Media.

    Science.gov (United States)

    Berwick, Donald M.; Thibodeau, Lawrence A.

    1980-01-01

    Over 13 weeks during two periods in 1978 the diagnostic rate for acute otitis media was monitored among febrile children in the emergency room of a large children's hospital. Temporal variation in diagnostic rates by physicians was largely attributable to differences among individual providers and independent of level of training. (Author/MLW)

  19. The Importance of Serum Cytokine Levels in Febrile Neutropenia

    Directory of Open Access Journals (Sweden)

    Nuray Buyukberber

    2003-02-01

    Full Text Available The most important evaluation of the neutropenic patients is to determine the risk group. The desired approach to patients with low risks should be either not to hospitalize or to hospitalize for a short period of time which both decreases the cost and exposure to the resistant flora. The early diagnosis of sepsis in patients with high risk may be life saving. Recently, the determination of low and high-risk groups only by the clinical variables is not found to be a reliable method. The laboratory parameters supported by the clinical variables may be more practical. The determination of serum cytokines levels in febrile neutropenia may be helpful for the early risk diagnosis, new treatment approaches, and prognosis. [Archives Medical Review Journal 2003; 12(1.000: 12-19

  20. Acute toxicity of copper, lead, cadmium, and zinc to early life stages of white sturgeon (Acipenser transmontanus) in laboratory and Columbia River water.

    Science.gov (United States)

    Vardy, David W; Santore, Robert; Ryan, Adam; Giesy, John P; Hecker, Markus

    2014-01-01

    Populations of white sturgeon (Acipenser transmontanus) are in decline in North America. This is attributed, primarily, to poor recruitment, and white sturgeon are listed as threatened or endangered in several parts of British Columbia, Canada, and the United States. In the Columbia River, effects of metals have been hypothesized as possible contributing factors. Previous work has demonstrated that early life stage white sturgeon are particularly sensitive to certain metals, and concerns over the level of protectiveness of water quality standards are justified. Here we report results from acute (96-h) toxicity tests for copper (Cu), cadmium (Cd), zinc (Zn), and lead (Pb) from parallel studies that were conducted in laboratory water and in the field with Columbia River water. Water effect ratios (WERs) and sensitivity parameters (i.e., median lethal accumulations, or LA50s) were calculated to assess relative bioavailability of these metals in Columbia River water compared to laboratory water, and to elucidate possible differences in sensitivity of early life stage white sturgeon to the same concentrations of metals when tested in the different water sources. For Cu and Pb, white sturgeon toxicity tests were initiated at two life stages, 8 and 40 days post-hatch (dph), and median lethal concentrations (LC50s) ranged between 9-25 μg Cu/L and 177-1,556 μg Pb/L. LC50s for 8 dph white sturgeon exposed to Cd in laboratory water and river water were 14.5 and 72 μg/L, respectively. Exposure of 8 dph white sturgeon to Zn in laboratory and river water resulted in LC50s of 150 and 625 μg/L, respectively. Threshold concentrations were consistently less in laboratory water compared with river water, and as a result, WERs were greater than 1 in all cases. In addition, LA50s were consistently greater in river water exposures compared with laboratory exposures in all paired tests. These results, in combination with results from the biotic ligand model, suggest that the observed

  1. Neuroprotective Potential of Mesenchymal Stem Cell-Based Therapy in Acute Stages of TNBS-Induced Colitis in Guinea-Pigs.

    Directory of Open Access Journals (Sweden)

    Ainsley M Robinson

    Full Text Available The therapeutic benefits of mesenchymal stem cells (MSCs, such as homing ability, multipotent differentiation capacity and secretion of soluble bioactive factors which exert neuroprotective, anti-inflammatory and immunomodulatory properties, have been attributed to attenuation of autoimmune, inflammatory and neurodegenerative disorders. In this study, we aimed to determine the earliest time point at which locally administered MSC-based therapies avert enteric neuronal loss and damage associated with intestinal inflammation in the guinea-pig model of colitis.At 3 hours after induction of colitis by 2,4,6-trinitrobenzene-sulfonate (TNBS, guinea-pigs received either human bone marrow-derived MSCs, conditioned medium (CM, or unconditioned medium by enema into the colon. Colon tissues were collected 6, 24 and 72 hours after administration of TNBS. Effects on body weight, gross morphological damage, immune cell infiltration and myenteric neurons were evaluated. RT-PCR, flow cytometry and antibody array kit were used to identify neurotrophic and neuroprotective factors released by MSCs.MSC and CM treatments prevented body weight loss, reduced infiltration of leukocytes into the colon wall and the myenteric plexus, facilitated repair of damaged tissue and nerve fibers, averted myenteric neuronal loss, as well as changes in neuronal subpopulations. The neuroprotective effects of MSC and CM treatments were observed as early as 24 hours after induction of inflammation even though the inflammatory reaction at the level of the myenteric ganglia had not completely subsided. Substantial number of neurotrophic and neuroprotective factors released by MSCs was identified in their secretome.MSC-based therapies applied at the acute stages of TNBS-induced colitis start exerting their neuroprotective effects towards enteric neurons by 24 hours post treatment. The neuroprotective efficacy of MSC-based therapies can be exerted independently to their anti

  2. Evaluation of acute kidney injury as defined by the risk, injury,failure, loss, and end-stage criteria in critically ill patients undergoing abdominal aortic aneurysm repair

    Institute of Scientific and Technical Information of China (English)

    YUE Jia-ning; LUO Zhe; GUO Da-qiao; XU Xin; CHEN Bin; JIANG Jun-hao; YANG Jue

    2013-01-01

    Background Acute kidney injury (AKI) is considered as a common and significant complication following abdominal aortic aneurysm (AAA) repair.This study aimed to assess the associated risk factors of AKI in the critically ill patients undergoing AAA repair and to evaluate the appropriate AKI management in the specific population.Methods We retrospectively examined data from all critically ill patients undergoing AAA repairs at our institution from April 2007 to March 2012.Multivariable analysis was used to identify factors associated with postoperative AKI,which was defined by risk,injury,failure,loss and end-stage (RIFLE) kidney disease criteria.The goal-directed hemodynamic optimization (maintenance of optimal hemodynamics and neutral or negative fluid balance) and renal outcomes were also reviewed.Results Of the 71 patients enrolled,32 (45.1%) developed AKI,with 30 (93.8%) cases diagnosed on admission to surgical intensive care unit (SICU).Risk factors for AKI were ruptured AAA (odds ratio (OR)=5.846,95% confidence interval (Cl):1.346-25.390),intraoperative hypotension (OR=6.008,95% CI:1.176 to 30.683),and perioperative blood transfusion (OR=4.611,95% CI:1.307-16.276).Goal-directed hemodynamic optimization resulted in 75.0% complete and 18.8% partial renal recovery.Overall in-hospital mortality was 2.8% AKI was associated with significantly increased length of stay ((136.9±24.5) hours vs.(70.4±11.3) hours)in Surgical Intensive Care Unit.Conclusions Critically ill patients undergoing AAA repair have a high incidence of AKI,which can be early recognized by RIFLE criteria.Rupture,hypotension,and blood transfusion are the significant associated risk factors.Application of goal-directed hemodynamic optimization in this cohort appeared to be effective in improving renal outcome.

  3. Easy and inexpensive molecular detection of dengue, chikungunya and zika viruses in febrile patients.

    Science.gov (United States)

    Calvo, Eliana P; Sánchez-Quete, Fernando; Durán, Sandra; Sandoval, Isabel; Castellanos, Jaime E

    2016-11-01

    Dengue (DENV), chikungunya (CHIKV) and zika (ZIKV) are arthropod-borne viruses (arboviruses) sharing a common vector, the mosquito Aedes aegypti. At initial stages, patients infected with these viruses have similar clinical manifestations, however, the outcomes and clinical management of these diseases are different, for this reason early and accurate identification of the causative virus is necessary. This paper reports the development of a rapid and specific nested-PCR for detection of DENV, CHIKV and ZIKV infection in the same sample. A set of six outer primers targeting the C-preM, E1, and E gene respectively was used in a multiplex one-step RT-PCR assay, followed by the second round of amplification with specific inner primers for each virus. The specificity of the present assay was validated with positive and negative serum samples for viruses and supernatants of infected cells. The assay was tested using clinical samples from febrile patients. In these samples, we detected mono and dual infections and a case of triple co-infection DENV-CHIKV-ZIKV. This assay might be a useful and an inexpensive tool for detection of these infections in regions where these arboviruses co-circulate.

  4. Cost Minimization Analysis of the Use of Meropenem and Ceftazidime in Febrile Neutropenia Therapy

    Directory of Open Access Journals (Sweden)

    Rizky Abdulah

    2016-06-01

    Full Text Available Use of antibiotics is required in febrile neutropenia therapy. The variety choice on the use of antibiotics has increased the role of pharmacoeconomics study to determine the most effective and efficient antibiotic in a specific area. The purpose of this study was to investigate the lowest cost antibiotic between meropenem and ceftazidime that were used as one of febrile neutropenia treatments at one of referral hospitals in West Java province during 2011–2013. This study was a retrospective, observational and analytical study that was performed on February 2014 by collecting medical record data related to febrile neutropenia inpatient who received meropenem or ceftazidime therapy. The result showed that although it was not statistically significant, the total cost for ceftazidime therapy was IDR7,082,523, which was lower than meropenem therapy (IDR11,094,147. Hopefully, this result can assist the health professionals in the management of febrile neutropenia therapy.

  5. Bacteriology profile of febrile infectious complications after transrectal ultrasound-guided prostate biopsy

    Directory of Open Access Journals (Sweden)

    Tzu-Hao Huang

    2014-09-01

    Conclusion: Our study demonstrated an overall postbiopsy febrile complicating infection rate of 1.39%. E. coli was the most common pathogen. Fluoroquinolones or second generation cephalosporins are suggested as the initial choice in patients with postbiopsy fever.

  6. Prenatal exposure to cigarettes, alcohol, and coffee and the risk for febrile seizures

    DEFF Research Database (Denmark)

    Vestergaard, M; Wisborg, K; Henriksen, TB

    2005-01-01

    of extensive brain growth and differentiation in this period. We evaluated the association between prenatal exposure to cigarettes, alcohol, and coffee and the risk for febrile seizures in 2 population-based birth cohorts. METHODS: The Aarhus Birth Cohort consisted of 25,196 children of mothers who were...... Birth Cohort, but the corresponding association was weak in the Aalborg-Odense cohort. We found no association between maternal alcohol and coffee consumption and the risk for febrile seizures. The results were similar for simple and complex febrile seizures. CONCLUSIONS: Our data suggest that prenatal...... exposure to low to moderate levels of alcohol and coffee has no impact on the risk for febrile seizures, whereas a modest smoking effect cannot be ruled out....

  7. Use of Peptide-Based Enzyme-Linked Immunosorbent Assay followed by Immunofluorescence Assay To Document Ehrlichia chaffeensis as a Cause of Febrile Illness in Nicaragua.

    Science.gov (United States)

    Chikeka, Ijeuru; Matute, Armando J; Dumler, J Stephen; Woods, Christopher W; Mayorga, Orlando; Reller, Megan E

    2016-06-01

    Ehrlichia chaffeensis, the etiologic agent of human monocytic ehrlichiosis (HME), has been extensively studied as a cause of acute febrile illness and an emerging tick-borne zoonosis in the United States. Limited data suggest its presence in other regions, including Central and South America but not Nicaragua to date. Diagnosis of E. chaffeensis infection by indirect immunofluorescence assay (IFA) is the reference standard due to its presumed high sensitivity and specificity, but IFA is impractical, variably reproducible, and cumbersome for large epidemiologic studies and for clinical diagnosis in resource-poor regions. We evaluated a high-throughput, objective peptide-based enzyme-linked immunosorbent assay (ELISA) for use alone or in combination with IFA. We found that it performed best as a screening test (sensitivity, 100%; specificity, 84%) to reduce the proportion of serum samples that were required by the more cumbersome and subjective IFA testing to ELISA is positive), we identified E. chaffeensis or a serologically and antigenically similar organism as a heretofore unrecognized cause of acute febrile illness in humans in Nicaragua and demonstrated the utility of the peptide ELISA as a screening tool for large-scale clinical studies.

  8. Towards Improving Point-of-Care Diagnosis of Non-malaria Febrile Illness: A Metabolomics Approach.

    Directory of Open Access Journals (Sweden)

    Saskia Decuypere

    2016-03-01

    Full Text Available Non-malaria febrile illnesses such as bacterial bloodstream infections (BSI are a leading cause of disease and mortality in the tropics. However, there are no reliable, simple diagnostic tests for identifying BSI or other severe non-malaria febrile illnesses. We hypothesized that different infectious agents responsible for severe febrile illness would impact on the host metabolome in different ways, and investigated the potential of plasma metabolites for diagnosis of non-malaria febrile illness.We conducted a comprehensive mass-spectrometry based metabolomics analysis of the plasma of 61 children with severe febrile illness from a malaria-endemic rural African setting. Metabolite features characteristic for non-malaria febrile illness, BSI, severe anemia and poor clinical outcome were identified by receiver operating curve analysis.The plasma metabolome profile of malaria and non-malaria patients revealed fundamental differences in host response, including a differential activation of the hypothalamic-pituitary-adrenal axis. A simple corticosteroid signature was a good classifier of severe malaria and non-malaria febrile patients (AUC 0.82, 95% CI: 0.70-0.93. Patients with BSI were characterized by upregulated plasma bile metabolites; a signature of two bile metabolites was estimated to have a sensitivity of 98.1% (95% CI: 80.2-100 and a specificity of 82.9% (95% CI: 54.7-99.9 to detect BSI in children younger than 5 years. This BSI signature demonstrates that host metabolites can have a superior diagnostic sensitivity compared to pathogen-detecting tests to identify infections characterized by low pathogen load such as BSI.This study demonstrates the potential use of plasma metabolites to identify causality in children with severe febrile illness in malaria-endemic settings.

  9. Treatment of Febrile Neutropenia and Prophylaxis in Hematologic Malignancies: A Critical Review and Update

    Directory of Open Access Journals (Sweden)

    Paola Villafuerte-Gutierrez

    2014-01-01

    Full Text Available Febrile neutropenia is one of the most serious complications in patients with haematological malignancies and chemotherapy. A prompt identification of infection and empirical antibiotic therapy can prolong survival. This paper reviews the guidelines about febrile neutropenia in the setting of hematologic malignancies, providing an overview of the definition of fever and neutropenia, and categories of risk assessment, management of infections, and prophylaxis.

  10. Febrile seizures: an appropriate-aged model suitable for long-term studies

    OpenAIRE

    1997-01-01

    Seizures induced by fever are the most prevalent age-specific seizures in infants and young children. Whether they result in long-term sequelae such as neuronal loss and temporal lobe epilepsy is controversial. Prospective studies of human febrile seizures have found no adverse effects on the developing brain. However, adults with temporal lobe epilepsy and associated limbic cell loss frequently have a history of prolonged febrile seizures in early life. These critical issues may be resolved ...

  11. Doença de Mucha-Habermann úlceronecrótica febril em adulto com boa resposta à corticoterapia oral Febrile ulceronecrotic Mucha-Habermann disease in adult patient successfully treated with systemic corticosteroid

    Directory of Open Access Journals (Sweden)

    Priscila Wolf Nassif

    2010-12-01

    Full Text Available A doença de Mucha-Habermann ulceronecrótica febril (FUMHD é uma variante clínica rara da pitiríase liquenoide variceliforme aguda (PLEVA. Tem etiologia incerta e é caracterizada por lesões úlceronecróticas, associadas a sintomas sistêmicos. Relata-se um caso de paciente masculino, com início agudo de lesões máculo-papulares, vesicobolhosas e úlceronecróticas, associadas à febre alta e mialgia. Tratado com prednisona 0,5 mg/kg/dia, obteve-se excelente resposta terapêutica. A FUMHD é uma variante severa da PLEVA, cujo diagnóstico é clínico e histopatológico. Vários tratamentos são descritos, tais como: metrotexate, corticoesteroides, PUVA, mas nenhum foi estabelecido.The Febrile Ulceronecrotic Mucha-Habermann (FUMHD disease is a rare variant of pityriasis lichenoides et varioliformis acuta (PLEVA. Its etiology still remains unknown and it is characterized by a sudden onset of ulceronecrotic skin lesions associated with systemic symptons. It is reported here the case of a male patient with a sudden and acute evolution of macules and papules, ulceronecrotic and vesicle-bullous lesions associated with systemic symptons. The patient was treated with prednisone 0,5 mg/kg/day with a dramatic response. The FUMHD is a severe variant of PLEVA and its diagnosis is clinical and histopathological. Many treatments such as methotrexate, corticosteroids and PUVA have been described .However, none of them has been settled.

  12. SerumTrace Elements in Febrile Seizure: A Case-Control Study

    Science.gov (United States)

    NAMAKIN, Kokab; ZARDAST, Mahmoud; SHARIFZADEH, Golamreza; BIDAR, Toktam; ZARGARIAN, Samaneh

    2016-01-01

    Objective Febrile seizure (FS) is one of the most common neurological problems during childhood.Pathogenesis of febrile convulsion is unknown. This study investigated some trace elements among children admitted with FS compared with thoseof febrile without seizure attacks. Materials & Methods This case-control study was conducted on48 children (6 months to 5 yrold) diagnosed with febrile seizure as the cases and 48 age-matched febrile children as the control group. Serum levels of magnesium, calcium, sodium, potassium, and serum zinc were measured. Statistical analysis was performed with SPSS (version 15) using Student t-test. Results There were no significant differences between the cases and controls in terms of gender or age. The means of serum level of zinc, sodium, calcium and magnesium in the case group was lower than those of the control group. There was no significant difference onserum potassium mean level between the case and control groups. Conclusion Deficiency of trace elements was correlated significantly with febrile convulsion, while further investigations on trace elements are required. PMID:27375757

  13. The Relationship between Zinc Deficiency and Febrile Convulsion in Isfahan,Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Modarresi

    2011-05-01

    Full Text Available Objective Febrile convulsion (FC is a common cause of seizure in young children, with an excellent prognosis. In addition to genetic predisposition and infections,FCs are generally thought to be induced by metabolic and elemental changes during fever such as Zinc (Zn deficiency. Regarding the high prevalence of febrile convulsions and the role of Zn deficiency, we investigated the role of Zn in FC patients in Isfahan, Iran. Materials and Methods In a controlled cross sectional study, 90 patients aged 9 months to 5 years were studied in a period of 12 months. They were assigned to three groups. Thirty patients were included in the Febrile Seizure group, thirty febrile children without convulsion or previous history of convulsion were included in the febrile group and thirty afebrile healthy ones were enrolled as controls. Venous blood was obtained and Zn concentration in serum was measured using Graphite Furnance Atomic Absorbance Spectrophotometering (GF-AAS. Results Patients and the control groups had no difference in either mean age or sex distribution. No significant relationship was observed between serum Zn level and age or sex among patients in the FC group and two other control groups. Conclusion Our findings showed that Zinc level was significantly lower in the febrile seizure group compared to two other groups. We tried to categorize various conditions in a more practical form. Also, Zinc is in close relationship with socioeconomic level of the individuals which was well considered in the current survey.

  14. Extremely elevated IL-18 levels may help distinguish systemic-onset juvenile idiopathic arthritis from other febrile diseases

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    Y. Xia

    Full Text Available The aim of this research was to explore whether IL-18 can be a serological marker for the diagnosis of systemic-onset juvenile idiopathic arthritis (sJIA. A total of 23 sJIA patients (13 males, median age 8.2, 20 acute lymphoblastic leukemia (ALL patients, 18 patients with severe infections (SIF, 26 Kawasaki disease (KD patients, 18 juvenile idiopathic arthritis (JIA patients, and 25 healthy control patients were selected for this study. Enzyme-linked immunosorbent assays (ELISAs were used to determine the serum concentrations of the S100A8, S100A9, and IL-6 proteins. The serum IL-18 levels were detected by a cytometric bead array (CBA. The serum IL-6 concentrations in various disease groups were significantly higher than that in the healthy control group. The IL-6 concentrations exhibited no significant difference between disease groups. The S100A8 level in the sJIA group was significantly higher than those of the ALL, JIA, and healthy control groups but showed no significant difference compared to the SIF and KD groups. The S100A9 serum concentration in the sJIA group was significantly higher than those in the ALL and healthy control groups and exhibited no significant difference from the SIF, KD, and JIA groups. The IL-18 level of the sJIA group was significantly higher than that of the other febrile disease groups. The IL-18 serum concentration may be used as a biological serum marker to distinguish sJIA from other febrile diseases.

  15. Extremely elevated IL-18 levels may help distinguish systemic-onset juvenile idiopathic arthritis from other febrile diseases

    Science.gov (United States)

    Xia, Y.; Cui, P.; Li, Q.; Liang, F.; Li, C.; Yang, J.

    2017-01-01

    The aim of this research was to explore whether IL-18 can be a serological marker for the diagnosis of systemic-onset juvenile idiopathic arthritis (sJIA). A total of 23 sJIA patients (13 males, median age 8.2), 20 acute lymphoblastic leukemia (ALL) patients, 18 patients with severe infections (SIF), 26 Kawasaki disease (KD) patients, 18 juvenile idiopathic arthritis (JIA) patients, and 25 healthy control patients were selected for this study. Enzyme-linked immunosorbent assays (ELISAs) were used to determine the serum concentrations of the S100A8, S100A9, and IL-6 proteins. The serum IL-18 levels were detected by a cytometric bead array (CBA). The serum IL-6 concentrations in various disease groups were significantly higher than that in the healthy control group. The IL-6 concentrations exhibited no significant difference between disease groups. The S100A8 level in the sJIA group was significantly higher than those of the ALL, JIA, and healthy control groups but showed no significant difference compared to the SIF and KD groups. The S100A9 serum concentration in the sJIA group was significantly higher than those in the ALL and healthy control groups and exhibited no significant difference from the SIF, KD, and JIA groups. The IL-18 level of the sJIA group was significantly higher than that of the other febrile disease groups. The IL-18 serum concentration may be used as a biological serum marker to distinguish sJIA from other febrile diseases. PMID:28225869

  16. 热性惊厥导致T细胞功能改变的观察%Immune-Functional Changes of T-lymphocytes in Children with Febrile Convulsions

    Institute of Scientific and Technical Information of China (English)

    陈遂 陈遂; 邹峥; 梅魁敏; 陈志军; 徐淑娟

    2000-01-01

    探讨热性惊厥患儿外周血T淋巴细胞免疫功能的变化。方法:应用APSAP法检测82例热性惊厥患儿、40例上呼吸道感染患儿及40例正常小儿T淋巴细胞亚群、CD25抗原在自然状态和PHA激活后的活化状态的百分率。结果:热性惊厥患儿外周血中,CD3、CD4、CD4/CD8比值,均显著低于两对照组;热性惊厥患儿在自然状态下的CD25抗原表达率明显低于两对照组,经PHA刺激后,CD25抗原表达在各组均显著增多,但热性惊厥组仍低于两对照组。结论:热性惊厥患儿存在着细胞免疫损害,这可能是热性惊厥发生和复发的一个重要因素。预防热性惊厥复发,必须从提高细胞免疫功能着手。%To ineestigate the immune-functional changes of T-lymphocytes of peripheral blood in chil dren with febrile convulsions. Methods: Eighty-two children with febrile convulsions, forty with acute upper respiratory tract infection and forty normals were studied. The distribution of T-lymphocytes subsets, the expression of active marker CD25+ before and after PHA stimulation were investigated by APAAP assay. Results:Compared with the other control groups, the percentages of CD3, CD4 and CD4/CD8 ratio of T-lymphocytes were all significantly depressed in the peripheral blood in children with febrile convulsions. The expression rate of CD25 antigen before PHA stimulation was significantly lower than those in two control groups. After PHA stimulation, the expression rates of CD25 antigen were all higher than before, but the rate of the febrile convulsion group was still lower than those of the control groups. Conclusion: Impairment of T-lymphocyte s-mediated immune function was associated with febrile convulsion and it might be a important cause of occurrence of febrile convulsion in children. For prevention and reduction of recurrence and subsequent brain damage, it is important to improve the T-lymphocyte s-mediated immune function of the

  17. In vivo approaches reveal a key role for DCs in CD4+ T cell activation and parasite clearance during the acute phase of experimental blood-stage malaria.

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    Henrique Borges da Silva

    2015-02-01

    Full Text Available Dendritic cells (DCs are phagocytes that are highly specialized for antigen presentation. Heterogeneous populations of macrophages and DCs form a phagocyte network inside the red pulp (RP of the spleen, which is a major site for the control of blood-borne infections such as malaria. However, the dynamics of splenic DCs during Plasmodium infections are poorly understood, limiting our knowledge regarding their protective role in malaria. Here, we used in vivo experimental approaches that enabled us to deplete or visualize DCs in order to clarify these issues. To elucidate the roles of DCs and marginal zone macrophages in the protection against blood-stage malaria, we infected DTx (diphtheria toxin-treated C57BL/6.CD11c-DTR mice, as well as C57BL/6 mice treated with low doses of clodronate liposomes (ClLip, with Plasmodium chabaudi AS (Pc parasites. The first evidence suggesting that DCs could contribute directly to parasite clearance was an early effect of the DTx treatment, but not of the ClLip treatment, in parasitemia control. DCs were also required for CD4+ T cell responses during infection. The phagocytosis of infected red blood cells (iRBCs by splenic DCs was analyzed by confocal intravital microscopy, as well as by flow cytometry and immunofluorescence, at three distinct phases of Pc malaria: at the first encounter, at pre-crisis concomitant with parasitemia growth and at crisis when the parasitemia decline coincides with spleen closure. In vivo and ex vivo imaging of the spleen revealed that DCs actively phagocytize iRBCs and interact with CD4+ T cells both in T cell-rich areas and in the RP. Subcapsular RP DCs were highly efficient in the recognition and capture of iRBCs during pre-crisis, while complete DC maturation was only achieved during crisis. These findings indicate that, beyond their classical role in antigen presentation, DCs also contribute to the direct elimination of iRBCs during acute Plasmodium infection.

  18. In Vivo Approaches Reveal a Key Role for DCs in CD4+ T Cell Activation and Parasite Clearance during the Acute Phase of Experimental Blood-Stage Malaria

    Science.gov (United States)

    Borges da Silva, Henrique; Fonseca, Raíssa; Cassado, Alexandra dos Anjos; Machado de Salles, Érika; de Menezes, Maria Nogueira; Langhorne, Jean; Perez, Katia Regina; Cuccovia, Iolanda Midea; Ryffel, Bernhard; Barreto, Vasco M.; Marinho, Cláudio Romero Farias; Boscardin, Silvia Beatriz; Álvarez, José Maria; D’Império-Lima, Maria Regina; Tadokoro, Carlos Eduardo

    2015-01-01

    Dendritic cells (DCs) are phagocytes that are highly specialized for antigen presentation. Heterogeneous populations of macrophages and DCs form a phagocyte network inside the red pulp (RP) of the spleen, which is a major site for the control of blood-borne infections such as malaria. However, the dynamics of splenic DCs during Plasmodium infections are poorly understood, limiting our knowledge regarding their protective role in malaria. Here, we used in vivo experimental approaches that enabled us to deplete or visualize DCs in order to clarify these issues. To elucidate the roles of DCs and marginal zone macrophages in the protection against blood-stage malaria, we infected DTx (diphtheria toxin)-treated C57BL/6.CD11c-DTR mice, as well as C57BL/6 mice treated with low doses of clodronate liposomes (ClLip), with Plasmodium chabaudi AS (Pc) parasites. The first evidence suggesting that DCs could contribute directly to parasite clearance was an early effect of the DTx treatment, but not of the ClLip treatment, in parasitemia control. DCs were also required for CD4+ T cell responses during infection. The phagocytosis of infected red blood cells (iRBCs) by splenic DCs was analyzed by confocal intravital microscopy, as well as by flow cytometry and immunofluorescence, at three distinct phases of Pc malaria: at the first encounter, at pre-crisis concomitant with parasitemia growth and at crisis when the parasitemia decline coincides with spleen closure. In vivo and ex vivo imaging of the spleen revealed that DCs actively phagocytize iRBCs and interact with CD4+ T cells both in T cell-rich areas and in the RP. Subcapsular RP DCs were highly efficient in the recognition and capture of iRBCs during pre-crisis, while complete DC maturation was only achieved during crisis. These findings indicate that, beyond their classical role in antigen presentation, DCs also contribute to the direct elimination of iRBCs during acute Plasmodium infection. PMID:25658925

  19. Kidney imaging in management of delayed febrile urinary tract infection

    Directory of Open Access Journals (Sweden)

    Sayed Abolhassan Sayedzadeh

    2011-01-01

    Full Text Available We report a cross-sectional study performed to evaluate the imaging findings of 40 children, aged one month to five years (16.65 ± 14.97 months, who presented with protracted fever of more than 48 hours due to urinary tract infection (UTI. About 85% of the patients had positive Tc99-Dimercaptosuccinic acid (DMSA scan and 58% had vesicoureteral reflux (VUR. Kidney sonography aided in the diagnosis and treatment in 10% of the patients. Age, sex, presence or laterality of VUR did not contribute to defective DMSA scan (pyelonephritis (P > 0.05. Delayed diagnosis and treatment of febrile UTI is associated with a high incidence of positive findings of DMSA scan irrespective of age, sex or presence/absence of VUR. In mild VUR, the DMSA scan may be normal while in patients with moderate and severe VUR the DMSA scan is almost always abnormal. Thus, our study shows that a normal DMSA scan can help in ruling out moderate to severe forms of VUR and that cystography remains an excellent and standard tool for the diagnosis of VUR.

  20. Kidney imaging in management of delayed febrile urinary tract infection.

    Science.gov (United States)

    Sayedzadeh, Sayed Abolhassan; Malaki, Majid; Shoaran, Maryam; Nemati, Massood

    2011-11-01

    We report a cross-sectional study performed to evaluate the imaging findings of 40 children, aged one month to five years (16.65 ± 14.97 months), who presented with protracted fever of more than 48 hours due to urinary tract infection (UTI). About 85% of the patients had positive Tc99-Dimercaptosuccinic acid (DMSA) scan and 58% had vesicoureteral reflux (VUR). Kidney sonography aided in the diagnosis and treatment in 10% of the patients. Age, sex, presence or laterality of VUR did not contribute to defective DMSA scan (pyelonephritis) (P > 0.05). Delayed diagnosis and treatment of febrile UTI is associated with a high incidence of positive findings of DMSA scan irrespective of age, sex or presence/absence of VUR. In mild VUR, the DMSA scan may be normal while in patients with moderate and severe VUR the DMSA scan is almost always abnormal. Thus, our study shows that a normal DMSA scan can help in ruling out moderate to severe forms of VUR and that cystography remains an excellent and standard tool for the diagnosis of VUR.

  1. [Efficacy of Levofloxacin Hydrate in Febrile Neutropenia for Outpatient Chemotherapy].

    Science.gov (United States)

    Inagaki, Manato; Sato, Junya; Nihei, Satoru; Kashiwaba, Masahiro; Kudo, Kenzo

    2016-05-01

    Management of febrile neutropenia (FN) is important for the safety of patients undergoing outpatient chemotherapy. Oral antimicrobials are usually prescribed as the initial treatment for FN, and outpatients are instructed to begin medication prior to chemotherapy. However, the effectiveness and safety of the use of these oral antibiotics have not yet been established. In this study, we investigated the effectiveness and safety of levofloxacin hydrate (LVFX) for breast cancer patients with FN, and the factors associated with the onset of FN in 134 breast cancer patients who underwent chemotherapy including the anticancer drug anthracycline (total, 513 courses), in an outpatient chemotherapy department. The effectiveness and safety of LVFX were defined respectively as defervescence within 5 days, and the appearance of side effects such as diarrhea and rashes. Fever was observed in 89 (66%) of the 134 patients, and during 164 (32%) of 513 courses. Defervescence was observed with the LVFX medication in 149 (93%) of 160 courses. The primary side effect was the development of rashes, and only 2 (1%) of the 160 courses were discontinued. Onset of stomatitis during chemotherapy was observed as a factor of FN (odds ratio: 1.36, p<0.05). Our results suggest that the use of LVFX according to the patients' discretion might be an effective and safe option for the management of FN during outpatient chemotherapy.

  2. Leptin levels in patients with anorexia nervosa are reduced in the acute stage and elevated upon short-term weight restoration

    DEFF Research Database (Denmark)

    Hebebrand, J; Blum, W F; Barth, N;

    1997-01-01

    Circulating leptin concentrations are known to be low in acute anorexia nervosa (AN), which is characterized by low weight, amenorrhea and specific psychopathological features. In this study plasma leptin concentrations were determined during inpatient treatment of 23 adolescent females...

  3. Leptin levels in patients with anorexia nervosa are reduced in the acute stage and elevated upon short-term weight restoration

    DEFF Research Database (Denmark)

    Hebebrand, J; Blum, W F; Barth, N

    1997-01-01

    Circulating leptin concentrations are known to be low in acute anorexia nervosa (AN), which is characterized by low weight, amenorrhea and specific psychopathological features. In this study plasma leptin concentrations were determined during inpatient treatment of 23 adolescent females with AN u......Circulating leptin concentrations are known to be low in acute anorexia nervosa (AN), which is characterized by low weight, amenorrhea and specific psychopathological features. In this study plasma leptin concentrations were determined during inpatient treatment of 23 adolescent females...

  4. Assessing the prevalence distribution of abnormal laboratory tests in patients with simple febrile seizure

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    Parsa Yousefichaijan

    2015-01-01

    Full Text Available Introduction: Febrile seizure is an important issue in pediatric practice. Even some pediatricians do not have a proper approach to febrile seizure, making the sick child undergo complex laboratory tests or invasive procedures or even long-term treatment with anticonvulsant drugs. In spite of multiple studies, many controversies have still remained about the significance of febrile seizure. The goal of this study is to assess the prevalence distribution of routinely requested laboratory tests results in simple febrile seizure. Materials and Methods: In a descriptive study, 549 patients with simple febrile seizure were studied. The routine lab tests including complete blood count, electrolyte, urine analysis, and cerebrospinal fluid (CSF analysis had already been performed for all patients and the results had been recorded in their medical data. These results were collected and statistically analyzed through SPSS software. Results: About 58.7% of our cases were male. Most of the cases were 12-24 months old and the mean body temperature of them was 38.2°C. 99.3% of blood sugar tests, 98% of blood calcium tests, 100% and 99.5% of sodium, and potassium tests, respectively, 100% of blood creatinine, 96.9% of blood urea nitrogen, and 99.1% of urine analysis tests were normal. CSF analysis was done in only 49 cases and the results were normal in all of them. Conclusion: The percentage of abnormal laboratory test results was not statistically significant in febrile seizure and shows that performing all these tests in all patients with simple febrile seizure as routine is not necessary.

  5. The Relationship between Zinc Deficiency and Febrile Convulsion in Isfahan,Iran

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    Mohammad Reza MODARRESI

    2011-05-01

    Full Text Available Objective  Febrile convulsion (FC is a common cause of seizure in young children, with an excellent prognosis. In addition to genetic predisposition and infections,FCs are generally thought to be induced by metabolic and elemental changes during fever such as Zinc (Zn deficiency. Regarding the high prevalence of febrile convulsions and the role of Zn deficiency, we investigated the role of Zn in FC patients in Isfahan, Iran.  Materials and Methods  In a controlled cross sectional study, 90 patients aged 9 months to 5 years were studied in a period of 12 months. They were assigned to three groups. Thirty patients were included in the Febrile Seizure group, thirty febrile children without convulsion or previous history of convulsion were included in the febrile group and thirty afebrile healthy ones were enrolled as controls. Venous blood was obtained and Zn concentration in serum was measured using Graphite Furnance Atomic Absorbance Spectrophotometering (GF-AAS.  Results  Patients and the control groups had no difference in either mean age or sex distribution. No significant relationship was observed between serum Zn level and age or sex among patients in the FC group and two other control groups.   Conclusion  Our findings showed that Zinc level was significantly lower in the febrile seizure group compared to two other groups. We tried to categorize various conditions in a more practical form. Also, Zinc is in close relationship with socioeconomic level of the individuals which was well considered in the current survey.  Keywords: Zinc; Zinc deficiency; Febrile Convulsion.

  6. Prospective cohort study of febrile neutropenia in breast cancer patients with neoadjuvant and adjuvant chemotherapy: CSPOR-BC FN study.

    Science.gov (United States)

    Ishikawa, Takashi; Sakamaki, Kentaro; Narui, Kazutaka; Kaise, Hiroshi; Tsugawa, Koichiro; Ichikawa, Yasushi; Mukai, Hirofumi

    2016-07-01

    With the increasing use of adjuvant chemotherapy for treating early breast cancer, febrile neutropenia management has become crucial. Guidelines for febrile neutropenia management are mostly based on a Caucasian population survey although ethnic differences are reported in terms of adverse events. We survey the current status of febrile neutropenia and risk factors in Japanese female breast cancer patients receiving neoadjuvant and adjuvant chemotherapy regimens potential for febrile neutropenia. Subsequently, we plan to conduct a multicenter prospective cohort study involving 1000 patients with operable breast cancer. With the current state of oral antibiotics being routinely prescribed without hematology tests, we survey febrile neutropenia based on two different definitions, namely, true febrile neutropenia: ≥37.5°C and Grade 4 neutropenia, and surrogate febrile neutropenia: ≥37.5°C and oral antibiotic and antipyretic intake. The comparison of true febrile neutropenia and surrogate febrile neutropenia incidences is anticipated to provide information on the safety and feasibility of chemotherapy management without performing blood tests.

  7. [Prehospital management of febrile convulsions by the Mobile Emergency Care Unit in the Capital Region of Denmark

    DEFF Research Database (Denmark)

    Lindekaer, A.L.; Nielsen, S.L.; Pedersen, Ulf Gøttrup

    2008-01-01

    INTRODUCTION: We conducted a quality assurance project of The Mobile Emergency Care Unit (MECU) in the Capital Region of Denmark when dispatched to febrile convulsions. The study focuses on prehospital treatment, comparison between prehospital and in-hospital diagnoses and parents' perceptions...... of their child's febrile convulsions and their satisfaction with the MECU. MATERIAL AND METHODS: The period of investigation was from March 1st 2004 to March 31st 2005. Children with a diagnosis of febrile convulsions or relevant differential diagnoses were eligible for inclusion. Children were excluded...... should still be dispatched primarily to febrile convulsions Udgivelsesdato: 2008/11/24...

  8. ST段抬高型急性心肌梗死早期ST段改变的研究现状%Research of ST-segment Change in the Early Stage of ST-Elevation Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    刘奥雪; 刘仁光; 李今朝

    2016-01-01

    As the early reperfusion therapy for acute myocardial infarction was extensively developed, the clinical emphasized o-pening infarction related artery as early as possible in order to benefit the patients to the extreme. The electrocardiogram change in the early stage of acute myocardial infarction has become the focus of clinical attention and study. On the basis of the recent literatures and our own researches, this paper makes a brief overview on the typical manifestation, special manifestation and contradictory phenome-non of ST-segment changes in the early stage of ST- elevation acute myocardial infarction.%随着急性心肌梗死早期再灌注治疗的广泛开展,临床强调尽早开通梗死相关动脉,使患者最大程度获益,急性心肌梗死早期的心电图改变已成为临床关注和研究的热点。本文结合近年文献和我们自己的研究,仅就ST段抬高型急性心肌梗死早期ST段改变的典型表现、特殊表现和矛盾现象做简要概述。

  9. The prognosis of CALM-AF10-positive adult T-cell acute lymphoblastic leukemias depends on the stage of maturation arrest

    Science.gov (United States)

    Ben Abdelali, Raouf; Asnafi, Vahid; Petit, Arnaud; Micol, Jean-Baptiste; Callens, Céline; Villarese, Patrick; Delabesse, Eric; Reman, Oumedaly; Lepretre, Stephane; Cahn, Jean-Yves; Guillerm, Gaelle; Berthon, Céline; Gardin, Claude; Corront, Bernadette; Leguay, Thibaut; Béné, Marie-Christine; Ifrah, Norbert; Leverger, Guy; Dombret, Hervé; Macintyre, Elizabeth

    2013-01-01

    CALM-AF10 (also known as PICALM-MLLT10) is the commonest fusion protein in T-cell acute lymphoblastic leukemia, but its prognostic impact remains unclear. Molecular screening at diagnosis identified CALM-AF10 in 30/431 (7%) patients with T-cell acute lymphoblastic leukemia aged 16 years and over and in 15/234 (6%) of those aged up to 15 years. Adult CALM-AF10-positive patients were predominantly (72%) negative for surface (s)CD3/T-cell receptor, whereas children were predominantly (67%) positive for T-cell receptor. Among 22 adult CALM-AF10-positive patients treated according to the LALA94/GRAALL03-05 protocols, the poor prognosis for event-free survival (P=0.0017) and overall survival (P=0.0014) was restricted to the 15 T-cell receptor-negative cases. Among CALM-AF10-positive, T-cell receptor-negative patients, 82% had an early T-cell precursor phenotype, reported to be of poor prognosis in pediatric T-cell acute lymphoblastic leukemia. Early T-cell precursor acute lymphoblastic leukemia corresponded to 22% of adult LALA94/GRAALL03-05 T-cell acute lymphoblastic leukemias, but had no prognostic impact per se. CALM-AF10 fusion within early T-cell precursor acute lymphoblastic leukemia (21%) did, however, identify a group with a poor prognosis with regards to event-free survival (P=0.04). CALM-AF10 therefore identifies a poor prognostic group within sCD3/T-cell receptor negative adult T-cell acute lymphoblastic leukemias and is over-represented within early T-cell precursor acute lymphoblastic leukemias, in which it identifies patients in whom treatment is likely to fail. Its prognosis and overlap with early T-cell precursor acute lymphoblastic leukemia in pediatric T-cell acute lymphoblastic leukemia merits analysis. The clinical trial GRAALL was registered at Clinical Trials.gov number NCT00327678. PMID:23831922

  10. Out-of-pocket costs and other determinants of access to healthcare for children with febrile illnesses: a case-control study in rural Tanzania.

    Directory of Open Access Journals (Sweden)

    Joëlle Castellani

    Full Text Available To study private costs and other determinants of access to healthcare for childhood fevers in rural Tanzania.A case-control study was conducted in Tanzania to establish factors that determine access to a health facility in acute febrile illnesses in children less than 5 years of age. Carers of eligible children were interviewed in the community; cases were represented by patients who went to a facility and controls by those who did not. A Household Wealth Index was estimated using principal components analysis. A multivariable logistic regression analysis was performed to understand the factors which influenced attendance of healthcare facility including severity of the illness and household wealth/socio-demographic indicators. To complement the data on costs from community interviews, a hospital-based study obtained details of private expenditures for hospitalised children under the age of 5.Severe febrile illness is strongly associated with health facility attendance (OR: 35.76, 95%CI: 3.68-347.43, p = 0.002 compared with less severe febrile illness. Overall, the private costs of an illness for patients who went to a hospital were six times larger than private costs of controls ($5.68 vs. $0.90, p<0.0001. Household wealth was not significantly correlated with total costs incurred. The separate hospital based cost study indicated that private costs were three times greater for admissions at the mission versus public hospital: $13.68 mission vs. $4.47 public hospital (difference $ 9.21 (95% CI: 7.89 -10.52, p<0.0001. In both locations, approximately 50% of the cost was determined by the duration of admission, with each day in hospital increasing private costs by about 12% (95% CI: 5% - 21%.The more severely ill a child, the higher the probability of attending hospital. We did not find association between household wealth and attending a health facility; nor was there an association between household wealth and private cost.

  11. Epilepsy, hippocampal sclerosis and febrile seizures linked by common genetic variation around SCN1A

    Science.gov (United States)

    Kasperavičiūtė, Dalia; Catarino, Claudia B.; Matarin, Mar; Leu, Costin; Novy, Jan; Tostevin, Anna; Leal, Bárbara; Hessel, Ellen V. S.; Hallmann, Kerstin; Hildebrand, Michael S.; Dahl, Hans-Henrik M.; Ryten, Mina; Trabzuni, Daniah; Ramasamy, Adaikalavan; Alhusaini, Saud; Doherty, Colin P.; Dorn, Thomas; Hansen, Jörg; Krämer, Günter; Steinhoff, Bernhard J.; Zumsteg, Dominik; Duncan, Susan; Kälviäinen, Reetta K.; Eriksson, Kai J.; Kantanen, Anne-Mari; Pandolfo, Massimo; Gruber-Sedlmayr, Ursula; Schlachter, Kurt; Reinthaler, Eva M.; Stogmann, Elisabeth; Zimprich, Fritz; Théâtre, Emilie; Smith, Colin; O’Brien, Terence J.; Meng Tan, K.; Petrovski, Slave; Robbiano, Angela; Paravidino, Roberta; Zara, Federico; Striano, Pasquale; Sperling, Michael R.; Buono, Russell J.; Hakonarson, Hakon; Chaves, João; Costa, Paulo P.; Silva, Berta M.; da Silva, António M.; de Graan, Pierre N. E.; Koeleman, Bobby P. C.; Becker, Albert; Schoch, Susanne; von Lehe, Marec; Reif, Philipp S.; Rosenow, Felix; Becker, Felicitas; Weber, Yvonne; Lerche, Holger; Rössler, Karl; Buchfelder, Michael; Hamer, Hajo M.; Kobow, Katja; Coras, Roland; Blumcke, Ingmar; Scheffer, Ingrid E.; Berkovic, Samuel F.; Weale, Michael E.; Delanty, Norman; Depondt, Chantal; Cavalleri, Gianpiero L.; Kunz, Wolfram S.

    2013-01-01

    Epilepsy comprises several syndromes, amongst the most common being mesial temporal lobe epilepsy with hippocampal sclerosis. Seizures in mesial temporal lobe epilepsy with hippocampal sclerosis are typically drug-resistant, and mesial temporal lobe epilepsy with hippocampal sclerosis is frequently associated with important co-morbidities, mandating the search for better understanding and treatment. The cause of mesial temporal lobe epilepsy with hippocampal sclerosis is unknown, but there is an association with childhood febrile seizures. Several rarer epilepsies featuring febrile seizures are caused by mutations in SCN1A, which encodes a brain-expressed sodium channel subunit targeted by many anti-epileptic drugs. We undertook a genome-wide association study in 1018 people with mesial temporal lobe epilepsy with hippocampal sclerosis and 7552 control subjects, with validation in an independent sample set comprising 959 people with mesial temporal lobe epilepsy with hippocampal sclerosis and 3591 control subjects. To dissect out variants related to a history of febrile seizures, we tested cases with mesial temporal lobe epilepsy with hippocampal sclerosis with (overall n = 757) and without (overall n = 803) a history of febrile seizures. Meta-analysis revealed a genome-wide significant association for mesial temporal lobe epilepsy with hippocampal sclerosis with febrile seizures at the sodium channel gene cluster on chromosome 2q24.3 [rs7587026, within an intron of the SCN1A gene, P = 3.36 × 10−9, odds ratio (A) = 1.42, 95% confidence interval: 1.26–1.59]. In a cohort of 172 individuals with febrile seizures, who did not develop epilepsy during prospective follow-up to age 13 years, and 6456 controls, no association was found for rs7587026 and febrile seizures. These findings suggest SCN1A involvement in a common epilepsy syndrome, give new direction to biological understanding of mesial temporal lobe epilepsy with hippocampal sclerosis with febrile seizures

  12. Microbial Translocation Contribute to Febrile Episodes in Adults with Chemotherapy-Induced Neutropenia

    Science.gov (United States)

    Wong, Michelle; Barqasho, Babilonia; Öhrmalm, Lars; Tolfvenstam, Thomas; Nowak, Piotr

    2013-01-01

    In this study we sought to determine the contribution of microbial translocation to febrile episodes with no attributable microbiological cause (Fever of Unknown Origin, FUO) in an adult febrile neutropaenic cohort. Endotoxin concentrations were measured with the chromogenic Limulus Amoebocyte Assay and used as a direct measure of bacterial products whilst soluble CD14 (sCD14), measured with ELISA was selected as an indicator of the early host response to endotoxins. Endotoxin concentrations in this cohort were generally elevated but did not differ with the presentation of fever. Further stratification of the febrile episodes based on the microbiological findings revealed significantly (p = 0.0077) elevated endotoxin concentrations in FUO episodes compared with episodes with documented bacterial and viral findings. sCD14 concentrations were however, elevated in febrile episodes (p = 0.0066) and no association was observed between sCD14 concentration and microbiological findings. However, FUO episodes and episodes with Gram-negative bacteraemia were associated with higher median sCD14 concentrations than episodes with Gram-positive bacteraemia (p = 0.030). In conclusion, our findings suggest that in the absence of microbiological findings, microbial translocation could contribute to febrile episodes in an adult neutropaenic cohort. We further observed an association between prophylactic antibiotic use and increased plasma endotoxin concentrations (p = 0.0212). PMID:23874493

  13. The PIC Cystogram: Its Place in the Treatment Algorithm of Recurrent Febrile UTIs

    Directory of Open Access Journals (Sweden)

    Jennifer A. Hagerty

    2008-01-01

    Full Text Available Purpose. A common pediatric dilemma involves management of children with recurrent febrile urinary tract infections (UTIs who have normal voiding cystourethrograms. Vesicoureteral reflux (VUR has been demonstrated in such cases by performing a cystogram which positions the instillation of contrast (PIC at the ureteral orifice. We describe the evidence supporting this diagnostic test. Materials and Methods. The literature was searched to identify and subsequently evaluate all studies investigating PIC cystography. Results. In patients with febrile UTIs and negative VCUGs, the PIC cystogram has been demonstrated to identify occult reflux (PIC-VUR. When identified and treated, these patients have a significant reduction in the incidence of febrile UTIs. Conclusions. Although the current literature on PIC cystography is limited, it appears to be a clinically useful test in a select group of patients with recurrent febrile UTIs, that are not found to have VUR on a conventional VCUG. A prospective randomized trial is underway to further define its role in the treatment algorithm of febrile UTIs.

  14. Microbial translocation contribute to febrile episodes in adults with chemotherapy-induced neutropenia.

    Directory of Open Access Journals (Sweden)

    Michelle Wong

    Full Text Available In this study we sought to determine the contribution of microbial translocation to febrile episodes with no attributable microbiological cause (Fever of Unknown Origin, FUO in an adult febrile neutropaenic cohort. Endotoxin concentrations were measured with the chromogenic Limulus Amoebocyte Assay and used as a direct measure of bacterial products whilst soluble CD14 (sCD14, measured with ELISA was selected as an indicator of the early host response to endotoxins. Endotoxin concentrations in this cohort were generally elevated but did not differ with the presentation of fever. Further stratification of the febrile episodes based on the microbiological findings revealed significantly (p = 0.0077 elevated endotoxin concentrations in FUO episodes compared with episodes with documented bacterial and viral findings. sCD14 concentrations were however, elevated in febrile episodes (p = 0.0066 and no association was observed between sCD14 concentration and microbiological findings. However, FUO episodes and episodes with Gram-negative bacteraemia were associated with higher median sCD14 concentrations than episodes with Gram-positive bacteraemia (p = 0.030. In conclusion, our findings suggest that in the absence of microbiological findings, microbial translocation could contribute to febrile episodes in an adult neutropaenic cohort. We further observed an association between prophylactic antibiotic use and increased plasma endotoxin concentrations (p = 0.0212.

  15. Clinical profile of high-risk febrile neutropenia in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Mohan V Bhojaraja

    2016-06-01

    Full Text Available Background Infection in the immunocompromised host has been a reason of concern in the clinical setting and a topic of debate for decades. In this study, the aim was to analyse the clinical profile of high-risk febrile neutropenic patients. Aims To study the clinical profile of high risk febrile neutropenia patients with the objective of identifying the most common associated malignancy, most common associated pathogen, the source of infection, to correlate the treatment and management with that of the Infectious Diseases Society of America (IDSA 2010 guidelines and to assess the clinical outcome. Methods A cross-sectional time bound study was carried out and a total of 80 episodes of high-risk febrile neutropenia were recorded among patients with malignancies from September 2011 to July 2013 with each episode being taken as a new case. Results Non-Hodgkin’s lymphoma (30 per cent was the most common malignancy associated, commonest source of infection was due to central venous catheters, the commonest pathogens were gram negative (52 per cent the treatment and management of each episode of high risk febrile neutropenia correlated with that of IDSA 2010 guidelines and the mortality rate was 13.75 per cent. Conclusion Febrile neutropenia is one of the major complications and cause of mortality in patients with malignancy and hence understanding its entire spectrum can help us reduce morbidity and mortality.

  16. THE RHEOLOGICAL PROPERTIES OF BLOOD IN THE MOST ACUTE STAGE OF ISCHEMIC STROKE AND THEIR RELATION TO THE SEVERITY OF NEUROLOGICAL IMPAIRMENT

    Directory of Open Access Journals (Sweden)

    M. N. Azhermacheva

    2013-01-01

    Full Text Available The study evaluated the rheological parameters of blood: blood viscosity, plasma viscosity, hematocrit, red blood cell aggregation and deformability. The severity of the patients was assessed by clinical scales:Glasgowcoma scale, the scale NIHSS, Barthel index. The study found that in the acute phase of ischemic stroke increased blood viscosity by increasing red blood cell aggregation and reduced erythrocyte deformability. The increase in the viscosity of the blood in acute ischemic stroke is accompanied by increased severity of neurological disorders.

  17. Observation on therapeutic effect of acupuncture in the treatment of no-premonitory migraine at acute stage%针刺治疗急性期无先兆偏头痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    曹磊

    2011-01-01

    Objective: To observe the therapeutic effect of acupuncture on no-premonitory migraine at acute stage. Methods: 56 patients who were conformed to the diagnose (1HS) of no-premoitory migraine at acute stage were selected as the observation object, these patients were given acupuncture combined with electro-Acupuncture, the scores of pain extent and accompained symptoms of headache were investigated before treatment and after treatment of 0.5, 24, 48, 72 hours. Results: After treatment of each period of time, the scores of both items had significant differences (P<0.01). The total effective rate was 96.43%. Conclusion: Acupuncture has obvious analges effect on no-premoitory migraine at acute stage.%目的:观察针刺对急性期无先兆偏头痛的临床疗效.方法:采用自身前后对照研究,选取符合国际头痛协会2004年制订的无先兆偏头痛的诊断标准且处于急性期的患者56例,给予针刺加电针治疗,观察治疗前与治疗后0.5、24、48、72 h头痛强度和伴随症状的评分情况.结果:治疗后各时间段两项评分与治疗前比较,差异有高度统计学意义(P<0.01);综合疗效评定总有效率为96.43%.结论:针刺治疗急性期无先兆偏头痛有明显止痛效果,且疗效确切.

  18. The Effects of Acute Restraint Stress on Plasma Levels of Prolactin and Corticosterone across Life-History Stages in a Short-Lived Bird: Gambel's White-Crowned Sparrow (Zonotrichia leucophrys gambelii).

    Science.gov (United States)

    Krause, Jesse S; Meddle, Simone L; Wingfield, John C

    2015-01-01

    The general reproductive effort model attempts to predict the resources that will be allocated to a current reproductive bout or to future survival by aborting the current reproductive attempt. Life-history theory predicts that short-lived species should devote more resources toward a reproductive event because brood value is far greater compared with that of long-lived species that have multiple breeding opportunities. Previous bird studies have used patterns of hormone secretion to understand the regulation of parental investment in response to environmental challenges, such as stress. The two key hormones investigated have been prolactin, which promotes parental investment, and corticosterone, which can reduce parental investment. Research on long-lived seabirds showed that prolactin levels decrease in response to a stressor, but the magnitude of the decline was positively correlated with future reproductive potential. However, little is known about the role of prolactin in short-lived species. Here we present prolactin and corticosterone data from a short-lived Arctic breeding, migratory songbird-the white-crowned sparrow, Zonotrichia leucophrys gambelii-at multiple stages of the breeding and nonbreeding seasons following standardized acute restraint stress. These data show that both prolactin and corticosterone are modulated seasonally. Corticosterone levels increased significantly in response to acute restraint stress during the breeding season in both sexes, but prolactin levels did not change in response to acute restraint stress at any stage of the annual cycle. We found no relationship between corticosterone or prolactin at either baseline or peak induced levels during any stage of breeding.

  19. Neurogenic pulmonary edema combined with febrile seizures in early childhood-A report of two cases.

    Science.gov (United States)

    Tasaka, Keiji; Matsubara, Kousaku; Hori, Masayuki; Nigami, Hiroyuki; Iwata, Aya; Isome, Kenichi; Kawasaki, Yu; Nagai, Sadayuki

    2016-01-01

    Neurogenic pulmonary edema (NPE) is a clinical entity that can occur following central nervous system disorders. However, NPE occurs quite rarely in early childhood, and there has only been one report about pediatric NPE associated with febrile seizures. Two cases are reported here. One case involved a 2-year-old girl who presented with febrile seizures, which rapidly progressed to severe NPE. Since the NPE occurred in the emergency department room, the patient was able to be resuscitated via immediate endotracheal intubation. The other case involved an 11-month-old boy who developed respiratory distress following a 50-min episode of febrile status epilepticus. Both patients required respiratory management in the intensive care unit. However their conditions were dramatically improved within several days and fully recovered without any sequelae.

  20. Acute toxicity profile and compliance to accelerated radiotherapy plus carbogen and nicotinamide for clinical stage T2-4 laryngeal cancer: results of a phase III randomized trial.

    NARCIS (Netherlands)

    Janssens, G.O.R.J.; Terhaard, C.H.J.; Doornaert, P.A.; Bijl, H.P.; Ende, P. van den; Chin, A.; Pop, L.A.M.; Kaanders, J.H.A.M.

    2012-01-01

    PURPOSE: To report the acute toxicity profile and compliance from a randomized Phase III trial comparing accelerated radiotherapy (AR) with accelerated radiotherapy plus carbogen and nicotinamide (ARCON) in laryngeal cancer. METHODS AND MATERIALS: From April 2001 to February 2008, 345 patients with

  1. ACUTE TOXICITY PROFILE AND COMPLIANCE TO ACCELERATED RADIOTHERAPY PLUS CARBOGEN AND NICOTINAMIDE FOR CLINICAL STAGE T2-4 LARYNGEAL CANCER : RESULTS OF A PHASE III RANDOMIZED TRIAL

    NARCIS (Netherlands)

    Janssens, Geert O.; Terhaard, Chris H.; Doornaert, Patricia A.; Bijl, Hendrik P.; van den Ende, Piet; Chin, Alim; Pop, Lucas A.; Kaanders, Johannes H.

    2012-01-01

    Purpose: To report the acute toxicity profile and compliance from a randomized Phase III trial comparing accelerated radiotherapy (AR) with accelerated radiotherapy plus carbogen and nicotinamide (ARCON) in laryngeal cancer. Methods and Materials: From April 2001 to February 2008, 345 patients with

  2. Effect of surgical castration of bull calves at different stages of maturity with or without analgesia on the acute phase response (APR) and complete blood count (CBC)

    Science.gov (United States)

    The study objective was to determine if surgical castration at birth or weaning impacts the acute phase response (APR) or complete blood counts (CBC) and whether concurrent administration of an oral analgesic (meloxicam) ameliorates inflammation. Bull calves (n=29) from the University of Arkansas re...

  3. Relationships between static foot alignment and dynamic plantar loads in runners with acute and chronic stages of plantar fasciitis: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Ana P. Ribeiro

    2016-02-01

    Full Text Available BACKGROUND: The risk factors for the development of plantar fasciitis (PF have been associated with the medial longitudinal arch (MLA, rearfoot alignment and calcaneal overload. However, the relationships between the biomechanical variables have yet to be determined. OBJECTIVE: The goal of this study was to investigate the relationships between the MLA, rearfoot alignment, and dynamic plantar loads in runners with unilateral PF in acute and chronic phases. METHOD: Cross-sectional study which thirty-five runners with unilateral PF were evaluated: 20 in the acute phase (with pain and 15 with previous chronic PF (without pain. The MLA index and rearfoot alignment were calculated using digital images. The contact area, maximum force, peak pressure, and force-time integral over three plantar areas were acquired with Pedar X insoles while running at 12 km/h, and the loading rates were calculated from the vertical forces. RESULTS: The multiple regression analyses indicated that both the force-time integral (R2=0.15 for acute phase PF; R2=0.17 for chronic PF and maximum force (R2=0.35 for chronic PF over the forefoot were predicted by an elevated MLA index. The rearfoot valgus alignment predicted the maximum force over the rearfoot in both PF groups: acute (R2=0.18 and chronic (R2=0.45. The rearfoot valgus alignment also predicted higher loading rates in the PF groups: acute (R2=0.19 and chronic (R2=0.40. CONCLUSION: The MLA index and the rearfoot alignment were good predictors of plantar loads over the forefoot and rearfoot areas in runners with PF. However, rearfoot valgus was demonstrated to be an important clinical measure, since it was able to predict the maximum force and both loading rates over the rearfoot.

  4. Relationships between static foot alignment and dynamic plantar loads in runners with acute and chronic stages of plantar fasciitis: a cross-sectional study

    Science.gov (United States)

    Ribeiro, Ana P.; Sacco, Isabel C. N.; Dinato, Roberto C.; João, Silvia M. A.

    2016-01-01

    BACKGROUND: The risk factors for the development of plantar fasciitis (PF) have been associated with the medial longitudinal arch (MLA), rearfoot alignment and calcaneal overload. However, the relationships between the biomechanical variables have yet to be determined. OBJECTIVE: The goal of this study was to investigate the relationships between the MLA, rearfoot alignment, and dynamic plantar loads in runners with unilateral PF in acute and chronic phases. METHOD: Cross-sectional study which thirty-five runners with unilateral PF were evaluated: 20 in the acute phase (with pain) and 15 with previous chronic PF (without pain). The MLA index and rearfoot alignment were calculated using digital images. The contact area, maximum force, peak pressure, and force-time integral over three plantar areas were acquired with Pedar X insoles while running at 12 km/h, and the loading rates were calculated from the vertical forces. RESULTS: The multiple regression analyses indicated that both the force-time integral (R 2=0.15 for acute phase PF; R 2=0.17 for chronic PF) and maximum force (R 2=0.35 for chronic PF) over the forefoot were predicted by an elevated MLA index. The rearfoot valgus alignment predicted the maximum force over the rearfoot in both PF groups: acute (R 2=0.18) and chronic (R 2=0.45). The rearfoot valgus alignment also predicted higher loading rates in the PF groups: acute (R 2=0.19) and chronic (R 2=0.40). CONCLUSION: The MLA index and the rearfoot alignment were good predictors of plantar loads over the forefoot and rearfoot areas in runners with PF. However, rearfoot valgus was demonstrated to be an important clinical measure, since it was able to predict the maximum force and both loading rates over the rearfoot. PMID:26786073

  5. Etiology of Acute Undifferentiated Febrile Illness in the Amazon Basin of Ecuador

    Science.gov (United States)

    2009-01-01

    Quito, Ecuador; Departamento de Medicina Interna, Hospital General de las Fuerzas Armadas, Quito, Ecuador; Policlínico Militar San Jorge, Sangolqui...of a lack of access to advanced laboratory equipment; clinicians in the developed world likewise struggle to find a specific etiology for AUFI...personal conflict of interest related to this study. Tadeusz J. Kochel had full access to all data in the study and serves as the guarantor for

  6. Arboviral Etiologies of Acute Febrile Illnesses in Western South America, 2000-2007

    Science.gov (United States)

    2010-08-01

    Ecuador, 6 Asociación Rayos del Sol, Asunción, Paraguay, 7 Instituto de Medicina Tropical ‘‘Alexander von Humboldt’’, Universidad Peruana Cayetano...March 2, 2009; Accepted July 12, 2010; Published August 10, 2010 This is an open- access article distributed under the terms of the Creative Commons Public

  7. A Case of Mixed Infections in a Patient Presenting with Acute Febrile Illness in the Tropics

    Directory of Open Access Journals (Sweden)

    L. S. Yong

    2013-01-01

    Full Text Available Concurrent infections with more than one etiological agent can result in an illness with overlapping symptoms, resulting in a situation where the diagnosis and management of such a patient could be challenging. We report a case of vivax malaria in a patient who was also serologically positive for leptospirosis and dengue.

  8. Etiology of Acute, Non-Malaria, Febrile Illnesses in Jayapura, Northeastern Papua, Indonesia

    Science.gov (United States)

    2012-01-01

    against poliomyelitis and several flaviviruses: Japanese encephalitis (JE) virus , dengue virus 1 and 2, and Murray Valley encephalitis virus . 13 In 1996...Hyg 66: 431 – 434 . 13. Van Tongeren HA , Wilterdink JB , Timmers WC , 1960 . Neutraliz- ing antibodies to the virus of poliomyelitis ...study in the same area found evidence of JE, Murray Valley encephalitis virus and Kunjin virus . 15 An outbreak of influenza A occurred in the

  9. Voriconazole-induced psychosis in a case of acute myeloid leukemia with febrile neutropenia

    Directory of Open Access Journals (Sweden)

    Hemendra Singh

    2015-01-01

    Full Text Available Voriconazole-induced psychosis is a rare side effect. It is important that clinicians are made aware of voriconazole-induced potential psychosis. We report a case of voriconazole-induced psychosis that responded to haloperidol.

  10. Outpatient management of febrile neutropenia: time to revise the present treatment strategy

    DEFF Research Database (Denmark)

    Carstensen, M.; Sørensen, Jens Benn

    2008-01-01

    We reviewed medical literature on the efficacy and safety of outpatient versus hospital-based therapy of low-risk febrile neutropenia in adult cancer patients. A PubMed search for all studies evaluating the outpatient treatment of adults diagnosed with solid tumors who suffered from low-risk febr......We reviewed medical literature on the efficacy and safety of outpatient versus hospital-based therapy of low-risk febrile neutropenia in adult cancer patients. A PubMed search for all studies evaluating the outpatient treatment of adults diagnosed with solid tumors who suffered from low...

  11. Profilaxia intermitente na convulsão febril com diazepam via oral

    Directory of Open Access Journals (Sweden)

    Marilisa M. Guerreiro

    1992-06-01

    Full Text Available Apresentamos a profilaxia intermitente com diazepam via oral como opção de tratamento para convulsão febril. Justificamos essa proposta diante dos importantes efeitos colaterais que ocorrem com as duas medicações classicamente usadas na profilaxia contínua (fenobarbital e valproato. Foram tratados 19 pacientes. Obtivemos resultados favoráveis, pois apenas um caso apresentou recorrência de convulsão febril em vigência de dose adequada do diazepam. Houve efeitos colaterais transitórios em 36,8% da nossa casuística.

  12. A brucellosis case presenting with vesicular and maculopapular rash and febrile neutropenia

    Directory of Open Access Journals (Sweden)

    Selmin Dirgen Çaylak

    2014-03-01

    Full Text Available Brucellosis is a systemic disease in which all kind of tissues and organs can be affected. Brucellosis may present with different symptoms and symptoms are non-specific. A broad spectrum of clinical manifestations can be seen, therefore diagnosis can be difficult. Cutaneous complications and febrile neutropenia have been rarely reported. Here, a rare brucellosis case was reported that he applied with fever, skin eruption and neutropenia. We emphasized that especially in endemic areas brucellosis should always be kept on mind in the differential diagnosis of patient with skin eruption and febril neutropenia.J Microbiol Infect Dis 2014;4(1: 39-41

  13. Fatal Aspergillus rhinosinusitis during induction chemotherapy in a child with acute lymphoblastic leukemia.

    NARCIS (Netherlands)

    Vlaardingerbroek, H.; Flier, M. van der; Borgstein, J.A.; Lequin, M.H.; Sluis, I.M. van der

    2009-01-01

    Invasive fungal infections are a major problem in patients treated for hematologic malignancies. We report a 3-year-old girl who suffered from febrile neutropenia during induction therapy for acute lymphoblastic leukemia. Initial chest computed tomography revealed no evidence of intrapulmonary funga

  14. The accuracy of clinical symptoms and signs for the diagnosis of serious bacterial infection in young febrile children: prospective cohort study of 15 781 febrile illnesses

    OpenAIRE

    Craig, Jonathan C.; Williams, Gabrielle J; Jones, Mike; Codarini, Miriam; Macaskill, Petra; Hayen, Andrew; Irwig, Les; Fitzgerald, Dominic A; Isaacs, David; McCaskill, Mary

    2010-01-01

    Objectives To evaluate current processes by which young children presenting with a febrile illness but suspected of having serious bacterial infection are diagnosed and treated, and to develop and test a multivariable model to distinguish serious bacterial infections from self limiting non-bacterial illnesses. Design Two year prospective cohort study. Setting The emergency department of The Children’s Hospital at Westmead, Westmead, Australia. Participants Children aged less than 5 years pres...

  15. CLINICAL ANALYSIS ABOUT CHANGES OF MYOCARDIAL ENZYME IN 62 CHILDREN WITH FEBRILE CONVULSION%62例小儿热性惊厥心肌酶谱变化临床分析

    Institute of Scientific and Technical Information of China (English)

    任莉英; 陈颖; 石霖

    2011-01-01

    [目的]通过对热性惊厥患儿抽搐后心肌酶谱的检测,探讨热性惊厥对心肌的损害.[方法]对2008年10月~2010年10月收治的62例急性上呼吸道感染致热性惊厥患儿进行心肌酶谱检测.[结果]观察组血清肌酸激酶同工酶(c reatine kinase-MB,CK-MB)、肌酸激酶(creatine k inase,CK)、乳酸脱氢酶(lac tare dehydrogenase,LDH)较对照组升高,与对照组比较差异有统计学意义(P<0.01).[结论]热性惊厥患儿抽搐时会引起心肌受损.治疗热性惊厥患儿时要注意保护心肌,有助于患儿早日康复.%[Objective] Through the detection of myocardial enzymes of children with febrile convulsion after convulsion, to investigate the myocardial damage. [Methods] From October 2008-October 2010, myocardial enzymes of 62 children with febrile convulsion admitted in because of acute upper respiratory tract infection were detected. [ Results] The serum levels of creatine kinase (c reatine kinase-MB, CK-MB) , creatine kinase (creatine k inase, CK) , lactate dehydrogenase (lac tate dehydrogenase, LDH) were higher than those in control group, there was a significant difference (P < 0.01). [Conclusion] The convulsions in children with febrile convulsion may cause myocardial damage. When treating febrile convulsion children, it should pay attention to the pmtection of the cardiac muscle, which helps children to recovery early.

  16. Frequency of Meningitis in Children Presenting with Febrile Seizures at Ali- Asghar Children’s Hospital

    Directory of Open Access Journals (Sweden)

    Azita TAVASOLI

    2014-12-01

    Full Text Available How to Cite This Article: Tavasoli A, Afsharkhas L, Edraki A. Frequency of Meningitis in Children Presenting with Febrile Seizure in Ali-Asghar Children’s Hospital. Iran J Child Neurol. 2014 Autumn; 8(4:51-56.AbstractObjectiveFebrile seizures (FS are the most common type of childhood seizures, affecting 2–5% of children. As the seizure may be the sole presentation of bacterial meningitis in febrile infants, it is mandatory to exclude underlying meningitis in children presenting with fever and seizure. To determine the frequency of meningitis in children with FS and related risk factors, the present study was conducted at Ali-Asghar Children’s Hospital.Materials & MethodsThe records of children aged from 1-month–6 years of age with fever and seizure admitted to the hospital from October 2000–2010 were studied. The charts of patients who had undergone a lumbar puncture were studied and cases of meningitis were selected. The related data was collected and analyzed with SPSS version 16.ResultsA total of 681 patients with FS were known from which 422 (62% lumbar punctures (LP were done. Meningitis (bacterial or aseptic was identified in 19 cases (4.5%, 95% CI 2.9–6.9 by Wilson- Score internal and bacterial meningitis in 7 (1.65%, 95% CI 0.8–3.3. None of the patients with bacterial meningitis had meningeal irritation signs. Complex FS, first attack of FS, and impaired consciousness were more common in patients with meningitis when compared to non- meningitis patients.ConclusionMeningitis is more common in patients less than 18 months presenting with FS; however, complex features of seizures, first attack of FS, or impaired consciousness seem significant risk factors for meningitis in these children and an LP should be considered in this situation. ReferencesKimia A, Ben-Joseph EP, Rudleo T, et al. Yield of lumbar puncture among children who present with their first complex febrile seizure. Pediatrics.2010; 126: 62

  17. 幼儿急疹合并热性惊厥的临床特征%Clinical characterstics of roseola infantum with febrile convulsions

    Institute of Scientific and Technical Information of China (English)

    王云峰; 周忠蜀

    2009-01-01

    Objective To explore the clinical characteristics of roseola infantmn with febrile convulsions.Methods All cases with roseola infantum or with febrile convulsions were retrospectively collected who were confirmed during January 2005 to February 2008. There were 31 cases of roseola infantum with febrile convulsions. Their clinical features were compared with cases of roseola infantum without febrile convulsions and eases of other febrile convulsions,respectively, and further analyzed with literature. Results There were 17.1% (3 1 / 181 ) roseola infantum with febrile convulsions among febrile convulsions and 24.4% (31/127)among febrile convulsions less than 2 years;The incidence of roseola infantum with febrile convulsions was 15.7% (31/198) among roseola infantum. The median age of roseola infantum with febrile convulsions was less than that of other febrile convulsions. There were no significant differences in sex, age, maximum body temperature, duration of fever and day of rash onset between roseola infantum with and without febrile convulsions ( P > 0.05 ), but the frequency of family history of febrile convulsions was significantly higher in roseola infantum with febrile convulsions than in those without febrile convulsions ( P 0.05),而热性惊厥家族史有显著差别(P<0.05).结论 遗传因素是导致幼儿急疹并热性惊厥发作的一个危险因素;幼儿急疹并热性惊厥时一般预后良好,但要警惕发生严重中枢神经系统损伤的可能性,如癫痫.对于1岁内初次发热并出现热性惊厥的患儿要注意幼儿急疹的可能.

  18. Cerebrospinal fluid purine metabolite and neuron-specific enolase concentrations after febrile seizures.

    Science.gov (United States)

    Rodríguez-Núñez, A; Cid, E; Rodríguez-García, J; Camiña, F; Rodríguez-Segade, S; Castro-Gago, M

    2000-10-01

    If febrile seizures cause significant compromise of neuronal metabolism (whether permanent or reversible), this should be reflected in an increase in the cerebrospinal fluid concentrations of neuron-specific enolase (NSE) and/or adenosine triphosphate (ATP) breakdown products. In the present study, AMP, IMP, inosine, adenosine, guanosine, adenine, guanine, hypoxanthine, xanthine, uric acid and NSE concentrations were determined in the cerebrospinal fluid of 90 children 1 h after febrile seizure (73 simple febrile seizures (SFS); 17 complex febrile seizures (CFS)), and in a control group of 160 children. There was no statistically significant difference between the SFS group and the control group for any of the substances determined, suggesting that SFS neither significantly depletes neuronal ATP concentration, nor significantly increases NSE concentration; thus, SFS do not appear to constitute a threat to neuronal integrity. However, patients with CFS showed significantly lower IMP concentrations and significantly higher adenine concentrations than controls, and significantly higher AMP concentrations than SFS patients; these results suggest that CFS may affect energy metabolism in the brain. However, NSE concentrations were normal in the cerebrospinal fluid of both SFS and CFS patients, suggesting that neither type of seizure causes significant neuronal damage, at least early after the seizure.

  19. Duration of Fever and Course of Symptoms in Young Febrile Children Presenting with Uncomplicated Illness

    NARCIS (Netherlands)

    Kool, Marijke; Elshout, Gijs; Moll, Henriette A.; Koes, Bart W.; van der Wouden, Johannes C.; Berger, Marjolein Y.

    2013-01-01

    Purpose: It is important to advise parents when to consult a doctor when their child has fever. To provide evidence-based, safety-net advice for young febrile children, we studied the risk of complications, the occurrence of alarm symptoms, the duration of fever. Methods: In a 7-day prospective foll

  20. When your child with epilepsy die suddenly: febrile seizures are part of the process?

    Directory of Open Access Journals (Sweden)

    V C Terra

    2011-01-01

    Full Text Available Febrile seizures (FS affect almost 2-5% of children and factors related to an increase susceptibility of children to FS may involve an imbalance of inflammatory cytokines and genetic factors. FS had low morbidity, but may be associated with the occurrence of late chronic epilepsy. Here we describe factors related to FS and its possible correlation with SUDEP.

  1. Parental perspectives on inpatient versus outpatient management of pediatric febrile neutropenia.

    Science.gov (United States)

    Diorio, Caroline; Martino, Julia; Boydell, Katherine Mary; Ethier, Marie-Chantal; Mayo, Chris; Wing, Richard; Teuffel, Oliver; Sung, Lillian; Tomlinson, Deborah

    2011-01-01

    To describe parent preference for treatment of febrile neutropenia and the key drivers of parental decision making, structured face-to-face interviews were used to elicit parent preferences for inpatient versus outpatient management of pediatric febrile neutropenia. Parents were presented with 4 different scenarios and asked to indicate which treatment option they preferred and to describe reasons for this preference during the face-to-face interview. Comments were recorded in writing by research assistants. A consensus approach to thematic analysis was used to identify themes from the written comments of the research assistants. A total of 155 parents participated in the study. Of these, 80 (51.6%) parents identified hospital-based intravenous treatment as the most preferred treatment scenario for febrile neutropenia. The major themes identified included convenience/disruptiveness, physical health, emotional well-being, and modifiers of parental decision making. Most parents preferred hospital-based treatment for febrile neutropenia. An understanding of issues that influence parental decision making may assist health care workers in planning program implementation and further support families in their decision-making process.

  2. Medication management of febrile children: a qualitative study on pharmacy employees' experiences.

    Science.gov (United States)

    Stakenborg, Jacqueline P G; de Bont, Eefje G P M; Peetoom, Kirsten K B; Nelissen-Vrancken, Marjorie H J M G; Cals, Jochen W L

    2016-10-01

    Background While fever is mostly self-limiting, antibiotic prescription rates for febrile children are high. Although every parent who receives a prescription visits a pharmacy, we have limited insight into pharmacy employees' experiences with these parents. Pharmacy employees do however exert an important role in ensuring children receive correct dosages and in advising parents on administration of antibiotics. Objective To describe pharmacists' and pharmacy assistants' experiences with parents contacting a pharmacy for their febrile child, and to identify ways of improving medication management of these children. Setting Community pharmacies in the Netherlands. Method A qualitative study including 24 Dutch pharmacy employees was conducted, performing four focus group discussions among pharmacy employees. Analysis was based on constant comparative technique using open and axial coding. Main outcome measure Pharmacy employees' experiences with parents contacting a pharmacy for their febrile child. Results Three categories were identified: (1) workload and general experience, (2) inconsistent information on antibiotic prescriptions, (3) improving communication and collaboration. Pharmacy employees experienced that dosing errors in antibiotic prescriptions occur frequently and doctors provide inconsistent information on prescriptions. Consequently, they have to contact doctors, resulting in a higher workload for both stakeholders. They believe this can be improved by providing the indication for antibiotics on prescriptions, especially when deviating from standard dosages. Conclusion Pharmacy employees experience a high amount of dosing errors in paediatric antibiotic prescriptions. Providing the indication for antibiotics in febrile children on prescriptions, especially when deviating from standard dosages, can potentially reduce dosage errors and miscommunication between doctors and pharmacy employees.

  3. Alarm signs and antibiotic prescription in febrile children in primary care : an observational cohort study

    NARCIS (Netherlands)

    Elshout, Gijs; van Ierland, Yvette; Bohnen, Arthur M.; de Wilde, Marcel; Oostenbrink, Rianne; Moll, Henriette A.; Berger, Marjolein Y.

    2013-01-01

    Background Although fever in children is often self-limiting, antibiotics are frequently prescribed for febrile illnesses. GPs may consider treating serious infections by prescribing antibiotics. Aim To examine whether alarm signs and/or symptoms for serious infections are related to antibiotic pres

  4. Alarm signs and antibiotic prescription in febrile children in primary care: An observational cohort study

    NARCIS (Netherlands)

    G. Elshout (Gijs); Y. van Ierland (Yvette); A.M. Bohnen (Arthur); M. de Wilde (Marcel); R. Oostenbrink (Rianne); H.A. Moll (Henriëtte); M.Y. Berger (Marjolein)

    2013-01-01

    textabstractBackground Although fever in children is often self-limiting, antibiotics are frequently prescribed for febrile illnesses. GPs may consider treating serious infections by prescribing antibiotics. Aim To examine whether alarm signs and/or symptoms for serious infections are related to ant

  5. Chikungunya Virus in Febrile Humans and Aedes aegypti Mosquitoes, Yucatan, Mexico

    Science.gov (United States)

    Cigarroa-Toledo, Nohemi; Blitvich, Bradley J.; Cetina-Trejo, Rosa C.; Talavera-Aguilar, Lourdes G.; Baak-Baak, Carlos M.; Torres-Chablé, Oswaldo M.; Hamid, Md-Nafiz; Friedberg, Iddo; González-Martinez, Pedro; Alonzo-Salomon, Gabriela; Rosado-Paredes, Elsy P.; Rivero-Cárdenas, Nubia; Reyes-Solis, Guadalupe C.; Farfan-Ale, Jose A.; Garcia-Rejon, Julian E.

    2016-01-01

    Chikungunya virus (CHIKV) was isolated from 12 febrile humans in Yucatan, Mexico, in 2015. One patient was co-infected with dengue virus type 1. Two additional CHIKV isolates were obtained from Aedes aegypti mosquitoes collected in the homes of patients. Phylogenetic analysis showed that the CHIKV isolates belong to the Asian lineage. PMID:27347760

  6. Cost effectiveness of primary pegfilgrastim prophylaxis in patients with breast cancer at risk of febrile neutropenia

    NARCIS (Netherlands)

    Aarts, M.J.; Grutters, J.P.C.; Peters, F.P.; Mandigers, C.M.P.W.; Dercksen, M.W.; Stouthard, J.M.; Nortier, H.J.; Laarhoven, H.W.M. van; Warmerdam, L.J. van; Wouw, A.J. van de; Jacobs, E.M.G.; Mattijssen, V.; Rijt, C.C. van der; Smilde, T.J.; Velden, A.W. van der; Temizkan, M.; Batman, E.; Muller, E.W.; Gastel, S.M. van; Joore, M.A.; Borm, G.F.; Tjan-Heijnen, V.C.

    2013-01-01

    PURPOSE: Guidelines advise primary granulocyte colony-stimulating factor (G-CSF) prophylaxis during chemotherapy if risk of febrile neutropenia (FN) is more than 20%, but this comes with considerable costs. We investigated the incremental costs and effects between two treatment strategies of primary

  7. Use of alarm features in referral of febrile children to the emergency department : an observational study

    NARCIS (Netherlands)

    van Ierland, Yvette; Elshout, Gijs; Moll, Henritte A.; Nijman, Ruud G.; Vergouwe, Yvonne; van der Lei, Johan; Berger, Marjolein Y.; Oostenbrink, Rianne

    2014-01-01

    Background The diagnostic value of alarm features of serious infections in low prevalence settings is unclear. Aim To explore to what extent alarm features play a role in referral to the emergency department (ED) by GPs who face a febrile child during out-of-hours care. Design and setting Observatio

  8. Chikungunya Virus in Febrile Humans and Aedes aegypti Mosquitoes, Yucatan, Mexico.

    Science.gov (United States)

    Cigarroa-Toledo, Nohemi; Blitvich, Bradley J; Cetina-Trejo, Rosa C; Talavera-Aguilar, Lourdes G; Baak-Baak, Carlos M; Torres-Chablé, Oswaldo M; Hamid, Md-Nafiz; Friedberg, Iddo; González-Martinez, Pedro; Alonzo-Salomon, Gabriela; Rosado-Paredes, Elsy P; Rivero-Cárdenas, Nubia; Reyes-Solis, Guadalupe C; Farfan-Ale, Jose A; Garcia-Rejon, Julian E; Machain-Williams, Carlos

    2016-10-01

    Chikungunya virus (CHIKV) was isolated from 12 febrile humans in Yucatan, Mexico, in 2015. One patient was co-infected with dengue virus type 1. Two additional CHIKV isolates were obtained from Aedes aegypti mosquitoes collected in the homes of patients. Phylogenetic analysis showed that the CHIKV isolates belong to the Asian lineage.

  9. Mucosal barrier injury, fever and infection in neutropenic patients with cancer: introducing the paradigm febrile mucositis

    NARCIS (Netherlands)

    Velden, W.J.F.M. van der; Herbers, A.H.E.; Netea, M.G.; Blijlevens, N.M.A.

    2014-01-01

    Infection remains one of the most prominent complications after cytotoxic treatment for cancer. The connection between neutropenia and both infections and fever has long been designated as 'febrile neutropenia', but treatment with antimicrobial agents and haematopoietic growth factors has failed to

  10. The use of FDG-PET/CT in patients with febrile neutropenia

    NARCIS (Netherlands)

    Vos, F.J.; Bleeker-Rovers, C.P.; Oyen, W.J.G.

    2013-01-01

    Fever is a frequent complication of neutropenia induced by the treatment of various neoplasms. This is referred to as febrile neutropenia, which is considered to be a sign of a potentially life-threatening infectious complication until proven otherwise. However, most infectious foci do not have loca

  11. Chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy.

    Science.gov (United States)

    Hashiguchi, Yasunori; Kasai, Mari; Fukuda, Takeshi; Ichimura, Tomoyuki; Yasui, Tomoyo; Sumi, Toshiyuki

    2015-11-01

    Chemotherapy-induced neutropenia is a common complication in cancer treatment. In this study, we investigated chemotherapy-induced neutropenia that was recently detected in all patients with gynecologic malignancy. Between January 2009 and December 2011, we examined cases of chemotherapy-induced neutropenia reported in our hospital. We analyzed the incidence and clinical features of chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy. During the study period, we administered over 1614 infusions (29 regimens) to 291 patients. The median age of the patients was 60 years (range 24-84 years). Chemotherapy-induced neutropenia occurred in 147 (50.5%) patients over 378 (23.4%) chemotherapy cycles. Febrile neutropenia occurred in 20 (6.9%) patients over 25 (1.5%) cycles. The mean duration of neutropenia and fever was 3.6 days (range 1-12 days) and 3.4 days (range 1-9 days), respectively. The source of fever was unexplained by examination or cultures in 14 (56.0%) cycles. There were two cases of neutropenia-related death. Chemotherapy-induced neutropenia was associated with older age (over 70 years) (PFebrile neutropenia was associated with poor performance status (Pneutropenia nor febrile neutropenia was associated with bone marrow metastases or previous radiotherapy. By identifying risk factors for febrile neutropenia, such as performance status, no previous chemotherapy, disseminated disease, and distant metastatic disease, the safe management of chemotherapy-induced neutropenia may be possible in patients with gynecologic malignancy.

  12. Expression Profiling after Prolonged Experimental Febrile Seizures in Mice Suggests Structural Remodeling in the Hippocampus.

    Directory of Open Access Journals (Sweden)

    Bart C Jongbloets

    Full Text Available Febrile seizures are the most prevalent type of seizures among children up to 5 years of age (2-4% of Western-European children. Complex febrile seizures are associated with an increased risk to develop temporal lobe epilepsy. To investigate short- and long-term effects of experimental febrile seizures (eFS, we induced eFS in highly febrile convulsion-susceptible C57BL/6J mice at post-natal day 10 by exposure to hyperthermia (HT and compared them to normotherm-exposed (NT mice. We detected structural re-organization in the hippocampus 14 days after eFS. To identify molecular candidates, which entrain this structural re-organization, we investigated temporal changes in mRNA expression profiles eFS 1 hour to 56 days after eFS. We identified 931 regulated genes and profiled several candidates using in situ hybridization and histology at 3 and 14 days after eFS. This is the first study to report genome-wide transcriptome analysis after eFS in mice. We identify temporal regulation of multiple processes, such as stress-, immune- and inflammatory responses, glia activation, glutamate-glutamine cycle and myelination. Identification of the short- and long-term changes after eFS is important to elucidate the mechanisms contributing to epileptogenesis.

  13. Cognitive performance and convulsion risk after experimentally-induced febrile-seizures in rat

    NARCIS (Netherlands)

    Rajab, Ebrahim; Abdeen, Zahra; Hassan, Zuhair; Alsaffar, Yousif; Mandeel, Mohammad; Al Shawaaf, Fatima; Al-Ansari, Sali; Kamal, Amer

    2014-01-01

    Many reports indicated that small percentage of children with febrile seizures develop epilepsy and cognitive disorders later in adulthood. In addition, the neuronal network of the hippocampus was reported to be deranged in adult animals after being exposed to hyperthermia-induced seizures in their

  14. Phenotyping mouse chromosome substitution strains reveal multiple QTLs for febrile seizure susceptibility

    NARCIS (Netherlands)

    Hessel, E V S; van Gassen, K L I; Wolterink-Donselaar, I G; Stienen, P J; Fernandes, C; Brakkee, J H; Kas, M J H; de Graan, P N E

    2009-01-01

    Febrile seizures (FS) are the most common seizure type in children and recurrent FS are a risk factor for developing temporal lobe epilepsy. Although the mechanisms underlying FS are largely unknown, recent family, twin and animal studies indicate that genetics are important in FS susceptibility. He

  15. Phenotyping mouse chromosome substitution strains reveal multiple QTLs for febrile seizure susceptibility.

    NARCIS (Netherlands)

    Hessel, E.V.; Gassen, K.L.I. van; Wolterink-Donselaar, I.G.; Stienen, P.J.; Fernandes, C.; Brakkee, J.H.; Kas, M.J.; Graan, P.N. de

    2009-01-01

    Febrile seizures (FS) are the most common seizure type in children and recurrent FS are a risk factor for developing temporal lobe epilepsy. Although the mechanisms underlying FS are largely unknown, recent family, twin and animal studies indicate that genetics are important in FS susceptibility. He

  16. First Complete Genome Sequences of Zika Virus Isolated from Febrile Patient Sera in Ecuador

    Science.gov (United States)

    Márquez, S.; Carrera, J.; Pullan, S. T.; Lewandowski, K.; Paz, V.; Loman, N.; Quick, J.; Bonsall, D.; Powell, R.; Thézé, J.; Pybus, O. G.; Klenerman, P.; Eisenberg, J.; Coloma, J.; Carroll, M. W.; Trueba, G.

    2017-01-01

    ABSTRACT Here, we present the complete genome sequences of two Zika virus (ZIKV) strains, EcEs062_16 and EcEs089_16, isolated from the sera of febrile patients in Esmeraldas City, in the northern coastal province of Esmeraldas, Ecuador, in April 2016. These are the first complete ZIKV genomes to be reported from Ecuador. PMID:28232448

  17. Treatment duration of febrile urinary tract infection (FUTIRST trial: a randomized placebo-controlled multicenter trial comparing short (7 days antibiotic treatment with conventional treatment (14 days

    Directory of Open Access Journals (Sweden)

    Kuijper Ed J

    2009-08-01

    Full Text Available Abstract Background Current guidelines on the management of urinary tract infection recommend treating febrile urinary tract infection or acute pyelonephritis with antimicrobials for at least 14 days. Few randomized trials showed the effectiveness of treatment durations of 5 to 7 days but this has only been studied in young previously healthy women. Methods/Design A randomized placebo-controlled double-blind multicenter non-inferiority trial in which 400 patients with community acquired febrile urinary tract infection will be randomly allocated to a short treatment arm (7 days of ciprofloxacin or 7 days of empirical β-lactams ± gentamicin intravenously with early switch to oral ciprofloxacin followed by 7 days of blinded placebo or standard treatment arm (7 days of ciprofloxacin or 7 days of empirical β-lactams ± gentamicin intravenously with early switch to oral ciprofloxacin followed by 7 days of blinded ciprofloxacin. The study is performed in the Leiden region in which one university hospital, 6 general hospitals and 32 primary health care centers are clustered. Patients eligible for randomization are competent patients aged 18 years or above with a presumptive diagnosis of acute pyelonephritis as defined by the combination of fever, one or more symptoms of urinary tract infection and a positive urine nitrate test and/or the presence of leucocyturia. Exclusion criteria are known allergy to fluoroquinolones, female patients who are pregnant or lactating, polycystic kidney disease, permanent renal replacement therapy, kidney transplantation, isolation of ciprofloxacin-resistant causal uropathogen, renal abscess, underlying chronic bacterial prostatitis, metastatic infectious foci and inability to obtain follow-up. The primary endpoint is the clinical cure rate through the 10- to 18-day post-treatment visit. Secondary endpoints are the microbiological cure rate 10- to 18-day post-treatment, the 30- and 90-day overall mortality rate, the

  18. 高血糖对急性出血性卒中早期预后的影响%Influence of hyperglycemia on the prognosis of patients with acute hemorrhagic stroke in early stage

    Institute of Scientific and Technical Information of China (English)

    李佐君; 钟历勇; 綦雯雯; 王春雪; 赵性泉

    2012-01-01

    Objective To investigate the influence of hyperglycemia on the prognosis of patients with acute hemorrhagic stroke in early stage. Methods In a consecutive way, 105 patients with acute hemorrhagic stroke (<72 hours) were enrolled in this prospective study. The scores of National Institutes of Health Stroke Scale (NIHSS) were calculated and the random serum glucose concentrations when they were admitted to hospital were tested, and the scores of Modified Rankin Scales (mRS) were evaluated 30 days after stroke. The multivariate stepwise logistic regression analysis on the factors affecting the glycemia level and on the influence of hyperglycemia on the prognosis of patients were carried out. Results (1)Of the 105 patients. 61 (58. 1%) presented with hyperglycemia at admission. Age, history of diabetes mellitus, infection, and NIHSS score were risk factors for acute hemorrhagic stroke accompanied with hyperglycemia (P<0. 05). History of diabetes mellitus and NIHSS score were independent risk factors for acute hemorrhagic stroke patients accompanied with hyperglycemia (P<0. 05). (2) The influence of infection, hyperglycemia, and NIHSS score on the score of mRS were statistically significant (P<0. 01), and hyperglycemia and NIHSS score were independent risk factors for poor prognosis (P< 0.05). Conclusion Hyperglycemia in the acute stage of hemorrhagic stroke predicates a serious degree of stroke. Hyperglycemia is an independent risk factor for poorer outcome in patients with acute hemorrhagic stroke in early stage.%目的 探讨高血糖对急性出血性卒中早期预后的影响. 方法 连续纳入发病72 h内入院的急性出血性卒中患者105例,入院时评定美国国立卫生研究院卒中量表(NIHSS)评分并检测随机静脉血清葡萄糖,发病30 d时进行改良Rankin量表评分(mRS).采用多元逐步Logistic回归分析影响急性出血性卒中患者血糖水平的因素及高血糖对急性出血性卒中早期预后的影响. 结果 (1)

  19. Knowledge, attitude and practices of parents of children with febrile convulsion.

    Directory of Open Access Journals (Sweden)

    Parmar R

    2001-01-01

    Full Text Available CONTEXT: Parental anxiety and apprehension is related to inadequate knowledge of fever and febrile convulsion. AIMS: To study the knowledge, attitude, and practices of the parents of children with febrile convulsions. SETTINGS AND DESIGN: Prospective questionnaire based study in a tertiary care centre carried over a period of one year. SUBJECTS AND METHODS: 140 parents of consecutive children presenting with febrile convulsion were enrolled. STATISTICAL ANALYSIS USED: Chi-square test. RESULTS: 83 parents (59.3% could not recognise the convulsion; 90.7% (127 did not carry out any intervention prior to getting the child to the hospital. The commonest immediate effect of the convulsion on the parents was fear of death (n= 126, 90% followed by insomnia (n= 48, 34.3%, anorexia (n= 46, 32.9%, crying (n= 28, 20% and fear of epilepsy (n= 28, 20%. Fear of brain damage, fear of recurrence and dyspepsia were voiced by the fathers alone (n= 20, cumulative incidence 14.3%. 109 (77.9% parents did not know the fact that the convulsion can occur due to fever. The long-term concerns included fear of epilepsy (n= 64, 45.7% and future recurrence (n= 27, 19.3% in the affected child. For 56 (40% of the parents every subsequent episode of fever was like a nightmare. Only 21 parents (15% had thermometer at home and 28 (20% knew the normal range of body temperature. Correct preventive measures were known only to 41 (29.2%. Awareness of febrile convulsion and the preventive measures was higher in socio-economic grade (P< 0.05. CONCLUSIONS: The parental fear of fever and febrile convulsion is a major problem with serious negative consequences affecting daily familial life.

  20. Hypothalamic neuronal histamine modulates febrile response but not anorexia induced by lipopolysaccharide.

    Science.gov (United States)

    Chiba, Seiichi; Itateyama, Emi; Oka, Kyoko; Masaki, Takayuki; Sakata, Toshiie; Yoshimatsu, Hironobu

    2005-05-01

    This study examined the contribution of hypothalamic neuronal histamine (HA) to the anorectic and febrile responses induced by lipopolysaccharide (LPS), an exogenous pyrogen, and the endogenous pyrogens interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha). Intraperitoneal (ip) injection of LPS, IL-1beta, or TNF-alpha suppressed 24-hr cumulative food intake and increased rectal temperature in rats. To analyze the histaminergic contribution, rats were pretreated with intracerebroventricular (icv) injection of 2.44 mmol/kg or ip injection of 244 mmol/kg of alpha-fluoromethylhistidine (FMH), a suicide inhibitor of histidine decarboxylase (HDC), to deplete neural HA. The depletion of neural HA augmented the febrile response to ip injection of LPS and IL-1beta and alleviated the anorectic response to ip injection of IL-1beta. However, the depletion of neural HA did not modify the LPS-induced anorectic response or TNF-alpha-induced febrile and anorectic responses. Consistent with these results, the rate of hypothalamic HA turnover, assessed by the accumulation of tele-methylhistamine (t-MH), was elevated with ip injections of LPS and IL-1beta, but unaffected by TNF-alpha at equivalent doses. This suggests that (i) LPS and IL-1beta activate hypothalamic neural HA turnover; (ii) hypothalamic neural HA suppresses the LPS- and IL-1beta-induced febrile responses and accelerates the IL-1beta-induced anorectic response; and (iii) TNF-alpha modulates the febrile and anorectic responses via a neural HA-independent pathway. Therefore, hypothalamic neural HA is involved in the IL-1beta-dominant pathway, rather than the TNF-alpha-dominant pathway, preceding the systemic inflammatory response induced by exogenous pyrogens, such as LPS. Further research on this is needed.

  1. Febrile morbidity in severe and critical ovarian hyperstimulation syndrome: a multicentre study.

    Science.gov (United States)

    Abramov, Y; Elchalal, U; Schenker, J G

    1998-11-01

    The objective of this study was to define the incidence of febrile morbidity and its causes in severe and critical ovarian hyperstimulation syndrome (OHSS). For this purpose, we reviewed the medical records of all OHSS patients hospitalized in 16 out of 19 tertiary medical centres in Israel between January 1987 and December 1996. Febrile morbidity was defined as at least one episode of temperature rise above 38 degrees C lasting > or =24 h. A total of 2902 patients (3305 hospitalizations) with OHSS was identified, of whom 196 had severe, and 13 critical, OHSS. Among the 209 patients investigated the incidence of febrile morbidity was 82.3%, of which 20.5% was attributed to urinary tract infection, 3.8% to pneumonia, 3.3% to upper respiratory tract infection, 2.0% to intravenous line phlebitis, 1.0% to cellulitis at an abdominal puncture site, 1.0% to postoperative wound infections and 0.5 % to gluteal abscess at the site of progesterone injection. Non-typical organisms were frequently isolated, such as Pseudomonas, Proteus, Klebsiella and Enterobacter species. No infectious aetiology was found in 105 patients (50.2%). Hypoglobulinaemia was recorded in most patients, while ascitic and pleural fluids aspirated from these patients contained high globulin concentrations. We conclude that infection-related febrile morbidity in severe and critical OHSS is high, and may be attributed to some degree of immunodeficiency associated with loss of plasma globulins to the third space. However, non-infection-related febrile morbidity is even higher and may be attributed to endogenous pyrogenic mechanisms.

  2. Acute fever and delayed leukoencephalopathy following low dose intraventricular methotrexate.

    OpenAIRE

    Boogerd, W.; vd Sande, J J; Moffie, D

    1988-01-01

    Nine out of 14 patients treated with intraventricular methotrexate (MTX) for meningeal carcinomatosis from breast carcinoma and surviving more than 4 months developed disseminated necrotising leukoencephalopathy (DNL). All four patients who had received both intraventricular MTX and whole brain radiotherapy developed DNL. Five of the six patients who experienced an acute febrile reaction with mild encephalopathic signs following intraventricular administration of MTX developed DNL after a mea...

  3. 整脊治疗膝关节骨性关节炎急性期的疗效观察%Efficacy Observation on Acute Stage of Knee Osteoarthritis with Chiropractic Therapy

    Institute of Scientific and Technical Information of China (English)

    陈小砖; 陈淑惠

    2013-01-01

    Objective:To investigate the effects of chiropractic therapy on acute stage of knee osteoarthritis. Methods:60 cases of knee osteoarthritis in acute stage were randomly divided into treatment group and control group with each of 30 cases, treatment group received chiropractic and local conventional treatment on knee joint, control group with conventional manipulation treatment on knee joint, to evaluate the knee joint function, pain degree and curative effects of two groups after 3 months. Results:The total effective rate of treatment group was 90%, significantly higher than that of control group by 73.3%(P<0.05);improvements of pain degree and knee joint function in treatment group were better than those in control group (P<0.05). Conclusion:Chiropractic therapy significantly reduces the pain of osteoarthritis knee in acute stage, and improves the overall function of knee joint.%目的:探讨整脊疗法对膝关节骨性关节炎急性期的作用。方法:60例膝关节骨性关节炎急性期患者随机分为治疗组和对照组各30例,治疗组予整脊及膝关节局部常规手法治疗,对照组采用膝关节局部常规手法治疗,3个月后评价两组膝关节功能、疼痛度及疗效。结果:治疗组总有效率90.0%,明显高于对照组的73.3%(P<0.05);治疗组疼痛度及膝关节功能改善情况均优于对照组(P<0.05)。结论:整脊疗法明显减轻膝关节骨性关节炎急性期关节疼痛,改善膝关节整体功能。

  4. [Acute kidney injury

    NARCIS (Netherlands)

    Hageman, D.; Kooman, J.P.; Lance, M.D.; Heurn, L.W. van; Snoeijs, M.G.

    2012-01-01

    - 'Acute kidney injury' is modern terminology for a sudden decline in kidney function, and is defined by the RIFLE classification (RIFLE is an acronym for Risk, Injury, Failure, Loss and End-stage kidney disease).- Acute kidney injury occurs as a result of the combination of reduced perfusion in the

  5. OUTCOME AND TRANSFORMATION OF FEBRILE SEIZURES IN CHILDREN (DATA OF SVT. LUKA'S INSTITUTE OF CHILD NEUROLOGY & EPILEPSY

    Directory of Open Access Journals (Sweden)

    M. B. Mironov

    2012-01-01

    Full Text Available According to definition, febrile seizures — benign, age-dependent, genetically predisposed condition in which the brain is susceptible to epileptic seizures, occurring in response to the fever. The article presents the outcome and trans­formation of febrile seizures in children by data of Svt. Luka's Institute of child neurology & epilepsy. The authors found, thatfebrile seizures can occur at onset of 21 epileptic syndromes with different etiologic factors and outcome. The clini­cal characteristics, EEG and neuroimaging data, as well as the effectiveness of antiepileptic drugs and prognosis of dif­ferentforms of epilepsy with febrile seizures in history are described in detail.  

  6. Analysis of clinical characteristics and plasma level of mannose-binding lectin in 68 children with febrile convulsion%68例热性惊厥患儿临床特点及其血浆甘露糖结合凝集素水平变化

    Institute of Scientific and Technical Information of China (English)

    王超前; 华春珍; 罗巧二; 王琦婧; 戴凯丽; 黄邢邢; 杨钦梳

    2012-01-01

    [Objective] To analyze the clinical characteristics of febrile convulsion (FC) occurred in children and study the mannose-binding lectin (MBL) levels in plasma at both acute and convalescent stages in the case group. [Methods] Plasma samples were separated from whole blood which was collected from children with FC at the acute and convalescent stages during August 2010 to July 2011. The MBL concentrations were measured by ELISA method and the SPSS 11. 0 software was used in the study. [Results] Among all 68 cases,The mean MBL levels were (595 + 559)ng/mL at acute stage and (585 ± 466)ng/mL in recovery stage,and no significant difference was found between the two groups (Z = 0. 207,P = 0. 836). However,there was a significant correlation of the MBL levels between the two stages (r=0. 809, P<0. 01). 29. 4% of all individuals had low MBL levels less than 200 ng/mL at convalescent stage. Acute reaction of MBL was observed in 38. 2% children with FC. No correlation was found between MBL levels and CRP levels(r =-0. 15,P=0. 22). It was found that 89. 7% of the FC children was caused by acute upper respiratory tract infection. The creatine kinase-MB exceeding normal value was found in 54. 1% of all individuals. [Conclusion] As a whole, convulsion acting as a kind of stress, had no significant effects on the MBL level in vivo.%[目的]了解热性惊厥患儿的临床特点及其血浆甘露糖结合凝集素(mannose-binding lectin,MBL)水平在惊厥前后的变化. [方法]对2010年8月-2011年7月在本院住院的68例热性惊厥患儿,应用ELISA法检测急性期与恢复期血浆MBL浓度,同时进行临床特点分析.统计分析采用SPSS 11.0. [结果]急性期和恢复期MBL平均浓度分别为(595±559) ng/mL和(585±466) ng/mL,二者差异无统计学意义(Z=0.207,P=0.836),急性期与恢复期MBL水平呈线性相关(r=0.809,P<0.01).其中恢复期MBL血浆浓度<200 ng/mL的病例占29.4%,MBL参与急性应答占全部病例的38.2%.MBL浓

  7. Feasibility and acute toxicity of 3-dimensional conformal external-beam accelerated partial-breast irradiation for early-stage breast cancer after breast-conserving surgery in Chinese female patients

    Institute of Scientific and Technical Information of China (English)

    LI Feng-yan; HE Zhen-yu; XUE Ming; CHEN Li-xin; WU San-gang; GUAN Xun-xing

    2011-01-01

    Background A growing number of studies worldwide have advocated the replacement of whole-breast irradiation with accelerated partial breast irradiation using three-dimensional conformal external-beam radiation (APBI-3DCRr) for early-stage breast cancer. But APBI can be only used in selected population of patients with early-staged breast cancer. It is not replacing the whole breast radiotherapy. This study aimed to examine the feasibility and acute normal tissue toxicity of the APBI-3DCRT technique in Chinese female patients who generally have smaller breasts compared to their Western counterparts.Methods From May 2006 to December 2009, a total of 48 Chinese female patients (with early-stage breast cancer who met the inclusion criteria) received APBI-3DCRT after breast-conserving surgery at Sun Yat-sen University Cancer Center. The total dosage from APBI-3DCRT was 34 Gy, delivered in 3.4 Gy per fractions, twice per day at intervals of at least six hours. The radiation dose, volume of the target area and volume of irradiated normal tissues were calculated.Acute toxicity was evaluated according to the Common Toxicity Criteria (CTC) 3.0.Results Among the 48 patients, the planning target volume for evaluation (PTVE) was (90.42±9.26) cm3, the ipsilateral breast volume (IBV) was (421.74±28.53) cm3, and the ratio between the two was (20.74±5.86)%. Evaluation of the dosimetric characteristics of the PTVE revealed excellent dosimetric results in 14 patients and acceptable results in 34 patients. The dose delivered to the PTVE ranged from 93% to 110% of the prescribed dose. The average ratio of the volume of PTVE receiving 95% of the prescription dose (V95) was (99.26±0.37)%. The habituation index (HI) and the conformity index (CI) were 1.08±0.01 and 0.72±0.02, respectively, suggesting good homogeneity and conformity of the dose delivered to the target field. The radiation dose to normal tissues and organs was within the dose limitation.Subjects experienced mild acute

  8. Procedures and characteristics of rehabilitative nursing and rehabilitative training in the acute stage of stroke%脑卒中急性期康复护理及康复训练的程序及特征

    Institute of Scientific and Technical Information of China (English)

    邓景贵

    2005-01-01

    目的:为使脑卒中患者最大限度地恢复受损的神经功能,回归社会,提高生活质量,制定急性期早期规范的康复程序.方法:康复程序包括康复治疗、康复护理、体位处理、主动运动、被动运动、日常生活活动训练和失禁处理.结果:急性期的早期康复能使脑卒中患者受损的神经功能最大限度地得到恢复,并发症减少.结论:脑卒中患者早期康复有助于受损神经神经功能的恢复.%AIM: To establish early normative rehabilitative procedure at acute stage for maximizing the restoration of injured neural function for the patients with stroke,letting them back to the social life and improving their quality of life.METHODS: Rehabilitative procedure including rehabilitative therapy,rehabilitative nursing,position management,active exercise,passive exercise,training of daily life activity and the management of incontinence.RESULTS: Early rehabilitation in acute stage can maximally restore the injured neural functions in the patients with stroke and reduce complications.CONCLUSION: Early rehabilitation for patients with stroke is helpful to the restoration of injured neural functions.

  9. 脑出血急性期血肿扩大的临床分析%Clinical Analysis of the enlargement of the lntracerebral hematomas in the acute stage of cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    王岭; 李海燕

    2001-01-01

    Objective:To explore the incidence,causes,clinical,manifestation of the enlargement of hematomas in the acute stage of cerebral hemorrhage and the measures to it .Methods:The clinical course and their CT of 867 cases with cerebral hemorrhage occuning during 1994~2000 were analyses.Results:The incidence of the enlargement of the intracerebral hematomas in the acute stage of cerebral hemorrhage was 20.1% ,which was related to the degree of hypertension,coagulation statement,bleeding site,morphologic charge of hematomas and extreme dehydration in early stage.The enlargement of the hematomas would make higher incident of the cerebral hemorrhage .Conclusions:The progress was affected by the enlargement hematomas,so we should diagnose it as possibly earlier and take effective measures to improve prognosis of patients.%目的:探讨脑出血急性期血肿扩大的发生率、原因、临床表现、预后及采取的相应措施。方法:回顾性分析1994~2000年间诊治的867例脑出血病人的临床和CT资料。结果:脑出血急性期血肿扩大的发生率为20.1%,其主要与血压增高的程度、凝血功能、出血部位、血肿形态及早期过度脱水有关,血肿扩大增加了病人的死亡率。结论:血肿扩大的发生影响病人预后,应尽早确诊,采取积极防治措施,改善病人预后。

  10. False-positive rapid plasma reagin testing in patients with acute Plasmodium vivax malaria: a case control study.

    Science.gov (United States)

    Maves, Ryan C; Dean, Katherine; Gadea, Nilda; Halsey, Eric S; Graf, Paul C F; Lescano, Andres G

    2014-01-01

    Non-treponemal tests such as the rapid plasma reagin (RPR) assay are mainstays of syphilis diagnosis, but false-positive tests are common. We identified false-positive RPR titers in 8.2% of patients with malaria due to Plasmodium vivax in northern Peru. Similar rates were not detected in patients with other acute febrile illnesses.

  11. Effect of zinc protoporphyrin on carbon monoxide/heme oxygenase-1 system in rats subjected to recurrent febrile convulsion

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Studies on febrile convulsion (FC)-caused brain injury are disputed in many aspects.How FC cause nervous system injury in the developmental period and what are the characteristics of these pathological injury are unknown. The current studies have demonstrated that heme oxygenase-1 (HO-l) exerts effects on brain injury mainly by catalyzing hemoglobin to produce degradation products, and HO-1 not only has neuroprotective effects, but also has neurotoxic effects during the FC-caused brain injury. Study on the effect of zinc protoporphyrin (ZnPP) on brain injury is still in the stage of animal experiment.OBJECTIVE: To observe the effects of ZnPP on carbon monoxide (CO)/HO-1 system of rats subjected to FC, and to analyze the action pathway of ZnPP in brain protective effect.DESIGN: A randomized controlled animal experiment.SETTING: Department of Pediatrics, First Hospital Affiliated to Jiamusi University.MATERIALS: Sixty-five Wistar rats, of either gender, were involved in this study. They were randomized into normal control group( n =14, 37 ℃ water bath) and febrile treatment group (n =51, 44.5 ℃ hot water bath). Febrile treatment group was sub-divided into febrile non-convulsion group (FNC group, n =16) and FC group (n =35). FC group was further sub-divided into simple convulsion group (n =20) and ZnPP treatment group (n =15). HO-1 mRNA in situ hybridization kit was provided by Boster Bioengineering Co.,Ltd. ZnPP(dark brown powder) was the product of Jingmei Bioengineering Company.METHODS: This study was carried out in the postgraduate laboratory of Jiamusi University between January 2004 and January 2007. Rats in the febrile treatment group were placed in the 44.5 ℃ hot water bath box. If rats did not convulse in the water within 5 minutes, they were taken out, namely FNC group (n =16), and those, which were convulsed within 5 minutes, were taken out immediately when they presented such a phenomenon, namely FC group (n =35). Convulsion induction was

  12. Routine radiography does not have a role in the diagnostic evaluation of ambulatory adult febrile neutropenic cancer patients

    NARCIS (Netherlands)

    Nijhuis, CSMO; Gietema, JA; Vellenga, E; Daenen, SMGJ; De Bont, ESJM; Kamps, WA; Groen, HJM; van der Jagt, EJ; van der Graaf, WTA

    2003-01-01

    Cancer patients treated with chemotherapy are susceptible to bacterial infections. When an adult patient presents with febrile neutropenia. standard diagnostic care includes physical examination, laboratory diagnostics, chest X-ray (CXR) and sinus radiography. However, the yield of routine radiograp

  13. Intermittent diazepam and continuous phenobarbital to treat recurrence of febrile seizures: a systematic review with meta-analysis

    Directory of Open Access Journals (Sweden)

    Masuko Alice Hatsue

    2003-01-01

    Full Text Available Convulsions triggered by fever are the most common type of seizures in childhood, and 20% to 30% of them have recurrence. The prophylactic treatment is still controversial, so we performed a systematic review to find out the effectiveness of continuous phenobarbital and intermittent diazepam compared to placebo for febrile seizure recurrence. METHOD: Only randomized, double-blind, placebo-controlled trials were analyzed. The recurrence of febrile seizure was assessed for each drug. RESULTS: Ten eligible clinical trials were included. Febrile seizure recurrence was smaller in children treated with diazepam or phenobarbital than in placebo group. Prophylaxis with either phenobarbital or diazepam reduces recurrences of febrile seizures. The studies were clinical, methodological, and statistically heterogeneous. CONCLUSION: The effectiveness of phenobarbital and diazepam could not be demonstrated because clinical trials were heterogeneous, and the recommendation for treatment recurrence should rely upon the experience of the assistant physician yet.

  14. On the Nursing of Children with Febrile Convulsion%关于小儿热惊厥护理

    Institute of Scientific and Technical Information of China (English)

    冷婷

    2014-01-01

    This paper mainly discusses the nursing of children with febrile convulsion, including the causes, treatment, family nursing and post-illness observation of febrile convulsion. Ob-jective:The nursing of children with febrile convulsion. Method:The obtained data and materials. Reason: To strengthen child nursing. Result: The process of the nursing of children with febrile convulsion is obtained.%关于小儿热惊厥的护理,其中包括小儿热惊厥的病因、治疗、家庭护理以及病后观察。研究目的:小儿热惊厥的护理。研究方法:已经得出的数据资料。研究原因:加强对小儿的护理。研究结果:得出小儿热惊厥的护理过程。

  15. Regional cerebral blood flow in acute stage with ischemic cerebrovascular disease by xenon-133 inhalation and single photon emission computerized tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kurokawa, Hiroyuki; Iino, Katsuro; Kojima, Hisashi; Saito, Hitoshi; Suzuki, Mikio; Watanabe, Kazuo; Kato, Toshiro

    1987-05-01

    Single photon emission computed tomography (SPECT) with xenon-133 inhalation method was undertaken within 48 hr after the onset in 68 patients with ischemic cerebrovascular disease. The results for regional cerebral blood flow (rCBF) were compared with concurrently available computed tomography (CT) scans. In patients with cerebral infarction, SPECT detected ischemic lesions earlier than CT, with the detectability being 92 %. The area with a decreased blood flow, as seen on SPECT, was more extensive than the low density area on CT, with a concomitant decrease in blood flow in the contralateral cerebral hemisphere. Crossed cerebellar diaschisis was associated with stenosis of the internal carotid artery in 50 % (7/14), and with stenosis of the middle cerebral artery in 35 % (9/26). Abnormal SPECT findings were seen in 47 % (8/17) of the patients with transient ischemic attack (TIA). Five TIA patients had a decreased rCBF on SPECT, which was not provided by CT scans. On the contrary, small infarct lesions in the cerebral basal ganglia, as observed in 4 patients, was not detected by SPECT, but detected by CT. This may imply the limitations of SPECT in the detection of deep-seated lesions of the cerebrum. The results led to the conclusion that SPECT can be performed safely even in acute, seriously ill patients to know changes in rCBF because it is noninvasive and is capable of being repeated in a short time. (Namekawa, K.).

  16. 阶段性管理缓解初产妇第一产程急性疼痛的效果评价%Effectiveness evaluation of stage management to reduce the acute pain in the first stage of labor

    Institute of Scientific and Technical Information of China (English)

    毛佳慧; 马建娣; 喻晓芬; 朱瑛; 王慧

    2014-01-01

    目的:通过阶段性管理深入研究评价规范化疼痛管理和互替疗法减轻初产妇疼痛的效果,并探索增进舒适支持策略。方法选取门诊定期产检并在孕妇学校上课的60名产妇作为研究对象,由研究者进行产时管理;临产后按照随机数字表法将产妇分为对照组和观察组各30人。对照组第一产程常规护理,观察组按照规范化疼痛管理和替代经验、治疗性按摩、音乐冥想及产球互替的方法进行护理。采用长海痛尺评估产妇的疼痛程度,视觉模拟评分法( VAS)测评产妇的情绪、舒适度;将两组产妇干预后的疼痛情况、情绪变化及舒适度进行比较。结果观察组产妇疼痛程度轻度者12人(40.00%),中度者17人(56.67%),重度者1人(3.33%);对照组产妇疼痛程度轻度者5人(16.67%),中度者21人(70.00%),重度者4人(13.33%),两组比较,差异有统计学意义(U=2.235,P=0.025)。观察组产妇轻微不适者22人(73.33%),中度不适者8人(26.67%),无重度不适者;对照组产妇轻微不适者10人(33.33%),中度不适者17人(56.67%),重度不适者3人(10.00%),两组比较,差异有统计学意义(U=3.222,P=0.001)。观察组产妇的情绪反应与对照组比较,差异无统计学意义(U=0.800,P=0.424)。结论阶段性管理能显著减轻初产妇产时的疼痛感并提高舒适感。%Objective Using the stage management to evaluate the normalized pain management and to alleviate pain of primipara during delivery and improve comfort .Methods Sixty pregnant women were selected and were divided into the control group and the observation group , each with 30 cases.The control group was given the usual care during the first stage of delivery , while the observation group was given a set of normalized pain management and alternative

  17. Chinese Medicine and Western Medicine Systematic Rehabilitation in the Early Stage of Acute Myocardial Infarction%急性心肌梗死早期中西医结合系统化康复探讨

    Institute of Scientific and Technical Information of China (English)

    朱初麟; 杜廷海; 牛琳琳

    2015-01-01

    Objective To investigate the advantages and pathway of chinese medicine and western medicine systematic rehabilitation in theearly stage of acute myocardial infarction.MethodsExploring the effect of early rehabilitation on acute myocardial infarction and advantages of traditional Chinese medicine (TCM),then,proposing theidea and model of cardiac rehabilitation unit.Results An optimized,standardized rehabilitation treatment system were established after optimizing drug medication,physical therapy,psychological rehabili-tation,external TCM treatment through rehabilitation process and integrating effective TCM therapy and western therapy.Conclusion Itwas needed to exert the advantages of chinese medicine rehabilitation and improve the systematic management model of chinese medicine and western medicine. Applying integrative and optimized cardiac rehabil-itation in the early stage of acute myocardial infarction would be beneficial for health undoubtly.%目的:探讨急性心肌梗死早期中西医结合系统化康复的优势和途径。方法论述早期康复运动对急性心肌梗死的影响、中医心脏康复的特色优势,提出了心脏康复单元的理念和模式。结果通过康复流程,以优化药物、物理治疗、心理康复、中医外治等,把中医和西医有效的治疗方法重新进行整合,形成一个优化的、程序标准化的康复治疗系统。结论发挥中医康复学的优势,健全中西医心脏康复系统化管理模式,将整体、优化的中医心脏康复应用于急性心肌梗死早期,无疑有助于疗效的进一步提高。

  18. 偏头痛急性期患者溶血磷脂酸与TCD的变化%Changes of lysophosphatidic acid and TCD in patients with migraine during acute stage

    Institute of Scientific and Technical Information of China (English)

    宋叶华; 牛建平; 汤婷; 叶良灶; 何倪靖

    2013-01-01

    Objective Observation the changesof plasma lysophosphatidic acid (LPA) 、lysophosphatidic acid similar levels of phospholipids(AP) and Transcranial Doppler ultrasound (TCD) in acute migraine patients. Methodes Determination plasma LPA and AP in migraine patients with acute period (migraine without aura and migraine with aura group) ,at the same time,were examined by TCD, compared with normal patients. Results Migraine patients with LPA 、AP increased significantly, especial y for migraine with aura group increased more significantly, suggesting that platelet activation in patients with acute migraine attacks, and blood flow velocity in patients with migraine acute stage significantly increased in patients with migraine.The results support functions - vascular nerve disorder in patients with migraine.%目的观察偏头痛急性发作期患者血浆溶血磷脂酸(LPA)及溶血磷脂酸相似磷脂水平(AP)、经颅多普勒超声(TCD)的变化。方法测定偏头痛急性期患者(无先兆偏头痛组及有先兆偏头痛组)血浆LPA及AP水平,同时对患者行TCD检查,与正常患者进行对照。结果偏头痛组血浆LPA水平高于对照组,尤其是有先兆偏头痛组,且偏头痛急性期TCD以血流速度增快为主,尤其是患侧大脑中动脉血流速度。结论偏头痛发作期患者LPA、AP明显升高,尤其是有先兆偏头痛组升高更明显,提示偏头痛急性发作期患者存在血小板活化过程,同时偏头痛急性期患者血流速度常明显增快,支持偏头痛患者存在神经-血管功能紊乱。

  19. High Prevalence of Intermediate Leptospira spp. DNA in Febrile Humans from Urban and Rural Ecuador.

    Science.gov (United States)

    Chiriboga, Jorge; Barragan, Verónica; Arroyo, Gabriela; Sosa, Andrea; Birdsell, Dawn N; España, Karool; Mora, Ana; Espín, Emilia; Mejía, María Eugenia; Morales, Melba; Pinargote, Carmina; Gonzalez, Manuel; Hartskeerl, Rudy; Keim, Paul; Bretas, Gustavo; Eisenberg, Joseph N S; Trueba, Gabriel

    2015-12-01

    Leptospira spp., which comprise 3 clusters (pathogenic, saprophytic, and intermediate) that vary in pathogenicity, infect >1 million persons worldwide each year. The disease burden of the intermediate leptospires is unclear. To increase knowledge of this cluster, we used new molecular approaches to characterize Leptospira spp. in 464 samples from febrile patients in rural, semiurban, and urban communities in Ecuador; in 20 samples from nonfebrile persons in the rural community; and in 206 samples from animals in the semiurban community. We observed a higher percentage of leptospiral DNA-positive samples from febrile persons in rural (64%) versus urban (21%) and semiurban (25%) communities; no leptospires were detected in nonfebrile persons. The percentage of intermediate cluster strains in humans (96%) was higher than that of pathogenic cluster strains (4%); strains in animal samples belonged to intermediate (49%) and pathogenic (51%) clusters. Intermediate cluster strains may be causing a substantial amount of fever in coastal Ecuador.

  20. Transient reduced diffusion in the cortex in a child with prolonged febrile seizures.

    Science.gov (United States)

    Kato, Toru; Okumura, Akihisa; Hayakawa, Fumio; Tsuji, Takeshi; Natsume, Jun

    2012-10-01

    We report on a 4-year-old boy with transient reduced diffusion in the cortex, thalamus, and hippocampus on diffusion-weighted imaging (DWI) performed after prolonged febrile seizures (PFS). He had experienced intermittent right hemiconvulsions lasting about 90 min during the febrile illness, but his neurological symptom resolved completely after several hours. DWI performed immediately after the PFS showed abnormally high signal intensities in the left extended cortex and pulvinar of the ipsilateral thalamus. Two days later, these DWI lesions resolved completely, but abnormally high signal intensities were observed in the left hippocampus. Three months later, the DWI was normal, and no atrophy or gliosis was seen. This patient had unique lesions on DWI after PFS, but it is nevertheless important to attend to such lesions on the DWI of patients with PFS.

  1. Two-Stage Priming of Allogeneic Natural Killer Cells for the Treatment of Patients with Acute Myeloid Leukemia: A Phase I Trial.

    Directory of Open Access Journals (Sweden)

    Panagiotis D Kottaridis

    Full Text Available Human Natural Killer (NK cells require at least two signals to trigger tumor cell lysis. Absence of ligands providing either signal 1 or 2 provides NK resistance. We manufactured a lysate of a tumour cell line which provides signal 1 to resting NK cells without signal 2. The tumor-primed NK cells (TpNK lyse NK resistant Acute Myeloid Leukemia (AML blasts expressing signal 2 ligands. We conducted a clinical trial to determine the toxicity of TpNK cell infusions from haploidentical donors. 15 patients with high risk AML were screened, 13 enrolled and 7 patients treated. The remaining 6 either failed to respond to re-induction chemotherapy or the donor refused to undergo peripheral blood apheresis. The conditioning consisted of fludarabine and total body irradiation. This was the first UK trial of a cell therapy regulated as a medicine. The complexity of Good Clinical Practice compliance was underestimated and led to failures requiring retrospective independent data review. The lessons learned are an important aspect of this report. There was no evidence of infusional toxicity. Profound myelosuppression was seen in the majority (median neutrophil recovery day 55. At six months follow-up, three patients treated in Complete Remission (CR remained in remission, one patient infused in Partial Remission had achieved CR1, two had relapsed and one had died. One year post-treatment one patient remained in CR. Four patients remained in CR after treatment for longer than their most recent previous CR. During the 2 year follow-up six of seven patients died; median overall survival was 400 days post infusion (range 141–910. This is the first clinical trial of an NK therapy in the absence of IL-2 or other cytokine support. The HLA-mismatched NK cells survived and expanded in vivo without on-going host immunosuppression and appeared to exert an anti-leukemia effect in 4/7 patients treated.ISRCTN trial registry ISRCTN11950134.

  2. Markers of iron status are associated with stage of pregnancy and acute-phase response, but not with parity among pregnant women in Guinea-Bissau.

    Science.gov (United States)

    Kæstel, Pernille; Aaby, Peter; Ritz, Christian; Friis, Henrik

    2015-10-14

    While prenatal Fe supplementation prevents maternal Fe deficiency and anaemia, it is uncertain whether it improves infant health outcomes, at least when taken by Fe-replete women. Inflammation as well as physiological changes complicates the assessment of Fe status during pregnancy. In the present study, we measured the concentrations of serum ferritin and soluble transferrin receptors (sTfR), Hb and the acute-phase proteins C-reactive protein (CRP) and α1-antichymotrypsin (ACT) in a cross-sectional study among 738 pregnant women attending antenatal care in Guinea-Bissau, West Africa. Multiple linear regression analysis was used to identify the predictors of Fe status markers. The mean gestational age was 23 (sd 7) weeks. Serum ferritin values were lower with progressing gestation, from 27% lower during weeks 16-20 of gestation up to 59% lower after 29 weeks of gestation compared with early pregnancy. Using cut-off values for Fe deficiency as established in non-pregnant individuals, 52% of the women had sTfR levels >2·3 mg/l, while only 25% had serum ferritin levels 2·3 mg/l decreased to 47% after adjustment for elevated serum CRP and ACT levels. On the contrary, the proportion of serum ferritin < 12 μg/l increased to 33% after adjustment for ACT and CRP. The high proportion of elevated serum sTfR calls for pregnancy-specific cut-offs since increased erythropoiesis is expected in response to increased plasma volume of pregnancy. The present study further underlines the need to adjust for inflammation when serum sTfR and serum ferritin are used to assess Fe status in pregnancy.

  3. The PIC Cystogram: Its Place in the Treatment Algorithm of Recurrent Febrile UTIs

    OpenAIRE

    Jennifer A. Hagerty; Max Maizels; Cheng, Earl Y.

    2008-01-01

    Purpose. A common pediatric dilemma involves management of children with recurrent febrile urinary tract infections (UTIs) who have normal voiding cystourethrograms. Vesicoureteral reflux (VUR) has been demonstrated in such cases by performing a cystogram which positions the instillation of contrast (PIC) at the ureteral orifice. We describe the evidence supporting this diagnostic test. Materials and Methods. The literature was searched to identify and subsequently evaluate all studies invest...

  4. Treatment of febrile seizures with intermittent clobazam Tratamento de convuslsões febris com clobazam intermitente

    OpenAIRE

    1997-01-01

    Fifty children, 24 female and 26 male, with ages varying from 6 to 72 months (mean=23.7 m.) that experienced at least one febrile seizure (FS) entered a prospective study of intermittent therapy with clobazam. Cases with severe neurological abnormalities, progressive neurological disease, afebrile seizures, symptomatic seizures of other nature, or seizures during a central nervous system infection were excluded. Seizures were of the simple type in 25 patients, complex in 20 and unclassified i...

  5. Adrenomedullin--A New Marker in Febrile Neutropenia: Comparison With CRP and Procalcitonin.

    Science.gov (United States)

    Demirkaya, Metin; Tugcu, Deniz; Akcay, Arzu; Aydogan, Gönül; Akıcı, Ferhan; Salcioglu, Zafer; Ekmekci, Hakan; Sevinir, Betül; Balci Ekmekci, Ozlem

    2015-01-01

    In this study, we aimed to determine serum adrenomedullin levels and compare them with levels of C-reactive protein (CRP) and procalcitonin (PCT). Cancer patients aged 0-18 years who experienced febrile neutropenia attacks were included in the study. Adrenomedullin, CRP, and PCT were analyzed at admission, day 3, and days 7-10 later. Fifty episodes of febrile neutropenia that developed in 37 patients were analyzed in this study. The mean age of the patients was 7.5 ± 4.7 (1-18) years. The patients had leukemia (73%), solid tumors (19%), and lymphoma (8%). The percentages of the patients in the clinically documented infection (CDI), fever of unknown origin (FUO), sepsis, and microbiological documented infection (MDI) categories were 34%, 34%, 20%, and 12%, respectively. During the study period, four patients were lost. In the MDI group, adrenomedullin levels on day 3 were significantly higher than those in the CDI and FUO groups. PCT levels were significantly higher in the sepsis group than those in the CDI group at admission, day 3, and days 7-10. In the sepsis group, PCT levels on days 7-10 days were significantly higher than those in the sepsis group. PCT values from the deceased patients on days 7-10 were significantly higher than those from patients who survived. CRP levels did not differ significantly among the febrile neutropenia groups. First, in our study, adrenomedullin was used as a biomarker in the febrile neutropenia episodes of children with cancer. Among adrenomedullin, CRP, and PCT, procalcitonin demonstrates the highest correlation with the severity of infection.

  6. Study of recurrence and serum indicator change after levetiracetam treatment of children febrile convulsion

    Institute of Scientific and Technical Information of China (English)

    Hui-Qin Meng

    2016-01-01

    Objective:To analyze the recurrence and serum indicator change after levetiracetam treatment of children febrile convulsion.Methods:A total of 92 cases of children with febrile convulsion who received treatment in our hospital from March 2012 to December 2014 were selected as research subjects and randomly divided into observation group and control group according to different treatment methods, each group with 46 cases. Control group received conventional therapy, observation group received levetiracetam combined with conventional therapy, and then differences in recurrence of febrile convulsion, cranial nerve-related factors, contents of trace elements and iron as well as humoral and cellular immune function of two groups were compared.Results:Average number of fever, frequency of recurrence of convulsion and the proportion of developing to epilepsy of observation group after treatment were less than those of control group, and the time from the end of treatment to the first convulsive seizure was longer than that of control group; serum NSE, S-100β and BDNF levels of observation group after treatment were lower than those of control group; serum Ca2+, P, SI and SF levels of observation group after treatment were higher than those of control group, and ALP level was lower than that of control group; serum IgA, IgM, IgG and CD8+ levels of observation group after treatment were lower than those of control group, and levels of CD4+ and CD4+/ CD8+ were higher than those of control group.Conclusion:Levetiracetam therapy for children with febrile convulsion reduces convulsive seizure and meantime can optimize children’s microenvironment and enhance immune function.

  7. Association of Interleukin-1 Gene Cluster and Interleukin-1 Receptor Polymorphisms With Febrile Seizures.

    Science.gov (United States)

    Soltani, Samaneh; Zare-Shahabadi, Ameneh; Shahrokhi, Amin; Rezaei, Arezou; Zoghi, Samaneh; Zamani, Gholam Reza; Mohammadi, Mahmoud; Ashrafi, Mahmoud Reza; Rezaei, Nima

    2016-05-01

    Interleukin-1 (IL-1) plays a key role in inflammation, has an effect on a wide variety of cells, and often leads to tissue destruction. While the ratio between IL-1 and IL-1Ra could influence the development of different diseases of the central nervous system, its gene polymorphisms were investigated in a group of patients with febrile seizures. Ninety patients with febrile seizures were enrolled and compared with 140 controls. The allele and genotype frequency of single nucleotide polymorphisms within the IL-1α, β, IL-1 R and IL-1Ra gene were determined. The frequency of the IL-1Ra/C allele at position Mspa-I 11100 was decreased significantly (P= .002) and the IL-1Ra/T frequency was significantly increased in patients (P= .002). In addition, the CT genotype frequency at the same position was significantly overrepresented in controls compared to patients (P= .001). Certain alleles and genotypes in the IL-1 gene were overrepresented in patients with febrile seizures, which possibly could predispose individuals to this disease.

  8. Emergency Department Crowding and Time to Antibiotic Administration in Febrile Infants

    Directory of Open Access Journals (Sweden)

    Jennifer K Light

    2013-09-01

    Full Text Available Introduction: Early antibiotic administration is recommended in newborns presenting with febrile illness to emergency departments (ED to avert the sequelae of serious bacterial infection. Although ED crowding has been associated with delays in antibiotic administration in a dedicated pediatric ED, the majority of children that receive emergency medical care in the U.S. present to EDs that treat both adult and pediatric emergencies. The purpose of this study was to examine the relationship between time to antibiotic administration in febrile newborns and crowding in a general ED serving both an adult and pediatric population.Methods: We conducted a retrospective chart review of 159 newborns presenting to a general ED between 2005 and 2011 and analyzed the association between time to antibiotic administration and ED occupancy rate at the time of, prior to, and following infant presentation to the ED.Results: We observed delayed and variable time to antibiotic administration and found no association between time to antibiotic administration and occupancy rate prior to, at the time of, or following infant presentation (P > 0.05. ED time to antibiotic administration was not associated with hospital length of stay, and there was no inpatient mortality.Conclusion: Delayed and highly variable time to antibiotic treatment in febrile newborns was common but unrelated to ED crowding in the general ED study site. Guidelines for time to antibiotic administration in this population may reduce variability in ED practice patterns. [West J Emerg Med. 2013;14(5:518-524.

  9. Study of febrile seizure and its relation to low serum sodium levels

    Directory of Open Access Journals (Sweden)

    Noroozi Z

    1998-06-01

    Full Text Available Febrile seizure is the most frequent type of seizure in childhood occurring in 2-4% of children under the age of 5. Although pathogenesis of seizure following fever is not well understood, multiple risk factors are known to contribute to its precipitation. One of the possible risk factors which had not been mentioned yet in reference texts and still is in the research phase is a serum sodium level below the normal limits which specially plays a role in the recurrence of febrile seizure. In this descriptive retrospective study records of 400 in-patients cases of primary episodes of febrile seizure in Bahrami children hospital in the years of 1996-1997 were reviewed. 214 (53.5% cases had serum sodium levels of <135 m.mol/L. The mean serum sodium level for all the cases was 135.28±4.65 m.mol/L which is considerly less than the serum sodium level of 140±0.8 m.mol/L seen in healthy children. There was no significant difference in serum sodium levels different sex and age groups in this patient population

  10. Mucosal barrier injury, fever and infection in neutropenic patients with cancer: introducing the paradigm febrile mucositis.

    Science.gov (United States)

    van der Velden, Walter J F M; Herbers, Alexandra H E; Netea, Mihai G; Blijlevens, Nicole M A

    2014-11-01

    Infection remains one of the most prominent complications after cytotoxic treatment for cancer. The connection between neutropenia and both infections and fever has long been designated as 'febrile neutropenia', but treatment with antimicrobial agents and haematopoietic growth factors has failed to significantly reduce its incidence. Moreover, emerging antimicrobial resistance is becoming a concern that necessitates the judicious use of available antimicrobial agents. In addition to neutropenia, patients who receive cytotoxic therapy experience mucosal barrier injury (MBI) or 'mucositis'. MBI creates a port-de-entrée for resident micro-organisms to cause blood stream infections and contributes directly to the occurrence of fever by disrupting the highly regulated host-microbe interactions, which, even in the absence of an infection, can result in strong inflammatory reactions. Indeed, MBI has been shown to be a pivotal factor in the occurrence of inflammatory complications after cytotoxic therapy. Hence, the concept 'febrile neutropenia' alone may no longer suffice and a new concept 'febrile mucositis' should be recognized as the two are at least complementary. This review we summarizes the existing evidence for both paradigms and proposes new therapeutic approaches to tackle the perturbed host-microbe interactions arising from cytotoxic therapy-induced tissue damage in order to reduce fever in neutropenic patients with cancer.

  11. Evaluation of febrile neutropenia in patients undergoing hematopoietic stem cell transplantation.

    Directory of Open Access Journals (Sweden)

    Shahideh Amini

    2014-01-01

    Full Text Available The aim of this study was to determine the incidence and causes of fever as a major problem contributing to transplantation related mortality among patients undergoing hematopoietic stem cell transplantation (HSCT and evaluation of antibiotic use, according to reliable guidelines.We retrospectively reviewed hospital records of 195 adult patients who underwent HSCT between 2009-2011 at hematology-oncology and bone marrow transplantation research center. Baseline information and also data related to fever and neutropenia, patient's outcomes, duration of hospitalization and antibiotic use pattern were documented.A total of 195 patients were analyzed and a total of 268 febrile episodes in 180 patients were recorded (mean 1.5 episodes per patient. About 222 episodes (82% were associated with neutropenia which one-fourth of them were without any documented infection sources. Microbiologic documents showed that the relative frequencies of gram positive and gram negative bacteria were 62.5% and 37.5%, respectively. The hospital stay duration was directly related to the numbers of fever episodes (P<0.0001.The rate of febrile episodes in autologous stem cell transplantation was significantly higher compared to allogeneic type (P<0.05.It is necessary to determine not only the local profile of microbiologic pattern, but also antibiotic sensitivities in febrile neutropenic patients following hematopoietic stem cell transplantation, and reassess response to antibiotic treatment to establish any necessity for modifications to treatment guidelines in order to prevent any fatal complications from infection.

  12. Risk Factors for Febrile Status Epilepticus: A Case-Control Study

    Science.gov (United States)

    Hesdorffer, Dale C.; Shinnar, Shlomo; Lewis, Darrell V.; Nordli, Douglas R.; Pellock, John M.; Moshé, Solomon L.; Shinnar, Ruth C.; Litherland, Claire; Bagiella, Emilia; Frank, L. Matthew; Bello, Jacqueline A.; Chan, Stephen; Masur, David; MacFall, James; Sun, Shumei

    2013-01-01

    Objective To identify risk factors for developing a first febrile status epilepticus (FSE) among children with a first febrile seizure (FS). Study design Cases were children with a first FS that was FSE drawn from the Consequences of Prolonged Febrile Seizures in Childhood and Columbia cohorts. Controls were children with a first simple FS and separately, children with a first complex FS that was not FSE. Identical questionnaires were administered to family members of the 3 cohorts. Magnetic resonance imaging protocol and readings were consistent across cohorts, and seizure phenomenology was assessed by the same physicians. Risk factors were analyzed using logistic regression. Results Compared with children with simple FS, FSE was associated with younger age, lower temperature, longer duration (1-24 hours) of recognized temperature before FS, female sex, structural temporal lobe abnormalities, and first-degree family history of FS. Compared with children with other complex FS, FSE was associated with low temperature and longer duration (1-24 hours) of temperature recognition before FS. Risk factors for complex FS that was not FSE were similar in magnitude to those for FSE but only younger age was significant. Conclusions Among children with a first FS, FSE appears to be due to a combination of lower seizure threshold (younger age and lower temperatures) and impaired regulation of seizure duration. Clinicians evaluating FS should be aware of these factors as many episodes of FSE go unnoticed. Further work is needed to develop strategies to prevent FSE. PMID:23809042

  13. Predictive indices of empirical clinical diagnosis of malaria among under-five febrile children attending paediatric outpatient clinic

    Directory of Open Access Journals (Sweden)

    Hassan A Elechi

    2015-01-01

    Full Text Available Background: Malaria has remained an important public health problem in Nigeria with children under 5 years of age bearing the greatest burden. Accurate and prompt diagnosis of malaria is an important element in the fight against the scourge. Due to the several limitations of microscopy, diagnosis of malaria has continued to be made based on clinical ground against several World Health Organization (WHO recommendations. Thus, we aim to assess the performance of empirical clinical diagnosis among febrile children under 5 years of age in a busy pediatric outpatient clinic. Materials and Methods: The study was a cross-sectional study. Children aged <5 years with fever or 72 h history of fever were recruited. Children on antimalarial prophylaxis or on treatment for malaria were excluded. Relevant information was obtained from the caregiver and clinical note of the child using interviewer administered questionnaire. Two thick and two thin films were made, stained, and read for each recruited child. Data was analysed using SPSS version 16. Results: Of the 433 children studied, 98 (22.6% were empirically diagnosed as having malaria and antimalarial drug prescribed. Twenty-three (23.5% of these children were confirmed by microscopy to have malaria parasitemia, while 75 (76.5% were negative for malaria parasitemia. Empirical clinical diagnosis show poor predictive indices with sensitivity of 19.2%, specificity of 76.0%, positive predictive value of 23.5% and negative predictive value of 71%. Conclusion and Recommendations: Empirical clinical diagnosis of malaria among the under-five children with symptoms suggestive of acute malaria is highly not reliable and hence the need to strengthen parasitological diagnosis.

  14. Cultural categorization of febrile illnesses in correlation with herbal remedies used for treatment in Southwestern Nigeria.

    Science.gov (United States)

    Ajaiyeoba, E O; Oladepo, O; Fawole, O I; Bolaji, O M; Akinboye, D O; Ogundahunsi, O A T; Falade, C O; Gbotosho, G O; Itiola, O A; Happi, T C; Ebong, O O; Ononiwu, I M; Osowole, O S; Oduola, O O; Ashidi, J S; Oduola, A M J

    2003-04-01

    The ethnographic study was conducted in two communities in Oyo State in Southwestern Nigeria. The study sites consisted of a rural and an urban local government area located in the tropical rain forest zone of Nigeria. The study was designed to obtain information on febrile illnesses and herbal remedies for treatment with the aim of identifying potential antimalarial drugs. The study revealed that fever is a general term for describing illnesses associated with elevated body temperature. The indigenous Yoruba ethnic population has categorized fever based on symptoms and causes. The present communication is the result of focus group discussion and semi-structured questionnaire administered to traditional healers, herb sellers, elders and mothers. This was on types of fevers, symptoms and causes of febrile illnesses. The investigation also included use of traditional herbs in the prevention and treatment of the illnesses in the two communities.A total of 514 respondents were interviewed. This was made up of 266 (51.8%) from Atiba local government area (LGA), an urban centre while 248 (48.2%) respondents were interviewed from Itesiwaju LGA, a rural community. The LGAs are located in Oyo State of Nigeria. The respondents proffered 12 types of febrile illnesses in a multiple response answering system in Yoruba language. The most common ones (direct translation into English) were: yellow fever (39.1%), typhoid (34.8%), ordinary (28.8%), rainy season (20.8%) and headache (10.5%) fevers, respectively. Perceived causes of each of the febrile illnesses included stress, mosquito bites, unclean water, rains and over exposure to the sun. Methods of fever prevention were mainly with the use of herbal decoctions, powdered herbs, orthodox medications and maintenance of proper hygiene. Of a total of 112 different herbal remedies used in the treatment of the febrile illnesses compiled from the study, 25 recipes are presented. Recipes consisted of 2-7 ingredients. Oral decoctions (84

  15. [Chemotherapy-induced febrile neutropenia: about 200 episodes. Clinical, microbiological and therapeutic characteristics].

    Science.gov (United States)

    Gharbi, O; Ben Hadj Hassen, S; Kaabia, N; Limam, S; Hadj Amor, M; Ben Fatma, L; Landolsi, A; Hochlef, M; Letaief, A; Boukadida, J; Ben Ahmed, S

    2008-05-01

    Cytotoxic chemotherapy suppresses the haematopoietic system, febrile neutropenia is the most serious haematological toxicity associated with the risk of life-threatening infections. We present a retrospective study of 200 episodes of febrile neutropenia in 128 patients treated in department of medical oncology. The aim of this study was to determinate the clinical, therapeutic and evolutive characteristics in patients treated essentially for solid tumors. Among these patients, 72% of them have at least two episodes, the median age was 34 years with extremes six and 75 years. It has been noticed that 26.3% of patients have diabetes, the dominate neoplasm was solid tumors in 79.7%, 65% of patients have received preventive colony-stimulating factors, 83% have received preventive buccal disinfection with antifungic. The median duration of hospitalisation was 12 days, the median delay of febrile neutropenia was 10 days with extremes two and 31 days, median duration of febrile neutropenia was 5.45 days with extremes one and 24 days. Among these cases, 9.45% of them have nadir zero, 68% of patients have clinical documented infections, ORL in 47% of cases. According to the study, 12% of cases have documented microbiological fever, the sites was urinary in 33% of cases, blood in 33% of cases, derm in 30% of cases. The microbe was staphylococcus negative coagulase in 37.5% essentially in blood and derm, the Escherichia coli in 20.8% essentially in urinary and blood. First line antibiotherapy was cefotaxim associated with amikacine in 93.5%, second line antibiotherapy was association of imipenam and amikacine in 82% of cases. Among these cases,7% of them have received anti-staphylococcus, and antifungic treatment in 50% of cases. The thermic defervescence was obtained in median delay of 2.8 days. We have noted nine deaths (22% of cases). Recent surveys indicate that neutropenia remains a prevalent problem associated with substantial morbidity, mortality and costs. The colony

  16. Clinical Investigation on Characteristics of TCM Symptom and Sign of UC in Acute Stage and Stable Stage%溃疡性结肠炎活动期和缓解期中医症状分布特点的临床调查

    Institute of Scientific and Technical Information of China (English)

    陈剑明; 张声生; 王新月; 李军祥; 赵洪川; 苏娟萍; 邹小娟; 孙立亭; 刘冬梅; 赵文霞; 韩捷; 王天芳; 刘亚军; 邓鑫; 吴秀艳; 岳宏; 杨璐; 赵丹; 薛晓琳; 赵燕; 王庆国

    2012-01-01

    .0 software. Results;951 cases altogether, included 829 cases of acute stage, and 122 cases in stable stage. The distribution characteristics of TCM Symptoms: frequency of symptoms is equal or greater and equal to 35% in active period has 35, and in remission there are 21. In acute stage, the common symptoms of digestive system are diarrhea, pus and blood stools (blood more than pus), abdominal pain, abdominal distension, te-nesmus, borborygmus increased,fart increased, dropping of the anus, unsmooth defecation, burning sensation in the anus, urgent diarrhea. The parenteral symptoms;fatigue, shenpi, chills, disinclination to talk, weak waist, lower limb weakness, bitter taste in mouth, oropharynx drying, inappetence, insomnia, dreaminess, irritable and agitated, depression, fat tongue, tooth marks tongue, yellow coating, greasy coating, thick coating, dry coating, fine pulse, string pulse, slippery pulse. In stable stage, the common symptoms of digestive system are abdominal pain, diarrhea, te-nesmus,abdominal distension, unsmooth defecation, borborygmus increased. The parenteral symptoms; tooth marks tongue, fine pulse, fatigue, greasy coating, fat tongue, oropharynx drying, irritable and agitated, white coating, shallow white tongue, chills, weak waist, shenpi, sink pulse, depression, disinclination to talk. Conclusion:The common symptoms of the patients with UC in both acute and stable stages are diarrhea, abdominal pain, abdominal distension. And frequency of the symptoms 'occurrence of acute stage is higher. But the frequency of entire symptoms mainly appears at acute stage; the main characteristic of pathological mechanism of UC is mixed with excessiveness and deficiency, which include damp - heat focusing in large intestine as excess syndrome with yang - qi deficiency symptoms, and comparasively, spleen and kidney yang - qi deficiency syndrome as deficiency with dampness obstruction symptoms.

  17. Mossy Fiber Plasticity and Enhanced Hippocampal Excitability, Without Hippocampal Cell Loss or Altered Neurogenesis, in an Animal Model of Prolonged Febrile Seizures

    OpenAIRE

    2003-01-01

    Seizures induced by fever (febrile seizures) are the most frequent seizures affecting infants and children; however, their impact on the developing hippocampal formation is not completely understood. Such understanding is highly important because of the potential relationship of prolonged febrile seizures to temporal lobe epilepsy. Using an immature rat model, we have previously demonstrated that prolonged experimental febrile seizures render the hippocampus hyperexcitable throughout life. He...

  18. Treatment of febrile seizures with intermittent clobazam Tratamento de convuslsões febris com clobazam intermitente

    Directory of Open Access Journals (Sweden)

    Maria Luiza G. Manreza

    1997-01-01

    Full Text Available Fifty children, 24 female and 26 male, with ages varying from 6 to 72 months (mean=23.7 m. that experienced at least one febrile seizure (FS entered a prospective study of intermittent therapy with clobazam. Cases with severe neurological abnormalities, progressive neurological disease, afebrile seizures, symptomatic seizures of other nature, or seizures during a central nervous system infection were excluded. Seizures were of the simple type in 25 patients, complex in 20 and unclassified in 5. The mean follow-up period was 7.9 months (range=l to 23 m., and the age at the first seizure varied from 5 to 42 months (mean=16.8 m.. Clobazam was administered orally during the febrile episode according to the child's weight: up to 5 kg, 5 mg/day; from 5 to 10 kg, 10 mg/day; from 11 to 15 kg, 15 mg/day, and over 15 kg, 20 mg/day. There were 219 febrile episodes, with temperature above 37.8 °C, in 40 children during the study period. Twelve children never received clobazam and 28 received the drug at least once. Drug efficacy was measured by comparing FS recurrence in the febrile episodes that were treated with clobazam with those in which only antipyretic measures were taken. Ten children (20% experienced a FS during the study period. Of the 171 febrile episodes treated with clobazam there were only 3 recurrences (1.7%, while of the 48 episodes treated only with antipyretic measures there were 11 recurrences (22.9%, a difference highly significant (pAvaliamos prospectivamente o uso intermitente do clobazam na profilaxia de convulsão febril em 50 crianças, 24 do sexo feminino e 26 do masculino, com idades entre 6 e 72 meses (média = 23,7 meses que haviam apresentado pelo menos um episódio de convulsão febril. Foram excluídas crianças com anormalidades neurológicas severas, doença neurológica progressiva, crises durante infecção do SNC e crises epilépticas sintomáticas outras. As convulsões febris foram classificadas como simples em 25

  19. Infections in acute leukemia in Indian Children

    Directory of Open Access Journals (Sweden)

    B Roy

    2014-01-01

    Full Text Available Aims: In the present study acute leukemic children were studied to determine the incidence and principal site of infection, correlation with absolute neutrophil count, causative organisms and to standardize the initial empirical anti microbial therapy. Materials and methods: A total 40 children in the age group 6 month to 12 year with acute leukemia relapse were included in this study. A total 82 infectious episodes including 61 febrile episodes were investigated for infectious etiology. Results: We found that the frequency of infections increased significantly with the degree of immunocompromisation specially neutropenia (ANC < 500/cmm. The skin and soft tissue was the commonest site of infection (26.83%, followed by respiratory tract (21.95%. Staphylococcus nonhemolytic coagulase-negative (34%, followed by Klebsiella (17% were the most common organisms isolated from blood. Staphylococcus non-hemolytic coagulase-negative was also the commonest isolate (26% from other sites of infection. Most strains were sensitive to Cloxacillin, cephalosporin and aminoglycosides. Conclusion: For the treatment of febrile episodes, empirical use of beta-lactamase resistant penicillin e.g. Cloxacillin or cephalosporin combined with an aminoglycosides with a broad spectrum antifungal like fluconazole in selective cases at the first sign of infection is recommended. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 40-47 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9672

  20. Maternal use of antibiotics and the risk of childhood febrile seizures: a Danish population-based cohort.

    Directory of Open Access Journals (Sweden)

    Jessica E Miller

    Full Text Available OBJECTIVE: In a large population-based cohort in Denmark to examine if maternal use of antibiotics during pregnancy, as a marker of infection, increases the risk of febrile seizures in childhood in a large population-based cohort in Denmark. METHODS: All live-born singletons born in Denmark between January 1, 1996 and September 25, 2004 and who were alive on the 90(th day of life were identified from the Danish National Birth Registry. Diagnoses of febrile seizures were obtained from the Danish National Hospital Register and maternal use of antibiotics was obtained from the National Register of Medicinal Product Statistics. Hazard ratios (HR and 95% confidence intervals (95% CI were estimated by Cox proportional hazard regression models. RESULTS: We followed 551,518 singletons for up to 5 years and identified a total of 21,779 children with a diagnosis of febrile seizures. Slightly increased hazard ratios were observed among most exposure groups when compared to the unexposed group, ex. HR 1.08 95% CI: 1.05-1.11 for use of any systemic antibiotic during pregnancy. CONCLUSION: We found weak associations between the use of pharmacologically different antibiotics during pregnancy and febrile seizures in early childhood which may indicate that some infections, or causes or effects of infections, during pregnancy could affect the fetal brain and induce susceptibility to febrile seizures.

  1. Local heparinization in endovascular embolization of ruptured intracranial aneurysms at acute stage%急性出血期颅内动脉瘤血管内栓塞术中局部肝素化的应用

    Institute of Scientific and Technical Information of China (English)

    刘东; 吕明; 李佑祥; 杨新健; 姜除寒; 吴中学

    2014-01-01

    Objective To evaluate the efficacy of ization in endovascular embolization of the ruptured intracranial aneurysms at acute stage.Methods Between April 2011 and September 2011,127 patients with ruptured intracranial aneurysms treated with endovascular embolization at acute stage (< 14 days) were retrospectively reviewed to evaluate the efficacy of ization (3 IU/ml heparin saline was dropped into the guiding catheter at 3 ml/min.).Results Total 148 aneurysms were observed in 127 patients and 135 aneurysms were treated with endovascular coil embolization under ization at acute stage,aneurysm perforation related to manipulation occurred in 5 patients (3.9%) which caused 4 deaths and 1 disability.The distal part of the parent artery was not filled well in 11 cases (8.7%),vasospasm in 2 cases without any neurological sequelae,over embolization in 7 cases resulted in 1 severe disability.Thromboembolic complication occurred in 2 cases causing 1 neurological deficit.Clinical outcomes at3.5 years were:GOS 5 in 107 cases (84.3%),4 in 7 cases (5.5%),3 in 6 cases (4.7%),2 in 0 cases (0%) and 1 in 7 cases (5.5%).Conclusions Local heparinizqtion may not increase the incidence of thromboernbolic or hemorrhagic complications compared to systemic heparin.ization could be effective for coil embolization of ruptured aneurysm at acute stage.%目的 探讨急性出血期颅内动脉瘤血管内栓塞术中局部肝素化的安全性.方法 收集2011年4月至2011年9月经血管内治疗的127例急性出血期(<14 d)颅内动脉瘤患者(共148个动脉瘤)的临床资料,该组患者在血管内栓塞术中均应用局部肝素化(经导引导管高压灌注浓度为3 IU/ml的肝素生理盐水,灌注速度为4 ml/min),回顾性分析术中血栓栓塞和动脉瘤破裂的发生率及预后.结果 127例患者148个动脉瘤中,行介入栓塞135个,其中5例(3.9%)发生术中动脉瘤破裂,均与操作相关,术后4例死亡,1例重残.11例(8.7%)术中出

  2. Comparison of Serum Zinc Levels among Children with Simple Febrile Seizure and Control Group: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Mohammad Mehdi NASEHI

    2015-01-01

    Full Text Available How to Cite This Article: Nasehi MM, Sakhaei R, Moosazadeh M, Aliramzany M. Comparison of Serum Zinc Levels among Children with Simple Febrile Seizure and Control Group: A Systematic Review. Iran J Child Neurol. 2015 Winter;9(1:17-24 .AbstractObjectiveSeveral factors are involved in the etiology of febrile seizure (FS, among themis zinc (Zn, which has been discussed in various studies. The present systematic review compares Zn levels in children with FS and a control group.Materials & MethodsWe searched keywords of febrile seizure, febrile convulsion, children, childhood,fever, trace elements, risk factor, predisposing, zinc, Zn, and epilepsy in thefollowing databases: SCOPUS, PubMed, and Google Scholar. The quality ofresearch papers was assessed using a checklist. Data was extracted from primarystudies based on demographic variables and amounts of Zn in case and controlgroups.ResultsTwenty primary studies were entered in the present study. Of which, eighteenstudies, reported that Zn serum levels were significantly lower in the case group(patients with FS than the control group.ConclusionThe present systematic review indicated that Zn is one factor for predicting FS.A low level of this element among children can be regarded as a contributingfactor for FS, a conclusion with a high consensus among different studies carriedout in different parts of the world. ReferencesHeydarian F, Ashrafzadeh F, Ghasemian A. Serum ZINC level in Patients with simple febrile seizure. Iran J Child Neurology 2010; 14(2:41-44.Mahyar A, Pahlavan AA, Varasteh-Nejad A. Serum zinc level in children with febrile seizure. Acta Medica Iranica 2008; 46(6: 477-80.Kunda GK, Rabin F, Nandi ER, Sheikh N, Akhter S. Etiology and Risk Factors of Febrile Seizure – An Update. Bangladesh J Child Health 2010; 34 (3:103-112.Abbaskhaniyan A, Shokrzadeh M, Rafati MR, Mashhadiakabr M, Arab A, Yazdani J. Survey and Relation of Serum Magnesium Level in Children with Seizure. J Mazand Univ

  3. Well staged

    Energy Technology Data Exchange (ETDEWEB)

    Budd, Godfrey

    2011-06-15

    Packers Plus Energy Services Inc. has commercially launched QuickFRAC, a multi-stage completition system which can fracture four to five isolated stages in one treatment and set up a record of 23-stage slickwater frac in less than 10 hours. It could take up to 40 days to do 100 fracture treatments with other systems. This technology makes it possible to distribute fluid at each port thanks to the limited entry system. In order to make multiple isolated stages within one treatment zone, each zone includes multiple QuickPORT sleeves with packers on either side. The other technology which made this possible is the repeater port system, it allows them to perform more frac stages. This technology could be useful in the future since the need for stages will be doubling soon with microdarcy shale oil extraction which is more difficult than gas.

  4. Surveillance of febrile patients in a district and evaluation of their spatiotemporal associations: a pilot study

    Directory of Open Access Journals (Sweden)

    Lee Lap-yip

    2010-02-01

    Full Text Available Abstract Background Fever is an undifferentiated clinical feature that may enhance the sensitivity of syndromic surveillance systems. By studying the spatiotemporal associations of febrile patients, it may allow early detection of case clustering that indicates imminent threat of infectious disease outbreaks in the community. Methods We captured consecutive emergency department visits that led to hospitalization in a district hospital in Hong Kong during the period of 12 Sep 2005 to 14 Oct 2005. We recorded demographic data, provisional diagnoses, temperature on presentation and residential location for each patient-episode, and geocoded the residential addresses. We applied Geographical Information System technology to study the geographical distribution these cases, and their associations within a 50-m buffer zone spatially. A case cluster was defined by three or more spatially associated febrile patients within each three consecutive days. Results One thousand and sixty six patient-episodes were eligible for analysis; 42% of them had fever (>37°C; oral temperature on presentation. Two hundred and four patient-episodes (19.1% came from residential care homes for elderly (RCHE. We detected a total of 40 case clusters during the study period. Clustered cases were of older age; 57 (33.3% were residents of RCHE. We found a median of 3 patients (range: 3 - 8 and time span of 3 days (range: 2 - 8 days in each cluster. Twenty five clusters had 2 or more patients living in the same building block; 18 of them were from RCHE. Conclusions It is technically feasible to perform surveillance on febrile patients and studying their spatiotemporal associations. The information is potentially useful for early detection of impending infectious disease threats.

  5. Trading stages

    DEFF Research Database (Denmark)

    Steiner, Uli; Tuljapurkar, Shripad; Coulson, Tim

    2012-01-01

    Interest in stage-and age structured models has recently increased because they can describe quantitative traits such as size that are left out of age-only demography. Available methods for the analysis of effects of vital rates on lifespan in stage-structured models have not been widely applied ...... examples. Much of our approach relies on trading of time and mortality risk in one stage for time and risk in others. Our approach contributes to the new framework of the study of age- and stage-structured biodemography....

  6. Acute diarrhea in children

    Directory of Open Access Journals (Sweden)

    Radlović Nedeljko

    2015-01-01

    Full Text Available Acute diarrhea (AD is the most frequent gastroenterological disorder, and the main cause of dehydration in childhood. It is manifested by a sudden occurrence of three or more watery or loose stools per day lasting for seven to 10 days, 14 days at most. It mainly occurs in children until five years of age and particularly in neonates in the second half-year and children until the age of three years. Its primary causes are gastrointestinal infections, viral and bacterial, and more rarely alimentary intoxications and other factors. As dehydration and negative nutritive balance are the main complications of AD, it is clear that the compensation of lost body fluids and adequate diet form the basis of the child’s treatment. Other therapeutic measures, except antipyretics in high febrility, antiparasitic drugs for intestinal lambliasis, anti-amebiasis and probiotics are rarely necessary. This primarily regards uncritical use of antibiotics and intestinal antiseptics in the therapy of bacterial diarrhea. The use of antiemetics, antidiarrhetics and spasmolytics is unnecessary and potentially risky, so that it is not recommended for children with AD.

  7. Changes of some trace elements and nutritional proteins in children with acute lymphoblastic leukemia and acute myeloid leukemia at stages of onset%儿童急性淋巴细胞白血病和急性粒细胞白血病发病初期微量元素及营养相关蛋白的变化

    Institute of Scientific and Technical Information of China (English)

    王静; 吴颖; 陈轶珏; 王剑; 李怀远; 傅启华

    2010-01-01

    Objective To investigate the changes of serum trace elements and nutritional proteins in children with acute lymphoblastic leukemia and acute myeloid leukemia at the stage of onset. Methods Serum levels of cuprum, zinc, iron, magnesium, phosphorus, calcium, ceruloplasmin, ferritin, transferrin, lactate dehydrogenase, total protein, albumin, hemoglobin, and erythrocytes were detected in 73 patients with acute lymphoblastic leukemia, 26 patients with acute myeloid leukemia at stages of onset, and 30 healthy controls using methods including atomic absorption spectrometry, nophelometry assay, dry chemical method, and/or chemiluminescence method. The differences of these indicators among these three groups were analyzed by t test. Results Serum levels of all detected elements except for zinc and phosphorus were significantly different between the onset groups and the control group (P < 0.05 ). Serum levels of cuprum, magnesium, iron, ferritin, ceruloplasmin, and lactate dehydrogenase in the onset groups were significantly higher than those in control group ( all P < 0.05 ). On the contrary, calcium, transferrin, total protein, albumin, hemoglobin, and erythrocyte count were significantly lower in the onset groups than those in control group (P < 0.05). Serum iron, cuprum, zinc, and their metabolism were significantly different between acute lymphoblastic leukemia group and acute myeloid leukemia group ( P < 0.05 ).Conclusion Serum levels of some trace elements and nutritional proteins are disordered and out of balance in chil dren with acute lymphoblastic leukemia and acute myeloid leukemia at stages of onset.%目的 探讨儿童急性淋巴细胞白血病和急性粒细胞白血病发病初期某些微量元素及营养相关蛋白的变化.方法 应用原子吸收光谱法、散射比浊法、干化学法和化学发光法等,对73例急性淋巴细胞白血病和26例急性粒细胞白血病发病初期的患儿血清铜、锌、铁、镁、磷、钙、

  8. Is the addition of aminoglycosides to beta-lactams in cancer patients with febrile neutropenia needed?

    OpenAIRE

    Valeria Contreras; Sebastián Sepúlveda; Ana Heredia

    2016-01-01

    En pacientes con cáncer que se presentan con neutropenia febril existe controversia sobre si es mejor utilizar una combinación de antibióticos betalactámicos y aminoglicósidos o si bastaría la monoterapia con betalactámicos de amplio espectro como tratamiento empírico inicial. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos tres revisiones sistemáticas que en conjunto incluyen 14 estudios aleatorizados pertinentes a esta p...

  9. Desarrollo de un IRP en niños con Infección Urinaria Febril

    OpenAIRE

    Mondragón Cedeño, Stella Enriqueta

    2016-01-01

    Introducción: La infección del tracto urinario (ITU) es una infección bacteriana frecuente en niños, del 50% al 75% de los casos de ITU febril desarrollan pielonefritis. La pielonefritis es un factor de riesgo de lesión renal permanente, que se puede asociar en la vida adulta a hipertensión arterial, disminución de la tasa de filtración glomerular, proteinuria y complicaciones durante la gestación. Objetivo: Construimos un Índice de Riesgo de Pielonefritis (IRP) en niños entre 1 mes y 2 año...

  10. Spontaneous remission of Crohn's disease following a febrile infection: case report and literature review

    Directory of Open Access Journals (Sweden)

    van Netten Johannes P

    2011-05-01

    Full Text Available Abstract Crohn's disease is a chronic illness that may often follow a relapsing-remitting course. Many of the factors that may be associated with the spontaneous remission of this disease (i.e. not related to specific treatment remain to be determined. In the present report, we review the medical history of a patient with a long history of moderate to severe Crohn's whose complete remission immediately followed the development of a febrile infection. The patient first developed symptoms of Crohn's in her late adolescent years. At the time of diagnosis at age 23, she was placed on mesalamine - without effective control her disease symptoms. Due to progressive deterioration, the patient underwent a bowel resection at age 25. Soon afterwards symptoms recurred, gradually increasing in severity. In February 2005, at age 36, the patient developed a painful abscess associated with a rectal fistula. Other symptoms at the time included chronic bone and stomach pain, swollen joints, and debilitating fatigue. Surgical correction was scheduled in mid-March. In late February, the patient developed a respiratory infection associated with fevers of 103-104°F. After the onset of fever, the abscess pain disappeared and this was soon followed by a disappearance of all other disease symptoms. By the time the corrective surgery occurred, she had no Crohn's symptoms. Her remission lasted 10 weeks when the previous symptoms then reappeared. The patient has subsequently used a variety of conventional therapies, but still suffers from severe symptoms of her disease. In recent years, a growing body of literature has emphasized the important role that innate immunity plays in the etiology of Crohn's disease; however, a key component of innate immunity, the febrile response, has been overlooked. Other cases of spontaneous remission following febrile infection in inflammatory bowel disease have been reported. Moreover, induction of a febrile response was in the past used

  11. Recurrent febrile neutropenia and thrombocytopenia in a chronic cocaine user: a case of levamisole induced complications.

    Science.gov (United States)

    Martinez, Eduardo; Alvi, Raza; Venkatram, Sindhaghatta; Diaz-Fuentes, Gilda

    2015-01-01

    Cocaine is used by approximately 1.5 million Americans each month and up to 69% of the cocaine seized contains levamisole. The real incidence of cocaine-levamisole induced neutropenia is unclear but probably underestimated. Associated complications include fever, thrombocytopenia, skin-vasculitis disorders, and rarely kidney injury. We present a young male, with chronic active cocaine use presenting with recurrent episodes of febrile neutropenia and thrombocytopenia. He underwent extensive work-up and was treated with many antibiotics and we suspect that his neutropenia and thrombocytopenia were caused by recurrent cocaine-levamisole use.

  12. Recurrent Febrile Neutropenia and Thrombocytopenia in a Chronic Cocaine User: A Case of Levamisole Induced Complications

    Directory of Open Access Journals (Sweden)

    Eduardo Martinez

    2015-01-01

    Full Text Available Cocaine is used by approximately 1.5 million Americans each month and up to 69% of the cocaine seized contains levamisole. The real incidence of cocaine-levamisole induced neutropenia is unclear but probably underestimated. Associated complications include fever, thrombocytopenia, skin-vasculitis disorders, and rarely kidney injury. We present a young male, with chronic active cocaine use presenting with recurrent episodes of febrile neutropenia and thrombocytopenia. He underwent extensive work-up and was treated with many antibiotics and we suspect that his neutropenia and thrombocytopenia were caused by recurrent cocaine-levamisole use.

  13. Fluoroquinolone prophylaxis against febrile neutropenia in areas with high fluoroquinolone resistance--an Asian perspective.

    Science.gov (United States)

    Ng, Esther Shu-Ting; Liew, Yixin; Koh, Liang Piu; Hsu, Li Yang

    2010-09-01

    Febrile neutropenia remains a major cause of morbidity and mortality in patients receiving chemotherapy. Major prophylactic strategies include granulocyte colony-stimulating factor and antibiotics, the most widely used of which are fluoroquinolones. While fluoroquinolone prophylaxis has been shown to be effective in areas where fluoroquinolone resistance is low, this same efficacy has not been proven in areas where resistance is high, such as in Asia. Given the increase in antimicrobial resistance with the use of prophylaxis, the risks and benefits of this strategy need to be carefully considered. This review presents the evidence for and against fluoroquinolone prophylaxis in areas of high fluoroquinolone resistance.

  14. [Septic shock following platelet transfusion contaminated with Citrobacter koseri in a child with postchemotherapy febrile neutropenia].

    Science.gov (United States)

    Tichit, R; Saumet, L; Marchandin, H; Haouy, S; Latry, P; Sirvent, N

    2016-01-01

    The bacterial transfusion risk is currently the greatest infectious risk of blood transfusion. We report the case of a child with postchemotherapy febrile neutropenia who presented septic shock following platelet transfusion contaminated with Citrobacter koseri. The life-threatening development could have been avoided by strict compliance with good clinical practice. The stability of mortality rates due to adverse effects of bacterial proliferation during platelet transfusions in France since 1994 calls for optimization of all preventive measures throughout the transfusion chain and perfect knowledge of transfusion rules by medical staff and care givers.

  15. Level of serum neuron-specific enolase and brain damage in children with febrile seizures

    Institute of Scientific and Technical Information of China (English)

    Lang Chen; Qiaobin Chen; Fang Yang; Zhi Lin; Xinfu Lin; Ying Huang; Xin Zheng; Yu Lin

    2006-01-01

    BACKGROUND: Febrile seizure (FS) has good prognosis in the majority of cases. But there is an ongoing debate on the relationship between complicated febrile seizure (CFS) and later development of temporal lobe epilepsy (TLE) due to hippocampal sclerosis.OBJECTIVE: To evaluate the level of serum neuron-specific enolase (S-NSE) of children with simple febrile seizure (SFS) and complicated febrile seizure and compare with children with non-FS respiratory tract infection. DESIGN: Contrast observation.SETTING: Department of Pediatrics and Department of Laboratory, Fujian Provincial Hospital. PARTICIPANTS: Forty-nine patients who were admitted to Department of Pediatrics of Fujian Provincial Hospital from June 2002 to September 2003 with FS were enrolled in this study. There were 28 boys and 21 girls aged from 5 to 72 months. All children were divided into 2 groups based on frequency and duration. Thirty-two children whose FS occurred within 24 hours (lasting shorter than single and twice durations and also shorter than 10 minutes) were regarded as SFS group; meanwhile, 17 children whose FS occurred within 24 hours (lasting longer than single and twice durations and also longer than 10 minutes) were regarded as CFS group. Another 23 patients who were admitted to our hospital with respiratory tract infection in the same period, without the history and positive symptoms/features of neurological dysfunction, were enrolled as control group. There were 13 boys and 10 girls aged from 5 months to 86 months. All parents were told the facts. METHODS: 2 mL venous blood was collected from FS children within 24 hours after the seizures. Meanwhile, 2 mL venous blood was also collected from children in the control group. Level of S-NSE was measured with enzyme immunoassay procedure, and differences among groups were compared with t test. MAIN OUTCOME MEASURES: Level of S-NSE in each group. RESULTS: A total of 49 children in FS group and 23 ones in control group were involved in the

  16. Molecular Detection of Fastidious and Common Bacteria as Well as Plasmodium spp. in Febrile and Afebrile Children in Franceville, Gabon.

    Science.gov (United States)

    Mourembou, Gaël; Fenollar, Florence; Socolovschi, Cristina; Lemamy, Guy Joseph; Nzoughe, Hermann; Kouna, Lady Charlene; Toure-Ndouo, Fousseyni; Million, Matthieu; Mbiguino, Angelique Ndjoyi; Lekana-Douki, Jean Bernard; Raoult, Didier

    2015-05-01

    Malaria was considered as the main cause of fever in Africa. However, with the roll back malaria initiative, the causes of fever in Africa may change. This study aimed to evaluate the prevalence of bacteria and Plasmodium spp. in febrile and afebrile (controls) children from Franceville, Gabon. About 793 blood samples from febrile children and 100 from controls were analyzed using polymerase chain reaction (PCR) coupled with sequencing. Plasmodium spp. was the microorganism most detected in febrile (74.5%, 591/793) and controls (13%, 13/100), P Gabon. Two fastidious bacteria, Rickettsia felis and Borrelia spp., were found. Inclusion of controls should improve the understanding of the causes of fever in sub-Saharan Africa.

  17. Headache in the presentation of noncephalic acute illness

    Directory of Open Access Journals (Sweden)

    Tomer Tzadok

    2015-01-01

    Full Text Available Background: Headache is a frequent symptom of many systemic diseases that do not involve cranial structures. In this observational study, we assessed factors associated with headache in the acute presentation of systemic conditions in a nonsurgical emergency department (ED. Methods: Consecutive patients, admitted to Soroka University Medical Center ED due to noncephalic illness, were prospectively surveyed using a structured questionnaire focused on the prevalence and characteristics of headache symptoms. Medical data were extracted from the patient's charts. Results: Between 1 and 6/2012, 194 patients aged 64.69 ± 19.52 years, were evaluated. Headache was reported by 83 (42.7% patients and was more common among patients with febrile illness (77.5% vs. 22.5%, P < 0.001. Respiratory illness and level of O2saturation were not associated with headache. Headache in the presentation of a noncephalic illness was associated with younger age (58 vs. 69, P < 0.001 and with suffering from a primary headache disorder (48.2% vs. 10.8%, P < 0.001. Headache was also associated with higher body temperature and lower platelets count. Conclusions: Headache is a common symptom in acute noncephalic conditions and was found to be associated with younger age and febrile disease on presentation. Patients who present with primary headache disorders are more prone to have headache during acute illness. Acute obstructive respiratory disease, hypercarbia or hypoxemia were not associated with headache.

  18. Comparison of serum zinc in children younger than 5 years old with febrile convulsion, children with seizures without fever and normal children

    Directory of Open Access Journals (Sweden)

    Ali Vahidi A

    2014-06-01

    Conclusion: Results of this study showed reduced serum zinc levels during febrile seizure. The need for continued research on surface tension in febrile children over several months is recommended. [Int J Res Med Sci 2014; 2(3.000: 972-975

  19. The diagnostic value of CRP, IL-8, PCT, and sTREM-1 in the detection of bacterial infections in pediatric oncology patients with febrile neutropenia

    NARCIS (Netherlands)

    Miedema, Karin G. E.; de Bont, Eveline S. J. M.; Elferink, Rob F. M. Oude; van Vliet, Michel J.; Nijhuis, Claudi S. M. Oude; Kamps, Willem A.; Tissing, Wim J. E.

    2011-01-01

    In this study, we evaluated C-reactive protein (CRP), interleukin (IL)-8, procalcitonin (PCT), and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) as predictors for bacterial infection in febrile neutropenia, plus their usefulness in febrile neutropenia during chemotherapy-induced

  20. Stages of Adult Acute Lymphoblastic Leukemia

    Science.gov (United States)

    ... and given back to the patient through an infusion . These reinfused stem cells grow into (and restore) ... will also have combination chemotherapy. Supportive care including antibiotics and red blood cell and platelet transfusions . CNS ...

  1. A Case-Control Study of the Association Between Serum Copper Level and Febrile Seizures in Children

    Directory of Open Access Journals (Sweden)

    abolfazl MAHYAR

    2012-03-01

    Full Text Available How to Cite this Article: Mahyar A, Ayazi P, Dalirani R, Bakhtiyari H, Daneshi Khohan MM, Javadi A. A Case-Control Study of the Association Between SerumCopper Level and Febrile Seizures in Children. Iranian Journal of Child Neurology 2012;6(1:23-28.ObjectiveFebrile seizures are the most common cause of seizure in children. Identification of risk factors is very important. This study was conducted to determine the association between the serum copper level and simple febrile seizure in children.Materials & MethodsIn this study, 30 children with simple febrile seizures (case group were compared with 30 children with febrile illness without seizures (control group regarding serum copper level. This study was conducted in Qazvin children’s hospital (Qazvin, Iran.ResultsThe mean serum copper levels in the case and control groups were 141.41±30.90 and 129.43±18.97 mcg/dl, respectively. This difference was not significant statistically.ConclusionThis study revealed that there is no association between serum copper levels and febrile seizures. It seems that copper deficiency is not a risk factor for febrile seizures in children.References1. Mikati MA. Febrile seizures in: Kliegman RM, Stanton BF, GemeIII JWS, Schor NF, Behrman RE. Nelson textbookof pediatrics.19th edition. Philadelphia: Saunders; 2011.p. 2017-19.2. Ferrie C, Newton R, Martland T. Febrile seizure in:Mclntosh N, Helms PJ, Smyth RL, Logan S. Forfar& Arneils textbook of pediatrics, London: ChurchillLivingstone; 2008. p. 860-1.3. Mahyar A, Ayazi P, Fallahi M, Javadi A.Risk factors ofthe first febrile seizures in Iranian children. Int J Pediatr2010;2010:862897.[Epub 2010 Jun 24].4. Siqueira LF. Febrile seizures: update on diagnosisand management. Rev Assoc Med Bras 2010 Jul-Aug;56(4:489-92.5. Daoud A, Batieha A. Iron status a possible risk factor forthe first seizure. Epilepsy 2002;43(7:740-43.6. Hartfield DS, Tan J, Yager JY, Rosychuk RJ, SpadyD, Haines C, et al. The association between

  2. Role of the sodium channel SCN9A in genetic epilepsy with febrile seizures plus and Dravet syndrome.

    Science.gov (United States)

    Mulley, John C; Hodgson, Bree; McMahon, Jacinta M; Iona, Xenia; Bellows, Susannah; Mullen, Saul A; Farrell, Kevin; Mackay, Mark; Sadleir, Lynette; Bleasel, Andrew; Gill, Deepak; Webster, Richard; Wirrell, Elaine C; Harbord, Michael; Sisodiya, Sanyjay; Andermann, Eva; Kivity, Sara; Berkovic, Samuel F; Scheffer, Ingrid E; Dibbens, Leanne M

    2013-09-01

    Mutations of the SCN1A subunit of the sodium channel is a cause of genetic epilepsy with febrile seizures plus (GEFS(+) ) in multiplex families and accounts for 70-80% of Dravet syndrome (DS). DS cases without SCN1A mutation inherited have predicted SCN9A susceptibility variants, which may contribute to complex inheritance for these unexplained cases of DS. Compared with controls, DS cases were significantly enriched for rare SCN9A genetic variants. None of the multiplex febrile seizure or GEFS(+) families could be explained by highly penetrant SCN9A mutations.

  3. Ictericia febril colestásica como forma de presentación de linfoma de Hodgkin

    OpenAIRE

    Max Schindler; Nicolás Kreplak; Lucía Acevedo; Héctor Damis; Guillermo Márquez; María del Carmen Ardaiz

    2014-01-01

    La ictericia febril colestásica como forma de presentación de los linfomas de Hodgkin es un cuadro muy infrecuente. Describimos aquí un caso de síndrome febril prolongado asociado a ictericia progresiva, en el que el diagnóstico de la enfermedad se realiza a través de la biopsia hepática, dada la ausencia de afectación ganglionar que caracteriza a esta enfermedad. Destacamos asimismo el cuadro clínico avanzado y el compromiso multisistémico de una enfermedad rápidamente evolutiva.

  4. Ictericia febril colestásica como forma de presentación de linfoma de Hodgkin

    Directory of Open Access Journals (Sweden)

    Max Schindler

    2014-02-01

    Full Text Available La ictericia febril colestásica como forma de presentación de los linfomas de Hodgkin es un cuadro muy infrecuente. Describimos aquí un caso de síndrome febril prolongado asociado a ictericia progresiva, en el que el diagnóstico de la enfermedad se realiza a través de la biopsia hepática, dada la ausencia de afectación ganglionar que caracteriza a esta enfermedad. Destacamos asimismo el cuadro clínico avanzado y el compromiso multisistémico de una enfermedad rápidamente evolutiva.

  5. Acute pancreatitis

    Science.gov (United States)

    ... its blood vessels. This problem is called acute pancreatitis. Acute pancreatitis affects men more often than women. Certain ... pancreatitis; Pancreas - inflammation Images Digestive system Endocrine glands Pancreatitis, acute - CT scan Pancreatitis - series References Forsmark CE. Pancreatitis. ...

  6. Cystitis - acute

    Science.gov (United States)

    Uncomplicated urinary tract infection; UTI - acute cystitis; Acute bladder infection; Acute bacterial cystitis ... cause. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...

  7. Is the addition of aminoglycosides to beta-lactams in cancer patients with febrile neutropenia needed?

    Directory of Open Access Journals (Sweden)

    Valeria Contreras

    2016-03-01

    Full Text Available En pacientes con cáncer que se presentan con neutropenia febril existe controversia sobre si es mejor utilizar una combinación de antibióticos betalactámicos y aminoglicósidos o si bastaría la monoterapia con betalactámicos de amplio espectro como tratamiento empírico inicial. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos tres revisiones sistemáticas que en conjunto incluyen 14 estudios aleatorizados pertinentes a esta pregunta. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que adicionar aminoglicósidos a los betalactámicos en el tratamiento de la neutropenia febril en pacientes con cáncer aumenta la nefrotoxicidad y podría aumentar la mortalidad en comparación con la monoterapia con betalactámicos.

  8. Transcriptomic evidence for modulation of host inflammatory responses during febrile Plasmodium falciparum malaria

    Science.gov (United States)

    Tran, Tuan M.; Jones, Marcus B.; Ongoiba, Aissata; Bijker, Else M.; Schats, Remko; Venepally, Pratap; Skinner, Jeff; Doumbo, Safiatou; Quinten, Edwin; Visser, Leo G.; Whalen, Elizabeth; Presnell, Scott; O’Connell, Elise M.; Kayentao, Kassoum; Doumbo, Ogobara K.; Chaussabel, Damien; Lorenzi, Hernan; Nutman, Thomas B.; Ottenhoff, Tom H. M.; Haks, Mariëlle C.; Traore, Boubacar; Kirkness, Ewen F.; Sauerwein, Robert W.; Crompton, Peter D.

    2016-01-01

    Identifying molecular predictors and mechanisms of malaria disease is important for understanding how Plasmodium falciparum malaria is controlled. Transcriptomic studies in humans have so far been limited to retrospective analysis of blood samples from clinical cases. In this prospective, proof-of-principle study, we compared whole-blood RNA-seq profiles at pre-and post-infection time points from Malian adults who were either asymptomatic (n = 5) or febrile (n = 3) during their first seasonal PCR-positive P. falciparum infection with those from malaria-naïve Dutch adults after a single controlled human malaria infection (n = 5). Our data show a graded activation of pathways downstream of pro-inflammatory cytokines, with the highest activation in malaria-naïve Dutch individuals and significantly reduced activation in malaria-experienced Malians. Newly febrile and asymptomatic infections in Malians were statistically indistinguishable except for genes activated by pro-inflammatory cytokines. The combined data provide a molecular basis for the development of a pyrogenic threshold as individuals acquire immunity to clinical malaria. PMID:27506615

  9. Effectiveness of intermittent diazepam prophylaxis in febrile seizures: long-term prospective controlled study.

    Science.gov (United States)

    Pavlidou, Efterpi; Tzitiridou, Maria; Panteliadis, Christos

    2006-12-01

    The efficacy of intermittent rectal diazepam prophylaxis is assessed in the prevention of febrile seizures. In a prospective randomized cohort trial, 139 children (77 girls, 62 boys) who experienced a first febrile seizure were allocated to two groups: group A, which received intermittent diazepam (n = 68), and group B, which received no prophylaxis (n = 71). All children had a 3-year follow-up. The inclusion criteria were no personal history of afebrile seizures, normal neurodevelopment, no previous anticonvulsant therapy, and age between 6 months and 3 years. Each group was stratified to low, intermediate, and high risk according to the available clinical data. The 36-month recurrence rates in the no-prophylaxis group were 83% in high-risk patients, 55% in intermediate-risk patients, and 46% in low-risk patients. In the prophylaxis group, the recurrence rates were reduced in all risk groups: 38%, 35%, and 33%, respectively. Intermittent diazepam prophylaxis reduces the recurrence rate mainly in high-risk children provided that sufficient doses are given on time and adequately.

  10. Is preemptive antifungal therapy a good alternative to empirical treatment in prolonged febrile neutropenia?

    Directory of Open Access Journals (Sweden)

    Erica Koch

    2016-06-01

    Full Text Available La neutropenia febril prolongada conlleva un alto riesgo de desarrollar infecciones fúngicas invasoras, por lo que habitualmente se administra terapia antifúngica empírica en estos casos. Sin embargo, esta se asocia a importantes efectos adversos, por lo que se ha propuesto como alternativa la estrategia "preemptive" o anticipada, es decir, la indicación de antifúngicos sólo ante la evidencia indirecta de infección fúngica invasora. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos tres revisiones sistemáticas que en conjunto incluyen doce estudios. Cuatro estudios aleatorizados evaluaron la pregunta abordada en este artículo. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que no está claro si la estrategia "preemptive" tiene algún efecto sobre la mortalidad porque la certeza de la evidencia es muy baja, pero podría disminuir levemente el uso de antifúngicos en pacientes con neutropenia febril prolongada.

  11. Comparison of renal ultrasonography and dimercaptosuccinic acid renal scintigraphy in febrile urinary tract infection.

    Science.gov (United States)

    Ayazi, Parviz; Mahyar, Abolfazl; Noroozian, Elham; Esmailzadehha, Neda; Barikani, Ameneh

    2015-12-01

    Accurate and early diagnosis and appropriate treatment of patient with urinary tract infection (UTI) are essential for the prevention or restriction of permanent damage to the kidneys in children. The aim of this study was to compare renal ultrasonography (US) and dimercaptosuccinic acid (DMSA) renal scan in the diagnosis of patients with febrile urinary tract infection. This study involved the medical records of children with febrile urinary tract infection who were admitted to the children's hospital in Qazvin, Iran. Pyelonephritis was diagnosed on the basis of clinical symptoms, laboratory tests and abnormal DMSA renal scans. The criteria for abnormality of renal US were an increase or a decrease in diffuse or focal parenchymal echogenicity, loss of corticomedullary differentiation, kidney position irregularities, parenchymal reduction and increased kidney size. Of the 100 study patients, 23% had an abnormal US and 46% had an abnormal DMSA renal scan. Of the latter patients, 15 had concurrent abnormal US (P value ≤ 0.03, concordance rate: 18%). Renal US had a sensitivity of 32%, specificity of 85%, positive predictive value of 65% and negative predictive value of 60%. Of the 77 patients with normal US, 31 (40.2%) had an abnormal DMSA renal scan. Despite the benefits and accessibility of renal US, its value in the diagnosis of pyelonephritis is limited.

  12. Pharmacoeconomic analysis of voriconazole vs. caspofungin in the empirical antifungal therapy of febrile neutropenia in Australia.

    Science.gov (United States)

    Al-Badriyeh, Daoud; Liew, Danny; Stewart, Kay; Kong, David C M

    2012-05-01

    In two major clinical trials, voriconazole and caspofungin were recommended as alternatives to liposomal amphotericin B for empirical use in febrile neutropenia. This study investigated the health economic impact of using voriconazole vs. caspofungin in patients with febrile neutropenia. A decision analytic model was developed to measure downstream consequences of empirical antifungal therapy. Clinical outcomes measured were success, breakthrough infection, persistent base-line infection, persistent fever, premature discontinuation and death. Treatment transition probabilities and patterns were directly derived from data in two relevant randomised controlled trials. Resource use was estimated using an expert clinical panel. Cost inputs were obtained from latest Australian sources. The analysis adopted the perspective of the Australian hospital system. The use of caspofungin led to a lower expected mean cost per patient than voriconazole (AU$40,558 vs. AU$41,356), with a net cost saving of AU$798 (1.9%) per patient. Results were most sensitive to the duration of therapy and the alternative therapy used post-discontinuation. In uncertainty analysis, the cost associated with caspofungin is less than that with voriconazole in 65.5% of cases. This is the first economic evaluation of voriconazole vs. caspofungin for empirical therapy. Caspofungin appears to have a higher probability of having cost-savings than voriconazole for empirical therapy. The difference between the two medications does not seem to be statistically significant however.

  13. Leukocyte Count and Erythrocyte Sedimentation Rate as Diagnostic Factors in Febrile Convulsion

    Directory of Open Access Journals (Sweden)

    Ali Akbar Rahbarimanesh

    2011-07-01

    Full Text Available "nFebrile convulsion (FC is the most common seizure disorder in childhood. white blood cell (WBC and erythrocyte sedimentation rate (ESR are commonly measured in FC. Trauma, vomiting and bleeding can also lead to WBC and ESR so the blood tests must carefully be interpreted by the clinician. In this cross sectional study 410 children(163 with FC, aged 6 months to 5 years, admitted to Bahrami Children hospital in the first 48 hours of their febrile disease, either with or without seizure, were evaluated over an 18 months period. Age, sex, temperature; history of vomiting, bleeding or trauma; WBC, ESR and hemoglobin were recorded in all children. There was a significant increase of WBC (P<0.001 in children with FC so we can deduct that leukocytosis encountered in children with FC can be due to convulsion in itself. There was no significant difference regarding ESR (P=0.113 between the two groups. In fact, elevated ESR is a result of underlying pathology. In stable patients who don't have any indication of lumbar puncture, there's no need to assess WBC and ESR as an indicator of underlying infection. If the patient is transferred to pediatric ward and still there's no reason to suspect a bacterial infection, there is no need for WBC test.

  14. Cognitive performance and convulsion risk after experimentally-induced febrile-seizures in rat.

    Science.gov (United States)

    Rajab, Ebrahim; Abdeen, Zahra; Hassan, Zuhair; Alsaffar, Yousif; Mandeel, Mohammad; Al Shawaaf, Fatima; Al-Ansari, Sali; Kamal, Amer

    2014-05-01

    Many reports indicated that small percentage of children with febrile seizures develop epilepsy and cognitive disorders later in adulthood. In addition, the neuronal network of the hippocampus was reported to be deranged in adult animals after being exposed to hyperthermia-induced seizures in their neonatal life. The aims of this study were to investigate (1) latency and probability of seizures, (2) spatial learning and memory, in adult rats after neonatal hyperthermia-induced febrile seizures (FS). Prolonged FS were elicited in 10-day old, male Sprague Dawleys (n=11/group) by exposure to heated air (48-52 °C) for 30 min; control rats were exposed to 30 °C air. After 1.5 months the animal's cognitive performance was assessed by 5 day trial in the Morris water maze. In another experiment the latency and probability of seizures were measured in response to pentylenetetrazole (PTZ) injections (increased doses ranged from 7 to 140 mg/kg; i.p.). In water maze, both groups showed improvements in escape latency and distance swam to reach the platform; effects were significantly greater in control versus hyperthermia-treated animals on days 3 and 4. Latency and probability of PTZ-induced seizures were shorter and higher respectively, in hyperthermia-treated animals compared to controls. We concluded that FS in neonatal rats leads to enhanced susceptibility for seizures, as well as cognitive deficits in adults.

  15. Cerebral blood perfusion in febrile convulsions with sup 123 -IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Michihiro, Narumi; Ariizumi, Motomizu; Shiihara, Hiroaki; Suemitsu, Tomoko; Kurosawa, Yumiko; Egami, Yuriko (Dokkyo University Hospital, Saitama (Japan))

    1990-04-01

    Twenty-five pediatric patients with febrile convulsions underwent single photon emission computed tomography (SPECT) with N-isopropyl-p-(I-123) iodoamphetamine. Nineteen patients (76%) had a localized, decreased blood flow on early images, 12 of whom had it in the temporal region. According to seizure type, the abnormality was seen in 85% (17/20) for complex type, in contrast to 40% (2/5) for simple type. This finding has implications for pathological similarities between epilepsy and febrile convulsion. Delayed imaging performed on 12 patients showed redistribution in 5 of 9 patients having a decreased blood flow on early images. In the other 3 patients having normal findings on early images, however, different findings were seen on delayed images - normal, increased or decreased blood flow. There was no correlation between SPECT and encephalographic findings. A localized, decreased blood flow on SPECT seemed to reflect the risk for developing epilepsy. A follow-up care for preventing epilepsy is mandatory when there are abnormal findings on SPECT. (N.K.).

  16. An investigation into febrile illnesses of unknown aetiology in Wipim, Papua New Guinea.

    Science.gov (United States)

    Bande, Grace; Hetzel, Manuel W; Iga, Jonah; Barnadas, Celine; Mueller, Ivo; Siba, Peter M; Horwood, Paul F

    2014-01-01

    In Papua New Guinea the aetiology of febrile illnesses remains poorly characterized, mostly due to poor diagnostic facilities and the inaccessibility of much of the rural areas of the country. We investigated the aetiological agents of febrile illnesses for 136 people presenting to Wipim Health Centre in Western Province, Papua New Guinea. Arboviral and rickettsial real-time polymerase chain reaction (PCR) assays, malaria blood smears and a malaria PCR test were used to identify pathogens associated with a history of fever. In 13% (n = 18) of cases an aetiological agent was identified. Dengue virus type 1 was detected in 11% (n = 15) of the samples tested and malaria in 2% (n = 3). None of the other arboviral or rickettsial pathogens tested for were detected in any of the samples. Although dengue viruses have been identified in Papua New Guinea using serological methods, this study represents the first direct detection of dengue in the country. The detection of malaria, on the other hand, was surprisingly low considering the previous notion that this was a hyperendemic region of Papua New Guinea.

  17. Morbidade febril puerperal em pacientes infectadas pelo HIV Puerperal morbidity in HIV-positive women

    Directory of Open Access Journals (Sweden)

    Andrea De Marcos

    2003-04-01

    Full Text Available OBJETIVO: avaliar as taxas de morbidade febril puerperal em pacientes infectadas pelo HIV e sua correlação com a via de parto, duração do trabalho de parto, tempo de rotura de membranas, número de células CD4+ e carga viral do HIV periparto. MÉTODOS: foram incluídas 207 gestantes infectadas pelo HIV, com seguimento pré-natal e parto entre maio de 1997 e dezembro de 2001, sendo 32 submetidas a parto vaginal e 175 a cesárea. Do total de pacientes, 62,8% foram submetidas a cesárea eletiva. A idade média no grupo analisado foi de 27,4 anos, 25,6% eram nulíparas e 26% primíparas, com idade gestacional média de 37,8 semanas no momento do parto. A contagem média de células CD4+ foi de 481 células /mm³ e da carga viral do HIV de 49.100 cópias/mL, ambas no final da gestação. RESULTADOS: a morbidade febril puerperal ocorreu em 34 pacientes, sendo 33 pós-cesárea e 1 pós-parto vaginal. O tipo mais comum de intercorrência infecciosa pós-cesárea foi infecção de cicatriz cirúrgica (13% dos casos de infecção. Os fatores analisados, como duração do trabalho de parto, tempo de rotura de membranas, contagem de células CD4+ ou carga viral do HIV periparto, não interferiram na taxa de morbidade febril puerperal. CONCLUSÕES: A incidência de morbidade febril puerperal foi de 16,8%, sendo mais freqüente pós-cesárea (18,9% que pós-parto vaginal (3,1%. Os demais fatores não mostraram relação significativa com a taxa de morbidade febril puerperal.PURPOSE: the morbidity in HIV-positive patients due to puerperal fever was studied and correlated to the method and duration of labor, the duration of premature rupture of the membranes, CD4+ cell count and the viral load (VL at peridelivery. METHODS: a total of 207 HIV-positive women with prenatal examinations and deliveries between May 1997 and December 2001 were enrolled. Of these, 32 had natural childbirth and 175 had a cesarean section. Of the total of enrolled patients, 62

  18. 心肌梗死患者急性期与恢复期焦虑抑郁状况因素分析%Analysis of factors influencing anxiety and depression at different stages among patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    朱凌燕; 卢惠娟; 许燕玲

    2013-01-01

    Objective To investigate the levels of anxiety and depression at different stages among patients with acute myocardial infarction (AMI),to explore the influencing factors,and to improve the stress management of AMI patients.Methods A total of 100 AMI patients from Shanghai Sixth People's Hospital from February to June 2012 were evaluated with the Hospital Anxiety and Depression Scale (HADS) during hospitalization and 2-3 months of follow-up.Results Among 100 patients,the incidence of anxiety was 29%,38% and 44% during hospitalization,early rehabilitation and rehabilitation,respectively.The incidence of depression was 40%,50% and 53% during hospitalization,early rehabilitation and rehabilitation,respectively.The influencing factors during hospitalization were education background,profession and age.During early rehabilitation the per capita household monthly income,medical payment method,myocardial infarction area and history were the influencing factors.While during rehabilitation the family care,marriage status,sports habit,and household were the influencing factors (P < 0.05).Conclusion The incidence of anxiety and depression among AMI patients increases with time going on.It is influenced by various factors at different stages of AMI.The patients' status should be evaluated comprehensively,and the effective intervention should be provided to prevent and reduce the negative psychological impacts.%目的 了解急性心肌梗死(acute myocardial infarction,AMI)患者住院急性期、恢复初期和恢复期的焦虑抑郁状况及相关因素.方法 采用便利抽样法,选取2012年2-6月收治于上海交通大学附属第六人民医院的AMI患者100例,采用综合医院焦虑/抑郁情绪测定表(hospital anxiety and depression scale,HADS)对其发病的急性期、恢复初期和恢复期进行问卷调查.结果 AMI患者在住院急性期焦虑阳性检出率占29%,恢复初期占38%,恢复期占44%;在住院急

  19. 糖尿病合并脑血管病急性期中医证候演变规律研究%Evolution laws of TCM syndromes of diabetes complicating cerebrovascular disease at acute stage

    Institute of Scientific and Technical Information of China (English)

    占戈; 袁玉娇; 田园; 陈志刚; 谢颖桢

    2012-01-01

    Objective To discuss the evolution laws of TCM syndromes of diabetes complicating cerebrovascular disease at acute stage. Methods The patients with diabetes complicating cerebrovascular disease (re = 137, complicating group) and those without diabetes complicating cerebrovascular disease (re = 158, other disease group) were selected. The TCM syndrome factors included wind, fire, phlegm, blood stasis, qi deficiency and yin deficiency with yang hyperactivity, and they were collected, reviewed and compared at four time points (hospitalized day, 7th day, 14* day and 28* day). Results The evolution laws of TCM syndromes in complicating group were from syndrome of wind stirring due to yin deficiency to phlegm-fire syndrome to phlegm-stasis syndrome to qi deficiency and blood stasis syndrome, and that in other disease group, from wind-phlegm syndrome to phlegm-fire syndrome to phlegm-stasis syndrome to phlegm-stasis syndrome. Conclusion The different evolution laws in diabetes complicating cerebrovascular disease and other diseases provide theoretical basis for treating stroke with TCM at different stages.%目的 探讨糖尿病合并脑血管病急性期中医证候演变规律.方法 选择糖尿病合并脑血管病患者137例,非糖尿病合并脑血管患者158例作为研究对象,中医证候要素分为风、火、痰、瘀、气虚、阴虚阳亢,分别于入院时、发病第7天、14天、28天,4个时点进行证候采集和评价,进行两组比较.结果 糖尿病合并脑血管病组证候演变规律为阴虚风动证→痰火证→痰瘀证→气虚血瘀证.非糖尿病合并脑血管病组证候演变规律为风痰证→痰火证→痰瘀证→痰瘀证.结论 糖尿病合并脑血管病组与非糖尿病合并脑血管病组存在不同的证候演变规律,为中风不同时期的中医临床辨证施治提供了理论依据.

  20. 急性缺血性卒中后抑郁危险因素的前瞻性队列研究%Risk Factors for Depression at the Acute Stage of Ischemic Stroke: A Prospective Cohort Study

    Institute of Scientific and Technical Information of China (English)

    杨中华; 张宁; 白莹; 王安心; 王展; 王艳云; 吴佳; 王春雪

    2012-01-01

    Objective To explore the independent risk factors of post-stroke depression(PSD) at the acute stage of ischemic stroke in the stroke unit in a prospective cohort study. Methods Eligible inpatients with acute ischemic cerebrovascular diseases within 14 days after onset were enrolled in this study. Demographic data, past history, associated clinical indicators and imaging data were collected. The assessments of neurological deficit and mental scale were carried out for all the enrolled patients within 14 day after onset, and according to the depression evaluation, all patients were divided into PSD group and non-PSD group. Demographic data and clinical data were compared between the two groups to analyze the risk factors for depression at the acute stage of ischemic stroke. Results Total of 268 patients were included in this study, 116 in PSD group and 152 in non-PSD group. Compared with the non-PSD group, a significantly higher proportion of patients in the PSD group were females, with a history of diabetes, and had impetuous and inward dispositions. The PSD group had significantly higher National Institutes of Health Stroke Scale(NIHSS) and lower Mini-Mental State Examination(MMSE) score than the non-PSD group on 14 days after onset. The imaging findings showed that acute infarction at basal ganglia was associated with high PSD incidence; the detection rate of encephalatrophy at bilateral medial temporal lobe, right parietal lobe, and bilateral occipital lobe were significantly higher in PSD group than that in non-PSD group. Gender(P<0.0001, OR 7.064, 95%CI 3.334-14.966) and NIHSS score on 14 days after onset(P=0.0020, OR 1.158, 95%CI 1.055-1.272) were the independent risk factors of PSD. Easygoing disposition before onset(P=0.0264, OR 0.447, 95%CY 0.220-0.910) was a protective factor for PSD. Conclusion Female-gender and neurological deficit on 14 days after onset are independent risk factors of PSD. Easygoing disposition before onset is a protective factor for

  1. Febrile seizures

    Science.gov (United States)

    ... in a safe area. Clear the area of furniture or other sharp objects. Slide a blanket under ... Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David ...

  2. Acute fever and delayed leukoencephalopathy following low dose intraventricular methotrexate.

    Science.gov (United States)

    Boogerd, W; vd Sande, J J; Moffie, D

    1988-10-01

    Nine out of 14 patients treated with intraventricular methotrexate (MTX) for meningeal carcinomatosis from breast carcinoma and surviving more than 4 months developed disseminated necrotising leukoencephalopathy (DNL). All four patients who had received both intraventricular MTX and whole brain radiotherapy developed DNL. Five of the six patients who experienced an acute febrile reaction with mild encephalopathic signs following intraventricular administration of MTX developed DNL after a mean time of 5 months and a low mean dose of 44 mg MTX. DNL was also noted in two patients without a previous febrile reaction or whole brain radiotherapy, following prolonged intraventricular MTX therapy after a mean time of 19.5 months and a mean dose of 147 mg MTX. These findings confirm the hazards of (1) high cumulative doses of intrathecal MTX and (2) combined intrathecal chemotherapy and whole brain radiotherapy. This study also suggests a possible relationship between an early and transient febrile reaction during intraventricular administration of MTX and the development of DNL.

  3. Acute fever and delayed leukoencephalopathy following low dose intraventricular methotrexate.

    Science.gov (United States)

    Boogerd, W; vd Sande, J J; Moffie, D

    1988-01-01

    Nine out of 14 patients treated with intraventricular methotrexate (MTX) for meningeal carcinomatosis from breast carcinoma and surviving more than 4 months developed disseminated necrotising leukoencephalopathy (DNL). All four patients who had received both intraventricular MTX and whole brain radiotherapy developed DNL. Five of the six patients who experienced an acute febrile reaction with mild encephalopathic signs following intraventricular administration of MTX developed DNL after a mean time of 5 months and a low mean dose of 44 mg MTX. DNL was also noted in two patients without a previous febrile reaction or whole brain radiotherapy, following prolonged intraventricular MTX therapy after a mean time of 19.5 months and a mean dose of 147 mg MTX. These findings confirm the hazards of (1) high cumulative doses of intrathecal MTX and (2) combined intrathecal chemotherapy and whole brain radiotherapy. This study also suggests a possible relationship between an early and transient febrile reaction during intraventricular administration of MTX and the development of DNL. Images PMID:3225584

  4. [Abnormal cerebral blood flow distributions during the post-ictal phase of febrile status epilepticus in three pediatric patients measured by arterial spin labeling perfusion MRI].

    Science.gov (United States)

    Hirano, Keiko; Fukuda, Tokiko

    2016-05-01

    The ability to visualize brain perfusion is important for identifying epileptic foci. We present three pediatric cases showing asymmetrical cerebral blood flow (CBF) distributions during the post-ictal phase of febrile status epilepticus measured by arterial spin labeling (ASL) perfusion MRI. During the acute phase, regional CBF measurements in the areas considered including epileptic foci were higher than in the corresponding area of the contralateral hemisphere, though the exact quantitative value varied between cases. We could not identify the correct epileptogenic foci, because those ASL images were taken after the prolonged and extraordinary activation of neurons in the affected area. During the recovery phase, the differences reduced and the average regional CBF measurement was 54.6 ± 6.1 ml/100 g per minute, which was a little less than the number of previous ASL studies. ASL perfusion MRI imaging provides a method for evaluating regional CBF by using magnetically labeled arterial blood water as an endogenous tracer. With this technique, we can repeatedly evaluate both the brain structure and the level of perfusion at the same time. ASL is noninvasive and easily accessible, and therefore it could become a routine tool for assessment of perfusion in daily practice of pediatric neurology.

  5. Risk of Febrile Seizures and Epilepsy After Vaccination With Diphtheria, Tetanus, Acellular Pertussis, Inactivated Poliovirus, and Haemophilus Influenzae Type b

    DEFF Research Database (Denmark)

    Sun, Yuelian; Christensen, Jakob Christensen; Hviid, Anders

    2012-01-01

    seizures within 0 to 7 days (0, 1-3, and 4-7 days) after each vaccination and HR of epilepsy after first vaccination in the cohort study. Relative incidence of febrile seizures within 0 to 7 days (0, 1-3, and 4-7 days) after each vaccination in the SCCS study. Results A total of 7811 children were...... diagnosed with febrile seizures before 18 months, of whom 17 were diagnosed within 0 to 7 days after the first (incidence rate, 0.8 per 100 000 person-days), 32 children after the second (1.3 per 100 000 person-days), and 201 children after the third (8.5 per 100 000 person-days) vaccinations. Overall......, children did not have higher risks of febrile seizures during the 0 to 7 days after the 3 vaccinations vs a reference cohort of children who were not within 0 to 7 days of vaccination. However, a higher risk of febrile seizures was found on the day of the first (HR, 6.02; 95% CI, 2.86-12.65) and on the day...

  6. Association between use of air-conditioning or fan and survival of elderly febrile patients: a prospective study.

    Science.gov (United States)

    Theocharis, G; Tansarli, G S; Mavros, M N; Spiropoulos, T; Barbas, S G; Falagas, M E

    2013-09-01

    Elderly individuals are more susceptible to excess summer heat. We sought to examine whether the use of cooling systems (air-conditioning or fan) affected the clinical outcomes of elderly febrile patients. We prospectively followed elderly (≥ 75 years old) febrile patients requesting the medical services of the SOS Doctors (a network of physicians performing house-call visits) from July 10 to August 20, 2011. Patients who used cooling systems ("users") were compared with those who did not ("non-users") regarding mortality, clinical outcome of primary illness (improvement or deterioration), and emergency hospitalization. Prospectively collected data were available for 339 individual elderly febrile patients. "Users" had lower mortality (10 % vs. 19 %, p air-conditioning and fan regarding mortality or clinical improvement, but fan use was associated with more hospitalizations (37 % vs. 19 %, p conditions), the sole variable significantly associated with mortality was the non-use of cooling systems [odds ratio (OR): 2.18, 95 % confidence interval (CI): 1.06-4.50]. The use of air-conditioning or fan during hot summer periods appeared to be beneficial for elderly febrile patients living in a large city. Large prospective studies are warranted in order to provide further insight into potential individual and public health initiatives aiming to alleviate the impact of excess summer heat on the health of elderly patients.

  7. Emergence of MRSA in positive blood cultures from patients with febrile neutropenia--a cause for concern.

    LENUS (Irish Health Repository)

    Morris, Patrick G

    2008-09-01

    Febrile neutropenia (FN) causes considerable morbidity in patients on cytotoxic chemotherapy. Recently, there has been a trend towards fewer Gram-negative and more Gram-positive infections with increasing antibiotic resistance. To assess these patterns, data from a supra-regional cancer centre in Ireland were reviewed.

  8. Mannose-Binding Lectin (MBL) and the Risk for Febrile Neutropenia and Infection in Pediatric Oncology Patients With Chemotherapy

    NARCIS (Netherlands)

    F.N.J. Frakking; J. Israëls; L.C.M. Kremer; T.W. Kuijpers; H.N. Caron; M.D. van de Wetering

    2011-01-01

    Background. We determined whether mannose-binding lectin (MBL) deficiency is associated with an increased risk of febrile neutropenia (FN) and/or infection in pediatric oncology patients. Procedure. We systematically searched and reviewed all the literature on MBL and infections in children with can

  9. Very early discharge versus early discharge versus non-early discharge in children with cancer and febrile neutropenia

    NARCIS (Netherlands)

    Loeffen, Erik A. H.; te Poele, Esther M.; Tissing, Wim J. E.; Boezen, H. Marike; de Bont, Eveline S. J. M.

    2016-01-01

    Background Chemotherapy-induced neutropenia is a common adverse effect in children with cancer. Due to the high relative risk of infections and infectious complications, standard care for children with cancer and febrile neutropenia consists of routine hospitalization and parenteral administration o

  10. Imbalances in serum angiopoietin concentrations are early predictors of septic shock development in patients with post chemotherapy febrile neutropenia

    Directory of Open Access Journals (Sweden)

    Lorand-Metze Irene

    2010-05-01

    Full Text Available Abstract Background Febrile neutropenia carries a high risk of sepsis complications, and the identification of biomarkers capable to identify high risk patients is a great challenge. Angiopoietins (Ang - are cytokines involved in the control microvascular permeability. It is accepted that Ang-1 expression maintains endothelial barrier integrity, and that Ang-2 acts as an antagonizing cytokine with barrier-disrupting functions in inflammatory situations. Ang-2 levels have been recently correlated with sepsis mortality in intensive care units. Methods We prospectively evaluated concentrations of Ang-1 and Ang-2 at different time-points during febrile neutropenia, and explored the diagnostic accuracy of these mediators as potential predictors of poor outcome in this clinical setting before the development of sepsis complications. Results Patients that evolved with septic shock (n = 10 presented higher levels of Ang-2 measured 48 hours after fever onset, and of the Ang-2/Ang-1 ratio at the time of fever onset compared to patients with non-complicated sepsis (n = 31. These levels correlated with sepsis severity scores. Conclusions Our data suggest that imbalances in the concentrations of Ang-1 and Ang-2 are independent and early markers of the risk of developing septic shock and of sepsis mortality in febrile neutropenia, and larger studies are warranted to validate their clinical usefulness. Therapeutic strategies that manipulate this Ang-2/Ang-1 imbalance can potentially offer new and promising treatments for sepsis in febrile neutropenia.

  11. Prevalence of HHV-6 in cerebrospinal fluid of children younger than 2 years of age with febrile convulsion.

    Directory of Open Access Journals (Sweden)

    Setareh Mamishi

    2014-04-01

    Full Text Available Febrile convulsion is a common disorder in children. Viral infections such as human herpes virus 6 (HHV-6 which results in roseola infantum may contribute to developing seizure. The objective of this study was to determine the prevalence of HHV-6 by detecting DNA in cerebrospinal fluid (CSF of children with febrile convulsion and without any rash of roseola infantum.In this descriptive cross-sectional study, CSF of 100 children younger than 2 years of age with febrile convulsion was evaluated for detecting HHV-6 DNA by PCR. All of them were referred to emergency ward in Pediatric Medical Center from March 2010 to March 2011. General information, clinical manifestations, laboratory tests and outcomes were collected in the questionnaires.One hundred children including 59 males and 41 females were evaluated. HHV-6 was detected from CSF in six patients (6% by PCR. Mean age was 8 months old. All children were younger than 12 months old. The most common primary manifestation was fever alone. None of them had rash. Majority of cases occurred in winter. All patients recovered without any encephalitis.These findings showed that primary infection with HHV-6 is frequently associated with febrile convulsion in infants which may be at risk for subsequent development of epilepsy.

  12. The incidence of human herpesvirus 6 infection in children with febrile convulsion admitted to the University Hospital, Kuala Lumpur.

    Science.gov (United States)

    Chua, K B; Lam, S K; AbuBakar, S; Koh, M T; Lee, W S

    1997-12-01

    From October 1996 to March 1997, 31 children with febrile convulsions were admitted to the University Hospital, Kuala Lumpur. Human Herpesvirus 6 (HHV 6) was virologically and/or serologically confirmed to be the cause of the febrile episode in 5 of these children (16.1%). Age, sex and other associated clinical features (diarrhoea, cough, running nose and type of seizure) were not useful in differentiating cases of febrile convulsion due to HHV 6 from those of other aetiology. However, uvulo-palatoglossal junctional ulcers were noted in children in whom the cause of the seizure could be attributed to HHV 6 but not in the remaining cases in the study group. HHV 6 DNA was detected in peripheral blood mononuclear cells from all patients with febrile convulsions attributed to HHV6, and in patients shown serologically to have already been exposed to the virus by nested polymerase chain reaction amplification. Only genotype HHV 6B was detected from patients with seizure due to HHV 6 but both genotype 6A and 6B were detected in the remaining cases studied.

  13. Bacteria causing bacteremia in pediatric cancer patients presenting with febrile neutropenia-species distribution and susceptibility patterns

    NARCIS (Netherlands)

    Miedema, Karin G. E.; Winter, Rik H. L. J.; Ammann, Roland A.; Droz, Sara; Spanjaard, Lodewijk; de Bont, Eveline S. J. M.; Kamps, Willem A.; van de Wetering, Marianne D.; Tissing, Wim J. E.

    2013-01-01

    Infections are a major cause of morbidity and mortality in pediatric cancer patients. The aim of this study was to establish the microbiological spectrum and the susceptibility patterns of bacteremia-causing bacteria in pediatric cancer patients with febrile neutropenia in relation to the use of pro

  14. Identification of febrile seizure susceptibility genes : studies in mouse chromosome substitution strains and temporal lobe epilepsy patients

    NARCIS (Netherlands)

    Hessel, E.V.S.

    2010-01-01

    Febrile Seizures (FS) are the most common seizure type in children and recurrent FS are a risk factor for developing temporal lobe epilepsy (TLE). Although the mechanisms underlying FS are largely unknown, recent family, twin and animal studies indicate that genetics are important in FS susceptibili

  15. Acute Bronchitis

    Science.gov (United States)

    ... Smoking also slows down the healing process. Acute bronchitis treatment Most cases of acute bronchitis can be treated at home.Drink fluids, but ... bronchial tree. Your doctor will decide if this treatment is right for you. Living with acute bronchitis Most cases of acute bronchitis go away on ...

  16. Reevaluation of Meta-analysis on prophylactic drug management for recurrence of febrile seizures

    Directory of Open Access Journals (Sweden)

    Huan LIAO

    2015-08-01

    Full Text Available Objective To explore the efficiency and safety of drugs to prevent the recurrence of febrile seizures (FS.  Methods Relevant literatures were searched via PubMed, EMBASE/SCOPUS, EBSCO-CINAHL, Web of Science, Cochrane Database of Systematic Reviews from December 1997 to November 2014 using the following keywords: febrile seizure OR febrile convulsion, recurrence, prevention OR prophylaxis, medicine OR medication. Publication type was limited to Meta-analysis. Extract the relevant information of Meta-analysis, such as characteristics of objects, types of study design, number of clinical trials, number of cases, search strategies, databases, information of methodology (methods of randomization, concealment, blinding, withdrawal and exit, follow-up time, heterogeneity analysis, subgroup analysis and outcome assessment, etc. Quality of Reporting of Meta-analyses (QUOROM and Oxman-Guyatt Overview Quality Assessment Questionnaire (OQAQ were used to assess the quality of included Meta-analyses. Jadad decision was used to assess inclusion and exclusion criteria, search strategies, effectiveness evaluation, data extraction and data analysis, to explore reliable evidence of evidence-based medicine.  Results Eventually, four Meta-analyses were included after screening of all the literatures that can be searched out. Among those Meta-analyses, the Meta-analysis of Offringa and Newton (2012 was relatively more reliable. The results suggesed that no clinically important benefits were found in administering intermittent oral or rectal diazepam, oral phenobarbitone, phenytoin, valproate, pyridoxine, buprofen, diclofenac and acetominophen to children with FE. Only one clinical trial reported that intermittent oral clobazam could reduce the recurrence of FE in comparing with placebo at 6-month follow-up (RR = 0.360, 95% CI: 0.200-0.640; P = 0.000, but it should be verified by more randomized controlled trials (RCTs. Among 4 Meta-analyses included in this study

  17. Neuroprotective effect of high-dose hyperbaric oxygenation on rats with acute cerebral infarction in super-early stage Curative comparison between 9-hour and 18-hour therapeutic protocols

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Previously, only single short-time low-dose hyperbaric oxygenation (HBO) protocol was administrated to treat acute ischemic stroke in early stage and the conflicting results were obtained. There are few studies to report the outcome of administering long-time (can cover all the natural pathologic progression period) high-dose HBO to treat the disease.OBJECTIVE: To evaluate the therapeutic effect between two kinds of high-dose hyperbaric oxygenation on super-early stage of acute permanent middle cerebral artery occlusion (MCAO) in rats.DESIGN: A randomized controlled experimental study.SETTING: Beijing Tiantan Hospital, Capital Medical University; Beijing Research Institute of Neurosurgery.MATERIALS: Seventy-four male SD rats, aged 2.5 months old, weighing (280±20) g, were provided by the Animal Institute, Chinese Academy of Medical Sciences. Hyperbaric oxygenation device was hyperbaric air cabin in which there was a self-made pure oxygen animal experimental cabin (made in China).METHODS: This experiment was carried out in the municipal laboratory of Beijing Tiantan Hospital affiliated to Capital Medical University and Beijing Research Institute of Neurosurgery. ① Experimental intervention: All the rats were developed into models of permanent MCAO by suture embolism. Then, they were randomly divided into two HBO groups (9hours and 18 hours) and control group, with 24 rats in each as well as 3-hour ultrastructure control group, with 2 rats. After being modeled for 3 hours, rats in the two HBO groups stayed in the hyperbaric cabin for 9 hours and 18 hours,separately. Rats in the 9-hour HBO group inhaled pure oxygen at hours 1, 3, 5, 7 and 9, and hyperbaric air at hours 2, 4, 6 and 8. Rats in the 18-hour HBO group inhaled pure oxygen at hours 1, 3, 5, 7, 9, 11, 13, 15 and 17, and hyperbaric air at hours 2, 4, 6, 8, 10 12, 14, 16 and 18. After being created into models, rats in the control group and 3-hour ultrastructure control group breathed room air.

  18. Staging atmospheres

    DEFF Research Database (Denmark)

    Bille, Mikkel; Bjerregaard, Peter; Sørensen, Tim Flohr

    2015-01-01

    The article introduces the special issue on staging atmospheres by surveying the philosophical, political and anthropological literature on atmosphere, and explores the relationship between atmosphere, material culture, subjectivity and affect. Atmosphere seems to occupy one of the classic...... localities of tensions between matter and the immaterial, the practical and the ideal, and subject and object. In the colloquial language there can, moreover, often seem to be something authentic or genuine about atmosphere, juxtaposing it to staging, which is implied to be something simulated or artificial....... This introduction seeks to outline how a number of scholars have addressed the relationship between staged atmospheres and experience, and thus highlight both the philosophical, social and political aspects of atmospheres...

  19. Acupuncture and Moxibustion Treatment of 150 Cases of Peripheral Facial Paralysis in Different Stages

    Institute of Scientific and Technical Information of China (English)

    YAN Huai-shi; HUANG Guo-qi

    2003-01-01

    Moxibustion was used in predominance in acute stage. Shallow needling technique plus electricstimulation was used in the restoration stage. Comprehensive therapy of acupuncture and massage was used in the sequels stage. 21 cases were cured in the acute stage. 101 cases were cured in the restoration stage.10 cases were cured in the sequels stage. The results indicate that the restoration stage is a key moment for treatment of peripheral facial paralysis.

  20. Utilization of public or private health care providers by febrile children after user fee removal in Uganda

    Directory of Open Access Journals (Sweden)

    Peterson Stefan

    2009-03-01

    Full Text Available Abstract Background Despite investments in providing free government health services in Uganda, many caretakers still seek treatment from the drug shops/private clinics. The study aimed to assess determinants for use of government facilities or drug shops/private clinics for febrile illnesses in children under five. Methods Structured questionnaires were administered to caretakers in 1078 randomly selected households in the Iganga – Mayuge Demographic Surveillance site. Those with children who had had fever in the previous two weeks and who had sought care from outside the home were interviewed on presenting symptoms and why they chose the provider they went to. Symptoms children presented with and reasons for seeking care from government facilities were compared with those of drug shops/private clinics. Results Of those who sought care outside the home, 62.7% (286/456 had first gone to drug shops/private clinics and 33.1% (151/456 first went to government facilities. Predictors of having gone to government facilities with a febrile child were child presenting with vomiting (OR 2.07; 95% CI 1.10 – 3.89 and perceiving that the health providers were qualified (OR 10.32; 95% CI 5.84 – 18.26 or experienced (OR 1.93; 95% CI 1.07 – 3.48. Those who took the febrile child to drug shops/private clinics did so because they were going there to get first aid (OR 0.20; 95% CI 0.08 – 0.52. Conclusion Private providers offer 'first aid' to caretakers with febrile children. Government financial assistance to health care providers should not stop at government facilities. Multi-faceted interventions in the private sector and implementation of community case management of febrile children through community medicine distributors could increase the proportion of children who access quality care promptly.

  1. Role of electroencephalogram and neuroimaging in first onset afebrile and complex febrile seizures in children from Kashmir

    Directory of Open Access Journals (Sweden)

    Akhter Rasool

    2012-01-01

    Full Text Available Objectives: (1 To determine the frequency of abnormal neuroimaging in children with new-onset afebrile and complex febrile seizures; (2 to draw a correlation between Electroencephalogram (EEG and neuroimaging. Study Design: A hospital-based prospective study. Materials and Methods: A total of 276 children (6 months to 14 years of age, who presented with new-onset afebrile or complex febrile seizures, underwent EEG and neuroimaging [Computed Tomography (CT and/or Magnetic Resonance Imaging (MRI]. Results: Generalized seizures constituted the major seizure group in our study - 116/276 (42% - followed by partial seizures 86/276 (31.2% and complex febrile seizure in 64/276 (23.2%. Generalized as well as partial seizures were more common in children aged 6-14 years, while complex febrile seizures were predominantly seen in children less than 6 years old. Most of the patients with generalized and partial seizures had EEG abnormalities, while EEG abnormalities were uncommon in patients with complex febrile seizures. A total of 27/276 (9.8% patients with seizure disorder had abnormal CT scans and this abnormality was more common in patients with partial seizures. CT abnormality was seen more commonly in those patients who had an abnormal EEG. EEG and CT correlation showed that patients with abnormal EEG had higher rates of CT abnormality, ie, 16.1% (25/155. Abnormal MRI was seen in 32/157 (20.4% of patients; accuracy of picking abnormality by MRI, when EEG was abnormal, was 24.8% (P<0.05. Conclusion: Our findings indicate that clinical examination and EEG results are good indicators for neuroimaging, and these can be used as one of the criteria for ordering neuroimaging in new-onset seizures.

  2. Esophageal Candidiasis as the Initial Manifestation of Acute Myeloid Leukemia.

    Science.gov (United States)

    Komeno, Yukiko; Uryu, Hideki; Iwata, Yuko; Hatada, Yasumasa; Sakamoto, Jumpei; Iihara, Kuniko; Ryu, Tomiko

    2015-01-01

    A 47-year-old woman presented with persistent dysphagia. A gastroendoscopy revealed massive esophageal candidiasis, and oral miconazole was prescribed. Three weeks later, she returned to our hospital without symptomatic improvement. She was febrile, and blood tests showed leukocytosis (137,150 /μL, blast 85%), anemia and thrombocytopenia. She was diagnosed with acute myeloid leukemia (AML). She received chemotherapy and antimicrobial agents. During the recovery from the nadir, bilateral ocular candidiasis was detected, suggesting the presence of preceding candidemia. Thus, esophageal candidiasis can be an initial manifestation of AML. Thorough examination to detect systemic candidiasis is strongly recommended when neutropenic patients exhibit local candidiasis prior to chemotherapy.

  3. [Infections in the child with acute leukemia].

    Science.gov (United States)

    Carrillo, J M; Jiménez, E; Jiménez, R

    1981-01-01

    One hundred and twenty-five febrile episodes in 82 children with acute leukemia were studied; 46% of the patients were from urban and 54% from rural areas. The origin of the fever was identified in 91% of the episodes, prevailing pneumonia, septicemia, chickenpox and herpes zoster. The etiological agent was identified in 46% of the cases. A viral predominance was evident, and among them varicela-zoster, following in importance gram-negative bacteria. Histoplasma capsulatum and Pneumocystis carinii were isolated in two occassions each. Sepsis was found more frequently in children with active leukemia than in those in remission (p less than 0.001). Forty-four febrile episodes occurred in patients with less than 1,000 neutrophils/ul. The daily-risk rate of infection was higher in children fom rural than in those from urban areas (p less than 0.001). After clinical and laboratory studies, methicillin and gentamicin were used, in addition to carbenicillin or trimethoprim-sulfamethoxazole is selected cases. This treatment was effective in 86% of the cases. Twelve (15%) children died, 6 of whom were in remission at that moment.

  4. Endovascular embolization treatment of ruptured intracranial aneurysms at the acute stage with micro - coils%微弹簧圈血管内栓塞治疗急性期破裂颅内动脉瘤

    Institute of Scientific and Technical Information of China (English)

    夏吉勇; 焦铁鹰; 李志强; 路长宇; 苗林; 郭吉卫

    2015-01-01

    Objective To investigate the efficacy and safety of the microcoil embolization treatment of ruptured intracranial aneurysms at the acute stage. Methods The clinical data of 30 cases(34 aneurysms)were retrospectively analyzed. All the patients were diagnosed as sub-arachnoid hemorrhage by CT. All cases were confirmed by DSA for intracranial aneurysms. And all of them underwent endovascular embolization within 72 hours after aneurysm rupture. Results Complete embolization was achieved in 24 of 34 aneurysms,95% embolization in 6 aneurysms, 90% embolization in 2 aneurysms,80% embolization in 2 aneurysms. The operation associated complications occurred in 6 patients. The last coil extruding into the patent artery was observed in 1 patient. Re - rupture of aneurysm during the operation in 1 patient,severe cerebral angiospasm in 2 patients and cerebral infarction in 2 patients. After operation,25 patients recovered well,4 patients with mild disability or paralysis,1 patient died of postoperative gastrointestinal bleeding. During the follow - up of 1 ~ 6 months,no rebleeding occurred. Conclusion Microcoil emboliza-tion is a safe and effective method to treat acutely ruptured intracranial aneurysms. Early intracranial surgery and timely treatment after operation is important to reduce fatality and disability.%目的:探讨微弹簧圈血管内栓塞治疗急性期破裂颅内动脉瘤的安全性及有效性。方法回顾性分析30例颅内动脉瘤在破裂出血后72小时内行微弹簧圈血管内栓塞治疗的临床资料。30例患者发病后均行 CT 检查,诊断为蛛网膜下腔出血,并经全脑血管造影证实为颅内动脉瘤,共检出34枚动脉瘤,其中单发26例,2枚4例。结果34枚动脉瘤中,100%栓塞24枚,95%栓塞6枚,90%栓塞2枚,80%栓塞2枚。术后发生手术相关并发症6例,包括微弹簧圈脱出至载瘤动脉1例,术中动脉瘤破裂1例,严重脑血管痉挛2例,术后脑梗死2

  5. Gerstmann's syndrome following an acute herpes simplex encephalitis.

    Science.gov (United States)

    Ilchevsky, S; Boev, I; Kazakova, T

    1998-01-01

    The authors present a rare clinical case of a woman who developed Gerstmann's syndrome following an acute Herpes simplex viral encephalitis. Clinical observation and laboratory evaluation were performed during the acute phase of the disease. After that the follow-up continued for one-year period. The localization of the pathologic process was determined by computerized tomography, conducted periodically. The characteristics of the clinical picture are interpreted in the context of the contemporary concepts of the topical diagnosis of Gerstmann's syndrome. The possibility of a sudden onset of acute Herpes simplex viral encephalitis without a preceding febrile-intoxication syndrome is worth noting. Conclusions are drawn stressing the need of an early etiologic treatment and the importance of the rehabilitation activities during the convalescence period.

  6. EVALUACION DE LA PRIMERA CRISIS FEBRIL EN 101 NIÑOS

    OpenAIRE

    Gutiérrez Contreras, Gabriela

    2012-01-01

    Las crisis febriles son una entidad clínica bien reconocida en niños. Constituyen una emergencia de observación frecuente. Son el tipo más común de ataques en la infancia, se consideran una causa que comúnmente demanda de la consulta neurológica pediátrica, no sólo por su frecuencia sino por lo dramático del cuadro y la angustiante experiencia de los padres. Se presentan del 2 al 5% de los niños entre los 6 meses y los 5 años, siendo poco frecuentes después de esta edad y con u...

  7. Malnourishment and length of hospital stay among paediatric cancer patients with febrile neutropaenia

    DEFF Research Database (Denmark)

    Conner, J Michael; Aviles-Robles, Martha J; Asdahl, Peter H;

    2016-01-01

    . The median length of hospital stay for malnourished patients was 15 days, which corresponded with a 50% (TR=1.5, 95% CL 1.0, 2.3) relative increase in length of stay compared with patients who were not malnourished. Patients with body mass indices equal to the mean of the world reference population had...... in Mexico City, and assess the association between malnourishment and length of hospital stay. METHODS: Individuals eligible for this study were paediatric cancer patients (aged Hospital Infantil de Mexico Federico Gomez (Mexico City) with febrile neutropaenia. Our exposure...... of interest, malnourishment, was defined as an age-adjusted and sex-adjusted z-scorehospital stay. RESULTS: Our study...

  8. [Bacteremia due to Abiotrophia defectiva in a febrile neutropenic pediatric patient].

    Science.gov (United States)

    Lopardo, H; Mastroianni, A; Casimir, L

    2007-01-01

    The presence of Granulicatella spp. in bacteremic episodes of neutropenic patients was recently highlighted whereas Abiotrophia defectiva, was only isolated in cases of infectious endocarditis. The aim of this study is to describe a case of A.defectiva bacteremia in a leukemic and febrile (40 degrees C) neutropenic (200 GB/mm3) boy. A.defectiva was only isolated from one of the two processed blood samples. Although the patient was undergoing an episode of varicela which could have accounted as the possible cause of fever, A. defectiva was considered a significant finding because this species is not part of the commensal skin flora. This case suggests that both A. defectiva and Granulicatella spp. should be regarded as possible causes of bacteremia in immunocompromised patients.

  9. Successful emergency department interventions that reduce time to antibiotics in febrile pediatric cancer patients

    Science.gov (United States)

    Spencer, Sandra; Nypaver, MIchele; Hebert, Katherine; Benner, Christopher; Stanley, Rachel; Cohen, Daniel; Rogers, Alexander; Goldstick, Jason; Mahajan, Prashant

    2017-01-01

    Children with cancer and fever are at high risk for sepsis related death. Rapid antibiotic delivery ( 38.0 C). A secondary objective was to identify interventions amenable to translation to other centers. We conducted a post project analysis of prospectively collected observational data from children practice guideline establishment 7) Family pre-ED education for fever and 8) Staff project updates. This core set of eight low cost, high yield QI interventions were developed independently by the three ED's which led to substantial reduction in time to antibiotic delivery in children with cancer presenting with fever. These interventions may inform future QI initiatives in other settings caring for febrile pediatric oncology patients. PMID:28321299

  10. Management of infection and febrile neutropenia in patients with solid cancer.

    Science.gov (United States)

    Virizuela, J A; Carratalà, J; Aguado, J M; Vicente, D; Salavert, M; Ruiz, M; Ruiz, I; Marco, F; Lizasoain, M; Jiménez-Fonseca, P; Gudiol, C; Cassinello, J; Carmona-Bayonas, A; Aguilar, M; Cruz, J J

    2016-06-01

    An expert group from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC, for its acronym in Spanish) and the Spanish Society of Medical Oncology (SEOM, for its acronym in Spanish) have reviewed the main aspects to be considered when evaluating patients with solid cancer and infectious complications contained in this article. Recommendations have, therefore, been put forth regarding the prophylaxis of the most prevalent infections in these patients, the use of vaccines, measures to control infection through vascular catheters, and preventing infection in light of certain surgical maneuvers. The following is a revision of the criteria for febrile neutropenia management and the use of colony-stimulating factors and closes with several guidelines for treating the cancer patient with serious infection. The document concludes with a series of measures to control hospital infection.

  11. THE STRUCTURE OF THE VIRAL TRIGGERS OF FEBRILE SEIZURES IN CHILDREN OF EARLY AGE

    Directory of Open Access Journals (Sweden)

    M. A. Stroganova

    2016-01-01

    Full Text Available The study presents the results of clinical and laboratory observations 121 children aged 3 to 36 months with the diagnosis «ARVI with convulsive syndrome».  The prevalence of patients with burdened hereditary anamnesis for the development of febrile seizures (FS (31.4 ± 4.2%. During the laboratory examination along with the respiratory viruses group noted the high herpes virus infection (51.2%, particularly human herpes virus 6 type (of 38.7%. The extension of the spectrum of the diagnostic examination of children  with FS will establish  the role of infectious triggers in the occurrence of FS and thereby define rational tactics and dispensary observation of this group of patients.

  12. Pronounced increase in breathing rate in the "hair dryer model" of experimental febrile seizures.

    Science.gov (United States)

    Schuchmann, Sebastian; Tolner, Else A; Marshall, Pepin; Vanhatalo, Sampsa; Kaila, Kai

    2008-05-01

    In a study using a heated chamber for induction of experimental febrile seizures (eFS) in rat pups, ictal activity was shown to be precipitated by a respiratory alkalosis (Schuchmann et al., 2006). In sharp contrast to this, in a recent review Dubé et al., (2007) suggest that the respiratory alkalosis is model specific, and that no increase in respiratory rate is observed in the widely used "hair dryer model" of eFS. The data in the present work, based on well-established techniques for measuring respiratory rates in rat pups, show a pronounced increase in the "hair dryer model" with values that are slightly higher than those recorded in the heated chamber model. Hence, a temperature-evoked increase in respiration is a common feature of these two models of eFS.

  13. Economic burden of chemotherapy-induced febrile neutropenia in patients with lymphoma: a systematic review.

    Science.gov (United States)

    Wang, Xiao Jun; Lopez, Shaun Eric; Chan, Alexandre

    2015-05-01

    The primary objective of this review was to identify the cost components that were most frequently associated with the economic burden of febrile neutropenia (FN) among patients with lymphoma. The secondary objective was to identify any parameter associated with higher FN cost. Ten cost of illness (COI) studies were identified. General characteristics on study design, country, perspective, and patient population were extracted and systematically reported. It was observed that majority (70%) of the studies employed the perspective of healthcare provider. 20% of the studies considered long-term costs. Estimated costs were adjusted to 2013 US dollars and ranged from US$5819 to US$34,756. The cost components that were most frequently associated with economic burden were ward and medication costs. Inpatient management, male gender, discharged dead, and comorbidity were positively associated with higher FN costs. Future COI studies on FN should focus on the accurate estimation on ward and medication costs.

  14. Gentianine protects hippocampal neurons in a rat model of recurrent febrile convulsion

    Institute of Scientific and Technical Information of China (English)

    Xuewei Liu; Shumin Liu; Na Wang; Fang Lu; Min Cao

    2011-01-01

    Gentianine has been shown to have a protective effect on hippocampal CA1 neurons in rats subjected to recurrent febrile convulsion (FC).The present study sought to explore the possible mechanism of gentianine by intraperitoneally injecting gentianine into rats with warm water-induced FC.The results revealed that neuronal organelle injury was slightly ameliorated in the hippocampal CA1 region.The level of glutamate was decreased,but the level of γ-aminobutyric acid was increased,as detected by ninhydrin staining.In addition,glutamate acid decarboxylase expression in hippocampal CA1 was increased,as determined by immunohistochemistry.The results demonstrated that gentianine can ameliorate FC-induced neuronal injury by enhancing glutamate acid decarboxylase activity,decreasing glutamate levels and increasing γ-aminobutyric acid levels.

  15. Impact of multiplex PCR on antimicrobial treatment in febrile neutropenia: a randomized controlled study.

    Science.gov (United States)

    Idelevich, Evgeny A; Silling, Gerda; Niederbracht, Yvonne; Penner, Hanna; Sauerland, Maria Cristina; Tafelski, Sascha; Nachtigall, Irit; Berdel, Wolfgang E; Peters, Georg; Becker, Karsten

    2015-10-01

    Multiplex PCR (mPCR) directly from blood has been suggested as a promising method for rapid identification of pathogens causing sepsis. This study aimed to investigate whether mPCR has any impact on antimicrobial treatment. Hematological patients with febrile neutropenia were randomized into two groups. In the study group, mPCR was performed as an addition to standard diagnostics, and PCR finding was immediately communicated to the clinicians, thus being available for decision making. In the control group, clinicians were not aware of PCR result. PCR samples were collected simultaneously with clinically indicated blood culture specimens from peripheral vein and/or central venous catheter at fever onset and once again if fever persisted up to 72 h. Overall, 74 patients of the study group and 76 patients of the control group were enrolled and 253 samples collected. Therapy was changed to targeted antimicrobial therapy (AMT) in 12 patients (16.2%) in the study group and in 12 patients (15.8%) in the control group. For patients with changes, the median time to change to the targeted AMT was 21.4 h in the study group and 47.5 h in the control group (p = 0.018). In the study group, 57.1% (8/14) of changes to targeted AMT was due to PCR finding. PCR led to AMT change in 9.5% (7/74) of study group patients, i.e., in 33.3% (7/21) of patients who had positive PCR finding. There were no significant differences in patient outcomes (secondary endpoints). In conclusion, PCR method accelerates change to the targeted AMT in febrile neutropenic patients.

  16. Hippocampal Malrotation (HIMAL) is Associated with Prolonged Febrile Seizures: Results of the FEBSTAT Study

    Science.gov (United States)

    Chan, Stephen; Bello, Jacqueline A.; Shinnar, Shlomo; Hesdorffer, Dale C.; Lewis, Darrell V.; MacFall, James; Shinnar, Ruth C.; Gomes, William; Litherland, Claire; Xu, Yuan; Nordli, Douglas R.; Pellock, John M.; Frank, Matthew L.; Moshé, Solomon L.; Sun, Shumei

    2015-01-01

    Objective HIMAL (hippocampal malrotation) is characterized by incomplete hippocampal inversion with rounded shape and blurred internal architecture. There is still debate whether or not HIMAL has pathological significance. We present findings from the FEBSTAT study on the frequency and risk factors for HIMAL. Materials and Methods FEBSTAT is a prospective multicenter study investigating consequences of febrile status epilepticus (FSE) in childhood. MR imaging studies of 226 FSE subjects were analyzed visually by two board-certified neuroradiologists blinded to clinical details and compared to MR imaging studies of 96 subjects with first simple febrile seizure (FS). Quantitative analysis of hippocampal volume was performed by two independent observers. Results HIMAL was present in 20 (8.8%), of FSE cases compared with 2 (2.1%) of controls (odds ratio 4.56; 95% CI=1.05, 19.9). HIMAL was exclusively left-sided in 18 (81.8%), and bilateral in the remaining 4 (18.2%). There was no case of exclusively right-sided HIMAL. HIMAL was more common in boys than in girls (OR 6.1, 95%CI = (1.7, 21.5) On quantitative volumetric MR imaging analysis, the left hippocampal volume in HIMAL cases was smaller than in simple FS controls (p=0.004), and the R/L hippocampal volume ratio was higher in the HIMAL group compared to the simple FS group (p<0.001). Conclusion HIMAL is a developmental malformation that predominantly affects the left hippocampus in males, and is more frequently found in children with prolonged FSE than in controls. These data provide further evidence that HIMAL represents a pathological error in brain development rather than a normal variant. PMID:26496555

  17. 脑出血患者偏瘫急性期体位护理观察%Posture nursing observation for patients with hemiplegia caused by cerebral hemorrhage in acute stage

    Institute of Scientific and Technical Information of China (English)

    阮选; 纪光州

    2016-01-01

    Objective:To investigate the effect of different body positions on the rehabilitation of patients with hemiplegia caused by cerebral hemorrhage in acute stage.Methods:60 cases of patients with hemiplegia caused by cerebral hemorrhage were divided into two groups randomly.The control group was given routine nursing.The observation group was given posture nursing on the basis of the control group.The muscle strength,incidence of adverse reactions in the two groups were compared.Results:The total effective rate of the observation group was significantly higher than that of the control group (P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that of the control group,and the difference was statistically significant (P<0.05).Conclusion:Proper posture could improve the muscle strength of patients with hemiplegia caused by cerebral hemorrhage significantly and improve the quality of life,which was safe and effective.%目的:探讨脑出血导致偏瘫的患者在急性期采取不同体位对康复的影响。方法:收治脑出血导致偏瘫的患者60例,随机分为两组。对照组给予常规护理,观察组在对照组基础上给予体位护理,比较两组肌力、不良反应发生情况。结果:观察组的治疗总有效率明显高于对照组(P<0.05)。观察组不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:合适的体位能显著提高脑出血导致偏瘫的患者的肌力,改善生活质量,且安全、有效。

  18. Pathological study at the early stage of acute lung injury induced by paraquat in rabbits%百草枯致兔急性肺损伤早期的病理研究

    Institute of Scientific and Technical Information of China (English)

    陈高飞; 宋祖军; 尹文; 曹建霞; 敖国昆; 袁小东

    2013-01-01

    目的 研究百草枯(PQ)致兔急性肺损伤(ALI)早期的病理生理改变.方法 20只新西兰白兔随机分为对照组和百草枯组.百草枯组以35 mg/kg剂量一次性腹腔注射百草枯,建立ALI模型,对照组以等体积生理盐水注射.实验各组分别于建模2、4、6h时间点行320排CT扫描胸腔,得到灌注图像的CTP(CT Perfusion)参数[包括局部血流量(regional blood flower,rBF)、局部血容量(regional blood volume,rBV)、毛细血管通透性(permeability surface,rPS)],测定血清血管内皮生长因子(VEGF)质量浓度.6h后用空气栓塞法处死动物,取肺组织行病理观察.结果 分析百草枯组CTP参数和血清VEGF质量浓度,rBF和rBV随实验延长逐渐降低,rPS和血清VEGF质量浓度随时间延长逐渐升高,各个时间点与对照组比较差异均有统计学意义(P<0.05).病理观察显示,光镜下百草枯组炎细胞浸润明显,肺泡上皮细胞增生,弥漫性肺泡间隔增宽,可见灶性出血.结论 PQ致兔ALI早期时肺灌注不良,血清VEGF质量浓度升高,结合病理结果提示,ALI早期时肺血管通透性增加.%Objective To study the pathophysiological changes at the early stage of acute lung injury (ALI) induced by paraquat (PQ) in rabbits. Methods 20 New Zealand white rabbits were randomly divided into control group and PQ group. The rabbits in PQ group were treated with PQ at 35 mg/kg through intraperitoneal injection,then would be made the model of ALI . The rats in control group were treated with the same volume of saline. In experimental groups, chest was scanned by 320 - slice CT for CT perfusion (CTP) parameters including the regional blood flower (rBF) , the regional blood volume(rBV) and the permeability surface(rPS) , and the vascular endothelial growth factor (VEGF) mass concentration was measured in serum on 2, 4, 6 h respectively after building models. Animals were sacrificed by air embolism and the lung tissues were obtained for pathological

  19. Alterations of cell-mediated immune response in children with febrile seizures Alterações da resposta imune celular em crianças portadoras de convulsão febril

    Directory of Open Access Journals (Sweden)

    Terezinha C.B. Montelli

    1997-06-01

    Full Text Available The aim of the present investigation was to study the distribution of T-cell subsets in peripheral blood defined by monoclonal antibodies and by the lymphocyte proliferative response to phytohemagglutinin (PH A in 30 children with febrile seizures and in 14 age-matched control subjects. Frequent respiratory, urinary and dermatologic infections were observed in 22 patients. The immunologic parameters showed that 64% of the patients presented an increased number of CD8+ cells and a low helper/suppressor ratio was observed in 60% of the patients. In addition, the proliferative response of lymphocytes to PHA was impaired in the patients. It was observed the presence of inhibitory activity on lymphocyte function in the plasma of 33% of children with febrile seizures. These results suggest that patients with febrile seizures have an impairment of cellular immunity that may be connected with this epileptic syndrome and explain the infections observed.O objetivo da presente investigação foi estudar a distribuição das subpopulações de células T por meio de anticorpos monoclonais e a resposta proliferativa de linfócitos em resposta a fito-hemaglutinina (PHA em 30 crianças portadoras de convulsão febril e em 14 crianças saudáveis de mesma faixa etária dos pacientes. Infecções respiratórias, urinárias e dermatológicas frequentes foram observadas em 22 pacientes. Os parâmetros imunológicos demonstraram que 64% dos pacientes apresentaram valores elevados de células CD8+. Diminuição da relação de células CD4/CD8 foi observada em 60% dos pacientes. Além disso, a resposta proliferativa de linfócitos frente a PHA apresentou-se deprimida nos pacientes. Foi observada a presença de atividade inibidora da função de linfócitos no plasma de 33% das crianças com convulsão febril. Esses resultados sugerem que pacientes com convulsão febril apresentam depressão da resposta imune celular que poderia implicar em associação patog

  20. Acute sensorineural hearing loss and severe otalgia due to scrub typhus

    Directory of Open Access Journals (Sweden)

    Kim Dong-Min

    2009-10-01

    Full Text Available Abstract Background Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. Case presentations We encountered a patient with sensorineural hearing loss complicating scrub typhus, and three patients with scrub typhus who complained of otalgia, which was sudden onset, severe, paroxysmal, intermittent yet persistent pain lasting for several seconds, appeared within 1 week after the onset of fever and rash. The acute sensorineural hearing loss and otalgia were resolved after antibiotic administration. Conclusion When patients in endemic areas present with fever and rash and have sensorineural hearing loss or otalgia without otoscopic abnormalities, clinicians should suspect scrub typhus and consider empirical antibiotic therapy.

  1. Staging Mobilities

    DEFF Research Database (Denmark)

    Jensen, Ole B.

    In recent years, the social sciences have taken a “mobilities turn.” There has been a developing realisation that mobilities do not “just happen.” Mobilities are carefully and meticulously designed, planned and staged (from above). However, they are equally importantly acted out, performed...... that mobility is more than movement between point A and B. It explores how the movement of people, goods, information, and signs influences human understandings of self, other and the built environment. Moving towards a new understanding of the relationship between movement, interaction and environments......, the book asks: what are the physical, social, technical, and cultural conditions to the staging of contemporary urban mobilities?...

  2. Acute Rheumatic Fever: An Evidence-Based Approach To Diagnosis And Initial Management.

    Science.gov (United States)

    Khanna, Kajal; Liu, Deborah R

    2016-08-01

    Acute rheumatic fever is an inflammatory reaction involving the joints, heart, and nervous system that occurs after a group A streptococcal infection. It typically presents as a febrile illness with clinical manifestations that could include arthritis, carditis, skin lesions, or abnormal movements. Of these, the cardiac manifestations of acute rheumatic fever are most concerning, as children may present in acute heart failure and may go on to develop valvular insufficiency or stenosis. Because this is a rare presentation to emergency departments in developed countries, it is crucial for clinicians to keep a broad differential when presented with clinical presentations suspicious for acute rheumatic fever. This issue focuses on the clinical evaluation and treatment of patients with acute rheumatic fever by offering a thorough review of the literature on diagnosis and recommendations on appropriate treatment.

  3. 特发性面神经麻痹急性期针灸干预疗效观察%Observation on therapeutic effect of acupuncture on spontaneous facial paralysis in acute stage

    Institute of Scientific and Technical Information of China (English)

    钟润芬; 黄石玺

    2011-01-01

    Objective To observe the therapeutic effect and to explore the best opportunity of acupuncture on spontaneous facial paralysis in acute stage.Methods By prospective cohort study, 80 patients were divided into art observation group (n=59) and a control group (n=21).The course of disease was less than 5 days in the observation group and more than 7 days in the control group and had not received acupuncture treatment.They were all treated with acupuncture at Sibai (ST 2), Dicang (ST 4), Jiache (ST 6) and Cuanzhu (BL 2) etc.for 8 weeks, The facial nerve function grading (House-Brackmann, HB) and facial disable index (FDI) before treatment, 8 days after onset, 2, 4, 6, 8 weeks and 3 months after treatment were evaluated.Results Both two groups could decrease HB grading and increase FDI score (all P<0.05), and the observation group was superior to the control group in improvement degree (all P<0.05).The cured rate of 86.4% (51/59) in the observation group was superior to that of 76.2% (16/21) in the control group, with significant difference between the two groups (P< 0.05).Compared with the control group, the treatment time of cured patients in the observation group was shorter [(25.98±11.25)days va (39.31±13.07)days, P<0.01], and the incidence of sequelae of 5.1% (3/59) in the observation group was lower than that of 9.5% (2/21) in the control group (P<0.05).Conclusion Acupuncture can improve the therapeutic effect, shorten the treatment course and reduce the sequelae incidence of spontaneous facial paralysis in acute stage.%目的:观察特发性面神经麻痹急性期针灸干预的疗效,探索针灸治疗面神经麻痹的最佳治疗时机.方法:使用前瞻性队列研究,将80例患者分为观察组(59例)和对照组(21例),观察组痛程不超过5天(以保证急性进展期最少3次的针灸治疗),对照组病程7天以上,未接受过针灸治疗.两组患者入组后均接受针灸治疗,穴取四白、地

  4. Patterns of neutropenia and risk factors for febrile neutropenia of diffuse large B-cell lymphoma patients treated with rituximab-CHOP.

    Science.gov (United States)

    Choi, Yong Won; Jeong, Seong Hyun; Ahn, Mi Sun; Lee, Hyun Woo; Kang, Seok Yun; Choi, Jin-Hyuk; Jin, U Ram; Park, Joon Seong

    2014-11-01

    Febrile neutropenia (FN) is the major toxicity of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen in the treatment of diffuse large B-cell lymphoma (DLBCL). The prediction of neutropenia and FN is mandatory to continue the planned R-CHOP therapy resulting in successful anti-cancer treatment. The clinical features and patterns of neutropenia and FN from 181 DLBCL patients treated with R-CHOP were analyzed retrospectively. Sixty percent (60.2%) of patients experienced at least one episode of grade 4 neutropenia. Among them, 42.2% of episodes progressed to FN. Forty-eight percent (48.8%) of patients with FN was experienced their first FN during the first cycle of R-CHOP. All those patients never experienced FN again during the rest cycles of R-CHOP. Female, higher stage, international prognostic index (IPI), age ≥65 yr, comorbidities, bone marrow involvement, and baseline serum albumin ≤3.5 mg/dL were significant risk factors for FN by univariate analysis. Among these variables, comorbidities (P=0.009), bone marrow involvement (P=0.006), and female gender (P=0.024) were independent risk factors for FN based on multivariate analysis. On observing the patterns of neutropenia and FN, primary prophylaxis of granulocyte colony-stimulating factor (G-CSF) and antibiotics should be considered particularly in female patients, patients with comorbidities, or when there is bone marrow involvement of disease.

  5. Neutropenia febril em pacientes com câncer de mama submetidas à quimioterapia: experiência de 12 anos Febrile neutropenia in patients with breast cancer submitted to chemotherapy: a 12 year experience

    Directory of Open Access Journals (Sweden)

    Omero Benedicto Poli Neto

    2004-12-01

    Full Text Available OBJETIVOS: Identificar as características das pacientes com câncer de mama que desenvolveram neutropenia febril, estabelecer fatores de risco para a sua ocorrência e indicadores de evolução desfavorável. MÉTODOS: Realizamos um estudo caso-controle com 65 pacientes. Foram incluídas 13 pacientes que desenvolveram neutropenia febril e quatro controles por caso pareados por data e número de ciclos de quimioterapia prévios, drogas e doses empregadas. Os dados clínicos e laboratoriais foram obtidos dos prontuários médicos. Utilizamos odds ratio (OR e intervalo de confiança (IC de 95% para estimar a significância dos fatores de risco. RESULTADOS: Identificamos dois fatores de risco associados à ocorrência de neutropenia febril: a realização de quimioterapia nas primeiras 24 horas após a cirurgia (OR: 159,9 IC 95%: 9,5 a 2699 e a realização concomitante de quimioterapia e radioterapia da mama (OR: 108,3 IC 95%: 4,9 a 2391. Não observamos diferenças significativas entre casos e controles quanto à idade, índice de massa corporal e contagem de neutrófilos e monócitos antes da quimioterapia. Três pacientes foram a óbito (23,1%. Duas delas tinham idade superior a 60 anos, não apresentavam comorbidades, tinham recebido o primeiro ciclo de CMF nas primeiras 24 horas após a cirurgia e tiveram infecção de sítio cirúrgico. CONCLUSÕES: Os principais fatores de risco associados a neutropenia febril em pacientes com câncer de mama foram quimioterapia nas primeiras 24 horas após a cirurgia, e uso concomitante de quimioterapia e radioterapia da mama. Nosso estudo mostra, portanto, que estas situações devem ser evitadas.PURPOSE: To identify the characteristis of patients with breast cancer who developed febrile neutropenia and to establish risk factors for its incidence and parameters for an unfavorable evolution. PATIENTS AND METHODS: A case-control study was performed and included 65 patients: 13 patients presented febrile

  6. Clinical studies on severe acute pancreatitis patients in early stage associated with serum potassium%重症急性胰腺炎早期血钾变化的临床分析

    Institute of Scientific and Technical Information of China (English)

    樊景云; 徐建玉

    2013-01-01

    目的:探讨重症急性胰腺炎(SAP)患者早期血钾变化的发生机制和临床特点,对预后的影响及治疗措施。方法2002年9月1日至2012年5月31日收治的SAP 331例,分成轻度低钾血症组(血钾2.5~3.5 mmol/L)74例和重度低钾血症组(<2.5 mmol/L)5例,血钾正常组(3.5~5.5 mmol/L)233例,高钾血症组(>5.5 mmol/L)19例。分析比较各组SAP患者的相关并发症、相关临床参数、病死率和感染率。结果在 SAP 病程早期重度低钾血症组急性呼吸窘迫综合征(ARDS)发生率与血钾正常组相比无明显差异(P>0.05)。重度低钾血症组胰性脑病的发生率与其他三组相比差异显著(P<0.01)。高钾血症组肾功能衰竭、ARDS、心力衰竭及消化道出血的发生率明显高于轻度低钾血症组(P<0.01)。高钾血症组的脉搏、呼吸、LDH、血糖、甘油三酯、血钙、HCT、Ranson 评分、APACHEⅡ评分、CT 评分均明显异于其他三组患者(P<0.01)。高钾血症组与其他三组比较死亡率明显增高(P<0.01),轻度低钾血症组与重度低钾血症组比较差异明显(P<0.05),血钾正常组与轻度低钾血症组的死亡率相比较差异无明显统计学意义(P>0.05)。说明患者如出现高钾血症死亡风险明显高于其他血钾异常组,血钾太低死亡风险亦增加。重度低钾血症组患者感染率与其他三组患者相比差异有明显统计学意义(P<0.05)。结论高钾血症组出现肾脏、肺、心、消化道器官衰竭的概率高,而重度低钾血症组胰性脑病的发生率高。高钾血症组的SAP患者病情严重度高,死亡率高,但感染率不高于其他组患者。血钾降低死亡风险亦增加。%Objective To investigate the mechanism and clinical characteristics of severe acute pancreatitis (SAP) associated with potassium anomaly in the early stage and its influence on the prognosis of

  7. Detection of bacteria, fungi, and viruses by a real-time PCR assay using universal primers and probes from blood in patients with febrile neutropenia.

    OpenAIRE

    TERANISHI, Hideto; OUCHI, Kazunobu

    2014-01-01

    Febrile neutropenia is the main treatment-related cause of mortality in cancer patients. During June 2012 to April 2013, 76 blood culture samples from patients receiving chemotherapy for hematological malignancy and cancer with febrile neutropenia episodes (FNEs) were examined for the presence of bacteria and fungi based on 16S rRNA gene and 18S rRNA combined with real-time PCR amplification and sequencing. Furthermore, we used a loopmediatedisothermal amplification (LAMP) assay for the detec...

  8. Vorinostat and Decitabine in Treating Patients With Advanced Solid Tumors or Relapsed or Refractory Non-Hodgkin's Lymphoma, Acute Myeloid Leukemia, Acute Lymphocytic Leukemia, or Chronic Myelogenous Leukemia

    Science.gov (United States)

    2014-08-26

    Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Blastic Phase Chronic Myelogenous Leukemia; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Nodal Marginal Zone B-cell Lymphoma; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Secondary Acute Myeloid Leukemia; Splenic Marginal Zone Lymphoma; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Small Lymphocytic Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma

  9. Seroprevalencia y factores asociados con leptospirosis en pacientes con síndrome febril en Ayacucho, Perú 2005

    Directory of Open Access Journals (Sweden)

    Félix Vargas-Cuba

    2008-04-01

    Full Text Available Objetivos. Estimar la prevalencia de leptospirosis y factores asociados en pacientes febriles que acuden al Hospital de Apoyo San Francisco en Ayna, Ayacucho. Materiales y métodos. Estudio transversal realizado con 209 pacientes febriles con descarte de malaria, hepatitis B y tifoidea. Se les realizó una encuesta epidemiológica y se tomaron muestras de sangre que fueron analizadas por ELISA IgM y microaglutinación (MAT para la determinación de serovares de leptospira. Se calcularon la prevalencia y los factores de riesgo usando un modelo de regresión logística múltiple. Resultados. La seroprevalencia fue de 30,6 (IC95%: 24,1-37,1%, 39% de las amas de casa, 33% de los agricultores y 30% de los profesionales de la salud examinados fueron positivos a leptospiras. Se detectaron 15 serovares, cinco de ellos (Autumnalis, Wolffi, Tarassovi, Patoc y Hardjo nuevos para la zona de estudio. Sólo 18% de los casos tuvo el clásico dolor en pantorrillas. Lavar la ropa en el río (ORa: 2,7; IC95% 1,4-5,2, la presencia de ratas en la vivienda (ORa: 2,2; IC95%: 1,1-4,5 y el uso de sandalias para las actividades diarias (ORa: 2,2; IC95%: 1,1-4,5 son factores de riesgo para la positividad de anticuerpos contra leptospira en pacientes febriles independientemente de los otros factores evaluados. Conclusiones. La leptospirosis es una etiología frecuente del síndrome febril en pacientes que acudieron al Hospital de San Francisco, los signos y síntomas de la enfermedad no son específicos y los factores de riesgo están relacionados con saneamiento básico deficiente y costumbres de la población.

  10. Molecular Detection of Streptococcus pneumoniae on Dried Blood Spots from Febrile Nigerian Children Compared to Culture.

    Directory of Open Access Journals (Sweden)

    Pui-Ying Iroh Tam

    Full Text Available Nigeria has one of the highest burdens of pneumococcal disease in the world, but accurate surveillance is lacking. Molecular detection of infectious pathogens in dried blood spots (DBS is an ideal method for surveillance of infections in resource-limited settings because of its low cost, minimal blood volumes involved, and ease of storage at ambient temperature. Our study aim was to evaluate a Streptococcus pneumoniae real-time polymerase chain reaction (rt-PCR assay on DBS from febrile Nigerian children on Whatman 903 and FTA filter papers, compared to the gold standard of culture.Between September 2011 to May 2015, blood was collected from children 5 years of age or under who presented to six hospital study sites throughout northern and central Nigeria with febrile illness, and inoculated into blood culture bottles or spotted onto Whatman 903 or FTA filter paper. Culture and rt-PCR were performed on all samples.A total of 537 DBS specimens from 535 children were included in the study, of which 15 were culture-positive for S. pneumoniae. The rt-PCR assay detected S. pneumoniae in 12 DBS specimens (2.2%. One positive rt-PCR result was identified in a culture-negative specimen from a high-risk subject, and two positive rt-PCR results were negative on repeat testing. Six culture-confirmed cases of S. pneumoniae bacteremia were missed. Compared to culture, the overall sensitivities of Whatman 903 and FTA DBS for detection of S. pneumoniae were 57.1% (95% CI 18.4-90.1% and 62.5% (95% CI 24.5-91.5%, respectively. Nonspecific amplification was noted in an additional 22 DBS (4.1%. Among these, six were positive for a non-S. pneumoniae pathogen on culture.Rt-PCR was able to detect S. pneumoniae from clinical DBS specimens, including from a culture-negative specimen. Our findings show promise of this approach as a surveillance diagnostic, but also raise important cautionary questions. Several DBS specimens were detected as S. pneumoniae by rt-PCR despite

  11. Febrile seizure, but not hyperthermia alone, induces the expression of heme oxygenase-1 in rat cortex

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background Febrile seizure (FS) is the most common seizure disorders. Approximately one third of children with a febrile seizure have recurrent events. The mechanism of FS remains unclear. Heme oxygenase-1 (HO-1) is a member of the heat shock proteins family and can be induced in the brain by various stresses, including hyperthemia and seizure. This study aimed at investigating the changes of HO-1 in the cortex of rats after recurrent FS.Methods FS in rats was induced ten times, once every 2 days. In a bath of warm water, developing rats were randomly divided into two groups: control group (n=16) and warm water-treated group (n=50). The latter group was subdivided into hyperthermia group (n=19) and FS group (n=23). The expression and content of HO-1 mRNA in cortex were observed using in situ hybridization and quantitative reverse transcription-polymerase chain reaction (RT-PCR). The content of HO-1 protein in cortex was measured using Western blotting. Results HO-1 mRNA expression of cortex neurons in FS group was markedly increased in comparison with those in hyperthermia and control groups (P=0.00), however, there was no statistic difference between hyperthermia group and control group (P=0.16). The relative amount of HO-1 mRNA in cortex in FS group was increased by 53.13% and 96% in comparison with those in hyperthermia group and control group respectively (P=0.00), but there was no obvious difference between the later two groups (P=0.051). Western blotting analysis showed that the HO-1 protein content in cortex in FS group was increased by 198% and 246% in comparison with those in hyperthermia group and control group respectively (P=0.00). There was no obvious difference in HO-1 protein content between the later two groups ( P=0.09).Conclusions Recurrent FS in rats can cause the increase of HO-1 mRNA and protein in cortex which may be involved in the mechanism of FS. The short-time recurrent hyperthermia can not induce the increase of HO-1 mRNA and protein.

  12. Critical appraisal of biosimilar filgrastim (Nivestim™ for febrile and chemotherapy-induced neutropenia

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    Waller CF

    2012-08-01

    bioequivalence included the mean time to recovery of absolute neutrophil count and incidence of febrile neutropenia. The most common treatment-related adverse event with Nivestim was grade 1–2 bone pain. As a result of these preclinical and clinical trials, Nivestim was approved by the European Medicines Agency and in Australia for prevention of febrile neutropenia and treatment of neutropenia in cancer patients treated with cytotoxic chemotherapy (except in patients with myelodysplastic syndromes and chronic myelogenous leukemia. Nivestim is also indicated for the treatment of myelosuppression after bone marrow transplantation, of neutropenia in patients with human immunodeficiency virus, and of severe congenital, cyclic, or idiopathic neutropenia.Keywords: filgrastim, biosimilar, granulocyte colony-stimulating factor, neutropenia, Nivestim™

  13. An outbreak of febrile gastroenteritis associated with jellied pork contaminated with Listeria monocytogenes.

    Science.gov (United States)

    Pichler, Juliane; Much, Peter; Kasper, Sabine; Fretz, Rainer; Auer, Bettina; Kathan, Julia; Mann, Michaela; Huhulescu, Steliana; Ruppitsch, Werner; Pietzka, Ariane; Silberbauer, Karl; Neumann, Christian; Gschiel, Ernst; de Martin, Alfred; Schuetz, Angelika; Gindl, Josef; Neugschwandtner, Ernst; Allerberger, Franz

    2009-01-01

    In September 2008, the Austrian Agency for Health and Food Safety (AGES) learned of an outbreak of diarrheal illness that included a 71-year-old patient hospitalized for gastroenteritis with a blood culture positive for Listeria monocytogenes. Three stool specimens provided by seven of 19 persons attending a day trip to a foreign city, including a final break at an Austrian tavern, yielded L. monocytogenes. All isolates were of serovar 4b and had fingerprints indistinguishable from each other. A cohort study revealed that the outbreak of gastroenteritis occurred among 16 persons who had eaten dinner at the wine tavern on September 6. Of the 15 persons who ate from platters of mixed cold-cuts, 12 (80%) developed symptoms of febrile gastroenteritis within 24-48 h. The median age of those who became ill was 62 years. A 72-year-old patient recovered from gastroenteritis but was hospitalized with bacterial meningitis on day 19 after the dinner. The epidemiological investigation identified the consumption of mixed cold-cuts (including jellied pork) at the wine tavern as the most likely vehicle of the foodborne outbreak (P = 0.0015). This hypothesis was confirmed by microbiological investigation of jellied pork produced by the tavern owner on September 3. L. monocytogenes was isolated from leftover food in numbers of 3 x 10(3)-3 x 10(4) colony forming units/g and was indistinguishable from the clinical outbreak isolates. Symptoms reported by the 12 patients included unspecified fever (12x), diarrhea (9x), headache (5x), vomiting (4x), body aches (2x) and sore throat (1x). Active case finding identified one case of rhombencephalitis (female, age 48) among another group of four guests, among whom only the patient and her asymptomatic husband had eaten jellied pork on September 6. This is the first outbreak of L. monocytogenes-associated gastroenteritis reported in Austria. The occurrence of a secondary case of meningitis (diagnosed on day 19 after consumption of jellied

  14. Acute pancreatitis

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    Bo-Guang Fan

    2010-01-01

    Full Text Available Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions : Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  15. Acute pancreatitis

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    Bo-Guang Fan

    2010-05-01

    Full Text Available Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions: Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  16. [Difficulties in the diagnosis of a febrile exanthema of different etiologies in a tuberculous patient in Madagascar].

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    Rakotoarimanana, R; Rakotonirainy, O H; Razanamparany, O; Raonivelo, T; Ralandison, S

    2012-12-01

    This article illustrates the difficulties in the treatment of tuberculosis through the case of a patient with tuberculosis presenting with a haemophagocytic syndrome, severe drug hypersensitivity and a dissemination of the disease. A month after tuberculosis chemotherapy was started, Mrs. R.S, aged 45 years, presented with febrile exanthema, confusion, multiple lymph nodes enlargement/polyadenopathy, bi-cytopenia and a severe hepatic cytolysis. The haemophagocytic syndrome was confirmed by a myelogram and had shown a good response to the administration of methylprednisolone. Tuberculosis chemotherapy was stopped for a month and when resumed, there was a recurrence of the febrile exanthema without haematologic abnormalities but a moderate hepatic cytolysis. The association of haemophagocytic syndrome with tuberculosis is a rare occurrence. It was important to differentiate drug hypersensitivity and recurrence of haemophagocytic syndrome, as the sole treatment interruption was sufficient to heal the patient during the second febrile rash. Corticotherapy, discontinuation of tuberculostatic treatment and a very progressive reintroduction of antituberculosis drugs was successful though it caused the dissemination of the tuberculosis disease.

  17. Serum interleukin -8 is not a reliable marker for prediction of vesicoureteral reflux in children with febrile urinary tract infection

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    Abolfazl Mahyar

    2015-12-01

    Full Text Available Objective: In view of the side effects of voiding cystourethrography (VCUG, identification of noninvasive markers predicting the presence of vesicoureteral reflux (VUR is important. This study was conducted to determine the predictive value of serum interleukin-8 (IL-8 in diagnosis of VUR in children with first febrile urinary tract infection (UTI. Materials and Methods: Eighty children with first febrile UTI were divided into two groups, with and without VUR, based on the results of VCUG. The sensitivity, specificity, positive and negative predictive value positive and negative likelihood ratio, and accuracy of IL-8 for prediction of VUR were investigated. Results: Of the 80 children with febrile UTI, 30 (37.5% had VUR. There was no significant difference between the children with and without VUR and also between low and high-grade VUR groups in terms of serum concentration of IL-8 (P>0.05. Based on ROC curve, the sensitivity, specificity, likelihood ratio positive, and accuracy of serum IL-8 was lower than those of erythrocyte sedimentation rate and C-reactive protein. Multivariate logistic regression analysis showed significant positive correlation only between erythrocyte sedimentation rate and VUR. Conclusions: This study showed no significant difference between the children with and without VUR in terms of the serum concentration of IL-8. Therefore, it seems that serum IL-8 is not a reliable marker for prediction of VUR.

  18. Generalized epilepsy with febrile seizures plus (GEFS+) spectrum: clinical manifestations and SCN1A mutations in Indonesian patients.

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    Herini, Elisabeth Siti; Gunadi; Harahap, Indra Sari Kusuma; Yusoff, Surini; Morikawa, Satoru; Patria, Suryono Yudha; Nishimura, Noriyuki; Sunartini; Sutaryo; Takada, Satoshi; Matsuo, Masafumi; Nishio, Hisahide

    2010-06-01

    Generalized epilepsy with febrile seizures plus (GEFS+) is a childhood genetic epilepsy syndrome. GEFS+ includes a wide spectrum of clinical manifestations, and SCN1A mutations have frequently been reported among the GEFS+-related gene abnormalities. In this study, to clarify the distributions of the clinical subtypes, we analyzed 34 families with GEFS+ in Indonesia using the hospital records of the patients and questionnaires for the family members. The number of patients with febrile seizures plus (FS+), FS+ and afebrile generalized/partial seizures, borderline severe myoclonic epilepsy in infancy (SMEB) and severe myoclonic epilepsy in infancy (SMEI) were 9, 11, 7, and 7, respectively. Most patients had a family history of febrile seizures. Next, we performed molecular analyses to clarify the contributions of SCN1A mutations to the development of the GEFS+ subtypes. Only 3 of 34 probands showed SCN1A mutations. These mutations were two missense mutations, p.V1612I and p.C1756G, in two patients with SMEI and SMEB, and one silent mutation, p.G1762G, in a patient with FS+ and afebrile partial seizures. In conclusion, the majority of GEFS+ patients in Indonesia were not associated with SCN1A mutations. To detect the GEFS+-causing mutations, we must search and analyze other genes in these patients.

  19. 小儿高热惊厥的护理体会%Nursing Experience of Febrile Convulsion in Children

    Institute of Scientific and Technical Information of China (English)

    钟芬芳

    2015-01-01

    目的:探讨小儿高热性惊厥的原因及急救措施和护理。方法对我院儿科2014年1月~2015年1月收治的30例高热性惊厥患儿的临床资料进行回顾性分析。结果30例小儿高热惊厥的快速抽搐,及时冷却,保持呼吸道通畅,吸氧,加强监控等一系列综合治疗和护理后全部转危为安。结论对高热惊厥患儿的治疗关键是高热,惊厥,迅速控制迅速冷却,加强综合护理。%Objective To investigate the cause of febrile convulsion in children and the emergency treatment and nursing. Methods The clinical data of 30 cases of febrile convulsion in our hospital from January 2014 to January 2015 were retrospectively analyzed. Results 30 cases of children with febrile convulsion of fast twitch, timely cooling, maintain respiratory tract unobstructed, oxygen, strengthen monitoring and so on a series of comprehensive treatment and nursing after turning the corner. Conclusion The key to the treatment of children with high fever convulsion is high fever, convulsion, rapid control rapid cooling, strengthen comprehensive nursing.

  20. Glucose-6-phosphate dehydrogenase deficiency A- variant in febrile patients in Haiti.

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    Carter, Tamar E; Maloy, Halley; von Fricken, Michael; St Victor, Yves; Romain, Jean R; Okech, Bernard A; Mulligan, Connie J

    2014-08-01

    Haiti is one of two remaining malaria-endemic countries in the Caribbean. To decrease malaria transmission in Haiti, primaquine was recently added to the malaria treatment public health policy. One limitation of primaquine is that, at certain doses, primaquine can cause hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd). In this study, we genotyped two mutations (A376G and G202A), which confer the most common G6PDd variant in West African populations, G6PDd A-. We estimated the frequency of G6PDd A- in a sample of febrile patients enrolled in an on-going malaria study who represent a potential target population for a primaquine mass drug administration. We found that 33 of 168 individuals carried the G6PDd A- allele (includes A- hemizygous males, A- homozygous or heterozygous females) and could experience toxicity if treated with primaquine. These data inform discussions on safe and effective primaquine dosing and future malaria elimination strategies for Haiti.

  1. SEROLOGICAL EVIDENCE OF RECENT DENGUE VIRUS INFECTION AMONG FEBRILE CHILDREN IN A SEMI ARID ZONE

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    Faneye Adedayo

    2013-01-01

    Full Text Available Presence of Dengue virus has been established in Nigeria; owing to the severity of this disease and its attendant complications we investigated the presence of this virus serologically in febrile Nigerian children under 5 years of age from Ilorin. Blood samples were tested from 130 children under the age of 5 years for the presence of IgM antibodies against all the Dengue virus serotypes using ELISA Kit by IVD research, Inc® California USA. A prevalence rate of 40(30.8% was recorded, with male children having a higher rate of 30(44.1% while female children recorded 10(16.1%. Age range distribution was highest in group 3>5 years with 10(62.5% and lowest in age group <1 with 12(16.2%. Our findings in this study indicate potential endemicity of this virus infection in some parts of Nigeria. We therefore recommend further studies into circulating serotypes in human populations and urgent preventive and control measures of this emerging infectious disease.

  2. Early discontinuation of intravenous antimicrobial therapy in pediatric oncology patients with febrile neutropenia

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    Grundy Paul E

    2005-05-01

    Full Text Available Abstract Background There are no standard criteria for when to discontinue intravenous antimicrobial therapy (IVAMT in children with febrile neutropenia (FN, but it is now common to discontinue IVAMT and discharge patients with an absolute neutrophil count (ANC ≤ 500 /mm3. The purpose of this study was to evaluate the outcome of a large cohort of children with FN who had IVAMT discontinued with an ANC ≤ 500 /mm3 Methods A retrospective chart review was completed of patients in the Northern Alberta Children's Cancer Program with FN and no apparent clinical source of fever from June 1, 1997 to July 1, 2002. Results Out of a total of 275 patients, 127 (46% had at least one episode of FN, with FN occurring in patients with sarcomas more commonly than in those with leukemia/ lymphoma and least in those with other solid tumors. In 59 of 276 episodes of FN (21% patients had a microbiologically defined infection at admission. Of the 217 remaining episodes, 112 of 199 patients (56% with known neutrophil counts had IVAMT discontinued before their absolute neutrophil count (ANC reached 500 /mm3 at the discretion of the clinician. Fever recurred in only two of these patients after discharge, and there were no bacterial infections diagnosed after parenteral antibiotics were discontinued. Conclusion Even without use of standard criteria for early discharge, clinicians appear to be skilled at selecting children with FN who can safely have IVAMT discontinued with an ANC ≤ 500 /mm3.

  3. Evaluation of Serum Selenium Levels in Children with Recurrent Febril Convulsions

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    Erhan Berk

    2011-12-01

    Full Text Available Introduction: The febrile convulsion (FC occurs in neurologically normal children aged between six months and five years and it is defined as convulsions occurred during fever and in the absence of central nervous system (CNS infection, electrolyte imbalance, diseases affecting directly CNS, and history of afebrile convulsion. The aims of this study were to determine the serum levels of selenium in patients with recurrent FC and to compare them with those of healthy children. Materials and Methods: The study included 61 pediatric patients diagnosed with recurrent FC. At the same session, 54 healthy children who admitted to our pediatric clinic for routine controls without history of fever and convulsion, are assigned as control group. The serum level of selenium was measured by atomic absorption spectrometric method (hydride technique.Results: Mean level of selenium was determined as 67.10±8.87 µg/L in patients and 81.99±13.13 µg/L in control group; the difference was statistically significant (p<0.05. Discussion: The lower serum levels of selenium in patients with recurrent FC may be the cause of triggering of convulsion or may contribute to its recurrence. Further studies are necessary to clarify this relationship. (Jo­ur­nal of Cur­rent Pe­di­at­rics 2011; 9: 110-5

  4. Transcriptome analysis of the hippocampus in novel rat model of febrile seizures.

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    Zhongcheng Wang

    Full Text Available Febrile seizures (FS are the most common type of convulsive events in infants and young children, but the precise underlying genetic mechanism remains to be explored. To investigate the underlying pathogenic factors in FS and subsequent epilepsy, alterations in gene expression between the two new strains of rats (hyperthermia-prone [HP] vs hyperthermia-resistant [HR], were investigated by using the Whole Rat Genome Oligo Microarray. This process identified 1,140 differentially expressed genes (DEGs; 602 upregulated and 538 downregulated, which were analyzed to determine significant Gene Ontology (GO categories, signaling pathways and gene networks. Based on the GO analyses, the modified genes are closely related to various FS pathogenesis factors, including immune and inflammatory responses and ion transport. Certain DEGs identified have not been previously examined in relation to FS pathogenesis. Among these genes is dipeptidyl peptidase 4 (DPP4, a gene closely linked to interleukin 6 (IL-6, which played a key role in the gene network analysis. Furthermore, sitagliptin, a DPP4 inhibitor significantly decreased epileptic discharge in rats, observed via electroencephalogram, suggesting an important role for DPP4 in FS. The effectiveness of sitagliptin in reducing seizure activity may occur through a mechanism that stabilizes cellular Ca2+ homeostasis. In addition, DPP4 expression may be regulated by DNA methylation. The hippocampal gene expression profiles in novel rat models of FS provides a large database of candidate genes and pathways, which will be useful for researchers interested in disorders of neuronal excitability.

  5. Febrile-range hyperthermia augments pulmonary neutrophil recruitment and amplifies pulmonary oxygen toxicity.

    Science.gov (United States)

    Hasday, Jeffrey D; Garrison, Allen; Singh, Ishwar S; Standiford, Theodore; Ellis, Garrettson S; Rao, Srinivas; He, Ju-Ren; Rice, Penny; Frank, Mariah; Goldblum, Simeon E; Viscardi, Rose M

    2003-06-01

    Febrile-range hyperthermia (FRH) improves survival in experimental infections by accelerating pathogen clearance, but may also increase collateral tissue injury. We hypothesized that FRH would worsen the outcome of inflammation stimulated by a non-replicating agonist and tested this hypothesis in a murine model of pulmonary oxygen toxicity. Using a conscious, temperature-controlled mouse model, we showed that maintaining a core temperature at FRH (39 degrees C to 40 degrees C) rather than at euthermic levels (36.5 degrees C to 37 degrees C) during hyperoxia exposure accelerated lethal pulmonary vascular endothelial injury, reduced the inspired oxygen threshold for lethality, induced expression of granulocyte-colony stimulating factor, and expanded the circulating neutrophil pool. In these same mice, FRH augmented pulmonary expression of the ELR(+) CXC chemokines, KC and LPS-induced CXC chemokine, enhanced recruitment of neutrophils, and changed the histological pattern of lung injury to a neutrophilic interstitial pneumonitis. Immunoblockade of CXC receptor-2 abrogated neutrophil recruitment, reduced pulmonary vascular injury, and delayed death. These combined data demonstrate that FRH may enlist distinct mediators and effector cells to profoundly shift the host response to a defined injurious stimulus, in part by augmenting delivery of neutrophils to sites of inflammation, such as may occur in infections. In certain conditions, such as in the hyperoxic lung, this process may be deleterious.

  6. Teicoplanin plus ciprofloxacin versus gentamicin plus piperacillin in the treatment of febrile neutropenic patients.

    Science.gov (United States)

    Kelsey, S M; Weinhardt, B; Collins, P W; Newland, A C

    1992-06-01

    Teicoplanin plus ciprofloxacin was compared with gentamicin plus piperacillin for the empirical treatment of fever in 80 neutropenic patients. A favourable response was seen in 78% of patients receiving teicoplanin plus ciprofloxacin and in 49% receiving gentamicin plus piperacillin (p less than 0.05). When microbiologically documented episodes were analysed separately, the response to teicoplanin plus ciprofloxacin was favourable in 81% of patients whereas only 35% responded favourably to gentamicin plus piperacillin (p = 0.034). Gram-positive organisms accounted for 76% of bacterial isolates, Staphylococcus epidermidis being the most common pathogen. Ten of 12 (83%) Staphylococcus epidermidis infections resolved when treated with teicoplanin plus ciprofloxacin as compared with 2 of 8 (25%) treated with gentamicin plus piperacillin. Teicoplanin is at least as effective as gentamicin plus piperacillin in the empirical treatment of febrile neutropenic patients and may be more effective in situations where gram-positive organisms are prevalent. The high incidence of gram-positive infections in our unit justifies the use of an agent with specific activity against gram-positive organisms in the first-line antibiotic regimen.

  7. Urinary tract infections in febrile infants younger than 8 weeks of age.

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    Crain, E F; Gershel, J C

    1990-09-01

    In this prospective study of 442 infants younger than 8 weeks of age who attended a pediatric emergency department with temperature greater than or equal to 100.6 degrees F (38.1 degrees C), urinary tract infections (UTIs) were found in 33 patients (7.5%), 2 of whom were bacteremic. Clinical and laboratory data were not helpful for identifying UTIs. Of the 33 patients with UTIs, 32 had urinalyses recorded; 16 were suggestive of a UTI (more than five white blood cells per high-power field or any bacteria present). Of the 16 infants with apparently normal urinalysis results, three had an emergency department diagnosis suggesting an alternative bacterial focus of infection. If the physician had decided on the basis of apparently normal urinalysis results to forgo obtaining a urine culture, more than half of the UTIs would have been missed. Bag-collected specimens were significantly more likely to yield indeterminate urine culture results than either catheter or suprapubic specimens. In addition, uncircumcised males were significantly more likely to have a UTI than circumcised boys. These results suggest that a suprapubic or catheter-obtained urine specimen for culture is a necessary part of the evaluation of all febrile infants younger than 8 weeks of age, regardless of the urinalysis findings or another focus of presumed bacterial infection.

  8. Loss of synaptic Zn2+ transporter function increases risk of febrile seizures.

    Science.gov (United States)

    Hildebrand, Michael S; Phillips, A Marie; Mullen, Saul A; Adlard, Paul A; Hardies, Katia; Damiano, John A; Wimmer, Verena; Bellows, Susannah T; McMahon, Jacinta M; Burgess, Rosemary; Hendrickx, Rik; Weckhuysen, Sarah; Suls, Arvid; De Jonghe, Peter; Scheffer, Ingrid E; Petrou, Steven; Berkovic, Samuel F; Reid, Christopher A

    2015-12-09

    Febrile seizures (FS) are the most common seizure syndrome and are potentially a prelude to more severe epilepsy. Although zinc (Zn(2+)) metabolism has previously been implicated in FS, whether or not variation in proteins essential for Zn(2+) homeostasis contributes to susceptibility is unknown. Synaptic Zn(2+) is co-released with glutamate and modulates neuronal excitability. SLC30A3 encodes the zinc transporter 3 (ZNT3), which is primarily responsible for moving Zn(2+) into synaptic vesicles. Here we sequenced SLC30A3 and discovered a rare variant (c.892C > T; p.R298C) enriched in FS populations but absent in population-matched controls. Functional analysis revealed a significant loss-of-function of the mutated protein resulting from a trafficking deficit. Furthermore, mice null for ZnT3 were more sensitive than wild-type to hyperthermia-induced seizures that model FS. Together our data suggest that reduced synaptic Zn(2+) increases the risk of FS and more broadly support the idea that impaired synaptic Zn(2+) homeostasis can contribute to neuronal hyperexcitability.

  9. [Imaging and follow-up of children with first febrile Urinary Tract Infection (UTI)].

    Science.gov (United States)

    Grossman, Zachi; Miron, Dan

    2009-10-01

    Urinary tract infection (UTI) in children might, in a minority of cases, cause renal scarring and permanent damage. Known risk factors for renal damage are: obstruction to urinary flow, vesicoureteric reflux and recurrent infections. The current recommendations for imaging and follow-up of children with first febrile UTI include renal ultrasound to rule out anatomic abnormalities, particularly obstruction, cystography for possible diagnosis of vesicoureteric reflux, and prophylactic antibiotic therapy to prevent recurrent infections in children with detected reflux. DMSA renal scanning for the detection of renal scars is recommended as part of the imaging protocol by some institutions. Recently, published data doubts the importance of the various imaging techniques, as well as the effectiveness of prophylactic antibiotic therapy. In the current review, the role of renal ultrasound is examined, especially with regards to familiar data from fetal ultrasound. The complex relationship between vesicoureteric reflux and renal scarring is presented, with the possible implications on the importance of performing routine cystography and DMSA scanning after UTI. Studies questioning the effectiveness of prophylactic antibiotic therapy emphasize the importance of rapid diagnosis and therapy of suspected recurrent UTI as the preferred approach to prevent renal damage. Imaging studies are only recommended for high risk groups and not as a routine following UTI.

  10. Which Variables Are Useful for Predicting Severe Infection in Children With Febrile Neutropenia?

    Science.gov (United States)

    Delebarre, Mathilde; Garnier, Nathalie; Macher, Emilie; Thebaud, Estelle; Mazingue, Françoise; Leblond, Pierre; Duhamel, Alain; Martinot, Alain; Dubos, François

    2015-11-01

    To distinguish children with chemotherapy-induced febrile neutropenia (FN) at low risk of severe infection, the variables that are significant risk factors must be identified. Our objective was to identify them by applying evidence-based standards. This retrospective 2-center cohort study included all episodes of chemotherapy-induced FN in children in 2005 and 2006. The medical history, clinical, and laboratory data available at admission were collected. Severe infection was defined by bacteremia, a positive culture of a normally sterile body fluid, invasive fungal infection, or localized infection at high risk of extension. Univariate analysis identified potential predictive variables. A generalized mixed model was used to determine the adjusted variables that predict severe infection. We analyzed 372 FN episodes. Severe infections occurred in 16.1% of them. Variables predictive of severe infection at admission were: disease with high risk of prolonged neutropenia (adjusted odds ratio [aOR]=2.5), blood cancer (aOR=1.9), fever ≥38.5°C (aOR=3.7), and C-reactive protein level ≥90 mg/L (aOR=4.5). Now that we have identified these variables significantly associated with the risk of severe infection, they must be validated prospectively before combining the best predictive variables in a decision rule that can be used to distinguish children at low risk.

  11. The Risk of Serious Bacterial Infection in Neutropenic Immunocompetent Febrile Children.

    Science.gov (United States)

    Barg, Assaf A; Kozer, Eran; Mordish, Yair; Lazarovitch, Tsilia; Kventsel, Iris; Goldman, Michael

    2015-08-01

    Only few reports have looked into the risk of invasive bacterial infection in children with neutropenia that is not malignancy related. The objective of the current study was to determine the clinical significance of neutropenia as a predictor of serious bacterial infection (SBI) in immunocompetent children. We conducted a retrospective case-control study including children 3 months to 18 years of age with fever ≥ 38°C hospitalized or presenting to the emergency department. Patients who had neutropenia ≤ 1000 ANC/μL and had a blood culture taken were matched for age with the consecutive febrile patients for whom a blood culture was taken. The main outcome was the rate of SBI. SBIs were more prevalent among the control group than in the group of children with neutropenia, 19/71 and 6/71, respectively (P = 0.0005). More children were treated with antibiotics among the control group than in the group of children with neutropenia, 39/71 and 20/71, respectively (P neutropenia do not carry a higher risk for SBIs compared with patients with fever who do not have neutropenia.

  12. Modified Glasgow Coma Scale to predict mortality in febrile unconscious children.

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    Chaturvedi, P; Kishore, M

    2001-04-01

    A prospective hospital based study was conducted in the Department of Pediatrics of the Kasturba Hospital, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha to predict the mortality in children admitted with fever and unconsciousness using the Modified Glasgow Coma Scale (MGCS) score. Forty eight children were admitted with fever and unconsciousness; cases of febrile convulsions, epilepsy and cerebral palsy were excluded. MGCS scores were assessed on admission and repeated at 12 hours, 24 hours, 48 hours and 72 hours after admission in each case. Diagnosis in each case was confirmed by history, examinations and investigations. All the cases were regularly followed up till death/discharge. The overall mortality was 29.1% (14/48) out of which 85% (12/14) died within the first 24 hours. Mortality was highest in the toddler age group and in patients with pyogenic meningitis. There was a significant association between death and MGCS scores on admission with a post test probability for discharge being only 10% with a score of less than 5 and 99% with a score of more than 10 respectively. MGCS scores on admission can be used to predict mortality in patients hospitalized with fever and unconsciousness. The scale is simple, easy, can be applied at bed side and does not need any investigations. Its application in developing countries with limited investigative and intensive care facilities can help the treating physician decide regarding referral and counseling the parents regarding the probable clinical outcome.

  13. Lack of association between TNF-α gene polymorphisms at position -308 A, -850T and risk of simple febrile convulsion in pediatric patients

    Science.gov (United States)

    Khoshdel, Abolfazl; Kheiri, Soleman; Habibian, Roya; Nozari, Ahora; Baradaran, Azar

    2012-01-01

    Background: Febrile convulsions (FCs), occurring between 6 months and 6 years of age is the most common seizure disorder during childhood. The febrile response is thought to be mediated by the release of pyrogenic cytokines, such as tumor necrosis factor and interleukin-1 (IL-1). There is a significant relationship between genetic components for susceptibility of FCs and different report mutation. We investigated association between two polymorphisms in the tumor necrosis factor (TNF)-α promoter region (G-308A, C-850T) and FCs in the southwest area of Iran. Materials and Methods: In this matched case–control study, 100 patients with febrile convulsion as case group and 130 healthy children as control group were enrolled in the study. Peripheral blood samples were collected and DNA was extracted by standard phenol–chloroform method. The genotype and allele frequencies of TNF- α polymorphisms in case and control groups were determined by using PCR-RFLP (polymerase chain reaction restriction fragment length polymorphism) method. Statistical analysis was done using Chi-square test. Results: The average age of case and control groups were 3.4 ± 1.4 and 3.4 ± 1.2 years, respectively. There was no significant difference between age and sex in both the groups (P > 0.05). A family history of febrile convulsion was detected in 44% of patients. Moreover, the simple febrile convulsion was detected in 85% of the case group. Conclusion: RFLP analysis of TNF- α promoter region polymorphisms, considering P = 0.146 and P = 0.084 for G-308A and C-850T, respectively, showed no correlation between TNF- α polymorphisms and predisposition to simple febrile, based on the kind of convulsion (atypical and simple febrile convulsion). We found a significant relation between genotype distribution of G-308A and atypical febrile convulsion in case group (P = 0.04). A significant correlation between genotype distribution of G-308A and atypical febrile convulsion in the case group was

  14. Acute toxicity of fenoxycarb to zebrafish(Brachydanio rerio)at different development stages and chronic toxicity to embryo and sac-fry stage%苯氧威对斑马鱼不同发育阶段急性毒性及胚胎卵黄囊仔鱼阶段慢性毒性作用

    Institute of Scientific and Technical Information of China (English)

    孙兴泽; 王成菊; 李学锋; 郑明奇; 邱立红

    2015-01-01

    为了解苯氧威对斑马鱼的毒性作用,采用半静态方法,研究了苯氧威对斑马鱼不同发育阶段的急性毒性。结果表明:苯氧威对斑马鱼胚胎、孵化12 h和72 h的仔鱼以及成鱼的96 h-LC50值分别为2.35、0.98、1.87和1.67 mg/L,其对斑马鱼成鱼具有中等毒性;苯氧威对斑马鱼胚胎的自主运动、心率、孵化率、仔鱼体长等亚致死效应指标均有影响,并使得胚胎出现了心包囊肿、脊柱弯曲及无黑色素附着等畸形现象。进一步研究了苯氧威对斑马鱼胚胎卵黄囊仔鱼阶段的慢性毒性作用。结果显示:苯氧威对斑马鱼胚胎24 h自主运动、48 h心率、72 h畸形率及11 d孵化仔鱼体长均有不同程度的抑制作用,其最低可观测效应浓度( LOEC )值分别为0.60、0.20、0.60和0.80 mg/L,而与之对应的无可观测效应浓度( NOEC)值分别为0.40、0.10、0.40和0.60 mg/L。试验中还发现:苯氧威对斑马鱼胚胎孵化有明显抑制作用;心率是斑马鱼胚胎卵黄囊仔鱼阶段毒性试验最敏感的观察指标。%In order to provide information for the safety and rational use of fenoxycarb,the acute toxicity of fenoxycarb to different development stages of zebrafish( Brachydanio rerio)was investigated by semi-static method. Results showed that the 96 h LC50 values of fenoxycarb were 2. 35,0. 98,1. 87 and 1. 67 mg/L for embryo,12 h-old larva,72 h-old larva and adult of zebrafish,respectively. There were also some sublethal and teratogenic effects observed. Fenoxycarb could affect the spontaneous movements,heart rate,hatching rate of embryo and the body length of hatched larvae,as well as cause pericardial edema,axial malformation and unnormal develpoment of melanocytes in the embryo of zebrafish. The chronic toxicity of fenoxycarb to zebrafish embryo and sac-fry stage was further studied. According to different endpoints tested,the lowest observed effect concentration( LOEC )

  15. Acute generalized exanthematous pustulosis associated with spider bite*

    Science.gov (United States)

    Milman, Laura de Mattos; Müller, Giana Paula; Souza, Paulo Ricardo Martins; Grill, Aline Barcellos; Rhoden, Deise Louise Bohn; Mello-da-Silva, Carlos Augusto; Vettorato, Gerson

    2016-01-01

    Acute generalized exanthematous pustulosis (AGEP) is an acute febrile rash, usually induced by drugs, which recently has been linked to spider bite. We report a case of a male patient, 48 years old, with an erythematous rash accompanied by fever and small non-follicular pustules. He reported previous pain in the buttock with the onset of a necrotic plaque. The lesion was compatible with spider bite of the genus Loxosceles. According to the EuroSCAR group instrument, the patient scored +10 indicating definite diagnosis of AGEP. As the patient had a compatible lesion and had no other triggers of AGEP, in an Loxosceles endemic area, the AGEP would be associated with spider bite, as described in other publications. PMID:27579754

  16. FIRST REPORT OF ACUTE CHAGAS DISEASE BY VECTOR TRANSMISSION IN RIO DE JANEIRO STATE, BRAZIL

    Directory of Open Access Journals (Sweden)

    Luiz Henrique Conde SANGENIS

    2015-08-01

    Full Text Available SUMMARY Chagas disease (CD is an endemic anthropozoonosis from Latin America of which the main means of transmission is the contact of skin lesions or mucosa with the feces of triatomine bugs infected by Trypanosoma cruzi. In this article, we describe the first acute CD case acquired by vector transmission in the Rio de Janeiro State and confirmed by parasitological, serological and PCR tests. The patient presented acute cardiomyopathy and pericardial effusion without cardiac tamponade. Together with fever and malaise, a 3 cm wide erythematous, non-pruritic, papule compatible with a "chagoma" was found on his left wrist. This case report draws attention to the possible transmission of CD by non-domiciled native vectors in non-endemic areas. Therefore, acute CD should be included in the diagnostic workout of febrile diseases and acute myopericarditis in Rio de Janeiro.

  17. Acute cholecystitis

    OpenAIRE

    Halpin, Valerie

    2014-01-01

    Acute cholecystitis causes unremitting right upper quadrant pain, anorexia, nausea, vomiting, and fever, and if untreated can lead to perforations, abscess formation, or fistulae. About 95% of people with acute cholecystitis have gallstones.It is thought that blockage of the cystic duct by a gallstone or local inflammation can lead to acute cholecystitis, but we don't know whether bacterial infection is also necessary.

  18. Acute psychosis followed by fever: Malignant neuroleptic syndrome or viral encephalitis?

    Directory of Open Access Journals (Sweden)

    Stojanović Zvezdana

    2014-01-01

    Full Text Available Introduction. Neuroleptic malignant syndrome is rare, but potentially fatal idiosyncratic reaction to antipsychotic medications. It is sometimes difficult to diagnose some clinical cases as neuroleptic malignant syndrome and differentiate it from the acute viral encephalitis. Case report. We reported a patient diagnosed with acute psychotic reaction which appeared for the first time. The treatment started with typical antipsychotic, which led to febrility. The clinical presentation of the patient was characterised by the signs and symptoms that might have indicated the neuroleptic malignant syndrome as well as central nervous system viral disease. In order to make a detailed diagnosis additional procedures were performed: electroencephalogram, magnetic resonance imaging of the head, lumbar puncture and a serological test of the cerebrospinal fluid. Considering that after the tests viral encephalitis was ruled out and the diagnosis of neuroleptic malignant syndrome made, antipsychotic therapy was immediately stopped. The patient was initially treated with symptomatic therapy and after that with atypical antipsychotic and electroconvulsive therapy, which led to complete recovery. Conclusion. We present the difficulties of early diagnosis at the first episode of acute psychotic disorder associated with acute febrile condition. Concerning the differential diagnosis it is necessary to consider both neuroleptic malignant syndrome and viral encephalitis, i.e. it is necessary to make the neuroradiological diagnosis and conduct cerebrospinal fluid analysis and blood test. In neuroleptic malignant syndrome treatment a combined use of electroconvulsive therapy and low doses of atypical antipsychotic are confirmed to be successful.

  19. 哺乳期急性乳腺炎强化护理的临床研究%Clinical research on strengthening nursing care of patients with acute mastitis in lactation stage

    Institute of Scientific and Technical Information of China (English)

    杨凯平; 李明; 徐红; 谢景红; 任艳军

    2008-01-01

    @@ 乳腺炎(mastitis)是发生于乳房组织的一种感染性或非感染性炎症性疾病.哺乳期急性乳腺炎(acute mastitis)多由金黄色葡萄球菌感染引起,如治疗延误易发展成乳腺脓肿(breast abscess)[1,2],发生率为3%~20%[3,4].

  20. Clinical observation on severe acute pancreatitis at early stage of volume therapy%急性重症胰腺炎早期容量治疗的临床观察

    Institute of Scientific and Technical Information of China (English)

    王玉东; 王婧

    2013-01-01

    Objective To improve the severe acute pancreatitis understanding,and observe clinical efficacy and safety on capacity treatment for severe acute pancreatitis.Methods 80 cases of acute pancreatitis patients were randomly divided into observation group of 40 cases and control group of 40 cases,control group was given Regular Crystal Fluid Physiological Saline Injection capacity support,the treatment group was given the Conventional Crystal Fluid Physiological Saline Injection combined with Hydroxyethyl Starch Injection capacity support.Results Systemic inflammatory response syndrome,bowel sound recovery time,blood amylase restore normal time,C-reactive protein duration,the average hospitalization time of treatment group were shorter than that in control group (P < 0.05),the treatment group's total effective rate was significantly higher than that in control group (P < 0.05),the treatment group's complication rates significantly lower than that in control group (P < 0.05).Conclusion Severe acute pancreatitis acute reaction period should be early line capacity support,curative effect is reliable,and can reduce the complications.%目的 提高对重症急性胰腺炎的认识,观察容量治疗重症胰腺炎的临床疗效和安全性.方法 将80例急性胰腺炎患者随机分为观察组40例和对照组40例,对照组给予常规晶体液生理盐水注射液容量支持,治疗组在常规晶体液生理盐水注射液联合羟乙基淀粉注射液容量支持.观察两组治疗前后临床指标的变化.结果 治疗组的全身炎症反应综合征、肠鸣音恢复时间、血淀粉酶恢复正常时间、C-反应蛋白持续时间、平均住院时间均短于对照组(P<0.05),治疗组的总有效率显著高于对照组(P<0.05),治疗组的并发症发生率显著低于对照组(P<0.05).结论 重症急性胰腺炎急性反应期宜早期行容量支持,疗效可靠,并能减少并发症.

  1. 伴高热惊厥史的儿童癫痌病例分析%Analysis of children epilepsy with history of febrile convulsion

    Institute of Scientific and Technical Information of China (English)

    常杏芝; 孟洪弟; 秦炯; 游石琼

    2001-01-01

    分析伴高热惊厥史的癫痌患儿的临床特点,探讨高热惊厥脑损伤及其与颞叶癫痌的关系。方法对1996~1999年本院儿科神经病房480例住院癫痌患儿进行回顾性分析,包括首发年龄、家族史、持续时间、癫痌发作类型、神经影像学及脑电图改变等。结果115例(23.9%)患儿有前期高热惊厥史。伴高热惊厥史的患儿癫痌发作早且易于出现癫痌持续状态。与无高热惊厥史的患儿相比,伴高热惊厥史的患儿强直-阵挛发作较多,复杂部分性发作较少。408例患儿曾行影像学检查,4例提示有海马硬化者均无高热惊厥史。在伴高热惊厥史的癫痌患儿中脑电图局灶起源的异常放电显著低于无高热惊厥史的癫痌患儿。有6.08%(7/115)伴高热惊厥史的癫痌惠儿和6.84%(25/365)无高热惊厥史的癫痌患儿脑电图表现为单纯颞叶异常放电,二组相比无明显差异。结论在癫痌患儿中,高热惊厥可能伴有脑损伤,且可能与后期的癫痌发生有关,伴高热惊厥史者不一定发展为颞叶癫痌。%To investigate clinical characteristics in children with epilepsywho have a history of preceding febrile seizures ,the possible brain damage with febrile seizures, and the relationship of prior febrile seizures to temporal lobe epilepsy. Methods 480 children who were admitted to our pediatric neurological unit from 1996 to 1999 were studied by retrospective analysis including age at onset ,family history, status epilepticus and seizure type, neuroimaging and EEG. Results 115 ( 23.9% ) cases had preceding history of febrile seizures. Children with febrile seizures were younger at onset of epilepsy,and were more likely to develop status epilepticus. Compared with children without febrile seizures, children with prior febrile seizures had more tonic-clonic onset, fewer complex partial seizures. Imaging studies were performed in 408 children(85%), of the 4 children

  2. 热性惊厥患儿颅脑磁共振检查的合理应用%Reasonable use of MRI in children with febrile seizures

    Institute of Scientific and Technical Information of China (English)

    马学梅

    2016-01-01

    Objective To investigate the results of brain MRI in children with febrile seizures in order to provide the basis for using brain MRI properly.Methods The clinical data of 1 92 children with febrile seizures hospitalized from June 2013 to June 2014 examined with brain MRI were analyzed retrospectively, and the rate of abnormal brain MRI result was compared between the children with simple febrile seizures and complex febrile seizures.Results There were 1 67 cases of simple febrile seizures and 25 cases of com-plex febrile seizures in all 1 92 children with febrile seizures.Abnormal brain MRI results were detected in 25 cases,the rate of abnormal MRI was 10.2% in simple febrile seizures and 32% in complex febrile seizures. There was significant difference in the rate of abnormal brain MRI between children with simple febrile sei-zures and complex febrile seizures.Conclusion The brain MRI doesn't need to be used routinely in children with simple febrile seizures.If there is higher positive rate of brain MRI in children with complex febrile sei-zures and basic pathological changes are found,the brain MRI should be used routinely.%目的:分析热性惊厥患儿颅脑磁共振检查结果,为临床医生合理应用磁共振检查提供依据。方法解放军第二〇二医院儿科2013年6月至2014年6月收治住院并进行颅脑 MRI 检查的热性惊厥患儿192例,对其临床资料进行分析,比较单纯性和复杂性热性惊厥患儿磁共振检查结果的异常率。结果192例热性惊厥患儿中,单纯性167例,复杂性25例。MRI 结果异常25例,其中单纯性 MRI 异常率为10.2%(17/167),复杂性 MRI 异常率为32.0%(8/25),单纯性与复杂性热性惊厥患儿 MRI 异常率比较差异有统计学意义(P <0.01)。MRI 异常的患儿中,脑白质髓鞘化不良11例,脑室增大和脑外间隙增宽6例,脑室周围白质软化4例,蛛网膜下腔囊肿3例,多发小软化灶1例。结论对于单纯性热性

  3. G-CSF, but not corticosterone, mediates circulating neutrophilia induced by febrile-range hyperthermia.

    Science.gov (United States)

    Ellis, Garrettson S; Carlson, Drew E; Hester, Lisa; He, Ju-Ren; Bagby, Gregory J; Singh, Ishwar S; Hasday, Jeffery D

    2005-05-01

    We previously showed that sustained exposure to febrile-range hyperthermia (FRH) for 24 h caused an increase in circulating granulocyte colony-stimulating factor (G-CSF) levels and a peripheral neutrophilia in mice (Hasday J, Garrison A, Singh I, Standiford T, Ellis G, Rao S, He JR, Rice P, Frank M, Goldblum S, and Viscardi R. Am J Pathol 162: 2005-2017, 2003). In this study, we utilized a conscious temperature-clamped mouse model to analyze the kinetics of G-CSF expression and peripheral neutrophil expansion and the contributions of FRH-induced G-CSF expression, glucocorticoid generation, and catecholamine-induced neutrophil demargination. In conscious mice housed at an ambient temperature of 34.5 degrees C, core temperature rapidly equilibrated at 39.5-40 degrees C. Peripheral neutrophil counts increased 2-fold after 24-h exposure to hyperthermia, peaked at 3.6-fold baseline levels after 36-h exposure to FRH, and returned to baseline levels after 42 h of sustained hyperthermia. Plasma G-CSF levels were increased by 6.8-fold after 24 h and peaked at 40-fold baseline levels after 36 h in the hyperthermic mice. Plasma corticosterone levels peaked at 3.3-fold baseline levels after 30-h sustained hyperthermia and returned to baseline by 42 h. Immunoneutralization of G-CSF blocked FRH-induced peripheral neutrophilia, but blockade of the glucocorticoid receptor with mifepristone failed to modify FRH-induced neutrophilia. Epinephrine induced similar increases in peripheral blood absolute neutrophil counts in euthermic mice (2.2-fold increase) and mice exposed to FRH for 36 h (1.8-fold increase). Collectively, these data suggest that FRH-induced expression of G-CSF drives the sustained peripheral neutrophilia that occurs during sustained (36 h) hyperthermia, whereas glucocorticoid generation and catecholamine-induced demargination play little role in this response.

  4. Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases

    Directory of Open Access Journals (Sweden)

    Weycker Derek

    2013-02-01

    Full Text Available Abstract Background Healthcare claims databases have been used in several studies to characterize the risk and burden of chemotherapy-induced febrile neutropenia (FN and effectiveness of colony-stimulating factors against FN. The accuracy of methods previously used to identify FN in such databases has not been formally evaluated. Methods Data comprised linked electronic medical records from Geisinger Health System and healthcare claims data from Geisinger Health Plan. Subjects were classified into subgroups based on whether or not they were hospitalized for FN per the presumptive “gold standard” (ANC 9/L, and body temperature ≥38.3°C or receipt of antibiotics and claims-based definition (diagnosis codes for neutropenia, fever, and/or infection. Accuracy was evaluated principally based on positive predictive value (PPV and sensitivity. Results Among 357 study subjects, 82 (23% met the gold standard for hospitalized FN. For the claims-based definition including diagnosis codes for neutropenia plus fever in any position (n=28, PPV was 100% and sensitivity was 34% (95% CI: 24–45. For the definition including neutropenia in the primary position (n=54, PPV was 87% (78–95 and sensitivity was 57% (46–68. For the definition including neutropenia in any position (n=71, PPV was 77% (68–87 and sensitivity was 67% (56–77. Conclusions Patients hospitalized for chemotherapy-induced FN can be identified in healthcare claims databases--with an acceptable level of mis-classification--using diagnosis codes for neutropenia, or neutropenia plus fever.

  5. Predictive values of serum amyloid-A and CRP for infection in febrile neutropenic cancer patients

    Directory of Open Access Journals (Sweden)

    Ayşe Batırel

    2014-12-01

    Full Text Available Objectives: To evaluate predictive values of serum amyloid A (SAA and C-reactive protein (CRP for infection and mor­tality in patients with febrile neutropenia (FEN. Methods: Daily measurement of serum SAA and CRP levels of patients during antibiotherapy for FEN. Results: Sixty-five FEN episodes of 52 patients were evaluated. Median CRP and SAA levels on 1st day of FEN were 137 mg/L (23-420 mg/L and 547 mg/L (11-1660 mg/L, respectively. For detection of infection of infection the sensitivity, positive predictive value (PPV, and negative predictive value (NPV of SAA at a level of >80 mg/L were as 100%, 48% and 100%. Whilethe sensitivity, PPV, and NPV of CRP at a level of >50mg/L were as 86%, 47% and 60%, respectively. Predictive values of initial SAA and CRP levels for infection didn’t differ significantly (CRP: p=0.24, SAA: p=0.39. SAA and CRP levels on the last day of FEN course were significant for infection and mortality (for infection: p=0.003 for CRP and p=0.026 for SAA; for mortality: p<0.001 for CRP and p=0.021 for SAA. Both initial and daily SAA and CRP levels correlated with each other positively and statistically significantly (p<0.001. The area under the curve (AUC on the re­ceiver operating character (ROC curve for CRP and SAA were 0.72 (p=0.003, 95% CI: 0.59-0.86 and 0.68 (p=0.19, 95% CI: 0.54-0.82, respectively. Conclusions: Despite low predictive values in decision of initial therapy, these parameters would be helpful in decision of modification and evaluation of response to therapy. J Microbiol Infect Dis 2014; 4(4: 128-135

  6. The Frequency of Urinary Tract Infection among Children with Febrile Convulsion

    Directory of Open Access Journals (Sweden)

    Ali Akbar Momen

    2011-06-01

    Full Text Available objectiveThis study was conducted to determine the frequency of urinary tract infection(UTI among children with febrile convulsion (FC.Materials & MethodsWe analyzed the hospital records of 137 children who had been admitted to thepediatric ward from March 2004 to February 2007 because of FC. Informationsuch as age, sex, developmental status, type of FC, family history of seizure,urine sampling method, and the results of antibiograms were recorded.ResultsThe age distribution of 137 patients (82 boys, 55 girls was as follows: 1-6 monthsof age, 1 infant (0.7%; 6-12 months, 21 infants (15.3%; 1-3 years, 75 (54.8%;3-5 years, 30 (21.9%; and more than 5 years, 10 (7.3%. Three out of the 82boys and 6 out of the 55 girls had UTI (3.7% vs. 10.9%, total, 6.6%. The agedistribution of these 9 patients was as follows: 1-6 months, 1 patient (11.1%;7-12 months, 5 (55.6%; and 1-3 years, 3 (33.3%. The relative incidence of UTIwas 6.6%. The most common organisms causing infections were Escherichiacoli in 8 and Proteus spp., in 1 patient (88.8% vs. 11.1%. Simple FC was seenin all 9 patients with UTI.ConclusionIn this study, the relative frequency of UTI among children with FC was 6.6%and this frequency was higher that the incidence of UTI in girls and boys(3-5% and 1%, respectively. Therefore, we recommend that UTI should beconsidered as an important cause of FC in children.

  7. Doença de Mucha-Habermann úlceronecrótica febril em adulto com boa resposta à corticoterapia oral Febrile ulceronecrotic Mucha-Habermann disease in adult patient successfully treated with systemic corticosteroid

    OpenAIRE

    2010-01-01

    A doença de Mucha-Habermann ulceronecrótica febril (FUMHD) é uma variante clínica rara da pitiríase liquenoide variceliforme aguda (PLEVA). Tem etiologia incerta e é caracterizada por lesões úlceronecróticas, associadas a sintomas sistêmicos. Relata-se um caso de paciente masculino, com início agudo de lesões máculo-papulares, vesicobolhosas e úlceronecróticas, associadas à febre alta e mialgia. Tratado com prednisona 0,5 mg/kg/dia, obteve-se excelente resposta terapêutica. A FUMHD é uma vari...

  8. 小儿热性惊厥的动态脑电图分析%Analysis on ambulatory electroencephalogram of children with febrile convulsion

    Institute of Scientific and Technical Information of China (English)

    王江涛; 辛翠娟; 梁东; 贾飞勇; 丁臻博

    2011-01-01

    目的:探讨小儿热性惊厥的动态脑电图变化.方法:对167例热性惊厥患儿的动态脑电图