scholarly journals BCG skin reactions by 2 months of age are associated with better survival in infancy: a prospective observational study from Guinea-Bissau

2020 ◽  
Vol 5 (9) ◽  
pp. e002993
Author(s):  
Frederik Schaltz-Buchholzer ◽  
Mike Berendsen ◽  
Adam Roth ◽  
Kristoffer Jarlov Jensen ◽  
Morten Bjerregaard-Andersen ◽  
...  
Keyword(s):  
Observational Study ◽  
Skin Reaction ◽  
Mortality Risk ◽  
Prospective Observational Study ◽  
Linear Trend ◽  
Skin Reactions ◽  
Link Type ◽  
Guinea Bissau ◽  
Cytokine Responses ◽  
All Cause Mortality

IntroductionReceiving Bacille Calmette-Guérin (BCG)-Denmark vaccine at birth has been associated with ~40% reductions in all-cause neonatal mortality. We evaluated determinants of BCG skin reaction characteristics by age 2 months and tested the association with subsequent mortality.MethodsProspective observational study amalgamating five trials providing BCG-at-birth that were conducted between 2002 and 2018 in Guinea-Bissau. The reaction status and size were evaluated at home-visits by 2 months of age among 6012 neonates; mortality from 2 to 12 months was assessed at subsequent visits. Reaction determinants were evaluated by binomial regression providing risk ratios (RRs). In Cox-models providing adjusted mortality rate ratios (aMRRs), we assessed the association between (1) having a 2-month reaction (yes/no) and (2) reaction size tertiles and subsequent all-cause mortality risk. A subgroup had their BCG reaction evaluated and were bled at age 4 weeks; their samples underwent in vitro analysis for specific and non-specific cytokine responses.ResultsThe BCG strain was the main determinant for developing a 2-month reaction and the reaction size: the BCG-Russia/BCG-Denmark RR for large-reaction was 0.38 (0.30–0.47) and the BCG-Russia/BCG-Japan RR was 0.61 (0.51–0.72). 5804 infants (96.5%) were reactors by age 2 months; 208 (3.5%) were non-reactors. The 2–12 months mortality risk was 4.8% (10/208) for non-reactors, 2.9% (64/2213) for small reactors, 1.8% (30/1710) for medium reactors and 0.8% (15/1881) for large reactors. The reactor/non-reactor aMRR was 0.49 (0.26–0.95) and there was a linear trend of decreasing mortality with increasing reaction size (p for trend <0.001). BCG reactors had higher 4-week specific and non-specific cytokine responses, responses that were highest among those with large reactions.ConclusionAmong BCG-vaccinated infants, having a BCG skin reaction by age 2 months was associated with markedly better survival, as was the reaction size. Our findings thus support that BCG has substantial effects on all-cause mortality. Emphasising at-birth vaccination with immunogenic BCG strains and revaccinating non-reactors and small reactors could have major public health benefits.Trial registration numbersNCT00146302, NCT00168610, NCT00625482, NCT01989026 and NCT02447536.

CLINICAL OUTCOMES OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AFTER PERCUTANEOUS CORONARY INTERVENTION AMONG CARDIAC REHABILITATION AND NON CARDIAC REHABILITATION GROUPS-A PROSPECTIVE OBSERVATIONAL STUDY

2021 ◽  
pp. 25-27
Author(s):  
Saroj Mandal ◽  
Vignesh. R ◽  
Sidnath Singh
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Observational Study ◽  
Cardiac Rehabilitation ◽  
Prospective Observational Study ◽  
Coronary Intervention ◽  
Cardiac Mortality ◽  
Percutaneous Coronary ◽  
All Cause Mortality

OBJECTIVES To determine clinical outcome and to nd out the association between participation of patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) in cardiac rehabilitation programme. DESIGN A Prospective observational study. STUDY AREA : Department of Cardiology, Institute of Postgraduate Medical Education and Research,Kolkata. PARTICIPANTS: Patients aged ≥18 years who underwent PCI due to AMI. OUTCOME MEASURES The outcomes were subsequent myocardial infarction, revascularisation, all-cause readmission, cardiac readmission, all-cause mortality and cardiac mortality. RESULT: The data of 1107 patients were included and 60.07%% of them participated in CR program. The risks of revascularisation, all cause readmission and cardiac readmission among CR participants were compared. The results of those analysis were consistent and showed that the CR participants had lower allcause mortality ,cardiac mortality,all cause readmission, cardiac admission. However no effect was observed for subsequent myocardial infarction or revascularisation. CONCLUSIONS: It was suggested CR participation may reduce the risk of all-cause mortality ,cardiac mortality, all cause readmission and cardiac admission.

scholarly journals A metabolic profile of all-cause mortality risk identified in an observational study of 44,168 individuals

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Joris Deelen ◽  
Johannes Kettunen ◽  
Krista Fischer ◽  
Ashley van der Spek ◽  
Stella Trompet ◽  
...  
Keyword(s):  
Observational Study ◽  
Mortality Risk ◽  
Metabolic Profile ◽  
All Cause Mortality

scholarly journals All-cause mortality risk in elderly individuals with disabilities: a retrospective observational study

BMJ Open ◽  
2016 ◽  
Vol 6 (9) ◽  
pp. e011164 ◽  
Author(s):  
Li-Wei Wu ◽  
Wei-Liang Chen ◽  
Tao-Chun Peng ◽  
Sheng-Ta Chiang ◽  
Hui-Fang Yang ◽  
...  
Keyword(s):  
Observational Study ◽  
Mortality Risk ◽  
Retrospective Observational Study ◽  
Individuals With Disabilities ◽  
Elderly Individuals ◽  
All Cause Mortality

scholarly journals Brain and renal oxygenation measured by NIRS related to patent ductus arteriosus in preterm infants: a prospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jurate Navikiene ◽  
Ernestas Virsilas ◽  
Ramune Vankeviciene ◽  
Arunas Liubsys ◽  
Augustina Jankauskiene
Keyword(s):  
Observational Study ◽  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Prospective Observational Study ◽  
Cerebral Oxygenation ◽  
Ductus Arteriosus ◽  
Oxygen Extraction ◽  
Tissue Oxygen ◽  
Link Type ◽  
Patent Ductus

Abstract Background Patent ductus arteriosus (PDA) is common among preterm neonates. Haemodynamically significant ductus arteriosus (hsPDA) can cause ductal steal and contribute to poor outcomes. Our aim was to evaluate ductus arteriosus patency and significance using two-site near-infrared spectroscopy (NIRS) measurements in preterm infants older than 72 h as a supplemental tool to echocardiography. Methods In this prospective observational study, 123 preterm infants (gestational age (GA) < 32 weeks, birth weight < 1500 g) were enrolled. Sixty-four newborns had closed ductus arteriosus (noPDA), and 41 and 18 patients were assigned to the PDA and hsPDA groups, respectively, per predefined echocardiographic criteria. Cerebral and renal oxygenation were assessed during NIRS monitoring. Results A higher renal mean (±SD) regional tissue oxygen saturation (rSpO2) (76.7 (±7.64)) was detected in the noPDA group than in the PDA (71.7 (±9.02)) and hsPDA (67.4 (±13.48)) groups (p < 0.001). Renal fractional tissue oxygen extraction (FTOE) (0.18 (±0.079)) was lower in the noPDA group than in the PDA (0.23 (±0.092)) and hsPDA (0.24 (±0.117))0.117 groups (p = 0.002). Cerebral oxygenation was significantly lower in the hsPDA group (77.0 (±5.16)) than in the noPDA (79.3 (±2.45)) and PDA (79.7 (±2.27)) groups (p = 0.004). There was no significant difference in cerebral fractional tissue oxygen extraction (FTOE) between any of the groups. Conclusions Our results suggest that renal oxygenation is affected by ductus patency in preterm infants older than 72 h. Significant differences in cerebral oxygenation were observed between the hsPDA group and the PDA and noPDA groups. Trial registration ClinicalTrials.gov Identifier: NCT04295395. Registration date: 4 March 2020. This study was retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04295395.

scholarly journals Association between preoperative serum homocysteine and delayed neurocognitive recovery after non-cardiac surgery in elderly patients: a prospective observational study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Zhen-Feng Zhang ◽  
Qing-Chun Sun ◽  
Yi-Fan Xu ◽  
Ke Ding ◽  
Meng-Meng Dong ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Observational Study ◽  
Elderly Patients ◽  
Sex Education ◽  
Prospective Observational Study ◽  
Cognitive Disorders ◽  
Vitamin B ◽  
Link Type ◽  
Preoperative Serum ◽  
Increased Risk

Abstract Background Homocysteine, folate, and vitamin B12 involved in 1-carbon metabolism are associated with cognitive disorders. We sought to investigate the relationships between these factors and delayed neurocognitive recovery (dNCR) after non-cardiac surgery. Methods This was a prospective observational study of patients (n = 175) who were ≥ 60 years of age undergoing non-cardiac surgery. Patients were evaluated preoperatively and for 1 week postoperatively by using neuropsychological tests and were divided into dNCR or non-dNCR groups according to a Z-score ≤ − 1.96 on at least two of the tests. The relationship between the occurrence of dNCR and preoperative levels of homocysteine, folate, and vitamin B12 was analyzed. Univariate and multivariable logistic regression analyses were conducted to identify factors associated with dNCR. Results Delayed neurocognitive recovery was observed in 36 of 175 patients (20.6%; 95% confidence interval [CI], 14.5–26.6%) 1 week postoperatively. Patients who developed dNCR had significantly higher median [interquartile range (IQR)] homocysteine concentrations (12.8 [10.9,14.4] μmol/L vs 10.6 [8.6,14.7] μmol/L; P = 0.02) and lower folate concentrations (5.3 [4.2,7.3] ng/mL vs 6.9 [5.3,9.5] ng/mL; P = 0.01) than those without dNCR. Compared to the lowest tertile, the highest homocysteine tertile predicted dNCR onset (odds ratio [OR], 3.9; 95% CI, 1. 3 to 11.6; P = 0.02), even after adjusting for age, sex, education, and baseline Mini Mental State Examination. Conclusions Elderly patients with high homocysteine levels who underwent general anesthesia for non-cardiac surgery have an increased risk of dNCR. This knowledge could potentially assist in the development of preventative and/or therapeutic measures. Trial registration NCT03084393 (https://www.clinicaltrials.gov)

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