Risk factors for severe hand foot mouth disease in Singapore: a case control study

Background:
Hand foot mouth disease (HFMD) is a common childhood infection that can potentially lead to serious complications. The aim of this study is to identify risk factors of acquiring severe HFMD in our population.
Methods:
We performed a case control study using patients admitted to our hospital from August 2004 to July 2014. Cases were patients with severe HFMD disease while controls were age-matched patients obtained from the same year, in a 2:1 ratio. Data comprising demographic characteristics, clinical symptoms and signs, and lab findings were collected. Conditional univariable logistic regression was performed to determine risk factors for severe disease.
Results:
A total of 24 cases of severe HFMD were identified and matched with 48 controls. Seventeen (70.8 %) cases had central nervous system complications. Seven (29.2 %) had cardiovascular complications without evidence of myocarditis. One patient died of encephalitis. The overall mortality of severe disease is 4 %. Evidence of hypoperfusion, seizure, altered mentation, meningeal irritation, tachycardia, tachypnea, raised absolute neutrophil count and EV-A71 (Enterovirus A71) positivity were significantly associated with a severe course of HFMD.
Conclusion:
In managing children with HFMD, physicians should consider these factors to help identify patients at risk for severe disease.

Worldwide update shows drug-resistant TB rate is worsening | Vaccine News

“Yet another year of disheartening statistics, such as TB’s persistent annual 1.5 million death toll, should serve as a wake-up call that enormous work still needs to be done to reduce the burden of this ancient, yet curable disease,” Grania Brigden, interim medical director with the Doctors Without Borders’ Access Campaign, said. “When it comes to the deadlier forms of the disease – such as multidrug-resistant TB – the news is particularly bleak. Despite progress in rolling out better diagnostics such as rapid molecular tests, fewer people were detected with MDR-TB in 2014 than in 2013, even though the estimated number of new cases remained steady.”

Source: Worldwide update shows drug-resistant TB rate is worsening | Vaccine News

Humans of New York

“I was a costume designer, and I joined a famous dance company shortly after moving to New York. On my first day, one of the dancers told me that she’d met her best friend while on the job. I remember wishing that I could be so lucky. When I met Chris, he was still a dancer. But he was so talented that soon the director was giving him his own shows to choreograph. We worked together on everything. We could not have been more different. I had no interest in being famous. I grew up in a quiet family. I didn’t want to have a famous name or make a million dollars. But both of Chris’s parents had been Olympic skiers. So Chris wanted to win. He wanted his name in the paper. He’d always say things like: ‘That job should have been mine,’ or ‘I could have done that show better than him.’ I’m a born assistant. I didn’t have that drive but I enjoyed being close to it. It was like this breeze was coming off him all the time. He brought 100% of himself into everything he did. He was the kind of dancer that you’d pay to watch him walk a dog. I think he valued me because I was a willing participant in all his schemes. It was exciting just to be around him.” (

Source: Humans of New York

Humans of New York

“Chris didn’t tell me he was HIV positive until he began to get really sick. It was 1991, so there wasn’t much that could be done back then. It was the only time we ever argued. I wanted him to take care of himself so he could live as long as possible. He wanted to keep traveling, and drinking, and eating whatever he wanted. He kept working right until the end. Even when he was so sick that he had to be hooked up to an IV feed, he was making plans to go to the Netherlands to choreograph a show. He’d located a doctor there and everything. But he never made it. He began to lose his lucidity toward the end. One night he began to direct us. There were three of us in his hospital room, and he told us to arrange the lamp a certain way, then he had us lift him into the air. He seemed to be somewhere else. I think in his mind he was actually on a stage.”

Source: Humans of New York

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