Objective Perimetry in Sporting-Related Mild Traumatic Brain Injury

Supported by National Health and Medical Research Council Project Grant APP1063458 and Rebecca Cooper Medical Foundation Grant PG2018040

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection ar

Assessing concussion with multifocal pupillographic objective perimetry

Purpose: Recent results indicate that multifocal pupillographic objective perimetry (mfPOP) drives the cortical input to the pupillary system. Here we compare diagnostic power of 3 mfPOP variants in athletes who have had concussive injuries. Methods: The 3 dichoptic mfPOP variants included a version with 44 test regions/eye that had a test duration of 6 minutes, and two 80-second tests with 12 test regions/eye. The two 80-second tests had maximum luminances of 156 and 216 cd/m2. We tested male subjects: 18 control subjects aged 24.3 ± 4.09 y (mean ± SD), and 37 rugby athletes with prior concussion aged 21.6 ± 2.11 y. We categorised the concussion patients into tertiles according to: days since concussion, concussions in the last year, and life-time number of concussions. All the concussions caused removal from the playing field. We conducted ROC analysis on the using regional sensitivities, delays and linear discriminant scores combining sensitivities and delays. Results: The best discrimination was obtained between controls and persons who had concussion between 4 and 34 days before testing for the dimmer 80-second test, using the combined scores resulting in an area under the ROC curve of 0.85 ± 0.07 (mean ± SE). Performance was about equal for the mean of the worst 4 to 6 regions/eye. Thus the best discrimination was for a small number of defective visual field regions. Conclusions: Reasonable diagnostic power was obtained for recently concussed athletes. Studies with more subjects, and more recent concussion, are needed. Nevertheless the results were encouraging

Assessing concussion with multifocal pupillographic objective perimetry

Purpose: Recent results indicate that multifocal pupillographic objective perimetry (mfPOP) drives the cortical input to the pupillary system. Here we compare diagnostic power of 3 mfPOP variants in athletes who have had concussive injuries. Methods: The 3 dichoptic mfPOP variants included a version with 44 test regions/eye that had a test duration of 6 minutes, and two 80-second tests with 12 test regions/eye. The two 80-second tests had maximum luminances of 156 and 216 cd/m2. We tested male subjects: 18 control subjects aged 24.3 ± 4.09 y (mean ± SD), and 37 rugby athletes with prior concussion aged 21.6 ± 2.11 y. We categorised the concussion patients into tertiles according to: days since concussion, concussions in the last year, and life-time number of concussions. All the concussions caused removal from the playing field. We conducted ROC analysis on the using regional sensitivities, delays and linear discriminant scores combining sensitivities and delays. Results: The best discrimination was obtained between controls and persons who had concussion between 4 and 34 days before testing for the dimmer 80-second test, using the combined scores resulting in an area under the ROC curve of 0.85 ± 0.07 (mean ± SE). Performance was about equal for the mean of the worst 4 to 6 regions/eye. Thus the best discrimination was for a small number of defective visual field regions. Conclusions: Reasonable diagnostic power was obtained for recently concussed athletes. Studies with more subjects, and more recent concussion, are needed. Nevertheless the results were encouraging