scholarly journals Clinical and Microbiological Characteristics of Visceral Leishmaniasis Outbreak in a Northern Italian Nonendemic Area: A Retrospective Observational Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
E. Franceschini ◽  
C. Puzzolante ◽  
M. Menozzi ◽  
L. Rossi ◽  
A. Bedini ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Observational Study ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Mediterranean Area ◽  
Retrospective Observational Study ◽  
Attributable Mortality ◽  
Microbiological Characteristics ◽  
The One ◽  
Bone Marrow Blood

Background. Visceral leishmaniasis (VL) caused byLeishmania infantumis endemic in the Mediterranean area. In the last decades a northward spread of the parasite has been observed in Italy. This paper describes a VL outbreak in Modena province (Emilia-Romagna, Northern Italy) between 2012 and 2015.Methods. Retrospective, observational study to evaluate epidemiological, microbiological characteristics, and clinical management of VL in patients referring to Policlinico Modena Hospital.Results. Sixteen cases of VL occurred in the study period. An immunosuppressive condition was present in 81.3%. Clinical presentation included anemia, fever, leukopenia, thrombocytopenia, and hepatosplenomegaly. Serology was positive in 73.3% of cases, peripheral blood PCR in 92.3%, and bone marrow blood PCR in 100%. Culture was positive in 3/6 cases (50%) and all the isolates were identified asL. infantumby ITS1/ITS2 sequencing. The median time between symptom onset and diagnosis was 22 days (range 6–131 days). All patients were treated with liposomal amphotericin b. 18.8% had a VL recurrence and were treated with miltefosine. Attributable mortality was 6.3%.Conclusions. VL due toL. infantumcould determine periodical outbreaks, as the one described; thus it is important to include VL in the differential diagnosis of fever of unknown origin, even in low-endemic areas.

scholarly journals Visceral Leishmaniasis in A Patient Presenting with Fever of Unknown Origin: A Case Report From a Low-endemic Region of Turkey

2019 ◽  
Vol 43 (4) ◽  
pp. 210-212
Author(s):  
Muhammed B. Jaiteh ◽  
Nursel Çalık Başaran ◽  
Lale Özışık ◽  
Orkun Akman ◽  
Nasib Hasanlı ◽  
...  
Keyword(s):  
Case Report ◽  
Visceral Leishmaniasis ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Endemic Region

scholarly journals Attributable Mortality of Hip Fracture in Older Patients: A Retrospective Observational Study

2020 ◽  
Vol 9 (8) ◽  
pp. 2370
Author(s):  
Lorène Zerah ◽  
David Hajage ◽  
Mathieu Raux ◽  
Judith Cohen-Bittan ◽  
Anthony Mézière ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Postoperative Complications ◽  
Mortality Rate ◽  
Observational Study ◽  
Older Patients ◽  
Final Analysis ◽  
Primary Objective ◽  
Retrospective Observational Study ◽  
Attributable Mortality ◽  
Baseline Characteristics

Hip fracture (HF) in older patients is associated with a high six-month mortality rate. Several clinical conditions may affect outcome, including baseline characteristics, co-existing acute illnesses, perioperative factors, and postoperative complications. Our primary objective was to estimate the respective effect of these four domains on six-month mortality after HF. A retrospective observational study using a monocentric cohort of older patients was conducted. All patients ≥ 70 years old admitted to the emergency department for HF and hospitalized in our perioperative geriatric care unit from June 2009 to September 2018 were included. Among 1015 included patients, five (0.5%) were lost to follow-up, and 1010 were retained in the final analysis (mean age 86 ± 6 years). The six-month mortality rate was 14.8%. The six-month attributable mortality estimates were as follows: baseline characteristics (including age, gender, comorbidities, autonomy, type of fracture): 62.4%; co-existing acute illnesses (including acute events present before surgery that could result from the fracture or cause it): 0% (not significantly associated with six-month mortality); perioperative factors (including blood transfusion and delayed surgery): 12.3%; severe postoperative complications: 11.9%. Baseline characteristics explained less than two-thirds of the six-month mortality after HF. Optimizing patients care by improving management of perioperative factors and thus decreasing postoperative complications, could reduce by a maximum of one quarter of the six-month mortality rate after HF.

scholarly journals Does the estimation of burn extent at admission differ from the assessment at discharge?

2021 ◽  
Vol 7 ◽  
pp. 205951312110194 ◽  
Author(s):  
Sebastian Holm ◽  
Olof Engström ◽  
Ida Petäjä ◽  
Fredrik Huss
Keyword(s):  
Observational Study ◽  
Total Body Surface Area ◽  
Paediatric Population ◽  
Retrospective Observational Study ◽  
Initial Assessment ◽  
Accurate Estimation ◽  
Paediatric Patients ◽  
Total Body ◽  
Correct Estimation ◽  
The One

Introduction: Estimation of total body surface area (TBSA) burnt and burn depth are among the most central parts of acute burn assessment/treatment as they determine the level and type of care needed. Traditional methods for determining burn extent on admission often lead to inaccurate estimations, especially in paediatric or overweight patients. Aim: To compare %TBSA at admission with validated %TBSA at discharge in different patient populations to investigate if significant over- or underestimation occurs. Method: This retrospective observational study is based on a patient registry of all the patients (n = 863) treated at the Uppsala University Hospital’s Burn Centre between 2010 and 2018. The patients were divided into subgroups based on age, gender, body mass index (BMI) and validated burn extent. The %TBSA estimated at admission was compared to the validated %TBSA in all groups separately. Results: As has been published before, we also found that the %TBSA in paediatric patients was more often overestimated as were the smaller injuries, whereas larger injuries were often underestimated. BMI did not clearly affect the estimations and there was no clear difference between the genders in estimated %TBSA. Conclusion: Inaccurate estimations of %TBSA are common, particularly for paediatric patients and small or large injuries. We recommend a careful accurate approach when calculating %TBSA in the paediatric population to avoid over- and under-resuscitation. Increased education and training are recommended to improve accurate estimation in the future. Lay Summary The correct estimation of both extent and depth of burn is very important. This assessment guides the lever of care needed, the necessary amount of fluid resuscitation, the predicted outcome and more. It has been proven notably difficult to correct assess, especially the extent of a burn. Despite different tools as the “Rule of Nine” (body area divided into multiples of 9% body surfaces), the “Rule of Palm” (Patient’s palm, fingers included, approximates 1% of body surfaces), the Lund & Browder chart (detailed, age-specific body areas) and different more technical solutions. Often inaccurate estimations are done which thus affect the treatment. This depth and extent estimation is usually performed when the patient is admitted. However, it is known that burns change appearance during the first few days of care. In our Burn Center we have also performed this estimation when the patient is discharged. At this point it is known the true extent and depth of the initial burn. In this retrospective observational study, we compared the burn extent estimated on admission with the one on discharge to investigate whether the initial assessment is accurate. This study highlights the issue of frequent inaccurate burn extent estimations, especially in subgroups as overweight patient or pediatric patients.

scholarly journals Fever in the tropics: aetiology and clinical profile of fever of unknown origin in children-a prospective observational study in a tertiary care hospital in South India

2019 ◽  
Vol 6 (5) ◽  
pp. 1834
Author(s):  
Ramachandran Sumathisri ◽  
Karuppiah Pandi ◽  
Sadagopan Srinivasan
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Fever Of Unknown Origin ◽  
Urine Analysis ◽  
Complete Blood Count ◽  
Tertiary Care ◽  
Unknown Origin ◽  
Tuberculin Test ◽  
Care Hospital ◽  
Indian Children

Background: Fever of unknown origin (FUO) is an important cause of morbidity and mortality in children, especially in tropical countries with varied aetiology and clinical presentation. Aim of this study is to determine the aetiology and outcome of FUO in Indian children. Study design is Prospective, observational study.  Methods: We enrolled 75 children aged 1 to 12 years who were admitted with fever >8 days to the paediatric department from January 2015 to August 2016. Initial evaluation included complete blood count, peripheral smear, urine analysis, chest radiography, blood culture and tuberculin test.  Results: In 72 children (96%), a definitive diagnosis could be established, whereas 3 children (4%) remained undiagnosed. Most common aetiology of FUO was infectious disease (90.6%) followed by malignancy (4%) and collagen vascular disease (1.3%). Among the infections group, scrub typhus was found to be the commonest aetiology (52%).Conclusions: Infections were the most common etiological factor for FUO in children aged 1-12 years of our region.

scholarly journals Fever of Unknown Origin and Visceral Leishmaniasis: a Series of 20 Adult Patients

2018 ◽  
Vol 23 (2) ◽  
pp. 92-94
Author(s):  
Hüsnü PULLUKÇU ◽  
Nevin TURGAY ◽  
Meltem IŞIKGÖZ TAŞBAKAN ◽  
Deniz AKYOL ◽  
Oğuz Reşat SİPAHİ ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Adult Patients

scholarly journals ETIOLOGY AND CLINICAL PROFILE OF FEVER OF UNKNOWN ORIGIN IN CHILDREN-A PROSPECTIVE OBSERVATIONAL STUDY IN PEDIATRICS DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2020 ◽  
pp. 1-3
Author(s):  
Raman Paswan ◽  
Ashok KUMAR ◽  
Debarshi Jana
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Fever Of Unknown Origin ◽  
Urine Analysis ◽  
Complete Blood Count ◽  
Unknown Origin ◽  
Tuberculin Test ◽  
Test Results ◽  
Indian Children ◽  
Peripheral Smear

Background: Fever of unknown origin (FUO) is an important cause of morbidity and mortality in children, especially in tropical countries with varied aetiology and clinical presentation. Aim of this study is to determine the aetiology and outcome of FUO in Indian children. Study design is Prospective, observational study. Methods: We enrolled 75 children aged 1 to 12 years who were admitted with fever >8 days to the pediatric department of DMCH, Laheriasarai, Bihar from November 2019 to June 2020. Initial evaluation included complete blood count, peripheral smear, urine analysis, chest radiography, blood culture and tuberculin test. Results: In 72 children (96%), a definitive diagnosis could be established, whereas 3 children (4%) remained undiagnosed. Most common aetiology of FUO was infectious disease (90.6%) followed by malignancy (4%) and collagen vascular disease (1.3%). Among the infections group, scrub typhus was found to be the commonest aetiology (52%). Conclusions: Infections were the most common etiological factor for FUO in children aged 1-12 years of our region.

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