Breakthrough Invasive Candidiasis in Children

Abstract Background Breakthrough invasive candidiasis (bIC) has been described in adults, but the epidemiology and outcomes in children are unknown. Methods Retrospective cohort analysis of children diagnosed with IC from 9/1/09 to 1/30/17. bIC was defined as isolation of Candida spp. from sterile site despite receiving ≥3 doses of antifungal (AF) to which isolate is susceptible. Clinical and microbiological data, management, and outcomes were collected. Non-parametric and logistic regression statistics were applied. Results There were 92 patients with IC, 23 of which were bIC (Table 1). Underlying conditions included GI (n = 26), hem/onc (n = 17), prematurity (n = 16), cardiac (n = 15), HCT (n = 4), SOT (n = 5), and other (n = 9). Patients received an azole (n = 17), micafungin (n = 5), or amphotericin B (n = 1) for median of 20 days [3–522] before bIC as: prophylaxis (n = 8), targeted therapy (n = 5), or empiric fever driven therapy (n = 10). bIC was caused by non-albicans Candida in 16/23 (70%) cases. Compared with IC controls, children with bIC had increased ICU admission, vasopressor use, mechanical ventilation, and renal failure (all with P < 0.01). In multivariate analysis, immunosuppression was an independent risk factor for bIC (OR 39.4, 95% CI 7.5–205). Death attributable to IC occurred in bIC group (n = 3, P = 0.04). Conclusion bIC in our cohort was caused most frequently by non-albicans Candida spp. and associated with significantly worse outcomes, including mortality. Disclosures All authors: No reported disclosures.

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The use of mechanical ventilation in patients with idiopathic pulmonary fibrosis in the United States: A nationwide retrospective cohort analysis

Respiratory Medicine ◽

10.1016/j.rmed.2015.12.005 ◽

2016 ◽

Vol 111 ◽

pp. 72-76 ◽

Cited By ~ 43

Author(s):

Barret Rush ◽

Katie Wiskar ◽

Landon Berger ◽

Donald Griesdale

Keyword(s):

United States ◽

Mechanical Ventilation ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Retrospective Cohort ◽

Cohort Analysis ◽

The United States ◽

Retrospective Cohort Analysis

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Early Bronchoscopy Improves Extubation Rates after Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10143055 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3055

Author(s):

Gregor S. Zimmermann ◽

Jana Palm ◽

Anna Lena Lahmann ◽

Friedhelm Peltz ◽

Rainer Okrojek ◽

...

Keyword(s):

Mechanical Ventilation ◽

Cardiac Arrest ◽

Hospital Admission ◽

Retrospective Cohort ◽

Cohort Analysis ◽

Optimal Timing ◽

Test Results ◽

Microbiological Test ◽

Retrospective Cohort Analysis ◽

Hospital Cardiac Arrest

Background: Patients suffering from out-of-hospital cardiac arrest (OHCA) frequently receive a bronchoscopy after being admitted to the ICU. We investigated the optimal timing and the outcome in these patients. Methods: All patients who suffered from OHCA and were treated in our ICU from January 2013 to December 2018 were retrospectively analyzed. The data were collected from the patients’ medical files, and included duration of mechanical ventilation, antibiotics, microbiological test results and neurological outcome. The outcome was the effect of early bronchoscopy (≤48 h after administration) on the rate of intubated patients on day five and day seven. Results: From January 2013 to December 2018, 190 patients were admitted with OHCA. Bronchoscopy was performed in 111 patients out of the 164 patients who survived the first day. Late bronchoscopy >48 h was associated with higher rates of intubation on day five (OR 4.94; 95% CI 1.2–36.72, 86.7% vs. 55.0%, p = 0.036) and day seven (OR 4.96; 95% CI 1.38–24.69; 80.0% vs. 43.3%, p = 0.019). Conclusion: This study shows that patients who suffered from OHCA might have a better outcome if they receive a bronchoscopy early after hospital admission. Our data suggests an association of early bronchoscopy with a shorter intubation period.

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Association of alanine transaminase to aspartate aminotransferase ratio and incident diabetes in Chinese adults: a second retrospective cohort study

10.21203/rs.3.rs-26173/v1 ◽

2020 ◽

Author(s):

Zhilin Liang ◽

Haofei Hu ◽

Xunxun Wang ◽

Xianxiong Chen ◽

Min Zhang ◽

...

Keyword(s):

Risk Factor ◽

Aspartate Aminotransferase ◽

Retrospective Cohort ◽

Independent Risk Factor ◽

Cohort Analysis ◽

Incident Diabetes ◽

Chinese Adults ◽

Retrospective Cohort Analysis ◽

Serum Aspartate Aminotransferase ◽

Cox Proportional Hazard Regression

Abstract Aims/Introduction: Previous studies have indicated that serum alanine aminotransferase (ALT) level, serum aspartate aminotransferase (AST) level or ALT/AST ratio may be bound up with diabetes. But the association of ALT/AST ratio and incident diabetes in Chinese adults have not been elaborated yet. The main objective of the present study was to analyze whether ALT/AST ratio was an independent risk factor which attached to the risk of incident diabetes in Chinese adults.Materials and Methods From 2010 to 2016, 685,277 Chinese adults who received a health check in Rich Healthcare Group including all medical records, and the present article was a second retrospective cohort analysis based on above population. As the target independent variable, ALT/AST ratio was measured at baseline while the dependent variable, incident diabetes appeared during follow-up. We used Cox proportional hazard regression models to analyze the prognostic value of ALT/AST on the risk of incident diabetes.Results ALT/AST demonstrated undeniable correlation with incident diabetes (HR = 2.535, 95%CI: 2.190 to 2.934, P < 0.00001). The association between ALT/AST and incident diabetes is only linear. The cumulative incidence (95% CI) rate of incident diabetes in total participants, ALT/AST quartile 1, 2, 3, and 4 was 2.112 (2.016–2.208), 0.992 (.0.857–1.127), 1.430 (1.274–1.586), 2.396 (2.192-2.600) and 3.559 (3.314–3.803), separately. The population with age (30 to < 40 years), BMI (< 24 kg/m2) and SBP (< 140 mmHg) was found to be the stronger association in subgroup analysis.Conclusion In Chinese adults, ALT/AST ratio is an independent risk factor for incident diabetes.

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Association of Alanine Transaminase to Aspartate Aminotransferase Ratio and Incident Diabetes in Chinese Adults: A Second Retrospective Cohort Study

10.21203/rs.3.rs-30966/v1 ◽

2020 ◽

Author(s):

Zhilin Liang ◽

Haofei Hu ◽

Xunxun Wang ◽

Xianxiong Chen ◽

Zhigang Liu ◽

...

Keyword(s):

Risk Factor ◽

Aspartate Aminotransferase ◽

Retrospective Cohort ◽

Independent Risk Factor ◽

Cohort Analysis ◽

Incident Diabetes ◽

Chinese Adults ◽

Retrospective Cohort Analysis ◽

Serum Aspartate Aminotransferase ◽

Cox Proportional Hazard Regression

Abstract Background Previous studies have indicated that serum alanine aminotransferase (ALT) level, serum aspartate aminotransferase (AST) level or ALT/AST ratio may be bound up with diabetes. But the association of ALT/AST ratio and incident diabetes in Chinese adults have not been elaborated yet. The main objective of the present study was to analyze whether ALT/AST ratio was an independent risk factor which attached to the risk of incident diabetes in Chinese adults. Methods From 2010 to 2016, 685,277 Chinese adults who received a health check in Rich Healthcare Group including all medical records, and the present article was a second retrospective cohort analysis based on above population. As the target independent variable, ALT/AST ratio was measured at baseline while the dependent variable, incident diabetes appeared during follow-up. We used Cox proportional hazard regression models to analyze the prognostic value of ALT/AST on the risk of incident diabetes. Results ALT/AST demonstrated undeniable correlation with incident diabetes (HR = 2.535, 95%CI: 2.190 to 2.934, P < 0.00001). The association between ALT/AST and incident diabetes is only linear. The cumulative incidence (95% CI) rate of incident diabetes in total participants, ALT/AST quartile 1, 2, 3, and 4 was 2.112 (2.016–2.208), 0.992 (.0.857–1.127), 1.430 (1.274–1.586), 2.396 (2.192-2.600) and 3.559 (3.314–3.803), separately. The population with age (30 to < 40 years), BMI (< 24 kg/m2) and SBP (< 140 mmHg) was found to be the stronger association in subgroup analysis. Conclusion In Chinese adults, ALT/AST ratio is an independent risk factor for incident diabetes.

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Association of alanine transaminase to aspartate aminotransferase ratio and incident diabetes in Chinese adults: a second retrospective cohort study

10.21203/rs.3.rs-30966/v2 ◽

2020 ◽

Author(s):

Zhilin Liang ◽

Haofei Hu ◽

Xunxun Wang ◽

Xianxiong Chen ◽

Zhigang Liu ◽

...

Keyword(s):

Risk Factor ◽

Aspartate Aminotransferase ◽

Retrospective Cohort ◽

Independent Risk Factor ◽

Cohort Analysis ◽

Incident Diabetes ◽

Chinese Adults ◽

Retrospective Cohort Analysis ◽

Serum Aspartate Aminotransferase ◽

Cox Proportional Hazard Regression

Abstract Background : Previous studies have indicated that serum alanine aminotransferase ( ALT ) level, serum aspartate aminotransferase ( AST ) level or ALT/AST ratio may be bound up with diabetes. But the association of ALT/AST ratio and incident diabetes in Chinese adults have not been elaborated yet. The main objective of the present study was to analyze whether ALT/AST ratio was an independent risk factor which attached to the risk of incident diabetes in Chinese adults. Methods: From 2010 to 2016, 685,277 Chinese adults who received a health check in Rich Healthcare Group including all medical records, and the present article was a second retrospective cohort analysis based on above population. As the target independent variable, ALT/AST ratio was measured at baseline while the dependent variable, incident diabetes appeared during follow-up. We used Cox proportional hazard regression models to analyze the prognostic value of ALT/AST on the risk of incident diabetes. Results: ALT/AST demonstrated undeniable correlation with incident diabetes (HR=2.535, 95%CI: 2.190 to 2.934, P <0.00001). The association between ALT/AST and incident diabetes is only linear. The cumulative incidence (95% CI) rate of incident diabetes in total participants, ALT/AST quartile 1, 2, 3, and 4 was 2.112 (2.016-2.208), 0.992 (.0.857-1.127), 1.430 (1.274-1.586), 2.396 (2.192-2.600) and 3.559 (3.314-3.803), separately. The population with age (30 to <40 years), BMI (<24kg/m2) and SBP (<140mmHg) was found to be the stronger association in subgroup analysis. Conclusion: In Chinese adults, ALT/AST ratio is an independent risk factor for incident diabetes .

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