Post-weaning diarrhea in pigs weaned without medicinal zinc: risk factors, pathogen dynamics, and association to growth rate

Abstract Background Porcine post-weaning diarrhea (PWD) has reemerged as an important topic in pig production, as common control strategies based on prophylactic use of antimicrobials and zinc oxide have been deemed unsustainable. The objectives of this study were to estimate the cumulative incidence of porcine post-weaning diarrhea with different etiologies in production systems weaning without zinc oxide and prophylactic antimicrobials, to assess risk factors for post-weaning diarrhea, and to estimate the impact of post-weaning diarrhea on growth rate. A cohort study was conducted at two commercial indoor producers weaning without medicinal zinc oxide and prophylactic antimicrobials. Results Piglets were included at birth (n = 300) and 272 survived until weaning. After insertion to the nursery units, the piglets were clinically examined every day for 14 days, and rectal swabs were collected and analyzed for enterotoxigenic Escherichia coli (ETEC) and rotavirus A. The cumulative incidences of PWD the first 14 days after insertion to the nursery units were 41.8% (CI 33.6, 50.4) and 51.1% (CI 42.3, 60.0) at the two producers, respectively. We found a low incidence of cases associated to ETEC, and detected a substantial proportion of cases associated to rotavirus. We observed a biphasic pattern in the assumed etiology with rotavirus occurring first, and then a shift towards cases associated to ETEC/non-ETEC hemolytic E. coli. Being offspring of older sows was a protective factor for the development of PWD (Hazard ratio = 0.88 [CI 0.78, 0.99] per unit increase in parity of the dam). Low birth weight reduced the post-weaning growth rate (− 5.2 g/day [CI − 7.5, − 2.9] per 100 g decrease in birthweight) and increased the hazard of developing PWD (Hazard ratio for birthweight below 1100 g: 2.30 [CI 1.41–3.74]). The combined effect of having diarrhea for 2 days or more and receiving antimicrobial treatment was associated with an increased average daily weight gain. Conclusions This study suggests novel insights regarding pathogen dynamics and risk factors for PWD in productions not using prophylactic antimicrobials and medicinal zinc. The findings may have important implications for both antimicrobial usage and prevention strategies.

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Identification and Characterization of Recurrent Venous Thrombosis In Cancer Patients

Blood ◽

10.1182/blood.v116.21.3328.3328 ◽

2010 ◽

Vol 116 (21) ◽

pp. 3328-3328

Author(s):

Catherine Weber ◽

Nelly G. Adel ◽

Elyn Riedel ◽

Gerald A. Soff

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Overall Survival ◽

Cancer Patients ◽

Cancer Diagnosis ◽

Hazard Ratio ◽

Older Age ◽

Recurrent Thrombosis ◽

Recurrent Vte ◽

The Impact

Abstract Abstract 3328 Background: Venous thromboembolism (VTE) is a common cause of morbidity and mortality in cancer patients. Standard of care for treatment is Low Molecular Weight Heparin, but recurrence of VTE remains a concern. We performed a retrospective analysis of our institutional experience, to characterize the patients who had a recurrence of VTE while on therapeutic doses of Dalteparin. Objectives: 1. To determine the VTE recurrence rate for cancer patients on therapeutic Dalteparin. 2. To elucidate potential risk factors for recurrence. 3. To determine the impact of recurrent VTE on overall survival. Methods: Patients beginning treatment for VTE with dalteparin between 1/1/2008 and 12/10/ 2009 were retrospectively identified through the hospital's electronic medical records system and cases of recurrent VTE were characterized. Overall survival was estimated using the Kaplan-Meier method and the influence of VTE recurrence on overall survival was analyzed as a time-dependent covariate using a Cox proportional hazards model. Results: 1,392 patients, treated for VTE with dalteparin were included in this study. 34 recurrent VTE episodes were identified. The overall incidence of recurrent thrombosis by six months was 2.3% (95% CI: 1.7%-3.3%). Older age was significantly associated with recurrence (p=0.04). Lung cancer patients had a significantly elevated risk of recurrence (5.6%, p=0.03). No other cancer types were associated with a significant trend to increased recurrent VTE rates. The incidence of recurrent VTE was higher among females compared to males (3.0% vs. 1.6%), although this trend was not statistically significant (P = 0.08). After adjusting for gender, sex and cancer diagnosis, developing a recurrent VTE was associated with a 3.0-fold hazard ratio of death (<0.0001). Conclusions: The rate of recurrent VTE in cancer patients at MSKCC is low in comparison with previously published reports. However, we identified both older age and lung cancer diagnosis as statistically significant risk factors for recurrent VTE. Females also experienced a higher rate of recurrent thrombosis when compared to males, although this result was not statistically significant. The hazard ratio for death was three times that for a patient with recurrent thrombosis when compared to one without subsequent VTE, suggesting recurrence of VTE remains an important influence on cancer-associated mortality. Disclosures: No relevant conflicts of interest to declare.

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Trends of Healthcare-associated Infections in a Tuinisian University Hospital and Impact of COVID-19 Pandemic

INQUIRY The Journal of Health Care Organization Provision and Financing ◽

10.1177/00469580211067930 ◽

2021 ◽

Vol 58 ◽

pp. 004695802110679

Author(s):

Hela Ghali ◽

Asma Ben Cheikh ◽

Sana Bhiri ◽

Selwa Khefacha ◽

Houyem Said Latiri ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Protective Factor ◽

Bloodstream Infections ◽

Point Prevalence ◽

University Hospital ◽

Healthcare Associated Infection ◽

Tract Infections ◽

Healthcare Associated ◽

The Impact

Background Although efforts to manage coronavirus disease 2019 (COVID-19) pandemic have understandably taken immediate priority, the impacts on traditional healthcare-associated infection (HAI) surveillance and prevention efforts remain concerning. Aim To describe trends in HAIs in a Tunisian university hospital through repeated point prevalence surveys over 9 years, assess the impact of measures implemented for COVID-19 pandemic, and to identify associated factors of HAI. Methods The current study focused on data collected from annual point prevalence surveys conducted from 2012 to 2020. All types of HAIs as defined by the Centers for Disease Control and Prevention (CDC) were included. Data collection was carried out using NosoTun plug. Univariate and multivariate logistic analysis were used to identify HAI risk factors. Results Overall, 2729 patients were observed in the 9 surveys; the mean age was 48.3 ± 23.3 years and 57.5% were male. We identified 267 infected patients (9.8%) and 296 HAIs (10.8%). Pneumonia/lower respiratory tract infections were the most frequent HAI (24%), followed by urinary tract infection (20.9%).The prevalence of infected patients increased from 10.6% in 2012 to 14.9% in 2020. However, this increase was not statistically significant. The prevalence of HAIs increased significantly from 12.3% to 15.5% ( P =.003). The only decrease involved is bloodstream infections (from 2% to 1%). Independent risk factors significantly associated with HAI were undergoing surgical intervention (aOR = 1.7), the use of antibiotic treatment in previous 6 months (aOR = 1.8), peripheral line (aOR=2), parenteral nutrition (aOR=2.4), urinary tract within 7 days (aOR=2.4), central line (aOR = 6.3), and prosthesis (aOR = 12.8), length of stay (aOR = 3), and the year of the survey. Young age was found as protective factor (aOR = .98). Conclusion Contrary to what was expected, we noticed an increase in the HAIs rates despite the preventive measures put in place to control the COVID-19 pandemic. This was partly explained by the vulnerability of hospitalized patients during this period.

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Effects of dietary style on adult enterovirus infection risk factors: a retrospective analysis

10.21203/rs.3.rs-64911/v1 ◽

2020 ◽

Author(s):

Linghua Yu ◽

Linlin Wang ◽

Huixing Yi ◽

Xiaojun Wu ◽

Fei Sun

Keyword(s):

Risk Factors ◽

Gut Microbiota ◽

Dietary Patterns ◽

Dietary Pattern ◽

Clinical Characteristics ◽

Protective Factor ◽

Demographic Data ◽

Adult Patients ◽

Phone Calls ◽

The Impact

Abstract Background: Gut microbiota serves as a defense against enteric pathogens, whereas dietary intake influences the composition and function of gut microbiota. We aimed to examine the impact of diet on the enteroviral infection in adult patients of hand, foot, and mouth disease (HFMD). Methods: A total of 266 adult patients of HFMD were recruited in this study, with 80 healthyvolunteers served as the control. Swab samples and clinical characteristics were collected. Enteroviral genotype was further assessed by PCR testing. Social-demographic data and dietary records were obtained through follow-up phone calls. Dietary patterns were derived with PCA analysis. Correlation between dietary patterns and clinical characteristics, enterovirus genotype, and HFMD risk factors were evaluated. Results:Three distinct dietary patterns were identified in the participants, which were modern, "atypical south", and "traditional north", respectively. This study found the dietary pattern of adult HFMD significantly differed from that of the controls. A vast majority of controls followed the modern pattern, which was a healthy diet. In contrast, the result showed unhealthy dietary patterns ('atypical south' and 'traditional north') were risk factors for adult HFMD. Besides, the dining place was a leading contributor to the dietary pattern. Our data showed eating at a food stall, or take-out is a risk factor of adult HFMD, whereas eating at the dining room is a protective factor. Conclusions:Our study indicated dietary pattern was associated with the incidence of adult HMFD. Improving the dietetic habit might contribute to HFMD prevention.

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The Risk Factors and the Impact of Hernia Development on Technique Survival in Peritoneal Dialysis Patients: A Population-Based Cohort Study

Peritoneal Dialysis International ◽

10.3747/pdi.2013.00139 ◽

2015 ◽

Vol 35 (3) ◽

pp. 351-359 ◽

Cited By ~ 17

Author(s):

Shang-Feng Yang ◽

Chia-Jen Liu ◽

Wu-Chang Yang ◽

Chao-Fu Chang ◽

Chih-Yu Yang ◽

...

Keyword(s):

Risk Factors ◽

Peritoneal Dialysis ◽

Protective Factor ◽

Female Gender ◽

Population Based ◽

Chronic Obstructive ◽

Research Database ◽

Hernia Formation ◽

History Of ◽

The Impact

ObjectivesThere is a lack of consensus on the risk factors for hernia formation, and the impact on peritoneal dialysis (PD) survival has seldom been studied.MethodsThis was a population-based study and all collected data were retrieved from the National Health Insurance Research Database of Taiwan. Patients who commenced PD between January 1998 and December 2006 were screened for inclusion. Multiple logistic regression and Cox proportional hazards models were applied to estimate the predictors for hernia formation and determine the predictors of PD withdrawal.ResultsA total of 6,928 PD patients were enrolled and followed until December 2009, with 631 hernia events and 391 hernioplasties being registered in 530 patients (7.7%). The incidence rate was 0.04 hernias/patient/year. Longer PD duration (per 1 month increase, hazard ratio (HR) 1.019) and history of mitral valve prolapse (MVP) (HR 1.584) were independent risk factors for hernia formation during PD, and female gender (HR 0.617) was a protective factor. On the other hand, there were 4,468 PD withdrawals, with cumulative incidence rates of 41% at 1 year, 66% at 3 years, and 82% at 5 years. Independent determinants for cumulative PD withdrawal included hernia formation during PD (HR 1.154), age (per 1 year increase, HR 1.014), larger dialysate volume (per 1 liter increase, HR 0.496), female gender (HR 0.763), heart failure (HR 1.092), hypertension (HR 1.207), myocardial infarction (HR 1.292), chronic obstructive pulmonary disease (COPD) (HR 1.227), cerebrovascular accident (CVA) (HR 1.364), and history of MVP (HR 0.712)ConclusionsProlonged PD duration was a risk factor for hernia formation, and female gender was protective. Hernia formation during PD therapy may increase the risk of PD withdrawal.

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Impact of Immune Parameters on Long-Term Survival in Metastatic Renal Cell Carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.2005.03.9594 ◽

2006 ◽

Vol 24 (13) ◽

pp. 1997-2005 ◽

Cited By ~ 196

Author(s):

Frede Donskov ◽

Hans von der Maase

Keyword(s):

Risk Factors ◽

Renal Cell Carcinoma ◽

Multivariate Analysis ◽

Prognostic Factors ◽

Renal Cell ◽

Prognostic Model ◽

Tumor Tissue ◽

Hazard Ratio ◽

Clinical Factors ◽

The Impact

Purpose The purpose of this study was to evaluate the impact of immunologic prognostic factors in combination with established clinical prognostic factors in patients with metastatic renal cell carcinoma (mRCC). Patients and Methods A total of 120 consecutive patients with mRCC received interleukin-2 (IL-2) -based immunotherapy. Baseline tumor biopsies were available from 85 of these patients. Potential prognostic factors were analyzed by univariate and multivariate analyses. Results Multivariate analysis (N = 120) identified high lactate dehydrogenase, lymph node metastases, low hemoglobin, low Karnofsky performance status, and bone metastases as independent poor prognostic clinical factors. The impact of these clinical factors has been demonstrated by others. Multivariate analysis (n = 85) also identified a high blood neutrophil count (> 6.0 × 109/L; hazard ratio, 2.0; P = .015), the presence of intratumoral neutrophils (> 0 cells/mm2 tumor tissue; hazard ratio, 2.3; P = .001), and low intratumoral CD57+ natural killer cell count (< 50 cells/mm2 tumor tissue; hazard ratio, 2.1; P = .01) as independent poor prognostic immunologic factors. These three independent immunologic parameters had significant discriminatory power as supplemental risk factors in prognostic models based on the clinical risk factors, identifying subgroups within the favorable clinical group with estimated 5-year survival rates of 60%, 25%, and 0%, respectively. These findings were apparent in both our own prognostic model and in an extended Memorial Sloan-Kettering Cancer Center (New York, NY) prognostic model. Conclusion This study points on five clinical and three supplemental immunologic independent prognostic factors of survival in patients with mRCC receiving IL-2.

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Bottleneck Size-Dependent Changes in the Genetic Diversity and Specific Growth Rate of a Rotavirus A Strain

10.1101/702233 ◽

2019 ◽

Author(s):

Syun-suke Kadoya ◽

Syun-ichi Urayama ◽

Takuro Nunoura ◽

Miho Hirai ◽

Yoshihiro Takaki ◽

...

Keyword(s):

Genetic Diversity ◽

Growth Rate ◽

Specific Growth Rate ◽

Specific Growth ◽

Viral Population ◽

Dependent Manner ◽

Bottleneck Effect ◽

Rotavirus A ◽

Hidden Layer ◽

The Impact

ABSTRACTRNA viruses form a dynamic distribution of mutant swarm (termed “quasispecies”) due to the accumulation of mutations in the viral genome. The genetic diversity of a viral population is affected by several factors, including a bottleneck effect. Human-to-human transmission ex-emplifies a bottleneck effect in that only part of a viral population can reach the next susceptible hosts. In the present study, the rhesus rotavirus (RRV) strain of Rotavirus A was serially passaged five times at a multiplicity of infection (MOI) of 0.1 or 0.001 in duplicate (the 1st and 2nd lineages), and three phenotypes (infectious titer, cell binding ability and specific growth rate) were used to evaluate the impact of a bottleneck effect on the RRV population. The specific growth rate values of lineages passaged under the stronger bottleneck (MOI of 0.001) were higher after five passages. The nucleotide diversity also increased, which indicated that the mutant swarms of the lineages under the stronger bottleneck effect were expanded through the serial passages. The random distribution of synonymous and non-synonymous substitutions on rotaviral genome segments indicated that almost all mutations were selectively neutral. Simple simulations revealed that the presence of minor mutants could influence the specific growth rate of a population in a mutant frequency-dependent manner. These results indicate that a stronger bottleneck effect can create more sequence spaces for minor mutants originally existing in a hidden layer of mutant swarm.IMPORTANCEIn this study, we investigated a bottleneck effect on an RRV population, which may drastically impact a viral population structure. RRV populations were serially passaged under two levels of a bottleneck effect, which exemplified a human-to-human transmission. As a result, the genetic diversity and specific growth rate of RRV populations increased under the stronger bottleneck effect, which implied that a bottleneck could create a new sequence space in a population for minor mutants originally existing in a hidden layer of a mutant swarm of the double-stranded RNA virus. The results of this study suggest that the genetic drift caused by a bottleneck in a human-to-human transmission explains the random appearance of new genetic lineages causing viral outbreaks, which can be expected by the molecular epidemiology using next generation sequencing in which the viral genetic diversity within a viral population is investigated.

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Effect of Black Tea Consumption on Urinary Risk Factors for Kidney Stone Formation

Nutrients ◽

10.3390/nu13124434 ◽

2021 ◽

Vol 13 (12) ◽

pp. 4434

Author(s):

Roswitha Siener ◽

Albrecht Hesse

Keyword(s):

Risk Factors ◽

Kidney Stone ◽

Protective Factor ◽

Fluid Intake ◽

Stone Formation ◽

Black Tea ◽

Tea Consumption ◽

Increased Risk ◽

The Impact ◽

Kidney Stone Formation

Copious fluid intake is the most essential nutritional measure in the treatment of urolithiasis, and is suggested to be a protective factor in the primary prevention of urinary stone formation. Although the intake of black tea contributes to daily fluid intake, the high oxalate content could outweigh the beneficial effect of urine dilution. The present study investigated the effect of black tea consumption on urinary risk factors for kidney stone formation. Ten healthy men received a standardized diet for a period of ten days. Subjects consumed 1.5 L/day of fruit tea (0 mg/day oxalate) during the 5-day control phase, which was replaced by 1.5 L/day of black tea (86 mg/day oxalate) during the 5-day test phase. Fractional and 24-h urines were obtained. The intake of black tea did not significantly alter 24-h urinary oxalate excretion. Urinary citrate, an important inhibitor of calcium stone formation, increased significantly, while the relative supersaturation of calcium oxalate, uric acid, and struvite remained unchanged. No significantly increased risk for kidney stone formation could be derived from the ingestion of black tea in normal subjects. Further research is needed to evaluate the impact of black tea consumption in kidney stone patients with intestinal hyperabsorption of oxalate.

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Reevaluation of risk factors for time to subsequent events after first stroke occurrence using a new weighted all-cause effect measure

10.21203/rs.2.19014/v3 ◽

2020 ◽

Author(s):

Ann-Kathrin Ozga ◽

Bernhard Rauch ◽

Frederick Palm ◽

Christian Urbanek ◽

Armin Grau ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Atrial Fibrillation ◽

Recurrent Stroke ◽

Treatment Options ◽

Composite Endpoint ◽

Hazard Ratio ◽

Variable Degree ◽

One Year ◽

The Impact

Abstract Background: Risk diseases and risk factors for stroke include atrial fibrillation, hypertension, diabetes mellitus, smoking, and elevated LDL-cholesterol. Due to modern treatment options, the impact of these risk diseases on subsequent cardiovascular events or death after a first stroke is less clear and needs to be elucidated. We therefore aimed to get insights into the persistence of adverse prognostic effects of these risk diseases and risk factors on subsequent stroke or death events one year after the first stroke by using the new weighted all-cause hazard ratio.Methods: This study evaluates the one year follow-up of 470 first ever stroke cases identified in the area of Ludwigshafen, Germany, with 23 deaths and 34 subsequent stroke events. For this purpose, the recently introduced “weighted all-cause hazard ratio” was used, which allows a weighting of the competing endpoints within a composite endpoint. Moreover, we extended this approach to allow an adjustment for covariates. Results: None of these risk factors and risk diseases, most probably being treated after the first stroke, remained to be associated with a subsequent death or stroke [weighted hazard ratios (95% confidence interval) for diabetes mellitus, atrial fibrillation, high cholesterol, hypertension, and smoking are 0.4 (0.2 - 0.9), 0.8 (0.4 - 2.2), 1.3 (0.5 - 2.5), 1.2 (0.3 - 2.7), 1.6 (0.8 - 3.6), respectively]. However, when analyzed separately in terms of death and stroke, the risk factors and risk diseases under investigation affect the subsequent event rate to a variable degree.Conclusions: Using the new weighted hazard ratio, established risk factors and risk diseases for the occurrence of a first stroke do not remain to be significant predictors for subsequent events like death or recurrent stroke. It has been demonstrated that the new weighted hazard ratio can be used for a more adequate analysis of cardiovascular risk and disease progress. The results have to be confirmed within a larger study with more events.

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Prevalence and risk factors of bovine viral diarrhea in Colombian cattle

Veterinary World ◽

10.14202/vetworld.2020.1487-1494 ◽

2020 ◽

Vol 13 (8) ◽

pp. 1487-1494

Author(s):

Diego Ortiz Ortega ◽

Rodrigo Martínez ◽

Julio César Tobón Torreglosa ◽

Juan Felipe Rocha

Keyword(s):

Risk Factors ◽

Protective Factor ◽

Neospora Caninum ◽

Bovine Viral Diarrhea ◽

Farm Level ◽

Diarrhea Virus ◽

Viral Diarrhea ◽

Study Results ◽

Cattle Herds ◽

The Impact

Background and Aim: Bovine viral diarrhea virus (BVDV) is present in most cattle-raising countries around the world, and it has a negative economic impact in cattle herds. In Colombia, previous studies have estimated the prevalence of BVDV in specific locations. The aim of this study was to estimate the prevalence of BVDV in cattle herds located at several municipalities across the country and to identify the associated risk and protective factors. Materials and Methods: A cross-sectional study was carried out to investigate the prevalence of BVDV in Colombian cattle populations at farm and animal-levels. A total of 387 herds and 8110 animals located in seven different departments were included in this study. Results: An animal- and farm-level prevalence of 36% and 69%, respectively, were estimated. A high variation for the farm-level prevalence was found among the municipalities studied. Moreover, seropositive cattle to the infectious bovine rhinotracheitis virus (odds ratio (OR)=2.38, p=0.0479) and Neospora caninum (OR=3.15, p=0.0122) were more likely to be seropositive for BVDV, while the practice of burning dead animals at the farm was identified as a protective factor (OR=0.17, p=0.014). Conclusion: The prevalence of BVDV varied more at farm-level compared to animal-level. Two risk factors and one protective factor were identified. The results of the current study are essential to understand the epidemiology of BVDV in Colombia, and to formulate strategies in the region to mitigate the impact of this virus on the productive and reproductive indicators of cattle farms at the regional level.

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