CURB-65, HYPOXEMIA AS SEVERITY PREDICTORS AND FEMALE GENDER AS POOR OUTCOME INDICATOR IN COMMUNITY ACQUIRED PNEUMONIA (CAP)

2021 ◽  
pp. 253-255
Author(s):  
Shrey Kumar Srivastav ◽  
Anurag Prasad ◽  
Richi Kashyap ◽  
Ajoy Deshmukh
Keyword(s):  
Hospital Stay ◽  
Scoring System ◽  
Prospective Observational Study ◽  
Female Gender ◽  
Community Acquired Pneumonia ◽  
Inclusion Criteria ◽  
Poor Outcome ◽  
Female Total ◽  
And Gender ◽  
Good Individual

BACKGROUND - CAP is one of the leading causes of morbidity and mortality worldwide, so early prediction of severity and outcome is required for further management of CAP patients. OBJECTIVES - To assess the severity of CAP by using CURB-65 scoring system and status of hypoxemia in the patients who presented in emergency and outpatient department and gender specic outcome in the patients who are admitted in inpatient department. METHODOLOGY - A prospective, observational study which included all adults attending the EMD, OPD and admitted in IPD fullling the inclusion criteria. RESULTS - Out of 47 males and 23 female (total 70) patients admitted through EMD or OPD, 56 patient (80%) had low CURB score, 63 patients (90%) had hypoxemia, 53 patients (75%) presented with age of more than 65 years, 50% (7 out of 14) patients with high CURB-65 were confused. 13 out of 23 females (56%) patients had less stability and longer hospital stay as compared to 12 out of 47 male (26%) patients. CONCLUSION - CURB-65 scoring system was not adequately helpful in deciding the severity and further management while hypoxemia and age emerged as good individual predictors for severity of CAP while female gender was associated with poor outcome and longer hospital stay. Hypoxemia even with low CURB-65 score helped in severity assessment and ICU admission.

scholarly journals Acute cardiovascular events in patients with community acquired pneumonia: results from the observational prospective FADOI-ICECAP study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Filippo Pieralli ◽  
◽  
Vieri Vannucchi ◽  
Carlo Nozzoli ◽  
Giuseppe Augello ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Stay ◽  
Cardiovascular Events ◽  
Length Of Hospital Stay ◽  
Severe Pneumonia ◽  
Female Gender ◽  
Community Acquired Pneumonia ◽  
Newly Diagnosed ◽  
Coronary Syndrome ◽  
New Onset

Abstract Background The burden of cardiovascular (CV) complications in patients hospitalised for community-acquired pneumonia (CAP) is still uncertain. Available studies used different designs and different criteria to define CV complications. We assessed the cumulative incidence of acute of CV complications during hospitalisation for CAP in Internal Medicine Units (IMUs). Methods This was a prospective study carried out in 26 IMUs, enrolling patients consecutively hospitalised for CAP. Defined CV complications were: newly diagnosed heart failure, acute coronary syndrome, new onset of supraventricular or ventricular arrhythmias, new onset hemorrhagic or ischemic stroke or transient ischemic attack. Outcome measures were: in-hospital and 30-day mortality, length of hospital stay and rate of 30-day re-hospitalisation. Results A total of 1266 patients were enrolled, of these 23.8% experienced at least a CV event, the majority (15.5%) represented by newly diagnosed decompensated heart failure, and 75% occurring within 3 days. Female gender, a history of CV disease, and more severe pneumonia were predictors of CV events. In-hospital (12.2% vs 4.7%, p < 0.0001) and 30-day (16.3% vs 8.9%, p = 0.0001) mortality was higher in patients with CV events, as well as the re-hospitalisation rate (13.3% vs 9.3%, p = 0.002), and mean hospital stay was 11.4 ± 6.9 vs 9.5 ± 5.6 days (p < 0.0001). The occurrence of CV events during hospitalisation significantly increased the risk of 30-day mortality (HR 1.69, 95% CI 1.14–2.51; p = 0.009). Conclusion Cardiovascular events are frequent in CAP, and their occurrence adversely affects outcome. A strict monitoring might be useful to intercept in-hospital CV complications for those patients with higher risk profile. Trial registration NCT03798457 Registered 10 January 2019 - Retrospectively registered

scholarly journals Epidemiology of Thyroid Carcinomas in North Macedonia (1999-2015)

2021 ◽  
Vol 12 ◽  
pp. 215013272110042
Author(s):  
Makazlieva Tanja ◽  
Vaskova Olivija ◽  
Stojanoski Sinisha ◽  
Manevska Nevena ◽  
Miladinova Daniela ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Prevalence Rate ◽  
Epidemiological Data ◽  
Female Gender ◽  
The Elderly ◽  
Inclusion Criteria ◽  
Statistical State ◽  
Total Prevalence ◽  
Low Incidence ◽  
Histopathological Type

Objective: We have set as objective to analyze epidemiological data of diagnosed thyroid carcinoma (TC) cases, incidence and prevalence rate by gender, age, histopathological type, and statistical regions in R. of N. Macedonia during the period 1999 to 2015. Material and Methods: Retrospective analysis of medical data collected from the 2 state thyroid departments. Inclusion criteria included newly diagnosed cases of TC in appropriate years for the period 1999 to 2015. We have evaluated: yearly incidence rate, incidence and prevalence by gender, age, the distribution in 8 statistical state regions and histopathological types and subtypes representation. Results: A total number of 422 TC patients were detected, average incidence rate of 1.22/105, with most prevalent papillary TCs79.5%, followed by follicular 10.9%, medullar 4.1%, anaplastic 3.1%, and other rare types with 2.3%. The highest incidence rate was detected in Skopje region, while the lowest in Southeast and the Polog region. The total prevalence rate for the female gender was 32.61/104 and for male 9.27/104 (f/m ratio = 3.52:1), with lowest female/male difference found in the elderly > 65 years (f/m = 2.21/1). Conclusion: Compared with regional epidemiological data we can conclude that Republic of N. Macedonia has very low incidence and prevalence rate, while female/male ratio was similar to that described in the literature. Our low incidence and prevalence rate may be due to 2 possible reasons, 1 would be insufficient diagnosis of only small portion of the real cases in the population, or the second reason may be a real low incidence resulting of specific etiopathogenetic circumstances.

scholarly journals Factors Affecting the Control of Chronic Rhinosinusitis With Nasal Polyps: A Comparison in Patients With or Without NERD

2021 ◽  
Vol 12 ◽  
pp. 215265672110038
Author(s):  
Markus Jukka Lilja ◽  
Anni Koskinen ◽  
Paula Virkkula ◽  
Seija Inkeri Vento ◽  
Jyri Myller ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Female Gender ◽  
Sinus Surgery ◽  
Logrank Test ◽  
Free Survival ◽  
Factors Affecting ◽  
Advanced Therapy ◽  
And Gender

Objectives The aim was to compare the control of chronic rhinosinusitis with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS), in patients with/without nonsteroidal anti-inflammatory drug exacerbated respiratory disease (NERD). Study Desing: A retrospective hospital-based sample of CRSwNP patients with/without NERD with follow-up. Setting Tertiary rhinology centers. Methods Electronic patient record data from 116 CRSwNP patients (46 with NERD and 70 without NERD) undergoing ESS during 2001–17 were studied. Mean follow-up time was 9.9 years (range 1.1–15.3). Endpoints reflecting uncontrolled CRSwNP were revision ESS, and need for rescue/advanced therapy (e.g. antibiotics, oral corticosteroids and/or biological therapy) during follow-up. NERD was variable of interest and gender, age, asthma, allergic rhinitis (AR), smoking, Lund-Mackay (LM) score of sinus computed tomography scans previous ESS and baseline total ethmoidectomy were used as covariates. Results Twenty-one (49.7%) NERD patients and 18 (25.7%) non-NERD patients underwent revision ESS within a mean ± SD of 4.3 ± 2.8 and 3.7 ± 2.6 years, respectively (p = .013, by Logrank test). In Cox´s regression models, NERD, female gender, young age, asthma, AR, previous ESS, and lack of total ethmoidectomy were associated with revision-ESS. In adjusted model, only the total ethmoidectomy predicted revision-free survival. In adjusted logistic regression model, there was an insignificant trend that NERD and LM score were associated with the need for rescue/advanced therapy in the follow-up. Conclusions Patients with NERD had higher risk of uncontrolled CRSwNP than patient group without NERD, as measured by revision ESS and/or need for rescue/advanced therapy in the follow-up. In addition, baseline total ethmoidectomy was associated with revision-free survival.

scholarly journals 964. Impact of Doxycycline as Malaria Prophylaxis on Risk of Influenza Like Illness Among International Travelers

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S35-S35
Author(s):  
Kathryn Lago ◽  
Kalyani Telu ◽  
David R Tribble ◽  
Anuradha Ganesan ◽  
Anjali Kunz ◽  
...  
Keyword(s):  
Disease Transmission ◽  
Regression Models ◽  
Prospective Observational Study ◽  
Female Gender ◽  
Error Variance ◽  
Respiratory Pathogens ◽  
Malaria Prophylaxis ◽  
Influenza Like Illness ◽  
Increased Risk ◽  
The Caribbean

Abstract Background International travelers are often at risk for both influenza like illness (ILI) and malaria. Doxycycline is active against many pathogens causing ILI and is routinely used for malaria prophylaxis. We evaluated the incidence of and risk factors for ILI, and whether the choice of malaria prophylaxis was associated with ILI. Methods TravMil is a prospective observational study enrolling subjects presenting to 6 military travel clinics. We analyzed pre- and post-travel surveys from travelers to regions outside of the continental United States, Western or Northern Europe, Canada, or New Zealand between July 2010 and August 2018. ILI was defined as subjective fever associated with either a sore throat or cough. Characteristics of trip and traveler and the use of malaria prophylaxis were analyzed to determine association with development of ILI. Poisson regression models with robust error variance were used to estimate relative risk of ILI. Results A total of 3,227 travelers were enrolled: 62.1% male, median age of 39 (IQR 27, 59), median travel duration 19 days (IQR 12, 49). 32% traveled to Africa, 40% to Asia, and 27% to the Caribbean, Mexico, and Central or South America. Military travel (46%) and vacation (40%) were most common reasons for travel. Twenty percent took doxycycline for malaria prophylaxis, 50% other prophylaxis (89% atovaquone–proguanil), and 30% took none. 8.7% developed ILI. Compared with those on no or other prophylaxis, doxycycline was associated with decreased risk of ILI [RR 0.65 (0.43–0.99), P = 0.046], as was military travel [RR 0.30 (0.21–0.43), P &lt; 0.01]. Increased risk of ILI was associated with female gender [RR 1.57 (1.24–1.98), P &lt; 0.01], travel to Asia [RR 1.37 (1.08–1.75), P = 0.01], cruises [RR 2.21 (1.73–2.83), P &lt; 0.01], and longer duration of travel [RR 1.01 (1.00–1.01, P &lt; 0.01]. Conclusion The use of doxycycline is associated with a decreased risk of ILI compared with taking no or other malaria prophylaxis. The reasons for this are unclear but may be related to anti-inflammatory effects, activity against bacterial respiratory pathogens, effects on disease transmission in closed populations (e.g., military deploying groups), or other unmeasured factors. With few proven strategies for decreasing ILI risk in travelers, these findings bear further investigation. Disclosures All authors: No reported disclosures.

scholarly journals Predictors of fatigue following the onset of infectious mononucleosis

2003 ◽  
Vol 33 (5) ◽  
pp. 847-855 ◽  
Author(s):  
B. CANDY ◽  
T. CHALDER ◽  
A. J. CLEARE ◽  
A. PEAKMAN ◽  
A. SKOWERA ◽  
...  
Keyword(s):  
Infectious Mononucleosis ◽  
Illness Perceptions ◽  
A Priori ◽  
Univariate Analysis ◽  
Female Gender ◽  
Chronic Fatigue ◽  
Postal Questionnaire ◽  
Cognitive Responses ◽  
Poor Outcome ◽  
Primary Care Patients

Background. Infectious mononucleosis (IM) is a risk factor for chronic fatigue. Reduced activity is the most consistent factor found to be associated with poor outcome following the onset of infectious mononucleosis. However, little is known about the biological mechanisms involved in the pathogenesis of chronic fatigue following IM and no study, so far, has examined the relation between certain illness beliefs and poor outcome. This study explored immunological, endocrine, behavioural and cognitive responses to the acute illness and assessed which components of these groups of risk factors predicted a chronic course.Method. Using a prospective cohort design, 71 primary care patients with IM were enrolled onto the study and interviewed. Their recovery was explored by postal questionnaire up to 1 year later.Results. In the univariate analysis, increased baseline levels of immune activation were associated with fatigue at baseline and 3 months. Cortisol levels were not associated with fatigue at any point. Using multivariate models of clinical and psychosocial baseline factors, severity of symptoms and illness perceptions were found to predict fatigue 3 months later. At 6 months, fatigue was best predicted by female gender and illness perceptions, and at 12 months by female gender and a symptoms–disability factor.Conclusions. In the multivariate analysis no factors were found to predict poor outcome at all time-points. Instead the pattern of predictors changed over time, partly but not completely consistent with our a priori predictions. Larger studies are needed to explore further the predictive nature of biopsychosocial factors in the pathogenesis of chronic fatigue related to IM. The psycho-behavioural predictors found in this study are amenable to intervention. Such interventions should be tested in randomized controlled trials.

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