The incidence of several respiratory viral infections has been shown to be related to climate. Because humans spend most of their time indoors, measures of indoor climate, rather than outdoor ...climate, may be better predictors of disease incidence and transmission. Therefore, understanding the relationship between indoor and outdoor climate will help illuminate their influence on the seasonality of diseases caused by respiratory viruses. Indoor‐outdoor relationships between temperature and humidity have been documented in temperate regions, but little information is available for tropical regions, where seasonal patterns of respiratory viral diseases differ. We have examined indoor‐outdoor correlations of temperature, relative humidity (RH), and absolute humidity (AH) over a 1‐year period in each of seven tropical cities. Across all cities, the average monthly indoor temperature was 25 ± 3°C (mean ± standard deviation) with a range of 20–30°C. The average monthly indoor RH was 66 ± 9% with a range of 50–78%, and the average monthly indoor AH was 15 ± 3 g/m3 with a range of 10–23 g/m3. Indoor AH and RH were linearly correlated with outdoor AH when the air conditioning (AC) was off, suggesting that outdoor AH may be a good proxy of indoor humidity in the absence of AC. All indoor measurements were more strongly correlated with outdoor measurements as distance from the equator increased. Such correlations were weaker during the wet season, especially when AC was in operation. These correlations will provide insight for assessing the seasonality of respiratory viral infections using outdoor climate data, which is more widely available than indoor data, even though transmission of these diseases mainly occurs indoors.
Objective.
The DoTT (Decreasing Time to Therapy) project aimed to minimize the interval between fever onset and medical interventions for children with febrile neutropenia. The objective of this ...study was to determine the effect of implementing the DoTT project on the hospital time to antibiotic (TTA) and patient time to arrival (PTA) at the hospital in children with febrile neutropenia admitted to the emergency department.
Methods.
The DoTT project was implemented at a Peruvian hospital and followed the World Health Organization (WHO) multimodal improvement strategy model. Components included creating a healthcare delivery bundle and antibiotic selection pathways, training users of the bundle and pathways, monitoring patient outcomes and obtaining user feedback, encouraging use of the new system, and promoting the integration of DoTT into the institutional culture. Emergency room providers were trained in the care delivery for children with cancer and fever and taught to use the bundle and pathways. DoTT was promoted via pamphlets and posters, with a view to institutionalizing the concept and disseminating it to other hospital services.
Results.
Admission data for 129 eligible patients in our registry were analyzed. The TTA and PTA were compared before and after the DoTT intervention. The median TTA was 146 minutes (interquartile range IQR 97–265 minutes) before the intervention in 99 patients, and 69 minutes (IQR 50–120 minutes) afterwards in 30 patients (
p
<0.01). The median PTA was reduced from 1483 minutes at baseline to 660 minutes after the intervention (
p
<0.01).
Conclusions.
Applying the WHO multimodal improvement strategy model to the care of children with febrile neutropenia arriving at the hospital had a positive impact on the PTA and TTA, thus potentially increasing the survival of these patients.
Abstract
Background: Asthma has been shown to be associated with an increased risk of the 2009 novel H1N1 influenza (H1N1) infection among children. However, little is known about the role of asthma ...in severity of H1N1 infection. Objective: To determine the association between asthma and other atopic conditions and severity of H1N1 infection. Patients and methods: We conducted a population-based case-control study. Cases were all Olmsted County, MN residents admitted to the hospital within a week of a positive test for H1N1. Controls who had a positive H1N1 but were not admitted to hospital were individually matched to cases with regard to birth day, gender, clinic registration date, diagnostic method, and calendar month of influenza testing. Asthma was ascertained using predetermined criteria. Data were fit to conditional logistic regression models. Results: There were 46 eligible individuals admitted to hospitals with H1N1 infection during the study period. Ninety-seven controls were individually matched to their corresponding cases. Among cases, 23 (50%) were male and 29 (63.0%) were Caucasians. The median age at hospitalization was 20.7 years. Twenty-five (54.4%) cases had asthma before the date of hospitalization, compared to 33 (34.0%) controls (matched OR: 2.31; 95% CI, 1.13-4.73; p = 0.02). This association approached statistical significance after adjusting for all pertinent covariates (adjusted matched OR: 2.55; 95% CI, 0.98-6.64; p = 0.055). Conclusion: Asthma may be associated with severe H1N1 infection. In addition to timely influenza vaccination for asthmatics, consideration for prophylactic treatment for unimmunized asthmatics with significant exposure to influenza and immunized asthmatics with early flu-like symptoms should be given.
A recent study showed an increased risk of 2009 novel H1N1 influenza (H1N1) infection among asthmatic children. Little is known whether this is true for other atopic conditions. This study was ...designed to determine the association between atopic dermatitis and/or allergic rhinitis and the risk of H1N1 infection among children. We conducted a case-control study in Olmsted County, MN. We randomly selected children ≤18 years of age with a positive test for H1N1. Controls were randomly selected from a pool of residents with negative H1N1 tests and were matched to cases with regard to birthday, gender, clinic registration date, diagnostic test, and month of influenza testing using frequency matching. We compared the frequency of atopic conditions other than asthma between cases and their matched controls. We enrolled 168 cases and 172 controls. Among cases, 91 (54.2%) were male patients, and 106 (63.1%) were white. The median age of cases was 6.3 years (interquartile range, 3.1-11.5). Among cases, 79 (47.0%) had atopic dermatitis and/or allergic rhinitis diagnosed before or after the index date, whereas 54 (31.4%) controls had such conditions (odds ratio OR, 1.89; 95% CI, 1.15-3.12; p = 0.012, adjusting for asthma status, 2008-2009 seasonal influenza vaccine, time of illness at index date, and other comorbid conditions). History of receiving 2008-2009 seasonal influenza vaccine was associated with H1N1 infection (adjusted OR, 2.06; 95% CI, 1.32-3.28; p = 0.002). Our results suggest an association between H1N1 infection and atopic conditions other than asthma. The association between 2008-2009 seasonal influenza vaccinations and the risk of H1N1 requires further investigation.
Trichoderma longibrachiatum is an emerging pathogen in immunocompromised patients. We report a case of Trichoderma post-operative mediastinitis and peritonitis in a child with complex congenital ...cardiac disease and functional asplenia. The patient was treated unsuccessfully, initially with caspofungin alone followed by a combination of voriconazole (systemic and topical), caspofungin and intraperitoneal amphotericin B.
To assess interobserver reliability of the identification of episodes of the systemic inflammatory response syndrome in critically ill hospitalized infants and children.
Retrospective, ...cross-sectional study of the application of the 2005 consensus definition of systemic inflammatory response syndrome in infants and children by two independent, trained reviewers using information in the electronic medical record.
Eighteen-bed pediatric multidisciplinary medical/surgical pediatric intensive care unit.
A randomly selected sample of children admitted consecutively to the pediatric intensive care unit between May 1 and September 30, 2009.
None.
Sixty infants and children were selected from a total of 343 admitted patients. Their median age was 3.9 yrs (interquartile range, 1.5-12.7), 57% were female, and 68% were Caucasian. Nineteen (32%) children were identified by both reviewers as having an episode of systemic inflammatory response syndrome (88% agreement, 95% confidence interval 78-94; κ = 0.75, 95% confidence interval 0.59-0.92). Among these 19 children, agreement between the reviewers for individual systemic inflammatory response syndrome criteria was: temperature (84%, 95% confidence interval 60-97); white blood cell count (89%, 95% confidence interval 67-99); respiratory rate (84%, 95% confidence interval 60-97); and heart rate (68%, 95% confidence interval 33-87).
Episodes of systemic inflammatory response syndrome in critically ill infants and children can be identified reproducibly using the consensus definition.
Responses to the early (February-July 2020) COVID-19 pandemic varied widely, globally. Reasons for this are multiple but likely relate to the healthcare and financial resources then available, and ...the degree of trust in, and economic support provided by, national governments. Cultural factors also affected how different populations reacted to the various pandemic restrictions, like masking, social distancing and self-isolation or self-quarantine. The degree of compliance with these measures depended on how much individuals valued their needs and liberties over those of their society. Thus, several themes may be relevant when comparing pandemic responses across different regions. East and Southeast Asian populations tended to be more collectivist and self-sacrificing, responding quickly to early signs of the pandemic and readily complied with most restrictions to control its spread. Australasian, Eastern European, Scandinavian, some Middle Eastern, African and South American countries also responded promptly by imposing restrictions of varying severity, due to concerns for their wider society, including for some, the fragility of their healthcare systems. Western European and North American countries, with well-resourced healthcare systems, initially reacted more slowly, partly in an effort to maintain their economies but also to delay imposing pandemic restrictions that limited the personal freedoms of their citizens.
Con el objetivo de determinar la frecuencia viral y las características clínico-epidemiológicas en los episodios de infección respiratoria aguda de pacientes del Instituto Nacional de Salud del Niño ...San Borja en Lima, se analizó la información de los episodios de pacientes que requirieron al menos una prueba de inmunofluorescencia directa desde el 1 de enero del 2017 al 31 de diciembre del 2018. Se identificaron 1153 episodios en 707 pacientes. La mediana de la edad fue de 1 año y el 55% fueron del sexo masculino. La frecuencia viral fue del 13,4%; el virus respiratorio sincitial se identificó en el 10,7% de los episodios. La frecuencia viral fue mayor en los menores de 1 año (16,2%); en aquellos con enfermedad congénita respiratoria (38,9%) y durante el otoño (24,2%). Los síntomas más comunes fueron tos (70,3%) y fiebre (53,4%); y los principales diagnósticos fueron neumonía viral (31,8%) y bronquiolitis (23,4%). Se concluye que la frecuencia viral respiratoria estuvo relacionada con la edad, estacionalidad y patología preexistente.
Here, we report a draft genome sequence of a
bla
KPC-2
-carrying
Citrobacter braakii
isolated from pediatric hospital effluent. Genome CF248 represents a multidrug-resistant
C. braakii
isolate ...derived from a clinical environment in Peru.
ABSTRACT
Here, we report a draft genome sequence of a
bla
KPC-2
-carrying
Citrobacter braakii
isolate from pediatric hospital effluent. Genome CF248 represents a multidrug-resistant
C. braakii
isolate derived from a clinical environment in Peru.
Here, we report a draft genome sequence of a blaKPC-2-carrying Citrobacter braakii isolate from pediatric hospital effluent. Genome CF248 represents a multidrug-resistant C. braakii isolate derived ...from a clinical environment in Peru.
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