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Norio Ohmagari - One of the best experts on this subject based on the ideXlab platform.
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role of classic signs as diagnostic predictors for enteric fever among returned travellers relative bradycardia and Eosinopenia
PLOS ONE, 2017Co-Authors: Takashi Matono, Satoshi Kutsuna, Yasuyuki Kato, Yuichi Katanami, Kei Yamamoto, Nozomi Takeshita, Kayoko Hayakawa, Shuzo Kanagawa, Mitsuo Kaku, Norio OhmagariAbstract:BACKGROUND The lack of characteristic clinical findings and accurate diagnostic tools has made the diagnosis of enteric fever difficult. We evaluated the classic signs of relative bradycardia and Eosinopenia as diagnostic predictors for enteric fever among travellers who had returned from the tropics or subtropics. METHODS This matched case-control study used data from 2006 to 2015 for culture-proven enteric fever patients as cases. Febrile patients (>38.3°C) with non-enteric fever, who had returned from the tropics or subtropics, were matched to the cases in a 1:3 ratio by age (±3 years), sex, and year of diagnosis as controls. Cunha's criteria were used for relative bradycardia. Absolute Eosinopenia was defined as an eosinophilic count of 0/μL. RESULTS Data from 160 patients (40 cases and 120 controls) were analysed. Cases predominantly returned from South Asia (70% versus 18%, p <0.001). Relative bradycardia (88% versus 51%, p <0.001) and absolute Eosinopenia (63% versus 38%, p = 0.008) were more frequent in cases than controls. In multivariate logistic regression analysis, return from South Asia (aOR: 21.6; 95% CI: 7.17-64.9) and relative bradycardia (aOR: 11.7; 95% CI: 3.21-42.5) were independent predictors for a diagnosis of enteric fever. The positive likelihood ratio was 4.00 (95% CI: 2.58-6.20) for return from South Asia, 1.72 (95% CI: 1.39-2.13) for relative bradycardia, and 1.63 (95%CI: 1.17-2.27) for absolute Eosinopenia. The negative predictive values of the three variables were notably high (83-92%);. however, positive predictive values were 35-57%. CONCLUSIONS The classic signs of relative bradycardia and Eosinopenia were not specific for enteric fever; however both met the criteria for being diagnostic predictors for enteric fever. Among febrile returned travellers, relative bradycardia and Eosinopenia should be re-evaluated for predicting a diagnosis of enteric fever in non-endemic areas prior to obtaining blood cultures.
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Role of classic signs as diagnostic predictors for enteric fever among returned travellers: Relative bradycardia and Eosinopenia.
PloS one, 2017Co-Authors: Takashi Matono, Satoshi Kutsuna, Yasuyuki Kato, Yuichi Katanami, Kei Yamamoto, Nozomi Takeshita, Kayoko Hayakawa, Shuzo Kanagawa, Mitsuo Kaku, Norio OhmagariAbstract:BACKGROUND The lack of characteristic clinical findings and accurate diagnostic tools has made the diagnosis of enteric fever difficult. We evaluated the classic signs of relative bradycardia and Eosinopenia as diagnostic predictors for enteric fever among travellers who had returned from the tropics or subtropics. METHODS This matched case-control study used data from 2006 to 2015 for culture-proven enteric fever patients as cases. Febrile patients (>38.3°C) with non-enteric fever, who had returned from the tropics or subtropics, were matched to the cases in a 1:3 ratio by age (±3 years), sex, and year of diagnosis as controls. Cunha's criteria were used for relative bradycardia. Absolute Eosinopenia was defined as an eosinophilic count of 0/μL. RESULTS Data from 160 patients (40 cases and 120 controls) were analysed. Cases predominantly returned from South Asia (70% versus 18%, p
Kenneth B Christopher - One of the best experts on this subject based on the ideXlab platform.
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Eosinopenia and post hospital outcomes in critically ill non cardiac vascular surgery patients
Nutrition Metabolism and Cardiovascular Diseases, 2019Co-Authors: Gerdine C I Von Meijenfeldt, Sowmya Chary, M J Van Der Laan, Clark J Zeebregts, Kenneth B ChristopherAbstract:BACKGROUND AND AIMS Eosinopenia is a marker for acute inflammation. We hypothesized that Eosinopenia at Intensive Care Unit (ICU) admission in vascular surgery patients who receive critical care, would be associated with increased mortality following hospital discharge. METHODS AND RESULTS We performed a two-center observational cohort study of critically ill, non-cardiac adult vascular surgery patients who received treatment in Boston between 1997 and 2012 and survived hospital admission. The consecutive sample included 5083 patients (male 57%, white 82%, mean age [SD] 61.6 [17.4] years). The exposure was Absolute eosinophil count measured within 24 h of admission to the ICU and categorized as ≤10 cells/μL, 11-50 cells/μL, 51-100 cells/μL, 101-350 cells/μL (normal range), and >350 cells/μL. The primary outcome was all-cause mortality within 90 days of hospital discharge. The secondary outcome was discharge to home following hospitalization. 90-day post-discharge mortality was 6.7%, and 12.9% of patients were readmitted within 30 days. After multivariable adjustment, patients with Eosinopenia (≤10 cells/μL) have a 90-day post-discharge mortality OR of 1.97 (95%CI 1.42, 2.73; P < 0.001) relative to patients with an absolute eosinophil count of 101-350 cells/μL. Further, after multivariable adjustment, patients with Eosinopenia (≤10 cells/μL) have a 25% lower odds of discharge to home compared to patients with an absolute eosinophil count of 101-350 cells/μL [OR = 0.71 (CI 95% 0.59-0.85); P < 0.001]. CONCLUSION Eosinopenia at ICU admission is a robust predictor of increased mortality and lower likelihood of discharge to home in vascular surgery patients treated with critical care who survive hospitalization.
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Eosinopenia and post-hospital outcomes in critically ill non-cardiac vascular surgery patients.
Nutrition metabolism and cardiovascular diseases : NMCD, 2019Co-Authors: Gerdine C I Von Meijenfeldt, Sowmya Chary, M J Van Der Laan, Clark J Zeebregts, Kenneth B ChristopherAbstract:BACKGROUND AND AIMS Eosinopenia is a marker for acute inflammation. We hypothesized that Eosinopenia at Intensive Care Unit (ICU) admission in vascular surgery patients who receive critical care, would be associated with increased mortality following hospital discharge. METHODS AND RESULTS We performed a two-center observational cohort study of critically ill, non-cardiac adult vascular surgery patients who received treatment in Boston between 1997 and 2012 and survived hospital admission. The consecutive sample included 5083 patients (male 57%, white 82%, mean age [SD] 61.6 [17.4] years). The exposure was Absolute eosinophil count measured within 24 h of admission to the ICU and categorized as ≤10 cells/μL, 11-50 cells/μL, 51-100 cells/μL, 101-350 cells/μL (normal range), and >350 cells/μL. The primary outcome was all-cause mortality within 90 days of hospital discharge. The secondary outcome was discharge to home following hospitalization. 90-day post-discharge mortality was 6.7%, and 12.9% of patients were readmitted within 30 days. After multivariable adjustment, patients with Eosinopenia (≤10 cells/μL) have a 90-day post-discharge mortality OR of 1.97 (95%CI 1.42, 2.73; P
Pinillos Rojas, Maria Alejandra - One of the best experts on this subject based on the ideXlab platform.
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Utilidad de la Eosinopenia como predictor de mortalidad en niños con sepsis severa del Hospital Belen de Trujillo
Universidad Privada Antenor Orrego - UPAO, 2016Co-Authors: Pinillos Rojas, Maria AlejandraAbstract:engOBJECTIVE: To determine the utility of Eosinopenia as a predictor of mortality in children with severe sepsis in Hospital Belen de Trujillo, in the period January 2010 - December 2015. MATERIAL AND METHODS: Retrospective, observational, diagnosis test study to aplicate in 104 patients, that were divided into 2 groups: death patients for severe sepsis 34 patients) and survivos (70 patients).We calculated the sensivity, specificity, positive and negative predictive value. We applied the Chi Square test, T Student and the area under the curve. We used SPSS 23.0 statistical. RESULTS: The mean age was 29.6 months, and the group who dies14.12 months (CI: 8.6 to 19.6 SD 15.8). It was found a 47.8% with regard to the distribution of Eosinopenia and mortality, with a sensitivity of 65%, specificity of 66% (p
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Utilidad de la Eosinopenia como predictor de mortalidad en niños con sepsis severa del hospital Belén de Trujillo
Universidad Privada Antenor Orrego - UPAO, 2016Co-Authors: Pinillos Rojas, Maria AlejandraAbstract:Determinar si la Eosinopenia tiene utilidad como predictor de mortalidad en niños con sepsis severa del Hospital Belén de Trujillo, en el periodo Enero del 2010 – Diciembre 2015. MATERIAL Y MÉTODO: Un Estudio retrospectivo, observacional, de pruebas diagnósticas, en 104 pacientes, divididos en 2 grupos: Pacientes con sepsis severa fallecidos (34 pacientes) y sobrevivientes (70 pacientes). Se calculó la sensibilidad, especificidad, valor predictivo positivo y negativo para determinar aquel que ofreciera mayor validez predictiva de mortalidad. Se aplicó el test de Chi Cuadrado, T Student y la curva Roc. Se utilizó los paquetes estadísticos a base del SPSS 23.0. RESULTADOS: La edad promedio fue 29,6 meses, y para el grupo de fallecidos 14,12 meses (CI:8,6 – 19,6 DS: 15,8). Se encontró un 47,8% con respecto a la distribución de Eosinopenia y su mortalidad, con una sensibilidad de 65%, especificidad de 66% (p
Takashi Matono - One of the best experts on this subject based on the ideXlab platform.
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role of classic signs as diagnostic predictors for enteric fever among returned travellers relative bradycardia and Eosinopenia
PLOS ONE, 2017Co-Authors: Takashi Matono, Satoshi Kutsuna, Yasuyuki Kato, Yuichi Katanami, Kei Yamamoto, Nozomi Takeshita, Kayoko Hayakawa, Shuzo Kanagawa, Mitsuo Kaku, Norio OhmagariAbstract:BACKGROUND The lack of characteristic clinical findings and accurate diagnostic tools has made the diagnosis of enteric fever difficult. We evaluated the classic signs of relative bradycardia and Eosinopenia as diagnostic predictors for enteric fever among travellers who had returned from the tropics or subtropics. METHODS This matched case-control study used data from 2006 to 2015 for culture-proven enteric fever patients as cases. Febrile patients (>38.3°C) with non-enteric fever, who had returned from the tropics or subtropics, were matched to the cases in a 1:3 ratio by age (±3 years), sex, and year of diagnosis as controls. Cunha's criteria were used for relative bradycardia. Absolute Eosinopenia was defined as an eosinophilic count of 0/μL. RESULTS Data from 160 patients (40 cases and 120 controls) were analysed. Cases predominantly returned from South Asia (70% versus 18%, p <0.001). Relative bradycardia (88% versus 51%, p <0.001) and absolute Eosinopenia (63% versus 38%, p = 0.008) were more frequent in cases than controls. In multivariate logistic regression analysis, return from South Asia (aOR: 21.6; 95% CI: 7.17-64.9) and relative bradycardia (aOR: 11.7; 95% CI: 3.21-42.5) were independent predictors for a diagnosis of enteric fever. The positive likelihood ratio was 4.00 (95% CI: 2.58-6.20) for return from South Asia, 1.72 (95% CI: 1.39-2.13) for relative bradycardia, and 1.63 (95%CI: 1.17-2.27) for absolute Eosinopenia. The negative predictive values of the three variables were notably high (83-92%);. however, positive predictive values were 35-57%. CONCLUSIONS The classic signs of relative bradycardia and Eosinopenia were not specific for enteric fever; however both met the criteria for being diagnostic predictors for enteric fever. Among febrile returned travellers, relative bradycardia and Eosinopenia should be re-evaluated for predicting a diagnosis of enteric fever in non-endemic areas prior to obtaining blood cultures.
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Role of classic signs as diagnostic predictors for enteric fever among returned travellers: Relative bradycardia and Eosinopenia.
PloS one, 2017Co-Authors: Takashi Matono, Satoshi Kutsuna, Yasuyuki Kato, Yuichi Katanami, Kei Yamamoto, Nozomi Takeshita, Kayoko Hayakawa, Shuzo Kanagawa, Mitsuo Kaku, Norio OhmagariAbstract:BACKGROUND The lack of characteristic clinical findings and accurate diagnostic tools has made the diagnosis of enteric fever difficult. We evaluated the classic signs of relative bradycardia and Eosinopenia as diagnostic predictors for enteric fever among travellers who had returned from the tropics or subtropics. METHODS This matched case-control study used data from 2006 to 2015 for culture-proven enteric fever patients as cases. Febrile patients (>38.3°C) with non-enteric fever, who had returned from the tropics or subtropics, were matched to the cases in a 1:3 ratio by age (±3 years), sex, and year of diagnosis as controls. Cunha's criteria were used for relative bradycardia. Absolute Eosinopenia was defined as an eosinophilic count of 0/μL. RESULTS Data from 160 patients (40 cases and 120 controls) were analysed. Cases predominantly returned from South Asia (70% versus 18%, p
Gerdine C I Von Meijenfeldt - One of the best experts on this subject based on the ideXlab platform.
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Eosinopenia and post hospital outcomes in critically ill non cardiac vascular surgery patients
Nutrition Metabolism and Cardiovascular Diseases, 2019Co-Authors: Gerdine C I Von Meijenfeldt, Sowmya Chary, M J Van Der Laan, Clark J Zeebregts, Kenneth B ChristopherAbstract:BACKGROUND AND AIMS Eosinopenia is a marker for acute inflammation. We hypothesized that Eosinopenia at Intensive Care Unit (ICU) admission in vascular surgery patients who receive critical care, would be associated with increased mortality following hospital discharge. METHODS AND RESULTS We performed a two-center observational cohort study of critically ill, non-cardiac adult vascular surgery patients who received treatment in Boston between 1997 and 2012 and survived hospital admission. The consecutive sample included 5083 patients (male 57%, white 82%, mean age [SD] 61.6 [17.4] years). The exposure was Absolute eosinophil count measured within 24 h of admission to the ICU and categorized as ≤10 cells/μL, 11-50 cells/μL, 51-100 cells/μL, 101-350 cells/μL (normal range), and >350 cells/μL. The primary outcome was all-cause mortality within 90 days of hospital discharge. The secondary outcome was discharge to home following hospitalization. 90-day post-discharge mortality was 6.7%, and 12.9% of patients were readmitted within 30 days. After multivariable adjustment, patients with Eosinopenia (≤10 cells/μL) have a 90-day post-discharge mortality OR of 1.97 (95%CI 1.42, 2.73; P < 0.001) relative to patients with an absolute eosinophil count of 101-350 cells/μL. Further, after multivariable adjustment, patients with Eosinopenia (≤10 cells/μL) have a 25% lower odds of discharge to home compared to patients with an absolute eosinophil count of 101-350 cells/μL [OR = 0.71 (CI 95% 0.59-0.85); P < 0.001]. CONCLUSION Eosinopenia at ICU admission is a robust predictor of increased mortality and lower likelihood of discharge to home in vascular surgery patients treated with critical care who survive hospitalization.
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Eosinopenia and post-hospital outcomes in critically ill non-cardiac vascular surgery patients.
Nutrition metabolism and cardiovascular diseases : NMCD, 2019Co-Authors: Gerdine C I Von Meijenfeldt, Sowmya Chary, M J Van Der Laan, Clark J Zeebregts, Kenneth B ChristopherAbstract:BACKGROUND AND AIMS Eosinopenia is a marker for acute inflammation. We hypothesized that Eosinopenia at Intensive Care Unit (ICU) admission in vascular surgery patients who receive critical care, would be associated with increased mortality following hospital discharge. METHODS AND RESULTS We performed a two-center observational cohort study of critically ill, non-cardiac adult vascular surgery patients who received treatment in Boston between 1997 and 2012 and survived hospital admission. The consecutive sample included 5083 patients (male 57%, white 82%, mean age [SD] 61.6 [17.4] years). The exposure was Absolute eosinophil count measured within 24 h of admission to the ICU and categorized as ≤10 cells/μL, 11-50 cells/μL, 51-100 cells/μL, 101-350 cells/μL (normal range), and >350 cells/μL. The primary outcome was all-cause mortality within 90 days of hospital discharge. The secondary outcome was discharge to home following hospitalization. 90-day post-discharge mortality was 6.7%, and 12.9% of patients were readmitted within 30 days. After multivariable adjustment, patients with Eosinopenia (≤10 cells/μL) have a 90-day post-discharge mortality OR of 1.97 (95%CI 1.42, 2.73; P