Late-Onset Cryopyrin-Associated Periodic Syndromes due to Somatic NLRP3 Mosaicism: Experience from a Tertiary Center in Spain

2017 ◽  
Author(s):  
Anna Mensa-vilaro
Keyword(s):  
Late Onset ◽  
Tertiary Center

Trends in prescribing patterns of antiepileptic drugs among older adult inpatients in a Brazilian tertiary center

2021 ◽  
Vol 79 (1) ◽  
pp. 22-29
Author(s):  
Telma ASSIS ◽  
Aroldo BACELLAR ◽  
Luan CÔRTES ◽  
Silas SANTANA ◽  
Gersonita COSTA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiepileptic Drugs ◽  
Older Adult ◽  
Late Onset ◽  
Multivariate Logistic Regression Analysis ◽  
Prescribing Patterns ◽  
Convulsive Status Epilepticus ◽  
Tertiary Center ◽  
Symptomatic Seizures ◽  
Acute Symptomatic Seizures

ABSTRACT Background: Data on prescribing patterns of antiepileptic drugs (AEDs) to older adult inpatients are limited. Objective: To assess changes in prescribing patterns of AEDs to older adult inpatients with late-onset epilepsy between 2009-2010 and 2015-2019, and to interpret any unexpected patterns over the 2015-2019 period. Methods: Patients aged ≥60 years with late-onset epilepsy from a tertiary center were selected. Demographic data, seizure characteristics and etiology, comorbidities, and comedications were analyzed, in addition to prescription regimens of inpatients taking AEDs to treat epilepsy. AED regimens were categorized into two groups: group 1 included appropriate AEDs (carbamazepine, oxcarbazepine, valproic acid, gabapentin, clobazam, lamotrigine, levetiracetam, topiramate, and lacosamide); and group 2 comprised suboptimal AEDs (phenytoin and phenobarbital). Multivariate logistic regression analysis was performed to identify risk factors for prescription of suboptimal AEDs. Results: 134 patients were included in the study (mean age: 77.2±9.6 years). A significant reduction in the prescription of suboptimal AEDs (from 73.3 to 51.5%; p<0.001) was found; however, phenytoin remained the most commonly prescribed AED to older adult inpatients. We also found an increase in the prescription of lamotrigine (from 5.5 to 33.6%) and levetiracetam (from 0 to 29.1%) over time. Convulsive status epilepticus (SE) and acute symptomatic seizures associated with remote and progressive etiologies were risk factors for the prescription of suboptimal AEDs. Conclusions: Phenytoin was the main suboptimal AED prescribed in our population, and convulsive SE and acute symptomatic seizures associated with some etiologies were independent risk factors for phenytoin prescription. These results suggest ongoing commitment to reducing the prescription of suboptimal AEDs, particularly phenytoin in Brazilian emergence rooms.

Maternal and Perinatal Outcomes of Early-onset and Late-onset Preeclampsia at a Tertiary Center Hospital

2021 ◽  
Vol 13 (5) ◽  
pp. 338-342
Author(s):  
Muhammad IA Akbar ◽  
Hapsari Kinanti ◽  
Ernawati E Ernawati ◽  
Pudji Lestari
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Perinatal Outcomes ◽  
Tertiary Center ◽  
Center Hospital

Potential Clinical Predictors of Suspected Early and Late Onset Sepsis (EOS and LOS) in Preterm Newborns: a Single Tertiary Center Retrospective Study

2019 ◽  
Vol 65 (07/2019) ◽  
Author(s):  
Melinda Baizat ◽  
Gabriela Zaharie ◽  
Mihaela Iancu ◽  
Daniel Muresan ◽  
Monica Hășmășanu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Late Onset ◽  
Clinical Predictors ◽  
Late Onset Sepsis ◽  
Tertiary Center ◽  
Preterm Newborns

scholarly journals Microorganisms and clinical outcomes of early- and late-onset ventilator-associated pneumonia at Srinagarind Hospital, a tertiary center in Northeastern Thailand

2021 ◽  
Author(s):  
Pavarit Arayasukawat ◽  
Apichart - So-ngern ◽  
Wipa Reechaipichitkul ◽  
Worawat Chumpangern ◽  
Itthiphat Arunsurat ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Late Onset ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Ventilator Associated Pneumonia ◽  
Cross Sectional ◽  
Tertiary Center ◽  
Resistance Patterns

Abstract Background: Ventilator-associated pneumonia (VAP) is a common nocosomial infection in intensive care unit (ICU). Local microbiological surveillance of pathogens and resistance patterns for early-onset VAP (EOVAP) and late-onset VAP (LOVAP) will help to choose appropriate empiric antibiotics. Objective: To compare the multi-drug resistant (MDR) pathogens, treatment outcomes, and factors associated with hospital mortality of VAP. Method: A cross-sectional study between 1 January 2015 and 31 December 2017 at Srinagarind hospital, Khon Kaen University was conducted. The demographic data, causative pathogens, hospital length of stay (LOS), ICU LOS, mechanical ventilator (MV) days, and hospital mortality were retrospectively reviewed. Results: One hundred and ninety patients were enrolled; 42 patients (22%) were EOVAP and 148 patients (78%) were LOVAP. Acinetobacter baumannii was the most common pathogen in both groups (50 % EOVAP vs 52.7% LOVAP). MDR pathogens were significant greater in LOVAP (81.8 %) than EOVAP (61.9%) (p = 0.007). The EOVAP had a significantly better ICU LOS (median (interquartile range, IQR) 20.0 (11.0, 30.0) vs. 26.5 (17.0, 43.0) days), hospital LOS (median (IQR) 26.5 (15.0, 44.0) vs. 35.5 (24.0, 56.0) days) shorter MV days (median (IQR) 14.0 (10.0, 29.0) vs. 23.0 (14.0, 35.5) days) and lower hospital mortality (16.7% VS 35.1%) than LOVAP (p < 0.05). The factor associated with hospital mortality was having simplified acute physiology (SAP) II score ≥ 40 with an adjusted odds ratio (aOR) of 2.22 (95% confidence interval (CI), 1.08-4.54, p = 0.02). Conclusion: LOVAP had significantly higher MDR pathogens, MV days, ICU LOS, hospital LOS and hospital mortality than EOVAP. A broad-spectrum antibiotic to cover MDR pathogens should be considered in LOVAP. The factor associated with hospital mortality of VAP was a SAPII score ≥ 40.

scholarly journals Microorganisms and clinical outcomes of early- and late-onset ventilator-associated pneumonia at Srinagarind Hospital, a tertiary center in Northeastern Thailand

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pavarit Arayasukawat ◽  
Apichart So-ngern ◽  
Wipa Reechaipichitkul ◽  
Worawat Chumpangern ◽  
Itthiphat Arunsurat ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Late Onset ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Ventilator Associated Pneumonia ◽  
Cross Sectional ◽  
Tertiary Center ◽  
Resistance Patterns

Abstract Background Ventilator-associated pneumonia (VAP) is a common nocosomial infection in intensive care unit (ICU). Local microbiological surveillance of pathogens and resistance patterns for early-onset VAP (EOVAP) and late-onset VAP (LOVAP) will help to choose appropriate empiric antibiotics. Objective To compare the multi-drug resistant (MDR) pathogens, treatment outcomes, and factors associated with hospital mortality of VAP. Method A cross-sectional study between 1 January 2015 and 31 December 2017 at Srinagarind hospital, Khon Kaen University was conducted. The demographic data, causative pathogens, hospital length of stay (LOS), ICU LOS, mechanical ventilator (MV) days, and hospital mortality were retrospectively reviewed. Results One hundred and ninety patients were enrolled; 42 patients (22%) were EOVAP and 148 patients (78%) were LOVAP. Acinetobacter baumannii was the most common pathogen in both groups (50% EOVAP vs 52.7% LOVAP). MDR pathogens were significant greater in LOVAP (81.8%) than EOVAP (61.9%) (p = 0.007). The EOVAP had a significantly better ICU LOS [median (interquartile range, IQR) 20.0 (11.0, 30.0) vs. 26.5 (17.0, 43.0) days], hospital LOS [median (IQR) 26.5 (15.0, 44.0) vs. 35.5 (24.0, 56.0) days] shorter MV days [median (IQR) 14.0 (10.0, 29.0) vs. 23.0 (14.0, 35.5) days] and lower hospital mortality (16.7% vs 35.1%) than LOVAP (p < 0.05). The factor associated with hospital mortality was having simplified acute physiology (SAP) II score ≥ 40 with an adjusted odds ratio (aOR) of 2.22 [95% confidence interval (CI), 1.08–4.54, p = 0.02]. Conclusion LOVAP had significantly higher MDR pathogens, MV days, ICU LOS, hospital LOS and hospital mortality than EOVAP. A broad-spectrum antibiotic to cover MDR pathogens should be considered in LOVAP. The factor associated with hospital mortality of VAP was a SAPII score ≥ 40.

scholarly journals Microorganisms and clinical outcomes of early- and late-onset ventilator-associated pneumonia at Srinagarind Hospital, a tertiary center in Northeastern Thailand

2021 ◽  
Author(s):  
Pavarit Arayasukawat ◽  
Apichart - So-ngern ◽  
Wipa Reechaipichitkul ◽  
Worawat Chumpangern ◽  
Itthiphat Arunsurat ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Late Onset ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Ventilator Associated Pneumonia ◽  
Cross Sectional ◽  
Tertiary Center ◽  
Resistance Patterns

Abstract Background: Ventilator-associated pneumonia (VAP) is a common nocosomial infection in intensive care unit (ICU). Local microbiological surveillance of pathogens and resistance patterns for early-onset VAP (EOVAP) and late-onset VAP (LOVAP) will help to choose appropriate empiric antibiotics. Objective: To compare the multi-drug resistant (MDR) pathogens, treatment outcomes, and factors associated with hospital mortality of VAP. Method: A cross-sectional study between 1 January 2015 and 31 December 2017 at Srinagarind hospital, Khon Kaen University was conducted. The demographic data, causative pathogens, hospital length of stay (LOS), ICU LOS, mechanical ventilator (MV) days, and hospital mortality were retrospectively reviewed. Results: One hundred and ninety patients were enrolled; 42 patients (22%) were EOVAP and 148 patients (78%) were LOVAP. Acinetobacter baumannii was the most common pathogen in both groups (50 % EOVAP vs 52.7% LOVAP). MDR pathogens were significant greater in LOVAP (81.8 %) than EOVAP (61.9%) (p = 0.007). The EOVAP had a significantly better ICU LOS (median (interquartile range, IQR) 20.0 (11.0, 30.0) vs. 26.5 (17.0, 43.0) days), hospital LOS (median (IQR) 26.5 (15.0, 44.0) vs. 35.5 (24.0, 56.0) days) shorter MV days (median (IQR) 14.0 (10.0, 29.0) vs. 23.0 (14.0, 35.5) days) and lower hospital mortality (16.7% VS 35.1%) than LOVAP (p < 0.05). The factor associated with hospital mortality was having simplified acute physiology (SAP) II score ≥ 40 with an adjusted odds ratio (aOR) of 2.22 (95% confidence interval (CI), 1.08-4.54, p = 0.02). Conclusion: LOVAP had significantly higher MDR pathogens, MV days, ICU LOS, hospital LOS and hospital mortality than EOVAP. A broad-spectrum antibiotic to cover MDR pathogens should be considered in LOVAP. The factor associated with hospital mortality of VAP was a SAPII score ≥ 40.

scholarly journals Microorganisms and clinical outcomes of early- and late-onset ventilator-associated pneumonia at Srinagarind Hospital, a tertiary center in Northeastern Thailand

2020 ◽  
Author(s):  
Pavarit Arayasukawat ◽  
Apichart - So-ngern ◽  
Wipa Reechaipichitkul ◽  
Worawat Chumpangern ◽  
Itthiphat Arunsurat ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Late Onset ◽  
Demographic Data ◽  
Simplified Acute Physiology Score ◽  
Cross Sectional Study ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Ventilator Associated Pneumonia ◽  
Cross Sectional ◽  
Tertiary Center

Abstract Back ground: Ventilator-associated pneumonia (VAP) is a common nocosomial infection in intensive care unit (ICU). Local microbiological surveillance of pathogens and resistance patterns for early-onset VAP (EOVAP) and late-onset VAP (LOVAP) will help to choose appropriate empiric antibiotics. Objective: To compare the multi-drug resistant (MDR) pathogens, treatment outcomes, and factors associated with hospital mortality of VAP. Method: A cross-sectional study between 1 January 2015 and 31 December 2017 at Srinagarind hospital, Khon Kaen University was conducted. The demographic data, causative pathogens, hospital length of stay (LOS), ICU LOS, mechanical ventilator (MV) days, and hospital mortality were retrospectively reviewed. Results: One hundred and ninety patients were enrolled; 42 (22%) were EOVAP and 148 (78%) were LOVAP. Acinetobacter baummanii was the most common pathogen in both groups (50 % EOVAP vs 52.7% LOVAP). MDR pathogens were significant greater in LOVAP (81.8 %) than EOVAP (61.9%) (p = 0.007). The EOVAP had a significantly better ICU LOS (median 20.0 (11.0, 30.0) vs. 26.5 (17.0, 43.0) days), hospital LOS (median 26.5 (15.0, 44.0) vs. 35.5 (24.0, 56.0) days) shorter MV days (14.0 (10.0, 29.0) vs. 23.0 (14.0, 35.5) days) and lower hospital mortality (11.9 % VS 27.7%) than LOVAP ( p < 0.05). The factor associated with hospital mortality was having simplified acute physiology score (SAP) ≥ 40 with an adjusted odds ratio (aOR) of 2.22 (95%CI, 1.08-4.54, p = 0.02). Conclusion: LOVAP had significantly higher MDR pathogens, MV days, ICU LOS, hospital LOS and hospital mortality than EOVAP. A broad-spectrum antibiotic to cover MDR pathogens should be considered in LOVAP. The factor associated with hospital mortality of VAP was a SAPII score ≥ 40.

scholarly journals Microorganisms and Clinical Outcomes of Early- and Late-onset Ventilator-associated Pneumonia at Srinagarind Hospital, a Tertiary Center in Northeastern Thailand

2020 ◽  
Author(s):  
Pavarit Arayasukawat ◽  
Apichart - So-ngern ◽  
Wipa Reechaipichitkul ◽  
Worawat Chumpangern ◽  
Itthiphat Arunsurat ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Late Onset ◽  
Demographic Data ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Ventilator Associated Pneumonia ◽  
Cross Sectional ◽  
Tertiary Center ◽  
Back Ground ◽  
Microbiological Surveillance

Abstract Back ground: Ventilator-associated pneumonia (VAP) isacommon nocosomial infection inintensive care unit (ICU). Local microbiological surveillance of pathogens and resistance patternsfor early-onset VAP (EOVAP) and late-onset VAP (LOVAP)will help to choose appropriate empiric antibiotics.Objective: To comparethe multi-drug resistant (MDR) pathogens, treatment outcomes,and factors associated with hospital mortality of VAP. Method:A cross-sectional studybetween 1 January 2015 and 31 December 2017 at Srinagarind hospital, KhonKaen University was conducted. The demographic data, causative pathogens, hospital length of stay (LOS), ICU LOS, mechanical ventilator (MV) days, and hospital mortality were retrospectively reviewed.Results:One hundred and ninety patients were enrolled; 42 (22%) were EOVAP and 148 (78%) were LOVAP. Acinetobacterbaummanii was the most common pathogen in both groups (50 % EOVAP vs 52.7% LOVAP). MDR pathogens were significant greater in LOVAP (81.8 %) than EOVAP (61.9%) (p = 0.007). The EOVAP had a significantly better ICU LOS (median 20.0 (11.0, 30.0) vs. 26.5 (17.0, 43.0) days), hospital LOS (median 26.5 (15.0, 44.0) vs. 35.5 (24.0, 56.0) days) shorter MV days (14.0 (10.0, 29.0) vs. 23.0 (14.0, 35.5) days) and lowerhospital mortality (11.9 % VS 27.7%) than LOVAP ( p< 0.05). The factor associated with hospital mortality washavingsimplified acute physiology score (SAP)≥ 40 with an adjustedodds ratio(aOR) of 2.22 (95%CI, 1.08-4.54,p = 0.02). Conclusion: LOVAP had significantly higherMDR pathogens, MV days, ICU LOS, hospital LOS andhospital mortality than EOVAP. A broad-spectrum antibiotic to cover MDR pathogensshould be considered in LOVAP.The factor associated with hospital mortality of VAP was a SAPII score ≥ 40.

scholarly journals . The frequency and fetomaternal outcomes of early- and late-onset preeclampsia: The experience of a single tertiary center in the bustling metropolis of Turkey; İstanbul.

2015 ◽  
Author(s):  
Halenur Bozdağ ◽  
Fatma Bilge Öğütcüoğlu ◽  
Esra Akdeniz Duran ◽  
Sedef Rukiye Kabaca Kılıç ◽  
İlke Topdağı Aydın ◽  
...  
Keyword(s):  
Late Onset ◽  
Tertiary Center
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