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El Tahir O, Groenveld J, Jonge R, Oostrom K, Goei SL, Pronk J, Furth AM. Self-Reported Executive Functioning in Young Adult Survivors of Childhood Bacterial Meningitis. Arch Clin Neuropsychol 2024:acae040. [PMID: 38797959 DOI: 10.1093/arclin/acae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/15/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE This study investigated executive functions (EFs) in young adult survivors of childhood bacterial meningitis (BM). These skills are important for normal development, and their potential vulnerability in early years suggests that childhood BM could affect executive functions in the longer term. METHOD The adult self-report Behavior Rating Inventory of Executive Function was administered to 474 young adult survivors of childhood BM who participated in the 20|30 Dutch Postmeningitis study. Average scores were compared to population-norm group scores. Subgroup scores were compared according to causative pathogen and age at onset. RESULTS Young adult survivors of childhood BM scored lower on overall metacognition than the age-matched population norm group. Young adult survivors of childhood BM caused by Streptococcus pneumoniae, S. agalactiae, or Escherichia coli had lower scores than cases caused by Neisseria meningitidis. Survivors with age-at-onset below 12 months had a higher (worse) overall EF score than survivors with age-at-onset above 12 months. CONCLUSIONS Young adult survivors of childhood BM experience difficulties in EF. However, most of the self-reported EF scores were within the norm. Future studies need to additionally assess EF in adult survivors of childhood BM using performance-based tests.
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Affiliation(s)
- Omaima El Tahir
- Department of Pediatric Infectious Diseases and Immunology, AI&II, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Julia Groenveld
- Department of Pediatric Infectious Diseases and Immunology, AI&II, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Rogier Jonge
- Department of Pediatric and Neonatal Intensive Care Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Kim Oostrom
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Emma Children's Hospital, Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Sui Lin Goei
- LEARN! Learning Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jeroen Pronk
- Expertise Group Child Health, the Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
| | - Anne Marceline Furth
- Department of Pediatric Infectious Diseases and Immunology, AI&II, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Gu Y, Cao K, Li A, Wang J, Guo Y, Hao Y, Tian L, Jie Y. Association between sleep quality and dry eye disease: a literature review and meta-analysis. BMC Ophthalmol 2024; 24:152. [PMID: 38581010 PMCID: PMC10996221 DOI: 10.1186/s12886-024-03416-7] [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: 08/10/2023] [Accepted: 03/27/2024] [Indexed: 04/07/2024] Open
Abstract
OBJECTIVE The purpose of this article is to systematically review the association between dry eye and sleep quality. METHODS PubMed, EMBASE, Cochrane, Web of Science, and grey literature databases were searched for observational studies published before April 2023. Meta-analysis was performed using STAT15 software. RESULTS A total of 21 studies with 419,218 participants were included. The results showed that the dry eye subjects had a worse sleep quality than the healthy population, with poorer subjective sleep quality, longer sleep latency, and a higher risk of unhealthy sleep duration such as insufficient sleep or excessive sleep. The Pittsburgh Sleep Quality Index (PSQI) scores of the dry eye subjects were significantly higher than those of the control subjects (WMD = 1.78, 95%CI: 1.06, 2.50, P < 0.001). The dry eye subjects scored higher than the control subjects in sleep quality, sleep latency, and sleep disturbance in PSQI; there was no difference between the dry eye individuals and control subjects in sleep duration, sleep efficiency, daytime dysfunction, and sleep medication scores. The risk of sleep disorders in the dry eye subjects was significantly higher than that in the non-dry eye subjects (RR = 2.20, 95%CI: 1.78, 2.72, P < 0.001); the risk of insufficient sleep in the dry eye subjects was higher than that in the control subjects (RR = 3.76, 95%CI: 3.15, 4.48, P < 0.001), and the prevalence of excessive sleepiness in dry eye subjects was higher than that in the control subjects (RR = 5.53, 95%CI: 3.83, 7.18, P < 0.001). The ESS scores of the dry eye subjects were significantly higher than those of the control subjects (WMD = 3.02, 95%CI: 2.43, 3.60, P < 0.01). CONCLUSION Our meta-analysis suggests that individuals with dry eye have a worse sleep quality than the healthy population, with poorer subjective sleep quality, longer sleep latency, and higher risk of unhealthy sleep duration such as insufficient sleep or excessive sleepiness.
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Affiliation(s)
- Yixuan Gu
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Capital Medical University, No. 1 Dong Jiao Min Xiang, Dong Cheng District, 100730, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Capital Medical University, 100730, Beijing, China
| | - Ao Li
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Capital Medical University, No. 1 Dong Jiao Min Xiang, Dong Cheng District, 100730, Beijing, China
| | - Jingyi Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Capital Medical University, No. 1 Dong Jiao Min Xiang, Dong Cheng District, 100730, Beijing, China
| | - Yihan Guo
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Capital Medical University, No. 1 Dong Jiao Min Xiang, Dong Cheng District, 100730, Beijing, China
| | - Yiran Hao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Capital Medical University, No. 1 Dong Jiao Min Xiang, Dong Cheng District, 100730, Beijing, China
| | - Lei Tian
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Capital Medical University, No. 1 Dong Jiao Min Xiang, Dong Cheng District, 100730, Beijing, China.
| | - Ying Jie
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Capital Medical University, No. 1 Dong Jiao Min Xiang, Dong Cheng District, 100730, Beijing, China.
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Oncel MY, Cizmeci MN, Karadag-Oncel E, Elvan-Tuz A, Canpolat FE, Akin MA, Uslu S, Cetinkaya M, Erdeve O, Koc E. Epidemiology and Outcomes of Neonatal Meningitis: Results of the Turkish Neo-Meningitis Nationwide Study. Pediatr Infect Dis J 2024; 43:365-370. [PMID: 38134373 DOI: 10.1097/inf.0000000000004197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
OBJECTIVE To investigate the incidence and etiology of neonatal meningitis and to assess the associated risk factors, complications and outcomes in a nationwide multicenter retrospective descriptive study. METHOD Twenty-seven centers from 7 geographical regions participated in the study. Newborns with a positive cerebrospinal fluid culture and/or cerebrospinal fluid polymerase chain reaction were included in the study. Demographic characteristics, clinical, laboratory and neuroimaging findings and mortality characteristics were analyzed. RESULTS A total of 634 confirmed cases of neonatal meningitis were included in the final analysis. The incidence was 2.51 per 1000 intensive care unit hospitalizations and mortality was observed in 149 (23.5%). Gram-positive bacteria were the predominant pathogens (54.5%), with coagulase-negative Staphylococci accounting for 45.3% of the cases, followed by Gram-negative organisms (37.3%). Viral and fungal organisms were isolated in 3.2% and 1.7% of the infants, respectively. Gram-negative culture growth was more common in infants who died (51% vs. 34.6%; P < 0.001). In the multivariable model, the odds of mortality was higher in those with respiratory distress requiring invasive ventilatory support [odds ratio (OR): 10.3; 95% confidence interval (CI): 4.9-21.7; P < 0.01], hypotension requiring inotropes (OR: 4.4; 95% CI: 2.7-7.1; P < 0.001), low birth weight status (OR: 2.5; 95% CI: 1.4-4.6; P = 0.002), lack of exposure to antenatal steroids (OR: 2.4; 95% CI: 1.3-4.4; P = 0.005) and the presence of concomitant sepsis (OR: 1.9; 95% CI: 1.1-3.2; P = 0.017). CONCLUSIONS In this nationwide study, neonatal meningitis was found to be associated with high mortality. Coagulase-negative Staphylococci was the most common causative microorganism followed by Gram-negative bacteria. Severe clinical presentation with invasive mechanical ventilation and inotrope requirement, as well as concomitant sepsis, low birth weight status and lack of exposure to antenatal steroids, were found to be independent risk factors for mortality.
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Affiliation(s)
- Mehmet Yekta Oncel
- From the Division of Neonatology, Department of Pediatrics, Izmir Katip Celebi University, Izmir, Türkiye
| | - Mehmet N Cizmeci
- Division of Neonatology, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Eda Karadag-Oncel
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Dokuz Eylul University, Izmir, Türkiye
| | - Aysegul Elvan-Tuz
- Division of Pediatric Infectious Diseases , Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Türkiye
| | - Fuat Emre Canpolat
- Neonatal Clinic, Ministry of Health Ankara City Hospital, Ankara, Türkiye
| | - Mustafa Ali Akin
- Department of Pediatrics, Ondokuz Mayis University, Samsun, Türkiye
| | - Sinan Uslu
- Neonatal Clinic, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences
| | - Merih Cetinkaya
- Neonatal Clinic, Ministry of Health Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye
| | | | - Esin Koc
- Department of Pediatrics, Gazi University, Ankara, Türkiye
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Ambaye K, Yimer A, Mislu E, Wendimagegn Z, Kumsa H. Time to recovery from neonatal sepsis and its determinants among neonates admitted in Woldia comprehensive specialized hospital, Northeast Ethiopia: a retrospective cohort study. Front Pediatr 2024; 11:1289593. [PMID: 38333666 PMCID: PMC10850304 DOI: 10.3389/fped.2023.1289593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/26/2023] [Indexed: 02/10/2024] Open
Abstract
Background Neonatal sepsis is the most serious problem in neonates. It is the leading cause of neonatal death in developing countries, particularly in sub-Saharan Africa. The Ethiopian 2016 Demographic Health Survey report revealed that a high number of neonatal deaths are associated with neonatal sepsis. However, limited studies are available on exposure and time to recovery inferences in Ethiopia. Therefore, this study aimed to assess the time to recovery from neonatal sepsis and its determinants among neonates admitted to Woldia Comprehensive Specialized Hospital (WCSH), Northeast Ethiopia. Methods A retrospective cohort study was conducted, including 351 neonates, using systematic random sampling at WCSH from 7 to 30 March 2023. The data were entered into Epi data version 4.6 and exported to STATA 14 for analysis. Cox regression was used to identify the determinants of time to recovery from neonatal sepsis, and a variable with a p-value of less than 0.05, was used to declare significant association at a 95% confidence interval. Result Among 351 neonates with sepsis, 276 (78.63%) recovered, and the median time to recovery was 6 days. Induced labor (AHR = 0.54, 95% CI: 0.369, 0.78) and resuscitation at birth (AHR = 0.7, 95% CI: 0.51, 0.974) were significantly associated with the recovery time of neonatal sepsis. Conclusions and recommendation The time to recovery from neonatal sepsis is comparable to previous studies' results. The 25th and 75th percentiles were 4 and 8 days, respectively. Health professionals working in the NICU need to pay special attention to neonates born from mothers who had induced labor and those who were resuscitated at birth.
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Affiliation(s)
- Kassawmar Ambaye
- Department of Maternity and Child Care, Woldia Comprehensive Specialized Hospital, Woldia, Ethiopia
| | - Ali Yimer
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Esuyawkal Mislu
- Department of Midwifery, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Zeru Wendimagegn
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Henok Kumsa
- Department of Midwifery, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Zeng Q, Liu J, Mu J, Yang J, Gao Q, Wu F, Zhou H. Optimal biopsy site for the diagnosis of oral pemphigus vulgaris and mucous membrane pemphigoid: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2023; 52:1162-1172. [PMID: 37268547 DOI: 10.1016/j.ijom.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 05/07/2023] [Accepted: 05/11/2023] [Indexed: 06/04/2023]
Abstract
The aim of this study was to critically evaluate the diagnostic yields of direct immunofluorescence (DIF) analysis on perilesional and normal-appearing mucosa biopsy samples, to determine the optimal biopsy site for patients presenting with oral pemphigus vulgaris (PV) or mucous membrane pemphigoid (MMP). Electronic databases and article bibliographies were searched in December 2022. The primary outcome was the rate of DIF positivity. Of 374 records identified after the elimination of duplicates, 21 studies with 1027 samples were ultimately included. Meta-analysis revealed a pooled DIF positivity rate of 99.6% (95% confidence interval (CI) 97.4-100.0%, I2 = 0%) for PV and 92.6% (95% CI 87.9-96.5%, I2 = 44%) for MMP for biopsies from perilesional sites, and of 95.4% (95% CI 88.6-99.5%, I2 = 0%) for PV and 94.1% (95% CI 86.5-99.2%, I2 = 42%) for MMP for biopsies from normal-appearing sites. For MMP, there was no significant difference in the rate of DIF positivity between the two biopsy sites (odds ratio 1.91, 95% CI 0.91-4.01, I2 = 0%). The results suggest that the perilesional mucosa remains the optimal biopsy site for DIF diagnosis of oral PV, while the normal-appearing mucosa biopsy is optimal for oral MMP.
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Affiliation(s)
- Q Zeng
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - J Liu
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - J Mu
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - J Yang
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Q Gao
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - F Wu
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - H Zhou
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Guo Y, Lv Y, Liu X, Wang G. Association between heavy metal mercury in body fluids and tissues and diabetes mellitus: a systematic review and meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2023; 11:114. [PMID: 36819500 PMCID: PMC9929836 DOI: 10.21037/atm-22-6404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/11/2023] [Indexed: 01/31/2023]
Abstract
Background Recent studies have shown that the relationship between mercury exposure and diabetes is controversial. The aim of this study is to determine the relationship between mercury exposure and diabetes using a systematic review and meta-analysis approach. Methods We systematically searched PubMed, Web of Science, Cochrane, and Embase databases for cross-sectional, case-control, or cohort studies assessing the correlation between mercury exposure and diabetes in any population. Details of each included study were extracted using a pre-designed Excel spreadsheet. Quality assessment of cohort and case-control studies used the Newcastle-Ottawa Scale (NOS), whereas cross-sectional studies were assessed by the Agency for Healthcare Research and Quality (AHRQ) scale. Meta-analyses were performed using random-effects models to calculate the pooled odds ratio (OR), standardized mean difference (SMD), and their 95% confidence intervals (CIs). Subgroup and sensitivity analyses were employed to assess heterogeneity sources. Begg's and Egger's tests were used to evaluate publication bias. Results Our meta-analysis included 8 eligible articles, comprising a total of 40,891 subjects, reporting mercury OR and/or concentrations. Among the included studies, one was a case control, one was a cohort study, and the rest were cross-sectional studies. Two studies were rated as high quality and six as medium quality. The results revealed no link between mercury exposure and diabetes (OR: 1.11, 95% CI: 0.80, 1.55, n=6, I2=73.7%; and SMD: 0.41, 95% CI: -0.32, 1.14, n=3, I2=88.7%). In the stratified male and female subgroups, the pooled OR was 0.71 (95% CI: 0.57, 0.90, n=3, I2=0.0%), 1.11 (95% CI: 0.69, 1.79, n=3, I2=67.7%). The Begg's test results revealed no significant publication bias (P=0.06), but the Egger's test results did (P=0.013). The sensitivity analysis confirmed the stability of our results. Conclusions No significant relationship was observed between mercury and diabetes mellitus. However, more well-designed studies on mercury exposure and diabetes risk are still needed, particularly on the type of mercury (i.e., elemental, inorganic, and organic), exposure time and dose, type of biological specimen, and the population's sex and age.
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Affiliation(s)
- Yunran Guo
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - You Lv
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Xinming Liu
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
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Li YT, Li CX, Huang CJ, Wen QY, Deng SM, Zhu LP, Liu ZF, Chen ZG. Meconium-Stained Amniotic Fluid: Impact on Prognosis of Neonatal Bacterial Meningitis. J Trop Pediatr 2022; 68:6665809. [PMID: 35962981 DOI: 10.1093/tropej/fmac064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Clinical data with respect to the impact of meconium on the prognosis of neonatal bacterial meningitis are scarce. Therefore, in this study, we aimed to determine whether meconium-stained amniotic fluid (MSAF) represents a risk factor for poor prognosis of neonatal bacterial meningitis in a confirmed case population. METHODS This was a retrospective cohort study of 256 neonates diagnosed with bacterial meningitis hospitalized at one of three hospitals in Shantou, China, between October 2013 and September 2018. Clinical manifestation, laboratory test results and treatment were compared between the two groups, with outcomes dichotomized into 'good' or 'poor' prognosis. Multivariate analysis and follow-up logistic regression analysis were used to identify predictive factors of a poor outcome. RESULTS Of the 256 neonates with BM, 95 (37.1%) had a good prognosis at discharge and 161 (62.9%) had a poor prognosis. In the poor prognosis group, 131/161 (79.4%) neonates had a permanent neurological sequelae and 19 (11.8%) had ≥2 sequelae. Of note, 11 neonates died. The rate of poor prognosis of BM was significantly higher among neonates with than without MSAF (26.1% vs. 12.6%, respectively; p < 0.05). A logistic multivariate analysis to evaluate the prognostic effect of MSAF to BM showed that neonatal with MSAF is more likely to have a worse prognosis of BM [unadjusted odds ratio (OR), 2.44, 95% confidence interval (CI), 1.24-5.10; adjusted OR, 2.31; 95% CI, 1.09-5.17]. CONCLUSION MSAF is significantly associated with poor prognosis of neonatal bacterial meningitis. Therefore, in case of MSAF, more attention should be paid to neonatal bacterial meningitis.
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Affiliation(s)
- Ya-Ting Li
- Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Cai-Xia Li
- Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Chu-Jun Huang
- Department of Pediatrics, Shantou Central Hospital, Shantou, China
| | - Qian-Yu Wen
- Clinical Data Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Shu-Min Deng
- Department of Pediatrics, Shantou Central Hospital, Shantou, China
| | - Ling-Ping Zhu
- Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zi-Feng Liu
- Clinical Data Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zhuang-Gui Chen
- Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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Oumer M, Abebaw D, Tazebew A. Time to recovery of neonatal sepsis and determinant factors among neonates admitted in Public Hospitals of Central Gondar Zone, Northwest Ethiopia, 2021. PLoS One 2022; 17:e0271997. [PMID: 35900981 PMCID: PMC9374017 DOI: 10.1371/journal.pone.0271997] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 07/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Neonatal sepsis is a leading cause of neonatal morbidity and mortality,
particularly in developing countries. Time to recovery is an indicator of
the severity of sepsis, and risk factors varied significantly according to
study population and settings. Moreover, published literature regarding the
time to recovery of neonatal sepsis is scarce. Objective The aim of this study was to assess the time to recovery of neonatal sepsis
and determinant factors among neonates admitted in the Public Hospitals of
Central Gondar Zone, Northwest Ethiopia. Methods An institution-based prospective follow-up study design was conducted among
631 neonates with sepsis. A structured, pre-tested, interviewer-administered
questionnaire was used. The median time to recovery, life-table, the Kaplan
Meier curve, and the log-rank test were computed. Both bi-variable and
multivariable Cox regression models were applied to analyze the data. Results Of all septic neonates, 511 successfully recovered. They were followed for a
total of 4,740-neonate day’s observation and the median time to recovery was
7 days (IQR = 5–10 days). After adjusting for covariates, intrapartum fever
(AHR = 0.69, 95%CI: 0.49, 0.99), induced onset of labor (AHR = 0.68, 95%CI:
0.49, 0.94), chest indrawing (AHR = 0.67, 95%CI: 0.46, 0.99), late onset
sepsis (AHR = 0.55, 95%CI: 0.40, 0.75), non-oral enteral feeding (AHR =
0.38, 95%CI: 0.29, 0.50), assisted with bag and mask (AHR = 0.72, 95%CI:
0.56, 0.93), normal birth weight (AHR = 1.42, 95%CI: 1.03, 1.94),
gestational age of 37–42 weeks (AHR = 1.93, 95%CI: 1.32, 2.84), septic shock
(AHR = 0.08, 95%CI: 0.02, 0.39), infectious complications (AHR = 0.42,
95%CI: 0.29, 0.61), being in critical conditions (AHR = 0.68, 95%CI: 0.52,
0.89), and early recognition of illness (AHR = 1.83, 95%CI: 1.27, 2.63) were
independently associated with the time to recovery of neonatal sepsis. Conclusions and recommendations The time to recovery of this study was moderately acceptable as compared to
the previous studies. The above-mentioned factors could be used for the
early identification of neonates with sepsis at risk for protracted illness
and it could guide prompt referral to higher centers in primary health
sectors. This also will provide prognostic information to clinicians and
families as longer recovery time has economic and social implications in our
country.
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Affiliation(s)
- Mohammed Oumer
- Department of Human Anatomy, School of Medicine, College of Medicine and
Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Dessie Abebaw
- Department of Epidemiology and Biostatistics, Institute of Public Health,
College of Medicine and Health Sciences, University of Gondar, Gondar,
Ethiopia
| | - Ashenafi Tazebew
- Department of Pediatrics and Child Health, School of Medicine, College of
Medicine and Health Sciences, University of Gondar, Gondar,
Ethiopia
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Zeng Y, Cao R, Tao Z, Gao Y. Association between the severity of metabolic dysfunction-associated fatty liver disease and the risk of colorectal neoplasm: a systematic review and meta-analysis. Lipids Health Dis 2022; 21:52. [PMID: 35668493 PMCID: PMC9172084 DOI: 10.1186/s12944-022-01659-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/23/2022] [Indexed: 12/03/2022] Open
Abstract
Background The severity of metabolic dysfunction-associated fatty liver disease (MAFLD) reportedly plays a part in the etiology of colorectal tumors. However, there is no consensus. Methods Studies relevant with the impact of MAFLD severity on the risk of colorectal neoplasms published before 24th April 2022 were screened. The pooled odds ratio (OR) with corresponding 95% confidence intervals (95% CI) was obtained using standard and cumulative meta-analyses. Subgroup, meta-regression, and sensitivity analyses were carried out to identify heterogeneity. Results Fourteen studies with data from 37,824 MAFLD patients were included. The prevalence of colorectal neoplasms escalated with the progression of MAFLD compared to simple steatosis (OR = 1.93; 95% CI = 1.42–2.62). The magnitude and direction of the effect on these outcomes remained largely constant over time. Even after limiting the meta-analysis to 8 studies with available adjusted OR (aOR), the findings still suggested that MAFLD severity was positively related to colorectal neoplasms (aOR = 3.03; 95% CI = 2.02–4.53). Severe MAFLD was more likely to cause left colon tumors (OR = 3.86, 95% CI = 2.16–6.91) than right colon neoplasms (OR = 1.94, 95% CI = 1.15–3.28). Conclusion The severity of MAFLD was independently related to colorectal neoplasms and severe MAFLD was more likely to cause left colon tumors. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-022-01659-1.
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Affiliation(s)
- Yunqing Zeng
- Department of Gastroenterology, Qilu Hospital of Shandong University, 107 West Wen Hua Road, Jinan, 250012, Shandong, China
| | - Ruyue Cao
- Department of Gastroenterology, Qilu Hospital of Shandong University, 107 West Wen Hua Road, Jinan, 250012, Shandong, China
| | - Ziwen Tao
- Department of Gastroenterology, Qilu Hospital of Shandong University, 107 West Wen Hua Road, Jinan, 250012, Shandong, China
| | - Yanjing Gao
- Department of Gastroenterology, Qilu Hospital of Shandong University, 107 West Wen Hua Road, Jinan, 250012, Shandong, China.
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Liu M, Wang Y, Li N, Cui J, Fan W, Yang S, Li L, Zeng J, Li M. Effects of acupoint injection for stroke patients with hemiplegia: A protocol for systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2021; 100:e28374. [PMID: 34941161 PMCID: PMC8702274 DOI: 10.1097/md.0000000000028374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 12/02/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Acupoint injection has currently received increasing attention as a treatment for hemiplegia. A number of studies have reported that acupoint injection have some advantages in treatment of hemiplegia. However, currently no article has summarized the existing evidence. Our study will evaluate the efficacy and safety of acupoint injection as a clinical treatment for hemiplegia, so that it can provide an important reference for clinical decision-making. METHODS Randomized controlled trials and case control studies of acupoint injection for hemiplegia according to the included and excluded standard were identified in searches of 6 databases from their inception to February 2021. All data were assessed and extracted by 2 authors independently. The risk of bias assessment recommended by the Cochrane Collaboration was used to assess the quality of the selected studies. Review Manager 5.4 (Cochrane Collaboration) was used to conduct meta-analysis for the efficacy and safety of acupoint injection. RESULT The results of this systemic review and meta-analysis will be submitted to a recognized journal for publication. CONCLUSION This systemic review and meta-analysis will evaluate the efficacy and safety of acupoint injection as a clinical treatment for hemiplegia. We hope this study can make a definitive conclusion for acupoint injection in the treatment of hemiplegia. REGISTRATION PROSPERO (registration number CRD42021234453).
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Affiliation(s)
- Minghui Liu
- Guangzhou University of Chinese Medicine, Clinic Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou, China
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guizhou University of Traditional Chinese Medicine, China
| | - Yinyu Wang
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guizhou University of Traditional Chinese Medicine, China
| | - Ning Li
- Clinical Medical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine, China
| | - Jin Cui
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guizhou University of Traditional Chinese Medicine, China
| | - WenRui Fan
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guizhou University of Traditional Chinese Medicine, China
| | - Shuo Yang
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guizhou University of Traditional Chinese Medicine, China
| | - Li Li
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guizhou University of Traditional Chinese Medicine, China
| | - Jie Zeng
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guizhou University of Traditional Chinese Medicine, China
| | - Min Li
- Guangzhou University of Chinese Medicine, Clinic Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou, China
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11
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Haffner DN, Machie M, Hone E, Said RR, Maitre NL. Predictors of Neurodevelopmental Impairment After Neonatal Bacterial Meningitis. J Child Neurol 2021; 36:968-973. [PMID: 34256644 DOI: 10.1177/08830738211026053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Neonatal bacterial meningitis has high rates of morbidity and mortality. Early clinical signs and neuroimaging suggest adverse outcomes, but little is known about their combined predictive properties. We evaluated the combination of findings most associated with death and neurodevelopmental impairment. METHODS Single-center retrospective cohort study of term and late preterm neonates with bacterial meningitis. Predictors of death and neurodevelopmental impairment were identified on univariate analysis and incorporated into Lasso models to identify variables best predicting adverse outcomes. RESULTS Of 103 neonates, 6 died acutely; 30% of survivors had neurodevelopmental impairment. Clinical variables (seizures, pressor support) predicted death and neurodevelopmental impairment better than the neuroimaging or combined findings (area under the curve 0.88 vs 0.79 and 0.83, respectively). Among survivors, neuroimaging findings (cerebrovascular lesions, ventriculomegaly) predicted neurodevelopmental impairment better than clinical or combined findings (area under the curve 0.82 vs 0.80 and 0.77, respectively). CONCLUSIONS Seizures are important predictors of adverse outcomes in neonatal bacterial meningitis. Among survivors, neuroimaging findings help predict neurodevelopmental impairment.
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Affiliation(s)
- Darrah N Haffner
- Division of Neurology, Department of Pediatrics, Nationwide Children's Hospital and the Ohio State University, Columbus, OH, USA.,Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Division of Neurology, Department of Pediatrics, University of Texas Southwestern Medical School/Children's Health, Dallas, TX, USA
| | - Michelle Machie
- Division of Neurology, Department of Pediatrics, University of Texas Southwestern Medical School/Children's Health, Dallas, TX, USA
| | - Emily Hone
- Biostatistics Core, Nationwide Children's Hospital, Columbus, OH, USA
| | - Rana R Said
- Division of Neurology, Department of Pediatrics, University of Texas Southwestern Medical School/Children's Health, Dallas, TX, USA
| | - Nathalie L Maitre
- Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Division of Neonatology, Department of Pediatrics, Nationwide Children's Hospital and the Ohio State University, Columbus, OH, USA
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12
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Zhang Z, Song Y, Kang J, Duan S, Li Q, Feng F, Duan J. Epidemiology of patients with central nervous system infections, mainly neurosurgical patients: a retrospective study from 2012 to 2019 in a teaching hospital in China. BMC Infect Dis 2021; 21:826. [PMID: 34404351 PMCID: PMC8369693 DOI: 10.1186/s12879-021-06561-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/09/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Central nervous system (CNS) infections are relatively rare but are associated with high mortality worldwide. Empirical antimicrobial therapy is crucial for the survival of patients with CNS infections, and should be based on the knowledge of the pathogen distribution and antibiotic sensitivities. The aim of this study was to investigate the features of pathogens in patients with CNS infections in North China and evaluate the risk factors for mortality and multi-drug-resistant (MDR) bacterial infections. METHODS A retrospective study was conducted with patients with positive cerebrospinal fluid (CSF) cultures in a teaching hospital from January 2012 to December 2019. The following data were collected: demographic characteristics, laboratory data, causative organisms and antimicrobial sensitivity results. Data were analyzed with SPSS 16.0. Univariate analysis and binary logistic regression analyses were performed to identify the risk factors for mortality and MDR bacterial infections. RESULTS A total of 72 patients were diagnosed with CNS infections, and 86 isolates were identified. The proportions of Gram-positive bacteria, Gram-negative bacteria and fungi were 59.3, 30.2 and 10.5%, respectively. The predominant Gram-positive bacteria was Coagulase-negative Staphylococci. Acinetobacter baumannii, Escherichia coli and Klebsiella spp. were the predominant Gram-negative bacteria. Compared to 2012-2015 years, the proportion of Gram-negative bacteria increased markedly during 2016-2019 years. Coagulase-negative Staphylococci, Streptococcus pneumoniae and Enterococcus faecium had 100% sensitivity to vancomycin, teicoplanin and linezolid. Acinetobacter baumannii and Klebsiella pneumoniae were 100% sensitive to tigecycline. Escherichia coli had 100% sensitivity to amikacin, meropenem and imipenem. The overall mortality rate in the 72 patients was 30.6%. In multivariate analysis, age > 50 years, pulmonary infections and CSF glucose level < the normal value were associated with poor outcomes. CSF adenosine deaminase level > the normal value and the presence of external ventricular drainage/lumbar cistern drainage were associated with MDR bacterial infections. CONCLUSIONS The mortality rate due to CNS infections reached 30.6% in our study. The proportion of Gram-negative bacteria has increased markedly in recent years. We should give particular attention to patients with risk factors for mortality and MDR bacterial infections mentioned above.
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Affiliation(s)
- Zheng Zhang
- Department of Pharmacy, School of Pharmacy, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Yan Song
- Department of Pharmacy, Second Hospital of Shanxi Medical University, No 382, Wuyi Road, Xinghualing District, Taiyuan, Shanxi, People's Republic of China
| | - Jianbang Kang
- Department of Pharmacy, Second Hospital of Shanxi Medical University, No 382, Wuyi Road, Xinghualing District, Taiyuan, Shanxi, People's Republic of China
| | - Surong Duan
- Department of Information Management, Second Hospital of Shanxi Medical University, No 382, Wuyi Road, Xinghualing District, Taiyuan, Shanxi, People's Republic of China
| | - Qi Li
- Department of Pharmacy, School of Pharmacy, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Fuqiang Feng
- Department of Neurosurgery, Second Hospital of Shanxi Medical University, No 382, Wuyi Road, Xinghualing District, Taiyuan, Shanxi, People's Republic of China.
| | - Jinju Duan
- Department of Pharmacy, Second Hospital of Shanxi Medical University, No 382, Wuyi Road, Xinghualing District, Taiyuan, Shanxi, People's Republic of China.
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13
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Lal SN, Maria A, Bandyopadhyay T. Antimicrobial Resistance and Predictors of Adverse Outcomes in Neonates with Bacterial Meningitis: a Retrospective Study from a Tertiary Care Hospital of Northern India. JOURNAL OF PEDIATRIC NEUROLOGY 2021. [DOI: 10.1055/s-0041-1732347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractThis study aimed to determine antimicrobial resistance pattern and predictors of adverse outcome in neonatal meningitis. A retrospective study by analyzing case files of 134 cases of neonatal meningitis. We noted an alarming degree of multidrug resistance (MDR) among both gram-negative (Klebsiella spp., 50%; Escherichia coli, 100%; and and Acinetobacter spp., 50%), as well as positive (Enterococcus, 100%) isolates in cerebrospinal fluid (CSF) culture. The incidence rate of adverse outcome (i.e., mortality and abnormal neurological examination at discharge) was 8.2 and 17.2%, respectively. On univariate analysis, delayed seeking of medical care, bulging anterior fontanelle, vomiting, positive sepsis screen, shock during hospital course, ventriculitis, diversion procedures for raised intracranial pressure, central line placement, low CSF sugar, and failed hearing screening test at discharge were associated with increased risk of adverse outcome. Further, delayed seeking of medical care, shock during hospital course, positive sepsis screen, thrombocytopenia, and MDR infections were independently found to be associated with adverse outcomes. An alarming degree of antimicrobial resistance among the CSF isolates necessitates the need to understand the pathogenesis of resistance and curtail the irrational prescription of antibiotics in neonatal meningitis. Further, delayed seeking of medical care, shock during hospital course, positive sepsis screen, thrombocytopenia, and MRD infection may have prognostic value in neonatal meningitis
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Affiliation(s)
- Sandeep N. Lal
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Arti Maria
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Tapas Bandyopadhyay
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Pelkonen T, Urtti S, Cardoso O, Kyaw MH, Roine I, Peltola H. Risk factors for death in suspected severe bacterial infection in infants aged <90 days in Luanda, Angola. Int J Infect Dis 2021; 106:223-227. [PMID: 33781903 DOI: 10.1016/j.ijid.2021.03.070] [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: 02/20/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Yearly, about two million infants die during the first 28 days of life. Most of these deaths occur in sub-Saharan Africa and a third of those are caused by severe infections. The early identification of infants at risk of death is important when trying to prevent poor outcomes. OBJECTIVE The aim of this study was to identify risk factors for death among young infants with possible serious bacterial infection (pSBI) at hospital admission. METHODS This prospective, observational, single-site, descriptive study forms part of a larger study on bacterial meningitis in infants <90 days of age admitted to the Pediatric Hospital of Luanda, the capital of Angola, from February 1, 2016 to October 23, 2017. Infants with pSBI, a known outcome, and a final diagnosis were included. RESULTS Of 574 young infants with pSBI, 115 (20%) died in hospital. An altered level of consciousness, absence of spontaneous movements, dyspnea, CSF that is not clear, low CSF glucose, high CSF protein, heart rate over the median, and seizures were identified as risk factors for death in the univariate analysis. In the multivariate analysis, only heart rate over the median and seizures were independent predictors of death. CONCLUSIONS Easily recognizable clinical signs - tachycardia and seizures - may guide clinicians to identify infants at high risk of death due to severe bacterial infections in sub-Saharan Africa.
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Affiliation(s)
- Tuula Pelkonen
- New Children's Hospital, Pediatric Research Center, Helsinki, Finland; Pediatrics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Hospital Pediátrico David Bernardino (HPDB), Luanda, Angola.
| | - Suvi Urtti
- New Children's Hospital, Pediatric Research Center, Helsinki, Finland; Pediatrics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Ondina Cardoso
- Hospital Pediátrico David Bernardino (HPDB), Luanda, Angola.
| | - Moe H Kyaw
- Sanofi Pasteur, Epidemiology, Swiftwater, Pennsylvania, USA.
| | - Irmeli Roine
- Faculty of Medicine, University Diego Portales, Santiago, Chile.
| | - Heikki Peltola
- New Children's Hospital, Pediatric Research Center, Helsinki, Finland; Pediatrics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
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15
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Zhao Y, Li M, Tian X, Xie J, Liu P, Ying X, Wang M, Yuan J, Gao Y, Tian F, Yan X. Effects of arsenic exposure on lipid metabolism: a systematic review and meta-analysis. Toxicol Mech Methods 2021; 31:188-196. [PMID: 33472496 DOI: 10.1080/15376516.2020.1864537] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Lipid metabolism dysfunction is a risk factor for cardiovascular diseases. Reportedly, arsenic exposure could affect lipid metabolism, but this finding remains controversial. Herein, we updated and reevaluated evidence regarding the relationship between arsenic exposure and lipid metabolism. Electronic and manual searches were performed to determine the effect of arsenic exposure on lipid metabolism from inception up to 30 November 2019. Overall, five studies were included in our meta-analysis. Two reviewers independently extracted information. Standardized mean difference (SMD) and 95% confidence intervals (CI) were used to analyze the combined effects of four indicators related to lipid metabolism (total cholesterol [TC], triglyceride [TG], high-density lipoprotein [HDL], low-density lipoprotein [LDL]). Afterwards, subgroup and sensitivity analyses were performed to explore the source of heterogeneity. Publication bias was tested using funnel plots and Begg's test. In this study, we observed that arsenic exposure can affect lipid metabolism by reducing serum HDL levels and increasing serum LDL levels. Following subgroup analysis, the arsenic concentration appeared to affect lipid metabolism. Funnel plot and Begg's test suggested no asymmetry. In conclusion, we recommend that potential influencing factors, including age, exposure time, and multiple concentration gradients, should be considered to further explore the relationship between arsenic exposure and lipid metabolism.
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Affiliation(s)
- Yannan Zhao
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Meng Li
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiaolin Tian
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China.,Shanxi Key Laboratory of Ecological Animal Science and Environmental Veterinary Medicine, Shanxi Agricultural University, Taigu, Shanxi, China
| | - Jiaxin Xie
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Penghui Liu
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiaodong Ying
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Meng Wang
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiyu Yuan
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yi Gao
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Fengjie Tian
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiaoyan Yan
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
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16
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Hu Q, Li SJ, Chen QL, Chen H, Li Q, Wang M. Risk Factors for Acute Kidney Injury in Critically Ill Neonates: A Systematic Review and Meta-Analysis. Front Pediatr 2021; 9:666507. [PMID: 34336736 PMCID: PMC8316634 DOI: 10.3389/fped.2021.666507] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/07/2021] [Indexed: 12/29/2022] Open
Abstract
Background and Objective: Acute kidney injury (AKI) is recognized as an independent risk factor for mortality and long-term poor prognosis in neonates. The objective of the study was to identify the risk factors for AKI in critically ill neonates to provide an important basis for follow-up research studies and early prevention. Methods: The PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, WanFang Med, SinoMed, and VIP Data were searched for studies of risk factors in critically ill neonates. Studies published from the initiation of the database to November 19, 2020, were included. The quality of studies was assessed by the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality (AHRQ) checklist. The meta-analysis was conducted with Stata 15 and drafted according to the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Results: Seventeen studies (five cohort studies, ten case-control studies, and two cross-sectional studies) were included in meta-analysis, with 1,627 cases in the case group and 5,220 cases in the control group. The incidence of AKI fluctuated from 8.4 to 63.3%. Fifteen risk factors were included, nine of which were significantly associated with an increased risk of AKI in critically ill neonates: gestational age [standardized mean difference (SMD) = -0.31, 95%CI = (-0.51, -0.12), P = 0.002], birthweight [SMD = -0.37, 95%CI = (-0.67, -0.07), P = 0.015], 1-min Apgar score [SMD = -0.61, 95%CI = (-0.78, -0.43), P = 0.000], 5-min Apgar score [SMD = -0.71, 95%CI = (-1.00, -0.41), P = 0.000], congenital heart disease (CHD) [odds ratio (OR) = 2.94, 95%CI = (2.08, 4.15), P = 0.000], hyperbilirubinemia [OR = 2.26, 95%CI = (1.40, 3.65), P = 0.001], necrotizing enterocolitis (NEC) [OR = 6.32, 95%CI = (2.98, 13.42), P = 0.000], sepsis [OR = 2.21, 95%CI = (1.25, 3.89), P = 0.006], and mechanical ventilation [OR = 2.37, 95%CI = (1.50, 3.75), P = 0.000]. Six of them were not significantly associated with AKI in critically ill neonates: age [SMD = -0.25, 95%CI = (-0.54, 0.04), P = 0.095], male sex [OR = 1.10, 95%CI =(0.97, 1.24), P = 0.147], prematurity [OR = 0.90, 95%CI(0.52, 1.56), P = 0.716], cesarean section [OR = 1.52, 95%CI(0.77, 3.01), P = 0.234], prenatal hemorrhage [OR = 1.41, 95%CI = (0.86, 2.33), P = 0.171], and vancomycin [OR = 1.16, 95%CI = (0.71, 1.89), P = 0.555]. Conclusions: This meta-analysis provides a preliminary exploration of risk factors in critically ill neonatal AKI, which may be useful for the prediction of AKI. Systematic Review Registration: PROSPERO (CRD42020188032).
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Affiliation(s)
- Qian Hu
- Department of Nephrology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Shao-Jun Li
- Department of Emergency Department, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Qian-Ling Chen
- Department of Nephrology and Rheumatism, Hainan Women and Children's Medical Center, Haikou, China
| | - Han Chen
- Department of Nephrology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Qiu Li
- Department of Nephrology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Mo Wang
- Department of Nephrology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
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17
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Liu G, He S, Zhu X, Li Z. Early onset neonatal bacterial meningitis in term infants: the clinical features, perinatal conditions, and in-hospital outcomes: A single center retrospective analysis. Medicine (Baltimore) 2020; 99:e22748. [PMID: 33080738 PMCID: PMC7571871 DOI: 10.1097/md.0000000000022748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To compare clinical features and outcomes between early and late onset of neonatal bacterial meningitis (NBM).Patients were allocated in 2 groups: early onset neonatal bacterial meningitis (ENBM) and late onset neonatal bacterial meningitis (LNBM). Data analysis includes asphyxia at birth, premature rupture of membranes (PROM), amnionitis, amniotic fluid contamination, maternal age, clinical manifestations of the patients, laboratory findings, radiological results, complications related to meningitis, duration of hospitalization and therapeutic effect.There was no difference in gender, birth weight, gestational age, and incidence of asphyxia between 2 groups. The incidence of PROM, chorioamnionitis and amniotic fluid contamination, proportion of small-for-gestational-age infants, convulsions, intracranial hemorrhage, hyperbilirubinemia, and the protein level of cerebrospinal fluid in ENBM group were higher than that in LNBM group (P < .05); the proportion of fever, elevated C-reaction protein and the abnormal of platelet counts in LNBM group was higher than that in ENBM group (P < .05). There was no difference in the incidence of complications and hospitalization time between 2 groups. The rate of effective treatment in LNBM group was significantly higher than that in ENBM group (P < .05).Patients with conditions of amniotic fluid contamination, chorioamnionitis, small-for-gestational-age and PROM might be more prone to develop ENBM and ENBM had worse outcomes than LNBM.
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Affiliation(s)
- Gang Liu
- Department of Neonatology, Children's Hospital of Soochow University, Suzhou
| | - Shan He
- Department of Neonatology, Children's Hospital of Soochow University, Suzhou
| | - Xueping Zhu
- Department of Neonatology, Children's Hospital of Soochow University, Suzhou
| | - Zhenguang Li
- Department of Neonatology, The Affiliated Xuzhou Children's Hospital of Xuzhou Medical University, Xuzhou, China
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18
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Honda A, Nakao H, Shoji K, Kubota M, Ishiguro A. Neonatal group B streptococcal ventriculitis without red flags for meningitis. Pediatr Int 2020; 62:996-998. [PMID: 32686327 DOI: 10.1111/ped.14221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/09/2020] [Accepted: 03/03/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Aiko Honda
- Department of General Pediatrics & Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan.,Center for Postgraduate Education and Training, National Center for Child Health and Development, Tokyo, Japan
| | - Hiro Nakao
- Department of General Pediatrics & Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Kensuke Shoji
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Mitsuru Kubota
- Department of General Pediatrics & Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Akira Ishiguro
- Center for Postgraduate Education and Training, National Center for Child Health and Development, Tokyo, Japan
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Shinjoh M, Yamaguchi Y, Furuichi M, Yaginuma M, Takahashi T, Iwata S. Recent trends in pediatric bacterial meningitis in Japan, 2016-2018 - S. agalactiae has been the most common pathogen. J Infect Chemother 2020; 26:1033-1041. [PMID: 32546331 DOI: 10.1016/j.jiac.2020.05.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/25/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Haemophilus influenzae type b (Hib) vaccine and pneumococcal conjugated vaccine (PCV) have been widely used since 2010 in Japan. The overall incidence of bacterial meningitis decreased thereafter. Streptococcus agalactiae has become the main organism. OBJECTIVES The purpose of the present study was to investigate the incidence rate per 1000 admissions of bacterial meningitis and the change in causative organisms in subsequent years. METHODS A cross-sectional, multicenter, non-interventional retrospective study regarding pediatric bacterial meningitis was conducted in Japan in 2019. We analyzed the epidemiological and clinical data for 2016-2018, and compared the information obtained in our previous nationwide survey database. We also investigated the risk factors for disease outcome. RESULTS In the 2016-2018 surveys, 197 patients from 153 hospitals from all prefectures were evaluated. S. agalactiae (0-3 months, 39%), Streptococcus pneumoniae (2-112 months, 20%), and E. coli (0-136 months, 13%) were the main organisms. The total number of patients hospitalized with bacterial meningitis per 1000 admissions decreased from 1.00 to 1.68 in 2000-2010 to 0.38 in 2013-2015, bu remained stable thereafter (0.35-0.40 in 2016-2018). Only one case with Neisseria meningitidis was reported. Nine cases with death were reported, including four cases with S. agalactiae. Risk factors for death and sequelae were consciousness disturbance, duration of convulsion, low CSF glucose levels, and disuse of dexamethasone (p < 0.05). CONCLUSIONS The incidence in pediatric bacterial meningitis remained low, and S. agalactiae remains the most common cause of bacterial meningitis in Japan since 2012. S. pneumoniae is the most common cause after 3 months of age.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Yoshio Yamaguchi
- Department of Clinical Research, National Hospital Organization, Tochigi Medical Center, 1-10-37 Nakatomatsuri, Utsunomiya-city, Tochigi, Japan.
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Mizuki Yaginuma
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
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20
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Implementation of the eazyplex® CSF direct panel assay for rapid laboratory diagnosis of bacterial meningitis: 32-month experience at a tertiary care university hospital. Eur J Clin Microbiol Infect Dis 2020; 39:1845-1853. [DOI: 10.1007/s10096-020-03909-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 04/13/2020] [Indexed: 12/11/2022]
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Xie X, Huang R, Li X, Li N, Zhang H, Xu S, Li D, Xi S, Yang K. Association between hepatitis B virus infection and risk of osteoporosis: a systematic review and meta-analysis: A protocol for systematic review. Medicine (Baltimore) 2020; 99:e19719. [PMID: 32311959 PMCID: PMC7220488 DOI: 10.1097/md.0000000000019719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The potential association between hepatitis B virus (HBV) infection and development of osteoporosis has drawn significant attention from clinicians and researchers in recent years due to the increasing prevalence of HBV infection. This study aims to perform a systematic review and meta-analysis of the literature to show whether HBV infection is associated with an increased risk of osteoporosis. METHODS Case-control, cohort, and cross-sectional studies that report the incidence of osteoporosis, osteoporotic fracture, osteopenia, and bone mineral density level in populations with HBV infection will be selected. Four databases from their inception to October 2019 will be searched. All data were assessed and extracted by 2 authors independently. The Newcastle-Ottawa scale and (Agency for Healthcare Research and Quality) Agency for Healthcare Research and Quality checklist will be used to assess the quality of the selected studies. Stata 15.1 (Stata Corp, College Station, TX) will be used to conduct meta-analysis. RESULT The results of this systemic review and meta-analysis will be submitted to a recognized journal for publication. CONCLUSION This systemic review and meta-analysis will determine whether HBV infection is associated with an increased risk of osteoporosis. We hope this review can provide a reliable evidence. REGISTRATION PROSPERO (registration number CRD42020140522).
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Affiliation(s)
- Xingwen Xie
- Department of Orthopaedics, Affiliated Hospital of Northwest Minzu University
- Department of Orthopaedics, Gansu Second Provincial People's Hospital
| | - Rui Huang
- Clinical Medical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province
| | - Xiuxia Li
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province
| | - Ning Li
- Clinical Medical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine
| | - Haijun Zhang
- Department of Orthopaedics, Affiliated Hospital of Northwest Minzu University
- Department of Orthopaedics, Gansu Second Provincial People's Hospital
| | - Shihong Xu
- Department of Bone Oncology, Gansu Provincial Hospital of Tradition Chinese Medicine, Lanzhou, Gansu
| | - Dingpeng Li
- Department of Orthopaedics, Affiliated Hospital of Northwest Minzu University
| | - Shanshan Xi
- Department of Endocrinology and Nephrology, Hengshui Hospital of Traditional Chinese Medicine, Hengshui, Hebei
| | - Kehu Yang
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province
- Institute of Clinical Research and Evidence Based Medicine, Gansu Provincial People's Hospital
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
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