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10.1371/journal.pntd.0003866 http://scihub22266oqcxt.onion/10.1371/journal.pntd.0003866 C4482028!4482028!26110270     free     free     free Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       PLoS+Negl+Trop+Dis 2015 ; 9 (6): ä Nephropedia Template TP {{tp|p=26110270|t=2015. A Systematic Review of the Mortality from Untreated Leptospirosis |pdf=|usr=}}{{26110270}} gab.com Text A Systematic Review of the Mortality from Untreated Leptospirosis JO: PLoS Negl Trop Dis http://www.kidney.de/pget.php?&tw=1&pmid=26110270 #FOAvip Background: Leptospirosis occurs worldwide, but the global incidence of human disease and its mortality are not well understood. Many patients are undiagnosed and untreated due to its non-specific symptoms and a lack of access to diagnostics. This study systematically reviews the literature to clarify the mortality from untreated leptospirosis. Results will help quantify the global burden of disease and guide health policies. Methodology/Principal Findings: A comprehensive literature search was performed to identify untreated patient series. Included patients were symptomatic, but asymptomatic patients and those who had received antibiotics, dialysis or who were treated on Intensive Care Units were excluded. Included patients had a confirmed laboratory diagnosis by culture, PCR, or serological tests. Data was extracted and individual patient series were assessed for bias. Thirty-five studies, comprising 41 patient series and 3,390 patients, were included in the study. A high degree of bias within studies was shown due to limitations in study design, diagnostic tests and missing data. Median series mortality was 2.2% (Range 0.0 ? 39.7%), but mortality was high in jaundiced patients (19.1%) (Range 0.0 ? 39.7%), those with renal failure 12.1% (Range 0-25.0%) and in patients aged over 60 (60%) (Range 33.3-60%), but low in anicteric patients (0%) (Range 0-1.7%). Conclusions: This systematic review contributes to our understanding of the mortality of untreated leptospirosis and provides data for the estimation of DALYs attributable to this disease. We show that mortality is significantly higher in older patients with icteric disease or renal failure but is lower in younger, anicteric patients. Increased surveillance and accurate point-of-care diagnostics are required to better understand the incidence and improve diagnosis of disease. Empirical treatment strategies should prioritize early treatment to improve outcomes from leptospirosis. Twit Text FOAVip A Systematic Review of the Mortality from Untreated Leptospirosis ????PLoS Negl Trop Dis http://www.kidney.de/pget.php?&tw=1&pmid=26110270 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=26110270 #FOAvip English Wikipedia <ref>{{Cite pmid|26110270}}</ref> A Systematic Review of the Mortality from Untreated Leptospirosis #MMPMID26110270 Taylor AJ; Paris DH; Newton PN PLoS Negl Trop Dis 2015[Jun]; 9 (6): ä PMID26110270show ga Background: Leptospirosis occurs worldwide, but the global incidence of human disease and its mortality are not well understood. Many patients are undiagnosed and untreated due to its non-specific symptoms and a lack of access to diagnostics. This study systematically reviews the literature to clarify the mortality from untreated leptospirosis. Results will help quantify the global burden of disease and guide health policies. Methodology/Principal Findings: A comprehensive literature search was performed to identify untreated patient series. Included patients were symptomatic, but asymptomatic patients and those who had received antibiotics, dialysis or who were treated on Intensive Care Units were excluded. Included patients had a confirmed laboratory diagnosis by culture, PCR, or serological tests. Data was extracted and individual patient series were assessed for bias. Thirty-five studies, comprising 41 patient series and 3,390 patients, were included in the study. A high degree of bias within studies was shown due to limitations in study design, diagnostic tests and missing data. Median series mortality was 2.2% (Range 0.0 ? 39.7%), but mortality was high in jaundiced patients (19.1%) (Range 0.0 ? 39.7%), those with renal failure 12.1% (Range 0-25.0%) and in patients aged over 60 (60%) (Range 33.3-60%), but low in anicteric patients (0%) (Range 0-1.7%). Conclusions: This systematic review contributes to our understanding of the mortality of untreated leptospirosis and provides data for the estimation of DALYs attributable to this disease. We show that mortality is significantly higher in older patients with icteric disease or renal failure but is lower in younger, anicteric patients. Increased surveillance and accurate point-of-care diagnostics are required to better understand the incidence and improve diagnosis of disease. Empirical treatment strategies should prioritize early treatment to improve outcomes from leptospirosis. äA Systematic Review of the Mortality from Untreated Leptospirosis (epmc).pdf DeepDyve Pubget Overpricing