scholarly journals Paracoccidioidomycosis in Colombia: an ecological study

2001 ◽  
Vol 126 (2) ◽  
pp. 309-315 ◽  
Author(s):  
D. CALLE ◽  
D. S. ROSERO ◽  
L. C. OROZCO ◽  
D. CAMARGO ◽  
E. CASTAÑEDA ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Sea Level ◽  
Rural Population ◽  
Rate Ratio ◽  
Ecological Study ◽  
Incidence Rate Ratio ◽  
Paracoccidioides Brasiliensis ◽  
Natural Habitat ◽  
Ecological Variables

The natural habitat of Paracoccidioides brasiliensis, agent of paracoccidioidomycosis (PCM), remains unknown. This study is aimed at establishing associations between the ecological variables present in all Colombian municipalities and the incidence of PCM. Records of 940 patients were studied and several ecological variables analysed, as well as their association to amount of patients per total rural population in each municipality, determined through a multivariate analysis. All 940 patients came from 216 municipalities (20·3 %), out of which, 93 were birthplace and place of long-term residence for 121 patients. The Incidence Rate Ratio (IRR) was determined for these 93 municipalities. The following variables fitted the model: altitude from 1000 to 1499 metres above sea level (IRR = 6·37), rainfall from 2000 to 2999 mm (IRR = 2·15), presence of humid forests (Holdridge) (IRR = 1·79) and coffee (IRR = 1·95), tobacco (IRR = 3·59) crops. These results indicate that these municipalities constitute reservareas for P. brasiliensis (Borelli).

Tracheostomy trends in paediatric intensive care

2020 ◽  
pp. archdischild-2020-319396
Author(s):  
Jason Powell ◽  
Hannah L Buckley ◽  
Rachel Agbeko ◽  
Malcolm Brodlie ◽  
Steven Powell
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Incidence Rate ◽  
Paediatric Intensive Care Unit ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Great Variability ◽  
Paediatric Intensive Care ◽  
Long Term Ventilation

Paediatric tracheostomy is most commonly performed in children on the paediatric intensive care unit (PICU) to facilitate long-term ventilation. We sought to identify trends in UK tracheostomy practice in PICUs. Data were analysed from 250 261 admissions, including 4409 children tracheostomised between 2003 and 2017. The incidence of tracheostomy in 2017 was approximately half that in 2003 (incidence rate ratio=0.48, 95% CI 0.40 to 0.57). The percentage of patients tracheostomised during a PICU admission, as a proportion of all admissions, was 2.44% (n=319) in 2003 and reduced to 0.97% (n=180) in 2017. Nevertheless, we identified great variability in practice between different PICUs with tracheostomy rates between 0.0% and 4.0% of all admissions. Risk-adjusted PICU mortality was comparable between tracheostomised children and all admissions to PICU.

scholarly journals Long-term outcome and predictors of long-term disease activity in natalizumab-treated patients with multiple sclerosis: real life data from the Austrian MS Treatment Registry

2021 ◽  
Author(s):  
Michael Guger ◽  
◽  
Christian Enzinger ◽  
Fritz Leutmezer ◽  
Franziska Di Pauli ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Activity ◽  
Rate Ratio ◽  
Disease Duration ◽  
Treatment Initiation ◽  
Incidence Rate Ratio ◽  
Real Life ◽  
Life Data ◽  
Real Life Data

Abstract Objectives To evaluate long-term effectiveness of natalizumab (NTZ) and to determine demographic, clinical, and radiological predictors regarding long-term disease activity (≥ 7 years) in a nationwide observational cohort, using data collected prospectively in a real-life setting. Materials and methods We analysed data from 230 patients from the Austrian Multiple Sclerosis Treatment Registry (AMSTR), who had started treatment with NTZ at any time since 2006 and stayed on NTZ for at least 7 years without treatment gap of more than three months. Results Estimated mean annualised relapse rates (ARR) over a mean treatment period of 9.3 years were 0.07 for NTZ. Sustained EDSS progression for 12 weeks was observed in 36 (19%) patients and for 24 weeks in 31 (16.3%) cases. Sustained EDSS regression for 12 and 24 weeks was seen in 45 (23.7%) and 42 (22.1%) cases. The baseline parameters ≥ 1 Gadolinium-enhancing MRI lesion(s) [incidence rate ratio (IRR) of 0.409 (95% CI 0.283–0.593), p = 0.001], ARR ≤ 1 in the prior 12 month before treatment initiation with NTZ [IRR of 0.353 (95% CI 0.200–0.623), p = 0.001] and EDSS ≤ 1 [incidence rate ratio (IRR) of 0.081 (95% CI 0.011–0.581), p = 0.012] were significantly associated with a reduced relapse risk, whereas a disease duration ≤ 5 years increased significantly the ARR [IRR of 1.851 (95% CI 1.249–2.743), p = 0.002]. The only predictive baseline parameter for experiencing EDSS progression (sustained for 12 and 24 weeks) was age > 35 years [HR of 2.482 (95% CI 1.110–5.549), p = 0.027, and HR of 2.492 (95% CI 1.039–5.978), p = 0.041, respectively]. Conclusions These real-life data show a stable disease course regarding relapse activity and disease progression under NTZ treatment for more than 7 years. The main predictors for disease activity were higher relapse rate before treatment initiation, higher disability, shorter disease duration and absence of Gadolinium-enhancing MRI lesions at baseline. Older age at NTZ start was the only significant risk factor for disease progression over long-term.

Antimicrobial Stewardship in a Long-Term Acute Care Hospital Using Offsite Electronic Medical Record Audit

2016 ◽  
Vol 37 (4) ◽  
pp. 433-439 ◽  
Author(s):  
Kirthana Beaulac ◽  
Silvia Corcione ◽  
Lauren Epstein ◽  
Lisa E. Davidson ◽  
Shira Doron
Keyword(s):  
Incidence Rate ◽  
Acute Care ◽  
Antimicrobial Stewardship ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Acute Care Hospital ◽  
Antimicrobial Use ◽  
Care Hospital ◽  
Hospital Acquired

OBJECTIVETo offer antimicrobial stewardship to a long-term acute care hospital using telemedicine.METHODSWe conducted an uninterrupted time-series analysis to measure the impact of antimicrobial stewardship on hospital-acquired Clostridium difficile infection (CDI) rates and antimicrobial use. Simple linear regression was used to analyze changes in antimicrobial use; Poisson regression was used to estimate the incidence rate ratio in CDI rates. The preimplementation period was April 1, 2010–March 31, 2011; the postimplementation period was April 1, 2011–March 31, 2014.RESULTSDuring the preimplementation period, total antimicrobial usage was 266 defined daily doses (DDD)/1,000 patient-days (PD); it rose 4.54 (95% CI, −0.19 to 9.28) per month then significantly decreased from preimplementation to postimplementation (−6.58 DDD/1,000 PD [95% CI, −11.48 to −1.67]; P=.01). The same trend was observed for antibiotics against methicillin-resistant Staphylococcus aureus (−2.97 DDD/1,000 PD per month [95% CI, −5.65 to −0.30]; P=.03). There was a decrease in usage of anti-CDI antibiotics by 50.4 DDD/1,000 PD per month (95% CI, −71.4 to −29.2; P<.001) at program implementation that was maintained afterwards. Anti-Pseudomonas antibiotics increased after implementation (30.6 DDD/1,000 PD per month [95% CI, 4.9–56.3]; P=.02) but with ongoing education this trend reversed. Intervention was associated with a decrease in hospital-acquired CDI (incidence rate ratio, 0.57 [95% CI, 0.35–0.92]; P=.02).CONCLUSIONAntimicrobial stewardship using an electronic medical record via remote access led to a significant decrease in antibacterial usage and a decrease in CDI rates.Infect. Control Hosp. Epidemiol. 2016;37(4):433–439

scholarly journals Relationship between Socioeconomic Factors and Incidence of Cosmetic Surgery in Tehran, Iran

2021 ◽  
Author(s):  
Mohammad BIDKHORI ◽  
Mehdi YASERI ◽  
Ali AKBARI SARI ◽  
Reza MAJDZADEH
Keyword(s):  
Multivariate Analysis ◽  
Incidence Rate ◽  
Significant Relationship ◽  
Poisson Regression ◽  
Cosmetic Surgery ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Univariate Analysis ◽  
Factors Affecting ◽  
Socioeconomic And Demographic Factors

Background: Cosmetic surgery accompanied with high economic cost is increasing in Iran. It is necessary to be aware about factors affecting cosmetic surgery in order to control its increasing trend. Therefore, we aimed to determine the factors affecting the incidence of cosmetic surgery in Tehran, Iran. Methods: This survey was conducted on 2002 subjects between the ages of 15 to 60 yr using random digit dialing in Tehran, Iran 2015. Demographic data was collected from all of participants and in the presence of cosmetic surgery, the related cosmetic questions were asked in details. Cosmetic surgery was considered as an event and the incidence rate ratio for variables were estimated. For univariate analysis, Poisson regression was used as well as multi-level Poisson regression was used for multivariate analysis. Results: Totally, 224 participants (11%) undergone cosmetic surgery. There was a significant relationship between the age at surgery of participants with the incidence of cosmetic surgery (P<0.001). Cosmetic surgery in women was 1.9 times greater than in men (P <0.001). Incidence Rate Ratio (IRR) for the average and wealthy economic status in comparison to poor level was estimated (IRR=5.6, CI%95: 3.64,8.63) and (IRR=3.14, CI%95: 1.93,5.11), respectively. In addition, according to multivariate analysis all variables except the level of education and occupation, had significant relationship with the incidence of cosmetic surgery (P<0.001). Conclusion: Cosmetic surgery was related to socioeconomic and demographic factors. Given the high economic burden of this unnecessary surgery, it can be effective to emphasize on awareness-raising programs for those are more likely to undergo cosmetic surgery.

scholarly journals Failing our Most Vulnerable: COVID-19 and Long-Term Care Facilities in Ontario

2020 ◽  
Author(s):  
David N. Fisman ◽  
Isaac Bogoch ◽  
Lauren Lapointe-Shaw ◽  
Janine McCready ◽  
Ashleigh R. Tuite ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Rate Ratio ◽  
Long Term Care ◽  
Incidence Rate Ratio ◽  
Temporal Trends ◽  
Community Living ◽  
Term Care ◽  
Short Period ◽  
Care Facilities

AbstractBackgroundThe COVID-19 epidemic has taken a fearsome toll on individuals residing in long-term care facilities (LTC). As of April 10, 2020 half of Canada’s COVID-19 deaths had occurred in LTC. We sought to better understand trends and risk factors for COVID-19 death in LTC in Ontario.MethodsWe analyzed a COVID-19 outbreak database created by the Ontario Ministry of Health, for the period March 29-April 7, 2020. Mortality incidence rate ratios for LTC were calculated with community living Ontarians aged > 69 used as the comparator group. Count-based regression methods were used to model temporal trends and identify associations between infection risk in staff and residents, and subsequent LTC resident death.ResultsConfirmed or suspected cases of COVID-19 were identified in 272/627 LTC by April 7, 2020. The incidence rate ratio for COVID-19 death was 13.1 (9.9-17.3) relative to community living adults over 69. Incidence rate ratio increased over time and was 87.28 (90% CrI 9.98 to 557.08) by April 7, 2020. Lagged infection in staff was a strong predictor of death in residents (e.g., adjusted IRR for death per infected staff member 1.17, 95% CI 1.11 to 1.26 at a 6-day lag).InterpretationMortality risk in elders in Ontario is currently concentrated in LTC, and this risk has increased sharply over a short period of time. Early identification of risk requires a focus on testing and provision of personal protective equipment to staff, and restructuring the LTC workforce to prevent movement of COVID-19 between LTC.FundingThe research was supported by a grant to DNF from the Canadian Institutes for Health Research (2019 COVID-19 rapid researching funding OV4-170360).

scholarly journals Hospital Presentations in Long-Term Survivors of Stroke

Stroke ◽  
2020 ◽  
Vol 51 (12) ◽  
pp. 3673-3680
Author(s):  
Nadine E. Andrew ◽  
Monique F. Kilkenny ◽  
Vijaya Sundararajan ◽  
Joosup Kim ◽  
Steven G. Faux ◽  
...  
Keyword(s):  
Emergency Department ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Associated Factors ◽  
Negative Binomial ◽  
Incidence Rate Ratio ◽  
Study Cohort ◽  
Quality Of Life Scale ◽  
Long Term Survivors

Background and Purpose: A comprehensive understanding of the long-term impact of stroke assists in health care planning. We aimed to determine changes in rates, causes, and associated factors for hospital presentations among long-term survivors of stroke. Methods: Person-level data from the AuSCR (Australian Stroke Clinical Registry) during 2009 to 2013 were linked with state-based health department emergency department and hospital admission data. The study cohort included adults with first-ever stroke who survived the first 6 months after discharge from hospital. Annualized rates of hospital presentations (nonadmitted emergency department or admission)/person/year were calculated for 1 to 12 months prior, and 7 to 12 months (inclusive) after hospitalization. Multilevel, negative binomial regression was used to identify associated factors after adjustment for prestroke hospital presentations and stratification for perceived impairment status. Perceived impairments to health were defined according to the subscales and visual analog health status scores on the 5-Dimension European Quality of Life Scale. Results: There were 7183 adults with acute stroke, 7-month survivors (median age 72 years; 56% male; 81% ischemic, and 42% with impairment at 90–180 days) from 39 hospitals included in this landmark analysis. Annualized presentations/person increased from 0.88 (95% CI, 0.86–0.91) to 1.25 (95% CI, 1.22–1.29) between the prestroke and poststroke periods, with greater rate increases in those with than without perceived impairment (55% versus 26%). Higher presentation rates were most strongly associated with older age (≥85 versus 65 years, incidence rate ratio, 1.52 [95% CI, 1.27–1.82]) and greater comorbidity score (incidence rate ratio, 1.06 [95% CI, 1.02–1.10]), whereas reduced rates were associated with greater social advantage (incidence rate ratio, 0.71 [95% CI, 0.60–0.84]). Poststroke hospital presentations (7–12 months) were most frequently related to recurrent cardiovascular and cerebrovascular events and sequelae of stroke. Conclusions: A large increase in annualized hospital presentation rates after stroke indicates the potential for improved community management and support for this vulnerable patient group.

Multivariate analysis of long term water quality changes of shallow Lake Balaton

2006 ◽  
Vol 29 (4) ◽  
pp. 2051-2055 ◽  
Author(s):  
G. Kiss ◽  
Gy. Dévai ◽  
B. Tóthmérész ◽  
A. Szabó
Keyword(s):  
Water Quality ◽  
Multivariate Analysis ◽  
Shallow Lake ◽  
Lake Balaton ◽  
Quality Changes

scholarly journals OP0146 LONG TERM OUTCOME AND PROGNOSIS FACTORS OF ISOLATED AORTITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 93.1-93
Author(s):  
Y. Ferfar ◽  
S. Morinet ◽  
O. Espitia ◽  
C. Agard ◽  
M. Vautier ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Giant Cell Arteritis ◽  
Takayasu Arteritis ◽  
Vascular Complications ◽  
Event Free Survival ◽  
Prognosis Factors ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Free Survival

Background:Aortitis is a group of disorders characterized by the inflammation of the aorta. The most common causes of aortitis are the large-vessel vasculitis i.e. giant cell arteritis (GCA) and Takayasu arteritis (TA). However, aortitis may be isolated. Because of the wide variation in the course of aortitis, predicting outcome is challenging. The optimal management strategy of isolated aortitis (IA) is still unclear as IA is poorly defined, with data consisting of small retrospective and case control studies.Objectives:To assess the long-term outcome and prognosis factors for vascular complications in patients with isolated aortitis.Methods:Retrospective multicenter study of 353 patients with non-infectious aortitis including 136 giant cell arteritis (GCA), 96 Takayasu arteritis (TA) and 73 isolated aortitis (IA). Factors associated with event-free survival, vascular event-free survival and revascularization-free survival were assessed. Risk factors for vascular complications were identified in multivariate analysis.Results:After a median follow up of 52 months, vascular complications were observed in 32.3 %, revascularization in 30 % and death in 7.6%. The 5-year cumulative incidence of vascular complications was 58% (41; 71), 20% (13; 29), and 19 % (11; 28) in IA, GCA and TA, respectively. In multivariate analysis, IA [HR, 1.85 (1.19 to 2.88), p=0.017] and male gender [1.77 (1.26 to 2.49), p<0.0001] were independently associated with vascular events. The 5-year surgery-free survival was 45% (31; 65), 71% (62; 81) and 76% (68; 86) in IA, TA and GCA, respectively.Conclusion:IA has a worse vascular prognosis than GCA and TA. Sixty percent of IA patients will experience a vascular complication within 5 years from diagnosis.Disclosure of Interests:None declared

Sign in / Sign up

Export Citation Format

Share Document