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Kaagaard MD, Matos LO, Evangelista MVP, Wegener A, Holm AE, Vestergaard LS, Do Valle SCN, Silvestre OM, Lacerda MVG, de Souza RM, Barreto Dos Santos F, Biering-Sørensen T, Brainin P. Frequency of pleural effusion in dengue patients by severity, age and imaging modality: a systematic review and meta-analysis. BMC Infect Dis 2023; 23:327. [PMID: 37189054 PMCID: PMC10184094 DOI: 10.1186/s12879-023-08311-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/06/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Identification of pleural effusion (PE) in dengue infection is an objective measure of plasma leakage and may predict disease progression. However, no studies have systematically assessed the frequency of PE in patients with dengue, and whether this differs across age and imaging modality. METHODS We searched Pubmed, Embase Web of Science and Lilacs (period 1900-2021) for studies reporting on PE in dengue patients (hospitalized and outpatient). We defined PE as fluid in the thoracic cavity detected by any imaging test. The study was registered in PROSPERO (CRD42021228862). Complicated dengue was defined as hemorrhagic fever, dengue shock syndrome or severe dengue. RESULTS The search identified 2,157 studies of which 85 studies were eligible for inclusion. The studies (n = 31 children, n = 10 adults, n = 44 mixed age) involved 12,800 patients (30% complicated dengue). The overall frequency of PE was 33% [95%CI: 29 to 37%] and the rate of PE increased significantly with disease severity (P = 0.001) such that in complicated vs. uncomplicated dengue the frequencies were 48% and 17% (P < 0.001). When assessing all studies, PE occurred significantly more often in children compared to adults (43% vs. 13%, P = 0.002) and lung ultrasound more frequently detected PE than conventional chest X-ray (P = 0.023). CONCLUSIONS We found that 1/3 of dengue patients presented with PE and the frequency increased with severity and younger age. Importantly, lung ultrasound demonstrated the highest rate of detection. Our findings suggest that PE is a relatively common finding in dengue and that bedside imaging tools, such as lung ultrasound, potentially may enhance detection.
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Affiliation(s)
- Molly D Kaagaard
- Multidisciplinary Center, Federal University of Acre, Campus Floresta, Cruzeiro do Sul, Acre, Brazil.
- Cardiovascular Non-Invasive Imaging Research Laboratory, Department of Cardiology, Herlev-Gentofte University Hospital, Hellerup, Denmark.
| | - Luan Oliveira Matos
- Multidisciplinary Center, Federal University of Acre, Campus Floresta, Cruzeiro do Sul, Acre, Brazil
| | - Marliton V P Evangelista
- Multidisciplinary Center, Federal University of Acre, Campus Floresta, Cruzeiro do Sul, Acre, Brazil
| | - Alma Wegener
- Multidisciplinary Center, Federal University of Acre, Campus Floresta, Cruzeiro do Sul, Acre, Brazil
- Cardiovascular Non-Invasive Imaging Research Laboratory, Department of Cardiology, Herlev-Gentofte University Hospital, Hellerup, Denmark
| | - Anna Engell Holm
- Multidisciplinary Center, Federal University of Acre, Campus Floresta, Cruzeiro do Sul, Acre, Brazil
- Cardiovascular Non-Invasive Imaging Research Laboratory, Department of Cardiology, Herlev-Gentofte University Hospital, Hellerup, Denmark
| | - Lasse S Vestergaard
- Department of Bacteria, Parasites and Fungi, National Malaria Reference Laboratory, Statens Serum Institut, Copenhagen, Denmark
| | - Suiane C N Do Valle
- Multidisciplinary Center, Federal University of Acre, Campus Floresta, Cruzeiro do Sul, Acre, Brazil
| | - Odilson M Silvestre
- Health and Sport Science Center, Federal University of Acre, Rio Branco, Acre, Brazil
| | | | - Rodrigo Medeiros de Souza
- Multidisciplinary Center, Federal University of Acre, Campus Floresta, Cruzeiro do Sul, Acre, Brazil
| | | | - Tor Biering-Sørensen
- Cardiovascular Non-Invasive Imaging Research Laboratory, Department of Cardiology, Herlev-Gentofte University Hospital, Hellerup, Denmark
- Faculty of Biomedical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Philip Brainin
- Multidisciplinary Center, Federal University of Acre, Campus Floresta, Cruzeiro do Sul, Acre, Brazil
- Cardiovascular Non-Invasive Imaging Research Laboratory, Department of Cardiology, Herlev-Gentofte University Hospital, Hellerup, Denmark
- Sound Bioventures, Hellerup, Denmark
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The past, present, and prospective on UV-VIS-NIR skin photonics and spectroscopy-a wavelength guide. Med Biol Eng Comput 2020; 58:1159-1175. [PMID: 32319030 DOI: 10.1007/s11517-019-02077-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 11/07/2019] [Indexed: 10/24/2022]
Abstract
The study and applications of in vivo skin optics have been openly documented as early as the year 1954, or possibly earlier. To date, challenges in analyzing the complexities of this field remain, with wide scopes requiring more scrutiny. Recent advances in spectroscopic research and multivariate analytics allow a closer look into applications potentially for detecting or monitoring diseases. One of the challenges in this field is in establishing a reference for applications which correspond to certain bandwidths. This article reviews the scope on past research on skin spectroscopy, and the clinical aspects which have or may have applications on disease detection or enhancing diagnostics. A summary is supplied on the technicalities surrounding the measurements reported in literature, focused towards the wavelength-dependent applications in themes central to the respective research. Analytics on the topology of the papers' data cited in this work is also provided for a statistical perspective. In short, this paper strives to immediately inform the reader with possible applications via the spectroscopic devices at hand. Graphical Abstract .
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Poh AH, Mahamd Adikan FR, Moghavvemi M, Syed Omar SF, Poh K, Mahyuddin MBH, Yan G, Azizah Ariffin MA, Harun SW. Precursors to non-invasive clinical dengue screening: Multivariate signature analysis of in-vivo diffuse skin reflectance spectroscopy on febrile patients in Malaysia. PLoS One 2020; 15:e0228923. [PMID: 32236132 PMCID: PMC7112162 DOI: 10.1371/journal.pone.0228923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 01/26/2020] [Indexed: 11/18/2022] Open
Abstract
Dengue diagnostics have come a long way. Attempts at breaking away from lab-oriented dengue detection, such as NS1 antigen, IgM or IgG antibodies detection have extensively received numerous coverage. As a result, rapid detection tests (RDTs) have started to gain inroads in medical practice. Rapid detection tests notwithstanding, analysis of blood serum is still a relatively complicated task. This includes the necessity of phlebotomy, centrifugation for blood serum, and other reagent-based tests. Therefore, a non-invasive method of dengue detection was considered. In this study, we present the utility of diffuse reflectance skin spectroscopy (bandwidth of 200-2500nm) on the forearm during the triaging period for dengue screening potential. This is performed with multivariate analysis of 240 triaged febrile/suspected dengue patients. The data is then scrutinized for its clinical validity to be included as either confirmed or probable dengue, or a control group. Based on discriminant analysis of several data normalization models, we can predict the patients' clinical dengue-positivity at ranges of accuracy between ~93-98% depending on mode of the data, with a probably optimal sensitivity and specificity to the clinical diagnosis of ~89% and ~100% respectively. From the outcomes of this study, we recommend further trials with cautious optimism. With these findings, it is hoped that the elusive non-invasive detection of tropical diseases may gain platform in the near future.
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Affiliation(s)
- Abdul Halim Poh
- Department of Electrical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
- Integrated Lightwave Research Group, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
- Center of Research for Applied Electronics (CRAE), Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Faisal Rafiq Mahamd Adikan
- Department of Electrical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
- Integrated Lightwave Research Group, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
| | - Mahmoud Moghavvemi
- Department of Electrical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
- Center of Research for Applied Electronics (CRAE), Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
- University of Science and Culture, Tehran, Iran
| | - Sharifah Faridah Syed Omar
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Infectious Diseases and Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Khadijah Poh
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohamad Badrol Hisyam Mahyuddin
- Department of Electrical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
- Photonics Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Grace Yan
- Integrated Lightwave Research Group, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Sulaiman Wadi Harun
- Department of Electrical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
- Photonics Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
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Kalayanarooj S, Rothman AL, Srikiatkhachorn A. Case Management of Dengue: Lessons Learned. J Infect Dis 2017; 215:S79-S88. [PMID: 28403440 DOI: 10.1093/infdis/jiw609] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The global burden of dengue and its geographic distribution have increased over the past several decades. The introduction of dengue in new areas has often been accompanied by high case-fatality rates. Drawing on the experience in managing dengue cases at the Queen Sirikit National Institute of Child Health in Bangkok, Thailand, this article provides the authors' perspectives on key clinical lessons to improve dengue-related outcomes. Parallels between this clinical experience and outcomes reported in randomized controlled trials, results of efforts to disseminate practice recommendations, and suggestions for areas for further research are also discussed.
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Affiliation(s)
- Siripen Kalayanarooj
- Dengue Unit, Queen Sirikit National Institute of Child Health, Bangkok, Thailand; and
| | - Alan L Rothman
- Department of Cell and Molecular Biology and Institute for Immunology and Informatics, University of Rhode Island, Providence
| | - Anon Srikiatkhachorn
- Dengue Unit, Queen Sirikit National Institute of Child Health, Bangkok, Thailand ; and.,Department of Cell and Molecular Biology and Institute for Immunology and Informatics, University of Rhode Island, Providence
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Schlader ZJ, Rivas E, Soller BR, Convertino VA, Crandall CG. Tissue oxygen saturation during hyperthermic progressive central hypovolemia. Am J Physiol Regul Integr Comp Physiol 2014; 307:R731-6. [PMID: 25031230 DOI: 10.1152/ajpregu.00190.2014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
During normothermia, a reduction in near-infrared spectroscopy (NIRS)-derived tissue oxygen saturation (So2) is an indicator of central hypovolemia. Hyperthermia increases skin blood flow and reduces tolerance to central hypovolemia, both of which may alter the interpretation of tissue So2 during central hypovolemia. This study tested the hypothesis that maximal reductions in tissue So2 would be similar throughout normothermic and hyperthermic central hypovolemia to presyncope. Ten healthy males (means ± SD; 32 ± 5 yr) underwent central hypovolemia via progressive lower-body negative pressure (LBNP) to presyncope during normothermia (skin temperature ≈34°C) and hyperthermia (+1.2 ± 0.1°C increase in internal temperature via a water-perfused suit, skin temperature ≈39°C). NIRS-derived forearm (flexor digitorum profundus) tissue So2 was measured throughout and analyzed as the absolute change from pre-LBNP. Hyperthermia reduced (P < 0.001) LBNP tolerance by 49 ± 33% (from 16.7 ± 7.9 to 7.2 ± 3.9 min). Pre-LBNP, tissue So2 was similar (P = 0.654) between normothermia (74 ± 5%) and hyperthermia (73 ± 7%). Tissue So2 decreased (P < 0.001) throughout LBNP, but the reduction from pre-LBNP to presyncope was greater during normothermia (-10 ± 6%) than during hyperthermia (-6 ± 5%; P = 0.041). Contrary to our hypothesis, these findings indicate that hyperthermia is associated with a smaller maximal reduction in tissue So2 during central hypovolemia to presyncope.
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Affiliation(s)
- Zachary J Schlader
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital of Dallas, Dallas, Texas, and the University of Texas Southwestern Medical Center, Dallas, Texas
| | - Eric Rivas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital of Dallas, Dallas, Texas, and the University of Texas Southwestern Medical Center, Dallas, Texas; Department of Kinesiology, Texas Woman's University, Denton, Texas
| | - Babs R Soller
- Reflectance Medical Incorporated, Westborough, Massachusetts; Department of Anesthesiology, University of Massachusetts Medical School, Worcester, Massachusetts; and
| | | | - Craig G Crandall
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital of Dallas, Dallas, Texas, and the University of Texas Southwestern Medical Center, Dallas, Texas;
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