Case Report: Septic arthritis in children caused by Streptococcus pyogenes–rational use of antibiotics

To investigate the clinical characteristics and treatment of septic arthritis caused by Streptococcus pyogenes(S. pyogenes) in children, we retrospectively analyzed the clinical data, laboratory results, treatments and outcomes of three pediatric cases of septic arthritis caused by S. pyogenes occurring from 2016–2018. The three cases of septic arthritis included 1 boy and 2 girls, aged from 2–7 years. Two patients experienced fever, and in all three cases, the affected joints showed redness, swelling, an increased local skin temperature, tenderness and restricted limb movement. At the first visit, all three cases showed a significantly increased white blood cell count [(27.68–32.02)×109/mL] and a significantly increased erythrocyte sedimentation rate (113–134 mm/h). The C-reactive protein level was significantly increased in two cases (67 mg/L, 147.7 mg/L) and normal in one case. The procalcitonin level was normal in 1 case, elevated in 1 case, and undetected in 1 case. S. pyogenes isolated from cases 1 and 2 were emm1/ST28 and from case 3 was emm12/ST36. All patients were treated by abscess incision and drainage, and S. pyogenes was cultured in the abscess puncture fluid. All patients were treated with intravenous antibiotics after admission, and all patients were cured and discharged. The patients were followed up for 2 months, and their condition was improved and stable. No sequelae such as heart and kidney damage were detected. In conclusion, for children with septic arthritis, early diagnosis and timely treatment with incision and drainage followed by culture of the abscess puncture fluid are important. Once S. pyogenes infection is confirmed, β-lactam antibiotics provide effective treatment, avoiding use of broad-spectrum antibiotics

Dysfunctional gut microbiota and relative co-abundance network in infantile eczema

Additional file 1. The representative sequences of OTUs in 33 infants

Bacterial Signatures of Paediatric Respiratory Disease : An Individual Participant Data Meta-Analysis

Introduction: The airway microbiota has been linked to specific paediatric respiratory diseases, but studies are often small. It remains unclear whether particular bacteria are associated with a given disease, or if a more general, non-specific microbiota association with disease exists, as suggested for the gut. We investigated overarching patterns of bacterial association with acute and chronic paediatric respiratory disease in an individual participant data (IPD) meta-analysis of 16S rRNA gene sequences from published respiratory microbiota studies.Methods: We obtained raw microbiota data from public repositories or via communication with corresponding authors. Cross-sectional analyses of the paediatric (10 case subjects were included. Sequence data were processed using a uniform bioinformatics pipeline, removing a potentially substantial source of variation. Microbiota differences across diagnoses were assessed using alpha- and beta-diversity approaches, machine learning, and biomarker analyses.Results: We ultimately included 20 studies containing individual data from 2624 children. Disease was associated with lower bacterial diversity in nasal and lower airway samples and higher relative abundances of specific nasal taxa including Streptococcus and Haemophilus. Machine learning success in assigning samples to diagnostic groupings varied with anatomical site, with positive predictive value and sensitivity ranging from 43 to 100 and 8 to 99%, respectively.Conclusion: IPD meta-analysis of the respiratory microbiota across multiple diseases allowed identification of a non-specific disease association which cannot be recognised by studying a single disease. Whilst imperfect, machine learning offers promise as a potential additional tool to aid clinical diagnosis.Peer reviewe

Effect of Pre-Stretching on Microstructures and Mechanical Behaviors of Creep-Aged 7055 Al Alloy and Its Constitutive Modeling

The rational pre-stretching can contribute to obtaining better mechanical properties. This paper studies the effect of creep stain, mechanical properties, and microstructures of 7055 alloy under different pre-stretching conditions. The results show that compared with solid-quenched alloy, the 7055-T6 alloy is the optimal scheme to attain more creep strain, and the range of pre-stretching from 1.6% to 3.3% is suitable for creep-aged 7055-T6 alloy to obtain better mechanical properties. Further examination by TEM test shows that pre-stretching promotes the formation of dislocations, which provides superior nucleation regions for ή phase resulting in a higher strength alloy. Meanwhile, a unified creep-aging constitutive model for 7055-T6 alloy is established which can be used to accurately predict its creep behavior under the different pre-stretching

Incidence of frailty and construction of prediction model in elderly male patients with chronic obstructive pulmonary disease

The incidence of frailty was studied and prediction model was constructed for the elderly male patients with chronic obstructive pulmonary disease (COPD). Total of 266 elderly males having COPD were selected, and Fried Frailty Phenotype was employed to investigate their frailty status. According to the clinical experience, literature and reports; age, BMI (Body Mass Index), course and condition of COPD, laboratory findings, lung function, life quality, nutritional status and disease acceptance were designated as independent variables; and the incidence of frailty was taken as dependent variable. A binary logistic regression model was applied to analyze the factors affecting incidence of frailty, and a prediction model was constructed for the clinical screening of elderly male COPD patients at high frailty risk. The scores of 266 elderly male COPD patients investigated by frailty phenotype (FP) phenotype ranged from 0 to 5, and mean score was 1.83 ± 0.43. Total of 103 patients scored more than 3 among these patients. The frailty detection rate was 38.72%. Multi-factors logistic regression analysis suggested that age, hospitalization for acute exacerbation of COPD within a year, and interleukin 6 (IL-6) levels were the risk factors for incidence of frailty in elderly male COPD patients, while FEV1 (Forced Expiratory Volume in 1 second) and MNA-SF (Mini Nutritional Assessment Short-Form) levels were the protective factors. COPD frailty was higher in elderly men. Age, inflammatory response, lung function, disease control and nutritional status were the independent factors affecting incidence of frailty. Strengthening the screening for frailty in elderly patients and monitoring their inflammatory response, lung function, and nutritional status were significant in reducing incidence and improving prognosis

Multi-Level Inventory Matching And Order Planning Under The Hybrid Make-To-Order/Make-To-Stock Production Environment For Steel Plants Via Particle Swarm Optimization

This paper proposes a nonlinear integer programming model which co-optimizes the multi-level inventory matching and order planning for steel plants while combining Make-To-Order and Make-To-Stock policies. The model considers order planning and inventory matching of both finished and unfinished products. It combines multiple objectives, i.e., cost of earliness/tardiness penalty, tardiness penalty within delivery time window, production cost, inventory matching cost, and order cancelation penalty. This paper also proposes an improved Particle Swarm Optimization (PSO) method, where strategies to repair infeasible solutions and inventory-rematching scheme are introduced. Parameters of PSO and the rematching scheme are also analyzed. Three sets of real data from a steel manufacturing company are used to perform computational experiments for PSO, local search, and improved PSO. Numerical results show the validity of the model and efficacy of the improved PSO method

Broad range detection of viral and bacterial pathogens in bronchoalveolar lavage fluid of children to identify the cause of lower respiratory tract infections

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