Certain laboratory parameters can be used to quickly guide the diagnosis of a child with signs of acute illness, and C-reactive protein (CRP) is among the best characterized such biomarkers. We conducted a systematic literature search using PubMed to identify the most recent original articles or reviews published between 1 January 2016 and 30 September 2021, on the topic of the clinical utility of CRP in pediatric practice, using the following two-word combinations: "C-reactive protein” and "children”, and "CRP” and "children”. Although it does not have a high specificity to differentiate between viral or bacterial etiology, CRP can be used successfully in the clinic in the follow-up of children with acute infectious diseases, including newborns. We have identified in the literature an association between obesity, metabolic disorders, neuro-psychological status and CRP value. In conclusion the latest data show that CRP is an easy and reliable marker, but its value must be integrated into the patient's clinical context

Osteoporosis-associated bone loss is manifested as chronic pain, fractures and reduced quality of life. Osteoporosis increases the risk of fracture, especially in elderly people. Here we present the role of family doctor in osteoporosis management for the prevention of the occurrence of fractures, also particularities of medical and non-medical therapeutics. The preventive aspects and actual therapies plans of the disease are presented as a useful tool for healthcare givers implicated in osteoporosis treatments. In conclusion, family doctors play an important role in the global strategy for the prevention and treatment of osteoporosis and its socio-economic consequences.

This case report describes a relatively rare and specific situation of vancomycin-resistant E. faecium infective endocarditis. Such cases are not described on the published literature and the guidelines. As a consequence, their management is relegated to suboptimal treatment with possible side effects of antimicrobial agents.

Introduction This study aimed to explore the factors contributing to COVID-19 vaccine hesitancy (VH) among healthcare workers (HCWs) who missed the first dose of the COVID-19 vaccine in Nigeria. Methods We conducted a qualitative study of the factors contributing to COVID-19 VH among HCWs at the University College Hospital, Ibadan using purposive sampling technique. Each interview session was held through telephone conversation. Qualitative data were analyzed using Colaizzi’s phenomenological method. Results The mean age of the 15 HCWs was 34.33±3.77 years, 10 (66.7%) were females, 6 (40.0%) were physiotherapists. Three themes were identified. The first theme, "Factors contributing to COVID-19 VH among healthcare workers” had five clusters: i) Lack of adequate information regarding the COVID-19 vaccine, ii) Challenges with immunization schedule, iii) Fear of side effects of the COVID-19 vaccine, iv) Lack of trust in the government, and v) Concerns about the safety of the COVID-19 vaccine. The second theme, "Healthcare workers’ perception on the solution to COVID-19” had three clusters: i) Adherence to non-pharmaceutical measures, ii) Vaccine production: key to submerging the COVID-19 pandemic, and iii) Healthcare workers’ perception of their roles in patient education on the COVID-19 vaccine. The third theme, "Recommendations to encourage COVID-19 vaccine acceptance among healthcare workers” had three clusters: i) Disclosure of extensive information on COVID-19 vaccine components, ii) Decentralization of COVID-19 vaccine collection points, and iii) Procurement of other brands of the COVID-19 vaccine.

Introduction Plasmid-mediated quinolone resistance (PMQR) is a growing concern worldwide. Reports from Nigeria suggest quinolone-resistant clinical isolates are common, however, reports on the prevalence of PMQR genes are few. This study aimed to determine the prevalence ofPMQR genes in quinolone-resistant isolates from a tertiary healthcare hospital in Nigeria. Methods This was a cross-sectional study involving 390 gram-negative bacilli from diverse clinical infections. The isolates were characterized by the MicrobactTM identification kit and susceptibility patterns determined by the Kirby-Bauer disc diffusion technique. All quinolone-resistant isolates were investigated for the carriage of PMQR genes by multiplex polymerase chain reaction (PCR). Data analysis was performed with appropriate descriptive and inferential statistics. Results The isolates were distributed as Escherichia coli (n=121, 31.0%), Klebsiella species (n= 112, 28.7%), Pseudomonas aeruginosa (n=59, 15.1%), Proteus species (n=43, 11.0%), Salmonella species (n=6, 1.3%) and others. They were commonly resistant to nalidixic acid (62.6%), co-amoxiclav (57.7%), norfloxacin (52.3%), ofloxacin (52.1%) and ciprofloxacin (51.0%), but were least resistant to imipenem (n=36, 9.2%). Of 244 quinolone-resistant isolates, 180 (73.8%) harboured one or more PMQR gene with high prevalence of efflux-mediating determinants (qepA, 22.5%, oqxAB, 21.1%), and aminoglycoside acetyltransferase (aac(6’)-Ib-cr, 19.7%). A proportionately low level of target-protecting determinants: qnrB, 13.2%, qnrS, 8.7%, qnrA, 5.9%, qnrD, 4.5% and qnrC, 4.2% was found. Conclusions There is widespread quinolone resistance and distribution of PMQR genes in clinical isolates in Nigeria with a preponderance of efflux-mediating determinants and aminoglycoside acetyltransferase. This emphasizes the need for antimicrobial stewardship to guide the appropriate use of antibiotics and prevent the spread of resistance genes.

Introduction In this study, the hematological and inflammatory parameters of patients admitted to the emergency department with abdominal pain were examined and predictive values were determined. Methods A total of 12682 patients who applied to Sakarya Training and Research Hospital adult emergency service with abdominal pain between 01/01/2019-31/12/2019 were included in the study. Patients were divided into groups, as follows: Group 1: Patients discharged from the emergency room, Group 2: Patients who were hospitalized from the emergency department and discharged without surgery, Group 3: Patients who were hospitalized from the emergency department and underwent surgery. Results A total of 12682 patients were included in the study. In the operated group the median CRP level (23.1 [0.1-377.4] mg/dL) was the highest, the mean WBC number (13.8±6.2 K/µL) was the highest, the median lymphocyte percentage (12.8 [0.2-55.6] %) was the lowest, the median neutrophil number (9.9 [1.0-43.8] K/µL) was the highest, the mean platelet number (254.2±88.1 K/µL) was the highest, the median neutrophil/lymphocyte ratio (6.1 [0.5-425.2]) was the highest and the median platelet/lymphocyte ratio 143.9 [16.9-2019.4] was the highest. Conclusions Our large-scale study shows that hematological-inflammatory parameters, which are routinely studied in patients presenting with abdominal pain, can be used to distinguish patients who will be discharged from the emergency service and those who require hospitalization.

Antimicrobial resistance has gained our attention, extending the interest in bacteriology research and upgraded it in such a way that we no longer look at bacteria only as dangerous enemies, but also as fantastic allies. Why allies? Microbiota is one of the greatest, but an almost invisible armour the human body owns which functions similarly to an external immune system. What is known so far is that the human microbiome is a very dynamic and protective layer consisting of beneficial microbes which defend us from the threatening ones.