1,720,957 research outputs found
Prevalence and Antibiotic Susceptibility of Group A Beta Haemolytic Streptococcal Isolates and Assessment of the Sensitivity of Selected Clinical Predictive rules in Chuldren Presenting with Acute Pharyngitis to the University Teaching Hospital, Lusaka, Zambia
No full textBackground: Group A beta haemolytic streptococcus(GABHS) associated pharyngitis is an important infection in children because of its potential to complicate into rheumatic fever and rheumatic heart disease - these are preventable with timely and appropriate antibiotic treatment. Physicians in resource poor settings such as Zambia have largely had to rely on unvalidated clinical scoring systems to decide on whether to administer antibiotics when presented with a child who has evidence of pharyngitis. The objective of this study was to determine the prevalence and antibiotic susceptibility of GABHS isolates as well as to assess the sensitivity of three clinical diagnostic criteria in children presenting with acute pharyngitis to the paediatric department.
Methods: This was a descriptive cross sectional study that was carried out over a period of six months (April- September 2011) at the paediatric outpatient department of the University Teaching Hospital in Lusaka, Zambia, involving children 3-15 years of age presenting with pharyngitis. The enrolled study participants all underwent a standard clinical assessment during which their respective clinical findings were recorded using data sheets. In addition, all the recruited participants had laboratory work out that included a throat swab for culture and subsequent typing as well as antibiotic sensitivity testing of respective isolated organisms. Data analysis with regard to prevalence and antibiotic susceptibility of GABHS isolates as well as assessment of the sensitivity of three clinical diagnostic criteria (Zambia treatment guideline criteria; The WHO ARI management criteria; The modified Centor score) was done using Epi Info version 3.3.2 and Open Epi version 2.3.
Results: A total of 146 children were recruited. Of these, 22 had GABHS pharyngitis, accounting for a prevalence of 15.1%. All the GABHS isolates were susceptible to penicillin while 5(19%) had reduced susceptibility to erythromycin. None of the parameters on the Zambia treatment guideline criteria ,when used individually ,was found to have sensitivity to detect GABHS pharyngitis; Pharyngeal exudates had a sensitivity of 4.5%, 40% for painful enlarged tonsils, 18% for both fever and tender cervical lymph nodes and 36% for the absence of viral signs. The WHO ARI management criteria were not assessed because none of the children with GABHS pharyngitis displayed any of the signs required by the criteria. The modified
IV
Centor score had a sensitivity of only 9.1% while the area under the Reciever Operator Curve (ROC) was 0.51.
Conclusion: The prevalence of GABHS pharyngitis in children presenting with acute pharyngitis at UTH is 15.1%. Penicillin remains the suitable drug of choice for treatment and both tested criteria have poor sensitivity to identify GABHS pharyngitis. Further study in a primary care setting is needed to develop and adapt more sensitive criteria for the diagnosis of GABHS pharyngitis suitable for a high rheumatic heart disease endemic are
Prevalence and Antibiotic Susceptibility of Group A Beta Haemolytic Streptococcal Isolates and Assessment of the Sensitivity of Selected Clinical Predictive Rules in Children Presenting with Acute Pharyngitis to the University Teaching Hospital, Lusaka, Zambia
No full textBackground: Group A beta haemolytic streptococcus(GABHS) associated pharyngitis is an important infection in children because of its potential to complicate into rheumatic fever and rheumatic heart disease - these are preventable with timely and appropriate antibiotic treatment. Physicians in resource poor settings such as Zambia have largely had to rely on unvalidated clinical scoring systems to decide on whether to administer antibiotics when presented with a child who has evidence of pharyngitis. The objective of this study was to determine the prevalence and antibiotic susceptibility of GABHS isolates as well as to assess the sensitivity of three clinical diagnostic criteria in children presenting with acute pharyngitis to the paediatric department.
Methods: This was a descriptive cross sectional study that was carried out over a period of six months (April- September 2011) at the paediatric outpatient department of the University Teaching Hospital in Lusaka, Zambia, involving children 3-15 years of age presenting with pharyngitis. The enrolled study participants all underwent a standard clinical assessment during which their respective clinical findings were recorded using data sheets. In addition, all the recruited participants had laboratory work out that included a throat swab for culture and subsequent typing as well as antibiotic sensitivity testing of respective isolated organisms. Data analysis with regard to prevalence and antibiotic susceptibility of GABHS isolates as well as assessment of the sensitivity of three clinical diagnostic criteria (Zambia treatment guideline criteria; The WHO ARI management criteria; The modified Centor score) was done using Epi Info version 3.3.2 and Open Epi version 2.3.
Results: A total of 146 children were recruited. Of these, 22 had GABHS pharyngitis, accounting for a prevalence of 15.1%. All the GABHS isolates were susceptible to penicillin while 5(19%) had reduced susceptibility to erythromycin. None of the parameters on the Zambia treatment guideline criteria ,when used individually ,was found to have sensitivity to detect GABHS pharyngitis; Pharyngeal exudates had a sensitivity of 4.5%, 40% for painful enlarged tonsils, 18% for both fever and tender cervical lymph nodes and 36% for the absence of viral signs. The WHO ARI management criteria were not assessed because none of the children with GABHS pharyngitis displayed any of the signs required by the criteria. The modified Centor score had a sensitivity of only 9.1% while the area under the Reciever Operator Curve (ROC) was 0.51.
Conclusion: The prevalence of GABHS pharyngitis in children presenting with acute pharyngitis at UTH is 15.1%. Penicillin remains the suitable drug of choice for treatment and both tested criteria have poor sensitivity to identify GABHS pharyngitis. Further study in a primary care setting is needed to develop and adapt more sensitive criteria for the diagnosis of GABHS pharyngitis suitable for a high rheumatic heart disease endemic are
A ten year retrospective study of the aetiology and outcome of crescentic glomerulonephritis in children presenting to the Red Cross Children's Hospital, Cape Town, South Africa
Get PDFBackground: Crescentic glomerulonephritis represents the extreme end on the spectrum of glomerular injury. It can result from a wide range of disease conditions and clinically is marked by a rapid deterioration in renal function over days, weeks or months. Although rare, crescentic glomerulonephritis is an important entity to recognize because prompt treatment can improve patient outcomes significantly. Literature on the prevalence, clinical presentation, aetiology and outcome of histologically proven crescentic glomerulonephritis among children, in Africa, is scanty. Most of what is known about this entity is extrapolated from adult studies and from paediatric studies that have for the most part been conducted outside the African continent. Objective: This study was conducted in order to determine the incidence, clinical presentation, aetiology and outcome of histologically proven crescentic glomerulonephritis in children presenting to the Red Cross Children's Hospital, Cape Town, South Africa. Methods: This was a retrospective folder review in which the renal biopsy records of children less than 18 years old who had had native kidney biopsies performed between 2004 and July 2015 at the Red Cross Children's Hospital were reviewed. The clinical notes of patients found to have been diagnosed with crescentic glomerulonephritis were traced so as to extract demographic and clinical information which was then recorded onto the study data sheet. No attempt to contact patients or their families was made. Data analysis with regard to the incidence, the clinical features and the outcome of crescentic glomerulonephritis was done using SPSS version 22. Results: A total of 470 native kidney biopsies were performed in the period under review. Of these, 24 had crescentic glomerulonephritis, accounting for an incidence of 5.1 %. The sub-types of crescentic glomerulonephritis were immune-complex in 19 (80%), Pauci-immune in 2 (8 %), unspecified type in 3 (12 %) and no child had the anti-glomerular basement membrane subtype. The underlying aetiology of the immune complex sub-type was post-infectious in 11(57.9%), idiopathic in 4(21%), HSP/IgA nephropathy in 2 (10.5%), SLE in 1 (5.3%) and mesangiocapillary glomerulonephritis in 1(5.3%). Fourteen of the subjects were male thus giving a male to female ratio of 1.4 while the mean age of the children was 8.3 [range- 1 to 14 years]. The commonest clinical features were hypertension (90%), nephrotic range proteinuria (80%), macroscopic haematuria (57%), oedema (94%) and anaemia (88%). None of these had a statistically significant association to the renal outcome. Ten (77%) out of the 13 children with crescentic glomerulonephritis who were followed up for more than a year were found to have either died, had residual renal dysfunction or been transplanted at the last clinical contact. Conclusion: Crescentic glomerulonephritis was diagnosed in 5.1% of paediatric native renal biopsies which is consistent with what has been reported elsewhere. Unlike reports from other geographical areas the vast majority (80%) of the cases had immune-complex glomerulonephritis with a suspected post-infectious aetiology in over half of these. Similar to earlier reports from South Africa the outcome was poor in most (77%) of the patients. Further research is required to characterise the factors that make post-infectious glomerulonephritis particularly severe in this population
Prevalence and Antibiotic Susceptibility of Group A Beta Haemolytic Streptococcal Isolates and Assessment of the Sensitivity of Selected Clinical Predictive rules in Chuldren Presenting with Acute Pharyngitis to the University Teaching Hospital, Lusaka, Zambia
No full textBackground: Group A beta haemolytic streptococcus(GABHS) associated pharyngitis is an important infection in children because of its potential to complicate into rheumatic fever and rheumatic heart disease - these are preventable with timely and appropriate antibiotic treatment. Physicians in resource poor settings such as Zambia have largely had to rely on unvalidated clinical scoring systems to decide on whether to administer antibiotics when presented with a child who has evidence of pharyngitis. The objective of this study was to determine the prevalence and antibiotic susceptibility of GABHS isolates as well as to assess the sensitivity of three clinical diagnostic criteria in children presenting with acute pharyngitis to the paediatric department.
Methods: This was a descriptive cross sectional study that was carried out over a period of six months (April- September 2011) at the paediatric outpatient department of the University Teaching Hospital in Lusaka, Zambia, involving children 3-15 years of age presenting with pharyngitis. The enrolled study participants all underwent a standard clinical assessment during which their respective clinical findings were recorded using data sheets. In addition, all the recruited participants had laboratory work out that included a throat swab for culture and subsequent typing as well as antibiotic sensitivity testing of respective isolated organisms. Data analysis with regard to prevalence and antibiotic susceptibility of GABHS isolates as well as assessment of the sensitivity of three clinical diagnostic criteria (Zambia treatment guideline criteria; The WHO ARI management criteria; The modified Centor score) was done using Epi Info version 3.3.2 and Open Epi version 2.3.
Results: A total of 146 children were recruited. Of these, 22 had GABHS pharyngitis, accounting for a prevalence of 15.1%. All the GABHS isolates were susceptible to penicillin while 5(19%) had reduced susceptibility to erythromycin. None of the parameters on the Zambia treatment guideline criteria ,when used individually ,was found to have sensitivity to detect GABHS pharyngitis; Pharyngeal exudates had a sensitivity of 4.5%, 40% for painful enlarged tonsils, 18% for both fever and tender cervical lymph nodes and 36% for the absence of viral signs. The WHO ARI management criteria were not assessed because none of the children with GABHS pharyngitis displayed any of the signs required by the criteria. The modified
IV
Centor score had a sensitivity of only 9.1% while the area under the Reciever Operator Curve (ROC) was 0.51.
Conclusion: The prevalence of GABHS pharyngitis in children presenting with acute pharyngitis at UTH is 15.1%. Penicillin remains the suitable drug of choice for treatment and both tested criteria have poor sensitivity to identify GABHS pharyngitis. Further study in a primary care setting is needed to develop and adapt more sensitive criteria for the diagnosis of GABHS pharyngitis suitable for a high rheumatic heart disease endemic are
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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