scholarly journals Bacterial and Fungal Co-infection in a Cohort of 333 Patients Hospitalized for COVID-19 (COINFECOVID Study)

2021 ◽  
Author(s):  
Vicente Abril ◽  
Neus Gómez ◽  
Hilary Piedrahita ◽  
Mercedes Chanzá ◽  
Nuria Tormo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retrospective Study ◽  
Medical Records ◽  
Bacterial Infections ◽  
Main Risk Factor ◽  
Candida Spp ◽  
Factors Associated ◽  
Icu Stay ◽  
Prolonged Icu Stay

Abstract BackgroundCoinfections in COVID19 appear to worsen hospitalized patients prognosis.ObjectiveTo describe the characteristics of bacterial and fungal coinfections in patients admitted for COVID19 and to identify the risk factors associated with its occurrence.Patients and MethodsSingle-center retrospective study reviewing medical records of patients with COVID19 diagnosed with bacterial or fungal infection during hospital admission.Results333 patients were analyzed during March 15-May 15, 2020. 16.82% had some coinfection during admission. Coinfections were more frequent in patients with comorbidities (80.36% vs 19.64% p<0.025) and in those ICU admitted (52.46% vs 8.86%, p<0.001). Coinfections were significantly more frequent in patients with neutrophilia>7500 and increased procalcitonin on admission as well as lymphopenia<1500 on day 5. Mortality in patients with coinfection was 26.79% vs 23.47% in non-coinfected (p 0.596). Length of stay was longer in coinfected patients (mean 30.59 vs 13.47, p<0.01). Most frequent microorganisms were Enterococci, Candida spp, Enterobacteriaceae and Pseudomonas spp. 74% of patients received ceftriaxone: 17.34% of those treated had a coinfection compared to 15.48% not treated (p 0.694).ConclusionsOccurrence of coinfections is frequent and prolongs hospital stay without influencing mortality. The presence of comorbidities and ICU stay were identified as the main risk factor for coinfection, while increased neutrophils and procalcitonin at admission and lymphopenia during evolution were the main biological predictors. Enterococcus was the most frequent pathogen. Ceftriaxone use does not protect against appearance of bacterial infections. C. albicans was the most frequently isolated fungus and was associated with prolonged ICU stay.

Risk factors for screw migration after triple pelvic osteotomy

2001 ◽  
Vol 37 (3) ◽  
pp. 269-273 ◽  
Author(s):  
S Simmons ◽  
AL Johnson ◽  
DJ Schaeffer
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Medical Records ◽  
Pelvic Osteotomy ◽  
Factors Associated

The objective of this retrospective study was to identify risk factors for screw migration after triple pelvic osteotomy (TPO) in clinical patients. The medical records, radiographs made immediately after surgery, and follow-up radiographs documenting a healed osteotomy were reviewed for 52 dogs treated with unilateral TPO and 38 dogs treated with bilateral TPO. Signalment, surgeon expertise, length of surgery, sequence of surgery in dogs treated bilaterally, use of ischial or ilial wires or both, screw depth in the sacrum, and screw migration were documented for each of the 128 pelvic osteotomies. Screws placed in the first and second plate hole, securing the cranial portion of the plate, loosened most frequently. Factors associated with decreased screw migration included use of an ischial hemicerclage wire and increased depth of sacral purchase with the first and second cranial screws.

scholarly journals Subtype I (intrinsic) adenomyosis is an independent risk factor for dienogest-related serious unpredictable bleeding in patients with symptomatic adenomyosis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Sho Matsubara ◽  
Ryuji Kawaguchi ◽  
Mika Akinishi ◽  
Mika Nagayasu ◽  
Kana Iwai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retrospective Study ◽  
Medical Records ◽  
Independent Risk Factor ◽  
Univariate Analysis ◽  
Structural Type ◽  
Hemoglobin Level ◽  
Independent Variables

AbstractWe aimed to retrospectively analyze the risk factors of a continuous dienogest (DNG) therapy for serious unpredictable bleeding in patients with symptomatic adenomyosis. This is a retrospective study based on data extracted from medical records of 84 women treated with 2 mg of DNG orally each day between 2008 and 2017. 47 subjects were excluded from the original analyses due to an inadequate subcategorization into subtype I and subtype II and a lack of hemoglobin levels. The influence of various independent variables on serious unpredictable bleeding was assessed. Of the 37 eligible patients who received the continuous DNG therapy, 14 patients experienced serious unpredictable bleeding. Univariate analysis revealed that the serious bleeding group had subtype I adenomyosis (P = 0.027). There was no correlation between age, parity, minimum hemoglobin level before treatment, previous endometrial curettage, and duration of DNG administration, or uterine or adenomyosis size and the serious bleeding. A DNG-related serious unpredictable bleeding is associated with the structural type of adenomyosis (subtype I) in patients with symptomatic adenomyosis.

scholarly journals Risk Factors associated with Still Births

2010 ◽  
Vol 49 (177) ◽  
Author(s):  
S R Shrestha ◽  
B K Yadav
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retrospective Study ◽  
Adverse Outcome ◽  
Fetal Distress ◽  
Birth Injury ◽  
Still Birth ◽  
Factors Associated ◽  
Still Births ◽  
Associated Risk Factors

INTRODUCTION: Still birth is a common adverse outcome of pregnancy, associated with many risk factors like prematurity, infection, birth injury, eclamptic disorders. METHODS: A hospital based, retrospective study was conducted at Patan Hospital in the year 2064. The number of still births and their associated risk factors were assessed. RESULTS: There were three thousand and five hundred and eighty eight deliveries. Among all deliveries, still birth cases were counted forty seven with a rate of 14 per thousand deliveries. The major risk factors were prematurity, low birth weight, fetal distress and maternal jaundice. CONCLUSIONS: Prematurity was the commonest risk factor for still birth.  

Retrospective study of 476 tibial plateau levelling osteotomy procedures

2011 ◽  
Vol 24 (05) ◽  
pp. 333-341 ◽  
Author(s):  
J. Dupuis ◽  
J. Planté ◽  
M. Moreau ◽  
M. Gatineau
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retrospective Study ◽  
Postoperative Complications ◽  
Tibial Plateau ◽  
Pivot Shift ◽  
Activity Level ◽  
Sample Population ◽  
Factors Associated ◽  
Stifle Joint

SummaryObjective: To determine the rate of subsequent ‘pivot shift’, meniscal tear and risk factors associated with complications of tibial plateau levelling osteotomy (TPLO) and to assess clinical and owner perception outcome.Study design: Retrospective study.Sample population: Three hundred and forty-eight dogs that had undergone TPLO surgical procedures (n = 476 stifles).Methods: Medical records were reviewed for the retrieval of information on breed, sex, age, body weight, clinical history, radiograph findings, pre- and postoperative tibial plateau angle, limb alignment, unilateral versus bilateral disease, condition of cranial cruciate ligament (CCL) and menisci, implant material, healing time and complications. Clinical and owner-assessed questionnaire outcomes were also recorded.Results: Forty-six (9.7%) postoperative complications were reported. Twenty (4.2%) were classified as major complications requiring an additional surgical intervention, and 26 (5.5%) as minor complications. No risk factors associated with postoperative complications were identified. Ten (2.1%) subsequent meniscal injuries in the stifles with normal unaltered menisci at time of TPLO were reported with a median postoperative time of 9.5 months. Signs of postoperative ‘pivot shift’ were reported in 15 (3.1%) stifles. All stifles with a ‘pivot shift’ had a complete CCL rupture or a debrided partial CCL rupture a medial menisectomy was identified as a risk factor for a ‘pivot shift’ (p = 0.02). Dogs with intact medial meniscus had a significantly higher activity level (p <0.0001) and a shorter time to peak function (p = 0.02) than dogs that underwent menisectomy according to an owner questionnaire.Conclusions: Dogs with TPLO and intact meniscus seemed to have a better and faster recovery than dogs with TPLO and menisectomy based on owner questionnaires. ‘Pivot shift’ was infrequent after TPLO surgery. All dogs with a ‘pivot shift’ had a complete CCL rupture or a debrided partial CCL rupture and menisectomy was identified as a risk factor for its occurrence.Clinical relevance: Considering the relatively low rate of subsequent meniscal injury after TPLO, systematic medial meniscal release with TPLO may be unnecessary. The ‘pivot shift’ deserved further investigation to completely understand its mechanism, to identify its anatomic components and potential consequences on the stifle joint.

scholarly journals RI SK FACTOR OF BACTEREMI A I N CHI LDREN WI TH PNEUMONIA

2015 ◽  
Vol 2 (1) ◽  
pp. 34
Author(s):  
Retno Asih
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Retrospective Study ◽  
Blood Culture ◽  
Hospital Admission ◽  
Clinical Features ◽  
Medical Records ◽  
Blood Cultures ◽  
Factors Associated ◽  
Increased Risk

Background: Pneumonia is known as a frequent cause of morbidity and mortality among children in developing countries. In children,it caused predominantly by bacteria. Bacteremia has been associated with severity and mortalitas of pneumonia. Identify factors caused bacteremia important to prevent severity and mortalitas of pneumonia. Objective: The objective of this study was to identify risk factors of bacteremia in children with pneumonia. Methods: A retrospective study was conducted in children with pneumonia in Dr. Soetomo Surabaya Hospital from January 2007 to December 2008. Blood cultures be performed on all of this patients. Factors associated with bacteremia were identified following review of medical records include clinical features, laboratory , radiology and blood culture results. Results: Frequency of bacteremia was 8,2% (36 patients) of 438 children with pneumonia. Interval from onset of symptoms to hospital admission more than 5 days (22.69 CI 95%), severe malnourished (OR 9.05 CI 95%), anemia (OR 2.44 CI 95%), leucocyt counts less than 5000/mm3 and more than 20.000/mm3 (OR 2.41 CI 95%) and paO2 less than 80 mmHg (OR 4.25 CI 95%) were at increased risk of bacteremia in children with pneumonia. Conclusion: Risk factors bacteremia in children with pneumonia included age under 1 year, symptoms more than 5 days, severe malnourished ,anemia, leucosyt counts less than 5000/mmand more than 20.000/mm3 and paO2 less than 80 mmHg.

scholarly journals Microbial findings and the role of difficult-to-treat pathogens in patients with periprosthetic infection admitted to the intensive care unit

2020 ◽  
Vol 12 (3) ◽  
Author(s):  
Christopher Ull ◽  
Emre Yilmaz ◽  
Hinnerk Baecker ◽  
Thomas Schildhauer ◽  
Christian Waydhas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Joint Infection ◽  
Candida Spp ◽  
Icu Stay ◽  
Tertiary Healthcare ◽  
Prolonged Icu Stay

Little is known about patients with Periprosthetic Joint Infection (PJI) admitted to the Intensive Care Unit (ICU). The purpose of this study was threefold: i) To report the microbiological findings of ICUpatients with PJI. ii) To compare the clinical data between Difficult-To-Treat (DTT) and non-DTT PJI. iii) To identify risk factors for mortality. This is a retrospective study from a tertiary healthcare center in Germany from 2012-2016. A total of 124 patients with 169 pathogens were included. The most common bacteria were Staphyloccous aureus (26.6%), Staphyloccus epidermidis (12.4%), Enterococci ssp. and Escherichia coli (respectively 9.4%). DTT PJI was diagnosed in 28 patients (22.6%). The main pathogens of DTT PJI were Staphylococus epidermidis (14.5%), Escherichia coli (12.7%), Staphylococcus aureus and Candida spp. (respectively 9.1%). Polymicrobial PJI, number of pathogens, ICU stay and mortality were significantly differrent between DTT PJI and non-DTT PJI (p≤0.05). Multivariate logistic regression identified prolonged ICU stay and DTT PJI as risk factors for mortality. In conclusion, we suggest, that the term of DTT pathogens is useful for the intensivist to assess the clinical outcome in ICU-patients with PJI.

scholarly journals Factors influencing length of intensive care unit stay following a bidirectional cavopulmonary shunt

2021 ◽  
Author(s):  
Takashi Kido ◽  
Masamichi Ono ◽  
Lisa Anderl ◽  
Melchior Burri ◽  
Martina Strbad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Risk Factor ◽  
Intensive Care ◽  
Pulmonary Artery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Icu Stay ◽  
Prolonged Icu Stay ◽  
Cavopulmonary Shunt

Abstract OBJECTIVES The goal of this study was to identify the risk factors for prolonged length of stay (LOS) in the intensive care unit (ICU) after a bidirectional cavopulmonary shunt (BCPS) procedure and its impact on the number of deaths. METHODS In total, 556 patients who underwent BCPS between January 1998 and December 2019 were included in the study. RESULTS Eighteen patients died while in the ICU, and 35 died after discharge from the ICU. Reduced ventricular function was significantly associated with death during the ICU stay (P = 0.002). In patients who were discharged alive from the ICU, LOS in the ICU [hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.02–1.06; P &lt; 0.001] and a dominant right ventricle (HR 2.41, 95% CI 1.03–6.63; P = 0.04) were independent risk factors for death. Receiver operating characteristic analysis identified a cut-off value for length of ICU stay of 19 days. Mean pulmonary artery pressure (HR 1.03, 95% CI 1.01–1.05; P = 0.04) was a significant risk factor for a prolonged ICU stay. CONCLUSIONS Prolonged LOS in the ICU with a cut-off value of 19 days after BCPS was a significant risk factor for mortality. High pulmonary artery pressure at BCPS was a significant risk factor for a prolonged ICU stay.

Social and individual factors associated with condom use among single youths: an analysis of the 2018 Cameroon Demographic and Health Survey

2021 ◽  
pp. 1-27
Author(s):  
Jean-Robert Mburano Rwenge ◽  
Franklin Bouba Djourdebbe ◽  
Emmanuel Ekambi Ekambi
Keyword(s):  
Risk Factor ◽  
Condom Use ◽  
Sexual Intercourse ◽  
Health Survey ◽  
Protective Factor ◽  
Multivariate Logistic Regression Analysis ◽  
Demographic And Health Survey ◽  
Main Risk Factor ◽  
Factors Associated ◽  
Service Sectors

Abstract In Cameroon, two-fifths of the population is between the age of 15 and 24. Adolescents and youths are an important social group for the development of the country and the realization of the demographic dividend. The promotion of sexual and reproductive health will enable youth to transform their potential into development. This study aimed to identify the determinants of condom use at last sexual intercourse among single youths, highlight gender differences in the factors associated with condom use and identify the characteristics of youths who were less likely to use condoms. Data were taken from the 2018 Cameroon Demographic and Health Survey. The study sample comprised 1464 single females and 989 single males age 15–24. Multivariate logistic regression analysis was used to test the study hypotheses. Overall, 51% of the female and 66% of the male youths reported using condoms at last sexual intercourse. For both sexes, the protective factor was not having children. Among the females, belonging to the Bamileke or Mbo ethnic groups and delaying first sexual intercourse were also protective, while working in the modern or service sectors was the main risk factor. Among male youths, residing in households whose heads had a higher educational level was protective and household poverty was the main risk factor. These findings support Cameroon’s multi-sectoral approach to HIV/AIDS prevention among youths, and emphasize the importance of involving parents, teachers and youths in prevention strategies.

scholarly journals 798. Metronidazole Exposure Prior to Clostridiodes difficile Infection (CDI) is a Risk Factor for Severe C. difficile Disease in Cancer Patients

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S442-S443
Author(s):  
Denise Marie A Francisco ◽  
Liangliang Zhang ◽  
Ying Jiang ◽  
Adilene Olvera ◽  
Eduardo Yepez Guevara ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cancer Patients ◽  
Research Study ◽  
Research Support ◽  
Factors Associated ◽  
Patients With Cancer ◽  
Study Investigator ◽  
Severity Levels ◽  
Permutation Analysis

Abstract Background Antibiotic use is a risk factor for CDI. Few studies have correlated use of prior antibiotics with CDI severity in cancer patients. This study identified clinical and microbiology risk factors associated with severe CDI in patients with cancer. We hypothesized that previous antibiotic exposure and microbiome composition at time of CDI presentation, are risk factors for severe disease in cancer patients. Methods This non-interventional, prospective, single-center cohort study examined patients with cancer who had their first episode or first recurrence of CDI between Oct 27, 2016 and Jul 1, 2019. C. difficile was identified using nucleic acid amplification testing. Multivariate analysis was used to determine significant clinical risk factors for severe CDI as defined in the 2018 IDSA/SHEA guidelines. Alpha, and beta diversities were calculated to measure the average species diversity and the overall microbial composition. Differential abundance analysis and progressive permutation analysis were used to single out the significant microbial features that differed across CDI severity levels. Results Patient (n=200) demographics show mean age of 60 yrs., 53% female, majority White (76%) and non-Hispanic (85%). Prior 90 day metronidazole use (Odds Ratio OR 4.68 [1.47-14.91] p0.009) was a significant risk factor for severe CDI. Other factors included Horn’s Index &gt; 2 (OR 7.75 [1.05-57.35] p0.045), Leukocytosis (OR 1.29 [1.16-1.43] p&lt; 0.001), Neutropenia (OR 6.01 [1.34-26.89] p0.019) and Serum Creatinine &gt;0.95 mg/dL (OR 25.30 [8.08-79.17] p&lt; 0.001). Overall, there were no significant differences in alpha and beta diversity between severity levels. However, when identifying individual microbial features, the high presence of Bacteroides uniformis, Ruminococceae, Citrobacter koseri and Salmonella were associated with protection from severe CDI (p&lt; 0.05). Table 1 - Results of multivariate logistic regression analysis of factors associated with severe CDI Figure 1. Microbiome features identified by progressive permutation analysis as seen in a volcano plot. Conclusion A number of risk factors for severe CDI were identified among this population, including prior 90 day metronidazole use. Also, increased relative abundance of Bacteroides uniformis, Ruminococceae, Citrobacter koseri and Salmonella were linked to protection from severe CDI. Reducing metronidazole use in patients with cancer may help prevent subsequent severe CDI. Disclosures Adilene Olvera, MPH MLS (ASCP), MERK (Grant/Research Support, Scientific Research Study Investigator) Kevin W. Garey, PharmD, MS, FASHP, Merck & Co. (Grant/Research Support, Scientific Research Study Investigator) Ryan J. Dillon, MSc, Merck & Co., Inc., (Employee) Engels N. Obi, PhD, Merck & Co. (Employee)

scholarly journals Effect of Instruction on Preventing Delayed Bleeding after Colorectal Polypectomy and Endoscopic Mucosal Resection

2021 ◽  
Vol 10 (5) ◽  
pp. 928
Author(s):  
Takuya Okugawa ◽  
Tadayuki Oshima ◽  
Keisuke Nakai ◽  
Hirotsugu Eda ◽  
Akio Tamura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Colorectal Polyp ◽  
Control Group ◽  
Single Center ◽  
Antithrombotic Agents ◽  
Delayed Bleeding ◽  
Factors Associated ◽  
Independent Risk Factors ◽  
Continuous Use

Background: The frequency of delayed bleeding after colorectal polypectomy has been reported as 0.6–2.8%. With the increasing performance of polypectomy under continuous use of antithrombotic agents, care is required regarding delayed post-polypectomy bleeding (DPPB). Better instruction to educate endoscopists is therefore needed. We aimed to evaluate the effect of instruction and factors associated with delayed bleeding after endoscopic colorectal polyp resection. Methods: This single-center, retrospective study was performed to assess instruction in checking complete hemostasis and risk factors for onset of DPPB. The incidence of delayed bleeding, comorbidities, and medications were evaluated from medical records. Characteristics of historical control patients and patients after instruction were compared. Results: A total of 3318 polyps in 1002 patients were evaluated. The control group comprised 1479 polyps in 458 patients and the after-instruction group comprised 1839 polyps in 544 patients. DPPB occurred in 1.1% of polyps in control, and 0.4% in after-instruction. Instruction significantly decreased delayed bleeding, particularly in cases with antithrombotic agents. Hot polypectomy, clip placement, and use of antithrombotic agents were significant independent risk factors for DPPB even after instruction. Conclusion: The rate of delayed bleeding significantly decreased after instruction to check for complete hemostasis. Even after instruction, delayed bleeding can still occur in cases with antithrombotic agents or hot polypectomy.

Sign in / Sign up

Export Citation Format

Share Document