Secondary infection among hospitalized COVID ‐19 patients: A retrospective cohort study in a tertiary care setting

AbstractObjectivesBirth tears are a common complication of vaginal childbirth. We aimed to evaluate the outcomes of birth tears first by comparing the mode of vaginal birth (VB) and then comparing different vacuum cups in instrumental VBs in order to better advise childbearing women and obstetrical professionals.MethodsIn a retrospective cohort study, we analyzed nulliparous and multiparous women with a singleton pregnancy in vertex presentation at ≥37 + 0 gestational weeks who gave birth vaginally at our tertiary care center between 06/2012 and 12/2016. We compared the distribution of tear types in spontaneous births (SBs) vs. vacuum-assisted VBs. We then compared the tear distribution in the vacuum group when using the Kiwi Omnicup or Bird’s anterior metal cup. Outcome parameters were the incidence and distribution of the different tear types dependent on the mode of delivery and type of vacuum cup.ResultsA total of 4549 SBs and 907 VBs were analyzed. Birth tear distribution differed significantly between the birth modes. In 15.2% of women with an SB an episiotomy was performed vs. 58.5% in women with a VB. Any kind of perineal tear was seen in 45.7% after SB and in 32.7% after VB. High-grade obstetric anal sphincter injuries (OASIS) appeared in 1.1% after SB and in 3.1% after VB. No significant changes in tear distribution were found between the two different VB modes.ConclusionsThere were more episiotomies, vaginal tears and OASIS after VB than after SB. In contrast, there were more low-grade perineal and labial tears after SB. No significant differences were found between different vacuum cup systems, just a slight trend toward different tear patterns.

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Adrenalectomy in Ectopic Cushing’s syndrome: a retrospective cohort study from a tertiary care centre

Journal of Neuroendocrinology ◽

10.1111/jne.13030 ◽

2021 ◽

Author(s):

Ieva Lase ◽

Malin Grönberg ◽

Olov Norlén ◽

Peter Stålberg ◽

Staffan Welin ◽

...

Keyword(s):

Cohort Study ◽

Cushing’S Syndrome ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Tertiary Care ◽

Cushing's Syndrome ◽

Care Centre ◽

Tertiary Care Centre ◽

Ectopic Cushing’S Syndrome

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Clinical characteristics and factors related to antibiotic-associated diarrhea in elderly patients with pneumonia: a retrospective cohort study

BMC Geriatrics ◽

10.1186/s12877-021-02267-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yoko Takedani ◽

Tsukasa Nakamura ◽

Noriko Fukiwake ◽

Toshihiro Imada ◽

Junji Mashino ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Elderly Patients ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Tertiary Care ◽

Multivariate Logistic Regression Model ◽

Care Hospital ◽

Antibiotic Associated Diarrhea ◽

Elderly Inpatients

Abstract Background Antibiotic-associated diarrhea (AAD) is a common problem among elderly inpatients because many elderly patients are admitted for pneumonia or other conditions that necessitate antibiotic treatment. In the super aging population, more patients are suffering from pneumonia than before, but the incidence or risk factors for AAD among many elderly patients have not been well scrutinized. Methods We conducted a retrospective cohort study of elderly patients diagnosed with pneumonia from April 2014 to March 2019 who were admitted to the Department of General Medicine of a Tertiary Care Hospital in Japan. Patients (≥ 65 years of age) who were diagnosed with bacterial pneumonia or aspiration pneumonia and treated with antibiotics were included. We defined AAD by diarrhea with more than three loose or watery stools per day and included patients who had these symptoms for either one day or two or more consecutive days. We also assessed the length of hospital stay and in-hospital mortality. The potential risk factors for AAD included age, sex, body weight, body mass index, smoking, alcohol, activities of daily living (ADL),　comorbidities, vital signs, laboratories, the severity of pneumonia, antibiotic and other medication use. Results There were 1,067 patients, the mean age was 83 years, and men accounted for 59 %. β-Lactamase inhibitors were frequently prescribed antibiotics in 703 patients (66 %), and proton pump inhibitors (PPIs) were also commonly administered (48 %). AAD developed in 322 patients (30 %). The multivariate logistic regression model showed that β-lactamase inhibitors (OR 1.43, 95 % CI 1.05–1.95) and PPIs (OR 1.37, 95 % CI 1.03–1.83) were associated with AAD as well as age (OR 1.03 per year, 95 % CI 1.01–1.05). Conclusions AAD was common among elderly inpatients with pneumonia, and β-lactamase inhibitors and PPIs were associated with AAD. Strict use of such medication should be considered to decrease the risk of AAD.

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Uptake of clinical trials in a palliative care setting: A retrospective cohort study

Asia-Pacific Journal of Clinical Oncology ◽

10.1111/ajco.12321 ◽

2014 ◽

Vol 11 (1) ◽

pp. 62-67 ◽

Cited By ~ 1

Author(s):

Peter Eastman ◽

Brian Le ◽

Gillian McCarthy ◽

James Watt ◽

Mark Rosenthal

Keyword(s):

Palliative Care ◽

Clinical Trials ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Care Setting ◽

Palliative Care Setting

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Obstetric Emergencies requiring Rapid response team activation: A retrospective cohort study in a high-risk tertiary care centre

Journal of Obstetrics and Gynaecology Canada ◽

10.1016/j.jogc.2021.09.016 ◽

2021 ◽

Author(s):

Jillian Taras ◽

Gita Raghavan ◽

Kristi Downey ◽

Mrinalini Balki

Keyword(s):

Cohort Study ◽

High Risk ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Tertiary Care ◽

Rapid Response Team ◽

Care Centre ◽

Tertiary Care Centre ◽

Response Team ◽

Obstetric Emergencies

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Incidence of Secondary Microorganism Infections Following Utilization of Tocilizumab for the Treatment of COVID‑19 - A Matched Retrospective Cohort Study

10.54137/ijiid1782 ◽

2021 ◽

Vol 1 (1) ◽

Author(s):

Joanna L. Moore ◽

Stephanie J. Stroever ◽

Patricia E. Rondain ◽

Robyn N. Scatena

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Secondary Infection ◽

World Health ◽

Quantitative Relation ◽

Secondary Outcome ◽

Healthcare Associated Infection ◽

Kaplan Meier ◽

Healthcare Associated

Introduction: immunological disorder agent’s area unit theorized to focus on the protein storm syndrome in COVID‑19. However, the downstream effects concerning susceptibilities to secondary infection risk stay unknown. This study seeks to work out risk variations for secondary infections among COVID‑19 patients World Health Organization did and failed to receive tocilizumab. Methods: we have a tendency to conducted a matched retrospective cohort study from 2 giants, acute care hospitals in Western Connecticut from March 1 to May 31, 2020. we have a tendency to collected variables exploitation manual case history abstraction. the first exposure variable was any dose of tocilizumab. the first outcome was any healthcare‑associated microorganism or mycosis as outlined by the National Care Safety Network. we have a tendency to performed a Kaplan–Meier analysis to assess the crude distinction within the additive likelihood of healthcare‑associated infection (HAI) across exposure teams. we have a tendency to conjointly performed a multivariable Cox multivariate analysis to work out the hazard quantitative relation for HAI by exposure group whereas dominant for potential confounders. Results: The Kaplan–Meier analysis incontestable no distinction within the additive likelihood of HAI across teams. The adjusted hazard of HAI for patients given tocilizumab was zero.85 times that of patients not given tocilizumab (95% confidence interval = zero.29, 2.52, P = 0.780) once dominant for relevant confounders. Conclusions: Tocilizumab failed to increase the incidence of secondary infection among COVID‑19 patients. Larger, irregular trials ought to valuate infection as a secondary outcome to validate this finding.

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End-of-life Comfort Evaluation, is Clinic Enough? A Retrospective Cohort Study of Combined Comfort Evaluation with Analgesia/Nociception Index and Clinic in non-Communicative Patients

Journal of Palliative Care ◽

10.1177/08258597211063687 ◽

2021 ◽

pp. 082585972110636

Author(s):

Loïc Bauschert ◽

Chloé Prod’homme ◽

Magali Pierrat ◽

Luc Chevalier ◽

Hélène Lesaffre ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Care Setting ◽

Symptom Relief ◽

Pharmacological Interventions ◽

Specific Population ◽

Comfort Evaluation ◽

Palliative Care Setting ◽

Palliative Setting

Background: Comfort evaluation is one of the major challenges in the palliative care setting, particularly when it comes to non-communicative patients. For this specific population, validated tools for comfort evaluation are scarce and healthcare professionals have to rely on their clinical sense and experience. Objectives: To provide arguments for the use of Analgesia/Nociception Index (ANI) monitoring in order to improve clinical comfort evaluation. Methods: We conducted a retrospective cohort study of non-communicative patients at the end of their lives whose comfort was evaluated clinically and with ANI. We focused on the coherence or discordance of clinical and ANI evaluations and on pharmacological interventions driven by them. Results: 58 evaluations from 33 patients were analyzed. Clinical and demographic characteristics were highly variable. Simultaneous clinical and ANI evaluations were concordant in 45 measurements (77.58%), leading mostly to no treatment modification when indicating comfort and to increasing anxiolytic or pain-relief treatments when indicating discomfort. Thirteen (22.41%) evaluations were discordant, leading mostly to treatment incrementation. Conclusion: We suggest that the ANI monitor is a reliable tool in the palliative setting and may help provide patients with the best symptom relief and the most appropriate therapeutics.

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