scholarly journals Thrombocytopenia as an Indicator of Malaria in Adult Population

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Shiraz Jamal Khan ◽  
Yasir Abbass ◽  
Mumtaz Ali Marwat
Keyword(s):  
Observational Study ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
Adult Population ◽  
Mean Value ◽  
Medical Unit ◽  
Platelet Counts

Objectives. To evaluate the predictive value of thrombocytopenia in malaria. Patients and Methods. It was a prospective observational study on all febrile patients with thrombocytopenia presenting to the Medical Unit of Hayat Abad Medical Complex during November 2008 to November 2010. Results. Of the total of 228 patients with fever and thrombocytopenia, 121 patients (53%) proved to be suffering from malaria. Of them 82 patients (68%) had falciparum malaria while 39 patients (32%) had vivax infection. Of these 121 patients, platelet counts ranged between 25,000 and 150,000/dL with a mean value of 101,000/dL () and a median of 75,000/dL. Of the 107 patients who were not suffering from malaria, the counts ranged between 10,000 and 150,000/dL with a mean value of 58,000/dL () and median of 50,000/dL. Conclusions. The presence of thrombocytopenia may be a predictor of malaria in adult population.

Predictive value of thyroxine for prognosis in pediatric septic shock: a prospective observational study

2020 ◽  
Vol 33 (5) ◽  
pp. 653-659
Author(s):  
Jia Song ◽  
Yun Cui ◽  
Chunxia Wang ◽  
Jiaying Dou ◽  
Huijie Miao ◽  
...  
Keyword(s):  
Septic Shock ◽  
Thyroid Hormone ◽  
Observational Study ◽  
Hospital Mortality ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
Threshold Value ◽  
Nonthyroidal Illness ◽  
Hormone Levels ◽  
Thyroid Hormone Levels

AbstractBackgroundThyroid hormone plays an important role in the adaptation of metabolic function to critically ill. The relationship between thyroid hormone levels and the outcomes of septic shock is still unclear. The aim of this study was to assess the predictive value of thyroid hormone for prognosis in pediatric septic shock.MethodsWe performed a prospective observational study in a pediatric intensive care unit (PICU). Patients with septic shock were enrolled from August 2017 to July 2019. Clinical and laboratory indexes were collected, and thyroid hormone levels were measured on PICU admission.ResultsNinety-three patients who fulfilled the inclusion criteria were enrolled in this study. The incidence of nonthyroidal illness syndrome (NTIS) was 87.09% (81/93) in patients with septic shock. Multivariate logistic regression analysis showed that T4 level was independently associated with in-hospital mortality in patients with septic shock (OR: 0.965, 95% CI: 0.937–0.993, p = 0.017). The area under receiver operating characteristic (ROC) curve (AUC) for T4 was 0.762 (95% CI: 0.655–0.869). The cutoff threshold value of 58.71 nmol/L for T4 offered a sensitivity of 61.54% and a specificity of 85.07%, and patients with T4 < 58.71 nmol/L showed high mortality (60.0%). Moreover, T4 levels were negatively associated with the pediatric risk of mortality III scores (PRISM III), lactate (Lac) level in septic shock children.ConclusionsNonthyroidal illness syndrome is common in pediatric septic shock. T4 is an independent predictor for in-hospital mortality, and patients with T4 < 58.71 nmol/L on PICU admission could be with a risk of hospital mortality.

360 Predictive Value of Clinical Assessment of Severe Frostbite Injury - Preliminary Outcomes from a Prospective Observational Study

2018 ◽  
Vol 39 (suppl_1) ◽  
pp. S150-S150
Author(s):  
A M Lacey ◽  
J C Moore ◽  
A B Whitley ◽  
G Punjabi ◽  
T Masters ◽  
...  
Keyword(s):  
Observational Study ◽  
Clinical Assessment ◽  
Predictive Value ◽  
Prospective Observational Study

scholarly journals Superior Predictive Value for NTproBNP Compared with High Sensitivity cTnT in Dialysis Patients: A Pilot Prospective Observational Study

2014 ◽  
Vol 39 (6) ◽  
pp. 636-647 ◽  
Author(s):  
Luminita Voroneanu ◽  
Dimitrie Siriopol ◽  
Ionut Nistor ◽  
Mugurel Apetrii ◽  
Simona Hogas ◽  
...  
Keyword(s):  
Observational Study ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
High Sensitivity ◽  
Dialysis Patients

scholarly journals Utility of pleural fluid adenosine deaminase in diagnosing tubercular pleural effusion: a prospective observational study in a tertiary care hospital

2019 ◽  
Vol 6 (6) ◽  
pp. 1711
Author(s):  
Gayathri Devi H. J. ◽  
Sujith H.
Keyword(s):  
Pleural Effusion ◽  
Observational Study ◽  
Pleural Fluid ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical History ◽  
Diagnostic Methods ◽  
Care Hospital

Background: The diagnosis of Tubercular (TB) pleural effusion continues to be a challenge in clinical practice, as traditional diagnostic methods are useful but do not provide enough sensitivity and specificity.Methods: This was a prospective observational study carried out at Tertiary care Hospital with study population of 76 patients. Etiological diagnosis was based on clinical history with radiological imaging, biochemical and cytological examination of pleural fluid. Pleural fluid ADA was used as a biomarker for the diagnosis of tubercular pleural effusion.Results: The study included 76 patients with 69.7% (n=53) males and 30.3%(n=23) females. The mean age of patients was 48.97 17.03 years. Of 76 cases of pleural effusion, 62 were exudates and 14 transudates. Tuberculosis was the most common cause among exudates which accounted for 51.3% (n=39) of cases. The sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV), Accuracy of pleural fluid ADA in diagnosing tubercular pleural effusion was 92.3%, 97.3%, 97%, 92% and 94.7% respectively.Conclusions: Pleural fluid ADA can be one of the most reliable biomarkers for the diagnosis of TB pleural effusion considering its high sensitivity and specificity.

Immune (Idiopathic) Thrombocytopenic Purpura (ITP): Treatment Pattern and Splenectomy Rate from a Multinational Prospective Observational Study

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4538-4538
Author(s):  
Francesco Rodeghiero ◽  
Axel C. Matzdorff ◽  
Tiziano Barbui ◽  
Jean- Francois Viallard ◽  
Naveed M. Chowhan ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Intravenous Immunoglobulins ◽  
Treatment Pattern ◽  
Durable Response ◽  
Platelet Counts ◽  
Chronic Itp ◽  
Number Of Patients ◽  
Long Term Treatment ◽  
To Receive

Abstract ITP is an autoimmune disease characterized by low platelet counts due to increased platelet destruction and inadequate platelet production. It is often a chronic disorder that requires long-term treatment. Current common treatment therapies for chronic ITP include corticosteroids, intravenous immunoglobulins (IVIG), rituximab, and anti-D antibody. Splenectomy may be required for those patients who do not respond or relapse after these medical therapies, or require intolerable doses to achieve safe platelet counts. Few studies have reported treatment pattern of current therapies for ITP. We report results of an international multi-center retrospective and prospective observational study of adult patients receiving treatments and/or splenectomy for chronic ITP. Patients with a diagnosis of ITP were enrolled from 100 community and academic centers. Date of 1st ITP diagnosis, treatments received and medical history were obtained retrospectively from patient chart data. ITP treatments, dose, response, and duration of response were collected prospectively for 12 months. Among 326 patients with ITP studied (mean age=54 years, male 40.2%), 24% received a splenectomy during this study. In patients who were not splenectomized (n=248), 77% received ITP medications with corticosteroids being the most frequently prescribed medication among patients who received 1 type of ITP treatment. IVIG was most frequently prescribed in patients who received 2 types of ITP treatments, and patients were most likely to receive a splenectomy after receiving 2 or more types of ITP treatments (table). In splenectomized patients, the average duration from ITP diagnosis to splenectomy was 2.79 years (n=74, SD=4.42, min=0, max=23.38). Prior to surgery, splenectomized patients were most likely to receive corticosteroids in patients receiving 1 type of treatment, and IVIG in patients receiving 2 types of ITP treatments. Following surgery, splenectomized patients were also most likely to receive corticosteroids in patients receiving 1 type of ITP medication, and rituximab in patients with 2 types of ITP medications. Overall, patients with ITP are exposed to numerous ITP treatments, among which, corticosteroids were most frequently used in both splenectomized and non-splenectomized patients. All patients receiving a splenectomy also required 1 or more ITP treatments following surgery. These results demonstrate that current ITP therapies are limited in efficacy and durability and often lead to patients receiving multiple types of ITP treatments. Novel ITP therapies with better efficacy and durable response are needed. Splenectomizedb(N=78) ITP Treatments Received Overall (N=326) Pre-Splenectomy (N=74) Post-Splenectomy (N=74) Non-Splenectomized (N=248) aMost frequently used treatment or therapy observed within that subgroup (receiving 1, 2, 3, 4 or more treatments). Percentages (%) are calculated as n divided by the total number of patients within the corresponding subgroup. b4 splenectomized patients were excluded from the analysis due to missing data. 0 58 (18) 0 0 58 (23) 1 89 (27) 23 (31) 37 (50) 83 (33) Exposure Rate n(%) 2 82 (25) 15 (20) 17 (23) 62 (25) 3 49 (15) 18 (24) 11 (15) 27 (11) 4 or More 48 (15) 18 (24) 9 (12) 18 (7) 1 Corticosteroids (71%) Corticosteroids (57%) Corticosteroids (22%) Corticosteroids (76%) Most Frequently Used Therapy (%)a 2 IVIG (39%) IVIG (73%) Rituximab (24%) IVIG (52%) 3 Splenectomy (45%) IVIG (56%) IVIG (27%) IVIG (52%) 4 or More Splenectomy (63%) Rituximab (11%) Vincristine (22%) Rituximab (78%)

scholarly journals Prevention of postoperative bleeding after complex pediatric cardiac surgery by early administration of fibrinogen, prothrombin complex and platelets: a prospective observational study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nils Dennhardt ◽  
Robert Sümpelmann ◽  
Alexander Horke ◽  
Oliver Keil ◽  
Katja Nickel ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Observational Study ◽  
Blood Volume ◽  
Prospective Observational Study ◽  
Postoperative Bleeding ◽  
Maximum Amplitude ◽  
Mean Value ◽  
Pediatric Cardiac Surgery ◽  
Early Administration ◽  
Coagulation Parameters

Abstract Background Postoperative bleeding is a major problem in children undergoing complex pediatric cardiac surgery. The primary aim of this prospective observational study was to evaluate the effect of an institutional approach consisting of early preventive fibrinogen, prothrombin complex and platelets administration on coagulation parameters and postoperative bleeding in children. The secondary aim was to study the rate of re-intervention and postoperative transfusion, the occurrence of thrombosis, length of mechanical ventilation, ICU stay and mortality. Methods In fifty children (age 0–6 years) with one or more predefined risk factors for bleeding after cardiopulmonary bypass (CPB), thrombelastography (TEG) and standard coagulation parameters were measured at baseline (T1), after CPB and reversal of heparin (T2), at sternal closure (T3) and after 12 h in the ICU (T4). Clinical bleeding was evaluated by the surgeon at T2 and T3 using a numeric rating scale (NRS, 0–10). Results After CPB and early administration of fibrinogen, prothrombin complex and platelets, the clinical bleeding evaluation score decreased from a mean value of 6.2 ± 1.9 (NRS) at T2 to a mean value of 2.1 ± 0.8 at T3 (NRS; P <  0.001). Reaction time (R), kinetic time (K), maximum amplitude (MA) and maximum amplitude of fibrinogen (MA-fib) improved significantly (P <  0.001 for all), and MA-fib correlated significantly with the clinical bleeding evaluation (r = 0.70, P <  0.001). The administered total amount of fibrinogen (mg kg− 1) correlated significantly with weight (r = − 0.42, P = 0.002), priming volume as percentage of estimated blood volume (r = 0.30, P = 0.034), minimum CPB temperature (r = − 0.30, P = 0.033) and the change in clinical bleeding evaluation from T2 to T3 (r = 0.71, P <  0.001). The incidence of postoperative bleeding (> 10% of estimated blood volume) was 8%. No child required a surgical re-intervention, and no cases of thrombosis were observed. Hospital mortality was 0%. Conclusion In this observational study of children with an increased risk of bleeding after CPB, an early preventive therapy with fibrinogen, prothrombin complex and platelets guided by clinical bleeding evaluation and TEG reduced bleeding and improved TEG and standard coagulation parameters significantly, with no occurrence of thrombosis or need for re-operation. Trial registration German Clinical Trials Register DRKS00018109 (retrospectively registered 27th August 2019).

scholarly journals The utility of a shortened palliative care screening tool to predict death within 12 months – a prospective observational study in two south African hospitals with a high HIV burden

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Peter J. Raubenheimer ◽  
Cascia Day ◽  
Faried Abdullah ◽  
Katherine Manning ◽  
Clint Cupido ◽  
...  
Keyword(s):  
South Africa ◽  
Observational Study ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
Screening Tool ◽  
Young Patients ◽  
Public Hospitals ◽  
Mortality Data ◽  
Hospitalised Patients ◽  
Identification Tool

Abstract Background Timely identification of people who are at risk of dying is an important first component of end-of-life care. Clinicians often fail to identify such patients, thus trigger tools have been developed to assist in this process. We aimed to evaluate the performance of a identification tool (based on the Gold Standards Framework Prognostic Indicator Guidance) to predict death at 12 months in a population of hospitalised patients in South Africa. Methods Patients admitted to the acute medical services in two public hospitals in Cape Town, South Africa were enrolled in a prospective observational study. Demographic data were collected from patients and patient notes. Patients were assessed within two days of admission by two trained clinicians who were not the primary care givers, using the identification tool. Outcome mortality data were obtained from patient folders, the hospital electronic patient management system and the Western Cape Provincial death registry which links a unique patient identification number with national death certificate records and system wide electronic records. Results 822 patients (median age of 52 years), admitted with a variety of medical conditions were assessed during their admission. 22% of the cohort were HIV-infected. 218 patients were identified using the screening tool as being in the last year of their lives. Mortality in this group was 56% at 12 months, compared with 7% for those not meeting any criteria. The specific indicator component of the tool performed best in predicting death in both HIV-infected and HIV-uninfected patients, with a sensitivity of 74% (68–81%), specificity of 85% (83–88%), a positive predictive value of 56% (49–63%) and a negative predictive value of 93% (91–95%). The hazard ratio of 12-month mortality for those identified vs not was 11.52 (7.87–16.9, p < 0.001). Conclusions The identification tool is suitable for use in hospitals in low-middle income country setting that have both a high communicable and non-communicable disease burden amongst young patients, the majority under age 60.

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