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  1. Article ; Online: The evolving relationship between COVID-19 and serious bacterial infection evaluation in febrile neonates.

    Guernsey, David / Kostin, Shannon / Silver, Michael / Vazquez, Hector / Zerzan, Jessica

    Acta paediatrica (Oslo, Norway : 1992)

    2023  Volume 112, Issue 7, Page(s) 1398–1403

    Abstract: Aim: The COVID-19 omicron variant surge highlighted the evolving impact of COVID-19. Febrile infants <60 days old are high risk for serious bacterial infections (SBI). This study evaluated the rate of SBI based on COVID-19 infection.: Methods: We ... ...

    Abstract Aim: The COVID-19 omicron variant surge highlighted the evolving impact of COVID-19. Febrile infants <60 days old are high risk for serious bacterial infections (SBI). This study evaluated the rate of SBI based on COVID-19 infection.
    Methods: We conducted a retrospective chart review at an urban, academic paediatric emergency department. The study enrolled infants 60 days old or less with documented fever. The primary outcome was SBI diagnosed by blood, urine, and/or cerebrospinal fluid cultures. We compared the rate of SBI between COVID-19 groups with an omicron variant and 29- to 60-day-old subgroup analyses.
    Results: Two hundred and thirty-three (233) infants meet the criteria. The incidence of SBI was 18.7% in the COVID-19 negative and 1.7% in the COVID-19-positive group which is statistically significant (p < 0.001). Omicron subgroup analysis did not achieve statistical significance (p = 0.62) while COVID-19-positive infants 29-60 days old had a statistically significant lower rate of SBI (p = 0.006).
    Conclusion: The omicron variant surge provided an additional understanding of the impact of COVID-19 on these high-risk infants. These results can lead to decreased invasive testing and exposure to antibiotics as well as examine the utility of viral testing for risk stratification.
    MeSH term(s) Infant, Newborn ; Infant ; Child ; Humans ; Retrospective Studies ; COVID-19/diagnosis ; COVID-19/epidemiology ; SARS-CoV-2 ; Bacterial Infections/complications ; Bacterial Infections/diagnosis ; Bacterial Infections/epidemiology
    Language English
    Publishing date 2023-01-12
    Publishing country Norway
    Document type Journal Article
    ZDB-ID 203487-6
    ISSN 1651-2227 ; 0365-1436 ; 0803-5253
    ISSN (online) 1651-2227
    ISSN 0365-1436 ; 0803-5253
    DOI 10.1111/apa.16655
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: COVID-19 and Serious Bacterial Infection in Febrile Infants Less Than 60 Days Old.

    Guernsey, David / Pfeffer, Matthew / Kimpo, James / Vazquez, Hector / Zerzan, Jessica

    The western journal of emergency medicine

    2022  Volume 23, Issue 5, Page(s) 754–759

    Abstract: Introduction: The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to the coronavirus disease 2019 (COVID-19) pandemic that drastically impacted the United States. The evidence was not clear on how SARS-CoV-2 infection ...

    Abstract Introduction: The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to the coronavirus disease 2019 (COVID-19) pandemic that drastically impacted the United States. The evidence was not clear on how SARS-CoV-2 infection impacted children, given the high prevalence of SAR-CoV-2 infection. Febrile infants less than 60 days old are an ongoing challenge to risk-stratify for serious bacterial infection (SBI), including urinary tract infection (UTI), bacteremia, and meningitis. We hypothesized there would be a lower rate of SBI in SARS-CoV-2 positive febrile infants compared to those SARS-CoV-2 negative.
    Methods: This was a retrospective chart review with a nested, age-matched, case-control study performed from March 2020-June 2021. Infants less than 60 days old presenting with fever were assigned groups based on SARS-CoV-2 infection. Blood, urine, and cerebrospinal fluid cultures were used as the gold standard to diagnose SBI. We compared overall rate of SBI as well as individual rates of SBI between each group. We performed a subgroup analysis evaluating the age group 29-60 days old.
    Results: A total of 164 subjects met criteria for analysis: 30 COVID-19 positive and 134 COVID-19 negative subjects. Rate of SBI was 17.9% (95% confidence interval [CI]: 11.8-25.5%) in the COVID-19 negative group compared to 0% (95% CI: 0.0%-11.1%) in the COVID-19 group, which demonstrated statistical significance (p = 0.008). In the age-matched data, we found statistical significance for any SBI (p = <0.001). For individual rates of SBI, we found statistical significance for UTI (p = <0.001) and bacteremia (p = <0.001). The 29-60 days-old subgroup analysis did not achieve statistical significance (p = 0.11).
    Conclusion: This study demonstrated the utility of including SARS-CoV-2 infection as part of the risk stratification of febrile infants less than 60 days old. While overall there is a low incidence of bacteremia and meningitis in this age group, these results can contribute to existing literature and potentially help decrease invasive testing and exposure to broad-spectrum antibiotics.
    MeSH term(s) Anti-Bacterial Agents ; Bacteremia/epidemiology ; Bacteremia/microbiology ; Bacterial Infections/diagnosis ; Bacterial Infections/epidemiology ; Bacterial Infections/microbiology ; COVID-19 ; Case-Control Studies ; Child ; Fever/diagnosis ; Humans ; Infant ; Infant, Newborn ; Meningitis/complications ; Meningitis/microbiology ; Retrospective Studies ; SARS-CoV-2 ; Urinary Tract Infections/diagnosis ; Urinary Tract Infections/epidemiology
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2022-08-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2375700-0
    ISSN 1936-9018 ; 1936-9018
    ISSN (online) 1936-9018
    ISSN 1936-9018
    DOI 10.5811/westjem.2022.6.54863
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Streptococcus pneumoniae meningitis in a child with idiopathic nephrotic syndrome: a case report.

    Guernsey, David / Arun, Aparna / Agha, Rabia / Kupferman, Juan C

    Journal of medical case reports

    2022  Volume 16, Issue 1, Page(s) 403

    Abstract: Background: Children with nephrotic syndrome are at increased risk of infections, including bacterial peritonitis, pneumonia, and cellulitis. However, bacterial meningitis, a potentially life-threatening complication, has not been highlighted as an ... ...

    Abstract Background: Children with nephrotic syndrome are at increased risk of infections, including bacterial peritonitis, pneumonia, and cellulitis. However, bacterial meningitis, a potentially life-threatening complication, has not been highlighted as an infectious complication of nephrotic syndrome in recent reviews. We report a very subtle and unusual presentation of bacterial meningitis in a child with nephrotic syndrome, which without a high index of suspicion, would have been missed.
    Case presentation: A 9-year-old African-American male with a history of steroid-dependent nephrotic syndrome presented to the nephrology clinic for routine follow-up. His medications included mycophenolate mofetil and alternate-day steroids. His only complaint was neck pain and stiffness that the mother attributed to muscle tightness relieved by massage. There was no history of fever, vomiting, headache, photophobia, or altered mental status. On physical examination, he was afebrile (99 °F), but had mild periorbital swelling and edema on lower extremities. He appeared ill and exhibited neck rigidity, and demonstrated reflex knee flexion when the neck was bent. Laboratory evaluation revealed leukocytosis, elevated C-reactive protein, hypoalbuminemia, and proteinuria. Cerebrospinal fluid suggested bacterial meningitis. The patient was treated with ceftriaxone and vancomycin. Both cerebrospinal and blood cultures grew Streptococcus pneumoniae; vancomycin was discontinued. The child completed a 2-week course of ceftriaxone and was discharged home.
    Conclusions: A high index of suspicion is necessary in children with nephrotic syndrome treated with corticosteroids, as symptoms may be masked, and thus, a life-threatening disease be missed. Bacterial meningitis should be highlighted as a serious infection complication in children with nephrotic syndrome.
    MeSH term(s) Child ; Male ; Humans ; Meningitis, Pneumococcal/complications ; Nephrotic Syndrome/complications ; Nephrotic Syndrome/drug therapy ; Ceftriaxone/therapeutic use ; Vancomycin/therapeutic use ; Meningitis, Bacterial/complications ; Meningitis, Bacterial/diagnosis ; Meningitis, Bacterial/drug therapy
    Chemical Substances Ceftriaxone (75J73V1629) ; Vancomycin (6Q205EH1VU)
    Language English
    Publishing date 2022-11-07
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2269805-X
    ISSN 1752-1947 ; 1752-1947
    ISSN (online) 1752-1947
    ISSN 1752-1947
    DOI 10.1186/s13256-022-03648-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: The aftermath of the COVID-19 pandemic on pediatric mental health: A pediatric emergency department's perspective.

    Guernsey, David T / Slobod, Elina / Silver, Michael / Cohen, Lea / Ali, Ayesha / Toure, April / Zerzan, Jessica

    The American journal of emergency medicine

    2023  Volume 71, Page(s) 95–98

    Abstract: Background: Pediatric mental health visits in the United States has become a public health crisis. Pediatric emergency departments (PED) encounter these patients during mental health emergencies. The COVID-19 pandemic disrupted the social environment of ...

    Abstract Background: Pediatric mental health visits in the United States has become a public health crisis. Pediatric emergency departments (PED) encounter these patients during mental health emergencies. The COVID-19 pandemic disrupted the social environment of pediatric patients which potentially lead to new and worsening mental health issues. This study examined the proportion of mental health visits to PED around the first wave of the COVID-19 pandemic.
    Methods: This retrospective cohort study assessed the proportion of mental health visits at a urban, PED between September 2019 to February 2022. Inclusion criteria were subjects aged 6 to 18 years with a holding order assigned, and one of identified mental health International Classification of Disease, Tenth Division (ICD-10) codes: F01-F99, T14.19, R45, R46.89. Proportion of mental health visits were compared in 6-month periods with the first 6-months representing the pre-COVID-19 period. Secondary analysis compared demographic information and ICD-10 codes.
    Results: A total of 1036 charts were studied: 126 charts from 2019 to 2020, 512 from 2020 to 2021, and 398 from 2021 to 2022. The proportion of mental health visits from September 2019 to February 2020 was 1.4%, and for the following 6-month periods, the proportion of mental health visits was 1.2%, 7.5%, 4.9%, and 5.7%. There was a statistically significant difference (p < 0.001) demonstrating a higher proportion of mental health visits after the start of the COVID-19 pandemic. Secondary analysis demonstrated statistically significant difference in both median age (p < 0.001) and median length of hospitalization (p < 0.001).
    Conclusion: This study demonstrated a significant increase in pediatric mental health visits following the start of the COVID-19 pandemic. We believe further investigation into the needs and management during acute surges will improve the care we provide to this vulnerable population.
    MeSH term(s) Child ; Humans ; United States ; COVID-19/epidemiology ; Mental Health ; Retrospective Studies ; Pandemics ; Emergency Service, Hospital
    Language English
    Publishing date 2023-06-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2023.06.021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2005: Show issues Location:
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  5. Article ; Online: Resolution of Concussion Symptoms After Osteopathic Manipulative Treatment: A Case Report.

    Guernsey, David T / Leder, Adena / Yao, Sheldon

    The Journal of the American Osteopathic Association

    2016  Volume 116, Issue 3, Page(s) e13–7

    Abstract: A concussion is the result of a biomechanical force directed toward the head, causing neurologic dysfunction. The inflammatory response and the production of reactive oxygen species are proposed mechanisms for the symptoms and long-term sequelae of ... ...

    Abstract A concussion is the result of a biomechanical force directed toward the head, causing neurologic dysfunction. The inflammatory response and the production of reactive oxygen species are proposed mechanisms for the symptoms and long-term sequelae of concussion. Osteopathic manipulative treatment (OMT) may help reduce inflammation by improving glymphatic flow. The authors describe the effect of OMT on a patient with mild concussion symptoms, including nausea, dizziness, tinnitus, and imbalance. The patient was evaluated with the Sensory Organization Test before and after undergoing a 25-minute session of OMT. After the session, the patient reported resolution of symptoms, and his sensory organization test score improved by 6 points. The role of OMT must be further investigated as an essential and cost-effective tool in the management of concussions.
    MeSH term(s) Adult ; Brain Concussion/physiopathology ; Brain Concussion/rehabilitation ; Dizziness/etiology ; Dizziness/physiopathology ; Dizziness/rehabilitation ; Humans ; Male ; Manipulation, Osteopathic/methods
    Language English
    Publishing date 2016-03
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 410350-6
    ISSN 1945-1997 ; 0003-0287 ; 0098-6151
    ISSN (online) 1945-1997
    ISSN 0003-0287 ; 0098-6151
    DOI 10.7556/jaoa.2016.036
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Book ; Conference proceedings: Applying composites in the marine environment

    Guernsey, David T

    overcoming berrriers, setting standards, progressive learning ; Savannah, Georgia, November 8-10, 1993

    1993  

    Institution American Society of Naval Engineers
    Marine Composites Symposium
    Event/congress Marine Composites Symposium (1993.11.08-10, SavannahGa.)
    Author's details Marine Composites Symposium. Sponsored by American Society of Naval Engineers ... Symposium Chairman: David T. Guernsey, Jr
    Language English
    Size Getr. Zählung [ca.500 S.]
    Publisher American Society of Naval Engineers
    Publishing place s.l.
    Document type Book ; Conference proceedings
    Database Library catalogue of the German National Library of Science and Technology (TIB), Hannover

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