scholarly journals Liver Cirrhosis and Diabetes Mellitus Are Risk Factors forStaphylococcus aureusInfection in Patients with Healthcare-Associated or Hospital-Acquired Pneumonia

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Huang-Pin Wu ◽  
Chien-Ming Chu ◽  
Chun-Yao Lin ◽  
Chung-Chieh Yu ◽  
Chung-Ching Hua ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Liver Cirrhosis ◽  
Empiric Antibiotic Therapy ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
History Of ◽  
Hospital Acquired Pneumonia ◽  
Healthcare Associated ◽  
Hospital Acquired

Background.The risk factors forStaphylococcus aureus(S. aureus) pneumonia are not fully identified. The aim of this work was to find out the clinical characteristics associated withS. aureusinfection in patients with healthcare-associated pneumonia (HCAP) and hospital-acquired pneumonia (HAP), which may be applicable for more appropriate selection of empiric antibiotic therapy.Methods.From July 2007 to June 2010, patients who were admitted to the intensive care unit with severe HCAP/HAP and severe sepsis were enrolled in this study. Lower respiratory tract sample was semiquantitatively cultured. Initial broad-spectrum antibiotics were chosen by Taiwan or American guidelines for pneumonia management. Standard bundle therapies were provided to all patients according to the guidelines of the Surviving Sepsis Campaign.Results.The most frequently isolated pathogens werePseudomonas aeruginosa,S. aureus,Acinetobacter baumannii,Klebsiella pneumoniae, andEscherichia coli. Patients with positive isolation ofS. aureusin culture had significantly higher history of liver cirrhosis and diabetes mellitus, with odds ratios of 3.098 and 1.899, respectively. TheS. aureuspneumonia was not correlated with history of chronic obstructive pulmonary disease, hypertension, and hemodialysis.Conclusion.Liver cirrhosis and diabetes mellitus may be risk factors forS. aureusinfection in patients with severe HCAP or HAP.

Hospital Acquired Pneumonia

2016 ◽  
Author(s):  
Joshua Lupton
Keyword(s):  
The Elderly ◽  
Chronic Obstructive ◽  
Microbial Infection ◽  
Term Care ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
History Of ◽  
Hospital Acquired Pneumonia ◽  
Pulmonary Parenchyma ◽  
Hospital Acquired

Pneumonia consists of inflammation of the pulmonary parenchyma, typically resulting from a microbial infection. Hospital-acquired pneumonia (HAP) occurs in (typically elderly) patients in long-term care facilities, with regular IV therapy, with immunosuppression, or with a history of recent treatment at a hospital. It is associated with high mortality. The majority HAP patients present with some constellation of cough, fever, sputum production, and pleuritic chest pain. Patients with chronic obstructive pulmonary disease (COPD) and cystic fibrosis are at increased risk for pneumonia. The Infectious Disease Society of America requires infiltrates on chest x-ray or other imaging for the diagnosis of pneumonia. For hospitalized patients, empiric antimicrobial therapy for HAP should be given as soon as pneumonia is highly suspected. There is currently a vaccine available against Streptococcus pneumonia that all patients should be offered before discharge from the hospital. The elderly are already more susceptible to HAP due to decreased mobility and increased comorbidities.

Abstract 237: Prevalence of Cardiovascular Risk Factors and Cardiovascular Disease in Transgender Persons in The United States

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Aditi Malhotra ◽  
Hal A Skopicki ◽  
Smadar Kort ◽  
Noelle Mann ◽  
Puja Parikh
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Kidney Disease ◽  
The United States ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Transgender Persons

Background: There is a paucity of data regarding prevalence of cardiovascular disease (CVD) and corresponding cardiovascular (CV) risk factors in transgender individuals. We sought to assess the prevalence of CV risk factors and CVD in transgender persons in the United States. Methods: The 2018 Centers for Disease Control’s Behavioral Risk Factor Surveillance Survey was utilized to identify a cohort of 1,038 transgender individuals in the United States. Presence of CVD was noted with a single affirmative response to the following questions: “Has a health care professional ever told you that you had any of the following:” (1) a heart attack or myocardial infarction, (2) angina or coronary heart disease, (3) a stroke? Results: Among the 1,038 transgender individuals studied, a total of 145 (14.0%) had CVD while 893 (86.0%) did not. No differences in prevalence of CVD was noted in transgender individuals who transitioned from male-to-female (n=387), female-to-male (n=400), and gender nonconforming status (n=251) (15.0% vs 13.8% vs 12.7%, p=0.72). Transgender individuals with CVD were older, had lower annual income, higher rates of smoking (28.4% vs 18.1%, p=0.004), and higher rates of multiple co-morbidities including asthma (26.6% vs 17.4%, p = 0.009), skin cancer (21.8% vs 5.0%, p <0.001), non-skin cancers (16.8% vs 6.8%, p <0.001), chronic obstructive pulmonary disease (27.5% vs 7.0%, p <0.001), arthritis (65.3% vs 28.7%, p<0.001), depressive disorder (42.7% vs 31.0%, p= 0.006), chronic kidney disease (16.2% vs 3.3%, p< 0.001), and diabetes mellitus (42.0% vs 12.7%, p <0.001). No significant differences in race, health insurance status, or body mass index was noted between transgender individuals with CVD versus those without. In multivariable analysis, independent predictors of CVD in transgender individuals included older age, diabetes mellitus [odds ratio (OR) 2.82, 95% confidence interval (CI) 1.73 - 4.58], chronic kidney disease (OR 3.69, 95% CI 1.80 - 7.57), chronic obstructive pulmonary disease (OR 2.18, 95% CI 1.19 - 3.99), and depressive disorder (OR 1.82, 95% CI 1.09 - 3.03). Conclusions: In this observational contemporary study, CVD was prevalent in 14% of transgender individuals in the United States. Predictors of CVD in the transgender population exist and transgender persons should be appropriately screened for CV risk factors so as to minimize their risk of CVD.

scholarly journals Investigation of the Prevalence and Diagnosis of Chronic Obstructive Pulmonary Disease in a Group of Elderly Individuals Residing in an Island Area of Ningbo

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Wei Sheng ◽  
Youchang Huang ◽  
Zaichun Deng ◽  
Hongying Ma
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Diagnosis And Treatment ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Elderly Individuals ◽  
Island Area ◽  
History Of ◽  
Missed Diagnosis

Objective. This epidemiological investigation aimed at determining the current situation regarding the diagnosis and treatment of chronic obstructive pulmonary disease (COPD), especially missed diagnosis and missed treatment, in a group of individuals residing in an island area of Ningbo. Methods. Adults ≥60 years of age were selected from an island area of Ningbo. All participants completed a COPD-Screening Questionnaire and underwent a post-bronchodilator pulmonary function test. COPD-positive individuals then completed a questionnaire surveying the status of diagnosis and treatment of COPD and the reasons for missed diagnosis and treatment. The data were collated and analyzed using SPSS version 22.0 (IBM Corporation, Armonk, NY, USA). Findings. (1) A total of 1526 individuals were screened, of whom 1371 (89.8%) were eventually included in data analysis. From these, 254 were diagnosed with spirometry-defined COPD, corresponding to an overall prevalence of 18.5%. Prevalence was higher in men (28.9%) than in women (8.3%) among the sample. (2) According to chi-squared test results, risk factors for COPD included sex, age, smoking history (pack-years), cough, and dyspnea. Body mass index, family history of respiratory diseases, and exposure to biomass smoke from cooking were not risk factors for COPD. (3) Multivariate logistic regression analysis revealed that age and smoking were independent risk factors for COPD. (4) Receiver operating curve analysis revealed that, at a cutoff of 19.5, the highest sum of sensitivity and specificity was 69.7% and 75.5%, respectively. The COPD-Screening Questionnaire could be used as a preselection method to screen for COPD in primary care settings. (5) Of 254 individuals diagnosed with COPD, only 10 had a history of COPD and only 35 had a previous diagnosis of pneumonia or bronchitis. These data revealed that the rate of missed diagnosis of COPD in the Ningbo island area was 96.1%. Conclusion. The prevalence of COPD among elderly individuals in the Ningbo island area was significantly higher than in other parts of China. Moreover, the rate of missed diagnosis of COPD in the Ningbo island area was extremely high. Smoking and age were independent factors for the occurrence of COPD.

scholarly journals Incidence and Risk Factors for Prolonged Opioid Use after Arthroscopic Meniscal Surgery: An Analysis of 107,717 Cases

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0046
Author(s):  
Jacqueline Baron ◽  
Alan Shamrock ◽  
Trevor Gulbrandsen ◽  
Brian Wolf ◽  
Kyle Duchman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Logistic Regression ◽  
Chronic Obstructive ◽  
Multiple Logistic Regression ◽  
Opioid Use ◽  
Obstructive Pulmonary Disease ◽  
Factors Associated ◽  
Meniscal Surgery

Objectives: The current opioid epidemic in the United States is a significant cause of increasing morbidity and mortality. The purpose of this study was to determine rate of opioid use before and after arthroscopic meniscal surgery, and assess patient factors associated with prolonged opioid use following primary arthroscopic meniscal surgery. Methods: Patients undergoing primary arthroscopic meniscal surgery procedures from 2007-2016 were retrospectively accessed from the Humana Inc. administrative claims database. Patients were categorized as patients who filled opioid prescriptions within 3 months (OU), within 1 month (A-OU), between 1 to 3 months (C-OU), and never filled opioid prescriptions (N-OU) before surgery. Rates of opioid use were evaluated preoperatively and longitudinally tracked for OU and N-OU cohorts. Prolonged opioid use was defined as continued opioid prescription filling at ≥3 months after surgery. Multiple logistic regression analysis was used to control for various patient characteristics and identify factors associated with opioid use at 12 months after surgery, with significance defined as P<0.05 Results: There were 107,717 patients (54% female) that underwent arthroscopic meniscal surgery during the study period, of which 46.1% (n=49,630) were N-OU. One year after surgery, opioid fill rate was significantly higher in the OU group compared to the N-OU group with a relative risk of 6.98 (21.1% vs 3.02%; 95% CI: 6.61-7.36; p<0.0001). Multiple logistic regression model identified C-OU (OR:10.23, 95% CI: 9.74-10.76, p<0.0001) as the strongest predictor of opioid use at 12 months postoperatively. Furthermore, patients with acute preoperative opioid use (p<0.0001), preoperative diagnosis of diabetes mellitus (p<0.0001), hypertension (p<0.0001), chronic obstructive pulmonary disease (p<0.0001), anxiety or depression (p<0.0001), alcohol abuse (p= 0.0019), and tobacco use (p=0.0345) had a significantly increased odds of opioid use at 12 months postoperatively. However, males (p<0.0001) and patients <40 years (p<0.0001) had a significantly decreased odds of opioid use 12 months postoperatively. Conclusion: Preoperative opioid use is a significant risk factor for opioid use at 12 months following surgery. Diabetes mellitus, hypertension, chronic obstructive pulmonary disease, smoking status, and psychiatric diagnosis were independent risk factors for opioid use 1-year following surgery.

scholarly journals Clinical Characteristics and Risk Factors for Myocardial Injury and Arrhythmia in COVID-19 patients

2020 ◽  
Author(s):  
Hong Gang Ren ◽  
Xingyi Guo ◽  
Lei Tu ◽  
Qinyong Hu ◽  
Kevin Blighe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Myocardial Injury ◽  
Heart Diseases ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
History Of ◽  
Cross Sectional Design

ABSTRACTBackgroundPatients with COVID-19 can develop myocardial injury and arrhythmia during the course of their illness. However, the underlying risk factors for the development of cardiovascular related manifestations are unclear.MethodsUsing a register-based multi-center cross-sectional design, we analyzed 80 patients with myocardial injury and 401 controls, as well as 71 patients with arrhythmia and 409 controls, all admitted with COVID-19. Putative risk factors for myocardial injury and arrhythmia were evaluated with logistic regression with adjustment for potential confounders.ResultsCOVID-19 patients with myocardial injury had fatigue (66.2%) and dyspnea (63.7%), while those with arrhythmia had dyspnea (71.8%). Patients with myocardial injury and arrhythmia had a significant mortality of 92.5% and 94.4%, respectively. A history of chronic obstructive pulmonary disease (COPD) or heart diseases was associated with an increased risk of myocardial injury (odds ratio [OR] = 1.94, 95% confidence interval [CI]: 1.01-3.71; OR = 7.43, 95% CI: 3.99-13.83) and arrhythmia (OR = 1.94, 95% CI: 1.00-3.75; OR = 13.16, 95% CI: 6.75-25.68). In addition, we found that gamma glutamyltranspeptidase (GGT) >50U/L (OR = 2.14, 95% CI: 1.37-3.32; OR = 1.85, 95% CI: 1.19-2.85), serum creatinine >111μmol/L (OR = 8.96, 95% CI: 4.4-18.23; OR = 3.71, 95% CI: 2.01-6.85), serum sodium <136 mmol/L (OR = 4.68, 95% CI: 2.46-8.91; OR = 2.06; 95% CI: 1.06-4.00) were all associated with increased risk of myocardial injury and arrhythmia, respectively.ConclusionOur reported clinical characteristics and identified risk factors are important for clinical study of COVID-19 patients developing myocardial injury and arrhythmia.

scholarly journals Incidence of wound dehiscence after colorectal cancer surgery: results from a national population-based register for colorectal cancer

2019 ◽  
Vol 34 (10) ◽  
pp. 1757-1762 ◽  
Author(s):  
Harald Söderbäck ◽  
Ulf Gunnarsson ◽  
Anna Martling ◽  
Per Hellman ◽  
Gabriel Sandblom
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inflammatory Disease ◽  
Wound Dehiscence ◽  
Male Gender ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
History Of

Abstract Background Patient-related risk factors for wound dehiscence after colorectal surgery remain obscure. Methods All open abdominal procedures for colorectal cancer registered in the Swedish Colorectal Cancer Registry (SCRCR, 5) 2007–2013 were identified. Potential risk factors for wound dehiscence were identified by cross-matching between the SCRCR and the National Patient Register (NPR). The endpoint in this study was reoperation for wound dehiscence registered in either the SCRCR or NPR and patients not reoperated were considered controls. Results A total of 30,050 patients were included in the study. In a multivariable regression analysis, age > 70 years, male gender, BMI > 30, history of chronic obstructive pulmonary disease, history of generalised inflammatory disease, and duration of surgery less than 180 min were independently and significantly associated with increased risk for wound dehiscence. A history of diabetes, chronic renal disease, liver cirrhosis, and distant metastases was not associated with wound dehiscence. The hazard ratio for postoperative death was 1.24 for patients who underwent reoperation for wound dehiscence compared with that for controls. Discussion Patients reoperated for wound dehiscence face a significantly higher postoperative mortality than those without. Risk factors include male gender, age > 70 years, obesity, history of chronic obstructive pulmonary disease, and history of generalised inflammatory disease. Patients at high risk for developing wound dehiscence may, if identified preoperatively, benefit from active prevention measures implemented in routine surgical practice.

Respiratory disorders

2019 ◽  
pp. 271-311
Author(s):  
Carl Waldmann ◽  
Andrew Rhodes ◽  
Neil Soni ◽  
Jonathan Handy
Keyword(s):  
Management Strategies ◽  
Upper Airway ◽  
Inhalation Injury ◽  
Community Acquired Pneumonia ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Respiratory Disorders ◽  
Hospital Acquired Pneumonia ◽  
Ventilatory Management ◽  
Hospital Acquired

This chapter discusses respiratory disorders and includes definitions, pathophysiology, and management strategies of upper airway obstruction, respiratory failure, pulmonary collapse and atelectasis, chronic obstructive pulmonary disease, and acute respiratory distress syndrome (diagnosis, general, and ventilatory management strategies). It also includes sections detailing pathophysiology and management of pneumothoraces, empyema, haemoptysis, inhalation injury, pulmonary thromboembolism, community-acquired pneumonia, hospital-acquired pneumonia, and pulmonary hypertension.

Risk Factors for the Development of an Incisional Hernia after Sigmoid Resection for Diverticulitis: An Analysis of 33 Patient, Operative and Disease-associated Factors

2015 ◽  
Vol 81 (5) ◽  
pp. 492-497 ◽  
Author(s):  
Tara M. Connelly ◽  
Rafel Tappouni ◽  
Paul Mathew ◽  
Javier Salgado ◽  
Evangelos Messaris
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Incisional Hernia ◽  
Multivariate Regression Analysis ◽  
Sigmoid Resection ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
History Of

Incisional hernia (IH) is a relatively common sequelae of sigmoidectomy for diverticulitis. The aim of this study was to investigate factors that may predict IH in diverticulitis patients. Two hundred and one diverticulitis patients undergoing sigmoidectomy between January 2002 and December 2012 were identified (mean follow-up 5.15 ± 2.33 years). Patients with wound infections were excluded. Thirteen patient-associated, three diverticular disease-related, and 17 operative variables were evaluated in patients with and without IH. Volumetric fat was measured on pre-operative CTs. Fischer's exact, χ2, and Mann–Whitney tests and multivariate regression analysis were used for statistics. Thirty-four (17%) patients had an IH. On multivariate analysis, wound packing (OR 3.4, P = 0.017), postoperative nonwound infection (OR 7.4, P = 0.014), and previous hernia (OR 3.6, P = 0.005) were as independent predictors of IH. Fifteen of 34 (44%) patients who developed a hernia had a history of prior hernia. Of 33 potential risk factors analyzed, including smoking, chronic obstructive pulmonary disease, and obesity, the only patient factor present preoperatively associated with increased risk of a postsigmoidectomy hernia after multivariate analysis was a history of a previous hernia. Preoperative identification of patients with a history of hernia offers the opportunity to employ measures to decrease the likelihood of IH.

scholarly journals Simultaneous Pneumopericardium and Pneumomediastinum following pericardiocentesis: an unusual condition

2021 ◽  
Vol 04 (10) ◽  
pp. 01-03
Author(s):  
Ehsan Khalilipur
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Kidney Disease ◽  
Emergency Department ◽  
Kidney Disease ◽  
Chronic Obstructive ◽  
Shortness Of Breath ◽  
Obstructive Pulmonary Disease ◽  
Unusual Condition ◽  
History Of

An 80-year-old lady was referred to our cardiology emergency department with complaints of increasing shortness of breath since 45 days earlier, which had gradually worsened over the last week. She had a history of chronic obstructive pulmonary disease, diabetes mellitus, hypertension and chronic kidney disease

scholarly journals Clinical Experience of Personalized Phage Therapy Against Carbapenem-Resistant Acinetobacter baumannii Lung Infection in a Patient With Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 11 ◽  
Author(s):  
Xin Tan ◽  
Huaisheng Chen ◽  
Min Zhang ◽  
Ying Zhao ◽  
Yichun Jiang ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Clinical Medicine ◽  
Multidrug Resistant ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Carbapenem Resistant ◽  
Global Spread ◽  
Hospital Acquired Pneumonia ◽  
Polymyxin E ◽  
Hospital Acquired

Overuse of antibiotics in clinical medicine has contributed to the global spread of multidrug-resistant bacterial pathogens, including Acinetobacter baumannii. We present a case of an 88-year-old Chinese man who developed hospital-acquired pneumonia caused by carbapenem-resistant A. baumannii (CRAB). A personalized lytic pathogen-specific single-phage preparation was nebulized to the patient continuously for 16 days in combination with tigecycline and polymyxin E. The treatment was well tolerated and resulted in clearance of the pathogen and clinical improvement of the patient’s lung function.

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