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Artikel ; Online: A case of haemophagocytic syndrome in HIV-associated disseminated histoplasmosis.

Vaid, Nidhi / Patel, Parind

Acute medicine

2011 Band 10, Heft 3, Seite(n) 142–144

Abstract: Disseminated histoplasmosis is an opportunistic infection which is commonly associated with HIV. Haemophagocytic lymphohistiocytosis (HLH) has been described as a secondary phenomenon to infection, collagen-vascular disorders and malignancies. In ... ...

Abstract	Disseminated histoplasmosis is an opportunistic infection which is commonly associated with HIV. Haemophagocytic lymphohistiocytosis (HLH) has been described as a secondary phenomenon to infection, collagen-vascular disorders and malignancies. In patients with HIV, cases of reactive haemophagocytic syndrome associated with disseminated histoplasmosis have been reported with CD4 counts of less than 50 cells/µl (450-1660 cells/µl). We report a case of a 25 year old man with HIV who presented with a CD4 count of 153 cells/µl and would suggest that this diagnosis should be considered at higher CD4 counts than previously reported.
Mesh-Begriff(e)	AIDS-Related Opportunistic Infections/complications ; AIDS-Related Opportunistic Infections/diagnosis ; Adult ; CD4 Lymphocyte Count ; HIV Infections/immunology ; Histoplasmosis/complications ; Histoplasmosis/diagnosis ; Humans ; Lymphohistiocytosis, Hemophagocytic/complications ; Lymphohistiocytosis, Hemophagocytic/diagnosis ; Male
Sprache	Englisch
Erscheinungsdatum	2011
Erscheinungsland	England
Dokumenttyp	Case Reports ; Journal Article
ISSN	1747-4892
ISSN (online)	1747-4892
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Pre-hospital National Early Warning Score (NEWS) is associated with in-hospital mortality and critical care unit admission: A cohort study.

Abbott, Tom E F / Cron, Nicholas / Vaid, Nidhi / Ip, Dorothy / Torrance, Hew D T / Emmanuel, Julian

Annals of medicine and surgery (2012)

2018 Band 27, Seite(n) 17–21

Abstract: Background: National Early Warning Score (NEWS) is increasingly used in UK hospitals. However, there is only limited evidence to support the use of pre-hospital early warning scores. We hypothesised that pre-hospital NEWS was associated with death or ... ...

Abstract	Background: National Early Warning Score (NEWS) is increasingly used in UK hospitals. However, there is only limited evidence to support the use of pre-hospital early warning scores. We hypothesised that pre-hospital NEWS was associated with death or critical care escalation within the first 48 h of hospital stay. Methods: Planned secondary analysis of a prospective cohort study at a single UK teaching hospital. Consecutive medical ward admissions over a 20-day period were included in the study. Data were collected from ambulance report forms, medical notes and electronic patient records. Pre-hospital NEWS was calculated retrospectively. The primary outcome was a composite of death or critical care unit escalation within 48 h of hospital admission. The secondary outcome was length of hospital stay. Results: 189 patients were included in the analysis. The median pre-hospital NEWS was 3 (IQR 1-5). 13 patients (6.9%) died or were escalated to the critical care unit within 48 h of hospital admission. Pre-hospital NEWS was associated with death or critical care unit escalation (OR, 1.25; 95% CI, 1.04-1.51; p = 0.02), but NEWS on admission to hospital was more strongly associated with this outcome (OR, 1.52; 95% CI, 1.18-1.97, p < 0.01). Neither was associated with hospital length of stay. Conclusion: Pre-hospital NEWS was associated with death or critical care unit escalation within 48 h of hospital admission. NEWS could be used by ambulance crews to assist in the early triage of patients requiring hospital treatment or rapid transport. Further cohort studies or trials in large samples are required before implementation.
Sprache	Englisch
Erscheinungsdatum	2018-01-31
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2018.01.006
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Pneumoperitoneum, a urological source.

Hateley, Charlotte / Alçada, Joana / Park, Mirae / Vaid, Nidhi / Buckley, Jim

Lancet (London, England)

2016 Band 387, Heft 10015, Seite(n) 284

Mesh-Begriff(e)	Adult ; Emphysema/complications ; Emphysema/diagnosis ; Emphysema/diagnostic imaging ; Female ; Humans ; Kidney Diseases/complications ; Kidney Diseases/diagnosis ; Kidney Diseases/diagnostic imaging ; Pneumoperitoneum/diagnosis ; Pneumoperitoneum/diagnostic imaging ; Pneumoperitoneum/etiology ; Pyelonephritis/complications ; Pyelonephritis/diagnosis ; Pyelonephritis/diagnostic imaging ; Radiography
Sprache	Englisch
Erscheinungsdatum	2016-01-16
Erscheinungsland	England
Dokumenttyp	Case Reports ; Journal Article
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(15)60661-4
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Post-exposure prophylaxis in resource-poor settings: review and recommendations for pre-departure risk assessment and planning for expatriate healthcare workers.

Vaid, Nidhi / Langan, Katherine M / Maude, Richard J

Tropical medicine & international health : TM & IH

2013 Band 18, Heft 5, Seite(n) 588–595

Abstract: It is estimated that more than 3 million healthcare workers worldwide suffer needlestick and splash injuries whilst at work resulting in the potential transmission of blood-borne pathogens via exposure to bodily fluids. Under-reporting and the subsequent ...

Abstract	It is estimated that more than 3 million healthcare workers worldwide suffer needlestick and splash injuries whilst at work resulting in the potential transmission of blood-borne pathogens via exposure to bodily fluids. Under-reporting and the subsequent management of occupational injuries is a problem both in the United Kingdom and abroad. Many expatriate health care workers will work in low resource settings where the risk of transmission is greatest but in contrast to wealthier countries such as the United Kingdom, there is often a lack of effective systems for its safe management. This article provides important information about this risk and how to minimise it. The reasons for an increased risk in transmission, its subsequent management and pre-departure planning are discussed, together with the evidence for initiation of post-exposure prophylaxis; current National and International guidelines as well as the urgent need for International standardisation of these is also discussed.
Mesh-Begriff(e)	Africa ; Asia ; Blood-Borne Pathogens ; HIV Infections/prevention & control ; HIV Infections/transmission ; Health Personnel ; Health Planning Guidelines ; Hepatitis B/prevention & control ; Hepatitis B/transmission ; Hepatitis C/prevention & control ; Hepatitis C/transmission ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Needlestick Injuries/prevention & control ; Occupational Exposure/prevention & control ; Post-Exposure Prophylaxis/methods ; Risk Assessment ; Travel ; United Kingdom
Sprache	Englisch
Erscheinungsdatum	2013-03-06
Erscheinungsland	England
Dokumenttyp	Journal Article ; Review
ZDB-ID	1314080-2
ISSN	1365-3156 ; 1360-2276
ISSN (online)	1365-3156
ISSN	1360-2276
DOI	10.1111/tmi.12080
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: A single-centre cohort study of National Early Warning Score (NEWS) and near patient testing in acute medical admissions.

Abbott, Tom E F / Torrance, Hew D T / Cron, Nicholas / Vaid, Nidhi / Emmanuel, Julian

European journal of internal medicine

2016 Band 35, Seite(n) 78–82

Abstract: Introduction: The utility of an early warning score may be improved when used with near patient testing. However, this has not yet been investigated for National Early Warning Score (NEWS). We hypothesised that the combination of NEWS and blood gas ... ...

Abstract	Introduction: The utility of an early warning score may be improved when used with near patient testing. However, this has not yet been investigated for National Early Warning Score (NEWS). We hypothesised that the combination of NEWS and blood gas variables (lactate, glucose or base-excess) was more strongly associated with clinical outcome compared to NEWS alone. Methods: This was a prospective cohort study of adult medical admissions to a single-centre over 20days. Blood gas results and physiological observations were recorded at admission. NEWS was calculated retrospectively and combined with the biomarkers in multivariable logistic regression models. The primary outcome was a composite of mortality or critical care escalation within 2days of hospital admission. The secondary outcome was hospital length of stay. Results: After accounting for missing data, 15 patients out of 322 (4.7%) died or were escalated to the critical care unit. The median length of stay was 4 (IQR 7) days. When combined with lactate or base excess, NEWS was associated with the primary outcome (OR 1.18, p=0.01 and OR 1.13, p=0.03). However, NEWS alone was more strongly associated with the primary outcome measure (OR 1.46, p<0.01). The combination of NEWS with glucose was not associated with the primary outcome. Neither NEWS nor any combination of NEWS and a biomarker were associated with hospital length of stay. Conclusion: Admission NEWS is more strongly associated with death or critical care unit admission within 2days of hospital admission, compared to combinations of NEWS and blood-gas derived biomarkers.
Mesh-Begriff(e)	Adult ; Aged ; Aged, 80 and over ; Biomarkers ; Blood Gas Analysis ; Female ; Hospital Mortality ; Humans ; Intensive Care Units ; Length of Stay ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Patient Admission/statistics & numerical data ; Prospective Studies ; Risk Assessment ; Severity of Illness Index ; Time Factors ; United Kingdom
Chemische Substanzen	Biomarkers
Sprache	Englisch
Erscheinungsdatum	2016-11
Erscheinungsland	Netherlands
Dokumenttyp	Journal Article
ZDB-ID	1038679-8
ISSN	1879-0828 ; 0953-6205
ISSN (online)	1879-0828
ISSN	0953-6205
DOI	10.1016/j.ejim.2016.06.014
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Title: Risk factors for severe disease in patients admitted with COVID-19 to a hospital in London, England: a retrospective cohort study

Goodall, Jack W / Reed, Thomas A N / Ardissino, Maddalena / Bassett, Paul / Whittington, Ashley M / Cohen, David L / Vaid, Nidhi

medRxiv

Abstract: COVID-19 has caused a major global pandemic and necessitated unprecedented public health restrictions in almost every country. Understanding risk factors for severe disease in hospitalized patients is critical as the pandemic progresses. This ... ...

Abstract	COVID-19 has caused a major global pandemic and necessitated unprecedented public health restrictions in almost every country. Understanding risk factors for severe disease in hospitalized patients is critical as the pandemic progresses. This observational cohort study aimed to characterize the independent associations between the clinical outcomes of hospitalized patients and their demographics, comorbidities, blood tests and bedside observations. All patients admitted to Northwick Park Hospital, London, United Kingdom between 12 March and 15 April 2020 with COVID-19 were retrospectively identified. The primary outcome was death. Associations were explored using Cox proportional hazards modelling. The study included 981 patients. The mortality rate was 36.0%. Age (adjusted hazard ratio (aHR) 1.53), respiratory disease (aHR 1.37), immunosuppression (aHR 2.23), respiratory rate (aHR 1.28), hypoxia (aHR 1.36), Glasgow Coma Score <15 (aHR 1.92), urea (aHR 2.67), alkaline phosphatase (aHR 2.53), C-reactive protein (aHR 1.15), lactate (aHR 2.67), platelet count (aHR 0.77) and infiltrates on chest radiograph (aHR 1.89) were all associated with mortality. These important data will aid clinical risk stratification and provide direction for further research.
Schlagwörter	covid19
Sprache	Englisch
Erscheinungsdatum	2020-09-25
Verlag	Cold Spring Harbor Laboratory Press
Dokumenttyp	Artikel ; Online
DOI	10.1101/2020.09.24.20200337
Datenquelle	COVID19

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Artikel ; Online: Predictive Factors for Severe Disease in Patients Hospitalised with COVID-19 in London, England

Goodall, Jack / Reed, Thomas A N / Ardissino, Maddalena / Bassett, Paul / Whittington, Ashley M / Cohen, David L. / Vaid, Nidhi

SSRN Electronic Journal ; ISSN 1556-5068

A Retrospective Cohort Study

2020

Schlagwörter	covid19
Sprache	Englisch
Verlag	Elsevier BV
Erscheinungsland	us
Dokumenttyp	Artikel ; Online
DOI	10.2139/ssrn.3638298
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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Artikel ; Online: False-negative RT-PCR for COVID-19 and a diagnostic risk score: a retrospective cohort study among patients admitted to hospital.

Gupta-Wright, Ankur / Macleod, Colin Kenneth / Barrett, Jessica / Filson, Sarah Ann / Corrah, Tumena / Parris, Victoria / Sandhu, Gurjinder / Harris, Miriam / Tennant, Rachel / Vaid, Nidhi / Takata, Junko / Duraisingham, Sai / Gandy, Nemi / Chana, Harmeet / Whittington, Ashley / McGregor, Alastair / Papineni, Padmasayee

BMJ open

2021 Band 11, Heft 2, Seite(n) e047110

Abstract: Objective: To describe the characteristics and outcomes of patients with a clinical diagnosis of COVID-19 and false-negative SARS-CoV-2 reverse transcription-PCR (RT-PCR), and develop and internally validate a diagnostic risk score to predict risk of ... ...

Abstract	Objective: To describe the characteristics and outcomes of patients with a clinical diagnosis of COVID-19 and false-negative SARS-CoV-2 reverse transcription-PCR (RT-PCR), and develop and internally validate a diagnostic risk score to predict risk of COVID-19 (including RT-PCR-negative COVID-19) among medical admissions. Design: Retrospective cohort study. Setting: Two hospitals within an acute NHS Trust in London, UK. Participants: All patients admitted to medical wards between 2 March and 3 May 2020. Outcomes: Main outcomes were diagnosis of COVID-19, SARS-CoV-2 RT-PCR results, sensitivity of SARS-CoV-2 RT-PCR and mortality during hospital admission. For the diagnostic risk score, we report discrimination, calibration and diagnostic accuracy of the model and simplified risk score and internal validation. Results: 4008 patients were admitted between 2 March and 3 May 2020. 1792 patients (44.8%) were diagnosed with COVID-19, of whom 1391 were SARS-CoV-2 RT-PCR positive and 283 had only negative RT-PCRs. Compared with a clinical reference standard, sensitivity of RT-PCR in hospital patients was 83.1% (95% CI 81.2%-84.8%). Broadly, patients with false-negative RT-PCR COVID-19 and those confirmed by positive PCR had similar demographic and clinical characteristics but lower risk of intensive care unit admission and lower in-hospital mortality (adjusted OR 0.41, 95% CI 0.27-0.61). A simple diagnostic risk score comprising of age, sex, ethnicity, cough, fever or shortness of breath, National Early Warning Score 2, C reactive protein and chest radiograph appearance had moderate discrimination (area under the receiver-operator curve 0.83, 95% CI 0.82 to 0.85), good calibration and was internally validated. Conclusion: RT-PCR-negative COVID-19 is common and is associated with lower mortality despite similar presentation. Diagnostic risk scores could potentially help triage patients requiring admission but need external validation.
Mesh-Begriff(e)	Aged ; Aged, 80 and over ; COVID-19/diagnosis ; COVID-19 Nucleic Acid Testing ; False Negative Reactions ; Female ; Hospitalization ; Humans ; London/epidemiology ; Male ; Middle Aged ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Risk Factors
Sprache	Englisch
Erscheinungsdatum	2021-02-09
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2020-047110
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Utility of the FebriDx point-of-care assay in supporting a triage algorithm for medical admissions with possible COVID-19: an observational cohort study.

Houston, Hamish / Deas, Gavin / Naik, Shivam / Shah, Kamal / Patel, Shiras / Greca Dottori, Maria / Tay, Michael / Filson, Sarah Ann / Biggin-Lamming, James / Ross, John / Vaughan, Natalie / Vaid, Nidhi / Gopal Rao, Guduru / Amin, Amit K / Gupta-Wright, Ankur / John, Laurence

BMJ open

2021 Band 11, Heft 8, Seite(n) e049179

Abstract: Objective: To evaluate a triage algorithm used to identify and isolate patients with suspected COVID-19 among medical patients needing admission to hospital using simple clinical criteria and the FebriDx assay.: Design: Retrospective observational ... ...

Abstract	Objective: To evaluate a triage algorithm used to identify and isolate patients with suspected COVID-19 among medical patients needing admission to hospital using simple clinical criteria and the FebriDx assay. Design: Retrospective observational cohort. Setting: Large acute National Health Service hospital in London, UK. Participants: All medical admissions from the emergency department between 10 August 2020 and 4 November 2020 with a valid SARS-CoV-2 RT-PCR result. Interventions: Medical admissions were triaged as likely, possible or unlikely COVID-19 based on clinical criteria. Patients triaged as possible COVID-19 underwent FebriDx lateral flow assay on capillary blood, and those positive for myxovirus resistance protein A (a host response protein) were managed as likely COVID-19. Primary outcome measures: Diagnostic accuracy (sensitivity, specificity and predictive values) of the algorithm and the FebriDx assay using SARS-CoV-2 RT-PCR from nasopharyngeal swabs as the reference standard. Results: 4.0% (136) of 3443 medical admissions had RT-PCR confirmed COVID-19. Prevalence of COVID-19 was 46% (80/175) in those triaged as likely, 4.1% (50/1225) in possible and 0.3% (6/2033) in unlikely COVID-19. Using a SARS-CoV-2 RT-PCR reference standard, clinical triage had sensitivity of 96% (95% CI 91% to 98%) and specificity of 61.5% (95% CI 59.8% to 63.1%), while the triage algorithm including FebriDx had sensitivity of 93% (95% CI 87% to 96%) and specificity of 86.4% (95% CI 85.2% to 87.5%). While 2033 patients were deemed not to require isolation using clinical criteria alone, the addition of FebriDx to clinical triage allowed a further 826 patients to be released from isolation, reducing the need for isolation rooms by 9.5 per day, 95% CI 8.9 to 10.2. Ten patients missed by the algorithm had mild or asymptomatic COVID-19. Conclusions: A triage algorithm including the FebriDx assay had good sensitivity and was useful to 'rule-out' COVID-19 among medical admissions to hospital.
Mesh-Begriff(e)	Algorithms ; COVID-19 ; Cohort Studies ; Humans ; Point-of-Care Systems ; Retrospective Studies ; SARS-CoV-2 ; Sensitivity and Specificity ; State Medicine ; Triage
Sprache	Englisch
Erscheinungsdatum	2021-08-09
Erscheinungsland	England
Dokumenttyp	Journal Article ; Observational Study
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-049179
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Cross-sectional observational study of epidemiology of COVID-19 and clinical outcomes of hospitalised patients in North West London during March and April 2020

Paula Blomquist / Ayesha Akbar / Ashley Whittington / Miriam Harris / Alastair McGregor / Padmasayee Papineni / Guduru Gopal Rao / Alexander Allen / Liyang Wang / Laurence John / Stephen Hiles / Valerie Decraene / Bharat Patel / Yimmy Chow / Martin Kuper / Sharpe Roger / Cohen David / Tennant Rachel / Vaid Nidhi /

Sahnan Kapil / Gross Jamie / Husain Tariq / Parris Victoria / Sandhu Gurjinder / Rosen Stuart / Cayley Charles / Patel Sangita / Blair Mitchel / Lewis Simon / Chita Sunder / Winn Trish / Biggin-Lamming James / Sewel Catherine / Gregory Laila / Tozer Philip / Littler Stephen

BMJ Open, Vol 11, Iss

2021 Band 2

Abstract: Objective The aim of this paper is to describe evolution, epidemiology and clinical outcomes of COVID-19 in subjects tested at or admitted to hospitals in North West London.Design Observational cohort study.Setting London North West Healthcare NHS Trust ( ...

Abstract	Objective The aim of this paper is to describe evolution, epidemiology and clinical outcomes of COVID-19 in subjects tested at or admitted to hospitals in North West London.Design Observational cohort study.Setting London North West Healthcare NHS Trust (LNWH).Participants Patients tested and/or admitted for COVID-19 at LNWH during March and April 2020Main outcome measures Descriptive and analytical epidemiology of demographic and clinical outcomes (intensive care unit (ICU) admission, mechanical ventilation and mortality) of those who tested positive for COVID-19.Results The outbreak began in the first week of March 2020 and reached a peak by the end of March and first week of April. In the study period, 6183 tests were performed in on 4981 people. Of the 2086 laboratory confirmed COVID-19 cases, 1901 were admitted to hospital. Older age group, men and those of black or Asian minority ethnic (BAME) group were predominantly affected (p<0.05). These groups also had more severe infection resulting in ICU admission and need for mechanical ventilation (p<0.05). However, in a multivariate analysis, only increasing age was independently associated with increased risk of death (p<0.05). Mortality rate was 26.9% in hospitalised patients.Conclusion The findings confirm that men, BAME and older population were most commonly and severely affected groups. Only older age was independently associated with mortality.
Schlagwörter	Medicine ; R
Sprache	Englisch
Erscheinungsdatum	2021-02-01T00:00:00Z
Verlag	BMJ Publishing Group
Dokumenttyp	Artikel ; Online
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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