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https://www.readbyqxmd.com/read/28425207/bcg-vaccination-induced-suppurative-lymphadenitis-four-signs-to-pay-attention-to
#1
Sang Oon Baek, Hyo Sun Ko, Hyun Ho Han
Suppurative lymphadenitis is one of the severe complication after BCG vaccination, but its diagnostic criteria and treatment guidelines have not yet been established. In this article, we describe a case of suppurative lymphadenitis caused by BCG vaccination and propose diagnostic criteria and treatment guidelines of the disease. The lymphadenitis was presented as skin involving mass and was completely extirpated. Pathological evaluation revealed a necrotising lymphadenitis, consistent with the diagnosis of BCG lymphadenitis...
April 19, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28419275/clinical-care-guideline-for-improving-pediatric-acute-musculoskeletal-infection-outcomes
#2
Murray D Spruiell, Justin Benjamin Searns, Travis C Heare, Jesse L Roberts, Erin Wylie, Laura Pyle, Nathan Donaldson, Jaime R Stewart, Heather Heizer, Jennifer Reese, Halden F Scott, Kelly Pearce, Colin J Anderson, Mark Erickson, Sarah K Parker
Background.: Acute pediatric musculoskeletal infections are common, leading to significant use of resources and antimicrobial exposure. In order to decrease variability and improve the quality of care, Children's Hospital Colorado implemented a clinical care guideline (CCG) for these infections. The purpose of this study is to evaluate clinical and resource outcomes PRE and POST this CCG. Methods.: Retrospective chart review evaluated patients admitted to a large pediatric quaternary referral center (CHCO) diagnosed with acute osteomyelitis, septic arthritis, pyomyositis, and/or musculoskeletal abscess prior to and after guideline implementation...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28403751/management-of-dengue-in-australian-travellers-a-retrospective-multicentre-analysis
#3
MULTICENTER STUDY
Alex Yc Tai, Sarah L McGuinness, Roselle Robosa, David Turner, G Khai Lin Huang, Karin Leder, Tony M Korman, Irani Thevarajan, Andrew J Stewardson, Alexander A Padiglione, Douglas F Johnson
OBJECTIVES: To describe the epidemiology, clinical and laboratory features and outcomes of dengue in returned Australian travellers, applying the revised WHO dengue classification (2009) to this population. DESIGN, SETTING AND PARTICIPANTS: Retrospective case series analysis of confirmed dengue cases hospitalised at one of four Australian tertiary hospitals, January 2012 - May 2015. MAIN OUTCOME MEASURES: Clinical features, laboratory findings and outcomes of patients with dengue; dengue classification according to 2009 WHO guidelines...
April 17, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28391232/antibiotic-prescriptions-for-inpatients-having-non-bacterial-diagnosis-at-medicine-departments-of-two-private-sector-hospitals-in-madhya-pradesh-india-a-cross-sectional-study
#4
Kristoffer Landstedt, Ashish Sharma, Fredrik Johansson, Cecilia Stålsby Lundborg, Megha Sharma
OBJECTIVES: To present and compare antibiotic prescribing for inpatients among the most common non-bacterial diagnoses groups at medicine departments of a teaching (TH) and a non-teaching hospital (NTH) in central India. SETTING: An observational cross-sectional study was conducted at two tertiary care settings in Ujjain district, Madhya Pradesh, India. DATA AND PARTICIPANTS: The data were collected manually, using a customised form. Complete records of all inpatients, who were >15 years of age and had stayed for at least one night in either of the hospitals during 2008-2011, were analysed...
April 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28373758/typhoid-intestinal-perforation-in-developing-countries-still-unavoidable-deaths
#5
EDITORIAL
Sandro Contini
Typhoid fever is a public health challenge mostly concentrated in impoverished, overcrowded areas of the developing world, with lack of safe drinking and sanitation. The most serious complication is typhoid intestinal perforation (TIP), observed in 0.8% to 39%, with a striking rate difference between high-income and low-middle-income countries. Although the mortality rate consequent to TIP in resource-poor countries is improved in the last decades, it is still fluctuating from 5% to 80%, due to surgical- and not surgical-related constraints...
March 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28364306/-antipyretics-in-intensive-care-patients
#6
A Simon, A Leffler
BACKGROUND: Antipyretics are among the most widely prescribed drugs in German hospitals. Despite this widespread use, their role for treatment of critically ill patients still remains unclear. In particular, the questionable positive effects of reducing fever are discussed. OBJECTIVES: In this review we aimed to summarize and discuss current study results covering the use of antipyretics in critically ill patients. Suspected effects with regard to fever reduction and lethality should be considered...
March 31, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28363423/new-technique-for-nephron-sparing-surgery-in-polar-tumours-a-modification-of-the-kim-technique
#7
C Ameri, F M Lopez, G J Vitagliano, H Rios Pita, J M Guglielmi, L Blas
INTRODUCTION AND OBJECTIVES: Nephron-sparing surgery (NSS) is the indication, provided it is feasible and meets the international treatment guidelines. One of the objectives of performing NSS is to reduce the ischemia time as much as possible. We propose a surgical technique for treating polar renal tumours and those larger than 4cm based on the principle of the technique described by Kim in 1964. METHOD: The technique performs a continuous circular suture on the base of the tumour, achieving compression of the renal pole without vascular clamping, facilitating haemostasis and avoiding the blind transfixion performed in Kim's original technique...
March 28, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28361787/iap-guidelines-on-rickettsial-diseases-in-children
#8
Narendra Rathi, Atul Kulkarni, Vijay Yewale
OBJECTIVE: To formulate practice guidelines on rickettsial diseases in children for pediatricians across India. JUSTIFICATION: Rickettsial diseases are increasingly being reported from various parts of India. Due to low index of suspicion, nonspecific clinical features in early course of disease, and absence of easily available, sensitive and specific diagnostic tests, these infections are difficult to diagnose. With timely diagnosis, therapy is easy, affordable and often successful...
March 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28361596/a-case-of-fatal-agranulocytosis-that-developed-in-a-patient-with-%C3%AE-thalassemia-major-treated-with-deferiprone
#9
Maria Mainou, Aggeliki Kotsiafti, Philippos Klonizakis, Vasiliki Soulountsi, Chrysoula Apostolou, Kiriakos Psarras, Efthymia Vlachaki
A 29-year-old male with transfusion-dependent β-thalassemia major (β-TM), splenectomized and on chelation therapy with deferiprone (DFP or L1) due to heart and liver hemosiderosis, presented with high fever and agranulocytosis. Deferiprone was discontinued and a broad spectrum antibiotic therapy was started intravenously. The patient remained febrile and showed no recovery of neutrophil count even after the initiation of granulocyte colony-stimulation factor (G-CSF). After 12 days at the hospital, he developed respiratory failure and was transferred to the intensive care unit (ICU) where he developed multi-organ failure and died 3 days later...
November 2016: Hemoglobin
https://www.readbyqxmd.com/read/28357510/tracking-unnecessary-negative-urinalyses-to-reduce-healthcare-costs-a-transversal-study
#10
A Malmartel, M Dutron, C Ghasarossian
About 7 million urinalyses are reimbursed yearly by the French public healthcare system, but the results of most of these tests are normal. The aim of this study was to estimate the prevalence of negative urinalyses in ambulatory care, identify the associated factors and assess the relevance of prescriptions by general practitioners (GPs) according to French guidelines. A cross-sectional study was conducted in patients over 18 coming for urinalyses in two French ambulatory laboratories. Patients received a questionnaire on their symptoms, the reason for performing urinalysis and the use of urinary dipsticks...
March 29, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28356445/diagnosis-treatment-and-long-term-management-of-kawasaki-disease-a-scientific-statement-for-health-professionals-from-the-american-heart-association
#11
REVIEW
Brian W McCrindle, Anne H Rowley, Jane W Newburger, Jane C Burns, Anne F Bolger, Michael Gewitz, Annette L Baker, Mary Anne Jackson, Masato Takahashi, Pinak B Shah, Tohru Kobayashi, Mei-Hwan Wu, Tsutomu T Saji, Elfriede Pahl
BACKGROUND: Kawasaki disease is an acute vasculitis of childhood that leads to coronary artery aneurysms in ≈25% of untreated cases. It has been reported worldwide and is the leading cause of acquired heart disease in children in developed countries. METHODS AND RESULTS: To revise the previous American Heart Association guidelines, a multidisciplinary writing group of experts was convened to review and appraise available evidence and practice-based opinion, as well as to provide updated recommendations for diagnosis, treatment of the acute illness, and long-term management...
March 29, 2017: Circulation
https://www.readbyqxmd.com/read/28353453/a-change-for-the-antibacterial-treatment-policy-to-decrease-carbapenem-consumption-at-a-haematopoietic-stem-cell-transplantation-centre
#12
Gõkhan Metan, Leylagül Kaynar, Nuran Yozgat, Ferhan Elmali, Cemile Altay Kürkçüoglu, Emine Alp, Mustafa Çetin
After experiencing a high rate of carbapenem-resistant Gram-negative bacilli infections in febrile neutropenic patients, a two-stage intervention was introduced in the haematopoietic stem cell transplantation (HSCT) centre. During the first eight months of 2014, carbapenems remained the first choice for the empirical treatment of febrile neutropenia while the use of piperacillin/tazobactam (TZP) was encouraged in patients with stable clinical condition. When blood cultures were reported as negative and the patient was clinically stable the carbapenem/TZP treatment was stopped regardless of continuous fever and neutrophil count...
March 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28351439/-revision-of-the-dutch-college-of-general-practitioners-practice-guideline-children-with-fever
#13
W E Eizenga, W Opstelten
- Fever in children is usually caused by benign viral infection.- Approximately 1-10% of children with fever has or develops a serious infection such as pneumonia, meningitis or pyelonephritis.- It is more important to timely recognize symptoms that may indicate a potentially serious disease course than to make an exact diagnosis.- Children < 3 months are at greater risk for a serious disease course.- During follow-up it is important to provide parents with proper advice on the expected disease course and who they should contact, and when, in cases of deterioration or concern...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28345207/autoinflammatory-syndromes-associated-with-hidradenitis-suppurativa-and-or-acne
#14
REVIEW
Caroline Vinkel, Simon F Thomsen
Autoinflammatory syndromes associated with hidradenitis suppurativa (HS) and/or acne are rare but potentially debilitating disorders if not diagnosed and treated correctly. They share a common pathogenesis involving a dysregulated innate immune system with abnormal interleukin (IL)-1 signaling leading to sterile neutrophilic inflammation. The clinical features are recurrent episodes of fever, painful arthritis, and skin lesions consistent with HS, acne, and pyoderma gangrenosum (PG) accompanied by elevated systemic inflammatory markers in blood...
March 27, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28329131/effectiveness-of-long-term-doxycycline-treatment-and-cognitive-behavioral-therapy-on-fatigue-severity-in-patients-with-q-fever-fatigue-syndrome-qure-study-a-randomized-controlled-trial
#15
Stephan P Keijmel, Corine E Delsing, Gijs Bleijenberg, Jos W M van der Meer, Rogier T Donders, Monique Leclercq, Linda M Kampschreur, Michel van den Berg, Tom Sprong, Marrigje H Nabuurs-Franssen, Hans Knoop, Chantal P Bleeker-Rovers
Background.: Approximately 20% of patients with acute Q fever will develop chronic fatigue, referred to as Q fever fatigue syndrome (QFS). The objective of this randomized controlled clinical trial was to assess the efficacy of either long-term treatment with doxycycline or cognitive-behavioral therapy (CBT) in reducing fatigue severity in patients with QFS. Methods.: Adult patients were included who met the QFS criteria according to the Dutch guideline: a new onset of severe fatigue lasting ≥6 months with significant disabilities, related to an acute Q fever infection, without other somatic or psychiatric comorbidity explaining the fatigue...
April 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28321299/successful-emergency-department-interventions-that-reduce-time-to-antibiotics-in-febrile-pediatric-cancer-patients
#16
Sandra Spencer, MIchele Nypaver, Katherine Hebert, Christopher Benner, Rachel Stanley, Daniel Cohen, Alexander Rogers, Jason Goldstick, Prashant Mahajan
Children with cancer and fever are at high risk for sepsis related death. Rapid antibiotic delivery (< 60 minutes) has been shown to reduce mortality. We compared patient outcomes and describe interventions from three separate quality improvement (QI) projects conducted in three United States (US) tertiary care pediatric emergency departments (EDs) with the shared aim to reduce time to antibiotic (TTA) to < 60 minutes in febrile pediatric oncology patients (Temperature > 38.0 C). A secondary objective was to identify interventions amenable to translation to other centers...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28321277/clinical-outcomes-among-febrile-children-aged-2-to-59-months-with-negative-malaria-rapid-diagnostic-test-results-in-mchinji-district-malawi
#17
Dyson Mwandama, Chawanangwa Mwale, Andrew Bauleni, Themba Phiri, Joseph Chisaka, Humphreys Nsona, Don P Mathanga
BACKGROUND: Malawi malaria treatment guidelines recommend a definitive diagnosis, using a malaria rapid diagnostic test (mRDT), for all patients with fever or history of fever. Improving the management and outcomes of febrile children with negative mRDT results should be a priority. METHODS: Through a prospective cohort study designed to investigate clinical outcomes of children treated at the community level, we followed, for 7 days, children aged 2 to 59 months, who had negative mRDT results and were treated with antipyretic medication...
December 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28314783/umbilical-infections-in-foals-microbiological-investigation-and-management
#18
E Rampacci, F Passamonti, M Bottinelli, V Stefanetti, M Cercone, S Nannarone, R Gialletti, F Beccati, M Coletti, M Pepe
This study aims to investigate the bacteria involved in equine omphalitis and their susceptibility to antimicrobial drugs, and consequently to provide guidelines concerning the most suitable treatment protocol in accordance with the clinical, ultrasound and laboratory findings. Forty foals aged between one and 30 days were evaluated in the course of this investigation. An ultrasound examination of all umbilical remnants was carried out carefully in all foals; umbilical swabs were collected for bacteriological examination, and blood samples were collected for blood culture from 19 foals with fever and abnormal blood values...
March 17, 2017: Veterinary Record
https://www.readbyqxmd.com/read/28288172/the-impact-of-an-intervention-to-introduce-malaria-rapid-diagnostic-tests-on-fever-case-management-in-a-high-transmission-setting-in-uganda-a-mixed-methods-cluster-randomized-trial-prime
#19
Clare I R Chandler, Emily L Webb, Catherine Maiteki-Sebuguzi, Susan Nayiga, Christine Nabirye, Deborah D DiLiberto, Emmanuel Ssemmondo, Grant Dorsey, Moses R Kamya, Sarah G Staedke
BACKGROUND: Rapid diagnostic tests for malaria (mRDTs) have been scaled-up widely across Africa. The PRIME study evaluated an intervention aiming to improve fever case management using mRDTs at public health centers in Uganda. METHODS: A cluster-randomized trial was conducted from 2010-13 in Tororo, a high malaria transmission setting. Twenty public health centers were randomized in a 1:1 ratio to intervention or control. The intervention included training in health center management, fever case management with mRDTs, and patient-centered services; plus provision of mRDTs and artemether-lumefantrine (AL) when stocks ran low...
2017: PloS One
https://www.readbyqxmd.com/read/28286628/hemophagocytic-lymphohistiocytosis-an-unclear-nosologic-entity-case-report-of-an-adult-man-with-rising-of-amylase-and-lipase-and-spinal-cord-infiltration
#20
Moris Sangineto, Antonio Perrone, Pasquale Agosti, Viera Boccuti, Anna Campobasso, Carlo Sabbà
Here we present the case of a 57-years old patient affected by hemophagocytic lymphohistiocytosis (HLH), a rare disease characterized by an uncontrolled immune activation, resulting in clinical and biochemical manifestations of extreme inflammation. In a previous hospitalization, the patient showed fever, hepato-splenomegaly, pancytopenia, hyperferrtitinemia, lymphadenopathy and cholestasis. No diagnosis was done, however, he totally recovered after splenectomy. Eight months later, he relapsed, showing also hypofibrinogenemia, hypertriglyceridemia, hemophagocytic signs in bone marrow, cholestatic jaundice, high LDH and high PT-INR...
February 23, 2017: Hematology Reports
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