Isolated vascular rings in the era of high prenatal detection rates: Demographics, diagnosis, risk factors, and outcome

ABSTRACT OBJECTIVE While the emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) and related infections pose serious threats to global public health, the epidemiology and associated risk factors remain poorly understood and vary by geography. METHODS In a case-controlled retrospective study, we examined the prevalence, patient background and risk factors for CRE colonisation and infections, and all patient-derived CRE from January 2015 to January 2017. Isolated carbapenem-susceptible Enterobacteriaceae (CSE) from 2875 enrolled patients were randomly selected during the study. RESULTS CRE colonisation and infections detection rates were 47/2875 (1.6%). Respiratory tract specimens were most frequently seen in 20/47 (42.6%) cases. Klebsiella pneumoniae was the main isolate in 35/47 (74.5%) CRE. As for carbapenemase, KPC-2-producing bacteria was most frequently detected in 38/47 (80.9%) Enterobacteriaceae. No underlying conditions (P = 0.004), pulmonary diseases (P = 0.018) and no antibiotics used prior to culture within 30 days (P < 0.001) were statistically significant between the CRE and CSE groups. CONCLUSION Klebsiellapneumoniae was the main isolate of CRE. The blaKPC-2 was the predominant CRE gene. Underlying conditions especially pulmonary diseases and antibiotics used prior to culture within 30 days represented key risk factors for acquisition of CRE.

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Prenatal diagnosis of tibial hemimelia type I and omphalocele, a rare entity and postnatal correlation

BJR|case reports ◽

10.1259/bjrcr.20200002 ◽

2020 ◽

pp. 20200002

Author(s):

Saulo Molina-Giraldo ◽

Jesus Armando Saucedo ◽

Antonio José Navarro-Devia ◽

Marcela Buitrago-Leal

Keyword(s):

Prenatal Diagnosis ◽

Ultrasound Imaging ◽

Type I ◽

Long Bones ◽

Rare Entity ◽

Associated Anomalies ◽

Detection Rates ◽

Live Births ◽

Prenatal Detection ◽

Rare Anomaly

Hemimelia is a rare anomaly affecting the distal long bones of extremities, with an occurrence of 1–20 cases per million of live births depending on the affected bone. Hemimelia can be an isolated defect or be part of complex syndromes that affect extra skeletal structures. Prenatal detection by routine ultrasound imaging is difficult and yields low detection rates. The prenatal diagnosis of hemimelia should prompt a complete and detailed study of the fetal anatomy, since it can be associated with defects in other structures and systems, as the reported in this case. The prognosis depends upon the associated anomalies.

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Depression Symptoms and Risk Factors in Adult Emergency Department Patients: A Multisite Cross-Sectional Prevalence Survey

ISRN Emergency Medicine ◽

10.1155/2013/965103 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8

Author(s):

Nancy Khav ◽

Tracey J. Weiland ◽

George A. Jelinek ◽

Jonathan C. Knott ◽

Michael Salzberg

Keyword(s):

Mental Health ◽

Risk Factors ◽

Emergency Department ◽

Depression Screening ◽

Depression Symptoms ◽

Health Service Provider ◽

Prevalence Survey ◽

Cross Sectional ◽

Detection Rates ◽

Local Doctor

Objectives. To identify the proportion of adult emergency department (ED) patients who screen positive for depression. Secondary aims were to identify factors associated with a positive depression screen and determine predictors of a positive depression screen. Methods. This cross-sectional, prevalence survey of ED patients was conducted at two inner-city hospitals. 350 ED patients were screened for depression using the Patient Health Questionnaire-9 (PHQ-9). Clinical and demographic risk factors were examined through medical records and additional questionnaires. Results. Of 350 participants screened, 50 (14.3%; 95% CI = 11.0–18.4%) screened positive. Independent predictors of depression risk included self-reported depression and/or a previous diagnosis of depression (OR = 8.345; 95% CI = 3.524–19.762), seeing a mental health service provider in the past 6 months (OR = 4.518; 95% CI = 2.107–9.690), and previous discussion about mental health with a local doctor (OR = 2.369; 95% CI = 1.025–5.475). Conclusion. ED patients were found to be at a higher risk of depression than the general population. ED-based depression screening, particularly of high-risk populations, has the potential to increase case detection rates and allow earlier management of these patients. Further research and validation of an ED-based depression screening tool are required.

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Care-Related and Maternal Risk Factors Associated with the Antenatal Nondetection of Intrauterine Growth Restriction: A Case-Control Study from Bremen, Germany

BioMed Research International ◽

10.1155/2017/1746146 ◽

2017 ◽

Vol 2017 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Sinja Alexandra Ernst ◽

Tilman Brand ◽

Anna Reeske ◽

Jacob Spallek ◽

Knud Petersen ◽

...

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Case Control ◽

Maternal Risk Factors ◽

Maternal Complications ◽

Related Factors ◽

Detection Rates ◽

Maternal Risk ◽

Antenatal Detection ◽

Control Study

Objective. To identify care-related and maternal risk factors for the antenatal nondetection of IUGR.Methods. In this hospital-based case-control study we compared antenatally undetected IUGR neonates (cases) to detected IUGR neonates (controls). Data were collected using newborn documentation sheets and standardized personal interviews with the mothers. We calculated antenatal detection rates and used uni- and multivariable logistic regression models to assess the association of antenatal nondetection of IUGR and maternal and care-related factors.Results. A total of 161 neonates from three hospitals were included in the study. Suboptimal fetal growth was identified antenatally inn=77pregnancies while inn=84it was not detected antenatally (antenatal detection rate: 47.8%). Severity of IUGR, maternal complications, and a Doppler examination during the course of pregnancy were associated with IUGR detection. We did not find statistically significant differences regarding parental socioeconomic status and maternal migration background.Conclusions. In our study, about half of all pregnancies affected by suboptimal growth remained undetected. Future in-depth studies with larger study populations should further examine factors that could increase antenatal detection rates for IUGR.

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Intraamniotic synechiae: perinatal diagnosis and outcomes

10.21516/2413-1458-2020-19-4-343-351 ◽

2020 ◽

Author(s):

À.Å. Volkov

Keyword(s):

Risk Factors ◽

Blood Loss ◽

Perinatal Outcomes ◽

Breech Presentation ◽

Postnatal Period ◽

Premature Rupture ◽

Prenatal Detection ◽

Preterm Premature Rupture ◽

Ultrasound Diagnostics

The article presents an analysis of ultrasound diagnostics of intraamniotic synechia (IS) and perinatal outcomes, if any. The frequency of prenatal detection of IS by ultrasound was 0.63%. In the postnatal period, IS was observed in 0.5%. The issues of ultrasonic visualization of IS were discussed. Analysis of obstetric and perinatal outcomes revealed the absence of a statistically significant effect of IS on pregnancy, the development of the fetus, and the condition of the newborn. IS are risk factors for the formation of the breech presentation of the fetus, preterm premature rupture of the membranes, increased blood loss in childbirth.

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Encephalopathy and Delirium

10.2310/im.8221 ◽

2019 ◽

Author(s):

Alliya S. Qazi ◽

Juliana Barr

Keyword(s):

Risk Factors ◽

Clinical Judgment ◽

Assessment Tool ◽

Severity Of Illness ◽

Pharmacologic Agent ◽

Detection Rates ◽

Benzodiazepine Use ◽

Icu Delirium ◽

Abcdef Bundle

Delirium occurs commonly in critically ill patients. ICU delirium is associated with increased short-term and long-term mortality, increased ICU length of stay, and long-term cognitive deficits in these patients. There are significant health-care costs associated with ICU delirium. Delirium is often overlooked in patients when assessed by clinicians based on clinical judgment alone. The use of a validated delirium assessment tool increases delirium detection rates in patients. ICU delirium is a multifactorial process. Nonmodifiable risk factors include age, dementia, prior coma, emergency surgery or trauma, and a high severity of illness. Modifiable risk factors include benzodiazepine use and blood transfusions. There is no evidence to support the use of any pharmacologic agent for either the prevention or treatment of ICU delirium. Antipsychotics should only be used for symptom management in ICU patients with delirium, and then discontinued when no longer needed. The mainstay of delirium management should be a multi-component, non-pharmacologic strategy aimed at minimizing risk factors. One such multimodal strategy, the ABCDEF Bundle, can significantly decrease the incidence of ICU delirium. Additional research is needed to better understand the pathophysiology and management of ICU delirium. This review contains 5 figures, 5 tables, and 50 references. Keywords: Delirium, Encephalopathy, Intensive Care, Outcomes, ABCDEF Bundle, ICU Liberation.

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Common arterial trunk in the era of high prenatal detection rates: Results of neonatal palliation and primary repair

Journal of Cardiac Surgery ◽

10.1111/jocs.15964 ◽

2021 ◽

Author(s):

William N. Evans ◽

Ruben J. Acherman ◽

Michael L. Ciccolo ◽

Juan Lehoux ◽

Alvaro Galindo ◽

...

Keyword(s):

Primary Repair ◽

Detection Rates ◽

Prenatal Detection ◽

Common Arterial Trunk ◽

Arterial Trunk

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The efficacy of combining several risk factors as a screening test

Journal of Medical Screening ◽

10.1258/096914105775220642 ◽

2005 ◽

Vol 12 (4) ◽

pp. 197-201 ◽

Cited By ~ 37

Author(s):

Nicholas J Wald ◽

Joan K Morris ◽

Simon Rish

Keyword(s):

Risk Factors ◽

Risk Factor ◽

False Positive ◽

Detection Rate ◽

False Positive Rate ◽

Individual Risk ◽

Detection Rates ◽

Screening Performance ◽

Positive Rate ◽

The Individual

Objective: To determine the quantitative effect on overall screening performance (detection rate for a given false-positive rate) of using several moderately strong, independent risk factors in combination as screening markers. Setting: Theoretical statistical analysis. Methods: For the purposes of this analysis, it was assumed that all risk factors were independent, had Gaussian distributions with the same standard deviation in affected and unaffected individuals and had the same screening performance. We determined the overall screening performance associated with using an increasing number of risk factors together, with each risk factor having a detection rate of 10%, 15% or 20% for a 5% false-positive rate. The overall screening performance was estimated as the detection rate for a 5% false-positive rate. Results: Combining the risk factors increased the screening performance, but the gain in detection at a constant false-positive rate was relatively modest and diminished with the addition of each risk factor. Combining three risk factors, each with a 15% detection rate for a 5% false-positive rate, yields a 28% detection rate. Combining five risk factors increases the detection rate to 39%. If the individual risk factors have a detection rate of 10% for a 5% false-positive rate, it would require combining about 15 such risk factors to achieve a comparable overall detection rate (41%). Conclusion: It is intuitively thought that combining moderately strong risk factors can substantially improve screening performance. For example, most cardiovascular risk factors that may be used in screening for ischaemic heart disease events, such as serum cholesterol and blood pressure, have a relatively modest screening performance (about 15% detection rate for a 5% false-positive rate). It would require the combination of about 15 or 20 such risk factors to achieve detection rates of about 80% for a 5% false-positive rate. This is impractical, given the risk factors so far discovered, because there are too few risk factors and their associations with disease are too weak.

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