RESUMEN
OBJECTIVE: To validate the APACHE II and SOFA scores in patients with suspected infection in clinical settings other than intensive care units. MATERIALS AND METHODS: A secondary analysis was performed on 2,530 adult patients participating in 2 cohort studies, with suspected infection as admission diagnosis within the first 24 h of hospitalization. The performance of both scoring systems was studied in order to set calibration and discrimination, respectively, on the outcomes such as mortality, admission to Intensive Care Unit, development of septic shock, or multiple organ dysfunctions. RESULTS: The AUC-ROC values for mortality at discharge and on day 28 in the first cohort were around 0.50 for the SOFA and APACHE II scores; whereas for the second cohort the discrimination value was around 0.70. Calibration of both scoring systems for primary outcomes, according to Hosmer-Lemeshow test, showed p>.05 in the first cohort; while in the second cohort calibration it only showed a p>.05 in the case of the SOFA for mortality at hospital discharge. CONCLUSION: This validation study of SOFA and APACHE II scores in patients with suspected infection in-hospital units other than the Intensive Care Unit, showed no consistent performance for calibration and discrimination. Its application in emergency and in-hospital patients is limited.
Asunto(s)
Indicadores de Salud , Mortalidad Hospitalaria , Infecciones/mortalidad , Sepsis/mortalidad , APACHE , Adulto , Anciano , Área Bajo la Curva , Colombia/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Curva ROCRESUMEN
Reptiles can harbor pathogenic microorganisms asymptomatically and serve as potential reservoirs of infection for humans, domestic animals, and other reptiles. Infectious diseases are also problematic for free-ranging reptile populations and are an important consideration in reptile reintroduction and translocation projects. There have been limited serologic studies of free-ranging reptiles for evidence of exposure to potential pathogens. In the present study, serum or plasma samples from five male and five female free-ranging Venezuelan anacondas (Eunectes murinus) were screened for antibodies to eastern, western, and Venezuelan equine encephalitis viruses, vesicular stomatitis virus, ophidian paramyxovirus, 19 Leptospira interrogans serovars, and Cryptosporidium serpentes. Antibodies to these agents were not detected, or antibody titers were low and possibly nonspecific. These results for the limited number of anacondas surveyed suggest that they do not serve as significant reservoirs for these infectious agents at this location.
Asunto(s)
Boidae , Enfermedades Transmisibles/veterinaria , Animales , Animales Salvajes , Anticuerpos Antibacterianos/sangre , Anticuerpos Antiprotozoarios/sangre , Anticuerpos Antivirales/sangre , Enfermedades Transmisibles/epidemiología , Cryptosporidium/inmunología , Reservorios de Enfermedades/veterinaria , Virus de la Encefalitis Equina Venezolana/inmunología , Encefalomielitis Equina Oriental/inmunología , Encefalomielitis Equina del Oeste/inmunología , Ensayo de Inmunoadsorción Enzimática/veterinaria , Femenino , Pruebas de Inhibición de Hemaglutinación/veterinaria , Leptospira interrogans/inmunología , Masculino , Venezuela/epidemiología , Virus de la Estomatitis Vesicular Indiana/inmunologíaAsunto(s)
Humanos , Masculino , Femenino , Estudio Comparativo , Pruebas Respiratorias , Enfermedad Celíaca/fisiopatología , Permeabilidad de la Membrana Celular , Hidrógeno/análisis , Absorción Intestinal , Adolescente , Análisis de Varianza , Biopsia , Enfermedad Celíaca/diagnóstico , Enfermedad Celíaca/epidemiología , Niño , Preescolar , Resumen en Inglés , Intestino Delgado/patología , Lactulosa/diagnóstico , Ramnosa/diagnósticoAsunto(s)
Humanos , Masculino , Femenino , Pruebas Respiratorias , Permeabilidad de la Membrana Celular , Enfermedad Celíaca/fisiopatología , Hidrógeno/análisis , Absorción Intestinal , Adolescente , Análisis de Varianza , Biopsia , Niño , Preescolar , Enfermedad Celíaca/diagnóstico , Enfermedad Celíaca/epidemiología , Resumen en Inglés , Intestino Delgado/patología , Lactulosa , RamnosaRESUMEN
Permeability test with sugars (PTS) as a non-invasive diagnostic tool is of special interest in pediatric patients. This study evaluated the relationship between PTS and antigliadin antibodies (AA) with the intestinal biopsy and studied whether an altered expired hydrogen test (EHT) could interfere in this relation in celiac patients. Thirty children (13 girls, 17 boys) with diagnosis of celiac disease (ESPGAN criteria) were divided into three groups according to this histopathology: Group A (n = 23) normal biopsy; Group B (n = 7) biopsy grade III or IV; Group C (n = 25) controls. The intestinal permeability test showed significative differences (p < 0.01) of Group B (0.159 +/- 0.03) with Group A (0.048 +/- 0.005) and with the control Group C (0.039 +/- 0.002). The cut-off for the Youden maximum index (0.75) was 0.092 and ROC SE 0.87 +/- 0.7. The results of the AA were related to those of the PTS. The variance analysis showed that the results of the expired hydrogen test do not interfere statistically on the good correlation of PTS with the histology. The PTS is a good indicator of the status of intestinal mucosa. There is a good correlation between PTS and AA in celiac children. A pathological expired hydrogen test seems not to interfere with the correlation found between PTS and histological damage in our series.
Asunto(s)
Pruebas Respiratorias , Enfermedad Celíaca/fisiopatología , Permeabilidad de la Membrana Celular , Hidrógeno/análisis , Absorción Intestinal , Adolescente , Análisis de Varianza , Biopsia , Enfermedad Celíaca/diagnóstico , Enfermedad Celíaca/epidemiología , Niño , Preescolar , Femenino , Humanos , Intestino Delgado/patología , Lactulosa , Masculino , RamnosaRESUMEN
Permeability test with sugars (PTS) as a non-invasive diagnostic tool is of special interest in pediatric patients. This study evaluated the relationship between PTS and antigliadin antibodies (AA) with the intestinal biopsy and studied whether an altered expired hydrogen test (EHT) could interfere in this relation in celiac patients. Thirty children (13 girls, 17 boys) with diagnosis of celiac disease (ESPGAN criteria) were divided into three groups according to this histopathology: Group A (n = 23) normal biopsy; Group B (n = 7) biopsy grade III or IV; Group C (n = 25) controls. The intestinal permeability test showed significative differences (p < 0.01) of Group B (0.159 +/- 0.03) with Group A (0.048 +/- 0.005) and with the control Group C (0.039 +/- 0.002). The cut-off for the Youden maximum index (0.75) was 0.092 and ROC SE 0.87 +/- 0.7. The results of the AA were related to those of the PTS. The variance analysis showed that the results of the expired hydrogen test do not interfere statistically on the good correlation of PTS with the histology. The PTS is a good indicator of the status of intestinal mucosa. There is a good correlation between PTS and AA in celiac children. A pathological expired hydrogen test seems not to interfere with the correlation found between PTS and histological damage in our series.
RESUMEN
Permeability test with sugars (PTS) as a non-invasive diagnostic tool is of special interest in pediatric patients. This study evaluated the relationship between PTS and antigliadin antibodies (AA) with the intestinal biopsy and studied whether an altered expired hydrogen test (EHT) could interfere in this relation in celiac patients. Thirty children (13 girls, 17 boys) with diagnosis of celiac disease (ESPGAN criteria) were divided into three groups according to this histopathology: Group A (n = 23) normal biopsy; Group B (n = 7) biopsy grade III or IV; Group C (n = 25) controls. The intestinal permeability test showed significative differences (p < 0.01) of Group B (0.159 +/- 0.03) with Group A (0.048 +/- 0.005) and with the control Group C (0.039 +/- 0.002). The cut-off for the Youden maximum index (0.75) was 0.092 and ROC SE 0.87 +/- 0.7. The results of the AA were related to those of the PTS. The variance analysis showed that the results of the expired hydrogen test do not interfere statistically on the good correlation of PTS with the histology. The PTS is a good indicator of the status of intestinal mucosa. There is a good correlation between PTS and AA in celiac children. A pathological expired hydrogen test seems not to interfere with the correlation found between PTS and histological damage in our series.