Frequency of musculoskeletal complications among the patients receiving solid organ transplantation in a tertiary health-care center

Abstract Background An increase in nosocomial and health care-related infective endocarditis (IE) has been described. Solid organ transplantation (SOT) implies immunosuppression and frequent health care contact. Our aim was to compare characteristics of patients with IE and SOT against those without SOT. Methods We used data from the Spanish Collaboration on Endocarditis obtained during the period 2008–2018. Results We identified 4794 cases of IE, 85 (1.8%) in SOT (56 kidney, 18 liver, 8 heart, 3 lung). Thirteen patients had other types of transplantation (bone marrow, hematopoietic precursors, and cornea) and were excluded from the analysis. Compared with patients without SOT, patients with SOT had a higher median age (69 vs. 61 years, p<0.001), more comorbidities (mean age-adjusted Charlson index 5.7±2.9 vs. 4.9±2.9, p=0.004), a lower prevalence of native valvular heart disease (29.4 vs. 45.4%, p=0.003), more in-hospital and healthcare-related IE (70.5% vs. 36.3%, p<0.001) and Staphylococcus etiology (57.7% vs. 39.7%, p=0.001). Regarding evolution, patients with SOT had more frequent kidney function worsening (47.1% vs. 34.6%, p=0.02), septic shock (25.9% vs. 12.1%, p<0.001), sepsis (27.1% vs. 17.2%, p=0.02). Surgery indication (54.1% vs 66.3%, p=0.02) and surgery (32.9% vs. 46.3%, p=0.01) were less frequent in patients with SOT. We were unable to find significant differences in mortality: inhospital (30.6% vs. 25.6%, p=0.31), 1-year (38.8% vs. 31.9%, p=0.18). Conclusion IE in SOT patients has specific characteristics. Most of the cases are nosocomial and over 70% are hospital-or health care-related. Half have previously normal heart valves and almost 60% are due to Staphylococcus infections. Figure 1. Kaplan Meier survival curves for patients with and without solid organ transplantation (SOT). SOT: 56 kidney, 18 liver (2 combined with kidney), 8 heart, 3 lung. Funding Acknowledgement Type of funding source: None

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Behavioral health care in solid organ transplantation in a pediatric setting

Pediatric Transplantation ◽

10.1111/petr.13217 ◽

2018 ◽

Vol 22 (5) ◽

pp. e13217 ◽

Cited By ~ 7

Author(s):

Katharine Thomson ◽

Kristine McKenna ◽

Katherine Bedard-Thomas ◽

Melisa Oliva ◽

Patricia Ibeziako

Keyword(s):

Health Care ◽

Behavioral Health ◽

Organ Transplantation ◽

Solid Organ Transplantation ◽

Behavioral Health Care ◽

Solid Organ ◽

Pediatric Setting

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Non-Fatal Deliberate Self-Harm in Three Remote Indigenous Communities in Far North Queensland, Australia

Crisis ◽

10.1027/0227-5910/a000589 ◽

2019 ◽

Vol 40 (6) ◽

pp. 422-428 ◽

Cited By ~ 1

Author(s):

Chris Rouen ◽

Alan R. Clough ◽

Caryn West

Keyword(s):

Health Care ◽

Primary Health Care ◽

Care Center ◽

Indigenous Communities ◽

Indigenous Australians ◽

Deliberate Self Harm ◽

Health Care Center ◽

Far North ◽

Primary Health ◽

Self Harm

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.

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