摘要 :
Emerging infectious diseases are becoming more and more important throughout the world. Emerging or reemerging infectious diseases are characterized by a high and rapid increase of their incidence and by the uncertainty about thei...
展开
Emerging infectious diseases are becoming more and more important throughout the world. Emerging or reemerging infectious diseases are characterized by a high and rapid increase of their incidence and by the uncertainty about their exact impact on humans or on animals or on both in the case of zoonoses. In this paper, the conditions or of emergence and reemergence are presented and classified according to three parameters: the environment, host(s) and pathogen. Two examples of emerging diseases are presented: the first one concerns SARS in humans with the identification of potential animal reservoirs and the second one concerns the bluetongue virus, which has emerged recently in ruminants in Europe. The early identification, control and prevention of emerging and reemerging infectious diseases lies not only with clinicians and public health experts, but importantly with veterinarians, animal scientists and wildlife ecologists; surveillance of perturbations in ecosystems and surveillance of the animal and human health continuum must be done at the local, national and international levels to ensure that we are well prepared for future emerging threats.
收起
摘要 :
To evaluate the impact of a collaborative programme for the early recognition and management of patients admitted with sepsis in the northwest of England.14 hospitals in the northwest of England.A quality improvement programme (Ad...
展开
To evaluate the impact of a collaborative programme for the early recognition and management of patients admitted with sepsis in the northwest of England.14 hospitals in the northwest of England.A quality improvement programme (Advancing Quality (AQ) Sepsis) that promoted a sepsis care bundle including time-based recording of early warning scores, documenting systemic inflammatory response syndrome criteria and suspected source of infection, taking of blood cultures, measuring serum lactate levels, administration of intravenous antibiotics, administration of oxygen, fluid resuscitation, measurement of fluid balance and senior review.Inpatient mortality, 30-day readmission rates and duration of hospital ≥10 days.Data for 7776 patients were included in this study between 1 July 2014 and 29 December 2015. Participation in the AQ Sepsis programme was associated with a reduction in readmissions within 30 days (OR 0.81 (0.69–0.95)) and hospital stays over 10 days (OR 0.69 (0.60–0.78)). However, there was no reduction in mortality. Administration of a second litre of intravenous fluid within 2?hours, oxygen therapy and review by a senior clinician were associated with increased mortality. Starting a fluid balance chart within 4?hours was the only clinical process measure that did not affect mortality. Taking a blood culture sample, administering antibiotic therapy and measuring serum lactate within 3?hours of hospital arrival were all associated with reduced mortality (OR 0.69 (0.59–0.81), OR 0.77 (0.67–0.89) and OR 0.64 (0.54–0.77), respectively) and shorter hospitalisations (OR 0.58 (0.49–0.69), OR0.81 (0.70–0.94) and OR 0.54 (0.45–0.66), respectively). However, none of these measures had an impact on the risk of readmission to hospital within 30 days.The AQ Sepsis collaborative in northwest of England improved readmission and length of stay for patients admitted with sepsis but did not affect mortality. Further cost-effectiveness evaluation of the programme is needed.
收起
摘要 :
To describe the diagnostic value of the absolute band count (ABC) and ratio of immature to total neutrophils (I:T) for invasive bacterial infections (IBIs; bacterial meningitis and bacteraemia) among young febrile infants.We perfo...
展开
To describe the diagnostic value of the absolute band count (ABC) and ratio of immature to total neutrophils (I:T) for invasive bacterial infections (IBIs; bacterial meningitis and bacteraemia) among young febrile infants.We performed a cross-sectional study in a paediatric emergency department of febrile infants ≤60 days over 12 years to evaluate the accuracy of the ABC and I:T for IBI.Of 2930 included patients, 75 (2.6%) had IBIs. The area under the curve (AUC; 95% CI) for ABC was 0.69 (0.62 to 0.76) with sensitivity 0.27 (0.17 to 0.38) and specificity 0.94 (0.93 to 0.95) at cutoff ≥1500?cells/μL. The AUC for I:T was 0.65 (0.59 to 0.72) with sensitivity 0.29 (0.19 to 0.41) and specificity 0.88 (0.87 to 0.89) at cutoff ≥0.2. Only the ABC in infants 29–60 days was minimally accurate.The ABC and I:T were generally inaccurate for detecting IBI in febrile infants. Guidelines without these parameters may be better for risk assessment.
收起
摘要 :
he medical development brought about by the progress of science and technology has made great contributions to the improvement of diagnosis and treatment of many diseases including infection. However, it is undeniable that infecti...
展开
he medical development brought about by the progress of science and technology has made great contributions to the improvement of diagnosis and treatment of many diseases including infection. However, it is undeniable that infection is still an important disease threatening human beings. Even the most advanced technique of pathogen identification still cannot change the model of empirical treatment and comprehensive judgment, which is the main module of early diagnosis and treatment of infectious diseases (ID). Therefore, how to improve the comprehensive diagnosis and treatment of ID by clinicians is very important in the early diagnosis and treatment, especially in the current situation of general lack of ID specialists in our country. This article is to combine basic skills of clinical practice and international advanced experience to sort out the diagnosis and treatment of ID, in order to provide a feasible reference for clinicians.
收起
摘要 :
Transplant recipients are vulnerable to infections, including COVID-19, given their comorbidities and chronic immunosuppression. In this study, all hospitalized renal transplant recipients (RTR) with a positive nasal swab for Seve...
展开
Transplant recipients are vulnerable to infections, including COVID-19, given their comorbidities and chronic immunosuppression. In this study, all hospitalized renal transplant recipients (RTR) with a positive nasal swab for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV2) seen consecutively between 03/01/2020 and 05/01/2020 at the Detroit Medical Center were included. Data on demographics, clinical presentation, laboratory findings, management, and outcomes were collected. Twenty-five patients were included, all African American (AA) and deceased-donor transplant recipients. The most common presenting symptom was dyspnea, followed by fever, cough and diarrhea. Multifocal opacities on initial chest x-ray were seen in 52% patients and 44% of patients had a presenting oxygen saturation of less than or equal to 94%. Four patients (16%) required transfer to the intensive care unit, one required intubation and one expired. COVID-19-infected RTR in this cohort had low mortality of 4% (n = 1). Despite multiple comorbidities and chronic immunosuppression, our cohort of African American RTR had favorable outcomes compared to other reports on COVID-19 in RTR.
收起
摘要 :
Das Infektionsschutzgesetz wurde zum 01.01.2001 in Deutschland eingeführt. Es beinhaltet auch eine Meldepflicht für Einrichtungen der pathologisch-anatomischen Diagnostik. Alle während der letzten 45 Monate seit Inkrafttreten d...
展开
Das Infektionsschutzgesetz wurde zum 01.01.2001 in Deutschland eingeführt. Es beinhaltet auch eine Meldepflicht für Einrichtungen der pathologisch-anatomischen Diagnostik. Alle während der letzten 45 Monate seit Inkrafttreten diagnostizierten meldepflichtigen Krankheiten und Krankheitserreger wurden in dieser Arbeit ausgewertet.Zur Gruppe der meldepflichtigen Krankheiten mit tödlichem Verlauf nach § 6 gehörten 3 Meningokokkensepsis-, 13 Tuberkulose- und 5 Creutzfeldt-Jacob-Fälle. Von den gesicherten Tuberkulosen wurden 54% zu Lebzeiten nicht diagnostiziert. Bei den meldepflichtigen Krankheitserregern nach § 7 Abs. 1 handelte es sich 92-mal um den Mycobacterium-tuberculosis-Komplex, 2-mal um Influenzaviren und je einmal um eine Kryptosporidiose bzw. Giardia lamblia. Nach § 7 Abs. 2 gemeldet wurden 6 Echinococcus-granulosus-Zysten.
收起
原文获取