scholarly journals A Major Regional Measles Outbreak: Description of Hospitalized Cases in 2017–2018 at Bordeaux University Hospital, France

2020 ◽  
Vol 7 (9) ◽  
Author(s):  
Barthod Laure ◽  
Fourgeaud Jacques ◽  
Puges Mathilde ◽  
Rogues Anne-Marie ◽  
Coppry Maïder ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Immunoglobulin M ◽  
University Hospital ◽  
High Morbidity ◽  
Measles Outbreak ◽  
Care Workers ◽  
Vaccination Recommendations ◽  
Starting Point ◽  
Polymerase Chain ◽  
Medical Histories

Abstract Background Measles remains endemic worldwide, despite current vaccination recommendations, and is associated with high morbidity and mortality rates. We describe all cases hospitalized in Bordeaux University Hospital (BUH), the starting point of a national significant measles outbreak in 2017–2018. Methods In this retrospective study, we included all patients hospitalized in BUH from September 1, 2017, to May 31, 2018. Inclusion criteria were age >1 year, clinical symptoms, and biological confirmation by measles immunoglobulin M or measles reverse transcription polymerase chain reaction positivity. Results We included 171 patients. Most patients were immunocompetent; only 19% had preexisting medical histories. Most patients had rash and fever (97%), but some cases were atypical and difficult to diagnose. Köplik’s spots were reported in 66 cases (38%). The most frequent biological markers were blood inflammation markers (96%) and lymphopenia (81%). Unexpectedly, we found hyponatremia (<135 mmol/L) in 40% of patients. We identified peaks in January and March, corresponding to 76 D8 genotypes and 28 B3 strains. The following complications were reported in 65 patients (38%): pneumonia, hepatitis, and keratitis; 10 had neurological symptoms. One patient had Guillain-Barré syndrome, and a young immunocompromised patient died from measles inclusion-body encephalitis. Most of the patients (80%) had not been correctly vaccinated, including 28 health care workers. Some patients (n = 43, 25%) developed measles despite having plasma IgG. These included 12 possible vaccination failure cases. Conclusions During the BUH outbreak, measles was often complicated and sometimes atypical. Vaccination coverage was dramatically insufficient. We also describe vaccination failure cases that must be better investigated.

Excellent Long-Term Survival of Patients with Waldenström‘s Macroglobulinemia (WM) treated in Private Oncology Practices and a University hospital with different Treatment Strategies

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2671-2671
Author(s):  
Manfred Hensel ◽  
Jürgen Brust ◽  
Christoph Plöger ◽  
Dieter Schuster ◽  
Marie-Luise Memmer ◽  
...  
Keyword(s):  
Overall Survival ◽  
Research Funding ◽  
Standard Treatment ◽  
Clinical Symptoms ◽  
B Cell Lymphoma ◽  
Immunoglobulin M ◽  
University Hospital ◽  
Term Survival ◽  
Significant Difference ◽  
Time To First Treatment

Abstract Abstract 2671 Background: WM is a rare type of malignant B-cell lymphoma, defined as a lymphoplasmocytic lymphoma in bone marrow and a monoclonal gammopathy of immunoglobulin-M (IgM) type. Due to the paucity of large clinical trials, a standard treatment regimen is still controversial. The purpose of this study was to compare the standard treatment and outcome of patients (pts) treated in private oncology practices (PP) and a university hospital (UH) in a region of southern Germany (Nordbaden). Methods: We retrospectively reviewed the charts of all pts with WM of the last 2 decades of 4 PP in Mannheim, Heidelberg, Karlsruhe and Speyer and the department of hematology of the University of Heidelberg. Results: 170 patients with WM could be identified, 74 from PP, 96 from the UH. The median age of the 170 pts was 63.3 years (range 29.1–88.5). The clinical symptoms were splenomegaly in 21.2%, hyperviscosity in 15.9%, lymphadenopathy in 15.9%, and polyneuropathy in 11.2%. 12.9% had a previous phase of IgM-MGUS. Pts from PP were older (median 65.3 vs. 62.5, p=0.01). Mean hemoglobine level at diagnosis was lower in pts from UH (11.4 vs. 12.2, p=0.04). There was no significant difference in mean platelet count, IgM and ß2-microglobuline level at diagnosis. 54% of pts from PP have received treatment during the observation time, as compared to 78.1% of the UH (p<0.001). The most common first line treatment protocols of PP were Chlorambucil (17/40, 42.5%), Bendamustin (17.5%) and Rituximab(R)-Bendamustin (17.5%). The UH most commonly administered R-Pentostatin-Cyclophosphamide (28%), Chlorambucil (17.3%) and COP (16%). 35% of the treated pts of PP have received R, as compared to 62.6% of the pts of the UH (p<0.001). 60% of the treated pts of PP have received Bendamustin, as compared to 8% of the pts of the UH (p<0.001). The time to first treatment was significantly shorter in pts from the UH (median 13.7 mo.) as compared to PP (52.9 mo.) (p=0.05). Median overall survival of all pts was 25.0 yrs and did not differ between PP and UH. Conclusion: Pts with WM treated in PP were older and had higher initial hemoglobin levels as compared to pts from the UH. Treatment differs significantly between PP and UH. Time to first treatment was significantly shorter in pts from UH. Overall survival was excellent, and better than reported previously. Disclosures: Hensel: Roche: Honoraria, Research Funding; Mundipharma: Research Funding.

scholarly journals Clinical profile of dengue fever infection in King Abdul Aziz University Hospital Saudi Arabia

2010 ◽  
Vol 4 (08) ◽  
pp. 503-510 ◽  
Author(s):  
Maimoona M Ahmed
Keyword(s):  
Dengue Virus ◽  
Dengue Fever ◽  
Clinical Symptoms ◽  
Degradation Products ◽  
Disease Incidence ◽  
Inverse Correlation ◽  
Immunoglobulin M ◽  
Clinical Profile ◽  
Direct Bilirubin ◽  
University Hospital

Background: The study aimed to compare the clinical profile of all patients diagnosed with dengue viral infection at King Abdul Aziz University Hospital (KAAUH), during 2005-2008. Methodology: This retrospective study included 147 patients infected with dengue virus, age ≤ 16 years. Laboratory and haematological data were included. Results: Two peaks of infection occurred during 2006 and another two in 2008. Common clinical symptoms were fever, vomiting, and abdominal pain. Common haematological abnormalities were thrombocytopenia and leucopoenia. Differences existed between the years in the percentage of patients with fever, elevated alanine aminotransferase (ALT), direct bilirubin, lactate dehydrogenase (LDH), fibrin degradation products (FDPs), and haemoglobin (Hb) levels. Differences were found in nationalities between the years, but patient nationality had no effect on disease incidence. Differences were noted in the percentages of patients' immunoglobulin M (IgM) and polymerase chain reaction (PCR) positive. There was a slight inverse correlation of IgM positive with patient age. PCR, fever, ALT, direct bilirubin, LDH, FDPs, Hb, blood transfusion, and platelet transfusion showed no correlation with age or nationality. In 2005, all the patients survived, but there were 4.55%, 25%, and 2.7% deaths during 2006-2008. Conclusions: Significant differences in the clinical presentation of dengue virus (DENV) infection, indicative of a variation in disease severity from dengue fever (DF) to dengue hemhorrhagic fever (DHF)/dengue shock syndrome (DSS), were noted over the years. Possible reasons are infection with different serotypes, concurrent/sequential infection of more than one serotype, and differences in host immune responses associated with host genetic variations.

scholarly journals Evaluation of infection with N protein-specific Immunoglobulin M and G in naturally occurring distemper in dogs

2020 ◽  
Vol 65 (No. 4) ◽  
pp. 168-173
Author(s):  
HS Saltik ◽  
M Kale
Keyword(s):  
Canine Distemper Virus ◽  
Indirect Elisa ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Immunoglobulin M ◽  
High Morbidity ◽  
Canine Distemper ◽  
Cutaneous Lesions ◽  
N Protein

In dogs, canine distemper has a worldwide distribution with high morbidity/mortality, despite the widespread usage of vaccines and has no specific treatment. In susceptible animals with the canine distemper virus, respiratory, gastrointestinal and nervous system disorders, immunosuppression and cutaneous lesions can also be seen. Especially puppies and unvaccinated dogs are prone to get the viral infection. IgM and IgG antibodies constitute the major component of the natural antibodies produced during the primary and secondary antibody response that have long been recognised to inhibit viral infections. In the present study, the presence of the viral N protein-specific IgM and IgG was investigated by indirect ELISA in naturally infected dogs. Moreover, the rate of outbreaks in naturally infected dogs was shown by the detection of new and re-infections. In the Western Mediterranean region, blood serum samples were collected from 50 unvaccinated dogs for the mentioned infection between 2015 and 2017. At 0–12 months, in the dogs with clinical symptoms, the indirect ELISA detected 4% acute, 54% early convalescent, 40% late convalescent and 2% no infections phases. The clinical manifestations were studied in four main groups follow as: respiratory, gastrointestinal, nervous and cutaneous symptoms. The evaluation showed that the canine distemper virus N protein-specific antibodies detection by the indirect ELISA is quick and safe in naturally infected dogs. In conclusion, the method is very useful for the pre-diagnosis of the disease when evaluated together with the clinical symptoms. It helps to distinguish acute and convalescent (early/late) phases. Distinguishing these phases of infection is important for monitoring the spread of the outbreaks and identifying the risk of severe forms of canine distemper.

CLINICAL SYMPTOMS, ULTRASOUND AND HISTOPATHOLOGY OF TUMORLIKE LESIONS OF THE BLADDER.

2017 ◽  
pp. 41-46
Author(s):  
Van Mao Nguyen ◽  
Thi Bich Chi Nguyen
Keyword(s):  
Bladder Cancer ◽  
Bladder Tumor ◽  
Clinical Symptoms ◽  
Bladder Wall ◽  
Lower Abdominal Pain ◽  
University Hospital ◽  
Wall Thickening ◽  
Health Examination ◽  
Ultrasound Images ◽  
Key Words Bladder Cancer

Background: Bladder cancer is one of the most frequent type of urinary cancer which has been ever increasing. For the better treatment, the early discovery and definite diagnosis of this disease played an important role. Objective: To describe some clinical symptoms and ultrasound features of tumorlike lesions of the bladder. To diagnose and classify the histopathology of tumorlike lesions of the bladder. Materials, method: cross - sectional study on 64 cases in Hue University Hospital and Hue central hospital from April, 2016 to February, 2017. Results: Hematuria was the most common reason that patients went to hospital (79.7%). Lower abdominal pain and irritation during urination accounting for 9.4% and 6.2% respectively. Only 3 patients with bladder cancer were accidentally discovered through periodic health examination (4.7%). The characteristics of hematuria in bladder tumor was flesh red urine (62.5%) and total hematuria (60.7%). With ultrasonography, the results of 64 patients were divided in 3 groups as follow: bladder tumor, which was the highest rate 87.5%, bladder polyp was 3.1% and focal bladder wall thickening was 9.4%. Of which, the vast majority of these ultrasound images was tumor - like lesions protruding in the lumen of the bladder (75%), the rest was wall thickening lesions (25%). Tumors were different in size, the biggest tumor was 7cm in diameter and the smallest was 0.6cm. Those with the diameter 3cm or bigger accounting for 42.2%, the smaller was 57.8%. Most cases have only one lesion (62.5%) and at lateral wall (46.6%). Histopathologically, cancer was 59/64 case (92.2%): urothelial carcinoma was 98.3 %, squamous cell carcinomawas 1.7% and 5 cases (7.8%) were benign. Most cancerous cases were poorly differentiated, grade II (50.9%) and grade III (32.2%). The stage T1NxMx was 20.3% and worse than T2MxNx was 79.7%. Conclusion: hematuria was the most popular symptom, suggesting bladder cancer. Clinical diagnosing bladder cancer was not high sensitive (61.01%). Ultrasound could detect bladder tumor with high sensitive (89.8%). These patients also needed histopathology classification to diagnose and finally choose the best method for the appropriate treatment. Key words: bladder cancer, histopathology, ultrasound, uroepithelial carcinoma, hematuria

scholarly journals Variable clinical characteristics and laboratory results in five patients with Chinese Good's syndrome (thymoma and hypogammaglobulinemia): an 8-year retrospective analysis in a university hospital in China

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jinyao Ni ◽  
Junwu Zhang ◽  
Yanxia Chen ◽  
Weizhong Wang ◽  
Jinlin Liu
Keyword(s):  
Information System ◽  
Lichen Planus ◽  
Hospital Information System ◽  
Clinical Characteristics ◽  
Opportunistic Infections ◽  
Clinical Symptoms ◽  
University Hospital ◽  
Ivig Treatment ◽  
Good’S Syndrome ◽  
Laboratory Results

Abstract Background Good's syndrome (GS) is a rare secondary immunodeficiency disease presenting as thymoma and hypogammaglobulinemia. Due to its rarity, the diagnosis of GS is often missed. Methods We used the hospital information system to retrospectively screen thymoma and hypogammaglobulinemia patients at the First Affiliated Hospital of Wenzhou Medical University from Apr 2012 to Apr 2020. The clinical, laboratory, treatment, and outcome data for these patients were collected and analyzed. Results Among the 181 screened thymoma patients, 5 thymoma patients with hypogammaglobulinemia were identified; 3 patients had confirmed diagnoses of GS, and the other 2 did not have a diagnosis of GS recorded in the hospital information system. A retrospective review of the clinical characteristics, laboratory results, and follow-up data for these 2 undiagnosed patients confirmed the diagnosis of GS. All 5 GS patients presented with pneumonia, 2 patients presented with recurrent skin abscesses, 2 patients presented with recurrent cough and expectoration, 1 patient presented with recurrent oral lichen planus and diarrhea, and 1 patient presented with tuberculosis and granulomatous epididymitis. In the years after the diagnosis of hypogammaglobulinemia with mild symptoms, all 5 patients had received irregular intravenous immunoglobulin (IVIG) treatment. As the course of the disease progressed, the clinical symptoms of all patients worsened, but the symptoms were partly resolved with IVIG in these patients. However, 4 patients died due to comorbidities. Conclusion GS should be investigated as a possible diagnosis in thymoma patients who present with hypogammaglobulinemia, especially those with recurrent opportunistic infections, recurrent skin abscesses, chronic diarrhea, or recurrent lichen planus.

scholarly journals Early Confirmation of Mycoplasma pneumoniae Infection by Two Short-Term Serologic IgM Examination

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 353
Author(s):  
Ha Eun Jeon ◽  
Hyun Mi Kang ◽  
Eun Ae Yang ◽  
Hye Young Han ◽  
Seung Beom Han ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Early Stage ◽  
Immunoglobulin M ◽  
Enzyme Linked Immunosorbent Assay ◽  
Short Term ◽  
Serologic Tests ◽  
Polymerase Chain ◽  
Positive Correlations ◽  
Patient Selection Bias ◽  
Mycoplasma Pneumoniae Infection

The aim of the present study is to re-evaluate the clinical application of two-times serologic immunoglobulin M (IgM) tests using microparticle agglutination assay (MAA), an enzyme-linked immunosorbent assay (ELISA), and polymerase chain reaction (PCR) assay in diagnosing Mycoplasma pneumoniae (MP) infection. A retrospective analysis of 62 children with MP pneumonia during a recent epidemic (2019–2020) was conducted. The MAA and ELISA immunoglobulin M (IgM) and IgG measurements were conducted twice at admission and around discharge, and MP PCR once at presentation. Diagnostic rates in each test were calculated at presentation and at discharge. The seroconverters were 39% (24/62) of patients tested by MAA and 29% (18/62) by ELISA. At presentation, the diagnostic positive rates of MAA, ELISA, and PCR tests were 61%, 71%, and 52%, respectively. After the second examination, the rates were 100% in both serologic tests. There were positive correlations between the titers of MAA and the IgM values of ELISA. The single serologic IgM or PCR tests had limitations to select patients infected with MP in the early stage. The short-term, paired IgM serologic tests during hospitalization can reduce patient-selection bias in MP infection studies.

scholarly journals Prevalence, Persistence, and Factors Associated with SARS-CoV-2 IgG Seropositivity in a Large Cohort of Healthcare Workers in a Tertiary Care University Hospital in Northern Italy

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1064
Author(s):  
Gitana Scozzari ◽  
Cristina Costa ◽  
Enrica Migliore ◽  
Maurizio Coggiola ◽  
Giovannino Ciccone ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Multivariable Analysis ◽  
Northern Italy ◽  
University Hospital ◽  
Care Workers ◽  
Increased Risk ◽  
Never Smokers ◽  
The University ◽  
Job Profile ◽  
Pandemic Wave

This observational study evaluated SARS-CoV-2 IgG seroprevalence and related clinical, demographic, and occupational factors among workers at the largest tertiary care University-Hospital of Northwestern Italy and the University of Turin after the first pandemic wave of March–April 2020. Overall, about 10,000 individuals were tested; seropositive subjects were retested after 5 months to evaluate antibodies waning. Among 8769 hospital workers, seroprevalence was 7.6%, without significant differences related to job profile; among 1185 University workers, 3.3%. Self-reporting of COVID-19 suspected symptoms was significantly associated with positivity (Odds Ratio (OR) 2.07, 95%CI: 1.76–2.44), although 27% of seropositive subjects reported no previous symptom. At multivariable analysis, contacts at work resulted in an increased risk of 69%, or 24% for working in a COVID ward; contacts in the household evidenced the highest risk, up to more than five-fold (OR 5.31, 95%CI: 4.12–6.85). Compared to never smokers, being active smokers was inversely associated with seroprevalence (OR 0.60, 95%CI: 0.48–0.76). After 5 months, 85% of previously positive subjects still tested positive. The frequency of SARS-COV-2 infection among Health Care Workers was comparable with that observed in surveys performed in Northern Italy and Europe after the first pandemic wave. This study confirms that infection frequently occurred as asymptomatic and underlines the importance of household exposure, seroprevalence (OR 0.60, 95%CI: 0.48–0.76).

scholarly journals Adherence to personal protective equipment use among healthcare workers caring for confirmed COVID-19 and alleged non-COVID-19 patients

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Meike M. Neuwirth ◽  
Frauke Mattner ◽  
Robin Otchwemah
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
University Hospital ◽  
Protective Equipment ◽  
Care Workers

AbstractAdherence observations of health care workers (HCW) revealed deficiencies in the use of recommended personal protective equipment (PPE) among HCW caring in COVID-19 and non-COVID-19 wards during the first period of the SARS-CoV-2 pandemic in a university hospital in Germany. The adherence to wearing surgical face or FFP2-masks and disinfecting hands prior to donning and after doffing the PPE was significantly higher in COVID-19 wards However, there was no total adherence of 100% in COVID-19 wards.

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