Abstract We report results of a case–control study the association between receipt antimicrobial agents and diagnosis community-acquired methicillin-resistant Staphylococcus aureus (MRSA) in United Kingdom. Eligible adults, selected from General Practice Research Database, had no previous MRSA, hospitalization past 2 years, >2 years follow-up recorded database. For 2000–2004, we identified 1,981 MRSA case-patients 19,779 matched control-patients. The odds ratios (ORs) 95% confidence...

In critically ill patients, compromised microcirculation causes tissue hypoxia, organ failure, and death. These pathophysiological processes occur particularly in patients with high illness severity, so reliable hypoxia biomarkers should reflect this their occurrence. This secondary analysis of a prospective study categorized by burden dysfunction (BOD) using the cohort's median initial sequential failure assessment (SOFA) score 8 as cutoff. The kinetic parameters markers lactate...

Abstract Background For preoxygenation, German guidelines consider non-invasive ventilation (NIV) as a possible method in prehospital trauma care the absence of aspiration, severe head or face injuries, unconsciousness, patient non-compliance. As data on utilization and characteristics patients receiving NIV are lacking, this study aims to identify predictors usage using machine learning compare these findings with current national guideline. Methods A cross-regional registry emergency...

Resistance to antibacterial drugs can be contained by judicious prescribing. In particular, the use of these in children requires ongoing surveillance. While there was a decline prescribing UK during 1990s, recent trends are less well known.To describe antibiotic patterns and time over last two decades.We identified all ages 0-19 years from 1993 2007 their prescriptions General Practice Research Database. We used Poisson regression estimate prescription rates considering children's age...

Lifesaving early distinction of infectious systemic inflammatory response syndrome, known as "sepsis," from noninfectious syndrome is challenging in the ICU because high prevalence and lack specific biomarkers. The purpose this study was to use an automatic algorithm detect criteria (tachycardia, tachypnea, leukocytosis, fever) surgical patients for ICU-wide determination evaluation algorithm-derived descriptors sepsis prediction diagnosis a polytrauma cohort.Cross-sectional descriptive...

Abstract Background Outbreak reports suggest that community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections can be life-threatening. We conducted a population based cohort study to assess the magnitude of mortality associated with MRSA diagnosed in community. Methods used United Kingdom's General Practice Research Database (GPRD) form all patients community from 2001 through 2004 and up ten without an diagnosis. The latter were frequency-matched on age, GPRD practice...

Abstract Purpose To determine whether combination of sulfonylureas and metformin increases the risk death from any cause in patients with type 2 diabetes. Methods A nested case‐control study was conducted within a population‐based cohort UK General Practice Research Database (GPRD). The included over age 40 who were prescribed first oral hypoglycaemic agent between 1 January 1988 30 June 2008. Cases all deceased during follow‐up. Up to 10 controls matched each case on year birth, date entry...

Sepsis is the leading cause of death in intensive care units (ICUs), and its timely detection treatment improve clinical outcome survival. Systemic inflammatory response syndrome (SIRS) refers to concurrent fulfillment at least two out following four criteria: tachycardia, tachypnea, abnormal body temperature, leukocyte count. While SIRS was controversially abandoned from current sepsis definition, a dynamic representation still has potential for prediction diagnosis.We retrospectively...

A common final pathway of pathogenetic mechanisms in septic organ dysfunction and death is a lack or non-utilization oxygen. Plasma concentrations lactate serve as surrogates for the oxygen-deficiency-induced imbalance between energy supply demand. As S-adenosylhomocysteine (SAH) was shown to reflect tissue hypoxia, we compared ability SAH versus predict progression inflammatory disease death. Using univariate multiple logistic regression, found that but not lactate, taken upon patients'...

This study assessed the validity of Resident Assessment Instrument Minimum Data Set (RAI-MDS) Version 2.0 for diagnoses diabetes and comorbid conditions in residents long-term care facilities (LTCFs). Hospital inpatient, outpatient physician billing, RAI-MDS, population registry data 1997 to 2011 from Saskatchewan, Canada were used ascertain cases 12 conditions. Prevalence estimates calculated both RAI-MDS administrative health data. Sensitivity, specificity, positive negative predictive...

To investigate in children the association between antibacterial drugs and subsequent diagnosis of methicillin-resistant Staphylococcus aureus (MRSA) community.Population-based case-control study 1 to 19 years age.Primary care, General Practice Research Database, United Kingdom, 1994-2007.Cases were who had MRSA diagnosed as outpatients, controls individually matched on age practice, with case's date index for both. Main Exposures Antibacterial agents prescribed 180 30 days prior date,...

To analyze the performance of 1 mg dexamethasone suppression test (DST) in patients with obesity. Special attention was paid to influence interfering medication on DST.In this prospective cohort study (Mannheim Obesity Study), obesity were evaluated before bariatric surgery. For evaluation hypercortisolism, a dexamethasone-suppression all subjects performed. Medication assessed for possible interference.Two hundred seventy-eight mean age 42.3 years (68.8% women) and BMI 47.9 ± 8.4 kg/m(2)...

Sepsis-3 definition uses SOFA score to discriminate sepsis from uncomplicated infection, replacing SIRS criteria that were criticized for being inaccurate. Eligibility of sepsis-3 diagnosis and the applied validation methodology using mortality as endpoint are topic ongoing debate. We assessed impact different on in our ICU devised a mathematical approach mortality-based criteria. As infectious status is often unclear at clinical deterioration, we integrated non-infected patients into...

Abstract Background Sepsis is the leading cause of death in intensive care unit (ICU). Expediting its diagnosis, largely determined by clinical assessment, improves survival. Predictive and explanatory modelling sepsis critically ill commonly bases both outcome definition predictions on criteria for consensus definitions sepsis, to circularity. As a remedy, we collected ground truth labels sepsis. Methods In Ground Truth Questionnaire (GTSQ), senior attending physicians ICU documented daily...

Abstract Purpose To determine whether the use of thiazolidinediones (TZDs) decreases risk incident strokes in patients with type 2 diabetes. Methods We conducted a nested case‐control study within population‐based cohort from UK General Practice Research Database (GPRD). The comprised over age 40 who were prescribed first oral hypoglycemic agent between 1 January 1988 and 30 June 2008. Cases included all subjects experienced stroke during follow‐up. Up to 10 controls matched each case on (±2...

Purpose: Clinically unapparent microcirculatory impairment is common and has a negative impact on septic shock, but specific therapy not established so far. This prospective observational study aimed at identifying candidate parameters for microcirculatory-guided hemodynamic therapy. : NCT01530932. Materials Methods: Microcirculatory flow postcapillary venous oxygen saturation were detected during vaso-occlusive testing (VOT) days 1 (T0), 2 (T24), 4 (T72) in 20 patients with shock surgical...

Tissue hypoxia is associated with the development of organ dysfunction and death in critically ill patients commonly captured using blood lactate. The kinetic parameters serial lactate evaluations are superior at predicting mortality compared single values. S-adenosylhomocysteine (SAH), which also hypoxia, was recently established as a useful predictor septic death. We evaluated performance SAH for prediction cohort patients. For SAH, maxima means well normalized area scores were calculated...

Prescription medication use, which is common among long-term care facility (LTCF) residents, routinely used to describe quality of and predict health outcomes. Data sources that capture information, include surveys, medical charts, administrative databases, clinical assessment records, may not collect concordant can result in comparable prevalence effect size estimates. The purpose this research was estimate agreement between two population-based electronic data for measuring use several...

Statistical network analyses have become popular in many scientific disciplines, where an important task is to test for differences between two networks. We describe overall framework differential testing procedures that vary regarding (1) the estimation method, typically based on specific concepts of association, and (2) characteristic employed measure difference. Using permutation-based tests, our approach general applicable various overall, node-specific or edge-specific difference...

Background Intestinal ischemia is a common complication with obscure pathophysiology in critically ill patients. Since insufficient delivery of oxygen discussed, we investigated the influence delivery, hemoglobin, arterial saturation, cardiac index and systemic vascular resistance on development intestinal ischemia. Furthermore, evaluated predictive power elevated lactate levels for diagnosis Methods In retrospective case-control study data (mean minimum index) critical patients from...