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Yasuda I, Sando E. Combined treatment of Japanese spotted fever with tetracycline and fluoroquinolone requires careful evaluation using robust outcomes both in terms of its advantages and disadvantages. Int J Antimicrob Agents 2024; 64:107201. [PMID: 38768739 DOI: 10.1016/j.ijantimicag.2024.107201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/13/2024] [Accepted: 02/23/2024] [Indexed: 05/22/2024]
Affiliation(s)
- Ikkoh Yasuda
- Department of General Internal Medicine and Clinical Infectious Diseases, Fukushima Medical University, Fukushima, Japan; Department of General Internal Medicine and Infectious Diseases, Kita-Fukushima Medical Centre, Fukushima, Japan
| | - Eiichiro Sando
- Department of General Internal Medicine and Clinical Infectious Diseases, Fukushima Medical University, Fukushima, Japan; Department of General Internal Medicine and Infectious Diseases, Kita-Fukushima Medical Centre, Fukushima, Japan.
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Lee SYJ, Alzeen M, Ahmed A. Estimation of racial and language disparities in pediatric emergency department triage using statistical modeling and natural language processing. J Am Med Inform Assoc 2024; 31:958-967. [PMID: 38349846 PMCID: PMC10990499 DOI: 10.1093/jamia/ocae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES The study aims to assess racial and language disparities in pediatric emergency department (ED) triage using analytical techniques and provide insights into the extent and nature of the disparities in the ED setting. MATERIALS AND METHODS The study analyzed a cross-sectional dataset encompassing ED visits from January 2019 to April 2021. The study utilized analytical techniques, including K-mean clustering (KNN), multivariate adaptive regression splines (MARS), and natural language processing (NLP) embedding. NLP embedding and KNN were employed to handle the chief complaints and categorize them into clusters, while the MARS was used to identify significant interactions among the clinical features. The study also explored important variables, including age-adjusted vital signs. Multiple logistic regression models with varying specifications were developed to assess the robustness of analysis results. RESULTS The study consistently found that non-White children, especially African American (AA) and Hispanic, were often under-triaged, with AA children having >2 times higher odds of receiving lower acuity scores compared to White children. While the results are generally consistent, incorporating relevant variables modified the results for specific patient groups (eg, Asians). DISCUSSION By employing a comprehensive analysis methodology, the study checked the robustness of the analysis results on racial and language disparities in pediatric ED triage. The study also recognized the significance of analytical techniques in assessing pediatric health conditions and analyzing disparities. CONCLUSION The study's findings highlight the significant need for equal and fair assessment and treatment in the pediatric ED, regardless of their patients' race and language.
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Affiliation(s)
- Seung-Yup Joshua Lee
- Department of Health Services Administration, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL 35233, United States
| | - Mohammed Alzeen
- Department of Health Services Administration, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL 35233, United States
| | - Abdulaziz Ahmed
- Department of Health Services Administration, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL 35233, United States
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De Meneck F, Santana V, Brioschi GC, Haddad DS, Neves EB, Franco MDC, Brioschi ML. Infrared Imaging of the Brain-Eyelid Thermal Tunnel: A Promising Method for Measuring Body Temperature in Afebrile Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6867. [PMID: 37835137 PMCID: PMC10572929 DOI: 10.3390/ijerph20196867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023]
Abstract
(1) Infrared thermography of the inner canthus of the eye has emerged as a promising tool for temperature screening and fever diagnosis. Its non-invasive nature lends itself well to mass screening in diverse settings such as schools, public transport, and healthcare facilities. Swift and accurate temperature assessment plays a pivotal role in the early identification of potential fever cases, facilitating timely isolation, testing, and treatment, thereby mitigating the risk of disease transmission. Nonetheless, the reliability of this approach in the pediatric population, especially when compared to conventional thermometry methods, remains unexplored. This preliminary study aimed to evaluate the concordance between the temperature of the inner canthus of the eye (Tic,eye), referred to as the brain-eyelid thermal tunnel (BTT°), with axillary and tympanic methods in afebrile children. (2) Methods: A cohort of 36 children, matched in a 1:1 ratio for gender and age, underwent comprehensive assessments encompassing anthropometric data, blood pressure evaluations, axillary (Tax) and tympanic (Tty) temperature measurements, as well as BTT° infrared thermography. (3) Results: The findings revealed a high level of concordance among the tympanic, axillary, and BTT° measurement methods. Bland-Altman plots showed that the bias was minimal, and no statistically significant differences were observed when comparing BTT° with axillary (p = 0.136) and tympanic (p = 0.268) measurements. Passing-Bablok regression scatter plots further confirmed the agreement, aligning the fitted regression line closely with the identity line for both axillary versus BTT° and tympanic (Tty) versus BTT° comparisons. (4) Conclusions: This study holds significant implications for public health, especially in the context of infectious disease outbreaks such as COVID-19. BTT° infrared thermography of the inner canthus of the eye (Tic,eye) reliably measures body temperature in afebrile children in controlled settings; nevertheless, its practical application necessitates the adaptation of biothermodynamic parameters to accommodate diverse environmental conditions.
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Affiliation(s)
- Franciele De Meneck
- Division of Nephrology, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo 04023-062, SP, Brazil
| | - Vinicius Santana
- Division of Psychiatry, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo 04023-062, SP, Brazil;
| | | | - Denise Sabbagh Haddad
- Faculty of Dentistry, University of São Paulo (FOUSP), São Paulo 05508-000, SP, Brazil;
| | - Eduardo Borba Neves
- Graduate Program in Biomedical Engineering, Federal Technological University of Paraná (UTFPR), Curitiba 80230-901, PR, Brazil;
| | - Maria do Carmo Franco
- School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo 04023-062, SP, Brazil;
| | - Marcos Leal Brioschi
- Faculty of Medicine, University of São Paulo (HCFMUSP), São Paulo 05508-000, SP, Brazil
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4
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Kariya R, Kadota T, Okawa R, Ochiai M, Okuda M, Nakano K. Two cases of ectodermal dysplasia diagnosed based on congenital absence of multiple teeth. PEDIATRIC DENTAL JOURNAL 2023. [DOI: 10.1016/j.pdj.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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Dang R, Schroeder AR, Weng Y, Wang ME, Patel AI. A Cross-sectional Study Characterizing Pediatric Temperature Percentiles in Children at Well-Child Visits. Acad Pediatr 2023; 23:287-295. [PMID: 35914730 DOI: 10.1016/j.acap.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/18/2022] [Accepted: 07/22/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Temperature measurement plays a central role in determining pediatric patients' disease risk and management. However, current pediatric temperature thresholds may be outdated and not applicable to children. OBJECTIVE To characterize pediatric temperature norms and variation by patient characteristics, time of measurement, and thermometer route. METHODS In this cross-sectional study, we analyzed 134,641 well-child visits occurring between 2014-2019 at primary care clinics that routinely measured temperature. We performed bivariate and multivariable quantile regressions with clustered standard errors to determine temperature percentiles and variation by age, sex, time of measurement, and thermometer route. We performed sensitivity analyses: 1) using a cohort that excluded visits with infectious diagnoses that could explain temperature aberrations and 2) including clinic as a fixed effect. RESULTS The median rectal temperature for visits of infants ≤12 months old was 37.2˚C, which was 0.4˚C higher than the median axillary temperature. The median axillary temperature for children 1-18 years old was 36.7˚C, which was 0.1˚C lower than the median values of all other routes. The 99th percentile for rectal temperatures in infants was 37.8˚C and the 99.9th percentile for axillary temperatures in children was 38.5˚C. Adjusted analyses did not demonstrate clinically significant variation in temperature by sex, age, or time of measurement. CONCLUSIONS These updated temperature norms can serve as reference values in clinical practice and should be considered in the context of thermometer route used and the clinical condition being evaluated. Variations in temperature values by sex, age, and time of measurement were not clinically significant.
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Affiliation(s)
- Rebecca Dang
- Department of Pediatrics (R Dang, AR Schroeder, ME Wang, AI Patel), Stanford University School of Medicine, Palo Alto, Calif.
| | - Alan R Schroeder
- Department of Pediatrics (R Dang, AR Schroeder, ME Wang, AI Patel), Stanford University School of Medicine, Palo Alto, Calif
| | - Yingjie Weng
- Department of Medicine - Quantitative Sciences Unit (Y Weng), Stanford University School of Medicine, Palo Alto, Calif
| | - Marie E Wang
- Department of Pediatrics (R Dang, AR Schroeder, ME Wang, AI Patel), Stanford University School of Medicine, Palo Alto, Calif
| | - Anisha I Patel
- Department of Pediatrics (R Dang, AR Schroeder, ME Wang, AI Patel), Stanford University School of Medicine, Palo Alto, Calif
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Greene ND, Riley T, Mastroianni R, Billimoria ZC, Enquobahrie DA, Baker C, Gray MM, Umoren RA. Neonatal Vital Sign Trajectories and Risk Factors During Transport Within a Regional Care Network. Air Med J 2022; 41:542-548. [PMID: 36494170 DOI: 10.1016/j.amj.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/15/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The aim of this study was to characterize vital sign abnormalities, trajectories, and related risk factors during neonatal transport. METHODS We performed a retrospective analysis of neonates transported within a US regional care network in 2020 to 2021. Demographic and clinical data were collected from electronic records. Group-based trajectory modeling was applied to identify groups of neonates who followed distinct vital sign trajectories during transport. Patients with conditions likely to impact the assessed vital were excluded. Risk factors for trajectories were examined using modified Poisson regression models. RESULTS Of the 620 neonates in the study, 92% had one abnormal systolic blood pressure (SBP) measure, approximately half had an abnormal heart rate (47%) or temperature (56%), and 28% had an abnormal oxygen saturation measure during transport. Over half (53%) were in a low and decreasing SBP trajectory, and 36% were in a high and increasing heart rate trajectory. Most infants ≤ 28 weeks postmenstrual age had 2 or more concerning vital sign trajectories during transport. CONCLUSION Abnormal vital signs were common during neonatal transport, and potentially negative trajectories in heart rate and SBP were more common than temperature or oxygen saturation. Transport teams should be trained and equipped to detect concerning trends and respond appropriately while en route.
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Affiliation(s)
- Nancy D Greene
- Department of Health Services, University of Washington, Seattle, WA.
| | - Taylor Riley
- Department of Epidemiology, University of Washington, Seattle, WA
| | - Rossella Mastroianni
- Division of Neonatology, University of Washington School of Medicine, Seattle, WA
| | - Zeenia C Billimoria
- Division of Neonatology, University of Washington School of Medicine, Seattle, WA
| | | | | | - Megan M Gray
- Division of Neonatology, University of Washington School of Medicine, Seattle, WA
| | - Rachel A Umoren
- Division of Neonatology, University of Washington School of Medicine, Seattle, WA
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Schroeder AR, Dang R. Defining Normal. JAMA Pediatr 2022; 176:644-645. [PMID: 35467711 DOI: 10.1001/jamapediatrics.2022.0801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Alan R Schroeder
- Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Rebecca Dang
- Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
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Abstract
PURPOSE OF REVIEW Neonates have a high risk of perioperative morbidity and mortality. The NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE) investigated the anesthesia practice, complications and perioperative morbidity and mortality in neonates and infants <60 weeks post menstrual age requiring anesthesia across 165 European hospitals. The goal of this review is to highlight recent publications in the context of the NECTARINE findings and subsequent changes in clinical practice. RECENT FINDINGS A perioperative triad of hypoxia, anemia, and hypotension is associated with an increased overall mortality at 30 days. Hypoxia is frequent at induction and during maintenance of anesthesia and is commonly addressed once oxygen saturation fall below 85%.Blood transfusion practices vary widely variable among anesthesiologists and blood pressure is only a poor surrogate of tissue perfusion. Newer technologies, whereas acknowledging important limitations, may represent the currently best tools available to monitor tissue perfusion. Harmonization of pediatric anesthesia education and training, development of evidence-based practice guidelines, and provision of centralized care appear to be paramount as well as pediatric center referrals and international data collection networks. SUMMARY The NECTARINE provided new insights into European neonatal anesthesia practice and subsequent morbidity and mortality.Maintenance of physiological homeostasis, optimization of oxygen delivery by avoiding the triad of hypotension, hypoxia, and anemia are the main factors to reduce morbidity and mortality. Underlying and preexisting conditions such as prematurity, congenital abnormalities carry high risk of morbidity and mortality and require specialist care in pediatric referral centers.
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An Overview of the Implications for Perianesthesia Nurses in terms of Intraoperative Changes in Temperature and Factors Associated with Unintentional Postoperative Hypothermia. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:6955870. [PMID: 35444780 PMCID: PMC9015883 DOI: 10.1155/2022/6955870] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 11/17/2022]
Abstract
Patients undergo surgery and anaesthesia on a daily basis across the United States and throughout the world. A major source of worry for these patients continues to be inadvertent hypothermia, once core temperature <36°C (96.8°F). Despite well-documented adverse physiological consequences, anaesthesia nurses continue to have a difficult task in keeping patient warmth pre-/peri-/post-surgical procedure. Thermostasis within postoperative patient necessitates the collaboration of many individuals. In order to provide safe and high-quality treatment, it is essential to use the most up-to-date data to guide therapeutic procedures targeted at achieving balance body temperature in surgical patients. Providing a review of the physiology of perioperative temperature variations and the comorbidities linked with accidental intraoperative hypothermia, this article will also provide preventive and treatment methods.
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Rationalization of the Laboratory Diagnosis for Good Management of Malaria: Lessons from Transitional Methods. J Trop Med 2022; 2022:5883173. [PMID: 35502242 PMCID: PMC9056208 DOI: 10.1155/2022/5883173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/27/2021] [Accepted: 04/09/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Malaria is an endemic disease in sub-Saharan Africa. In clinical practice, the main concern is the overdiagnosis of malaria leading to inappropriate drug prescription without laboratory confirmation. Objective This study aimed to evaluate clinical examination reliability compared with translational laboratory methods of malaria diagnosis. Methods The study was conducted in Goundi Hospital among hospitalized patients over a seven-month period. Patients were interviewed, and malaria tests done included the Giemsa-stained thick and thin blood smears. Diagnostic accuracy was analysed by calculating sensitivity, specificity, and predictive values. Results Among 1,874 participants, 674 (35.96%) patients had positive Giemsa-stained thick blood films. The rate of positivity is higher for patients under 5 years of age. The parasite densities were between 160 and 84.000 parasites/μL. The threshold pyrogen of the parasitic density was around 10.000 parasites/μL for patients between 0 and 11 months of age, between 1 and 4 years of age, and between 5 and 14 years of age. This threshold was lower for patients over 15 years of age. The study reported some issues in the findings: 60.88% (607/997) cases of fever without positivity of the blood thick smear and 40.13% (284/674) cases of positivity of the thick drop without fever. The positive predictive value of malaria was between 80 and 85% for patients under 5 years of age. This value is lower for patients between 5 and 14 years of age and patients over 15 years of age. Conclusion A presumptive diagnosis of malaria should be confirmed by the laboratory in all suspected cases in all possible scenarios. Every parasitemia should be followed by the calculation of parasitic density. However, for the children under 5 years of age in areas of high transmission, the presumptive diagnosis of malaria in certain circumstances could be considered.
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11
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Choi Y, Ahn HY. Axillary temperature measurements based on smart wearable thermometers in South Korean children: comparison with tympanic temperature measurements. CHILD HEALTH NURSING RESEARCH 2022; 28:62-69. [PMID: 35172081 PMCID: PMC8858786 DOI: 10.4094/chnr.2022.28.1.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/11/2021] [Indexed: 11/06/2022] Open
Abstract
Purpose: This study explored the validity of a new type of thermometer and parent satisfaction with the new device. This 24-hour continuous monitoring smart wearable wireless thermometer (TempTraq®) uses a very small semiconductor sensor with a thin patch-like shape.Methods: We obtained 397 sets of TempTraq® axillary temperatures and tympanic temperatures from 44 pediatric patients. Agreement between the axillary and tympanic measurements, as well as the validity of the TempTraq® axillary temperatures, were evaluated. Satisfaction surveys were completed by 41 caregivers after the measurements.Results: The TempTraq® axillary temperatures demonstrated a strong positive correlation with the tympanic temperatures. The Bland-Altman plot and analysis of TempTraq® axillary temperatures and tympanic temperatures showed that the mean difference was +0.45 ℃, the 95% limits of agreement were -0.57 to +1.46 ℃. Based on a tympanic temperature of 38 ℃, the results of validity of fever detection were sensitivity 0.85 and specificity 0.86. Satisfaction scores for TempTraq® temperature measurement were all > 4 points (satisfactory).Conclusion: TempTraq® smart axillary temperature measurement is an appropriate method for measuring children's temperatures since it was highly correlated to tympanic temperatures, had a reliable level of sensitivity and specificity, and could be used safely and conveniently.
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Affiliation(s)
- Younglee Choi
- Lecturer, College of Nursing, Eulji University, Uijeongbu, Korea
| | - Hye Young Ahn
- Professor, College of Nursing, Eulji University, Uijeongbu, Korea
- Corresponding author Hye Young Ahn College of Nursing, Eulji University,712 Dongil-ro, Uijeongbu 11759, Korea TEL: +82-31-951-3813 FAX: +82-31-951-3916 E-MAIL:
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Goggins KA, Tetzlaff EJ, Young WW, Godwin AA. SARS-CoV-2 (Covid-19) workplace temperature screening: Seasonal concerns for thermal detection in northern regions. APPLIED ERGONOMICS 2022; 98:103576. [PMID: 34488191 PMCID: PMC8407948 DOI: 10.1016/j.apergo.2021.103576] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 06/13/2023]
Abstract
Workplace temperature screening has become standard practice during the SARS-CoV-2 pandemic. The objective was to determine the consistency of four temperature devices during exposure to simulated and actual environmental conditions reflective of a workplace. An infrared (IR) digital thermometer (accuracy(A)±0.2), IR laser thermometer (A±1), and thermal imaging camera (A±0.3) were used to measure forehead and tympanic (digital only) temperatures. The first experiment was conducted in a controlled simulated environment (-20 to 20 °C) with three participants (32-YOF, 27-YOM, 20-YOF). The second experiment used actual outdoor conditions (-0.48 to 45.6 °C) with two participants (32-YOF, 27-YOM). The tympanic measurement was the least impacted by environmental temperature (mean(±SD)): simulated (36.8(±0.18) °C) and actual (36.9(±0.16) °C). The thermal imaging camera had the lowest RMSE values (0.81-0.97 °C), with outdoor temperatures ranging from 0 to 45 °C. Environmental temperature influenced forehead temperature readings and required a resting period in a thermoneutral environment (5-9 min (-20 to -10 °C) to immediate (15-20 °C)).
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Affiliation(s)
- Katie A Goggins
- School of Kinesiology & Health Sciences, Laurentian University, Sudbury, Canada; Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, Canada.
| | - Emily J Tetzlaff
- School of Kinesiology & Health Sciences, Laurentian University, Sudbury, Canada; Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, Canada
| | - Wesley W Young
- Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, Canada; Bharti School of Engineering, Laurentian University, Sudbury, Canada
| | - Alison A Godwin
- School of Kinesiology & Health Sciences, Laurentian University, Sudbury, Canada; Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, Canada
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Alayed Y, Kilani MA, Hommadi A, Alkhalifah M, Alhaffar D, Bashir M. Accuracy of the Axillary Temperature Screening Compared to Core Rectal Temperature in Infants. Glob Pediatr Health 2022; 9:2333794X221107481. [PMID: 35755196 PMCID: PMC9218445 DOI: 10.1177/2333794x221107481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/29/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose. To compare the sensitivity of axillary and rectal temperature in infants who presents to the emergency department with a recent history of fever. Methods. A single-center cross-sectional comparative study of 201 patients who presents with a recent history of fever. Infants Up to 12 months of age were included. Demographic characteristics such as age and gender, weight, mean axillary and rectal temperatures were documented. Fever is defined as rectal temperature >38°C as opposed to >37.4 in the axillary method. Results. The mean age was 6.1 ± 3.5 months. The mean (SD) rectal-axillary temperature difference was 0.8°C ± 0.7°C which was statistically significant ( P < .001). The sensitivity, specificity, positive predictive and negative predictive values of the axillary method for fever >37.4 were 79.34% (95% CI [73-84.9]), 14.3% (95% CI [0.36-57.9]), 96.2% (95% CI [95-97.2]), and 2.4% (95% CI [0.4-13.5]), respectively. Conclusion. The rectal method remains highly important for accurate and prompt diagnosis in infants.
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Affiliation(s)
- Yazeed Alayed
- Paediatric Resident, King Saud Medical City, Paediatric Hospital, Riyadh, Saudi Arabia
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14
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Hou W, Yao Y, Li Y, Peng B, Shi K, Zhou Z, Pan J, Liu M, Hu J. Linearly shifting ferromagnetic resonance response of La 0.7Sr 0.3MnO 3 thin film for body temperature sensors. FRONTIERS OF MATERIALS SCIENCE 2022; 16:220589. [PMID: 35228892 PMCID: PMC8866917 DOI: 10.1007/s11706-022-0589-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/29/2021] [Indexed: 05/17/2023]
Abstract
Human body temperature not only reflects vital signs, but also affects the state of various organs through blood circulation, and even affects lifespan. Here a wireless body temperature detection scheme was presented that the temperature was extracted by investigating the out-of-plane (OP) ferromagnetic resonance (FMR) field of 10.2 nm thick La0.7Sr0.3MnO3 (LSMO) film using electron paramagnetic resonance (EPR) technique. Within the range of 34-42 °C, the OP FMR field changes linearly with the increasing or decreasing temperature, and this variation comes from the linear responses of magnetization to the fluctuant temperature. Using this method, a tiny temperature change (< 0.1 °C) of organisms can be detected accurately and sensitively, which shows great potential in body temperature monitoring for humans and mammals.
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Affiliation(s)
- Weixiao Hou
- Laboratory of Magnetic and Electric Functional Materials and the Applications, The Key Laboratory of Shanxi Province, College of Material Science and Technology, Taiyuan University of Science and Technology, Taiyuan, 030024 China
| | - Yufei Yao
- Electronic Materials Research Laboratory, Key Laboratory of the Ministry of Education & International Center for Dielectric Research, School of Electronic and Information Engineering State Key Laboratory for Mechanical Behavior of Materials and International Joint Laboratory for Micro/Nano Manufacture and Measurement Technology, Xi’an Jiaotong University, Xi’an, 710049 China
| | - Yaojin Li
- Electronic Materials Research Laboratory, Key Laboratory of the Ministry of Education & International Center for Dielectric Research, School of Electronic and Information Engineering State Key Laboratory for Mechanical Behavior of Materials and International Joint Laboratory for Micro/Nano Manufacture and Measurement Technology, Xi’an Jiaotong University, Xi’an, 710049 China
| | - Bin Peng
- Electronic Materials Research Laboratory, Key Laboratory of the Ministry of Education & International Center for Dielectric Research, School of Electronic and Information Engineering State Key Laboratory for Mechanical Behavior of Materials and International Joint Laboratory for Micro/Nano Manufacture and Measurement Technology, Xi’an Jiaotong University, Xi’an, 710049 China
| | - Keqing Shi
- Department of Intensive Care, Precision Medicine Center Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 China
| | - Ziyao Zhou
- Electronic Materials Research Laboratory, Key Laboratory of the Ministry of Education & International Center for Dielectric Research, School of Electronic and Information Engineering State Key Laboratory for Mechanical Behavior of Materials and International Joint Laboratory for Micro/Nano Manufacture and Measurement Technology, Xi’an Jiaotong University, Xi’an, 710049 China
| | - Jingye Pan
- Department of Intensive Care, Precision Medicine Center Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 China
| | - Ming Liu
- Electronic Materials Research Laboratory, Key Laboratory of the Ministry of Education & International Center for Dielectric Research, School of Electronic and Information Engineering State Key Laboratory for Mechanical Behavior of Materials and International Joint Laboratory for Micro/Nano Manufacture and Measurement Technology, Xi’an Jiaotong University, Xi’an, 710049 China
| | - Jifan Hu
- Laboratory of Magnetic and Electric Functional Materials and the Applications, The Key Laboratory of Shanxi Province, College of Material Science and Technology, Taiyuan University of Science and Technology, Taiyuan, 030024 China
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Hewitt MK, Klowak JA, Pernica JM, Leung J. Citrobacter koseri meningitis and septicemia in a neonate with borderline fever at home. CMAJ 2021; 193:E1592-E1594. [PMID: 34663602 PMCID: PMC8547249 DOI: 10.1503/cmaj.210285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mark Keith Hewitt
- Division of Emergency Medicine (Hewitt), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Pediatric Intensive Care (Klowak), Department of Pediatrics, Ottawa University, Ottawa, Ont.; Divisions of Pediatric Infectious Disease (Pernica) and Pediatric Emergency Medicine (Leung), Department of Pediatrics, McMaster University, Hamilton, Ont
| | - Jennifer Ann Klowak
- Division of Emergency Medicine (Hewitt), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Pediatric Intensive Care (Klowak), Department of Pediatrics, Ottawa University, Ottawa, Ont.; Divisions of Pediatric Infectious Disease (Pernica) and Pediatric Emergency Medicine (Leung), Department of Pediatrics, McMaster University, Hamilton, Ont
| | - Jeffrey M Pernica
- Division of Emergency Medicine (Hewitt), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Pediatric Intensive Care (Klowak), Department of Pediatrics, Ottawa University, Ottawa, Ont.; Divisions of Pediatric Infectious Disease (Pernica) and Pediatric Emergency Medicine (Leung), Department of Pediatrics, McMaster University, Hamilton, Ont
| | - James Leung
- Division of Emergency Medicine (Hewitt), Department of Medicine, McMaster University, Hamilton, Ont.; Division of Pediatric Intensive Care (Klowak), Department of Pediatrics, Ottawa University, Ottawa, Ont.; Divisions of Pediatric Infectious Disease (Pernica) and Pediatric Emergency Medicine (Leung), Department of Pediatrics, McMaster University, Hamilton, Ont.
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16
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Dante A, Gaxhja E, Masotta V, La Cerra C, Caponnetto V, Petrucci C, Lancia L. Evaluating the interchangeability of infrared and digital devices with the traditional mercury thermometer in hospitalized pediatric patients: an observational study. Sci Rep 2021; 11:17014. [PMID: 34426635 PMCID: PMC8382823 DOI: 10.1038/s41598-021-96587-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 07/26/2021] [Indexed: 11/24/2022] Open
Abstract
Gradual replacement of the mercury thermometers with alternative devices is ongoing around the world in a bid to protect human health and the environment from the adverse effects of mercury. However, to reduce the risks of misdiagnosis, unnecessary treatments, and omission of care in pediatric populations, more evidence on the reliability of alternative thermometers is needed. The aim of this comparative observational study was to detect any differences in temperature measurements between the use of the axillary mercury thermometer and the alternative techniques. Temperature values in degree Celsius (°C) were measured in a group of Albanian children aged up to 14 years using mercury and digital axillary thermometers, as well as forehead and tympanic infrared thermometers. The digital axillary device, compared with the mercury one, showed no clinically significant difference in the mean values (− 0.04 ± 0.29 °C) and the narrowest 95% level of agreement (+ 0.53 °C to − 0.62 °C) in the paired comparisons. For cut-off point of 37.5 °C, the digital axillary thermometer showed the highest levels of sensitivity (72.5%) and specificity (99.1%) in detecting fever. This study indicates that the digital axillary thermometer may be the better option since it adequately balances accuracy, safety, and children’s comfort.
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Affiliation(s)
- Angelo Dante
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Rita Levi Montalcini Building - G. Petrini Street, 67010, L'Aquila, Italy.
| | - Elona Gaxhja
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Rita Levi Montalcini Building - G. Petrini Street, 67010, L'Aquila, Italy
| | - Vittorio Masotta
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Rita Levi Montalcini Building - G. Petrini Street, 67010, L'Aquila, Italy
| | - Carmen La Cerra
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Rita Levi Montalcini Building - G. Petrini Street, 67010, L'Aquila, Italy
| | - Valeria Caponnetto
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Rita Levi Montalcini Building - G. Petrini Street, 67010, L'Aquila, Italy
| | - Cristina Petrucci
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Rita Levi Montalcini Building - G. Petrini Street, 67010, L'Aquila, Italy
| | - Loreto Lancia
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Rita Levi Montalcini Building - G. Petrini Street, 67010, L'Aquila, Italy
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17
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Anfigeno L, Sertorio F, Basso L, Fontana A, Bodria M, Pistorio A, Ghiggeri GM, Damasio MB. Diffusion-Weighted MRI in the Evaluation of Renal Parenchymal Involvement during Febrile Urinary Tract Infections in Children: Preliminary Data. J Clin Med 2021; 10:jcm10112239. [PMID: 34064114 PMCID: PMC8196731 DOI: 10.3390/jcm10112239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/03/2021] [Accepted: 05/14/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Urinary tract infection (UTI) is the most common infection in pediatric-age patients. Acute pyelonephritis (PNA) represents a worrying situation in pediatric patients due to the risk of sepsis and long-term cicatricial consequences. The purpose of this retrospective study is to evaluate the diagnostic role of DW-MRI in relation to clinical data, to understand if there are any clinical parameters useful in identifying which patients should undergo it. Methods: According to inclusion and exclusion criteria, we enrolled 51 patients ≤15 years old admitted to our Institute between September 2012 and April 2020 with a febrile UTI who underwent DW-MRI evaluation. Clinical, laboratory and imaging data were collected. Statistical analysis was performed. Results: 34 of 51 patients with an fUTI (66.7%) showed signs of acute parenchymal involvement at DW-MRI evaluation. In 27 of these 34 (79.4%), DW-MRI showed multiple areas of pyelonephritis. A statistically significant relationship (p = 0.0004) between older age at admission and pyelonephritis was demonstrated. No statistically significant relationship was found between the other clinical, anamnestic and laboratory parameters and the outcome of DWI. Only two ultrasound examinations allowed the identification of pathological areas on the renal parenchyma. Conclusions: From these preliminary investigations, we can say that selecting the patients with fUTI on whom to perform a DW-MRI is difficult. Nevertheless, thanks to the low cost, the very rare need for sedation and the accuracy in identifying pyelonephritic areas, the use of DW-MRI in patients with febrile UTI seems recommendable.
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Affiliation(s)
- Lorenzo Anfigeno
- Department of Health Sciences (DISSAL), Università degli Studi di Genova, 16132 Genova, Italy
- Radiology Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Giannina Gaslini, 16147 Genova, Italy; (F.S.); (L.B.); (M.B.); (M.B.D.)
- Correspondence:
| | - Fiammetta Sertorio
- Radiology Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Giannina Gaslini, 16147 Genova, Italy; (F.S.); (L.B.); (M.B.); (M.B.D.)
| | - Luca Basso
- Radiology Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Giannina Gaslini, 16147 Genova, Italy; (F.S.); (L.B.); (M.B.); (M.B.D.)
| | - Andrea Fontana
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, Italy;
| | - Monica Bodria
- Radiology Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Giannina Gaslini, 16147 Genova, Italy; (F.S.); (L.B.); (M.B.); (M.B.D.)
| | - Angela Pistorio
- Epidemiology and Biostatistics Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Giannina Gaslini, 16147 Genova, Italy;
| | - Gian Marco Ghiggeri
- Nephrology Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Giannina Gaslini, 16147 Genova, Italy;
| | - Maria Beatrice Damasio
- Radiology Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Giannina Gaslini, 16147 Genova, Italy; (F.S.); (L.B.); (M.B.); (M.B.D.)
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18
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Diffusion-Weighted MRI in the Evaluation of Renal Parenchymal Involvement during Febrile Urinary Tract Infections in Children: Preliminary Data. J Clin Med 2021. [DOI: 10.3390/jcm10112239
expr 943224684 + 995609622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Background: Urinary tract infection (UTI) is the most common infection in pediatric-age patients. Acute pyelonephritis (PNA) represents a worrying situation in pediatric patients due to the risk of sepsis and long-term cicatricial consequences. The purpose of this retrospective study is to evaluate the diagnostic role of DW-MRI in relation to clinical data, to understand if there are any clinical parameters useful in identifying which patients should undergo it. Methods: According to inclusion and exclusion criteria, we enrolled 51 patients ≤15 years old admitted to our Institute between September 2012 and April 2020 with a febrile UTI who underwent DW-MRI evaluation. Clinical, laboratory and imaging data were collected. Statistical analysis was performed. Results: 34 of 51 patients with an fUTI (66.7%) showed signs of acute parenchymal involvement at DW-MRI evaluation. In 27 of these 34 (79.4%), DW-MRI showed multiple areas of pyelonephritis. A statistically significant relationship (p = 0.0004) between older age at admission and pyelonephritis was demonstrated. No statistically significant relationship was found between the other clinical, anamnestic and laboratory parameters and the outcome of DWI. Only two ultrasound examinations allowed the identification of pathological areas on the renal parenchyma. Conclusions: From these preliminary investigations, we can say that selecting the patients with fUTI on whom to perform a DW-MRI is difficult. Nevertheless, thanks to the low cost, the very rare need for sedation and the accuracy in identifying pyelonephritic areas, the use of DW-MRI in patients with febrile UTI seems recommendable.
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19
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Chen HY, Chen A, Chen C. Investigation of the Impact of Infrared Sensors on Core Body Temperature Monitoring by Comparing Measurement Sites. SENSORS 2020; 20:s20102885. [PMID: 32438729 PMCID: PMC7284737 DOI: 10.3390/s20102885] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/13/2020] [Accepted: 05/19/2020] [Indexed: 01/24/2023]
Abstract
Many types of thermometers have been developed to measure body temperature. Infrared thermometers (IRT) are fast, convenient and ease to use. Two types of infrared thermometers are uses to measure body temperature: tympanic and forehead. With the spread of COVID-19 coronavirus, forehead temperature measurement is used widely to screen people for the illness. The performance of this type of device and the criteria for screening are worth studying. This study evaluated the performance of two types of tympanic infrared thermometers and an industrial infrared thermometer. The results showed that these infrared thermometers provide good precision. A fixed offset between tympanic and forehead temperature were found. The measurement values for wrist temperature show significant offsets with the tympanic temperature and cannot be used to screen fevers. The standard operating procedure (SOP) for the measurement of body temperature using an infrared thermometer was proposed. The suggestion threshold for the forehead temperature is 36 °C for screening of fever. The body temperature of a person who is possibly ill is then measured using a tympanic infrared thermometer for the purpose of a double check.
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Affiliation(s)
- Hsuan-Yu Chen
- Department of Materials Science and Engineering, University of California, San Diego, CA 92093, USA;
| | - Andrew Chen
- Africa Research Center, National Chung Hsing University, Taichung 40227, Taiwan;
| | - Chiachung Chen
- Department of Bio-industrial Mechatronics Engineering, National ChungHsing University, Taichung 40227, Taiwan
- Correspondence: ; Tel.: +886-4-22857562
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20
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Posthuma LM, Downey C, Visscher MJ, Ghazali DA, Joshi M, Ashrafian H, Khan S, Darzi A, Goldstone J, Preckel B. Remote wireless vital signs monitoring on the ward for early detection of deteriorating patients: A case series. Int J Nurs Stud 2020; 104:103515. [PMID: 32105974 DOI: 10.1016/j.ijnurstu.2019.103515] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/24/2019] [Accepted: 12/28/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Remote wireless monitoring is a new technology that allows the continuous recording of ward patients' vital signs, supporting nurses by measuring vital signs frequently and accurately. A case series is presented to illustrate how these systems might contribute to improved patient surveillance. METHODS AND RESULTS Five hospitals in three European countries installed a remote wireless vital signs monitoring system on medical or surgical wards. Heart rate, respiratory rate and temperature were measured by the system every 2 min. Four cases of (paroxysmal) atrial fibrillation are presented, two cases of sepsis and one case each of pyrexia, cardiogenic pulmonary edema and pulmonary embolisms. All cases show that the remote monitoring system revealed the first signs of ventilatory and circulatory deterioration before a change in the trends of the respective values became obvious by manual vital signs measurement. DISCUSSION This case series illustrates that a wireless remote vital signs monitoring system on medical and surgical wards has the potential to reduce time to detect deteriorating patients.
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Affiliation(s)
- L M Posthuma
- Department of Anaesthesiology, Amsterdam UMC, location AMC, H1-148, Amsterdam UMC, location AMC, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| | - C Downey
- Leeds Institute of Medical Research at St. James's, University of Leeds, United Kingdom
| | - M J Visscher
- Department of Anaesthesiology, Amsterdam UMC, location AMC, H1-148, Amsterdam UMC, location AMC, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| | - D A Ghazali
- Emergency Department, University Hospital of Bichat, Paris, France
| | - M Joshi
- Department of Surgery & Cancer, Academic Surgical Unit, St Mary's Hospital, Imperial College London, London, United Kingdom; Chelsea and Westminster Hospital NHS Foundation Trust, West Middlesex University Hospital, London, United Kingdom
| | - H Ashrafian
- Department of Surgery & Cancer, Academic Surgical Unit, St Mary's Hospital, Imperial College London, London, United Kingdom
| | - S Khan
- Chelsea and Westminster Hospital NHS Foundation Trust, West Middlesex University Hospital, London, United Kingdom
| | - A Darzi
- Department of Surgery & Cancer, Academic Surgical Unit, St Mary's Hospital, Imperial College London, London, United Kingdom
| | - J Goldstone
- Chief Intensivist, King Edward VII Hospital, The London Clinic and University College London Hospitals NHS Trust, London, United Kingdom
| | - B Preckel
- Department of Anaesthesiology, Amsterdam UMC, location AMC, H1-148, Amsterdam UMC, location AMC, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
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