Persistent inflammation, immunosuppression and catabolism syndrome (PICS) in critically ill children is associated with clinical outcomes: a prospective longitudinal study

2020 ◽  
Author(s):  
D. B. Hauschild ◽  
L. D. A. Oliveira ◽  
J. C. Ventura ◽  
M. S. Farias ◽  
E. Barbosa ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Children ◽  
Prospective Longitudinal Study ◽  
Persistent Inflammation ◽  
Prospective Longitudinal

scholarly journals Quality of life of critically ill patients in a developing country: a prospective longitudinal study

2016 ◽  
Vol 28 (10) ◽  
pp. 2915-2920
Author(s):  
José Marcelo e Souza Mafra ◽  
Janete Maria da Silva ◽  
Leda Tomiko Yamada da Silveira ◽  
Carolina Fu ◽  
Clarice Tanaka
Keyword(s):  
Quality Of Life ◽  
Longitudinal Study ◽  
Developing Country ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal

scholarly journals Herpes DNAemia and TTV Viraemia in Intensive Care Unit Critically Ill Patients: A Single-Centre Prospective Longitudinal Study

2021 ◽  
Vol 12 ◽  
Author(s):  
François Mallet ◽  
Léa Diouf ◽  
Boris Meunier ◽  
Magali Perret ◽  
Frédéric Reynier ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Wilcoxon Test ◽  
Icu Patients ◽  
Prospective Longitudinal Study ◽  
Severity Scores ◽  
Prospective Longitudinal

IntroductionWe analysed blood DNAemia of TTV and four herpesviruses (CMV, EBV, HHV6, and HSV-1) in the REAnimation Low Immune Status Marker (REALISM) cohort of critically ill patients who had presented with either sepsis, burns, severe trauma, or major surgery. The aim was to identify common features related to virus and injury-associated pathologies and specific features linking one or several viruses to a particular pathological context.MethodsOverall and individual viral DNAemia were measured over a month using quantitative PCR assays from the 377 patients in the REALISM cohort. These patients were characterised by clinical outcomes [severity scores, mortality, Intensive Care Unit (ICU)-acquired infection (IAI)] and 48 parameters defining their host response after injury (cell populations, immune functional assays, and biomarkers). Association between viraemic event and clinical outcomes or immune markers was assessed using χ2-test or exact Fisher’s test for qualitative variables and Wilcoxon test for continuous variables.ResultsThe cumulative incidence of viral DNAemia increased from below 4% at ICU admission to 35% for each herpesvirus during the first month. EBV, HSV1, HHV6, and CMV were detected in 18%, 12%, 10%, and 9% of patients, respectively. The incidence of high TTV viraemia (>10,000 copies/ml) increased from 11% to 15% during the same period. Herpesvirus viraemia was associated with severity at admission; CMV and HHV6 viraemia correlated with mortality during the first week and over the month. The presence of individual herpesvirus during the first month was significantly associated (p < 0.001) with the occurrence of IAI, whilst herpesvirus DNAemia coupled with high TTV viraemia during the very first week was associated with IAI. Herpesvirus viraemia was associated with a lasting exacerbated host immune response, with concurrent profound immune suppression and hyper inflammation, and delayed return to immune homeostasis. The percentage of patients presenting with herpesvirus DNAemia was significantly higher in sepsis than in all other groups. Primary infection in the hospital and high IL10 levels might favour EBV and CMV reactivation.ConclusionIn this cohort of ICU patients, phenotypic differences were observed between TTV and herpesviruses DNAemia. The higher prevalence of herpesvirus DNAemia in sepsis hints at further studies that may enable a better in vivo understanding of host determinants of herpesvirus viral reactivation. Furthermore, our data suggest that EBV and TTV may be useful as additional markers to predict clinical deterioration in ICU patients.

scholarly journals Dysglycemia in Critically Ill Children Admitted to Jimma Medical Centre, Southwest Ethiopia

2021 ◽  
Vol 31 (2) ◽  
Author(s):  
Habtamu Sime ◽  
Melkamu Berhane ◽  
Tsion Tilahun ◽  
Temam Kedir ◽  
Diriba Dereje ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Critically Ill ◽  
Glucose Level ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Critically Ill Children ◽  
Prospective Longitudinal Study ◽  
Southwest Ethiopia ◽  
Prospective Longitudinal

BACKGROUND፡ Abnormal blood glucose level is one of the most frequently encountered problems in children with severe illnesses. However, its magnitude and outcome have rarely been determined in Ethiopia. We aimed to determine the magnitude, associated factors and outcome of dysglycemia in critically ill children admitted to Jimma Medical Center.METHODS: Prospective longitudinal study was conducted on children aged 28 days to 14 years admitted with critical illnesses at the different units of the Department of Pediatrics and Child Health of Jimma Medical Center, Southwest Ethiopia, from June to August 2019. Data were collected by trained medical personnel using structured questionnaire and analyzed using Statistical Package for Social Sciences (SPSS) windows version 20.0. Dysglycemia was considered whenever the child had a random blood sugar >150mg/dl or <45mg/dl.RESULT: Dysglycemia was seen at admission in 139/481, 28.9% children; 24 (5.0%) had hypoglycemia whereas 115 (23.9%) had hyperglycemia. The factors associated with dysglycemia at admission were severe acute malnutrition (p=002, AOR=3.09, CI=1.18,7.77), impaired mental status (p=0.003, AOR=4.63, CI=1.68, 12.71), place of residence (p=0.01, AOR=1.85, CI=1.15-2.96) and presence of diarrhea on date of admission. Among the children who had dysglycemia at admission, 16/139, 11.5% died.CONCLUSION: Dysglycemia is a common problem in critically ill children in the setting. Blood glucose level should be determined for all critically ill children, and routine empirical administration of dextrose should be minimized since most of the children with dysglycemia had hyperglycemia than hypoglycemia.

scholarly journals Rationale, study design and methodology of the hypertension registry: a Pan-India, prospective, longitudinal study to assess management and real-world outcomes of high-risk essential hypertension

2021 ◽  
Vol 8 (3) ◽  
pp. 223
Author(s):  
Jabir Abdullakutty ◽  
Jay Shah ◽  
Abraham Oomman ◽  
J. Ezhilan ◽  
N. C. Krishnamani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Longitudinal Study ◽  
High Risk ◽  
Clinical Outcomes ◽  
Real World ◽  
Trial Registration ◽  
Dose Titration ◽  
Treatment Preferences ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal

<p class="abstract"><strong>Background:</strong> India contributes significantly towards a large part of the worldwide epidemic of hypertension (HTN) and its associated complications. As, there are limited longitudinal studies available in India to understand its occurrence over time, this Pan-India longitudinal study will aid to assess the real world outcomes of HTN across the country.</p><p class="abstract"><strong>Methods:</strong> This was a prospective, multi-centered, longitudinal, observational study investigating a large COHORT of people with HTN across India over a period of one year. The primary objective of this study was to evaluate blood pressure (BP) control and clinical outcomes in high-risk hypertensive patients distributed over 5 visits (including baseline visit). The secondary objective is to assess the co-morbidities/risk factors in different clinical settings across India. Participants (4,000) with HTN will be included from 200 centres across India and data will be recorded for the use of anti-hypertensives, demographics, socio-economic status, anthropometric measurements, family history, personal history, risk factors, co-morbid conditions and physician treatment preferences. Overall, clinical practice patterns were assessed for their relationship with clinical outcomes.</p><p class="abstract"><strong>Conclusions: </strong>This study is expected to reveal the trends in complications associated with HTN, treatment strategies used by physicians, and correlation among treatment, control and complications of HTN within the Indian context. The outcome of this study will help to identify the burden of HTN, along with pin-pointing the emergence of early-onset complications and dose titration patterns. This will eventually help to develop person-centred care and facilitate public health agencies to invest appropriate resources in the management of high-risk HTN across India.</p><p class="abstract"><strong>Trial registration:</strong> Since this is a real world evidence study no trial registration was needed as per Indian regulations.</p>

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