scholarly journals Investigation of the Role of the Cytomegalovirus as a Respiratory Pathogen in HIV-Infected Patients

1996 ◽  
Vol 3 (4) ◽  
pp. 235-240 ◽  
Author(s):  
Rafael E de la Hoz ◽  
Shizu Hayashi ◽  
Darrel Cook ◽  
Christopher Sherlock ◽  
James C Hogg
Keyword(s):  
Relative Risk ◽  
Hiv Infection ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Pneumocystis Carinii ◽  
Clinical Severity ◽  
University Hospital ◽  
Respiratory Pathogen ◽  
Short Term ◽  
Short Term Mortality

OBJECTIVE:To investigate the occurrence of cytomegalovirus (CMV) pneumonitis in the setting of human immunodeficiency virus (HIV) infection and whether the presence of CMV as copathogen is associated with increased clinical severity or short term mortality in patients withPneumocystis cariniipneumonia.DESIGN:Retrospective cohort study.SETTING:Tertiary care university hospital.PATIENTS:One-hundred and fourteen HIV-infected homosexual men with pneumonia, followed for a minimum of four weeks.MEASUREMENTS:Clinical indicators of severity of pneumonia, microbiology of bronchoalveolar fluid and relative risk of short term mortality.RESULTS:Only two cases of CMV pneumonitis were found, one together withP carinii. However, 45 of the 86 patients withP cariniipneumonia were co-infected with CMV. No difference in clinical severity was detected between patients co-infected withP cariniiand CMV and those withP cariniialone. The relative risk of short term mortality was 3.64 (95% CI 0.82 to 16.18), in patients with co-infection compared with those withP cariniialone. The risk reached statistical significance for patients with earlier stages of HIV infection.CONCLUSIONS:CMV pneumonitis occurs rarely in HIV-infected patients, while CMV co-infection occurs in at least 50% of the cases ofP cariniipneumonia. Although no difference in clinical severity was detected, this study suggests that short term mortality fromP cariniipneumonia may be increased by CMV co-infection, particularly in patients with earlier stages of the disease.

scholarly journals Short-term mortality and prognostic factors related to status epilepticus

2015 ◽  
Vol 73 (8) ◽  
pp. 670-675 ◽  
Author(s):  
Fernando Gustavo Stelzer ◽  
Guilherme de Oliveira Bustamante ◽  
Heidi Sander ◽  
Americo Ceiki Sakamoto ◽  
Regina Maria França Fernandes
Keyword(s):  
Multivariate Analysis ◽  
Status Epilepticus ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Case Fatality ◽  
Epileptic Seizures ◽  
University Hospital ◽  
Short Term ◽  
Clinical Complications ◽  
Short Term Mortality

Objective Status epilepticus (SE) is associated with significant morbidity and mortality, and there is some controversy concerning predictive indicators of outcome. Our main goal was to determine mortality and to identify factors associated with SE prognosis. Method This prospective study in a tertiary-care university hospital, included 105 patients with epileptic seizures lasting more than 30 minutes. Mortality was defined as death during hospital admission. Results The case-fatality rate was 36.2%, which was higher than in previous studies. In univariate analysis, mortality was associated with age, previous epilepsy, complex focal seizures; etiology, recurrence, and refractoriness of SE; clinical complications, and focal SE. In multivariate analysis, mortality was associated only with presence of clinical complications. Conclusions Mortality associated with SE was higher than reported in previous studies, and was not related to age, specific etiology, or SE duration. In multivariate analysis, mortality was independently related to occurrence of medical complications.

scholarly journals Mortality from Pulmonary Embolism by Clinical Severity

The Physician ◽  
2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Arushi Asthana ◽  
Niladri Konar ◽  
Indranil Chakravorty
Keyword(s):  
Pulmonary Embolism ◽  
Medical Records ◽  
Tertiary Care ◽  
Clinical Severity ◽  
Short Term ◽  
Missed Opportunities ◽  
Background Mortality ◽  
Large Tertiary Care ◽  
Short Term Mortality ◽  
Related Mortality

Aim: To report all-cause and PE related short term mortality by clinical severity of PE and to identify any missed opportunities for thrombolysis. Background: Mortality related to pulmonary embolism varies widely in the reported literature even for the same clinical severity category of PE. Method: Electronic medical records of all patients presenting to a large tertiary care teaching hospital in London, between October 1, 2018, and January 16, 2020, who had a discharge diagnosis of acute pulmonary embolism were reviewed retrospectively. Results: There was no PE related mortality in the low-risk PE group. There was one PE related death in the submassive PE group (1.47% mortality on day 14 and day 30).  Massive PE was associated with a 29.4% PE related mortality short-term mortality.

scholarly journals Validity of neuron-specific enolase as a prognostic tool in acute ischemic stroke in adults at Suez Canal University Hospital

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Mohammed H. Shash ◽  
Reda Abdelrazek ◽  
Nashwa M. Abdelgeleel ◽  
Rasha M. Ahmed ◽  
Adel H. El-baih
Keyword(s):  
Ischemic Stroke ◽  
Serum Level ◽  
Acute Ischemic Stroke ◽  
Cell Damage ◽  
Neuron Specific Enolase ◽  
Clinical Severity ◽  
University Hospital ◽  
Short Term ◽  
Prediction Of Mortality ◽  
Death Group

Abstract Background Biological markers of acute nerve cell damage can assist in the outcome of acute ischemic stroke, such as neuron-specific enolase (NSE) that have been tested for association with initial severity of stroke, extent of infarction, and functional outcome. Objective To determine short-term prognostic value of the biochemical marker neuron-specific enolase (NSE) in acute ischemic stroke. Methods A cohort study carried out on 37 patients with acute ischemic stroke. Data were gathered in a prepared data sheet. Initial serum NSE level was measured to the patients in the Emergency department within 6 h of the onset of stroke and another measurement after 48 h. National Institute of Health Stroke Scale (NIHSS) was held to the patients at presentation and after 28 days of stroke to determine short-term morbidity and mortality. Results Out of the 37 patients, 31 patients survived (no-death group) and 6 patients died (death group). The mean serum level of neuron-specific enolase at presentation and after 48 h was significantly higher in the death group than in the no-death group. There was a statistically significant positive correlation between neuron-specific enolase (NSE) serum level and clinical severity of stroke (NIHSS) among the patients at presentation (r = 0.737, p = 0.000). Conclusion Neuron-specific enolase (NSE) can be applied as single independent marker for prediction of mortality and short-term morbidity in ischemic stroke patients.

scholarly journals Short-Term Association between Black Carbon Exposure and Cardiovascular Diseases in Pakistan’s Largest Megacity

Atmosphere ◽  
2018 ◽  
Vol 9 (11) ◽  
pp. 420 ◽  
Author(s):  
Daniel Malashock ◽  
Haider Khwaja ◽  
Zafar Fatmi ◽  
Azhar Siddique ◽  
Yi Lu ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Black Carbon ◽  
Hospital Admissions ◽  
Statistical Significance ◽  
Fine Particulate Matter ◽  
Tertiary Care ◽  
Short Term ◽  
Residential Site ◽  
Fine Particulate ◽  
Tertiary Care Hospitals

This study investigated the association between black carbon (BC) exposure and hospital admissions (HAs) and outpatient department/emergency room (OPD/ER) visits for cardiovascular diseases (CVD) among residents of Karachi, the largest city in Pakistan. We measured daily concentrations of BC in fine particulate matter (PM2.5) and collected records of HAs and OPD/ER visits for CVD from 2 major tertiary care hospitals serving Karachi for 6 weeks continuously during each quarter over 1 year (August 2008–August 2009). We subsequently analyzed daily counts of hospital and BC data over 0–3 lag days. Daily mean BC concentrations varied from 1 to 32 µg/m3. Results suggest that BC concentrations are associated with CVD HAs and OPD/ER visits. However, associations were generally only observed when modeled with BC from Tibet Center, the commercial-residential site, as compared to Korangi, the industrial-residential site. Overall, low statistical significance suggests that while BC may be a valuable indicator for CVD health risks from combustion-derived particles, further evaluation of the constituents of PM2.5 and their relative contributions to CVD health impacts is necessary.

Angiopoietin-Like Protein 7 and Short-Term Mortality in Acute Heart Failure

2020 ◽  
Vol 10 (2) ◽  
pp. 116-124 ◽  
Author(s):  
Chongyu Zhang ◽  
Xin He ◽  
Jingjing Zhao ◽  
Yalin Cao ◽  
Jian Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Inflammatory Responses ◽  
Statistical Significance ◽  
Serum Levels ◽  
Enzyme Linked Immunosorbent Assay ◽  
Short Term ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Short Term Mortality

Introduction: Angiopoietin-like protein 7 (ANGPTL7) is involved in extracellular matrix expression and inflammatory responses. However, the prognostic utility of ANGPTL7 among patients with acute heart failure (AHF) remains unclear. Objective: To evaluate the association between ANGPTL7 and short-term mortality due to AHF. Methods and Results: Patients with AHF were prospectively studied. Serum levels of ANGPTL7 were measured by an enzyme-linked immunosorbent assay. Associations between 30- and 90-day mortality and tertiles of ANGPTL7 were assessed by multivariate logistic regression models. The study comprised 142 patients. Median patient age was 68 years, and 69.7% were male. There were 20 deaths within 30 days and 37 deaths within 90 days. Crude rates of 30-day mortality in low, intermediate, and high tertiles of ANGPTL7 were 4.6, 14.6, and 22.9%, respectively. Crude rates of 90-day mortality of corresponding tertiles were 15.2, 25.0, and 37.5%. After adjusting for potential confounders, including NT-proBNP, the high tertile of ANGPTL7 was associated with a significantly increased risk of both 30-day mortality (odds ratio [OR]: 6.77, 95% confidence interval [CI]: 1.41–32.61, p = 0.017) and 90-day mortality (OR: 3.78, 95% CI: 1.38–10.36, p = 0.010) compared with the low tertile of ANGPTL7. Although mortality risk tended to be higher in the intermediate tertile than the low tertile, it did not reach statistical significance (OR: 3.75, 95% CI: 0.73–19.14, p = 0.113 for 30-day mortality; OR: 1.88, 95% CI: 0.66–5.34, p = 0.236 for 90-day mortality). Conclusions: Serum level of ANGPTL7 was independently associated with short-term mortality among patients with AHF.

scholarly journals Short-term complication rate following orthopedic surgery in a tertiary care center in Argentina

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 26 ◽  
Author(s):  
Gaston Camino Willhuber ◽  
Joaquin Stagnaro ◽  
Matias Petracchi ◽  
Agustin Donndorff ◽  
Daniel Godoy Monzon ◽  
...  
Keyword(s):  
Orthopedic Surgery ◽  
Complication Rate ◽  
Care Center ◽  
Critical Role ◽  
Tertiary Care ◽  
Additional Treatment ◽  
Clinical Severity ◽  
Type I ◽  
Short Term ◽  
Start Time

Introduction: Registration of adverse events following orthopedic surgery has a critical role in patient safety and has received increasing attention. The purpose of this study was to determine the prevalence and severity of postoperative complications in the department of orthopedic unit in a tertiary hospital. Methods: A retrospective review from the postoperative complication registry of a cohort of consecutive patients operated in the department of orthopedic surgery from May 2015 to June 2016 was performed. Short-term complications (3 months after surgery), age gender, types of surgery (elective, scheduled urgency, non-scheduled urgency, and emergency), operative time, surgical start time (morning, afternoon or evening), American Society of Anesthesiologists score and surgeon's experience were assessed. Complications were classified based on their severity according to Dindo-Clavien system: Grade I complications do not require alterations in the postoperative course or additional treatment; Grade II complications require pharmacological treatment; Grade III require surgical, endoscopic, or radiological interventions without (IIIa) or with (IIIb) general anesthesia; Grade IV are life-threatening with single (IVa) or multi-organ (IVb) dysfunction(s), and require ICU management; and Grade V result in death of the patient. Complications were further classified in minor (Dindo I, II, IIIa) and major (Dindo IIIb, IVa, IVb and V), according to clinical severity. Results: 1960 surgeries were performed. The overall 90-day complication rate was 12.7% (249/1960). Twenty-three complications (9.2 %) were type I, 159 (63.8%) type II, 9 (3.6%) type IIIa, 42 (16.8%) type IIIb, 7 (2.8%) type IVa and 9 (3.6%) were grade V according to Dindo-Clavien classification (DCC). The most frequent complication was anemia that required blood transfusion (27%) followed by wound infection (15.6%) and urinary tract infection (6%). Discussion: The overall complication rate after orthopedic surgery in our department was 12.7%. The implementation of the DCC following orthopedic surgery was an important tool to measure the standard of care.

scholarly journals Impact of Fluid Resuscitation Regimes in Relative Risk of Mortality in Burned Patients

2021 ◽  
Vol 5 (2) ◽  
pp. 849-853
Author(s):  
Besnik Faskaj ◽  
Monika Belba
Keyword(s):  
Relative Risk ◽  
Statistical Significance ◽  
Burn Injuries ◽  
University Hospital ◽  
Burn Shock ◽  
Ringer Lactate ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Observational Prospective Cohort Study ◽  
The University

Background; Some studies have supported the opinion that patients who get greater volumes of resuscitation fluids are at a higher chance of edema, complications, and probably bad outcomes. In the results of the International Society of Burn Injuries approximately half (49.5%) added colloid before 24h. This study aims to analyze the relative risk for mortality comparing resuscitation in the first 24 hours with Parkland and resuscitation with the use of Colloids.  Material and Methods; This was an observational prospective cohort study conducted in the Service of Burns of the University Hospital Centre "Mother Teresa" in Tirana (UHCT), Albania. The study includes adult patients with critical burns > 40% TBSA, hospitalized in the Intensive Care Unit of the service during the period 2014 to 2019. Resuscitation in the first 24 hours is done with Ringer Lactate according to Parkland and with Ringer Lactate with the addition of colloids after 12 hours. Results; The data for organ dysfunction and organ insufficiency were the same in the two groups without statistical significance. Mortality in the RL group was 48% (24 deaths of 50 patients) while in the RL + Colloid rehydrated group was 46% (23 deaths of 50 patients). Patients which have 40-60% burns and are rehydrated with RL + Colloids have a risk of death 0.4 times less than those rehydrated with RL. Conclusions; Resuscitation with Ringer lactate and Colloids in the first 24 hours of thermal damage is a rehydration alternative for the treatment of burn shock. This therapy especially helps patients with major burns > 40% TBSA who during rehydration require large amounts of fluids and are associated with severe plasma hypoalbuminemia. Number Need to Treat (NNT benefit) is 10 so 1 in 10 patients can benefit in lowering the risk of death with RL + Colloid rehydration.

scholarly journals Analysis of the causes of death in HIV-infected individuals in 2008-2010 according to the data of the clinical infectious diseases hospital named after S.P. Botkin, St. Petersburg

2012 ◽  
Vol 93 (3) ◽  
pp. 522-526 ◽  
Author(s):  
A G Rakhmanova ◽  
A A Yakovlev ◽  
M I Dmitrieva ◽  
T N Vinogradova ◽  
A A Kozlov
Keyword(s):  
Infectious Diseases ◽  
Hiv Infection ◽  
Viral Hepatitis ◽  
Causes Of Death ◽  
Mortality Rates ◽  
Chronic Viral Hepatitis ◽  
Concomitant Disease ◽  
Short Term ◽  
Number Of Patients ◽  
Short Term Mortality

Aim. To analyse the causes of death of individuals infected with the human immunodeficiency virus (HIV)/patients with acquired immunodeficiency syndrome (AIDS) in the Clinical Infectious Diseases Hospital named after S.P. Botkin in 2008-2010 taking into account the timing of disease, comorbidities, and clinical and laboratory data. Methods. The study included 439 HIV-infected individuals, who died in the Clinical Infectious Diseases Hospital named after S.P. Botkin in 2008-2010. Two groups of patients were identified: deaths from HIV/AIDS (n=306) and from other diseases (n=133, HIV infection was considered to be a concomitant disease). In both groups, analyzed were the short-term mortality rates, the presence of drugs and/or alcohol dependency, and the main causes of death (according to autopsy results). Results. In the group of patients who died of HIV-infection/AIDS and who did not receive antiretroviral therapy, generalized tuberculosis was diagnosed most often (65.7% of cases). Other rare diseases were pneumocystis pneumonia, cryptococcosis, cerebral toxoplasmosis, generalized fungal infection, cerebral lymphoma, and cytomegalovirus infection. The most frequent causes of death in the group of patients whose HIV-infection was considered to be a concomitant diseases were chronic viral hepatitis in the cirrhotic stage (42.9%) and septic thromboendocarditis, which were mainly diagnosed in social maladjusted patients: patients with alcoholism or intravenous drugs users. During evaluation of the short-term mortality rates it was established that 21 to 29% of patients in different years died on the 1st-3rd day after admission, which was related to extremely severe conditions of the patients. In Russia, including St. Petersburg, an annual increase in the number of new cases of HIV infection and increased mortality are registered, which indicates the severity of the epidemic and makes it possible to predict the increase in the number of patients requiring hospital treatment. Conclusion. The main causes of death among HIV-infected individuals in 2008-2010 were generalized tuberculosis and chronic viral hepatitis in the stage of cirrhosis; the high index of short-term mortality among HIV-infected patients suggests the need for measures for early detection of HIV-positive individuals and their medical examination, as well as an increase in the number of beds in order to provide specialized care to HIV-infected individuals in St. Petersburg.

scholarly journals Anisocytosis is Associated With Short-Term Mortality in COVID-19 and May Reflect Proinflammatory Signature in Uninfected Ambulatory Adults

2020 ◽  
Vol 5 (1) ◽  
pp. 312
Author(s):  
Andrew Hornick ◽  
Nour Tashtish ◽  
Michael Osnard ◽  
Binita Shah ◽  
Allison Bradigan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Proportional Hazards Model ◽  
Statistical Significance ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Rank Test ◽  
Short Term ◽  
Distribution Width ◽  
Principle Components Analysis ◽  
Short Term Mortality

BackgroundRed cell distribution width (RDW), a measure of anisocytosis, is observed in chronic inflammation and is a prognostic marker in critically ill patients without COVID-19, but data in COVID-19 are limited.MethodsBetween March 12 and April 19, 2020, 282 individuals with confirmed COVID-19 and RDW available within 7 days prior to COVID-19 confirmation were evaluated. Individuals were grouped by quartiles of RDW. Association between quartiles of RDW and mortality was assessed using the Kaplan-Meier method and statistical significance was assessed using the log-rank test. The association between RDW and all-cause mortality was further assessed using a Cox proportional hazards model. Plasma cytokine levels in uninfected ambulatory adults without cardiovascular disease (n=38) were measured and bivariate Spearman correlations and principle components analysis were used to identify relationships between cytokine concentrations with RDW.ResultsAfter adjusting for age, sex, race, cardiovascular disease, and hemoglobin, there was an association between RDW and mortality (Quartile 4 vs Quartile 1: HR 4.04 [1.08-15.07]), with each 1% increment in RDW associated with a 39% increased rate of mortality (HR 1.39 [1.21-1.59]). Remote RDW was also associated with mortality after COVID-19 infection. Among uninfected ambulatory adults without cardiovascular disease, RDW was associated with elevated pro-inflammatory cytokines (TNF-α, IL8, IL6, IL1b), but not regulatory cytokines (TGFb).ConclusionsAnisocytosis predicts short-term mortality in COVID-19 patients, often predates viral exposure, and may be related to a pro-inflammatory phenotype. Additional study of whether the RDW can assist in the early identification of pending cytokine storm is warranted.

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