Methods: The pediatric patients diagnosed with scrub typhus durin

Methods: The pediatric patients diagnosed with scrub typhus during the 12-year period from 1995 through 2006 in

Feixian County, Shandong province were enrolled in the study. The cases were diagnosed based on either specific antibody detection using the indirect immunofluorescent assay or detection of partial Orientia tsutsugamushi gene by polymerase chain reaction.

Results: Seventy pediatric scrub typhus cases were included in the study. The cases occurred from September through November. The common clinical manifestations included headache (100%), skin rash (91%), eschar (84%), lymphadenopathy (61%), and gastrointestinal signs (56%). None of the patients had neurologic involvement or thrombocytopenia. All children responded well to treatment with chloramphenicol. The patients Compound Library chemical structure who presented with abnormal chest radiography took significantly longer time to defervescence (Z[r] = 2.528, P = 0.011). Three strains of O. tsutsugamushi were isolated and all were identified as Kawasaki type.

Conclusions: The manifestations of pediatric scrub typhus cases in the buy Napabucasin novel endemic region of northern China may be less severe than in other regions.

Careful examination of skin eschars is helpful for the clinical diagnosis.”
“Study Design. Systematic review of literature.

Objective. To determine the optimal indications and Selleckchem Mizoribine methods of surgical treatment for unstable type II odontoid fractures in skeletally mature individuals.

Summary of Background Data. Odontoid fractures are a frequently encountered injury pattern in the cervical spine. The surgical treatment of type II odontoid fractures varies among spinal surgeons. The optimal surgical indications and treatment for type II odontoid fractures remains unclear.

Methods. Five primary research questions, based on safety and efficacy, were determined by consensus of a panel of spine trauma surgeons consisting of fellowship trained orthopedic and neurologic surgeons. A comprehensive

review of the literature was performed using MeSH search terms in MEDLINE, PubMed, EMBASE, CINAHL, and the Cochrane Database of Systematic reviews. The quality of literature was rated as high, moderate, low, or very low. Using the GRADE evidence-based review system, the primary questions were answered using the literature review and expert opinion. These treatment recommendations were then rated as either strong or weak based on the quality of evidence and clinical expertise.

Results. The initial search resulted in over 1300 results. After initial application of all inclusion and exclusion criteria, 458 abstracts were reviewed from which 22 manuscripts were found to meet all criteria. These were obtained, reviewed, and used to create an evidentiary table. All articles were of either low or very low quality.


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