Demographic and clinical factors associated with immune reconstitution in HIV/HBV co‐infected and HIV mono‐infected patients: a retrospective cohort study

HIV Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 722-728
Author(s):  
TY Jiang ◽  
JH Hou ◽  
B Su ◽  
T Zhang ◽  
Y Yang ◽  
...  
BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022170 ◽  
Author(s):  
Andrea C Fernandes ◽  
David Chandran ◽  
Mizanur Khondoker ◽  
Michael Dewey ◽  
Hitesh Shetty ◽  
...  

ObjectiveTo investigate the demographic and clinical factors associated with antidepressant use for depressive disorder in a psychiatric healthcare setting using a retrospective cohort study design.SettingData were extracted from a de-identified data resource sourced from the electronic health records of a London mental health service. Relative risk ratios (RRRs) were obtained from multinomial logistic regression analysis to ascertain the probability of receiving common antidepressant treatments relative to sertraline.ParticipantsPatients were included if they received mental healthcare and a diagnosis of depression with antidepressant treatment between March and August 2015 and exposures were measured over the preceding 12 months.ResultsOlder age was associated with increased use of all antidepressants compared with sertraline, except for negative associations with fluoxetine (RRR 0.98; 95% CI 0.96 to 0.98) and a combination of two selective serotonin reuptake inhibitors (SSRIs) (0.98; 95% CI 0.96 to 0.99), and no significant association with escitalopram. Male gender was associated with increased use of mirtazapine compared with sertraline (2.57; 95% CI 1.85 to 3.57). Previous antidepressant, antipsychotic and mood stabiliser use were associated with newer antidepressant use (ie, selective norepinephrine reuptake inhibitors, mirtazapine or a combination of both), while affective symptoms were associated with reduced use of citalopram (0.58; 95% CI 0.27 to 0.83) and fluoxetine (0.42; 95% CI 0.22 to 0.72) and somatic symptoms were associated with increased use of mirtazapine (1.60; 95% CI 1.00 to 2.75) relative to sertraline. In patients older than 25 years, past benzodiazepine use was associated with a combination of SSRIs (2.97; 95% CI 1.32 to 6.68), mirtazapine (1.94; 95% CI 1.20 to 3.16) and venlafaxine (1.87; 95% CI 1.04 to 3.34), while past suicide attempts were associated with increased use of fluoxetine (2.06; 95% CI 1.10 to 3.87) relative to sertraline.ConclusionThere were several factors associated with different antidepressant receipt in psychiatric healthcare. In patients aged >25, those on fluoxetine were more likely to have past suicide attempt, while past use of antidepressant and non-antidepressant use was also associated with use of new generation antidepressants, potentially reflecting perceived treatment resistance.


2021 ◽  
Author(s):  
Jia-Yih Feng ◽  
Yi-Tzu Lee ◽  
Shen-Wei Pan ◽  
Kuang-Yao Yang ◽  
Yuh-Min Chen ◽  
...  

Abstract BackgroundColistin is widely used for the treatment of nosocomial infections caused by carbapenem-resistant gram-negative bacilli (CR-GNB). Colistin-induced nephrotoxicity is one of the major adverse reactions during colistin treatment. Comparisons of colistin-induced nephrotoxicity between different formulations of colistin are rarely reported. MethodsWe conducted a retrospective cohort study that enrolled ICU-admitted patients with cultured isolates of CR-GNB and treatment with intravenous colistin. Occurrences of acute kidney injury (AKI) during treatment with intravenous colistin were recorded. Colistin-induced nephrotoxicity between two formulations of colistin, Locolin® and Colimycin®, were compared. The treatment outcomes associated with the occurrence of colistin-induced nephrotoxicity were also investigated.ResultsA total of 195 patients, 95 treated with Locolin® and 100 treated with Colimycin®, were included for analysis. Patients treated with Locolin® had a higher rate of occurrence of stage 2 (46.3% vs. 32%, p=0.040) and stage 3 (29.5% vs. 13%, p=0.005) AKI than did those treated with Colimycin®. In multivariate analysis, the presence of septic shock (adjusted odds ratio (aOR) 2.07, 95% confidence interval (CI) 1.05–4.06), and inappropriate colistin dosage (aOR 2.49, 95% CI 1.01–60.16) were clinical factors associated with colistin-induced nephrotoxicity. Treatment with Colimycin® was an independent factor associated with a lower risk of colistin-induced nephrotoxicity (aOR 0.36, 95% CI 0.17-0.74). Other clinical factors associated with colistin-induced nephrotoxicity included the presence of septic shock (aOR 2.17, 95% CI 1.10-4.26) and inappropriate colistin dosage (aOR 2.52, 95% CI 1.00-6.33). A comparable mortality rate was noted between patients with and without colistin-induced nephrotoxicity. ConclusionsThe risk of colistin-induced nephrotoxicity significantly varied in different formulations of colistin in critically ill patients. Colistin-induced nephrotoxicity was not associated with increased mortality.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e049089
Author(s):  
Marcia C Castro ◽  
Susie Gurzenda ◽  
Eduardo Marques Macário ◽  
Giovanny Vinícius A França

ObjectiveTo provide a comprehensive description of demographic, clinical and radiographic characteristics; treatment and case outcomes; and risk factors associated with in-hospital death of patients hospitalised with COVID-19 in Brazil.DesignRetrospective cohort study of hospitalised patients diagnosed with COVID-19.SettingData from all hospitals across Brazil.Participants522 167 hospitalised patients in Brazil by 14 December 2020 with severe acute respiratory illness, and a confirmed diagnosis for COVID-19.Primary and secondary outcome measuresPrevalence of symptoms and comorbidities was compared by clinical outcomes and intensive care unit (ICU) admission status. Survival was assessed using Kaplan Meier survival estimates. Risk factors associated with in-hospital death were evaluated with multivariable Cox proportional hazards regression.ResultsOf the 522 167 patients included in this study, 56.7% were discharged, 0.002% died of other causes, 30.7% died of causes associated with COVID-19 and 10.2% remained hospitalised. The median age of patients was 61 years (IQR, 47–73), and of non-survivors 71 years (IQR, 60–80); 292 570 patients (56.0%) were men. At least one comorbidity was present in 64.5% of patients and in 76.8% of non-survivors. From illness onset, the median times to hospital and ICU admission were 6 days (IQR, 3–9) and 7 days (IQR, 3–10), respectively; 15 days (IQR, 9–24) to death and 15 days (IQR, 11–20) to hospital discharge. Risk factors for in-hospital death included old age, Black/Brown ethnoracial self-classification, ICU admission, being male, living in the North and Northeast regions and various comorbidities. Age had the highest HRs of 5.51 (95% CI: 4.91 to 6.18) for patients≥80, compared with those ≤20.ConclusionsCharacteristics of patients and risk factors for in-hospital mortality highlight inequities of COVID-19 outcomes in Brazil. As the pandemic continues to unfold, targeted policies that address those inequities are needed to mitigate the unequal burden of COVID-19.


2018 ◽  
Vol 124 (5) ◽  
pp. 607-614 ◽  
Author(s):  
Akihiro Komatsu ◽  
Tetsuhiro Yoshino ◽  
Takeshi Suzuki ◽  
Tomonori Nakamura ◽  
Takanori Kanai ◽  
...  

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