Understanding factors affecting length of hospital stay (LOS) in patients with severe influenza may improve their management.
A retrospective cohort study on laboratory-confirmed, adult influenza ...patients hospitalized in 2004 and 2005 was conducted. For all influenza cases during that period, immunofluorescence assay on nasopharyngeal aspirate was used for rapid diagnosis, and oseltamivir (75 mg twice daily for 5 days) prescribed if the patient presented within 2 days of symptom onset. Independent factors associated with time to discharge were identified using Cox proportional hazards models. An adjusted hazard ratio (aHR) >1 signifies a higher chance of early discharge. Viral shedding and influenza vaccination history were studied during one 'flu' season.
A total of 356 patients (influenza A 93.5%) were studied. The majority of patients were old (70.2 +/- 8.4 years), had > or = 1 comorbid illness (69.1%) and developed respiratory or cardiovascular complications (69.4%). Oseltamivir initiated within 2 days of illness was associated with shorter total LOS (Kaplan-Meier estimated median 4 versus 6 days -33%; aHR for discharge 1.54, 95% confidence intervals 95% CI 1.23-1.92, P < 0.0001). Older age (> or = 70 years), comorbidities and complications were associated with prolonged LOS. Prolonged viral RNA detection >day 4 of illness (23 out of 99 consecutive patients) was also independently associated with longer LOS (aHR 0.36 95% CI 0.19-0.71, P = 0.003), whereas influenza vaccination within 6 months was associated with shorter LOS (aHR 2.14 95% CI 1.18-3.85, P = 0.012).
Our analyses suggest that timely oseltamivir treatment is independently associated with shorter LOS in patients hospitalized for severe influenza. Efforts to ensure early diagnosis and therapeutic intervention are warranted.
Abstract
This paper introduces a new approach to measure the muon magnetic moment anomaly $a_{\mu} = (g-2)/2$ and the muon electric dipole moment (EDM) $d_{\mu}$ at the J-PARC muon facility. The goal ...of our experiment is to measure $a_{\mu}$ and $d_{\mu}$ using an independent method with a factor of 10 lower muon momentum, and a factor of 20 smaller diameter storage-ring solenoid compared with previous and ongoing muon $g-2$ experiments with unprecedented quality of the storage magnetic field. Additional significant differences from the present experimental method include a factor of 1000 smaller transverse emittance of the muon beam (reaccelerated thermal muon beam), its efficient vertical injection into the solenoid, and tracking each decay positron from muon decay to obtain its momentum vector. The precision goal for $a_{\mu}$ is a statistical uncertainty of 450 parts per billion (ppb), similar to the present experimental uncertainty, and a systematic uncertainty less than 70 ppb. The goal for EDM is a sensitivity of $1.5\times 10^{-21}~e\cdot\mbox{cm}$.
Pd nanophases in a Nafion polymer membrane electrolyte were used to enhance DMFC performance by preventing or reducing methanol crossover through the electrolyte. Interestingly, the Pd-impregnated ...nanocomposite membrane showed a lower permeability for methanol and maintained a proton conductivity comparable to that of a pure Nafion membrane. Because of the modification of the membrane by the Pd nanophases, a high molar concentration of methanol could be applied for use in practical DMFC without any power loss.
Aliment Pharmacol Ther 2010; 32: 74–82
Summary
Background Preferences to choose immunochemical faecal occult blood test (FIT) and colonoscopy as colorectal cancer (CRC) screening modalities among ...asymptomatic Chinese subjects remain unknown.
Aim To evaluate the preference of choosing colonoscopy vs. FIT among CRC screening participants.
Methods From a community‐based CRC screening programme for asymptomatic Hong Kong Chinese aged 50–70 years, participants attended standardized educational sessions and chose the options of annual FIT for 5 years or direct colonoscopy once. Factors associated with choosing colonoscopy were evaluated by multivariate regression analysis.
Results Among 3430 participants mean age 56.8 years (s.d. 5.0); female 55.1%, male 44.9%, 51.3% chose colonoscopy and 48.7% chose FIT. Older participants (65–70 years) were less likely to choose colonoscopy adjusted odds ratio (aOR) 0.731, P = 0.041. Subjects who chose colonoscopy were those disagreed screening would lead to discomfort (aOR 1.356, P < 0.001), had relatives or friends who had CRC (first degree relatives aOR 1.679, P < 0.001; second degree relatives aOR 1.304, P = 0.019; friends or others aOR 1.252, P = 0.026) and those who self‐perceived their health as poor (aOR 1.529, P = 0.025).
Conclusions Faecal occult blood test and direct colonoscopy were equally preferable to Chinese. Colonoscopy was preferred among the younger subjects, those with positive family history of CRC and self‐perceived poor health status.
Chronic rhinosinusitis (CRS) and chronic otitis media (COM) share pathophysiological mechanisms such as bacterial infection, biofilm, and persistence of the obstruction state of ventilation routes. ...However, only a few studies have investigated the relationship between these two diseases nationwide and in the general population. The purpose of this study was to determine whether the incidence of COM in patients with CRS differed from that of a matched control from the national health screening cohort.
Data from the Korean Health Insurance Review and Assessment Service-National Patient Samples were collected from 2002 to 2015. Participants who were treated ≥2 times and underwent head and neck computed tomography evaluation were selected. A 1:4 matched CRS group (n=8,057) and a control group (n=32,228) were selected. The control group included participants who were never treated with the ICD-10 code J32 from 2002 to 2015. The CRS group included CRS patients with/without nasal polyps.
The incidence of COM was significantly higher in the CRS group than in the control group. In a subgroup analysis, the incidence of COM in all age groups and in men and women was significantly higher in the CRS group than in the control group. More, CRS increased the risk of COM.
A significant association was observed between CRS and COM. This indicates that CRS patients have a high risk of developing COM.
Objective
To evaluate serial changes in renal function by investigating various clinical factors after radical nephrectomy (RN).
Patients and Methods
The study population consisted of 2068 ...consecutive patients who were treated at multiple institutions by RN for renal cortical tumour without metastasis between 1999 and 2011.
We measured the serial change in estimated glomerular filtration rate (eGFR) and clinical factors during a 60‐month follow‐up period.
The changes in eGFR over time were analysed according to baseline eGFR (eGFR ≥60 and 15–59 mL/min/1.73m2) using a linear mixed model.
The independent prognostic value of various clinical factors on the increase in eGFR was ascertained by multivariate mixed regression model.
Results
Overall, there was a subsequent restoration of renal function over the 60 months.
The slope for the relationship between the eGFR and the time since RN was 0.082 (95% confidence interval CI 0.039–0.104; P < 0.001) and 0.053 (95% CI 0.006–0.100; P = 0.038) in each baseline group, indicating that each month after RN was associated with an increase in eGFR of 0.082 and 0.053 mL/min/1.73m2, respectively.
When we analysed renal function based on various factors, postoperative eGFR of patients with diabetes mellitus, old age (≥70 years) or a preoperative eGFR of <30 mL/min/1.73 m2, was decreased or maintained at a certain level without any improvement in renal function.
Preoperative predictors of an increase in eGFR after RN were young age, no DM, no hypertension, a preoperative eGFR of ≥30 mL/min/1.73m2 and time after surgery (≥36 months).
Conclusions
Renal function recovered continuously during the 60‐month follow‐up period after RN.
However, the trends in functional recovery change were different according to various clinical factors and such information should be discussed with patients when being counselled about their treatment for renal cell carcinoma (RCC).
This study sought to identify culprit lesion (CL) precursors among acute coronary syndrome (ACS) patients based on qualitative and quantitative computed tomography–based plaque characteristics.
...Coronary computed tomography angiography (CTA) has been validated for patient-level prediction of ACS. However, the applicability of coronary CTA to CL assessment is not known.
Utilizing the ICONIC (Incident COroNary Syndromes Identified by Computed Tomography) study, a nested case-control study of 468 patients with baseline coronary CTA, the study included ACS patients with invasive coronary angiography–adjudicated CLs that could be aligned to CL precursors on baseline coronary CTA. Separate blinded core laboratories adjudicated CLs and performed atherosclerotic plaque evaluation. Thereafter, the study used a boosted ensemble algorithm (XGBoost) to develop a predictive model of CLs. Data were randomly split into a training set (80%) and a test set (20%). The area under the receiver-operating characteristic curve of this model was compared with that of diameter stenosis (model 1), high-risk plaque features (model 2), and lesion-level features of CL precursors from the ICONIC study (model 3). Thereafter, the machine learning (ML) model was applied to 234 non-ACS patients with 864 lesions to determine model performance for CL exclusion.
CL precursors were identified by both coronary angiography and baseline coronary CTA in 124 of 234 (53.0%) patients, with a total of 582 lesions (containing 124 CLs) included in the analysis. The ML model demonstrated significantly higher area under the receiver-operating characteristic curve for discriminating CL precursors (0.774; 95% confidence interval CI: 0.758 to 0.790) compared with model 1 (0.599; 95% CI: 0.599 to 0.599; p < 0.01), model 2 (0.532; 95% CI: 0.501 to 0.563; p < 0.01), and model 3 (0.672; 95% CI: 0.662 to 0.682; p < 0.01). When applied to the non-ACS cohort, the ML model had a specificity of 89.3% for excluding CLs.
In a high-risk cohort, a boosted ensemble algorithm can be used to predict CL from non-CL precursors on coronary CTA.
Display omitted
PDF
