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991.
Williams DN 《International journal of antimicrobial agents》1992,1(5-6):253-258
Concern regarding the soaring costs of in-hospital treatment has stimulated interest in providing alternatives when patients no longer need careful observation and daily nursing care. To facilitate ongoing intravenous antibiotic therapy for selected patients, home or outpatient intravenous therapy programs have been developed. Such therapies require a team approach with an emphasis on patient selection criteria, and educational strategies, as well as careful follow-up. It is likely that in the near future more intravenous anti-infective programs will be tailored to the infectious complications of the acquired immune deficiency syndrome than for the conditions. The increasing number of effective new oral drugs will undoubtedly reduce the need for intravenous therapy for specific infections such as septic arthritis, osteomyelitis, urinary tract infections and pneumonia. 相似文献
992.
Carlos Arias-Cabrales María José Pérez-Sáez Dolores Redondo-Pachón Anna Buxeda Carla Burballa Sheila Bermejo Adriana Sierra Marisa Mir Andrea Burón Ana Zapatero Marta Crespo Julio Pascual 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2018,38(5):503-513
Introduction
Kidney donor shortage requires expanding donor selection criteria, as well as use of objective tools to minimize the percentage of discarded organs. Some donor pre-transplant variables such as age, standard/expanded criteria donor (SCD/ECD) definition and calculation of the Kidney Donor Profile Index (KDPI), have demonstrated correlations with patient and graft outcomes. We aimed to establish the accuracy of the three models to determine the prognostic value of kidney transplantation (KT) major outcomes.Material and methods
We performed a retrospective study in deceased donor KTs at our institution. Unadjusted Cox and Kaplan–Meier survival, and multivariate Cox analyses were fitted to analyze the impact of donor age, SCD/ECD and KDPI on outcomes.Results
389 KTs were included. Mean donor age was 53.6 ± 15.2 years; 163 (41.9%) came from ECD; mean KDPI was 69.4 ± 23.4%. Median follow-up was 51.9 months. The unadjusted Cox and Kaplan–Meier showed that the three prognostic variables of interest were related to increased risk of patient death, graft failure and death-censored graft failure. However, in the multivariate analysis only KDPI was related to a higher risk of graft failure (HR 1.03 [95% CI 1.01–1.05]; p = 0.014).Conclusions
SCD/ECD classification did not provide significant prognostic information about patient and graft outcomes. KDPI was linearly related to a higher risk of graft failure, providing a better assessment. More studies are needed before using KDPI as a tool to discard or accept kidneys for transplantation. 相似文献993.
《Journal of the American Medical Directors Association》2022,23(12):1971-1976.e2
ObjectivesTo compare the Fried criteria for frailty diagnosis with the Frailty Screening Index (FSI) and the fatigue, resistance, ambulation, illness, and loss of weight (FRAIL) scale in older patients with cardiovascular disease (CVD).DesignWe conducted a retrospective 1-year follow-up cohort study of adult inpatients who participated in a cardiac rehabilitation program between June 2016 and September 2018.Setting and ParticipantsWe included 1472 Japanese patients age 65 years and older with CVD. After excluding 765 patients with incomplete frailty measurements, 707 patients were included in the analysis.MethodsFrailty and physical function were measured before hospital discharge according to each of the 3 definitions. Outcomes were all-cause mortality and physical dysfunction.ResultsThe prevalence of frailty according to the Fried criteria, the FRAIL scale, and the FSI was 213 (30.1%), 181 (25.6%), and 186 (26.3%), respectively. The FSI and the FRAIL scale showed moderate agreement with the Fried criteria [vs FSI: K = 0.52, 95% confidence interval (CI): 0.45–0.59; vs FRAIL scale: K = 0.45, 95% CI: 0.37–0.52; all P < .001]. We found a significant correlation between all-cause mortality and frailty assessed by all of the definitions, even after multivariate adjustment [FSI: hazard ratio (HR): 2.43, 95% CI: 1.30–4.58, P = .006; FRAIL scale: HR: 2.32, 95% CI: 1.21–4.45, P = .011; Fried criteria: HR: 1.99, 95% CI: 1.04–3.82, P = .038). However, the prediction accuracy of the FRAIL scale was higher than that of the FSI and comparable to that of the Fried criteria for physical dysfunction.Conclusions and ImplicationsThe FSI and the FRAIL scale showed moderate agreement with the Fried criteria regarding frailty diagnostic performance and had comparable prognostic value. However, only the FRAIL scale was as accurate as the Fried criteria in screening for physical dysfunction. 相似文献
994.
995.
Ana Cutillas-Tolín Julin Jesús Arense-Gonzalo Jaime Mendiola Evdochia Adoamnei Fuensanta Navarro-Lafuente María Luisa Snchez-Ferrer María Teresa Prieto-Snchez Ana Carmona-Barnosi Jesús Vioque Alberto M. Torres-Cantero 《Nutrients》2021,13(2)
Polycystic ovary syndrome (PCOS) is a complex hormonal disorder which impairs ovarian function. The adherence to healthy dietary patterns and physical exercise are the first line of recommended treatment for PCOS patients, but it is yet unclear what type of diet is more adequate. In this case-control study, we explored associations between adherence to five dietary quality indices and the presence of PCOS. We enrolled 126 cases of PCOS and 159 controls living in Murcia (Spain). Diagnostic of PCOS and its phenotypes were established following the Rotterdam criteria (hyperandrogenism (H), oligoanovulation (O), polycystic ovaries morphology (POM)). We used a validated food frequency questionnaires to calculate the scores of five dietary indices: alternate Healthy Eating index (AHEI), AHEI-2010, relative Mediterranean Dietary Score (rMED), alternate Mediterranean Dietary Score (aMED) and Dietary Approaches to Stop Hypertension (DASH). We used multivariable logistic regression to estimate adjusted odds ratios and confidence intervals. In the multivariable analysis, AHEI-2010 index was inversely associated with Hyperandrogenism + Oligoanovulation PCOS phenotype (ORQ3 vs. Q1 = 0.1; 95% CI: (0.0; 0.9); Pfor trend = 0.02). We did not find any statistical significant association between dietary indices and total anovulatory or ovulatory PCOS. However, further studies with higher sample sizes exploring these associations among the diverse phenotypes of PCOS are highly warranted. 相似文献
996.
Screening in healthcare is the process of identifying apparently healthy individuals in a given population who either have an early stage asymptomatic disease or are at a higher risk of developing a disease. The goal of a screening test is an early diagnosis of a disease, which then can be effectively managed at an early stage resulting in a reduced disease-specific or overall mortality. It can be used for a variety of health conditions and across a broad spectrum of population depending on the health condition. Screening for cancers started in the mid-20th century with the introduction of screening for cervical cancers, and has since been tested for and extended to a number of other cancers. In this article we discuss the principles of cancer screening including characteristics of screening tests, benefits and limitations of screening programs in a population, followed by a brief overview of current cancer screening programs in the UK. 相似文献
997.
Lindsay T. Kleeman-Forsthuber Roseann M. Johnson Anna C. Brady Aviva K. Pollet Douglas A. Dennis Jason M. Jennings 《The Journal of arthroplasty》2021,36(5):1746-1752
BackgroundAlpha-defensin (AD) is a synovial biomarker included as a minor criterion in the scoring system for diagnosing periprosthetic joint infection (PJI). The purpose of this study is to study the impact of AD on diagnosis and management of PJI.MethodsSynovial fluid from 522 patients after total knee and hip arthroplasty was retrospective reviewed. Synovial white blood cell count, percentage of neutrophils, and culture from the AD immunoassay laboratory were reviewed with serum erythrocyte sedimentation rate and C-reactive protein values from our institution. A modified version of the 2018 scoring system for diagnosis of PJI was used, only scoring white blood cell count, percentage of neutrophils, erythrocyte sedimentation rate, and C-reactive protein. AD was then analyzed with these scores to determine if AD changed diagnostic findings or clinical management.ResultsEight-two patients were categorized as “infected” (score ≥6), of which 76 patients had positive AD. Of the 6 “infected” patients with negative AD, 2 had positive cultures (Staphylococcus epidermidis). Two-hundred thirteen patients were diagnosed as “possibly infected” (score 2-5). Fourteen of these patients had positive AD, of which 5 had positive cultures assisting with the diagnosis. The AD test changed the diagnosis from “possibly infected” to “infected” in 8 patients (1.5%) but only altered treatment plan in 6 patients (1.1%). A score <2 (not infected) was calculated in 227 patients with no patients having positive AD.ConclusionAD may be beneficial in some cases where laboratory values are otherwise equivocal; however, its routine use for the diagnosis of PJI may not be warranted. 相似文献
998.
Vladimir J. Lozanovski Pascal Probst Alireza Arefidoust Ali Ramouz Ehsan Aminizadeh Mohammadsadegh Nikdad Elias Khajeh Omid Ghamarnejad Saeed Shafiei Sadeq Ali-Hasan-Al-Saegh Svenja E. Seide Eva Kalkum Arash Nickkholgh Zoltan Czigany Georg Lurje Markus Mieth Arianeb Mehrabi 《Transplant international》2021,34(5):778-800
This study aimed to identify cutoff values for donor risk index (DRI), Eurotransplant (ET)-DRI, and balance of risk (BAR) scores that predict the risk of liver graft loss. MEDLINE and Web of Science databases were searched systematically and unrestrictedly. Graft loss odds ratios and 95% confidence intervals were assessed by meta-analyses using Mantel–Haenszel tests with a random-effects model. Cutoff values for predicting graft loss at 3 months, 1 year, and 3 years were analyzed for each of the scores. Measures of calibration and discrimination used in studies validating the DRI and the ET-DRI were summarized. DRI ≥ 1.4 (six studies, n = 35 580 patients) and ET-DRI ≥ 1.4 (four studies, n = 11 666 patients) were associated with the highest risk of graft loss at all time points. BAR > 18 was associated with the highest risk of 3-month and 1-year graft loss (n = 6499 patients). A DRI cutoff of 1.8 and an ET-DRI cutoff of 1.7 were estimated using a summary receiver operator characteristic curve, but the sensitivity and specificity of these cutoff values were low. A DRI and ET-DRI score ≥ 1.4 and a BAR score > 18 have a negative influence on graft survival, but these cutoff values are not well suited for predicting graft loss. 相似文献
999.
Xingxing S. Cheng Philip J. Held Avi Dor Jennifer L. Bragg-Gresham Jane C. Tan John D. Scandling Glenn M. Chertow John P. Roberts 《American journal of transplantation》2021,21(11):3694-3703
A potential solution to the deceased donor organ shortage is to expand donor acceptability criteria. The procurement cost implications of using nonstandard donors is unknown. Using 5 years of US organ procurement organization (OPO) data, we built a cost function model to make cost projections: the total cost was the dependent variable; production outputs, including the number of donors and organs procured, were the independent variables. In the model, procuring one kidney or procuring both kidneys from double/en bloc transplantation from a single-organ donor resulted in a marginal cost of $55 k (95% confidence interval [CI] $28 k, $99 k) per kidney, and procuring only the liver from a single-organ donor results in a marginal cost of $41 k (95% CI $12 k, $69 k) per liver. Procuring two kidneys for two candidates from a donor lowered the marginal cost to $36 k (95% CI $22 k, $66 k) per kidney, and procuring two kidneys and a liver lowers the marginal cost to $24 k (95% CI $17 k, $45 k) per organ. Economies of scale were observed, where high OPO volume was correlated with lower costs. Despite higher cost per organ than for standard donors, kidney transplantation from nonstandard donors remained cost-effective based on contemporary US data. 相似文献
1000.
Lester D. R. Thompson Sarah G. Fitzpatrick Susan Müller Ellen Eisenberg Jasbir D. Upadhyaya Mark W. Lingen Nadarajah Vigneswaran Sook-Bin Woo Indraneel Bhattacharyya Elizabeth A. Bilodeau Roman Carlos Mohammed N. Islam Marino E. Leon James S. Lewis Jr. Kelly R. Magliocca Haresh Mani Mitra Mehrad Bibianna Purgina Mary Richardson Bruce M. Wenig Donald M. Cohen 《Head and neck pathology》2021,15(2):572