scholarly journals Differences between preterm infants receiving a dose for lung maturation and those receiving an additional rescue dose of corticosteroids

Bionatura ◽  
2021 ◽  
Vol 3 (3) ◽  
pp. 1960-1969
Author(s):  
Sandra Liliana Medina Poma ◽  
Fabricio González-Andrade
Keyword(s):  
Mechanical Ventilation ◽  
Preterm Infants ◽  
Invasive Mechanical Ventilation ◽  
Neurological Complications ◽  
Cross Sectional Study ◽  
Lung Maturation ◽  
Cross Sectional ◽  
Rescue Dose ◽  
Stay Time ◽  
The Difference

it is unknown if there is a difference between preterm infants with a history of receiving pulmonary corticosteroid maturation or using an additional rescue dose of corticosteroid. This paper aims to determine the difference between infants with pulmonary maturation and infants who received a rescue dose of corticosteroid. We performed an epidemiological, observational, and cross-sectional study. We analyzed time of stay, the requirement of mechanical ventilation, the use of surfactant, and neurological complications in newborns hospitalized in Neonatology of the Isidro Ayora Gyneco-Obstetric Hospital, 2019. We analyzed 204 preterm infants of 28-37 weeks who received a total lung maturation dose versus an added rescue dose. We analyzed the information with the statistical program SPSS v 22.0. With rescue dose the stay time was 28.4±21.6 days (p <0.05), days of invasive mechanical ventilation 3±5.7 days (p <0.05); Surfactant use 33.3% (p>0.05). We found neurological complications in 6.9% of patients (p> 0.05). In group 2 with not rescue dose use, the stay time was 21.5±16.6 days (p<0.05), days of invasive mechanical ventilation 1.8 ± 4.1 days (p <0.05). Surfactant use was 24.5% (p>0.05), and neurological complications 2% (p> 0.05). Preterm males weighing <1000 g from 30 to 32 weeks, who used rescue doses of corticosteroids, showed an increase in intraventricular hemorrhage (13.7%), seizures (6.9%), and leukomalacia (13.7%), associated with the fact that in the group with rescue dose they are younger and had lower weight.

scholarly journals Clinical and paraclinical predictive factors for in-hospital mortality in adult patients with COVID-19

2021 ◽  
Author(s):  
Seyed Alireza Mousavi ◽  
Reyhaneh Sadat Mousavi-Roknabadi ◽  
Fateme Nemati ◽  
Somaye Pourteimoori ◽  
Arefeh Ghorbani ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Mortality ◽  
Ct Scan ◽  
Predictive Factors ◽  
Invasive Mechanical Ventilation ◽  
Cross Sectional Study ◽  
Study Data ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Non Invasive

Abstract Background Since December 2019, a type of coronavirus has emerged in Wuhan, China, which has become the focus of global attention due to an epidemic of pneumonia of unknown cause, called COVID-19. This study aimed to investigate the factors affecting in-hospital mortality of patients with COVID-19 hospitalized in one of the main hospital in central Iran. Methods This retrospective cross-sectional study (February 2019-May 2020) was conducted on patients with confirmed diagnosis COVID-19, who were admitted in Yazd Shahid Sadoughi Hospital, in middle of Iran. The patients with uncompleted or missed medical files were excluded from the study. Data were extracted from the patients' medical files and then analyzed. The patients were categorized as survivors and non-survivors groups, and they were compared. Results Totally, 573 patients were enrolled, that 356 (62.2%) were male. The mean ± SD of age was 56.29 ± 17.53 years, and 93 (16.23%) were died. All the complications were more in non-survivors. Intensive care unit (ICU) admission was in 20.5% of the patients which was more in non-survivors (P < 0.001). The results of multivariate logistic regression test showed that plural effusion in lung computed tomography (CT) scan (OR = 0.055, P = 0.009), white blood cell (WBC) (OR = 1.417, P = 0.022), serum albumin (OR = 0.009, P < 0.001), non-invasive mechanical ventilation (OR = 34.315, P < 0.001), and acute respiratory distress syndrome (ARDS) (OR = 66.039, P = 0.001) were achieved as the predictive factors for in-hospital mortality were the predictive factors for in-hospital mortality. Conclusion In-hospital mortality in patients with COVID-19 was about 16%. Plural effusion in lung CT scan, WBC, albumin, non-invasive mechanical ventilation, and ARDS were obtained as the predictive factors for in-hospital mortality.

scholarly journals Combined association of obesity and other cardiometabolic diseases with severe COVID-19 outcomes: a nationwide cross-sectional study of 21,773 Brazilian adult and elderly inpatients

2021 ◽  
Author(s):  
Natanael J Silva ◽  
Rita C Ribeiro-Silva ◽  
Andrea JF Ferreira ◽  
Camila SS Teixeira ◽  
Aline S Rocha ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Dose Response ◽  
Invasive Mechanical Ventilation ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Icu Admission ◽  
Non Invasive ◽  
Elderly Inpatients

Objective: To investigate the combined association of obesity, diabetes mellitus (DM), and cardiovascular disease (CVD) with severe COVID-19 outcomes in adult and elderly inpatients. Design: Cross-sectional study based on registry data from Brazil's influenza surveillance system. Setting: Public and private hospitals across Brazil. Participants: Eligible population included 21,942 inpatients aged 20 years or older with positive RT-PCR test for SARS-CoV-2 until Jun 9th, 2020. Main outcome measures: Severe COVID-19 outcomes were non-invasive and invasive mechanical ventilation use, ICU admission, and death. Multivariate analyses were conducted separately for adults (20-59 years) and elders (>=60 years) to test the combined association of obesity (without and with DM and/or CVD) and degrees of obesity with each outcome. Results: A sample of 8,848 adults and 12,925 elders were included. Among adults, obesity with DM and/or CVD showed higher prevalence of invasive (PR 3.76, 95%CI 2.82-5.01) and non-invasive mechanical ventilation use (2.06, 1.58-2.69), ICU admission (1.60, 1.40-1.83), and death (1.79, 1.45-2.21) compared with the group without obesity, DM, and CVD. In elders, obesity alone (without DM and CVD) had the highest prevalence of ICU admission (1.40, 1.07-1.82) and death (1.67, 1.00-2.80). In both age groups, obesity alone and combined with DM and/or CVD showed higher prevalence in all outcomes than DM and/or CVD. A dose-response association was observed between obesity and death in adults: class I 1.32 (1.05-1.66), class II 1.41 (1.06-1.87), and class III 1.77 (1.35-2.33). Conclusions: The combined association of obesity, diabetes, and/or CVD with severe COVID-19 outcomes may be stronger in adults than in elders. Obesity alone and combined with DM and/or CVD had more impact on the risk of COVID-19 severity than DM and/or CVD in both age groups. The study also supports an independent relationship of obesity with severe outcomes, including a dose-response association between degrees of obesity and death in adults. These findings suggest important implications for the clinical care of patients with obesity and severe COVID-19 and support the inclusion of people with obesity in the high-risk and vaccine priority groups for protection from SARS-CoV-2.

scholarly journals High Frequency of SARS-CoV-2 RNAemia and Association With Severe Disease

2020 ◽  
Author(s):  
Catherine A Hogan ◽  
Bryan A Stevens ◽  
Malaya K Sahoo ◽  
ChunHong Huang ◽  
Natasha Garamani ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Severe Disease ◽  
Invasive Mechanical Ventilation ◽  
Tertiary Care ◽  
Prognostic Indicator ◽  
Cross Sectional Study ◽  
Clinical Severity ◽  
Plasma Samples ◽  
Cross Sectional ◽  
Icu Admission

Abstract Background Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in blood, also known as RNAemia, has been reported, but its prognostic implications are poorly understood. This study aimed to determine the frequency of SARS-CoV-2 RNA in plasma and its association with coronavirus disease 2019 (COVID-19) clinical severity. Methods An analytical cross-sectional study was performed in a single-center tertiary care institution and included consecutive inpatients and outpatients with confirmed COVID-19. The prevalence of SARS CoV-2 RNAemia and the strength of its association with clinical severity variables were examined and included intensive care unit (ICU) admission, invasive mechanical ventilation, and 30-day all-cause mortality. Results Paired nasopharyngeal and plasma samples were included from 85 patients. The median age was 55 years, and individuals with RNAemia were older than those with undetectable SARS-CoV-2 RNA in plasma (63 vs 50 years; P = .04). Comorbidities were frequent including obesity (37.6%), hypertension (30.6%), and diabetes mellitus (22.4%). RNAemia was detected in 28/85 (32.9%) of patients, including 22/28 (78.6%) who required hospitalization. In models adjusted for age, RNAemia was detected more frequently in individuals who developed severe disease including ICU admission (32.1 vs 14.0%; P = .04) and invasive mechanical ventilation (21.4% vs 3.5%; P = .02). All 4 deaths occurred in individuals with detectable RNAemia. An additional 121 plasma samples from 28 individuals with RNAemia were assessed longitudinally, and RNA was detected for a maximum duration of 10 days. Conclusions This study demonstrated a high proportion of SARS-CoV-2 RNAemia, and an association between RNAemia and clinical severity suggesting the potential utility of plasma viral testing as a prognostic indicator for COVID-19.

scholarly journals Characteristics and Clinical Course of Adult in-Patients With SARS-CoV-2 Pneumonia in Bogotá, Colombia.

2021 ◽  
Author(s):  
Javier Leonardo Galindo ◽  
Juan Ricardo Lutz ◽  
María Alejandra Izquierdo ◽  
Katherine Parra ◽  
Lina María Prieto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Invasive Mechanical Ventilation ◽  
Underlying Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Icu Admission ◽  
Arterial Ph ◽  
Critical Care Admission

Abstract Background: SARS-CoV-2 virus has spread worldwide causing a crisis in healthcare systems. We aimed to describe the clinical characteristics and to explore risk factors of death, critical care admission and use of invasive mechanical ventilation in hospitalized patients with SARS-CoV-2 pneumonia in Bogotá, Colombia.Methods: We conducted a cross-sectional study of adult patients with laboratory-confirmed SARS-CoV-2 pneumonia. Demographic and clinical data were extracted from electronic records. Univariate and multivariable methods were performed to investigate the relationship between each variable and clinical outcomes at 28 days of follow-up.Results: Between March 20 and June 30, 2020, 377 adults (56.8% male) were included in the study, of whom 85 (22.6%) died. Non-survivors were older on average than survivors (mean age, 56.7 years [SD 15.8] vs. 70.1 years [SD 13.9]) and more likely male (28 [32.9%] vs. 57 [67.1%]). Most patients had at least one underlying disease (333 [88.3%]), including arterial hypertension (149 [39.5%]), overweight (145 [38.5%]) and obesity (114 [30.2%]). Critical care admission (158 [41.9%]) and invasive mechanical ventilation (123 [32.6%]) was high. Age over 65 years (OR 9.26, 95% CI 3.29-26.01; p=0.00), ICU admission (OR 12.37, 95% CI 6.08-25.18; p=0.00), and arterial pH higher than 7.47 (OR 0.25, 95% CI 0.08-0.74; p=0.01) were associated with in-hospital mortality.Conclusions: In this study of in-hospital patients with SARS-CoV-2 pneumonia frequency of death was similar to what has been reported. ICU admission and use of invasive mechanical ventilation was high. Risk factors as older age, ICU admission, and arterial pH were associated with mortality.

scholarly journals Combined association of obesity and other cardiometabolic diseases with severe COVID-19 outcomes: a nationwide cross-sectional study of 21 773 Brazilian adult and elderly inpatients

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e050739
Author(s):  
Natanael de Jesus Silva ◽  
Rita de Cássia Ribeiro-Silva ◽  
Andrêa Jacqueline Fortes Ferreira ◽  
Camila Silveira Silva Teixeira ◽  
Aline Santos Rocha ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Dose Response ◽  
Invasive Mechanical Ventilation ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Icu Admission ◽  
Non Invasive ◽  
Elderly Inpatients

ObjectivesTo investigate the combined association of obesity, diabetes mellitus (DM) and cardiovascular disease (CVD) with severe COVID-19 outcomes in adult and elderly inpatients.DesignCross-sectional study based on registry data from Brazil’s influenza surveillance system.SettingPublic and private hospitals across Brazil.ParticipantsEligible population included 21 942 inpatients aged ≥20 years with positive reverse transcription-PCR test for SARS-CoV-2 until 9 June 2020.Main outcome measuresSevere COVID-19 outcomes were non-invasive and invasive mechanical ventilation use, intensive care unit (ICU) admission and death. Multivariate analyses were conducted separately for adults (20–59 years) and elders (≥60 years) to test the combined association of obesity (without and with DM and/or CVD) and degrees of obesity with each outcome.ResultsA sample of 8848 adults and 12 925 elders were included. Among adults, obesity with DM and/or CVD showed higher prevalence of invasive (prevalence ratio 3.76, 95% CI 2.82 to 5.01) and non-invasive mechanical ventilation use (2.06, 1.58 to 2.69), ICU admission (1.60, 1.40 to 1.83) and death (1.79, 1.45 to 2.21) compared with the group without obesity, DM and CVD. In elders, obesity alone (without DM and CVD) had the highest prevalence of ICU admission (1.40, 1.07 to 1.82) and death (1.67, 1.00 to 2.80). In both age groups, obesity alone and combined with DM and/or CVD showed higher prevalence in all outcomes than DM and/or CVD. A dose–response association was observed between obesity and death in adults: class I 1.32 (1.05 to 1.66), class II 1.41 (1.06 to 1.87) and class III 1.77 (1.35 to 2.33).ConclusionsThe combined association of obesity, diabetes and/or CVD with severe COVID-19 outcomes may be stronger in adults than in elders. Obesity alone and combined with DM and/or CVD had more impact on the risk of COVID-19 severity than DM and/or CVD in both age groups. The study also supports an independent relationship of obesity with severe outcomes, including a dose–response association between degrees of obesity and death in adults.

scholarly journals Characteristics and Clinical Course of Adult in-Patients With SARS-CoV-2 Pneumonia in Bogotá, Colombia.

2021 ◽  
Author(s):  
Javier Leonardo Galindo ◽  
Juan Ricardo Lutz ◽  
María Alejandra Izquierdo ◽  
Katherine Parra ◽  
Lina María Prieto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Invasive Mechanical Ventilation ◽  
Underlying Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Icu Admission ◽  
Arterial Ph ◽  
Critical Care Admission

Abstract Background: SARS-CoV-2 virus has spread worldwide causing a crisis in healthcare systems. We aimed to describe the clinical characteristics and to explore risk factors of death, critical care admission and use of invasive mechanical ventilation in hospitalized patients with SARS-CoV-2 pneumonia in Bogotá, Colombia.Methods: We conducted a cross-sectional study of adult patients with laboratory-confirmed SARS-CoV-2 pneumonia. Demographic, clinical, and treatment data were extracted from electronic records. Univariate and multivariable methods were performed to investigate the relationship between each variable and clinical outcomes at 28 days of follow-up.Results: Between March 20 and June 30, 2020, 377 adults (56.8% male) were included in the study, of whom 85 (22.6%) died. Non-survivors were older on average than survivors (mean age, 56.7 years [SD 15.8] vs. 70.1 years [SD 13.9]) and more likely male (28 [32.9%] vs. 57 [67.1%]). Most patients had at least one underlying disease (333 [88.3%]), including arterial hypertension (149 [39.5%]), overweight (145 [38.5%]), obesity (114 [30.2%]) and diabetes mellitus (82 [21.8%]). Frequency of critical care admission (158 [41.9%]) and invasive mechanical ventilation (123 [32.6%]) was high. Age over 65 years (OR 9.26, 95% CI 3.29-26.01; p=0.00), ICU admission (OR 12.37, 95% CI 6.08-25.18; p=0.00), and arterial pH higher than 7.47 (OR 0.25, 95% CI 0.08-0.74; p=0.01) were independently associated with in-hospital mortality.Conclusions: In this study of in-hospital patients with SARS-CoV-2 pneumonia frequency of death was similar to what has been reported. ICU admission and use of invasive mechanical ventilation was high. Risk factors as older age, ICU admission, and arterial pH were associated with mortality.

scholarly journals Characteristics of related infections health care in an intensive care unit of a hospital school goiânia-goiáscity

2019 ◽  
pp. 31570-31573
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Demographic Data ◽  
Invasive Mechanical Ventilation ◽  
Invasive Procedure ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Candida Sp ◽  
Bladder Catheterization

Objective: To describe the types of HAI in a public intensive care unit in the city of Goiânia. Method: a descriptive cross-sectional study conducted in an Intensive Care Unit between March and August 2012. A structured questionnaire was used, involving demographic data, hospitalization, risk factors and comorbidities. Results: 38 infections were identified in 26 patients. The HAI rate was 13%, pneumonia had the highest incidence 63%, followed by bloodstream infection with 13%, and surgical site 10%. Regarding the procedures, 92% of the patients were exposed to bladder catheterization, 65% used invasive mechanical ventilation and 61% underwent central venous catheterization. Pseudomonas aeruginosa was the most isolated microorganism, with an incidence of 29%, followed by Acinetobacterbaumannii, 25.8%, and Candida sp. 11%. Conclusion: Among all HAI, there was a predominance of mechanical ventilation-associated pneumonia (VAP), although bladder catheterization was the most common invasive procedure. It is believed that continuing education with all ICU staff combined with daily auditing can improve the results obtained.

scholarly journals Duration of Meconium Passage in Term and Preterm Infants

2013 ◽  
Vol 4 (1) ◽  
pp. 6-9
Author(s):  
Mumtahina Setu ◽  
Md Abid Hossain Mollah ◽  
Syed Khairul Amin ◽  
S M Nahid Morshed ◽  
Mehdi Pervez ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
First Passage ◽  
College Hospital ◽  
Term Infants ◽  
Cross Sectional ◽  
Group I ◽  
The Mean ◽  
The Difference

Delayed first passage of meconium and also prolongation of meconium passage creates great anxiety among parents. Some study showed that that first passage of meconium is delayed in preterm infants compared to term infants. The difference in duration of meconium passage in term and preterm infant has however never been assessed before. This cross sectional study was carried between July 2010 to December 2010 among 100 Newborn babies ranging from 28 to 42 weeks of gestation who were delivered in the Department of Obstetrics and Gynaecology or admitted in the Department of Neonatology of Dhaka Medical college Hospital were included in the study. Gestational age was determined from first day of last menstruation (when available) and also by using Expanded Ballard Scoring System. In case of any discrepancy of more than 2 weeks, the later was accepted. This study was carrying out to determine the time of first passage of meconium and duration of passage of meconium in term and preterm infants. Out of total 100 infants, 58 were male and 42 were female. The numbers of babies were 21, 28, 25 and 26 in group I, II, III and IV respectively. The mean age at which the babies passed first meconium were 23.5±3.5, 33.0±3.8, 25.7±4.2 and 17.3±4.6 hours in group I, II, III and IV respectively, which was<48 hours irrespective of gestational age. The mean gestational age of the babies who passed meconium for <4 days was 37.1±2.2 weeks. On the contrary, mean gestational age of the babies who passed meconium for>4 days was 32.6±4.3 weeks and this observation was statistically significant (p<0.001). First passage of meconium in all newborn was within 48 hours irrespective of gestational age. Duration of passage of meconium was significantly prolonged among babies with lower gestational age. DOI: http://dx.doi.org/10.3329/akmmcj.v4i1.13677 AKMMC J 2013; 4(1): 6-9

Perceived social support and burden of care of male and female caregivers of patient with schizophrenia

2017 ◽  
Vol 8 (1) ◽  
pp. 10
Author(s):  
Narendra Kumar Singh ◽  
Nishant Goyal
Keyword(s):  
Social Support ◽  
Perceived Social Support ◽  
Family Members ◽  
Well Being ◽  
Cross Sectional Study ◽  
Burden Of Care ◽  
Cross Sectional ◽  
Male And Female ◽  
The Social ◽  
The Difference

Background: Schizophrenia is associated with a high familial, social and economic burden. Schizophrenia is also associated with a high level of disability which may create impediments on the social and economic areas of the patients as well as on their respective family networks. Families with schizophrenia may encounter problems such as impairment of health and well being of other family members, restriction of social activities of the family members and shrinking of support from the social network. Aims: The present study examined the difference in perceived social support and burden of care between the male and female caregivers of patients with schizophrenia. Methods: This was a cross-sectional study examining the difference in perceived social support and burden of care between the male and female caregivers of patients with schizophrenia. The sample consisted of 60 (30 male and 30 female) caregivers of the patients with the diagnosis of schizophrenia as per ICD-10-DCR. Results and Conclusion: This study revealed that male caregivers perceived more social support and less burden of care as compared to female caregivers. Key words: Gender, social support, burden

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