Incidence Of Fever Research Articles

Neonatal and Maternal Outcomes of mRNA Compared With Non-mRNA Vaccinations in Pregnant Patients With COVID-19: A Systematic Review and Meta-Analysis [ID 2683437

INTRODUCTION: COVID-19 infection in pregnancy poses risks such as preeclampsia, preterm birth, and stillbirth, even when asymptomatic. Vaccination is recommended, but hesitancy exists because of limited pregnancy-related data. Notable vaccines in the United States considered safe in pregnancy are Pfizer and Moderna, two mRNA vaccines, and Johnson & Johnson, an adenovirus vaccine. We aimed to investigate the safety profile of mRNA versus non-mRNA vaccines, and if a particular vaccine type offered superior care. METHODS: We systematically searched Pubmed, Embase, and Cochrane Central for studies comparing mRNA and non-mRNA vaccines. RevMan5 and RStudio were used for statistical analyses. RESULTS: We included eight observational studies, with a total of 32,153 patients assessed for maternal and neonatal outcomes. Overall, mRNA vaccines had lower incidence of fetal death outcomes (P<.00001), and non-mRNA vaccines had lower incidence of fever (P<.00001). In subgroup analyses, the J&J vaccine (Ad26.COV2.S) was less associated with premature labor/delivery (P=.09) and missed/spontaneous abortion (P=.02) when compared to Pfizer. Leave-one-out analysis favored mRNA vaccines in reducing the risk of fetal or neonatal death and still favored non-mRNA vaccines for minimizing pyrexia, expressing low heterogeneity. CONCLUSION: This meta-analysis changes our current perspective on the safety profile of mRNA vaccines, providing insightful information, because the use of certain vaccine classes may benefit women prone to certain events, such as recurrent pregnancy loss or with a history of premature labor/delivery.

POLA SEBARAN DAN ANALISIS FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN DEMAM BERDARAH DENGUE

Dengue hemorrhagic fever (DHF) is a disease that causes death, known for > 200 years, and has become a health problem in the world, especially in developing countries, including Indonesia. Deli Serdang Regency had the highest number of cases in North Sumatra Province in 2019 with 1,326 cases, in 2020 there were 974 cases, IR: 50.4. In 2021, the Regency/City ranked 14th out of 514 Regency/City in Indonesia for the highest number of dengue fever cases in 2021 with 803 cases, IR/morbidity rate: 34.63/100,000 population, CFR/death rate: 0.12%. It is possible to identify the location of the patient to the address of the individual's location, so as to obtain information regarding the distribution pattern of cases in each region using the Geographic Information System (GIS) and analysis of factors related to the incidence of dengue hemorrhagic fever.This type of research is analytical observation with a case control approach. The sample in this study was all people living permanently in the working area of ??the Tanjung Morawa Community Health Center, totaling 48 respondents, 24 cases and 24 controls. The sampling technique was carried out using Simple Random Sampling, data was analyzed using the Chi Square test. Based on the research results, it shows that the variables related to the incidence of dengue fever are knowledge (p-value = 0.00; OR = 0.06), attitude (p-value = 0.00; OR = 21), 3M PSN (Mosquito Nest Eradication) actions Plus (p-value=0.000; OR=17) and unrelated variables are occupation (p-value=0.029; OR=0.23) and age (p-value=0.081; OR=0.29). It is recommended that the community health center be better able to increase public understanding about the management and prevention of dengue fever.

Overview of Dengue Fever (DHF) incidence based on population density in Indonesia

Dengue fever (DHF) is an infectious disease caused by the dengue virus, with Aedes aegypti and Aedes albopictus mosquitoes as vectors. The prevalence of DHF globally has increased significantly, and the infection has become endemic in many regions including Indonesia. The purpose of this study was to determine the relationship between population density and the incidence of Dengue Hemorrhagic Fever (DHF) in Indonesia. This research uses a descriptive method with a population correlation study. Descriptive analysis in this study utilized the Health Mapper version 4.3.0.0 application while the population correlation test used the SPSS data processing application with the Spearman bivariate test. The population in this study is provinces in Indonesia. The independent variable in this study is population density in provinces in Indonesia, while the dependent variable in this study is the incidence of Dengue Fever (DHF) in Indonesia in 2020, 2021, and 2022. The results showed that DHF cases are directly proportional to the high population density in a province. The correlation test on dengue cases and Indonesia's population density in 2020 showed a correlation coefficient of 0.811. The correlation test between DHF cases and Indonesia's population density in 2021 showed a correlation coefficient of 0.766. The correlation test between dengue cases and Indonesia's population density in 2022 showed a correlation coefficient of 0.741. This study concluded that there is a very strong relationship between dengue fever cases and population density in various regions in Indonesia.

Spatial Analysis of Environmental Factors in the Dengue Hemorrhagic Fever Incident at Soe City District

Introduction: In 2022, there was a large increase in cases resulting in extraordinary events cases in the TTS district with the number 226 cases. Half of the percentage of outbreak cases that occurred in Soe City with a number of cases is 134 cases. Spatial analysis can be used to see patterns of disease distribution in certain areas.Methods: This research is a type of descriptive research with a case study approach. This descriptive research was carried out using a survey method where there was no intervention on variables but simply observing natural phenomena or looking for relationships between these phenomena and other variables.Results: The research of dengue case data is divided into univariate analysis and spatial analysis, for example, classification, buffering and Moran index. Environmental factors in the form of the existence and condition of water reservoirs with dengue fever incidents can be seen in data related to the number of water reservoirs used by the community which are left open and the number is >3, making it easier for mosquitoes to breed. In the Spatial Classification Analysis, Nonohonis Village has the highest level of risk, but Autocorrelation Analysis states that the Oekefan area has larger cluster points than Nonohonis Village. Furthermore, environmental factors include the existence and condition of dug wells. at a depth of ≤15m with open conditions makes it easier for mosquitoes to breed. Apart from that, based on the buffer data above, it can be seen that at a radius of <100m it is 3 times larger than a radius of 100 to 300m and 2.7 times larger than a radius of 300m to 500m. Environmental factors include the existence and condition of waste water drainage channels (SPAL) with dengue fever incidents. Based on the buffer data above, it can be seen that at a radius of <100m it is 0.6 times greater than the radius from 100 to 300m and 0.8 times greater than the radius from 300m to 500m.Conclusion: It is necessary to control mosquito breeding in water reservoirs and dug wells through education regarding malaria risk factors in Soe City.

Faktor yang Berhubungan dengan Kejadian Dbd pada Anak di Wilayah Kerja Puskesmas Oesapa Kota Kupang

Dengue Hemorrhagic Fever (DHF) is still a health problem in the Oesapa Community Health Center working area. Data of dengue fever sufferers at the Oesapa Community Health Center for the last 3 years from 2020 there were 279 cases, in 2021 there were 94 cases and in 2022 there were 60 cases. This research aims the relationship between preventive measures, level of education, and support from families and health workers with the incidence of Dengue Hemorrhagic Fever in children in the working area of ​​the Oesapa Community Health Center, Kupang City. The type of research used is quantitative, analytical observational in nature. This research uses a case control or case control survey design. The sample in this study amounted to 94 respondents. The sampling technique used was simple random sampling with matching. Data analysis used with the Chi square test with a confidence level of 95% (α = 0.05). The results of the study showed that the factors related to the incidence of dengue fever were the action factor p= 0.007 (OR= 3.419), the education factor p= 0.023 (OR= 2.843), the family support factor p= 0.000, while the factors that were not related to the incidence of dengue fever were factors support from health workers p= 0.208. Lack of understanding of dengue prevention and control efforts is one of the factors in the occurrence of dengue fever so it is highly hoped that the participation of all family members in prevention efforts with the 3 M Plus movement.

Analysis of temperature, humidity, rainfall, and wind velocity on dengue hemorrhagic fever in Bandung municipality

The trend of dengue hemorrhagic fever prevalence every year continues to show an increase and number of deaths. This is due to an increase in the population of aedes aegypti mosquitoes. Climate change has the potential to affect mosquito-borne diseases, including dengue fever, which is a vulnerability for residents in Bandung Municipality. This research aims to analyse the relationship between temperature, humidity, rainfall, and wind velocity with dengue hemorrhagic fever in Bandung Municipality. The methodology research used in this study is descriptive analysis with a cross-sectional approach. This research was conducted in Bandung Municipality. The study samples were taken from data on dengue hemorrhagic fever sufferers, as well as data on temperature, humidity, rainfall, and wind speed. This study used secondary data. The data collected is in the form of data on temperature, humidity, rainfall, and wind speed, and the number of cases. To assess the correlation between variables using the person correlation test. To test the effect of all four variables simultaneously on the incidence of dengue hemorrhagic fever using a linear regression test. Average value of air temperature is 25.8°C, air humidity is 69.9%, rainfall is 201.5 mm, and the wind velocity is 1.8 knots. The prevalence of dengue hemorrhagic fever is 232.5 cases. There is a significant relationship between humidity with dengue hemorrhagic fever prevalency (p = 0.018, r = 0.873). Wind velocity with dengue hemorrhagic fever prevalency (p = 0.018, r = 0.629). The result of the coefficient of determination test on temperature, humidity, rainfall, and wind velocity with DHF cases is R2 = 0.745. The increase in dengue prevalence in Bandung City occurred from January to June, the decrease in prevalence occurred from July to December. Variations in temperature, humidity, rainfall and wind speed can simultaneously affect the incidence of dengue fever in Bandung. Therefore, in the future it is necessary to increase mosquito nest eradication activities to prevent dengue transmission considering that this disease has the potential to spread at any time.

Changing etiological spectrum of acute liver failure.

Acute liver failure (ALF) is an uncommon but potentially dramatic syndrome characterized by massive hepatic necrosis and has a very high mortality rate of 50% to75% without liver transplantation. This study is aimed at analyzing the etiological spectrum of ALF patients and compare these with ALF mimicssuch as malaria, dengue fever and other tropical infectious diseases. The study population included patients who presented with ALF and ALF mimics in a tertiary care center over two years. We retrospectively analyzed the patient case files and a comparison was made concerning the baseline demographic details, clinical profile, laboratory values and outcomes. Sixty-three patients were assessed, with 32 in ALF and 31 in ALF mimics group. The most common cause for ALF was hepatitis A virus (25%), followed by hepatitis B virus (18.7%), drug-induced liver injury (12.7%), autoimmune hepatitis (12.5%), hepatitis E virus (9.3%) and Wilson's disease (6.25%). In the ALF mimics group, malaria (58.06%) was the most common cause, followed by dengue fever (16.1%), leptospirosis (12.9%) and scrub typhus (12.9%). Patients in the ALF mimics group had significantly higher incidence of fever (p = 0.001), hepatosplenomegaly (p = 0.01), anemia (p = 0.02) and shorter jaundice to encephalopathy duration (p = 0.032) as compared to the ALF group, while higher transaminase levels (p = 0.03), bilirubin (p = 0.01), prothrombin time (p = 0.01), serum ammonia (p = 0.02) and mortality (p = 0.02) were observed in ALF patients. The most common cause for ALF was hepatitis A virus, followed by hepatitis B virus, while in ALF mimics it was malaria followed by dengue fever, in our study. Patients of ALF mimics can have similar presentation, but a high index of suspicion and awareness is required to identify the common infectious ALF mimics for early diagnosis.

Environmental Analysis Of The Aedes Aegypti Mosquito As Dhf Vector In The Enrekang District

Dengue Hemorrhagic Fever is a major health problem in Indonesia. The existence of the Aedes Aegypti mosquito is the main vector that causes Dengue Hemorrhagic Fever (RI Ministry of Health, 2020). The physical environment of the Aedes Aegypti mosquito greatly influences the ecology and development of the Aedes Aegypti mosquito, which is the main factor causing Dengue Hemorrhagic Fever (Listiono et al, 2020). The incidence of Dengue Fever in the people of Enrekang Regency is influenced by the physical environment of the Aedes Aegypti mosquito. Data on the physical environment of the Aedes Aegypti mosquito in the Enrekang Regency area is inadequate. In the Enrekang district area, there were 166 cases of dengue fever in 2019, in 2020 there was an increase of 209 cases and there was a decrease again in 2021 with 64 cases. Cases of Dengue Hemorrhagic Fever sufferers in Enrekang district are among the 10 highest diseases. The aim of the research is to determine the relationship between the physical environment (temperature, pH, humidity and residential density) of the Aedes Aegypti mosquito and the incidence of Dengue Hemorrhagic Fever in Enrekang district. The method in this research is analytical observational using a Case Control study approach. Analytical observational research is research that tries to identify how health phenomena occur. Sampling was carried out using the total sampling method. Data was obtained directly from the Enrekang District health office. The research results showed that there was a significant relationship between room temperature, water pH and room humidity with the incidence of Dengue Hemorrhagic Fever in Enrekang district with respective p-values of (0.007, 0.001 and 0.000). The results of the research show that the physical environment of the Aedes Aegypti mosquito is a risk factor for the occurrence of Dengue Fever in Enrekang district.

Effects of early debridement and conservative eschar removal followed by wound coverage with acellular dermal matrix in the treatment of children with deep burns

Effects of early debridement and conservative eschar removal followed by wound coverage with acellular dermal matrix in the treatment of children with deep burns

Dengue Hemorrhagic Fever (DHF) Education for Residents of Labuh Baru Timur RT 02/08, Payung Sekaki District, Pekanbaru

This community service is conducted in the form of public health initiatives aimed at combating dengue hemorrhagic fever (DHF) in Indonesia. These initiatives are implemented in Labuh Baru Timur Village, RT 02/08, located in Payung Sekaki District, Pekanbaru City, Riau Province. The target beneficiaries of these activities include toddlers, children, adolescent girls, housewives, and the broader community. The primary objective of this community service endeavor is to enhance the knowledge of the targeted partner communities, particularly mothers who are members of POSYANDU (integrated health post), PUSKESMAS (community health centers), doctors, and village midwives, regarding the causes, consequences, and prevention strategies related to dengue hemorrhagic fever (DHF). The methods employed for executing this community service activity involved conducting household visits and organizing discussions on dengue hemorrhagic fever (DHF). Data about participants’ understanding of DHF were collected through pre-test and post-test questionnaires. The anticipated outcome of these efforts is to reduce the incidence of dengue hemorrhagic fever (DHF) and minimize its impact on affected individuals. In instances where residents are diagnosed with DHF and necessitate hospitalization, the objective is to facilitate their prompt and full recovery, thereby enabling them to resume their daily routines, including school attendance.

Distinguishing Kikuchi-Fujimoto disease from lymphoma in patients by clinical and PET/CT features.

To develop a scheme for distinguishing Kikuchi-Fujimoto disease (KFD) from lymphoma in patients presenting enlarged lymph nodes (LNs) predominantly on the upper side of the diaphragm. From November 2015 to August 2023, 32 KFD patients and 38 lymphoma patients were pathologically confirmed and enrolled in this retrospectively study. Clinical and 18F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) features were collected. When comparing those PET/CT parameters, we set 5 models with different research objects: (1) all affected LNs; (2) the 5 largest affected LNs in terms of maximum diameter; (3) the 5 largest affected LNs in terms of maximum standard uptake values (SUVmax); (4) the largest affected LNs in terms of maximum diameter; (5) the largest affected LNs in terms of SUVmax. Compared to lymphoma patients, KFD patients were younger; and with higher incidence of fever, arthralgia, abnormal serum white blood cell, lactate dehydrogenase (LDH) and splenomegaly; lower incidence of affected LNs perinodal infiltration, necrosis and conglomeration; more affected LNs in Head and Neck nodes (particularly in level II) and Axillary in KFD (P ˂ .05). PET/CT parameters presented as various difference in each model. Finally, 11 clinical and PET/CT features (age ≤ 34, with fever, arthralgia, abnormal white blood cell, abnormal LDH, and without node necrosis and node conglomeration have a score of 2 each; splenomegaly, perinodal infiltration, median maximum diameter ≤ 20.5 and median SUVmax ≤ 7.1 of affected LNs in model 2 have score of 1 each) were selected as scheme items for distinguishing KFD from lymphoma. Individuals who have a total score > 8, meet the criteria for KFD. Sensitivity and specificity were high: 86.8% (95% CI: 71.9%, 95.5%) and 96.9% (95% CI: 83.7%, 99.5%), AUC = 0.975 (95% CI: 90.5%, 99.6%), respectively. It can effectively distinguish KFD from lymphoma by clinical and PET/CT parameters.

Fever in rheumatological diseases

Fever is afrequent and important symptom in patients with rheumatological diseases and can be an expression of activity of the underlying rheumatological disease. There is great variability in the incidence of fever as asymptom of the disease between individual diseases. The growing understanding of the molecular signatures of the diseases can help to explain these discrepancies: Agenetic overactivation of potently pyrogenic cytokines is the reason why fever is nearly always present in autoinflammatory syndromes. In contrast, fever is less common in polyarthritis and myositis and mostly limited to severe courses of disease. In the diagnostic work-up of fever, frequent differential diagnoses, such as infections, malignancies, side effects of drugs and hypersensitivity reactions should be considered. This article provides an overview of the physiology of the development of fever, describes the relevance of fever in individual rheumatological diseases and proposes aworkflow for the clinical clarification of rheumatological patients who present with fever.

Clinical characteristics of neonatal and infant osteomyelitis and septic arthritis: a multicenter retrospective study

ObjectiveSigns and symptoms of osteomyelitis or septic arthritis in neonates and infants are often nonspecific and early-stage bone infections in infants may often go unnoticed. The objective of this study was to analyze the clinical characteristics of newborns and infants with osteomyelitis and septic arthritis to improve understanding of the disorder and to assist clinicians with diagnosis. MethodsA retrospective multicenter study was conducted on neonates (0–28 days old, n = 94) and infants (1–12 months old, n = 415) with osteoarticular infections. Data consisting of clinical characteristics, complications, laboratory outcomes, and the pathogenic microorganisms causing osteomyelitis were tabulated. The statistics were further broken down into two regions and the significant differences between neonates and infants were evaluated and compared to the literature. ResultsCompared to infants, neonates had significantly lower incidences of fever (p < 0.0001), higher incidences of localized swelling (p = 0.0021), higher rate of infection at the humerus (p = 0.0016), higher percentage of Escherichia coli (p < 0.0001) and Klebsiella pneumoniae (p = 0.0039) infections, lower percentage of Staphylococcus aureus infections (p < 0.0001) and were more likely to develop septic arthritis (p < 0.0001). ConclusionDistinct differences were found between neonatal and infants with osteoarticular infections. Future studies should focus on improving diagnosis and subsequent treatment regimens for younger age groups.

Assessment of Gastrointestinal Manifestations and Predictive Factors Associated with Their Occurrence in Kawasaki Disease Patients: A Cross-Sectional Study

Background: Kawasaki disease is an idiopathic febrile systemic vasculitis, recognized as the leading cause of acquired heart disease in pediatric patients. Gastrointestinal manifestations can lead to delayed treatment, underscoring the importance of identifying and predicting factors associated with these manifestations to enable timely intervention. Objectives: The primary objective of this study was to identify the aforementioned factors. Methods: This retrospective study collected demographic information, medical history, physical examination findings, and laboratory results of 359 children suspected of having Kawasaki disease and referred to Mofid Children’s Hospital between 2013 and 2022. The study assessed the frequency of gastrointestinal manifestations and their association with physical examination findings and laboratory data. Results: A total of 359 patients were included in the study, comprising 153 males and 206 females. The mean age of participants was 2.8 ± 2.6 years. Abdominal pain was the most common clinical manifestation, reported in 39% of patients. Elevated levels of aspartate aminotransferase (AST) were observed in 38.1% of patients, while 30.2% showed elevated alanine aminotransferase (ALT) levels, and 10.5% exhibited direct hyperbilirubinemia. Patients with elevated ALT and AST levels had a higher incidence of abdominal pain, nausea/vomiting, and anorexia. Moreover, patients with positive findings of red blood cell (RBC) and white blood cell (WBC) in their stool examination had a higher incidence of fever and abdominal pain. Conclusions: Based on our statistical analysis, elevated AST and ALT levels, hyperbilirubinemia, and positive stool findings of RBC and WBC appear to be predictive factors for gastrointestinal manifestations in Kawasaki disease.

Are prophylactic antibiotics required for combined intracavitary and interstitial brachytherapy of gynecologic cancers?

The purpose of this study is to evaluate the need for prophylactic antibiotic treatment prior to combined intracavitary and interstitial (hybrid) brachytherapy for gynecologic cancer. A total of 105 gynecologic cancer patients received 405 brachytherapy sessions, including 302 sessions of intracavitary brachytherapy and 103 sessions of hybrid brachytherapy. Prophylactic antibiotics were administered before 35% of the hybrid brachytherapy sessions. The incidence of postbrachytherapy fever and the frequency of subsequent antibiotic use for infection were compared between treatment groups. Among patients treated with hybrid brachytherapy, fever ≥37.5°C occurred in 16.4% of those not receiving prophylactic antibiotics and 16.7% of those receiving prophylactic antibiotics (P > 0.05). Similarly, fever ≥38.0°C occurred in 4.9% of patients not receiving prophylactic antibiotics and 2.4% of those receiving prophylactic antibiotics (P > 0.05). Additional antibiotics were used to treat postbrachytherapy infections in 4.8% of the group receiving prophylactic antibiotics and 0% of those not receiving prophylactic antibiotics, again without statistically significant difference. There were also no significant differences in posttreatment fever incidence and antibiotics use for infection between intracavitary brachytherapy and hybrid brachytherapy sessions. In conclusion, the incidences of infection and fever are low following hybrid brachytherapy, so prophylactic antibiotics are generally unnecessary.

Complications and Efficacies of Surgical Versus Transcatheter Closure for Pediatric Ostium Secundum Atrial Septal Defect: A Meta-Analysis.

The optimal approach for pediatric ostium secundum atrial septal defect (ASD) closure remains uncertain. This study aims to assess complications and efficacies of surgical and transcatheter closures. Systematic search in Medline, Cochrane, and EMBASE databases identified cohort studies until July 2023. Complications, length of hospital stay, and efficacy outcomes were evaluated. Subgroup analyses considered ethnicity, ASD size, age, and rim deficiency involvement. Fourteen cohort studies involving 9695 patients were comprehensively analyzed. Regarding complications, the pediatric patients in the surgery group exhibited higher occurrences of cardiac arrhythmia (odds ratio [OR]: 1.87, 95% confidence interval [CI]: 1.22-2.87, p=0.004), pericardial effusion (OR: 14.80, 95% CI: 6.97-31.43, p<0.00001), and pulmonary complications (OR: 2.58, 95% CI: 1.73-3.85, p<0.00001) compared with those in the transcatheter group. However, no significant difference in fever incidence was observed (OR: 2.57, 95% CI: 0.90-7.34, p=0.08). Furthermore, length of hospital stay was notably shorter in the pediatric transcatheter group (mean difference [MD]: 4.00, 95% CI: 1.71-6.29, p=0.0006). Regarding efficacies, both groups demonstrated similar rates of successful closure (OR: 1.97, 95% CI: 0.56-6.92, p=0.29) and residual shunting (OR: 0.55, 95% CI: 0.17-1.77, p=0.31) in the pediatric cohort. Subgroup analyses revealed that surgical residual shunting was notably lower in the European pediatric population (OR: 0.18, 95% CI: 0.07-0.45, p=0.0002), in cases with ASD size exceeding 15 mm (OR: 0.19, 95% CI: 0.08-0.49, p=0.0006), and in pediatric patients younger than 8 years (OR: 0.33, 95% CI: 0.12-0.92, p=0.03). Interestingly, residual shunting involving complex ASD with rim deficiency was more pronounced in the surgery group (OR: 2.66, 95% CI: 1.33-5.32, p=0.006). Both surgical and transcatheter closures are equally effective, with transcatheter closure showing significantly fewer complications. This meta-analysis offers pivotal insights for clinicians grappling with the optimal approach to pediatric ostium secundum ASD closure. The observed higher incidence of cardiac arrhythmias, pericardial effusions, and pulmonary complications in surgical closures underscores the challenges associated with this modality. In contrast, transcatheter closure, with its comparable efficacy and shorter hospital stays, emerges as an appealing and less invasive alternative. These findings equip clinicians with evidence to make informed decisions, optimizing patient outcomes. Subgroup analyses further refine recommendations, emphasizing tailored considerations for European pediatric patients, larger ASDs, and those under 8 years old, ultimately fostering personalized and improved care strategies.

Association of temperature management strategy with fever in critically ill children after out-of-hospital cardiac arrest.

To determine whether ICU temperature management strategy is associated with fever in children with return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA). We conducted a single-center retrospective cohort study at a quaternary Children's hospital between 1/1/2016-31/12/2020. Mechanically ventilated children (<18 y/o) admitted to Pediatric or Cardiac ICU (PICU/CICU) with ROSC after OHCA who survived at least 72 h were included. Primary exposure was initial PICU/CICU temperature management strategy of: (1) passive management; or (2) warming with an air-warming blanket; or (3) targeted temperature management with a heating/cooling (homeothermic) blanket. Primary outcome was fever (≥38°C) within 72 h of admission. Over the study period, 111 children with ROSC after OHCA were admitted to PICU/CICU, received mechanical ventilation and survived at least 72 h. Median age was 31 (IQR 6-135) months, 64% (71/111) were male, and 49% (54/111) were previously healthy. Fever within 72 h of admission occurred in 51% (57/111) of patients. The choice of initial temperature management strategy was associated with occurrence of fever (χ2 = 9.36, df = 2, p = 0.009). Fever occurred in 60% (43/72) of patients managed passively, 45% (13/29) of patients managed with the air-warming blanket and 10% (1/10) of patients managed with the homeothermic blanket. Compared to passive management, use of homeothermic, but not of air-warming, blanket reduced fever risk [homeothermic: Risk Ratio (RR) = 0.17, 95%CI 0.03-0.69; air-warming: RR = 0.75, 95%CI 0.46-1.12]. To prevent fever in one child using a homeothermic blanket, number needed to treat (NNT) = 2. In critically ill children with ROSC after OHCA, ICU temperature management strategy is associated with fever. Use of a heating/cooling blanket with homeothermic feedback reduces fever incidence during post-arrest care.

Prospective Analysis of Acute Encephalitis Syndrome: Clinical Characteristics and Patient Outcomes in a Tertiary Care Pediatric Setting

Background: One of the most frequent neurological emergencies in pediatrics, central nervous system infections cause a considerable amount of death and morbidity. Especially in newborns, the symptoms are frequently modest, therefore a strong index of suspicion is needed to make the diagnosis. Inadequate or delayed treatment may result in fatalities or other severe consequences.  Objective: To ascertain the frequency, clinical characteristics, and etiological makeup of kids hospitalized in tertiary PICU due to acute encephalitis syndrome. Results of kids referred to tertiary PICUs with acute encephalitis symptoms.  Study Design: Hospital based prospective study.  Participants: Children with AES from one month up to 18 years of age admitted in PICU of hospitals.  Intervention: Thorough clinical assessments were completed, and blood samples will be sent for various baseline biochemical analyses. In every instance, samples of blood and urine were sent for sensitivity and culture while adhering to strict aseptic protocol. In every incidence of fever with altered sensorium, neuroimaging and CSF analysis will be carried out.The history, clinical examination, and pertinent laboratory investigations are used to determine the etiology of AES.  Results: Out of the one hundred cases that were examined, five had J.E., thirty had rickettsia, twenty had dengue, one had varicella, twelve had COVID-19, five had measles, four were pyogenic, one had tuberculosis, twelve had ADEM, and nine were undiagnosed. A total of 45 patients were lost to follow-up throughout the follow-up period. Of the patients, 16 had hearing loss, 10 had speech loss, 15 had extra pyramidal abnormality, 21 had behavioral abnormality, and 21 had cranial nerve impairments.  Conclusion: AES is a persistent public health issue that requires immediate attention, as well as cooperation and support from other sectors. Strengthening primary health care is urgently needed to provide access to both routine and emergency care, both of which are essential for better results.

Hantavirus Infections: Review of the Epidemiological Situation around the World. Analysis of the Epidemiological Situation on Hemorrhagic Fever with Renal Syndrome in the Russian Federation in 2023 and Forecast of Its Development for 2024

The paper describes the epidemiological situation in the countries of the world in terms of the incidence of Hantavirus diseases. The results of an epidemiological analysis of the incidence of hemorrhagic fever with renal syndrome (HFRS) in the Russian Federation in 2023 by federal districts are presented and a forecast for 2024 is made. In 2023, 5 093 cases of HFRS were registered in the Russian Federation (3.47 per 100 thousand population). The incidence was reported in 7 out of 8 federal districts of the country. The age structure was dominated by people in the 30–59 age category (65.7 %); 247 cases of the disease were noted among children under 17 years of age. The proportion of the male population was 70.3 %. 63.2 % of the total number of cases was registered among the urban residents. The mortality rate was at the level of 0.49 % – 25 lethal outcomes. Analysis of the data has revealed a decrease in the incidence of HFRS in Russia by 27.2 % as compared to the previous year. However, the data from epizootiological monitoring and the results of laboratory research of field material indicate a continuing tense situation in the country as a whole. In a number of regions, a high risk of complications of the epidemiological situation is predicted (mainly, in the constituent entities of the Volga and Central Federal Districts). Moderate risks of developing local complications of the epidemiological situation at the level of long-term average morbidity are expected to be realized in the entities of the Northwestern, Ural and Far Eastern Federal Districts. Sporadic cases of the disease in the territory of the Southern Federal District are not excluded. The aggravation of the situation on HFRS in the territory of the North-Caucasian and Siberian Federal Districts is not anticipated in 2024.

Effect of perioperative blood transfusion on complications and prognosis after radical gastrectomy in elderly patients: a retrospective study of 1,666 cases.

Multiple studies have examined the effect of perioperative blood transfusion (BTF) on postoperative complications and the prognosis of gastric cancer patients, but the conclusions remain controversial, and few studies related to elderly patients are present. This study sought to examine the effect of perioperative BTF on postoperative complications and the prognosis of elderly patients who underwent radical gastrectomy. The clinical data of 1,666 elderly patients (aged ≥60 years) at Xijing Hospital from October 2013 to October 2021 were retrospectively analyzed. The patients were stratified into the perioperative BTF group and the perioperative non-BTF group. The clinicopathological characteristics, postoperative complications, and long-term prognoses of the patients were compared. There were significant differences in terms of sex, tumor location, tumor size, gastrectomy range, tumor differentiation, T stage, N stage, tumor-node-metastasis (TNM) stage, preoperative anemia, and intraoperative blood loss between the two groups (P<0.05). The incidence of postoperative fever in the BTF group was significantly higher than that in the non-BTF group (31.6% vs. 15.4%, P<0.001), but there were no significant differences in the other complications between the two groups (P>0.05). The survival analysis showed that in stage III patients, the prognosis of the BTF group was inferior to that of the non-BTF group [the 3-year overall survival (OS) rates of the groups were 33.7% vs. 47.9% respectively, P<0.001], while there was no significant difference between the two groups among the stage I and stage II patients (P>0.05). There was no significant difference in the prognosis of patients with different transfusion times (preoperative/intraoperative/postoperative) (P>0.05). The multivariate analysis indicated that perioperative BTF was not an independent risk factor for prognosis in elderly patients with gastric cancer overall or elderly patients with gastric cancer in stage III (P>0.05). Perioperative BTF may elevate the incidence of fever but has no significant effect on other complications in elderly patients after radical gastrectomy. Perioperative BTF is not an independent risk factor affecting the postoperative prognosis of elderly patients with gastric cancer.