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BackgroundCurrently, the prevention and control of the novel coronavirus disease (COVID-19) outside Hubei province in China, and other countries have become more and more critically serious. We developed and validated a diagnosis aid model without computed tomography (CT) images for early identification of suspected COVID-19 pneumonia (S-COVID-19-P) on admission in adult fever patients and made the validated model available via an online triage calculator. MethodsPatients admitted from Jan 14 to February 26, 2020 with the epidemiological history of exposure to COVID-19 were included [Model development (n = 132) and validation (n = 32)]. Candidate features included clinical symptoms, routine laboratory tests, and other clinical information on admission. Features selection and model development were based on the least absolute shrinkage and selection operator (LASSO) regression. The primary outcome was the development and validation of a diagnostic aid model for S-COVID-19-P early identification on admission. ResultsThe development cohort contained 26 S-COVID-19-P and 7 confirmed COVID-19 pneumonia cases. The final selected features included 1 variable of demographic information, 4 variables of vital signs, 5 variables of blood routine values, 7 variables of clinical signs and symptoms, and 1 infection-related biomarker. The model performance in the testing set and the validation cohort resulted in the area under the receiver operating characteristic (ROC) curves (AUCs) of 0.841 and 0.938, the F-1 score of 0.571 and 0.667, the recall of 1.000 and 1.000, the specificity of 0.727 and 0.778, and the precision of 0.400 and 0.500. The top 5 most important features were Age, IL-6, SYS_BP, MONO%, and Fever classification. Based on this model, an optimized strategy for S-COVID-19-P early identification in fever clinics has also been designed. ConclusionsS-COVID-19-P could be identified early by a machine-learning model only used collected clinical information without CT images on admission in fever clinics with a 100% recall score. The well-performed and validated model has been deployed as an online triage tool, which is available at https://intensivecare.shinyapps.io/COVID19/.
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Objective To study the correlation between time of fever onset in the course of patients'illness and etiologies of fever of unknown origin (FUO).Methods A total of 1 570 patients with FUO admitted from January 2013 to December 2014 were retrospectively analyzed, and clinical data ( sex, age, time of fever onset) of 348 patients meeting FUO diagnosis criteria with definite etiology diagnosis and time of fever onset were collected for multivariate logistic regression analysis after bias check.Results No statistically significant bias was found between 348 selected cases and 1 570 overall cases in gender (χ2 =0.029, P=0.903) and age (t=-1.040, P=0.299), and multivariate logistic regression analysis showed positive correlation between fever onset during 13: 00-18: 00 and infection (P=0.044, B=1.275), 18:00-24: 00 and connective tissue diseases ( P =0.029, B =0.838 ) , and showed negative correlation between age and miscellaneous (P =0.010, B =-0.042).Conclusions Characteristics of fever onset time may have significant value in preliminary diagnosis and guiding the correct direction of final definite diagnosis by means of targeted examinations or diagnostic treatments.It is worth to be further studied and discussed.
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Extra-nodal malignant lymphoma is often characterized by a lack of typical symptoms and positive results of auxiliary examinations, which make diagnosis difficult. In some cases, fever can be the only clinical manifestation. For the lymphoma patients presenting with persistent fever with a duration over 3 weeks, characteristics of fever including time of fever attack, fever type and effects of drugs may have significant value in the diagnosis, especially in the early stage of the disease or in rare cases.
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Humans , Fever of Unknown Origin , Lymphoma , Diagnosis , Muscles , PathologyABSTRACT
OBJECTIVE To analyze the disease spectrum and the epidemiologic characteristics of fever patients,providing effective and precise medical service for them.METHODS The disease spectrum and the epidemiologic characteristics of 9376 cases of fever or intestinal disease patients from Oct 2007 to Mar 2008 were analyzed retrospectively.RESULTS Among those patients with fever,there were 57.99% patients with respiratory infection,followed by 18.60% cases with gastroenteritis,12.74% cases with infection at other sites and 4.59% cases with tonsillitis.The fist priority was given to the patients with severe syndromes and acute onset.CONCLUSIONS Fever cases usually have complicated disease history,with an easy-to-change character of disease status. This study will provide some clues to improve our future medical service for fever patients.
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OBJECTIVE To norm the isolation and management of special infection patients and eliminate the incidence of hospital infections.METHODS The measures,the implementation of training and personal management,and details of control were determined.RESULTS The system management and isolation measures were implemented to effectively control the incidence of hospital infections.CONCLUSIONS The isolation and control of special infection patients are a systematic and rigorous work,it is very important to form a scientific,complete and easy to implement workflow and management system for the control of hospital infections.
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AIM:To investigate the effect of calcitonin gene related peptide(CGRP)on the expression of cyclic AMP response element binding protein(CREB)and phosphorylated-CREB in rat parietal cortex during focal cerebral ischemia/reperfusion(I/R).METHODS:Focal cerebral ischemia/reperfusion model was induced by occlusion of the right middle cerebral artery using the intraluminal suture method.The expressions of CREB and phospho-CREB in the parietal cortex in different groups(sham group,focal cerebral ischemia/reperfusion group and CGRP group)were detected with immunohistochemistry and Western blotting,and the positive products were analyzed by image analysis system.RESULTS:There was definite expression of CREB in right parietal cortex in sham group,while it was lesser in I/R group than that in sham group,but it became more in CGRP group than that in I/R group(P
