scholarly journals The Impact of Postnatal Systemic Steroids on the Growth of Preterm Infants: A Multicenter Cohort Study

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2729
Author(s):  
Carlos Zozaya ◽  
Alejandro Avila-Alvarez ◽  
Fermín García-Muñoz Rodrigo ◽  
María L. Couce ◽  
Luis Arruza ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Invasive Mechanical Ventilation ◽  
Postnatal Growth ◽  
Linear Regression Models ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort ◽  
Major Congenital Malformations ◽  
The Impact

Postnatal steroids, often used to prevent and treat bronchopulmonary dysplasia, may influence the growth of preterm infants, although data are scarce in the literature. This is a multicenter cohort study including surviving preterm infants <32 weeks at birth (n = 17,621) from the Spanish Neonatal Network SEN1500 database, without major congenital malformations. Linear regression models were adjusted for postnatal steroids, respiratory severity course (invasive mechanical ventilation at 28 days), progression to moderate–severe bronchopulmonary dysplasia (O2 at 36 weeks), length of stay, sex, gestational age and z-scores at birth. A subgroup analysis depending on the timing of administration, ventilation status at 28 days and moderate–severe BPD diagnosis was also performed. Overall, systemic postnatal steroids were not independently associated with poorer weight gain (0.1; 95% CI: −0.05 to 0.2 g/kg/day), linear growth (0; 95% CI: −0.03 to 0.01 cm/week) or head circumference growth (−0.01; 95% CI: −0.02 to 0 cm/week). Patients who received steroids after 28 days or who were not O2 dependent at 36 weeks after having received steroids gained more weight (0.22; 95% CI: 0.04 to 0.4 and 0.2; 95% CI: 0.004 to 0.5 g/kg/day, respectively). Globally, systemic postnatal steroids had no significant adjusted effect on postnatal growth.

The Effect of Morbidity and Sex on Postnatal Growth of Very Preterm Infants: A Multicenter Cohort Study

Neonatology ◽  
2019 ◽  
Vol 115 (4) ◽  
pp. 348-354 ◽  
Author(s):  
Carlos Zozaya ◽  
Alejandro Avila-Alvarez ◽  
Luis Arruza ◽  
Fermín García-Muñoz Rodrigo ◽  
Cristina Fernandez-Perez ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Infants ◽  
Postnatal Growth ◽  
Multicenter Cohort Study ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Multicenter Cohort

scholarly journals Hospitalized Children with Critical SARS-CoV-2 Infection Cared for in a Limited Resource Setting: Multicenter Cohort Study

2021 ◽  
Author(s):  
Emmerson C.F. de Fariasa ◽  
Jefferson P. Piva ◽  
Manoel J.C. Pavão Junior ◽  
Susan C.D. Sales ◽  
Luciana M.P. Nascimento ◽  
...  
Keyword(s):  
Cohort Study ◽  
Children And Adolescents ◽  
Invasive Mechanical Ventilation ◽  
Laboratory Data ◽  
Length Of Hospital Stay ◽  
Limited Resource ◽  
Hospitalized Children ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort ◽  
Resource Setting

Abstract Background: Some children can develop severe forms of SARS-CoV-2 infection either acutely or later, as represented by multisystemic inflammatory syndrome in children (MIS- C). To identify the risk factors for worse outcomes in hospitalized children and adolescents with severe acute SARS-CoV-2 infection and MIS-C. Methods: This multicenter cohort study included all children and adolescents with confirmed or suspected critical SARS-CoV-2 infection admitted to the PICU between April 2020 and September 2021. The exclusion criteria were incomplete vaccinal status, immunocompromised status, and end-of-life decision. The main variables analyzed were epidemiological, clinical, and laboratory data, and ventilator settings at admission and after 72 h. The patients were divided into three groups (G): confirmed coronavirus disease (COVID-19) with MIS-C criteria (G1), confirmed COVID-19 without MIS-C criteria (G2), and MIS-C criteria without confirmed COVID-19. Results: The median age of the patients was 28 months in G1, with comorbidities in 40 patients (72.7%) (p < 0.0001). The duration of exposure (median 23 days; p = 0.004) and fever were longer in G1 (12 days; p = 0.001). Moreover, invasive mechanical ventilation (IMV) was required in 44 patients (80%, p < 0.0001), and cardiogenic shock occurred in 26 patients (54.2%, p < 0.0001) in G1. Subnutrition was most frequent in G1 in 55 cases (57.3%; p = 0.01). Under nutrition (< 2 SD for weight), longer exposure time (odds ratio [OR]: 2.11; 95% confidence interval [CI]: 1.37–3.25; p = 0.001), IMV time (OR: 2.6; 95% CI: 1.15–5.85; p = 0.03), and length of hospital stay (OR: 10.94; 95% CI: 1.93–63.1; p = 0.007) were associated with critical MIS-C in G1. Conclusions: In the Brazilian Amazon area, specifically in the Pará state, we identified a cluster of more severe forms of pediatric acute or late SARS-CoV-2 infection.

scholarly journals Neonatal Outcomes Following Extensive Delivery Room Resuscitation in Preterm Infants: A Multicenter Cohort Study

2012 ◽  
Vol 17 (suppl_A) ◽  
pp. 30A-30A
Author(s):  
AS Soraisham ◽  
N Singhal ◽  
K Aziz ◽  
A Lodha ◽  
SK Lee ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Infants ◽  
Neonatal Outcomes ◽  
Delivery Room ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort

scholarly journals The Impact of Body Mass Index on Fluoroscopy Time During Lumbar Epidural Steroid Injection; A Multicenter Cohort Study

Pain Medicine ◽  
2016 ◽  
Vol 18 (1) ◽  
pp. 25-35 ◽  
Author(s):  
Zachary L. McCormick ◽  
Sarah C. Choxi ◽  
David T. Lee ◽  
Austin Marcolina ◽  
Joel Press ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Body Mass ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Fluoroscopy Time ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort ◽  
Epidural Steroid ◽  
The Impact

scholarly journals COMBINATION OF TOCILIZUMAB AND STEROIDS TO IMPROVE MORTALITY IN PATIENTS WITH SEVERE COVID-19 INFECTION: A SPANISH, MULTICENTER, COHORT STUDY

2020 ◽  
Author(s):  
Belen Ruiz-Antoran ◽  
Aranzazu Sancho-Lopez ◽  
Ferran Torres ◽  
Victor Moreno-Torres ◽  
Itziar de Pablo Lopez de Abechuco ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Oxygen Therapy ◽  
Inclusion Criteria ◽  
Multicenter Cohort Study ◽  
Inverse Probability ◽  
Multicenter Cohort ◽  
Tertiary Hospitals ◽  
Randomised Controlled ◽  
The Impact

Background: We aimed to determine the impact of tocilizumab use in severe COVID-19 pneumonia mortality. Methods: We performed a multicentre retrospective cohort study in 18 tertiary hospitals in Spain, from March to April 2020. Consecutive patients admitted with severe COVID-19 treated with tocilizumab were compared to patients not treated with tocilizumab, adjusting by Inverse Probability of the Treatment Weights (IPTW). Tocilizumab effect in patients receiving steroids during the 48h following inclusion was analyzed. Results: During the study period, 506 patients with severe COVID-19 fulfilled inclusion criteria. Among them, 268 were treated with tocilizumab and 238 patients were not. Median time to tocilizumab treatment from onset of symptoms was 11 days (IQR 8-14). Global mortality was 23.7%. Mortality was lower in patients treated with tocilizumab than in controls (16.8% versus 31.5%, HR 0.514 [95CI 0.355-0.744], p<0.001; weighted HR 0.741 [95CI 0.619-0.887], p=0.001). Tocilizumab treatment reduced mortality by 14.7% relative to no tocilizumab treatment (RRR 46.7%). We calculated a number necessary to treat of 7. Among patients treated with steroids, mortality was lower in patients treated with tocilizumab than in those treated with steroids alone (10.9% versus 40.2%, HR 0.511 [95CI 0.352-0.741], p=0.036; weighted HR 0.6 [95CI 0.449-0.804], p<0.001) (Interaction p=0.094). Conclusions: These results show that survival of patients with severe COVID-19 is higher in patients treated with tocilizumab than in those not treated, and that tocilizumab effect adds to that of steroids administered to non-intubated cases with COVID-19 during the first 48 hours of presenting with respiratory failure despite of oxygen therapy. Randomised controlled studies are needed to confirm these results.

scholarly journals Gamma-glutamyl Transferase Levels are Associated with the Occurrence of Post-stroke Cognitive Impairment: A Multicenter Cohort Study

2021 ◽  
Author(s):  
Siqi Li ◽  
Xiaoling Liao ◽  
Yuesong Pan ◽  
Xianglong Xiang ◽  
Yumei Zhang
Keyword(s):  
Cohort Study ◽  
Cognitive Impairment ◽  
Gamma Glutamyl Transferase ◽  
Multicenter Cohort Study ◽  
Gamma Glutamyl ◽  
Post Stroke ◽  
Multicenter Cohort ◽  
Glutamyl Transferase ◽  
The Impact

Abstract Background: Gamma-glutamyl transferase (GGT) can maintain the physiological concentration of glutathione in cells, and protect them from oxidative stress-induced damage. However, its role in post-stroke cognitive impairment (PSCI) remains unknown. Here, we explored the impact of serum biomarker-GGT on PSCI. Methods: We conducted a prospective, multicenter cohort study. 1, 957 participants who suffered a stroke and measured baseline GGT were enrolled from the Impairment of Cognition and Sleep (ICONS) study of the China National Stroke Registry-3 (CNSR-3). They were categorized into four groups according to the quartiles of baseline GGT levels. Cognitive function was assessed by using the Montreal Cognitive Assessment (MoCA) approach. The multiple logistic regression models were performed to evaluate the relationship between GGT and PSCI at 3 months follow-up.Results: Among 1,957 participants, 671 (34.29%) patients suffered PSCI at 3 months follow-up. The highest GGT level quartile group exhibited a lower risk of PSCI in the fully adjusted model [OR (95% CI): 0.69 (0.50-0.96)], relative to the lowest group. Moreover, incorporation of GGT to the conventional model resulted in a slight improvement in PSCI outcomes after 3 months (NRI: 12.00%; IDI: 0.30%).Conclusions: Our findings demonstrated that serum GGT level was inversely associated with the risk of PSCI, with extremely low levels acting as a risk factor for PSCI.

Establishing Evidence-Based Criteria for Directly Observed Hand Hygiene Compliance Monitoring Programs: A Prospective, Multicenter Cohort Study

2014 ◽  
Vol 35 (9) ◽  
pp. 1163-1168 ◽  
Author(s):  
Jun Yin ◽  
Heather Schacht Reisinger ◽  
Mark Vander Weg ◽  
Marin L. Schweizer ◽  
Andrew Jesson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Sample Size Calculation ◽  
Hawthorne Effect ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort ◽  
Surveillance Programs ◽  
Hygiene Compliance ◽  
The Impact

ObjectiveHand hygiene surveillance programs that rely on direct observations of healthcare worker activity may be limited by the Hawthorne effect. In addition, comparing compliance rates from period to period requires adequately sized samples of observations. We aimed to statistically determine whether the Hawthorne effect is stable over an observation period and statistically derive sample sizes of observations necessary to compare compliance rates.DesignProspective multicenter cohort study.SettingFive intensive care units and 6 medical/surgical wards in 3 geographically distinct acute care hospitals.MethodsTrained observers monitored hand hygiene compliance during routine care in fixed 1-hour periods, using a standardized collection tool. We estimated the impact of the Hawthorne effect using empirical fluctuation processes and F tests for structural change. Standard sample-size calculation methods were used to estimate how many hand hygiene opportunities are required to accurately measure hand hygiene across various levels of baseline and target compliance.ResultsExit hand hygiene compliance increased after 14 minutes of observation (from 56.2% to 60.5%; P < .001) and increased further after 50 minutes (from 60.5% to 66.0%; P < .001). Entry compliance increased after 38 minutes (from 40.4% to 43.4%; P = .005). Between 79 and 723 opportunities are required during each period, depending on baseline compliance rates (range, 35%–90%) and targeted improvement (5% or 10%).ConclusionsLimiting direct observation periods to approximately 15 minutes to minimize the Hawthorne effect and determining required number of hand hygiene opportunities observed per period on the basis of statistical power calculations would be expected to improve the validity of hand hygiene surveillance programs.Infect Control Hosp Epidemiol 2014;35(9):1163-1168

scholarly journals Short-Physical Performance Battery (SPPB) score is associated with postoperative pulmonary complications in elderly patients undergoing lung resection surgery: A prospective multicenter cohort study

2020 ◽  
Vol 17 ◽  
pp. 147997312096184
Author(s):  
Masatoshi Hanada ◽  
Kota Yamauchi ◽  
Shinjiro Miyazaki ◽  
Yohei Oyama ◽  
Yorihide Yanagita ◽  
...  
Keyword(s):  
Cohort Study ◽  
Elderly Patients ◽  
Physical Performance ◽  
Lung Resection ◽  
Pulmonary Complications ◽  
Short Physical Performance Battery ◽  
Postoperative Pulmonary Complications ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort ◽  
The Impact

Elderly patients awaiting lung resection surgery often have poor physical function, which puts them at a high risk of postoperative pulmonary complications. The aim of this study was to investigate the impact of preoperative physical performance on postoperative pulmonary complications in patients awaiting lung resection surgery. In this prospective multicenter cohort study, the characteristics of patients and postoperative pulmonary complications were compared between subjects with low (<10) and high (≥10) Short Physical Performance Battery (SPPB) scores. Postoperative pulmonary complications were defined as over grade II in Clavien-Dindo classification system. We estimated the effects of physical performance on postoperative pulmonary complications using multivariable hierarchical logistic regression. The postoperative pulmonary complications were compared between 331 patients in the high and 33 patients in the low SPPB group. Patients in the low SPPB score group had a significantly higher rate of postoperative pulmonary complications (p < 0.001). Low SPPB score was associated with a higher risk of postoperative pulmonary complications (odds ratio, 8.80; p < 0.001). The SPPB is a clinically useful evaluation tool to assess surgical patients’ physical performance. The low physical performance indicated by the SPPB may be predictive of postoperative pulmonary complications after lung resection surgery. Trial registration: Clinical Trials. University hospital Medical Information Network Center (UMIN-CTR) UMIN000021875.

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