1346. The Risk of Readmission after RSV Hospitalization Among Children Younger than 5 Years

Abstract Background Respiratory Syncytial Virus (RSV) is one of the most common causes of childhood lower respiratory tract infection (LRTI) leading to hospitalization worldwide. Readmissions following viral LRTI hospitalization are common, however rates, timing and causes of readmission following RSV LRTI hospitalization are understudied. We evaluated readmissions occurring during 1-year post-discharge of RSV hospitalization. Methods We prospectively identified children < 5 years of age hospitalized with laboratory-confirmed RSV LRTI at Primary Children’s and Riverton hospitals in Salt Lake City, Utah during the 2019-2020 RSV season. An electronic alert system identified all-cause readmission between November 2019 and April 2021. Discharge diagnoses of readmissions were reviewed by two pediatricians. We calculated the incidence rate of all-cause and respiratory-related readmission. Results A total of 297 children had laboratory-confirmed RSV LRTI hospitalizations during the 2019-2020 RSV season, with 24% admitted to the intensive care unit (ICU) during index RSV hospitalization and 24% having a chronic medical condition. During the 1-year follow-up period, 59 readmissions occurred among 47 patients (Table 1). The incidence rate of all-cause and respiratory-related readmission was 19.9 (95%CI 15.5-24.9) and 13.1 (95%CI 9.5-17.5) per 100 patients, respectively. Median age of readmitted patients was 11 months (interquartile range 5.9-11 months). Median number of readmissions was 1 (range: 1-4), with initial readmissions occurring within 28 days (median) of index admission; most (74%) due to a respiratory-related illness. Second and 3rd admissions were less common and occurred at 67 (median) and 160 (median) days respectively. During all readmissions, 19% of children required ICU admission and 25% had chronic medical conditions. Conclusion All cause and respiratory readmission after Initial hospitalization with RSV LRTI commonly occurred among children < 5 years. These data support the need for RSV vaccines and immunoprophylaxis to prevent RSV hospitalization. A further study with a control group is needed to determine the role of RSV in readmission. Disclosures Yoonyoung Choi, PhD, MS, RPh, Merck (Employee) Lyn Finelli, DrPH, MS, Merck (Employee)

Download Full-text

Can a Software-Based Metronome Tool Enhance Compression Rate in a Realistic 911 Call Scenario Without Adversely Impacting Compression Depth for Dispatcher-Assisted CPR?

Prehospital and Disaster Medicine ◽

10.1017/s1049023x18000602 ◽

2018 ◽

Vol 33 (4) ◽

pp. 399-405 ◽

Cited By ~ 2

Author(s):

Greg Scott ◽

Tracey Barron ◽

Isabel Gardett ◽

Meghan Broadbent ◽

Holly Downs ◽

...

Keyword(s):

Cardiac Arrest ◽

Salt Lake ◽

Salt Lake City ◽

Controlled Study ◽

Control Group ◽

Compression Rate ◽

Compression Depth ◽

Lake City ◽

Automated Software ◽

Experimental Group

AbstractIntroductionImplementation of high-quality, dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is critical to improving survival from out-of-hospital cardiac arrest (OHCA). However, despite some studies demonstrating the use of a metronome in a stand-alone setting, no research has yet demonstrated the effectiveness of a metronome tool in improving DA-CPR in the context of a realistic 911 call or using instructions that have been tested in real-world emergency calls.HypothesisUse of the metronome tool will increase the proportion of callers able to perform CPR within the target rate without affecting depth.MethodsThe prospective, randomized, controlled study involved simulated 911 cardiac arrest calls made by layperson-callers and handled by certified emergency medical dispatchers (EMDs) at four locations in Salt Lake City, Utah USA. Participants were randomized into two groups. In the experimental group, layperson-callers received CPR pre-arrival instructions with metronome assistance. In the control group, layperson-callers received only pre-arrival instructions. The primary outcome measures were correct compression rate (counts per minute [cpm]) and depth (mm).ResultsA total of 148 layperson-callers (57.4% assigned to experimental group) participated in the study. There was a statistically significant association between the number of participants who achieved the target compression rate and experimental study group (P=.003), and the experimental group had a significantly higher median compression rate than the control group (100 cpm and 89 cpm, respectively; P=.013). Overall, there was no significant correlation between compression rate and depth.Conclusion:An automated software metronome tool is effective in getting layperson-callers to achieve the target compression rate and compression depth in a realistic DA-CPR scenario.Scott G, Barron T, Gardett I, Broadbent M, Downs H, Devey L, Hinterman EJ, Clawson J, Olola C. Can a software-based metronome tool enhance compression rate in a realistic 911 call scenario without adversely impacting compression depth for dispatcher-assisted CPR? Prehosp Disaster Med. 2018;33(4):399–405

Download Full-text

Streptococcus mutans Biofilm Adhesion on Composite Resin Surfaces After Different Finishing and Polishing Techniques

Operative Dentistry ◽

10.2341/10-285-l ◽

2011 ◽

Vol 36 (3) ◽

pp. 311-317 ◽

Cited By ~ 18

Author(s):

CA Pereira ◽

E Eskelson ◽

V Cavalli ◽

PCS Liporoni ◽

AOC Jorge ◽

...

Keyword(s):

Streptococcus Mutans ◽

Composite Resin ◽

Salt Lake ◽

Salt Lake City ◽

Human Saliva ◽

Composite Resins ◽

Bacterial Adherence ◽

Control Group ◽

Lake City ◽

Biofilm Development

SUMMARY This study evaluated Streptococcus mutans biofilm adhesion on the surface of three composite resins (nanofilled, Filtek Z350, 3M ESPE, Salt Lake City, UT, USA; nanohybrid, Vit-1-escence, Ultradent Products, South Jordan, UT, USA; and microhybrid, Esthet X, Dentsply, Milford, DE, USA) following different finishing and polishing techniques. Sixty standardized samples (6 × 3 mm) of each composite were produced and randomly divided into three finishing and polishing treatments (n=20): 1) control group: composite resin surface in contact with Mylar matrix strips with no finishing or polishing performed, 2) Sof-Lex aluminum oxide disc technique (3M ESPE, and 3) carbide bur finishing and Astrobrush polishing technique (Ultradent). Half the samples of each group were incubated in human saliva for 1 hour, and all the samples were subjected to S mutans (ATCC 35688) biofilm development. The mean log of CFU/mL present in the S mutans biofilm was calculated, and data were statistically analyzed by three-way analysis of variance and the Tukey test (p<0.05). Human saliva incubation promoted a significant increase of bacterial adherence on all three of the composites' surfaces, regardless of the polishing treatment performed (p<0.05). Of the three, the nanofilled composite (Filtek Z350) had the lowest bacterial adherence with each of the finishing and polishing techniques despite the presence or absence of human saliva (p<0.05). Mylar matrix strips (control group) promoted the lowest bacterial adhesion on the surface of the microhybrid and nanofilled composites in the absence of human saliva.

Download Full-text