Nocardiosis in Japan: a multicentric retrospective cohort study

2021 ◽  
Author(s):  
Akane Takamatsu ◽  
Takashi Yaguchi ◽  
Yasuaki Tagashira ◽  
Akira Watanabe ◽  
Hitoshi Honda
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hazard Analysis ◽  
Immunosuppressive Agents ◽  
Charlson Comorbidity Index Score ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Disseminated Nocardiosis ◽  
One Year

Background Nocardia species cause a broad spectrum of infections, especially in immunocompromised patients. Given its relative rarity, data on the prognosis and distribution of nocardiosis from a large cohort are scarce. The present study aimed to scrutinize the clinical features and outcomes of nocardiosis in Japan, including one-year mortality and microbiological data. Methods The present, multicentric, retrospective cohort study enrolled patients aged ≥ 18 years with nocardiosis diagnosed between January 2010 and December 2017 and recorded their clinical and microbiological characteristics. Factors associated with one-year mortality were also determined using Cox proportional hazard analysis. Results In total, 317 patients were identified at 89 hospitals. Almost half (155/317, 48.9%) were receiving immunosuppressive agents, and 51 had disseminated nocardiosis (51/317, 16.1%). The one-year, all-cause mortality rate was 29.4% (80/272; lost to follow-up, n = 45). The most frequently isolated species was Nocardia farcinica (79/317, 24.9%) followed by the N. nova complex (61/317, 19.2%). Selected antimicrobial agents were generally effective, with linezolid (100% susceptibility [S]) and amikacin (94% S) having the most activity against Nocardia species. In Cox proportional hazard analysis, factors independently associated with one-year mortality were a Charlson Comorbidity Index score ≥ 5 (adjusted hazard ratio [aHR], 3.61; 95% confidence interval [CI], 1.95-6.71, P < 0.001) and disseminated nocardiosis (aHR, 1.79; 95%CI, 1.01-3.18, P = 0.047). Conclusions The presence of advanced comorbidities and disseminated infection, rather than variations in antimicrobial therapy or Nocardia species, were independently associated with one-year mortality.

scholarly journals Time to develop severe acute malnutrition and its predictors among children living with HIV in the era of test and treat strategies at South Gondar hospitals, northwest, Ethiopia, 2021: a multicentre retrospective cohort study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Ermias Sisay Chanie ◽  
Getasew Legas ◽  
Shimeles Biru Zewude ◽  
Maru Mekie ◽  
Dagne Addisu Sewyew ◽  
...  
Keyword(s):  
Cohort Study ◽  
Treatment Failure ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Living With Hiv ◽  
South Gondar

Abstract Background Although severe acute malnutrition is a major public issue among HIV infected children, there is no prior evidence in Ethiopia. Hence, this study aims to assess the time to develop severe acute malnutrition and its predictors among children living with human immunodeficiency virus in Ethiopia, 2012. Methods An institution based retrospective cohort study was conducted in South Gondar hospitals among 363 HIV infected children from February 10, 2014, to January 7, 2021. Epi-data version 3.1 was used to enter data, which was then exported to STATA version 14 for analysis. Besides, WHO (World Health Organization) Anthro Plus software was used to assess the nutritional status of the children. A standardized data extraction tool was used to collect the data. The Kaplan Meier survival curve was used to estimate the median survival time. The Cox-proportional hazard model assumption was checked via the Schoenfeld residual ph test and a stph plot. Bivariable and multivariable Cox proportional hazard models were employed at 95% confidence intervals (CI). A variable having a p-value < 0.05 was considered a statistically significant predictor of severe acute malnutrition. Results A total of 363 children living with HIV, 97 (26.72%) developed severe acute malnutrition during the follow-up period. The overall incidence rate was 5.4 (95% CI: 4.7–5.9) person per year with a total of 21, 492 months or 1791 years of observation. Moreover, the median survival time was 126 months. Treatment failure [AHR =3.4 (95% CI: 2.05–5.75)], CD4 count below threshold [AHR =2.5 (95% CI: 1.64–3.95)], and WHO stage III & IV [AHR =2.9 (95% CI: 1.74–4.73)] were all significant predictors of severe acute malnutrition. Conclusion The time to develop severe acute malnutrition was found to be very low. Treatment failure, CD4 count below threshold, and WHO stage III were all significant predictors of severe acute malnutrition. Hence, emphasizing those predictor variables is essential for preventing and controlling the occurrence of severe acute malnutrition among HIV infected children.

scholarly journals Dementia in Scottish military veterans: early evidence from a retrospective cohort study

2021 ◽  
pp. 1-6
Author(s):  
B. P. Bergman ◽  
D. F. Mackay ◽  
J. P. Pell
Keyword(s):  
Cohort Study ◽  
Mood Disorder ◽  
Retrospective Cohort Study ◽  
Military Service ◽  
Retrospective Cohort ◽  
Military Veterans ◽  
Cognitive Status ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Increased Risk

Abstract Background Few studies have examined whether UK military veterans are at an increased risk of dementia. We explored the risk of dementia in Scottish military veterans aged up to 73 years in comparison with people who have never served. Methods Retrospective cohort study of 78 000 veterans and 253 000 people with no record of service, matched for age, sex and area of residence, with up to 37 years follow-up, using Cox proportional hazard analysis to compare risk of dementia in veterans and non-veterans, overall and by subgroup. Results Dementia was recorded in 0.2% of both veterans and non-veterans overall, Cox proportional hazard ratio 0.98, 95% confidence interval (CI) 0.82–1.19, p = 0.879 (landmark age: 50 years), with no difference for men but increased risk in veteran women and Early Service Leavers. Post-traumatic stress disorder (PTSD) was associated with a higher risk of dementia in both veterans and non-veterans, although possibly to a lesser degree in veterans. A history of mood disorder was strongly associated with developing dementia, greater in veterans than in non-veterans, odds ratio 1.54, 95% CI 1.01–2.35, p = 0.045. Conclusions There was no evidence to suggest that military service increased the risk of dementia, although this may change as the cohort ages. The well-documented association with PTSD shows no evidence of being stronger in veterans; by contrast, the association of mood disorder with dementia is much stronger in veterans. Healthcare providers should carefully assess the cognitive status of older veterans presenting with depressive illness in order to identify early dementia and ensure optimum management.

scholarly journals Association between Statin Use and Sepsis Risk in Patients with Dementia: A Retrospective Cohort Study

2019 ◽  
Vol 16 (9) ◽  
pp. 1626 ◽  
Author(s):  
Liang-Tsai Yeh ◽  
Chuan-Yi Tang ◽  
Shun-Fa Yang ◽  
Han-Wei Yeh ◽  
Ying-Tung Yeh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Positive Association ◽  
Research Database ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Sepsis Risk ◽  
Using Data ◽  
Statin Use

This study investigated the association of statin use with sepsis risk in patients with dementia. This retrospective cohort study was conducted in Taiwan by using data from the National Health Insurance Research Database. We identified and enrolled 308 patients with newly diagnosed dementia who used statin after dementia diagnosis. These patients were individually propensity score matched (1:1) according to age, sex, hypertension, hyperlipidemia, diabetes, cerebrovascular disease, renal disease, liver disease, asthma, malignancy, parkinsonism, and dementia drugs used (donepezil, rivastigmine, galantamine, and memantine) with 251 controls (statin non-users). A Cox proportional hazard model was used to estimate the adjusted hazard ratio for sepsis in statin users and non-users. After adjustment for other confounding factors, the incidence of sepsis in statin users was 1.42-fold higher than that in non-users (95% confidence interval = 0.81–2.5). In conclusion, our analysis showed no positive association of sepsis with statin use in patients with dementia.

Increased risk of rheumatoid arthritis among patients with endometriosis: a nationwide population-based cohort study

Rheumatology ◽  
2020 ◽  
Author(s):  
Yu-Hao Xue ◽  
Liang-Tian You ◽  
Hsin-Fu Ting ◽  
Yu-Wen Chen ◽  
Zi-Yun Sheng ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Propensity Scores ◽  
Population Based ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Potential Risks ◽  
Using Data

Abstract Objectives Autoimmunity may play a role in endometriosis. The association between endometriosis and RA remains unknown. This study was conducted to identify any evidence for this relationship. Methods This 13-year, nationwide, population-based, retrospective cohort study analysed the risk of RA in a cohort of individuals with endometriosis. We investigated the incidence of RA among patients with endometriosis using data from the Longitudinal Health Insurance Database 2000, which is maintained by the Taiwan National Health Research Institutes. We used propensity scores to match comorbidities in the two cohorts. Kaplan–Meier analysis and Cox proportional hazard model were employed to analyse the association between endometriosis and RA among patients with different potential risks. Results Patients with endometriosis [adjusted hazard ratio (HR) 1.75, 95% CI 1.27, 2.41], aged ≥45 years (adjusted HR 1.50, 95% CI 1.06–2.13) and with autoimmune disease (adjusted HR 6.99, 95% CI 2.84–17.21) had a significantly higher risk of RA. The analyses also showed that when stratified by age, comorbidities and medication use, the risk of RA in patients with endometriosis was also higher than in those without endometriosis. Conclusions This 14-year, nationwide, population-based retrospective cohort study revealed that patients with endometriosis have a higher risk of RA. In the clinical management of patients with RA, rheumatologists should be especially mindful of the possibility of underlying endometriosis.

scholarly journals Parathyroid hormone change after cinacalcet initiation and one-year clinical outcome risk: a retrospective cohort study

2015 ◽  
Vol 16 (1) ◽  
Author(s):  
Wendy L St. Peter ◽  
Akeem A Yusuf ◽  
Thy Do ◽  
Kimberly A Lowe ◽  
Jiannong Liu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Parathyroid Hormone ◽  
Clinical Outcome ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
One Year

One-Year Outcome Study of Anatomic Reconstruction of Lesser Metatarsophalangeal Joints

2019 ◽  
Vol 13 (4) ◽  
pp. 286-296 ◽  
Author(s):  
Jeremy J. Cook ◽  
Emily A. Cook ◽  
Daniel D. Hansen ◽  
Michael Matthews ◽  
Timothy Karthas ◽  
...  
Keyword(s):  
Cohort Study ◽  
Visual Analogue Scale ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Analogue Scale ◽  
Anatomic Repair ◽  
Plantar Plate ◽  
One Year ◽  
Radiographic Alignment

Background: Lesser metatarsophalangeal joint (MTPJ) and plantar plate pathologies are commonly seen forefoot conditions. Traditional rebalancing techniques are commonly used but can have concerning adverse effects. The purpose of this study was to analyze the 1-year outcomes of a new technique consisting of anatomic repair of the plantar plate and collateral ligaments involving lesser MTPJs. Methodology: A retrospective cohort study of 50 consecutive patients treated with anatomic plantar plate and collateral ligament reconstruction were evaluated for lesser MTPJ imbalances between 2013 and 2016. The primary outcome was postoperative digital stability defined as a normal dorsal drawer test and normal paper pull-out test. Secondary outcomes included pre- and postoperative visual analogue scale pain measurements, MTPJ radiographic alignment, and ACFAS Forefoot module scores. Results: All patients had digital instability prior to the surgical intervention. Final follow-up revealed that 92% of patients showed improved digital stability, P = .0005. Multivariate regression found statistically significant improvement in pain reduction via the visual analogue scale of 51.2 mm ( P < .0001) and ACFAS Forefoot module scores improved to 92 ( P < .0001). The 45 joints with preoperative abnormal transverse plane deformity, had either complete (n = 29) or partial (n = 16) radiographic MTPJ correction. Conclusion: These results suggest that anatomic repair of lesser MTPJ improved digital stability, pain, function and radiographic alignment with greater than one year of follow-up. Levels of Evidence: Level IV: Retrospective cohort study

Long-Distance Heart Procurement and One-Year Survival: A Retrospective Cohort Study

2017 ◽  
Vol 36 (4) ◽  
pp. S385-S386
Author(s):  
G.A. Braga ◽  
F.G. Marcondes-Braga ◽  
J.L. Xavier Junior ◽  
M. da Silva ◽  
S. Mangini ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Long Distance ◽  
One Year

scholarly journals Survival Status and Determinants of Mortality Among Severely Malnourished Children Aged 0-59 Months Admitted to Jinka Hospital, South Omo Zone, Ethiopia: A Retrospective Cohort Study 

2020 ◽  
Author(s):  
Shegaw Abiyu ◽  
Tesfaye Gobena ◽  
Gudina Egata
Keyword(s):  
Cohort Study ◽  
General Hospital ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Outcome Variable ◽  
Major Public Health Problem ◽  
Proportional Hazard ◽  
Global Test ◽  
Survival Status ◽  
Malnourished Children

Abstract Sever acute malnutrition (SAM) remains a major public health problem contributing to morbidity and mortality among children aged 0-59 months. However, little is known about the survival status and determinants of mortality among children admitted to stabilization centers (SC) in Ethiopia particularly in study setting. The objective: to assess the survival status and determinants of mortality among severely malnourished children aged 0-59 months admitted to SC in Jinka general hospital from September 1, 2014 to August 30, 2018. Hospital based retrospective cohort study design was used among 588 severely malnourished children aged 0-59 months admitted to SC of Jinka general hospital from March 20-30, 2019. Simple random sampling method was used to select medical records of the study participants. Proportional hazard assumption over time was checked by Schoenfeld’s global test. The Kaplan-Mei­er survival curve with log-rank test was used to compare survival across groups. Bivariable and multivariable Cox proportional hazard regression was used to assess the association between each independent variable and the outcome variable. Level of statistical significance was declared at p less than 0.05. Among cohort of children studied, nearly 11% of children were died during follow up. The overall mean survival time was 38 days, 95% CI :( 36.3, 39.7).Urban residence [AHR=2.24, 95% CI: (1.17, 4.30)], presence of dehydration [AHR =3.94, 95% CI:(1.89, 8.22)], presence of shock [AHR=4.15, 95% CI:(2.01, 8.55)], altered body temperature [AHR= 2.01, 95% CI:(1.01, 3.91)], failure to take F100 formula milk [AHR= 4.87, 95%CI:(2.75, 8.63)] and oral antibiotics [AHR=3.57, 95%CI:(1.88,6.77)] were identified to be the independent determinants of mortality The mortality rate for severely undernourished children was higher than global sphere standard and national protocol.Societal and individual level determinants of mortality were identified. Therefore, interventions to reduce mortality should focus on altered clinical conditions and comorbidities/ infections.

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