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febrile fit

Eefje G P M de Bont, Geert-Jan Dinant, Gijs Elshout, Gijs van Well, Nick A Francis, Bjorn Winkens, Jochen W L Cals
BACKGROUND: Fever is the most common reason for a child to be taken to a general practitioner (GP), especially during out-of-hours care. It is mostly caused by self-limiting infections. However, antibiotic prescription rates remain high, especially during out-of-hours care. Anxiety and lack of knowledge among parents, and perceived pressure to prescribe antibiotics amongst GPs, are important determinants of excessive antibiotic prescriptions. An illness-focused interactive booklet has the potential to improve this by providing parents with information about fever self-management strategies...
November 17, 2016: Trials
Fausto Petrelli, Gianluca Tomasello, Michele Ghidini, Rodolfo Passalacqua, Sandro Barni
Combination of docetaxel, cisplatin, and 5-fluorouracil (DCF) is an active but not well-tolerated regimen for advanced gastric cancer (GC) with standard 3-weekly doses. Several modified schedules (mDCFs) have been designed to reduce acute toxicities and improve feasibility as first-line therapy in patients with metastatic GC. The objective of this systematic review was to evaluate overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and grade (G) greater than or equal to 3 adverse event of mDCF chemotherapy in this setting...
February 2017: Anti-cancer Drugs
Pamala A Pawloski, Avis J Thomas, Sheryl Kane, Gabriela Vazquez-Benitez, Gary R Shapiro, Gary H Lyman
OBJECTIVES: Clinical guidelines recommending the use of myeloid growth factors are largely based on the prescribed chemotherapy regimen. The guidelines suggest that oncologists consider patient-specific characteristics when prescribing granulocyte-colony stimulating factor (G-CSF) prophylaxis; however, a mechanism to quantify individual patient risk is lacking. Readily available electronic health record (EHR) data can provide patient-specific information needed for individualized neutropenia risk estimation...
September 16, 2016: Journal of the American Medical Informatics Association: JAMIA
T Alex Perkins, Valerie A Paz-Soldan, Steven T Stoddard, Amy C Morrison, Brett M Forshey, Kanya C Long, Eric S Halsey, Tadeusz J Kochel, John P Elder, Uriel Kitron, Thomas W Scott, Gonzalo M Vazquez-Prokopec
Pathogens inflict a wide variety of disease manifestations on their hosts, yet the impacts of disease on the behaviour of infected hosts are rarely studied empirically and are seldom accounted for in mathematical models of transmission dynamics. We explored the potential impacts of one of the most common disease manifestations, fever, on a key determinant of pathogen transmission, host mobility, in residents of the Amazonian city of Iquitos, Peru. We did so by comparing two groups of febrile individuals (dengue-positive and dengue-negative) with an afebrile control group...
July 13, 2016: Proceedings. Biological Sciences
Gerardo Chowell, Doracelly Hincapie-Palacio, Juan Ospina, Bruce Pell, Amna Tariq, Sushma Dahal, Seyed Moghadas, Alexandra Smirnova, Lone Simonsen, Cécile Viboud
BACKGROUND: The World Health Organization declared the ongoing Zika virus (ZIKV) epidemic in the Americas a Public Health Emergency of International Concern on February 1, 2016. ZIKV disease in humans is characterized by a "dengue-like" syndrome including febrile illness and rash. However, ZIKV infection in early pregnancy has been associated with severe birth defects, including microcephaly and other developmental issues. Mechanistic models of disease transmission can be used to forecast trajectories and likely disease burden but are currently hampered by substantial uncertainty on the epidemiology of the disease (e...
2016: PLoS Currents
John B Presloid, Tasneem F Mohammad, Adam S Lauring, Isabel S Novella
The theory of plastogenetic congruence posits that ultimately, the pressure to maintain function in the face of biomolecular destabilization produces robustness. As temperature goes up so does destabilization. Thus, genetic robustness, defined as phenotypic constancy despite mutation, should correlate with survival during thermal challenge. We tested this hypothesis using vesicular stomatitis virus (VSV). We produced two sets of evolved strains after selection for higher thermostability by either preincubation at 37°C or by incubation at 40°C during infection...
September 2016: Virology
Francisco Javier Zamora-Camacho, Senda Reguera, Gregorio Moreno-Rueda
Immunocompetence benefits animal fitness by combating pathogens, but also entails some costs. One of its main components is fever, which in ectotherms involves two main types of costs: energy expenditure and predation risk. Whenever those costs of fever outweigh its benefits, ectotherms are expected not to develop fever, or even to show hypothermia, reducing costs of thermoregulation and diverting the energy saved to other components of the immune system. Environmental thermal quality, and therefore the thermoregulation cost/benefit balance, varies geographically...
2016: PeerJ
Ing-Kit Lee, Jien-Wei Liu, Yen-Hsu Chen, Yi-Chun Chen, Ching-Yen Tsai, Shi-Yu Huang, Chun-Yu Lin, Chung-Hao Huang
We aimed to develop and validate a risk score to aid in the early identification of laboratory-confirmed dengue patients at high risk of severe dengue (SD) (i.e. severe plasma leakage with shock or respiratory distress, or severe bleeding or organ impairment). We retrospectively analyzed data of 1184 non-SD patients at hospital presentation and 69 SD patients before SD onset. We fit a logistic regression model using 85% of the population and converted the model coefficients to a numeric risk score. Subsequently, we validated the score using the remaining 15% of patients...
2016: PloS One
Angela M Arlen, Siobhan E Alexander, Moshe Wald, Christopher S Cooper
INTRODUCTION AND OBJECTIVE: Factors influencing the decision to surgically correct vesicoureteral reflux (VUR) include risk of breakthrough febrile urinary tract infection (fUTI) or renal scarring, and decreased likelihood of spontaneous resolution. Improved identification of children at risk for recurrent fUTI may impact management decisions, and allow for more individualized VUR management. We have developed and investigated the accuracy of a multivariable computational model to predict probability of breakthrough fUTI in children with primary VUR...
October 2016: Journal of Pediatric Urology
Fereshte Sheybani, Hamid Reza Naderi, Sareh Sajjadi
The elderly comprise less than 13 percent of world population. Nonetheless, they represent nearly half of all hospitalized adults. Acute change in mental status from baseline is commonly seen among the elderly even when the main process does not involve the central nervous system. The term "geriatric syndrome" is used to capture those clinical conditions in older people that do not fit into discrete disease categories, including delirium, falls, frailty, dizziness, syncope, and urinary incontinence. Despite the growing number of elderly population, especially those who require hospitalization and the high burden of common infections accompanied by encephalopathy among them, there are several unresolved questions regarding the optimal management they deserve...
2016: Interdisciplinary Perspectives on Infectious Diseases
Nathaniel J Rhodes, Joseph L Kuti, David P Nicolau, Michael N Neely, Anthony M Nicasio, Marc H Scheetz
INTRODUCTION: Cefepime trough concentrations >22 mg/L (T(>22)) have been associated with neurotoxicity in a single study. PATIENTS AND METHODS: Neurotoxicity outcomes for 28 cefepime-treated adult patients with febrile neutropenia were abstracted from the literature. The precision of T(>22) to predict neurotoxicity was quantified using 95% confidence intervals. Thirty-two cefepime-treated patients contributed serum concentrations for a pharmacokinetic model, fit using the Nonparametric Adaptive Grid algorithm within the Pmetrics package for R...
February 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Marianna S Rivas-Coppola, Namrata Shah, Asim F Choudhri, Robin Morgan, James W Wheless
OBJECTIVE: To describe and analyze the chronological evolution of the radiological findings in seven children with febrile infection-related epilepsy syndrome. METHODS: This is a retrospective study describing the radiological findings and evolution in seven children with febrile infection-related epilepsy syndrome who presented from 2009 to 2013. The children all fit the defined clinical criteria for febrile infection-related epilepsy syndrome; all had a history of normal psychomotor development who presented with acute-onset catastrophic partial status epilepticus associated with a febrile illness or unspecific infectious process...
February 2016: Pediatric Neurology
Bonnie Mappin, Ewan Cameron, Ursula Dalrymple, Daniel J Weiss, Donal Bisanzio, Samir Bhatt, Peter W Gething
BACKGROUND: Large-scale mapping of Plasmodium falciparum infection prevalence relies on opportunistic assemblies of infection prevalence data arising from thousands of P. falciparum parasite rate (PfPR) surveys conducted worldwide. Variance in these data is driven by both signal, the true underlying pattern of infection prevalence, and a range of factors contributing to 'noise', including sampling error, differing age ranges of subjects and differing parasite detection methods. Whilst the former two noise components have been addressed in previous studies, the effect of different diagnostic methods used to determine PfPR in different studies has not...
November 17, 2015: Malaria Journal
Thomas Druetz, Federica Fregonese, Aristide Bado, Tieba Millogo, Seni Kouanda, Souleymane Diabaté, Slim Haddad
INTRODUCTION: Burkina Faso started nationwide community case management of malaria (CCMm) in 2010. In 2011, health center user fees for children under five were abolished in some districts. OBJECTIVE: To assess the effects of concurrent implementation of CCMm and user fees abolition on treatment-seeking practices for febrile children. METHODS: This is a natural experiment conducted in the districts of Kaya (CCMm plus user fees abolition) and Zorgho (CCMm only)...
2015: PloS One
Maryam Taghizadeh-Ghehi, Saeed Rezaee, Kheirollah Gholami, Molouk Hadjibabaie
OBJECTIVE: Many hematopoietic stem cell transplantation (HSCT) patients receive vancomycin empirically during febrile neutropenia. There are several models for estimation of vancomycin pharmacokinetic parameters and calculation of initial dosing regimen accordingly. However, the performance of these methods in HSCT patients remained to be evaluated. The aim of the study was to determine which of the vancomycin population pharmacokinetic methods best fit Iranian HSCT patients. METHODS: In order to evaluate predicted performance of seven vancomycin population pharmacokinetic models, the pharmacokinetic parameters of patients were estimated using each model's equations...
July 2015: Journal of Research in Pharmacy Practice
Taiwo Olugbemiga Adedeji, James E Tobih, Olusola A Sogebi, Attah Dickens Daniel
BACKGROUND: Hearing impairment is a hidden human disability with potentially catastrophic and age long consequences. This study highlighted the challenges associated with the management of congenital and early onset childhood hearing loss in a sub-Saharan African country. METHODS: A retrospective descriptive study of children seen between January 2008 and December 2013 RESULT: A total of 223 children consisting of 124 (55.6%) males with (M:F) of 1.3:1. Age ranged 1-15 years (mean±SD; 6...
October 2015: International Journal of Pediatric Otorhinolaryngology
Susan Shenoi, Jing-Ni Ou, Chester Ni, Claudia Macaubas, Vivian H Gersuk, Carol A Wallace, Elizabeth D Mellins, Anne M Stevens
BACKGROUND: Differentiation of systemic juvenile idiopathic arthritis (SJIA) fever from other childhood fevers is often delayed due to the lack of reliable, specific biomarkers. We hypothesized that PD-L1 expression is dysregulated in SJIA monocytes and compared it to other candidate SJIA biomarkers. METHODS: This pilot study enrolled children with fever without source and compared PD-L1 expression on myeloid cells to C-reactive protein, erythrocyte sedimentation rate, leukocyte counts, S100A12, S100A8, S100A9, calprotectin, and procalcitonin...
November 2015: Pediatric Research
Nicholas A Feasey, Dean Everett, E Brian Faragher, Arantxa Roca-Feltrer, Arthur Kang'ombe, Brigitte Denis, Marko Kerac, Elizabeth Molyneux, Malcolm Molyneux, Andreas Jahn, Melita A Gordon, Robert S Heyderman
INTRODUCTION: Nontyphoidal Salmonellae (NTS) are responsible for a huge burden of bloodstream infection in Sub-Saharan African children. Recent reports of a decline in invasive NTS (iNTS) disease from Kenya and The Gambia have emphasised an association with malaria control. Following a similar decline in iNTS disease in Malawi, we have used 9 years of continuous longitudinal data to model the interrelationships between iNTS disease, malaria, HIV and malnutrition. METHODS: Trends in monthly numbers of childhood iNTS disease presenting at Queen's Hospital, Blantyre, Malawi from 2002 to 2010 were reviewed in the context of longitudinal monthly data describing malaria slide-positivity among paediatric febrile admissions, paediatric HIV prevalence, nutritional rehabilitation unit admissions and monthly rainfall over the same 9 years, using structural equation models (SEM)...
2015: PLoS Neglected Tropical Diseases
C S Cooper, S E Alexander, K Kieran, D W Storm
INTRODUCTION: For children with VUR the grade of vesicoureteral reflux (VUR) remains one of the most predictive factors relative to outcome. However, the subjective nature of the currently accepted international reflux grading system (IRGS) leads to inter-observer variation. The potential of a direct measurement of the distal ureter on the voiding cystourethrogram (VCUG) normalized to the L1-L3 vertebral body distance (ureteral diameter ratio - UDR) to augment the ability of IRGS to predict the ultimate clinical outcome has previously been reported in a group of 79 children...
August 2015: Journal of Pediatric Urology
Mena Abdelsayed, Colin H Peters, Peter C Ruben
Cardiac arrhythmias are often associated with mutations in SCN5A the gene that encodes the cardiac paralogue of the voltage-gated sodium channel, NaV 1.5. The NaV 1.5 mutants R1193Q and E1784K give rise to both long QT and Brugada syndromes. Various environmental factors, including temperature, may unmask arrhythmia. We sought to determine whether temperature might be an arrhythmogenic trigger in these two mixed syndrome mutants. Whole-cell patch clamp was used to measure the biophysical properties of NaV 1...
September 15, 2015: Journal of Physiology
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