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1.
PLoS Negl Trop Dis ; 13(8): e0007144, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31430283

RESUMEN

The objective of this study was to assess the validity of the new dengue classification proposed by the World Health Organization (WHO) in 2009 and to develop pragmatic guidelines for case triage and management. This retrospective study involved 357 laboratory-confirmed cases of dengue infection diagnosed at King Abdulaziz University Hospital, Jeddah, Saudi Arabia over a 4-year period from 2014 to 2017. The sensitivity of the new classification for identifying severe cases was limited (65%) but higher than the old one (30%). It had a higher sensitivity for identifying patients who needed advanced healthcare compared to the old one (72% versus 32%, respectively). We propose adding decompensation of chronic diseases and thrombocytopenia-related bleeding to the category of severe dengue in the new classification. This modification improves sensitivity from 72% to 98% for identifying patients who need advanced healthcare without altering specificity (97%). It also improves sensitivity in predicting severe outcomes from 32% to 88%. In conclusion, the new classification had a low sensitivity for identifying patients needing advanced care and for predicting morbidity and mortality. We propose to include decompensation of chronic diseases and thrombocytopenia-related bleeding to the category of severe dengue in the new classification to improve the sensitivity of predicting cases requiring advanced care.


Asunto(s)
Dengue/clasificación , Dengue/diagnóstico , Organización Mundial de la Salud , Adolescente , Adulto , Niño , Preescolar , Enfermedad Crónica , Medicina Clínica/métodos , Medicina Clínica/normas , Dengue/fisiopatología , Femenino , Hemorragia , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Arabia Saudita , Sensibilidad y Especificidad , Dengue Grave/clasificación , Dengue Grave/diagnóstico , Índice de Severidad de la Enfermedad , Trombocitopenia , Adulto Joven
2.
Clin Case Rep ; 3(7): 553-7, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26273441

RESUMEN

Hypertension with Chronic kidney disease is often difficult to control medically. In such patients, nephrectomy can help to control blood pressure (BP). We describe a case of a 6-year-old boy with autosomal recessive polycystic kidney disease who showed a paradoxical increase in BP following bilateral nephrectomy.

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