Infectious diseases (London, England)
-
Background: An increasing number of international travellers are at risk for dengue infection. We analysed the characteristics of Finnish travellers with recently acquired dengue infections. Methods: Notified dengue infections from 2016 to 2019 were obtained from the Finnish National Infectious Disease Register. ⋯ Our study showed that there was low awareness regarding the risk of contracting the infection. In addition, many travellers reported inadequate use of protective measures. This calls for further public health actions, such as raising awareness of day-active mosquitoes, of risk at popular travelling destinations and the correct way of applying anti-vectorial measures.
-
Case Reports
Positive RT-PCR in urine from an asymptomatic patient with novel coronavirus 2019 infection: a case report.
Introduction: With the emergence of novel coronavirus disease 2019 (COVID-19) in many countries, medical resources currently focus on the treatment of confirmed patients and screening of suspected cases. Asymptomatic patients may be contagious, which makes epidemic control difficult. We describe an asymptomatic patient with a positive real-time polymerase chain reaction (RT-PCR) test in urine. ⋯ At follow-up on 26 March, she felt well, throat swab RT-PCR was negative, and isolation was lifted. Conclusion: The urine of asymptomatic patients may be contagious. RT-PCR in urine might be a useful supplement in screening when the RT-PCR is negative in throat swabs.
-
Randomized Controlled Trial
Combination of vitamin C, thiamine and hydrocortisone added to standard treatment in the management of sepsis: results from an open label randomised controlled clinical trial and a review of the literature.
Background: Combination of vitamin C, hydrocortisone and thiamine have recently been used in sepsis but data of efficacy are conflicting and no data are available from developing countries. We sought to study the effect of addition of this combination to standard care in patients with sepsis/septic shock in a north Indian setting. Methods: In a prospective, open label, randomised fashion, 100 patients with sepsis/septic shock were recruited to receive either standard therapy alone (control group, n = 50) or a combination of vitamin C, thiamine and hydrocortisone (treatment group, n = 50) in addition. ⋯ However, there was a significant difference in duration of vasopressor use (96.13 ± 40.50 h in control group v/s 75.72 ± 30.29 h in treatment group, p value = .010) and lactate clearance (control group: 41.81% v/s treatment group: 56.83%, p value =.031) between 2 groups. Conclusions: Addition of vitamin C, hydrocortisone, and thiamine into standard care of sepsis does not improve in-hospital or 30 day mortality. However lower vasopressor use and faster lactate clearance is observed with treatment.
-
Background: Procalcitonin is a biomarker that can be used to diagnose bacterial infection and monitor treatment. Clinical practice guidelines are evidence-based recommendations by experts that aim to aid decision-making. In this systematic review, we searched for clinical practice guidelines and evaluated recommendations given regarding use of procalcitonin. ⋯ None took a stand on how often procalcitonin should be analysed, and if it should be used as a single or as multiple measurements. Conclusions: One international and 11 national clinical practice guidelines endorse the use of procalcitonin in differential diagnosis of bacterial infections and/or to monitor antibiotic therapy. However, the evidence for or against the use of procalcitonin is weak.