absorption-nasal-bronchial-fluids-precision-sampling-human

Absorption of Nasal and Bronchial Fluids: Precision Sampling of the Human Respiratory Mucosa and Laboratory Processing of Samples

The methods of nasal absorption (NA) and bronchial absorption (BA) use synthetic absorptive matrices (SAM) to absorb the mucosal lining fluid (MLF) of the ...

Imperial College Healthcare Trust

Meningococcal infection remains a significant health problem in children, with a significant mortality and morbidity. Prompt recognition and aggressive early treatment are the only effective measures against invasive disease. This requires immediate administration of antibiotic therapy, and the recognition and treatment of patients who may have complications of meningococcal infection such as shock, raised intracranial pressure (ICP) or both. Encouragingly, its mortality has fallen in recent years. This is the result of several factors such as the centralization of care of seriously ill children in paediatric intensive care units (PICUs), the establishment of specialized mobile intensive care teams, the development of protocols for the treatment of meningococcal infection, and the dissemination by national bodies and charities of guidance about early recognition and management. We will review the pathophysiology and management of the different presentations of meningococcal disease and examine the possible role of adjunctive therapies.

Diagnosis and management of meningococcal disease: the need for centralized care.

The Researching Severe Sepsis and Organ Dysfunction in Children: A Global Perspective study of drotrecogin alpha activated versus placebo was the largest study of adjunctive therapy ever performed in children with severe sepsis. Despite this, the study failed to show any significant differences in outcome between the treatment and placebo groups. The results raise questions about how we should perform meaningful clinical trials in relatively rare conditions such as paediatric sepsis, where the easily measurable endpoints (such as death) are infrequent. A radical rethink of the design of such studies is urgently needed.

RESOLVE-ing sepsis in children--not yet!

Meningococcal meningitis and septicaemia remain a serious global health threat. This review focuses on the epidemiology of meningococcal disease following the recent implementation of effective vaccines and the potential utility of a vaccine against serogroup B meningococcus.

Prospects for eradication of meningococcal disease.

Political Lancet.

Meningococcal disease is a life-threatening infection that may progress rapidly, even after appropriate treatment has commenced. Early suspicion of the diagnosis is vital so that parenteral antibiotic treatment can be administered as soon as possible to reduce the complications of infection. The outcome of meningococcal disease is critically dependent on prompt recognition of two important complications: shock and raised intracranial pressure. Rapid recognition of disease and of these complications, together with appropriate management is crucial to the outcome of affected patients. This article summarizes the clinical features of invasive meningococcal disease, diagnostic tools, treatment modalities, and common post-infection sequelae.

Treatment of Meningococcal Disease.

Existing respiratory mucosal sampling methods are flawed, particularly in a pediatric bronchiolitis setting.

Article	Year
Diagnosis and management of meningococcal disease: the need for centralized care. FEMS microbiology reviews\| PubMed ID: 17233636	2007
RESOLVE-ing sepsis in children--not yet! Critical care (London, England)\| PubMed ID: 17561989	2007
Prospects for eradication of meningococcal disease. Archives of disease in childhood\| PubMed ID: 22984187	2012
Political Lancet. Lancet (London, England)\| PubMed ID: 24332078	2013
Treatment of Meningococcal Disease. The Journal of adolescent health : official publication of the Society for Adolescent Medicine\| PubMed ID: 27449146	2016
Nasosorption as a Minimally Invasive Sampling Procedure: Mucosal Viral Load and Inflammation in Primary RSV Bronchiolitis. The Journal of infectious diseases\| PubMed ID: 28368490	2017

Simon Nadel

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