Epidemiological and clinical characteristics of opium poisoning compared to other opioids in a poisoning referral center: Registry based study

Objective To investigate the epidemiological and clinical characteristics of human parainfluenza virus (HPIV) types 1 to 4 (HPIV1 to 4) infections among hospitalized children with acute lower respiratory tract infections, so as to evaluate the effects of HPIV4 on lower respiratory tract infections in children. Methods From January, 2015 to December, 2017, a total of 5 030 nasopharynal aspirate samples were collected from hospitalized children aged 0-14 years old with acute lower respiratory tract infections in Children's Hospital of Shanghai. Reverse transcript fluroscent PCR was used to detect HPIV1-4 and five other common respiratory viruses. The differences of epidemiological and clinical characteristics of HPIV1 to 4 were analyzed by chi-square test. Results From 5 030 child patients, 138 were positive of HPIV1 (2.74%), 31 were positive of HPIV2 (0.62%), 432 were positive of HPIV3 (8.59%) and 171 were positive of HPIV4 (3.40%). Co-infection rate of HPIV with 5 other common respiratory viruses were 10.23% (79/772). The differences of the positive rates of HPV1 to 4 among children of different ages and among different seasons were statistically significant. Comparing to HPIV3, children with HPIV4 infections showed statistically significant differences in clinical features, including cough, fever and diarrhea. Conclusions The positive rate of HPIV4 in child patients of acute lower respiratory tract infections was only lower than that of HPIV3. This should be concerned in clinical practice. Key words: Human parainfluenza virus; Acute lower respiratory tract infection; Epidemiological characteristics; Clinical features

Objective To analyze the epidemiological and clinical characteristics of human infections with avian influenza A (H7N9) and A (H5N6) viruses between 2013 and 2018 in Guangdong province. Methods The confirmed human infections cases of avian influenza viruses reported between 2013 and 2018 were used as research subjects. The basic information, disease distribution, exposure history, disease clustering and clinical characteristics were analyzed by statistical methods. Results A total of 259 human infection cases of influenza A (H7N9) virus were confirmed with the fatality rate of 38.6%. Eight human infection cases of influenza A (H5N6) were confirmed with the fatality rate of 62.5%. Most of the cases occurred from November to April and in the Pearl River Delta. The cases of influenza A (H7N9) virus infection were more common in male patients while the cases of influenza A (H5N6) infections were more common in female patients. Direct or indirect exposure to live poultry were obsevered in 245 influenza A (H7N9) virus infection cases (94.6%) and 7 influenza A (H5N6) virus infection cases (87.5%). There were six clusters of influenza A (H7N9) virus infection cases in Guangdong province. Regarding the clinical severity, most of the cases were severe, and the median value of time interval from onset to oseltamivir treatment were more than five days. Conclusions The epidemiological and clinical characteristics of humans infections with avian influenza A (H7N9) and A (H5N6) viruses were different in Guangdong province. Early detection and intervention of humans infections with different subtypes of avian influenza viruses should be enforced to prevent and control the spreading and epidemics of human infections with avian influenza viruses. Key words: Humans humans infections with avian influenza viruses; H7N9; H5N6; Epidemiological characteristics

Acute gastroenteritis is one of the most common causes of hospital admission in children. Treatment regimens differ depending on the pathogen. In our study, we aimed to evaluate the epidemiological and clinical features of pediatric patients whose gastrointestinal agents were detected by multiplex PCR. The study included 131 pediatric patients who were followed up at Eskişehir Osmangazi University, Pediatric Department between January 2018 and December 2021.Gastrointestinal pathogens were detected in stool samples by multiplex PCR. The epidemiological and clinical features were reviewed retrospectively. A total of 203 gastrointestinal pathogens were detected from the stool samples of 131 cases. Of these cases, 56% were male and 44% were female. The mean age was 66 (2-204) months. The most common symptoms were diarrhea, fever, vomiting and abdominal pain. The pathogen detection rate was 69% by multiplex PCR. A single pathogen was detected in 85 (65%) cases and multiple pathogens were detected in 46 (35%) cases. The most common pathogens were enteropathogenic Escherichia coli (EPEC, 23%), Clostridium difficile (21%), norovirus (17%), rotavirus (15%), salmonella (12%) and enterotoxigenic E. coli (ETEC, 11%). Stool culture was positive in 16 (12%) cases and microscopic examination positive in 17 (13%) cases. Probiotic treatment was given to 119 (92%) cases and antimicrobial treatment (metroinidazole, ceftriaxone, azithromycin and oral vancomycin) to 34 (26%) cases. Of the cases, 56 (42%) had chronic disease, 40 (30%) had a history of previous antibiotic use and 17 (13%) had a history of hospitalization in the intensive care unit. The sensitivity of the multiplex PCR in the detection of acute gastroenteritis agents is higher than stool microscopy, stool culture and stool antigen tests. However, due to the inability to distinguish between colonization, carrier state and pathogenicity, it should be evaluated together with other diagnostic tests and clinical findings in order to determine whether the determined agent is pathogenic or not and in the regulation of antimicrobial therapy.

BackgroundOver the last years, the mean age of subjects with HIV infection and AIDS is increasing. Moreover, some epidemiological and clinical differences between younger and older HIV-infected individuals have been observed. However, since introduction of HAART therapy, there are controversial results regarding their response to HAART. The aim of the present study is to evaluate epidemiological and clinical features, response to HAART, and survival in elderly HIV-infected patients with regard to younger HIV-infected patients.MethodsA prospective cohort study (1998–2003) was performed on patients from Sabadell Hospital, in Northeast of Spain. The cohort includes newly attended HIV-infected patients since January 1, 1998. For the purpose of this analysis, data was censured at December 31, 2003. Taking into account age at time of diagnosis, it was considered 36 HIV-positive people aged 50 years or more (Group 1, G1) and 419 HIV-positive people aged 13–40 years (Group 2, G2). Epidemiological, clinical, biological and therapy data are recorded. Statistical analysis was performed using Chi-squared test and Fisher exact test, Mann-Whitney U test, Kaplan-Meier, Log Rank test, and Two-Way ANOVA from random factors.ResultsG1 showed higher proportion of men than G2. The most common risk factors in G1 were heterosexual transmission (P = 0.01) and having sex with men or women (P < 0.001). G1 and G2 show parallel profiles through the time regarding immunological response (P = 0.989) and virological response (P = 0.074). However, older people showed lower CD4 cell counts at first clinic visit (P < 0.001) and, eventually, they did not achieve the same counts as G2. G1 presented faster progression to AIDS (P < 0.001) and shorter survival (P < 0.001).ConclusionOlder patients have different epidemiological features. Their immunological and virological responses are good. However, older patients do not achieve the same CD4 cell counts likely due to they have lower counts at first clinic visit. Thus, it is essential physicians know older HIV-infected patients features to consider the possibility of HIV infection in these patients with the aim of treatment would not be delayed.

Objectives: To determine the most relevant epidemiological, clinical, imaging, and structural characteristics of 80 Dominican patients affected by refractory trigeminal neuralgia treated consecutively at the Dominican Gamma Knife Center over an 8-year period.Material and Method: Retrospective study of 80 patients (47 women, 33 men) with refractory trigeminal neuralgia treated at the Dominican Gamma Knife Center between March 2011 and March 2019.All patients underwent a 1.5 Tesla MRI scan with 1-1.5 mm slices for three-dimensional reconstruction, including the following sequences: FIESTA, T1 without and with contrast, FLAIR, T2, and TOF.In addition to their epidemiological characteristics, the etiological type of neuralgia (essential or secondary), side of symptoms, affected branch(es), size of the trigeminal cistern (large, intermediate, small), nerve trophicity (eutrophic, atrophic, dystrophic), the presence or absence of neurovascular conflict with precision of side (homolateral or contralateral to the pain), affected trigeminal segment (proximal, intermediate, distal), caliber of the compromised artery (small, medium, large), correlation of trigeminal trophicity with respect to the presence or absence of neurovascular conflict and arterial caliber.The images were examined by the Principal Investigator (PI) on the Elekta Gamma Plan 11 stereotactic image management platform at the Dominican Gamma Knife Center.The data collected was processed using measures of central tendency and Pearson's correlation--dispersion coefficient on the Microsoft Excel 2016 platform.Results: Women predominated in our population (58.75% vs. 41.25%).The prevalent age range was between 50 and 79 years (71.25%).Essential trigeminal neuralgia (72%) was more fre-

Background: Since the early diagnosis of celiac disease (CD) is crucial, understanding its epidemiological characteristics can facilitate timely diagnosis and treatment. This study investigated CD's epidemiological, clinical, and laboratory characteristics in South Khorasan Province, Iran. Objectives: This study aimed to clarify the epidemiological characteristics, clinical manifestations, and laboratory findings of patients with CD in South Khorasan Province. Methods: This descriptive epidemiological research was conducted on 110 individuals with CD referred to the Gastroenterology Clinic from March to August 2019. The data were acquired via a comprehensive questionnaire, encompassing the participants' demographic specifications, medical records, the symptoms of the disease, laboratory diagnostic evaluations, and biopsy results. The data were employed for epidemiological inquiry, and the corresponding analyses were performed in SPSS v. 22. Results: The participants' mean age was 28.38 ± 15.25 years,78 (70.9%) were men, and 32 (29.1%) were women. The most common clinical gastrointestinal symptoms included abdominal pain in 70 (63.6%), diarrhea in 44 (40%), constipation in 43 (39.1%), and nausea in 35 (31.8%). Of the 83 biopsy cases, 3 (3.6%), 4 (4.8%), 9 (10.8%), 21 (25.3%), and 43 (55.4%) belonged to Marsh-I, Marsh-II, Marsh-IIIa, Marsh-IIIb, Marsh-IIIc categories, respectively. Conclusions: Most participants were male and aged 10 to 20 years. Abdominal pain was the most common clinical symptom. All the pathologically examined patients showed evidence of CD, while approximately two-thirds were serologically positive.

New-onset chronic pain has been acknowledged as part of the post-COVID-19 condition. However, available fine-grained data about its clinical phenotype, trajectories and main associated characteristics remain scarce. We described the distinct temporal evolutions of post-COVID-19 pain and their epidemiological and phenotypical features. A prospective cross-sectional study enrolled post-COVID-19 condition patients (i.e. who had persisting COVID-19-related symptoms over 30 days since their first positive laboratory test), whose COVID-19 diagnosis had been supported by RT-PCR of oral/nasopharyngeal swab or serology. They underwent in-person evaluations with a structured interview, pain and quality-of-life-related questionnaires and thorough physical examination. Chronic pain (CP) and probable neuropathic pain (NP) were defined according to IASP criteria. The present study included 226 individuals, 177 (78.3%) of whom presented over 3 months since their first COVID-19 symptom. New-onset pain occurred in 170 (75.2%) participants and was chronic in 116 (68.2%). A chronic course was associated with COVID-19-related hospitalization, new-onset fatigue, lower cognitive performance, motor and thermal sensory deficits, mood and sleep impairments and overall lower quality-of-life levels. Probable NP occurred in only 7.6% new-onset pain patients, and was associated with pain chronification, new-onset fatigue, motor and thermal sensory deficits, mechanical allodynia and lower rates of SARS-CoV-2 vaccination. Previous CP was reported by 86 (38.1%) individuals and had aggravated after the infection in 66 (76.7%) of them, which was associated with orthostatic hypotension. Post-COVID pain phenomena follow different paths, which are associated with specific clinical and epidemiological features, and possibly distinct underlying mechanisms, prognostic and therapeutic implications. COVID-19-related pain usually follows a chronic course and is non-neuropathic. Its possible courses and phenotypes are associated with distinct clinical and epidemiological features. This suggests differing underlying mechanisms, which may have significant prognostic and therapeutic implications.

We would like to share ideas on the publication Epidemiological and clinical characteristics of monkeypox cases in Brazil in 2022: a cross-sectional study 1 The epidemiological and clinical characteristics of mpox documented by Pascom et al., in Brazil, were comparable to those of other nations, such as México and Nigéria. 1, 2, 3 An epidemiological characteristic that has been common is the highest occurrence of the disease among males, especially homosexual men. 2, 3 The clinical manifestation of mpox is a crucial clinical aspect. The presence of both additional symptoms and occasional asymptomatic or mildly symptomatic individuals, without fever and with occult skin lesions, may hinder diagnosis. 4 According to recommendations from the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC), laboratory confirmation of samples of suspected mpox cases should be performed using nucleic acid amplification tests -such as real-time or conventional polymerase chain reaction -but also taking into consideration clinical and epidemiological information. 5

Objective To analyze the epidemiological characteristics, clinical manifestations and laboratory examinations of occupational brucellosis (OB) in Hulun Buir City, Inner Mongolia, from 2008 to 2016, in order to provide experience for prevention and treatment of OB. Methods The data of human OB cases from 2008 to 2016 in Hulun Buir were extracted from the Chinese Information System for Diseases Control and Prevention (CISDCP). The available information included population distribution, geographical distribution, time distribution, occupational distribution, clinical manifestations and laboratory examinations of the cases. Results Of the 213 cases, 191 were males and 22 females, aged from 23 to 62 years old, 149 cases in their 25 - 44 years of ages among all age-gender groups, and 20.19% of the cases (43) were reported in Ergun. Though occurred yearly and monthly, the disease reached the peaks in 2013 (41 cases), and in January (70 cases). A total of 212 cases had directly contacted with animals, only one was medical staff, 116 were veterinary. The dominant manifestations were arthralgia and myalgia in 144 cases, sweats in 131, fatigue in 123, fever in 94 cases, splenomegaly in 17 cases, hepatomegaly in 4 cases, and hepatosplenomegaly in 2 cases. The positive rate of the Bengal plate agglutination test (RBPT) was 100%, standard tube agglutination test (SAT) title ≥1 ∶ 100 (++) in 195, and SAT title ≥1 ∶ 50 (++) in 18 cases. Abnormal laboratory findings included elevated C-reactive protein (CRP), aspartate transaminase (AST), and alanine aminotransferase (ALT) levels in 34, 42 and 84 cases. Conclusions Occupational brucellosis is male-dominated, and concentrated in veterinary services. For exposed population, relevant departments should strengthen occupational health education, periodic occupational health examination. Key words: Occupational exposure; Brucellosis; Epidemiological characteristics; Clinical features

Epidemiological and clinical characteristics of a family cluster of psittacosis: A case report.

BackgroundIn view of the ongoing coronavirus disease (COVID-19) pandemic, it remains unclear whether the severity of illness and time interval from symptom onset to release from quarantine differ between cases that originated from clusters and cases reported in other areas. This study aimed to assess epidemiological and intergenerational clinical characteristics of COVID-19 patients associated with cluster outbreaks to provide valuable data for the prevention and control of COVID-19.MethodsWe identified the first employee with COVID-19 at a supermarket and screened the close contacts of this index patient. Confirmed cases were divided into two groups according to the generation (first generation comprising supermarket employees [group A] and second or third generations comprising family members or friends of the supermarket employees [group B]). The epidemiological and clinical characteristics of the two groups were retrospectively compared.ResultsA total of 8437 people were screened, and 24 COVID-19 patients were identified. Seven patients (29.2%) were asymptomatic; three patients were responsible for six symptomatic cases. The interval from the confirmation of the first case to symptom onset in symptomatic patients was 5–11 days. The clinical manifestations of symptomatic patients upon admission were non-specific. All patients (including the seven asymptomatic patients) were admitted based on chest computed tomography features indicative of pneumonia. There were 11 cases in group A (first generation) and 13 cases in group B (second generation, 11 cases; third generation, 2 cases), with no significant differences in clinical and epidemiological characteristics between the two groups, except for sex, duration from symptom onset to hospitalization, and underlying disease (P > 0.05).ConclusionsFor cluster outbreaks, it is important to comprehensively screen close the contacts of the index patient. Special attention should be paid to asymptomatic cases. The clinical management of cluster patients is similar to that of other COVID-19 patients.

Geographical variation in the distribution of Malassezia species associated with pityriasis versicolor (PV) has led to the necessity of studying epidemiological, mycological, and clinical characteristics of PV. To study the epidemiological, mycological, and clinical characteristics of PV in a tertiary care hospital. The study was carried out with a cross-sectional design. Two hundred and sixty-two consecutive PV patients were subjected to detailed history, clinical examination, and investigations. Skin scrapings were processed by direct microscopy and culture. Isolates were identified by phenotypic characteristics and polymerase chain reaction-restriction fragment length polymorphism. Association of Malassezia species with clinical and epidemiological characteristics was studied. Statistical analysis of the data was done using statistical software. Maximum number of PV cases (33.9%) belonged to the age group of 21-30 years with a male preponderance. 61.4% of the patients had a sedentary lifestyle, 70.2% showed the gradual onset of the disease, 51.1% presented with pruritus and in 66.4% of the patients symptoms were continuous. Most commonly involved body site was neck (27.8%), 77.09% of the lesions were bilaterally asymmetrical, 87.4% were macular, and 89.3% were hypopigmented. Malassezia furfur (77.3%) was the predominant species. Sedentary lifestyle (61.4%) and increased sweating (48%) were the most commonly associated predisposing factors. PV is more common in males. Distribution of Malassezia species varies significantly from those reported in other parts of India. M. furfur was the most common species responsible for PV in our region. Hence, further studies are required to evaluate the exact cause of this variation.

BackgroundContemporary registries on atrial fibrillation (AF) are scare in North African countries.HypothesisIn the context of the epidemiological transition, prevalence of valvular AF in Tunisia has decreased and the quality of management is still suboptimal.MethodsNATURE‐AF is a prospective Tunisian registry, involving consecutive patients with AF from March 1, 2017 to May 31, 2017, with a one‐year follow‐up period. All the patients with an Electrocardiogram‐documented AF, confirmed in the year prior to enrolment were eligible. The epidemiological characteristics and outcomes were described.ResultsA total of 915 patients were included in this study, with a mean age of 64.3 ± 22 years and a male/female sex ratio of 0.93. Valvular AF was identified in 22.4% of the patients. The mean CHA2DS2VASC score in nonvalvular AF was 2.4 ± 1.6. Monotherapy with antiplatelet agents was prescribed for 13.8% of the patients. However, 21.7% of the subjects did not receive any antithrombotic agent. Oral anticoagulants were prescribed for half of the patients with a low embolic risk score. In 341 patients, the mean time in therapeutic range was 48.87 ± 28.69%. Amiodarone was the most common antiarrhythmic agent used (52.6%). During a 12‐month follow‐up period, 15 patients (1.64%) had thromboembolism, 53 patients (5.8%) had major hemorrhage, and 52 patients (5.7%) died.ConclusionsNATURE‐AF has provided systematic collection of contemporary data regarding the epidemiological and clinical characteristics as well as the management of AF by cardiologists in Tunisia. Valvular AF is still prevalent and the quality of anticoagulation was suboptimal.

IntroductionOver 40,000 cases of coronavirus (CoV) disease 2019 (COVID-19) have been confirmed in China. The causative agent, 2019 novel CoV (2019-nCoV), has spread rapidly to more than 25 countries worldwide. Human-to-human transmission has accounted for most of the infections outside Wuhan. Most studies to date on COVID-19 have focused on disease etiology and the genomics of 2019-nCoV, with few reports on the epidemiologic and clinical characteristics of infected patients.MethodsWe report early clinical features of 26 patients with confirmed COVID-19 who were admitted to Liaocheng Infectious Disease Hospital in Shandong Province.ResultsThe median age of the 26 patients with COVID-19 in this study was 42 years. The most common occupation was retail staff (16 patients, 61.54%), with 11 patients or their family members working at the same supermarket. Only 2 patients had visited Wuhan since December 2019; the other cases of 2019-nCoV infection arose from patient-to-patient transmission. Twelve patients had more than one sign or symptom; however, seven patients had no sign or symptom. The average time from symptom onset to admission was 4.5 days. CT revealed signs of bronchitis in 2 patients and unilateral and bilateral pneumonia in 9 and 15 patients, respectively. The patients received the following treatments: antiviral therapy (100%), Chinese medicine (76.92%), antibiotics (50%), gastric mucosal protection (19.23%), immunotherapy (7.69%), and glucocorticoids (3.85%). Most patients (25/26) required ≥1 treatment.DiscussionIn contrast to previous reports, most patients (24/26) had not been in close contact with individuals from Wuhan. Additionally, 11 patients or their family members worked at the same supermarket, suggesting active viral transmission in a location frequented by a large number of people. Close monitoring is essential for preventing the large-scale spread of the virus in such places.

Objective To explore the clinical and epidemiological characteristics of measles,and to provide scientific basis for disease prevention.Methods The clinical data of 132 measles inpatients from 2001 to 2010 were retrospectively analyzed,and the clinical and epidemiological characteristics of them were summarized.Results Among 132 patients with measles.Most patients were found from February to June(84.00％,111 cases),aged from 19 to 36 years old (71.97 ％,95 cases) and was found in cities(81.82 ％,108 cases) ; the ratio of male to female was 2.57∶1.All the cases had fever,43.18％ (57 cases) of whom had body temperature ＞ 39 ℃,all patients had skin rash.The skin rash in 96 cases (72.73％) were typical and in 98 cases (74.24％) were onseting in 4 days of the disease course.Fifty-four patients (40.91％) had mucous patch.Pneumonia and bronchitis,liver function damage,cardiac damage were the main complication,which accounting for 27.27％ (36 cases),13.64％ ( 18 cases) and 7.58％ ( 10 cases).The vaccination rate of measles vaccine was only 31.82％ (42 cases).All the patients had good prognosis.Conclusions The incidence of measles in adult is increasing and the manifestations are typical,but the prognosis is good.It is suggested that consummating measles vaccine and paying more attention to reinforcement of immuno-inoculation in adults are very importment. Key words: Measles; Clinical characteristics; Epidemiological characteristics