المؤلفون: Anna Coppola, Alice Laudisio, Leonardo Rodano, Felice Marinosci, Raffaele Antonelli Incalzi, Alessandro Zizzo

المصدر: Journal of the American Medical Directors Association. 14:513-517

مصطلحات موضوعية: Male, Patient Transfer, medicine.medical_specialty, Urinary system, Drug Resistance, Urine, Cohort Studies, Antibiotic resistance, Risk Factors, Internal medicine, medicine, Humans, Risk factor, Intensive care medicine, General Nursing, Aged, Carbapenem resistance, Proportional hazards model, business.industry, Health Policy, Confounding, General Medicine, bacterial infections and mycoses, Anti-Bacterial Agents, Nursing Homes, Carbapenems, Urinary Tract Infections, Regression Analysis, Female, Geriatrics and Gerontology, Urinary Catheterization, business, Cohort study

الوصف: Objectives The emergence of antibiotic-resistant urinary pathogens represents a public health care concern. We aimed to detect antibiotic-resistance in elderly nursing home residents with urinary tract infection (UTI) and to assess the impact of carbapenem resistance on mortality. Methods This cohort study of 196 patients with UTI confirmed by a positive urine culture was conducted in a nursing home in Italy. Data on 6-month mortality was obtained by nursing home records and confirmed by death certificates. Diagnosis of UTI was ascertained by urine culture. Antibiotic resistance was defined according to antibiograms performed by the same laboratory. Cox regression analysis was used to assess the adjusted association between carbapenem resistance and 6-month mortality. Results Carbapenem resistance was found in 39/196 (20%) patients. After adjusting for potential confounders, carbapenem resistance was associated in Cox regression modeling with 6-month mortality (relative risk = 2.79; 95% confidence interval = 1.17–6.70; P = .021). Conclusions In elderly in-patients, UTI from carbapenem-resistant germs is an independent risk factor for 6-month mortality, irrespective of the etiologic agent. Further studies are needed to clarify the mechanisms underlying this association.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::813c69ed2cbbf9df20e94d4bc2ae3ec7Test
https://doi.org/10.1016/j.jamda.2013.02.016Test

المؤلفون: Elisa Gervasoni, Angelo Montesano, Michela Agostini, Davide Cattaneo, Rita Russo, Andrea Polli, Elisa Bianchi, Andrea Turolla, Gianluca Iacobone, M. Rovaris, Elisabetta Pupillo, Alessandra Rodanò, Silvia Romi, Ettore Beghi, Irene Aprile, Francesca Tettamanzi, Isabella Imbimbo, Johanna Jonsdottir, Arianna Cruciani

المساهمون: Beghi E., Gervasoni E., Pupillo E., Bianchi E., Montesano A., Aprile I., Agostini M., Rovaris M., Cattaneo D., Iacobone G., Jonsdottir J., Rodano A., Romi S., Russo R., Tettamanzi F., Cruciani A., Imbimbo I., Polli A., Turolla A.

المصدر: Archives of Physical Medicine and Rehabilitation. 99:641-651

مصطلحات موضوعية: 030506 rehabilitation, medicine.medical_specialty, medicine.medical_treatment, Poison control, Physical Therapy, Sports Therapy and Rehabilitation, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Fall, medicine, Multiple sclerosi, Prospective cohort study, Stroke, Rehabilitation, Proportional hazards model, business.industry, medicine.disease, Confidence interval, Parkinson disease, Berg Balance Scale, Physical therapy, Risk factor, 0305 other medical science, business, 030217 neurology & neurosurgery

الوصف: Objective To compare the risk of falls and fall predictors in patients with Parkinson disease (PD), multiple sclerosis (MS), and stroke using the same study design. Design Multicenter prospective cohort study. Setting Institutions for physical therapy and rehabilitation. Participants Patients (N=299) with PD (n=94), MS (n=111), and stroke (n=94) seen for rehabilitation. Interventions Not applicable. Main Outcome Measures Functional scales were applied to investigate balance, disability, daily performance, self-confidence with balance, and social integration. Patients were followed for 6 months. Telephone interviews were organized at 2, 4, and 6 months to record falls and fall-related injuries. Incidence ratios, Kaplan-Meier survival curves, and Cox proportional hazards models were used. Results Of the 299 patients enrolled, 259 had complete follow-up. One hundred and twenty-two patients (47.1%) fell at least once; 82 (31.7%) were recurrent fallers and 44 (17.0%) suffered injuries; and 16%, 32%, and 40% fell at 2, 4, and 6 months. Risk of falls was associated with disease type (PD, MS, and stroke in decreasing order) and confidence with balance (Activities-specific Balance Confidence [ABC] scale). Recurrent fallers were 7%, 15%, and 24% at 2, 4, and 6 months. The risk of recurrent falls was associated with disease type, high educational level, and ABC score. Injured fallers were 3%, 8%, and 12% at 2, 4, and 6 months. The only predictor of falls with injuries was disease type (PD). Conclusions PD, MS, and stroke carry a high risk of falls. Other predictors include perceived balance confidence and high educational level.

وصف الملف: ELETTRONICO

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7f1778627f9835e00a9acf98d7a037baTest
https://doi.org/10.1016/j.apmr.2017.10.009Test