multicentre prospective study
Recently Published Documents


TOTAL DOCUMENTS

250
(FIVE YEARS 84)

H-INDEX

35
(FIVE YEARS 5)

2022 ◽  
Vol 11 (2) ◽  
pp. 386
Author(s):  
Kim-Heang Ly ◽  
Nathalie Costedoat-Chalumeau ◽  
Eric Liozon ◽  
Stéphanie Dumonteil ◽  
Jean-Pierre Ducroix ◽  
...  

Fluorodesoxyglucose Positron Emission Tomography (PET/CT) has never been compared to Chest-Abdomen-Pelvis CT (CAPCT) in patients with a fever of unknown origin (FUO), inflammation of unknown origin (IUO) and episodic fever of unknown origin (EFUO) through a prospective and multicentre study. In this study, we investigated the diagnostic value of PET/CT compared to CAPCT in these patients. The trial was performed between 1 May 2008 through 28 February 2013 with 7 French University Hospital centres. Patients who fulfilled the FUO, IUO or EFUO criteria were included. Diagnostic orientation (DO), diagnostic contribution (DC) and time for diagnosis of both imaging resources were evaluated. One hundred and three patients were included with 35 FUO, 35 IUO and 33 EFUO patients. PET/CT showed both a higher DO (28.2% vs. 7.8%, p < 0.001) and DC (19.4% vs. 5.8%, p < 0.001) than CAPCT and reduced the time for diagnosis in patients (3.8 vs. 17.6 months, p = 0.02). Arthralgia (OR 4.90, p = 0.0012), DO of PET/CT (OR 4.09, p = 0.016), CRP > 30 mg/L (OR 3.70, p = 0.033), and chills (OR 3.06, p = 0.0248) were associated with the achievement of a diagnosis (Se: 89.1%, Sp: 56.8%). PET/CT both orients and contributes to diagnoses at a higher rate than CAPCT, especially in patients with FUO and IUO, and reduces the time for diagnosis.


2021 ◽  
pp. 2102293
Author(s):  
Yoshihiko Raita ◽  
Marcos Pérez-Losada ◽  
Robert J. Freishtat ◽  
Andrea Hahn ◽  
Eduardo Castro-Nallar ◽  
...  

The question addressed by the studyBronchiolitis is not only the leading cause of hospitalisation in U.S. infants but also a major risk factor for asthma development. Growing evidence supports clinical heterogeneity within bronchiolitis. To identify metatranscriptome profiles of infant bronchiolitis, and examine their relationship with host transcriptome and subsequent asthma development.Materials/patients and methodsAs part of multicentre prospective cohort study of infants (age <12 months) hospitalised for bronchiolitis, we integrated virus and nasopharyngeal metatranscriptome (species-level taxonomy and function) data measured at hospitalisation. We applied network-based clustering approaches to identify metatranscriptome profiles. We then examined their association with host transcriptome at hospitalisation and risk for developing asthma.ResultsWe identified five metatranscriptome profiles of bronchiolitis (n=244):A) virusRSVmicrobiomecommensals, B) virusRSV/RV-AmicrobiomeH.influenzae,C) virusRSVmicrobiomeS.pneumoniae, D) virusRSVmicrobiomeM.nonliquefaciens, andE) virusRSV/RV-CmicrobiomeM.catarrhalis. Compared with profile A, profile B infants were characterised by high proportion of eczema, H. influenzae abundance, and enriched virulence related to antibiotic resistance. These profile B infants also had upregulated TH17 and downregulated type I interferon pathways (FDR<0.005) and significantly higher risk for developing asthma (17.9% versus 38.9%; adjOR, 2.81; 95%CI, 1.11–7.26). Likewise, profile C infants were characterised by high proportion of parental asthma, S. pneumoniae dominance, and enriched glycerolipid and glycerophospholipid metabolism of microbiome. These profile C infants had upregulated receptor for advanced glycation end products signalling pathway (FDR<0.005) and higher risk of asthma (17.9% versus 35.6%; adjOR, 2.49; 95%CI, 1.10–5.87).Answer to the questionMetatranscriptome and clustering analysis identified biologically-distinct metatranscriptome profiles that have differential risks of asthma.


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052462
Author(s):  
Wai-Tat Wong ◽  
Anna Lee ◽  
Charles David Gomersall ◽  
Lam-hin Shek ◽  
Alfred Chan ◽  
...  

ObjectivesDetermine 90-day mortality of mechanically ventilated ward patients outside the intensive care unit (ICU) and its association with organisational factors.DesignMulticentre prospective observational study of mechanically ventilated ward patients. Modified Poisson regression was used to assess association between nurse to patient ratio (NPR) and 90-day mortality, adjusted for designated medical team, Society of Critical Care Medicine (SCCM) triage priority and centre effect. NPR was divided into low (1:9.6 to 1:10), medium (1:6 to 1:8) and high (1:2.6). Sensitivity analysis was conducted for pneumonia with or without acute respiratory distress syndrome (ARDS) to assess magnitude of association.Setting7 acute public hospitals in Hong Kong.ParticipantsAll 485 mechanically ventilated patients in wards from participating hospitals between 18 January 2016 and 17 April 2016 were recruited. Three hundred patients were included after excluding patients with limitation of therapy within 24 hours of intubation.Main outcomes90-day mortality, Mortality Prediction Model III Standardised mortality ratio (MPMIII0 SMR).Results201 patients died within 90 days after intubation (67.0%, 95% CI 61.5% to 72.1%), with MPMIII0 SMR 1.88, 95% CI 1.63 to 2.17. Compared with high NPR, medium and low NPRs were associated with higher risk of 90-day mortality (adjusted relative risk (RRadj) 1.84, 95% CI 1.70 to 1.99 and 1.64, 95% CI 1.47 to 1.83, respectively). For 114 patients with pneumonia with or without ARDS, low to medium NPR, too sick to benefit from ICU (SCCM priority 4b), no ICU consultation and designated medical team were associated with risk of 90-day mortality (RRadj 1.49, 95% CI 1.40 to 1.58; RRadj 1.60, 95% CI 1.49 to 1.72; RRadj 1.34, 95% CI 1.27 to 1.40; RRadj 0.85, 95% CI 0.78 to 0.93, respectively).ConclusionThe 90-day mortality rates of mechanically ventilated ward patients were high. NPR was an independent predictor of survival for mechanically ventilated ward patients.


Author(s):  
X.‐Q. Chen ◽  
D.‐Y. Zheng ◽  
Y.‐Y. Xiao ◽  
B.‐L. Dong ◽  
C.‐W. Cao ◽  
...  

2021 ◽  
Vol 429 ◽  
pp. 117662
Author(s):  
Michele Romoli ◽  
Laura Vandelli ◽  
Guido Bigliardi ◽  
Marcello Naccarato ◽  
Maurizio Balestrino ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document