• Title/Summary/Keyword: Fever management

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Airway Management for Initial PEG Insertion in the Pediatric Endoscopy Unit: A Retrospective Evaluation of 168 Patients

  • Peck, Jacquelin;Nguyen, Anh Thy H.;Dey, Aditi;Amankwah, Ernest K.;Rehman, Mohamed;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.1
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    • pp.100-108
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    • 2021
  • Purpose: Percutaneous endoscopic gastrostomy (PEG) tube placements are commonly performed pediatric endoscopic procedures. Because of underlying disease, these patients are at increased risk for airway-related complications. This study compares patient characteristics and complications following initial PEG insertion with general endotracheal anesthesia (GETA) vs. anesthesia-directed deep sedation with a natural airway (ADDS). Methods: All patients 6 months to 18 years undergoing initial PEG insertion within the endoscopy suite were considered for inclusion in this retrospective cohort study. Selection of GETA vs. ADDS was made by the anesthesia attending after discussion with the gastroenterologist. Results: This study included 168 patients (GETA n=38, ADDS n=130). Cohorts had similar characteristics with respect to sex, race, and weight. Compared to ADDS, GETA patients were younger (1.5 years vs. 2.9 years, p=0.04), had higher rates of severe American Society of Anesthesiologists (ASA) disease severity scores (ASA 4-5) (21% vs. 3%, p<0.001), and higher rates of cardiac comorbidities (39.5% vs. 18.5%, p=0.02). Significant associations were not observed between GETA/ADDS status and airway support, 30-day readmission, fever, or pain medication in unadjusted or adjusted models. GETA patients had significantly increased length of stay (eβ=1.55, 95% confidence interval [CI]=1.11-2.18) after adjusting for ASA class, room time, anesthesia time, fever, and cardiac diagnosis. GETA patients also had increased room time (eβ=1.20, 95% CI=1.08-1.33) and anesthesia time (eβ=1.50, 95% CI=1.30-1.74) in adjusted models. Conclusion: Study results indicate that younger and higher risk patients are more likely to undergo GETA. Children selected for GETA experienced longer room times, anesthesia times, and hospital length of stay.

Two Clinical Cases of Feline Hemoplasmosis in Korea

  • Kim, Young Ju;Bae, Hyeona;Shin, Sun Woo;Cho, ARom;Jeon, Yeseul;Hwang, Tae-Sung;Jung, Dong-In;Kim, Dae Young;Kang, Jun-Gu;Yu, DoHyeon
    • Parasites, Hosts and Diseases
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    • v.60 no.2
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    • pp.127-131
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    • 2022
  • Feline hemotropic mycoplasmosis (hemoplasmosis) is an infection of the red blood cells caused by the Mycoplasma haemofelis (Mhf), Candidatus Mycoplasma haemominutum (CMhm), and Candidatus Mycoplasma turicensis (CMt). The existence of Mhf, CMhm, and CMt has been demonstrated in feral cats in Korea using molecular methods, but no clinical cases have yet been reported. This study reports 2 clinical cases of hemotropic mycoplasmosis caused by CMhm and CMt in 2 anemic cats. The first case was a client-owned intact female domestic shorthair cat that presented with fever, pale mucous membranes, and normocytic normochromic non-regenerative anemia. Prior to referral, an immunosuppressive prednisolone dose was administered at the local veterinary clinic for 1 month. The cat was diagnosed with high-grade alimentary lymphoma. Organisms were found on the surface of the red blood cells on blood smear examination. The second case was of a rescued cat that presented with dehydration and fever. The cat had normocytic normochromic non-regenerative anemia. Necropsy revealed concurrent feline infectious peritonitis. Polymerase chain reaction assay targeting 16S rRNA revealed CMhm infection in case 1 and dual infection of CMhm and CMt in case 2. Normocytic normochromic non-regenerative anemia was observed in both cats before and during the management of the systemic inflammation. This is the first clinical case report in Korea to demonstrate CMhm and CMt infections in symptomatic cats.

Evaluation of the cost-effectiveness of ASF detection with or without the use of on-field tests in different scenarios, in Sardinia

  • Cappai, Stefano;Loi, Federica;Rolesu, Sandro;Coccollone, Annamaria;Laddomada, Alberto;Sgarangella, Francesco;Masala, Sergio;Bitti, Giuseppe;Floris, Vincenzo;Desini, Pietro
    • Journal of Veterinary Science
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    • v.21 no.2
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    • pp.14.1-14.10
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    • 2020
  • African swine fever (ASF) is a highly contagious disease of domestic pigs and wild boars (WBs). Without a vaccine, early antibody and antigen detection and rapid diagnosis are crucial for the effective prevention of the disease and the employment of control measures. In Sardinia, where 3 different suid populations coexisted closely for a long time, the disease persists since 1978. The recent ASF eradication plan involves more stringent measures to combat free-ranging pigs and any kind of illegality in the pig industry. However, critical issues such as the low level of hunter cooperation with veterinary services and the time required for ASF detection in the WBs killed during the hunting season still remain. Considering the need to deliver true ASF negative carcasses as early as possible, this study focuses on the evaluation and validation of a duplex pen-side test that simultaneously detects antibodies and antigens specific to ASF virus, to improve molecular diagnosis under field conditions. The main goal was to establish the specificity of the two pen-side tests performed simultaneously and to determine their ability to detect the true ASF negative carcasses among the hunted WBs. Blood and organ samples of the WBs hunted during the 2018/2019 hunting seasons were obtained. A total of 160 animals were tested using the pen-side kit test; samples were collected for virological and serological analyses. A specificity of 98% was observed considering the official laboratory tests as gold standards. The new diagnostic techniques could facilitate faster and cost-effective control of the disease.

Severe congenital neutropenia mimicking chronic idiopathic neutropenia: a case report

  • Juhyung Kim;Soyoon Hwang;Narae Hwang;Yeonji Lee;Hee Jeong Cho;Joon Ho Moon;Sang Kyun Sohn;Dong Won Baek
    • Journal of Yeungnam Medical Science
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    • v.40 no.3
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    • pp.283-288
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    • 2023
  • Severe chronic neutropenia is classified as severe congenital, cyclic, autoimmune, or idiopathic. However, there is a lot of uncertainty regarding the diagnosis of severe congenital neutropenia (SCN) and chronic idiopathic neutropenia, and this uncertainty affects further evaluations and treatments. A 20-year-old man presented with fever and knee abrasions after a bicycle accident. On admission, his initial absolute neutrophil count (ANC) was 30/µL. He had no medical history of persistent severe neutropenia with periodic oscillation of ANC. Although his fever resolved after appropriate antibiotic therapy, ANC remained at 80/µL. Bone marrow (BM) aspiration and biopsy were performed, and a BM smear showed myeloid maturation arrest. Moreover, genetic mutation test results showed a heterozygous missense variant in exon 4 of the neutrophil elastase ELANE: c597+1G>C (pV190-F199del). The patient was diagnosed with SCN. After discharge, we routinely checked his ANC level and monitored any signs of infection with minimum use of granulocyte colony-stimulating factor (G-CSF), considering its potential risk of leukemic transformation. Considering that SCN can be fatal, timely diagnosis and appropriate management with G-CSF are essential. We report the case of a patient with SCN caused by ELANE mutation who had atypical clinical manifestations. For a more accurate diagnosis and treatment of severe chronic neutropenia, further studies are needed to elucidate the various clinical features of ELANE.

Clinical Features and Risk Factors of Post-COVID-19 Condition in Korea

  • Myungwon Jang;Dongkwon Choi;Jonghyuk Choi;Ho-Jang Kwon
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.5
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    • pp.431-439
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    • 2023
  • Objectives: Numerous studies have explored the causes and spread of outbreaks, yet there is a lack of research on post-coronavirus disease 2019 condition (PCC) in Korea. The goal of this study was to identify the various types of PCC and associated factors in discharged patients and to provide directions for the ongoing health management of confirmed patients. Methods: A telephone survey was conducted among 680 coronavirus disease 2019 (COVID-19) patients diagnosed between July 7, 2021 and August 26, 2021, in Dangjin, Chungnam, Korea. A descriptive analysis of characteristics, univariate analysis, and regression were performed using data from basic epidemiological surveys conducted at the time of diagnosis and post-discharge questionnaires. Results: Of the 585 patients who responded, 159 (27.2%) developed PCC. Of the 211 patients with no initial symptoms, 27 (12.8%) developed PCC, versus 132 (35.3%) of the 374 patients with initial symptoms. Among the initial symptoms, fever or chills, cough or sputum, loss of smell, and sore throat were associated with PCC. Compared to patients with less than 10 days of hospitalization, those with a hospitalization period of 21 days to 30 days (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.0 to 5.2) and 31 days or more (OR, 5.8; 95% CI, 1.9 to 18.1) had a higher risk of PCC. Conclusions: More than a quarter of COVID-19 patients, including those who had no initial symptoms, experienced PCC in Korea. People with the initial symptoms of fever, chills, and respiratory symptoms and those who had prolonged hospital stays had a high risk of PCC.

A Case of 1-Month Fever Caused by CMV Infection in a Patient With MIS-C Treated With IVIG, Infliximab, and High-Dose Methylprednisolone

  • Gihun Jeong;Jihye You
    • Pediatric Infection and Vaccine
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    • v.31 no.1
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    • pp.140-146
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    • 2024
  • Multisystem inflammatory syndrome in children (MIS-C) is a rare complication of coronavirus disease 2019 (COVID-19), causing multi-organ damage affecting the heart, lungs, kidneys, digestive tract, and nervous system. As the cases of MIS-C have been increasing following the COVID-19 pandemic, the importance of appropriate management for MIS-C is becoming increasingly apparent. Immunomodulating agents such as anakinra, infliximab, and steroids are regarded as supplementary therapy to the first-line treatment with intravenous immunoglobulin. However, these immunomodulating therapies can potentially precipitate opportunistic infections, including those caused by cytomegalovirus (CMV), Epstein-Barr virus, and tuberculosis, or increase the risk of co-infections. Herein, we report a case of a 3-year-old boy who was treated with immunoglobulin, infliximab, and high-dose methylprednisolone for MIS-C, and subsequently developed a persistent fever lasting 32 days caused by a CMV infection.

The Occurrence of Renal Scarring in Children with Unilateral Vesicoureteral Reflux (일측성 방광 요관 역류 환아에서 신반흔의 발생)

  • Lee, Tae Ho;Son, Mi Ran;Byun, Soon Ok;Moon, Jung Woong
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.998-1003
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    • 2005
  • Purpose : We evaluated the occurrence of renal scarring in children with unilateral vesicoureteral reflux(VUR), and the relationships between renal scar formation and risk factors such as VUR, duration of fever, acute-phase reactant, age, and sex. Methods : We retrospectively analyzed the data of 35 children newly diagnosed with unilateral vesicoureteral reflux after urinary tract infection(UTI) in Wallace Memorial Baptist Hospital between January 1996 and December 2004. Ultrasonography, Erythrocyte sedimentation rate(ESR), and C-reactive protein(CRP) were performed initially. Voiding cystourethrography(VCUG) was performed 1 to 3 weeks after treatment with UTI. $^{99m}Tc$-dimercaptosuccinic acid(DMSA) scan was performed 4 to 6 months after treatment. Results : Scintigraphic renal damage was present in 29 percent of the refluxing and in 3 percent of the nonrefluxing kidneys(P<0.05). The severity of VUR was significantly correlated with renal scar formation(P<0.05). The duration of fever before treatmen($5.0{\pm}1.3$ vs $2.6{\pm}1.3$) and prolonged fever of over 5 days were significantly different between renal scar group and non-renal scar group(P<0.05). ESR($56.3{\pm}23.8$ vs $27.9{\pm}18.1mm/hr$, P<0.05) and CRP($12.8{\pm}7.3$ vs $3.9{\pm}3.8mg/dL$, P<0.05) at the diagnosis of UTI in the renal scar group were higher, compared to those of the non-renal scar group. There were no significant differences in age and sex between the two groups. Conclusion : The presence and grade of VUR, the duration of fever before treatment, prolonged fever over 5 days, ESR, and CRP were risk factors for renal scarring, irrespective of age and sex. Diagnosis and management of VUR, in children with UTI, is important to prevent renal scars.

The Study about Hominis Placenta in "Dong-Eui-Bo-Gam" ("동의보감(東醫寶鑑)" 내 자하거 관련 부분에 대한 고찰)

  • Oh, Chi-Seok;Lee, Hyun
    • Journal of Haehwa Medicine
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    • v.16 no.1
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    • pp.31-40
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    • 2007
  • Hominis placenta have been studied as herbal acupuncture because of it's limitation of use. The properties of Hominis placenta are warm and supplement of Jeong-Hyeol, Jin-Ki and I thought that Hominis placenta have various effectiveness. So I considered Hominis placenta in Dong-Eui-Bo-Gam which is famous comprehensive korean traditional medical book. Hominis placenta was mentioned parts of Sin, Chung, Hwa, Heo-Ro, Bu-In and most of them are mentioned in Heo-Ro part. As a source book, Eui-Hak-Ib-Mun was used the most. Prescription used in various parts as mental disease, forgetfulness, tuberculosis, fever, various malnutrition disease, sterility, but it's basic principle action is all supplement of Heo-Ro. In management of Hominis placenta, most useing method is heating with steam and most of additional medicinal stuffs had action of supplying Eum, Yang, Ki, Hyeol in composition of prescription.

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A Novel Marker for the Species-Specific Detection and Quantitation of Shigella sonnei by Targeting a Methylase Gene

  • Cho, Min Seok;Ahn, Tae-Young;Joh, Kiseong;Kwon, Oh-Sang;Jheong, Won-Hwa;Park, Dong Suk
    • Journal of Microbiology and Biotechnology
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    • v.22 no.8
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    • pp.1113-1117
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    • 2012
  • Shigella sonnei is a causal agent of fever, nausea, stomach cramps, vomiting, and diarrheal disease. The present study describes a quantitative polymerase chain reaction (qPCR) assay for the specific detection of S. sonnei using a primer pair based on the methylase gene for the amplification of a 325 bp DNA fragment. The qPCR primer set for the accurate diagnosis of Shigella sonnei was developed from publically available genome sequences. This quantitative PCR-based method will potentially simplify and facilitate the diagnosis of this pathogen and guide disease management.

Surgical Management of Occult Foreign Body in the Bronchus Intermedius (중간 기관지 내 이물의 수술적 치료)

  • Kim, Jae-Bum;Park, Chang-Kwon
    • Korean Journal of Bronchoesophagology
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    • v.16 no.1
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    • pp.51-54
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    • 2010
  • Occult bronchial foreign body is that long-standing foreign body lodge in bronchial tree. Occult bronchial foreign bodies arc rare in adults, whereas tracheobronchial aspiration of foreign bodies occurs commonly in children. A 65-year-old man with chronic cough, sputum production, and fever was transferred for treatment of right middle and lower lobc collapse and obstructive pneumonitis as evidenced by imaging studies. The patient was treated with right middle-lower bilobectomy because fiberoptic bronchoscopic removal of the foreign body failed. We report this case with review of literatures.

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