Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare but life‐threatening multisystem adverse reaction to a medication, with vancomycin being one of the most common cause reported. We present the HLA analysis of a pediatric patient who developed DRESS related to vancomycin and compared the results with the available literature. With further data, the use of pretreatment HLA analysis to prevent vancomycin related DRESS may be a valuable option in the near future.
This present study results support that HLA-Cw7 allele, an inhibitor of KIR ligand, may play a role in the pathogenesis of CVID.
Objective: Diagnostic delay is one of the major problems for patients with predominantly antibody deficiencies (PAD) that can lead to anxiety and depression disorders, like in other chronic diseases. We aimed to detect the frequencies of anxiety and depression in PAD patients. The second aim was to determine the influence of diagnosis delay on the patients’ anxiety and depression. Materials and Methods: In this prospective study, 40 patients and 50 healthy controls answered the Hospital Anxiety and Depression Scale (HADS). We compared the anxiety, depression, and the total scores of the patients and the healthy controls. We divided the patients into two groups as delayed and early diagnosed patients according to median diagnostic delay year and compared the HADS scores of the two groups. Results: The anxiety, depression and the total scores of PAD patients were significantly higher compared to the healthy controls; (p=0.001, p=0.001, p=0.001), respectively. The HADS scores were significantly higher in the delayed diagnosis patient group than the early diagnosed patient group (p=0.001, p=0.003, p=0.001), respectively. We also confirmed this positive relationship between delayed diagnosis and the HADS scores with Spearman’s correlation analysis. Conclusion: We demonstrated that psychiatric disorders such as anxiety and depression are common in PAD patients, and delayed diagnosis strongly affects their anxiety and depression. Collaboration with psychologists and psychiatrists during the management of these patients may improve the quality of their life. Keywords: Predominantly antibody deficiencies, early diagnosis, anxiety, depression
Introduction: Vitamin D has a pivotal role in bone metabolism. It regulates immunity and inflammation. In this current research, it was aimed to determine whether there is an association between the mortality rate and the vitamin D level of critically ill patients who were followed in intensive care unit (ICU). Material and Method: Fifty two patients (30 (58%) female and 22 (42%) male) admitted to ICU with the diagnosis of respiratory failure, sepsis, acute renal failure, multiple organ failure, GIS bleeding were included in the study. During the admission to the ICU, all of the patients' complete blood count, C-reactive protein, serum calcium, albumin, urea, creatinine, 25-OH vitamin D, potassium, and arterial/venous blood gas levels were measured. Their acceptable mortality risk was calculated according to the APACHE II scoring system. Results: The level of vitamin D was found at least 1 up to 78.6 range, and the average was 19.61 ng/dl. Eighteen (35%) patients were discharged and 34 (65%) of the ICU patients were died. Vitamin D deficiency was observed to be a very common issue in our critically ill patients (65.4%). The difference between the two groups of age, accepted mortality and urea levels were found to be statistically significant (p<0.05). According to the terms of the patient's vitamin D status, differences were not significant (p=0.269). Vitamin D deficiency in the multivariate analysis was not an independent risk factor for mortality. Discussion: Vitamin D deficiency occurs quite often in patients with chronic, severe disease. These patients are admitted to the ICU with more serious acute problems. They have high Apache II scores as well as poor prognosis and high mortality rates during ICU. Our results suggest that although vitamin D deficiency is not a real risk factor, it is a supporting factor in explaining increased mortality rates.
the population) for the region was 3.3% and consistent with national data, but rates within individual hospitals varied between 1.5% and 5.7% over the three year period. Bed days per 1000 population ('standardised bed days') per year varied almost fourfold, from 34.5 to 122.3 in different hospitals. Corrected length of stay showed high discordance when compared to average length of stay. Conclusions The average length of stay is substantially affected by admission rates, with hospitals who admit a greater proportion of infants appearing to have a shorter uncorrected length of stay. We propose that a single corrected measure for length of stay should be used when assessing the efficiency of care because it is unaffected by variations in local admission rates and is adjusted for local population size. O-197HEALTH SCHOOL FOR PARENTS Background In addition to looking after the physical and mental health of our patients, paediatricians have an educational role towards the population we attend. Objective Health education towards adults who are usually in charge of children: parents, grandparents and childminders. Material and methods -Antenatal and postnatal talks ABOUT childcare topics.-Paediatric Hospital Talks: sleep, feeding, teething, Internet and health.-Paediatric Cardiopulmonary Resuscitation (CPR) Workshop.-Breastfeeding Group: -Talks in Schools: Accident Prevention and First Aid, Infant Feeding.-Paediatric files: available at Hospital de Nens de Barcelona's web: an easy reference about childcare, feeding, common infections. Results Attendance during these 6 years has increased: 42 people attended our activities during the first year (2008-09), compared to 900 during the last academic year (2012-13). Participants actively proposed new subjects. We detected a positive appreciation in surveys after workshops and lectures. 99.3% of respondents (year 2012/13) rated as high or very high their degree of satisfaction after the activities. 86.9% of the participants answered the survey. All those who attended the CPR workshop believed that it should be extended to all citizens in contact with children because it had helped them acquire important new skills. Conclusions Active and increasing participation rate.We believe that the paediatric team has the duty, in these days where access to information is easy but not always truthful, of counselling families about common health problems and helping to improve the quality of life of their patients. Background and aims Effective communication and strong professional conduct are essential to the practice of medicine. Differences across cultures are likely to impact education in these areas. We conducted a cross-sectional survey of paediatric residents in United States (US) and Singapore to study these differences. Methods A 108-item written questionnaire was developed, addressing residents' perceptions and attitudes towards communication/professionalism using five-point Likert scales. Reliability was analysed using Cronbach's alpha. Results Response rate was 64% (89/139). M...
Objective: To evaluate the knowledge levels, sensitivity status, familial latex sensitivity, and attitudes towards the prevention and treatment of latex allergies of healthcare workers (HCWs) at a tertiary hospital. Materials and Methods: The study was carried out cross-sectionally between December 2012 and March 2013. A total of 566 HCWs at a tertiary hospital were included in the study. Results: The data of a total of 566 [333 (58.8%) female and 233 (41.2%) male] HCWs were analyzed. They consisted of 179 (31.6%) physicians, 48 (8.5%) technicians, 238 (42%) nurses, 48 (8.5%) laboratory technicians and 53 (9.4%) patient care workers. The family history of atopy was significantly higher in female HCWs (24.3%) compared to males (17.2%) (p= 0.041). A significant difference was identified between the occupational groups in terms of the rate of allergic symptoms after coming into contact with medical latex products (nurses 59.7%, doctors 17.6%, technicians 5.7%, laboratory technicians 6.9 %, patient care workers 10.1%; p= 0.001). Latexrelated symptoms were significantly more common in atopic HCWs (52.3%) compared to non-atopic ones (19.4%) (p= 0.001). The rate of latex-food syndrome was significantly more frequent in female HCWs (16%) compared to males (8.9%) (p= 0.038). Symptoms that developed after contact with medical and non-medical latex products were significantly more common in female HCWs (79.9% and 80.5%) compared to the male HCWs (21.1% and 19.5%) (p= 0.001). The rate of non-HCW(s) who shared the same house/room with the HCWs after work and who had allergic symptoms while in the same environment with the HCWs was 18%. The rate of these individuals was reported to be highest among the nurses at 53% and there was a statistically significant difference in terms of occupational groups (physicians 25.5%, technicians 9.8%, laboratory technicians 2.9%, patient care workers 7.8%; p= 0.030). Multivariate regression analysis showed that personal history of atopy (OR= 28.657, 95% CI= 6.548-125.411, p= 0.001) and the type of gloves used (latex gloves) (OR= 8.730, 95% CI= 3.490-21.834, p= 0.001) were independent predictors for latex allergy. Conclusion: In conclusion, latex is not only a cause of occupational allergy but is also an allergen that has the potential to cause allergic symptoms in people who share the same environment with HCWs. Questionnaires questioning the symptoms associated with past latex allergy may be an important tool for demonstrating latex sensitization in HCWs and managing latex-related reactions.
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