67 research outputs found
A retrospective, multicenter study of the efficacy of lapatinib plus trastuzumab in HER2-positive metastatic breast cancer patients previously treated with trastuzumab, lapatinib, or both: the Trastyvere study
[Purpose]: To evaluate the efficacy and safety of lapatinib (L) and trastuzumab (T) combination in HER2-positive metastatic breast cancer (MBC) patients previously treated with T and/or L.[Materials and methods]: We conducted a retrospective, post-authorized, multicenter study including patients with HER2-positive MBC or locally advanced breast cancer (ABC) treated with the combination of LâT. Concomitant endocrine therapy, as well as brain metastasis and/or prior exposure to L, were allowed.[Results]: One hundred and fifteen patients from 14 institutions were included. The median age was 59.8 years. The median number of prior T regimens in the advanced setting was 3 and 73 patients had received a prior L regimen. The clinical benefit rate (CBR) was 34.8% (95% CI 26.1â43.5). Among other efficacy endpoints, the overall response rate was 21.7%, and median progression-free survival (PFS) and overall survival were 3.9 and 21.6 months, respectively. Heavily pretreated andââ„â3 metastatic organ patients showed lower CBR and PFS than patients with a low number of previous regimens andâ<â3 metastatic organs. Moreover, CBR did not significantly change in L-pretreated compared with L-naĂŻve patients (31.5% versus 40.5% for L-pretreated versus L-naĂŻve). Grade 3/4 adverse events were reported in 19 patients (16.5%).[Conclusion]: The combination of LâT is an effective and well-tolerated regimen in heavily pretreated patients and remains active among patients progressing on prior L-based therapy. Our study suggests that the LâT regimen is a safe and active chemotherapy-free option for MBC patients previously treated with T and/or L.This work was supported by GlaxoSmithKline plc (GSK) through a contract with Medica Scientia Innovation Research (MedSIR), an academic research organization focused on independent clinical research development
Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies
Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42\ub74% vs 44\ub72%; absolute difference \u20131\ub769 [\u20139\ub758 to 6\ub711] p=0\ub767; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5\u20138] vs 6 [5\u20138] cm H2O; p=0\ub70011). ICU mortality was higher in MICs than in HICs (30\ub75% vs 19\ub79%; p=0\ub70004; adjusted effect 16\ub741% [95% CI 9\ub752\u201323\ub752]; p<0\ub70001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0\ub780 [95% CI 0\ub775\u20130\ub786]; p<0\ub70001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status. Funding: No funding
Spontaneous Breathing in Early Acute Respiratory Distress Syndrome: Insights From the Large Observational Study to UNderstand the Global Impact of Severe Acute Respiratory FailurE Study
OBJECTIVES: To describe the characteristics and outcomes of patients with acute respiratory distress syndrome with or without spontaneous breathing and to investigate whether the effects of spontaneous breathing on outcome depend on acute respiratory distress syndrome severity. DESIGN: Planned secondary analysis of a prospective, observational, multicentre cohort study. SETTING: International sample of 459 ICUs from 50 countries. PATIENTS: Patients with acute respiratory distress syndrome and at least 2 days of invasive mechanical ventilation and available data for the mode of mechanical ventilation and respiratory rate for the 2 first days. INTERVENTIONS: Analysis of patients with and without spontaneous breathing, defined by the mode of mechanical ventilation and by actual respiratory rate compared with set respiratory rate during the first 48 hours of mechanical ventilation. MEASUREMENTS AND MAIN RESULTS: Spontaneous breathing was present in 67% of patients with mild acute respiratory distress syndrome, 58% of patients with moderate acute respiratory distress syndrome, and 46% of patients with severe acute respiratory distress syndrome. Patients with spontaneous breathing were older and had lower acute respiratory distress syndrome severity, Sequential Organ Failure Assessment scores, ICU and hospital mortality, and were less likely to be diagnosed with acute respiratory distress syndrome by clinicians. In adjusted analysis, spontaneous breathing during the first 2 days was not associated with an effect on ICU or hospital mortality (33% vs 37%; odds ratio, 1.18 [0.92-1.51]; p = 0.19 and 37% vs 41%; odds ratio, 1.18 [0.93-1.50]; p = 0.196, respectively ). Spontaneous breathing was associated with increased ventilator-free days (13 [0-22] vs 8 [0-20]; p = 0.014) and shorter duration of ICU stay (11 [6-20] vs 12 [7-22]; p = 0.04). CONCLUSIONS: Spontaneous breathing is common in patients with acute respiratory distress syndrome during the first 48 hours of mechanical ventilation. Spontaneous breathing is not associated with worse outcomes and may hasten liberation from the ventilator and from ICU. Although these results support the use of spontaneous breathing in patients with acute respiratory distress syndrome independent of acute respiratory distress syndrome severity, the use of controlled ventilation indicates a bias toward use in patients with higher disease severity. In addition, because the lack of reliable data on inspiratory effort in our study, prospective studies incorporating the magnitude of inspiratory effort and adjusting for all potential severity confounders are required
Identifying associations between diabetes and acute respiratory distress syndrome in patients with acute hypoxemic respiratory failure: an analysis of the LUNG SAFE database
Background: Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of this study was to evaluate associations between pre-existing diabetes mellitus and ARDS in critically ill patients with acute hypoxemic respiratory failure (AHRF). Methods: An ancillary analysis of a global, multi-centre prospective observational study (LUNG SAFE) was undertaken. LUNG SAFE evaluated all patients admitted to an intensive care unit (ICU) over a 4-week period, that required mechanical ventilation and met AHRF criteria. Patients who had their AHRF fully explained by cardiac failure were excluded. Important clinical characteristics were included in a stepwise selection approach (forward and backward selection combined with a significance level of 0.05) to identify a set of independent variables associated with having ARDS at any time, developing ARDS (defined as ARDS occurring after day 2 from meeting AHRF criteria) and with hospital mortality. Furthermore, propensity score analysis was undertaken to account for the differences in baseline characteristics between patients with and without diabetes mellitus, and the association between diabetes mellitus and outcomes of interest was assessed on matched samples. Results: Of the 4107 patients with AHRF included in this study, 3022 (73.6%) patients fulfilled ARDS criteria at admission or developed ARDS during their ICU stay. Diabetes mellitus was a pre-existing co-morbidity in 913 patients (22.2% of patients with AHRF). In multivariable analysis, there was no association between diabetes mellitus and having ARDS (OR 0.93 (0.78-1.11); p = 0.39), developing ARDS late (OR 0.79 (0.54-1.15); p = 0.22), or hospital mortality in patients with ARDS (1.15 (0.93-1.42); p = 0.19). In a matched sample of patients, there was no association between diabetes mellitus and outcomes of interest. Conclusions: In a large, global observational study of patients with AHRF, no association was found between diabetes mellitus and having ARDS, developing ARDS, or outcomes from ARDS. Trial registration: NCT02010073. Registered on 12 December 2013
Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries
Background: To better understand the epidemiology and patterns of tracheostomy practice for patients with acute respiratory distress syndrome (ARDS), we investigated the current usage of tracheostomy in patients with ARDS recruited into the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) study. Methods: This is a secondary analysis of LUNG-SAFE, an international, multicenter, prospective cohort study of patients receiving invasive or noninvasive ventilation in 50 countries spanning 5 continents. The study was carried out over 4 weeks consecutively in the winter of 2014, and 459 ICUs participated. We evaluated the clinical characteristics, management and outcomes of patients that received tracheostomy, in the cohort of patients that developed ARDS on day 1-2 of acute hypoxemic respiratory failure, and in a subsequent propensity-matched cohort. Results: Of the 2377 patients with ARDS that fulfilled the inclusion criteria, 309 (13.0%) underwent tracheostomy during their ICU stay. Patients from high-income European countries (n = 198/1263) more frequently underwent tracheostomy compared to patients from non-European high-income countries (n = 63/649) or patients from middle-income countries (n = 48/465). Only 86/309 (27.8%) underwent tracheostomy on or before day 7, while the median timing of tracheostomy was 14 (Q1-Q3, 7-21) days after onset of ARDS. In the subsample matched by propensity score, ICU and hospital stay were longer in patients with tracheostomy. While patients with tracheostomy had the highest survival probability, there was no difference in 60-day or 90-day mortality in either the patient subgroup that survived for at least 5 days in ICU, or in the propensity-matched subsample. Conclusions: Most patients that receive tracheostomy do so after the first week of critical illness. Tracheostomy may prolong patient survival but does not reduce 60-day or 90-day mortality. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013
New insights into the genetic etiology of Alzheimer's disease and related dementias
Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE Δ4 allele
Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study
Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ℠0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe
XLVIII Coloquio Argentino de EstadĂstica. VI Jornada de EducaciĂłn EstadĂstica Martha Aliaga Modalidad virtual
Esta publicaciĂłn es una compilaciĂłn de las actividades realizadas en el marco del XLVIII Coloquio Argentino de EstadĂstica y la VI Jornada de EducaciĂłn EstadĂstica Martha Aliaga organizada por la Sociedad Argentina de EstadĂstica y la Facultad de Ciencias EconĂłmicas. Se presenta un resumen para cada uno de los talleres, cursos realizados, ponencias y poster presentados. Para los dos Ășltimos se dispone de un hipervĂnculo que direcciona a la presentaciĂłn del trabajo. Ellos obedecen a distintas temĂĄticas de la estadĂstica con una sesiĂłn especial destinada a la aplicaciĂłn de modelos y anĂĄlisis de datos sobre COVID-19.Fil: Saino, MartĂn. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Stimolo, MarĂa InĂ©s. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Ortiz, Pablo. Universidad Nacional de cĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Guardiola, Mariana. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Aguirre, Alberto Frank LĂĄzaro. Universidade Federal de Alfenas. Departamento de EstatĂstica. Instituto de CiĂȘncias Exatas; Brasil.Fil: Alves Nogueira, Denismar. Universidade Federal de Alfenas. Departamento de EstatĂstica. Instituto de CiĂȘncias Exatas; Brasil.Fil: Beijo, Luiz Alberto. Universidade Federal de Alfenas. Departamento de EstatĂstica. Instituto de CiĂȘncias Exatas; Brasil.Fil: Solis, Juan Manuel. Universidad Nacional de Jujuy. Centro de Estudios en BioestadĂstica, BioinformĂĄtica y AgromĂĄtica; Argentina.Fil: Alabar, Fabio. Universidad Nacional de Jujuy. Centro de Estudios en BioestadĂstica, BioinformĂĄtica y AgromĂĄtica; Argentina.Fil: Ruiz, SebastiĂĄn LeĂłn. Universidad Nacional de Jujuy. Centro de Estudios en BioestadĂstica, BioinformĂĄtica y AgromĂĄtica; Argentina.Fil: Hurtado, Rafael. Universidad Nacional de Jujuy; Argentina.Fil: AlegrĂa JimĂ©nez, Alfredo. Universidad TĂ©cnica Federico Santa MarĂa. Departamento de MatemĂĄtica; Chile.Fil: Emery, Xavier. Universidad de Chile. Departamento de IngenierĂa en Minas; Chile.Fil: Emery, Xavier. Universidad de Chile. Advanced Mining Technology Center; Chile.Fil: Ălvarez-Vaz, RamĂłn. Universidad de la RepĂșblica. Instituto de EstadĂstica. Departamento de MĂ©todos Cuantitativos; Uruguay.Fil: Massa, Fernando. Universidad de la RepĂșblica. Instituto de EstadĂstica. Departamento de MĂ©todos Cuantitativos; Uruguay.Fil: Vernazza, Elena. Universidad de la RepĂșblica. Facultad de Ciencias EconĂłmicas y de AdministraciĂłn. Instituto de EstadĂstica; Uruguay.Fil: Lezcano, Mikaela. Universidad de la RepĂșblica. Facultad de Ciencias EconĂłmicas y de AdministraciĂłn. Instituto de EstadĂstica; Uruguay.Fil: Urruticoechea, Alar. Universidad CatĂłlica del Uruguay. Facultad de Ciencias de la Salud. Departamento de NeurocogniciĂłn; Uruguay.Fil: del Callejo Canal, Diana. Universidad Veracruzana. Instituto de InvestigaciĂłn de Estudios Superiores, EconĂłmicos y Sociales; MĂ©xico.Fil: Canal MartĂnez, Margarita. Universidad Veracruzana. Instituto de InvestigaciĂłn de Estudios Superiores, EconĂłmicos y Sociales; MĂ©xico.Fil: Ruggia, Ornela. CONICET; Argentina. Universidad Nacional de CĂłrdoba. Facultad de Ciencias Agropecuarias. Departamento de desarrollo rural; Argentina.Fil: Tolosa, Leticia Eva. Universidad Nacional de CĂłrdoba; Argentina. Universidad CatĂłlica de CĂłrdoba; Argentina.Fil: Rojo, MarĂa Paula. Universidad Nacional de CĂłrdoba; Argentina.Fil: Nicolas, MarĂa Claudia. Universidad Nacional de CĂłrdoba; Argentina. Universidad CatĂłlica de CĂłrdoba; Argentina.Fil: Barbaroy, TomĂĄs. Universidad Nacional de CĂłrdoba; Argentina.Fil: Villarreal, Fernanda. CONICET, Universidad Nacional del Sur. Instituto de MatemĂĄtica de BahĂa Blanca (INMABB); Argentina.Fil: Pisani, MarĂa Virginia. Universidad Nacional del Sur. Departamento de MatemĂĄtica; Argentina.Fil: Quintana, Alicia. Universidad Nacional del Sur. Departamento de MatemĂĄtica; Argentina.Fil: Elorza, MarĂa Eugenia. CONICET. Universidad Nacional del Sur. Instituto de Investigaciones EconĂłmicas y Sociales del Sur; Argentina.Fil: Peretti, Gianluca. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Buzzi, Sergio MartĂn. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas. Departamento de EstadĂstica y MatemĂĄtica; Argentina.Fil: Settecase, Eugenia. Universidad Nacional de Rosario. Facultad de Ciencias EconĂłmicas y EstadĂsticas. Instituto de Investigaciones TeĂłricas y Aplicadas en EstadĂstica; Argentina.Fil: Settecase, Eugenia. Department of Agriculture and Fisheries. Leslie Research Facility; Australia.Fil: Paccapelo, MarĂa Valeria. Department of Agriculture and Fisheries. Leslie Research Facility; Australia.Fil: Cuesta, Cristina. Universidad Nacional de Rosario. Facultad de Ciencias EconĂłmicas y EstadĂsticas. Instituto de Investigaciones TeĂłricas y Aplicadas en EstadĂstica; Argentina.Fil: Saenz, JosĂ© Luis. Universidad Nacional de la Patagonia Austral; Argentina.Fil: Luna, Silvia. Universidad Nacional de la Patagonia Austral; Argentina.Fil: Paredes, Paula. Universidad Nacional de la Patagonia Austral; Argentina. Instituto Nacional de TecnologĂa Agropecuaria. EstaciĂłn Experimental Agropecuaria Santa Cruz; Argentina.Fil: Maglione, Dora. Universidad Nacional de la Patagonia Austral; Argentina.Fil: Rosas, Juan E. Instituto Nacional de InvestigaciĂłn Agropecuaria (INIA); Uruguay.Fil: PĂ©rez de Vida, Fernando. Instituto Nacional de InvestigaciĂłn Agropecuaria (INIA); Uruguay.Fil: Marella, Muzio. Sociedad AnĂłnima Molinos Arroceros Nacionales (SAMAN); Uruguay.Fil: Berberian, Natalia. Universidad de la RepĂșblica. Facultad de AgronomĂa; Uruguay.Fil: Ponce, Daniela. Universidad Estadual Paulista. Facultad de Medicina; Brasil.Fil: Silveira, Liciana Vaz de A. Universidad Estadual Paulista; Brasil.Fil: Freitas Galletti, Agda Jessica de. Universidad Estadual Paulista; Brasil.Fil: Bellassai, Juan Carlos. Universidad Nacional de CĂłrdoba. Facultad de Ciencias Exactas FĂsicas y Naturales. Centro de InvestigaciĂłn y Estudios de MatemĂĄticas (CIEM-Conicet); Argentina.Fil: Pappaterra, MarĂa LucĂa. Universidad Nacional de CĂłrdoba. Facultad de Ciencias Exactas FĂsicas y Naturales. Centro de InvestigaciĂłn y Estudios de MatemĂĄticas (CIEM-Conicet); Argentina.Fil: Ojeda, Silvia MarĂa. Universidad Nacional de CĂłrdoba. Facultad de MatemĂĄtica, AstronomĂa, FĂsica y ComputaciĂłn; Argentina.Fil: Ascua, Melina BelĂ©n. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: RoldĂĄn, Dana Agustina. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Rodi, Ayrton Luis. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Ventre, Giuliana. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: GonzĂĄlez, Agustina. Universidad Nacional de Rio Cuarto. Facultad de Ciencias Exactas, FĂsico-QuĂmicas y Naturales. Departamento de MatemĂĄtica; Argentina.Fil: Palacio, Gabriela. Universidad Nacional de Rio Cuarto. Facultad de Ciencias Exactas, FĂsico-QuĂmicas y Naturales. Departamento de MatemĂĄtica; Argentina.Fil: Bigolin, Sabina. Universidad Nacional de Rio Cuarto. Facultad de Ciencias Exactas, FĂsico-QuĂmicas y Naturales. Departamento de MatemĂĄtica; Argentina.Fil: Ferrero, Susana. Universidad Nacional de Rio Cuarto. Facultad de Ciencias Exactas, FĂsico-QuĂmicas y Naturales. Departamento de MatemĂĄtica; Argentina.Fil: Del Medico, Ana Paula. Universidad Nacional de Rosario. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Instituto de Investigaciones en Ciencias Agrarias de Rosario (IICAR); Argentina.Fil: Pratta, Guillermo. Universidad Nacional de Rosario. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Instituto de Investigaciones en Ciencias Agrarias de Rosario (IICAR); Argentina.Fil: Tenaglia, Gerardo. Instituto Nacional de TecnologĂa Agropecuaria. Instituto de InvestigaciĂłn y Desarrollo TecnolĂłgico para la Agricultura Familiar; Argentina.Fil: Lavalle, Andrea. Universidad Nacional del Comahue. Departamento de EstadĂstica; Argentina.Fil: Demaio, Alejo. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: HernĂĄndez, Paz. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Di Palma, Fabricio. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Calizaya, Pablo. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Avalis, Francisca. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Caro, Norma Patricia. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Caro, Norma Patricia. Universidad Nacional de CĂłrdoba. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas; Argentina.Fil: FernĂcola, Marcela. Universidad de Buenos Aires. Facultad de Farmacia y BioquĂmica; Argentina.Fil: Nuñez, Myriam. Universidad de Buenos Aires. Facultad de Farmacia y BioquĂmica; Argentina.Fil: Dundray, , FabiĂĄn. Universidad de Buenos Aires. Facultad de Farmacia y BioquĂmica; Argentina.Fil: Calviño, Amalia. Universidad de Buenos Aires. Instituto de QuĂmica y Metabolismo del FĂĄrmaco. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas; Argentina.Fil: FarfĂĄn Machaca, Yheni. Universidad Nacional de San Antonio Abad del Cusco. Departamento AcadĂ©mico de MatemĂĄticas y EstadĂstica; Argentina.Fil: Paucar, Guillermo. Universidad Nacional de San Antonio Abad del Cusco. Departamento AcadĂ©mico de MatemĂĄticas y EstadĂstica; Argentina.Fil: Coaquira, Frida. Universidad Nacional de San Antonio Abad del Cusco. Escuela de posgrado UNSAAC; Argentina.Fil: Ferreri, NoemĂ M. Universidad Nacional de Rosario. Facultad de Ciencias Exactas, IngenierĂa y Agrimensura; Argentina.Fil: Pascaner, Melina. Universidad Nacional de Rosario. Facultad de Ciencias Exactas, IngenierĂa y Agrimensura; Argentina.Fil: Martinez, Facundo. Universidad Nacional de Rosario. Facultad de Ciencias Exactas, IngenierĂa y Agrimensura; Argentina.Fil: Bossolasco, MarĂa Luisa. Universidad Nacional de TucumĂĄn. Facultad de Ciencias Naturales e Instituto Miguel Lillo; Argentina.Fil: Bortolotto, Eugenia B. Universidad Nacional de Rosario. Centro de Estudios FotosintĂ©ticos y BioquĂmicos (CEFOBI); Argentina.Fil: Bortolotto, Eugenia B. Universidad Nacional de Rosario. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas; Argentina.Fil: Faviere, Gabriela S. Universidad Nacional de Rosario. Centro de Estudios FotosintĂ©ticos y BioquĂmicos (CEFOBI); Argentina.Fil: Faviere, Gabriela S. Universidad Nacional de Rosario. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas; Argentina.Fil: Angelini, Julia. Universidad Nacional de Rosario. Centro de Estudios FotosintĂ©ticos y BioquĂmicos (CEFOBI); Argentina.Fil: Angelini, Julia. Universidad Nacional de Rosario. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas; Argentina.Fil: Cervigni, Gerardo. Universidad Nacional de Rosario. Centro de Estudios FotosintĂ©ticos y BioquĂmicos (CEFOBI); Argentina.Fil: Cervigni, Gerardo. Universidad Nacional de Rosario. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas; Argentina.Fil: Valentini, Gabriel. Instituto Nacional de TecnologĂa Agropecuaria. EstaciĂłn Experimental Agropecuaria INTA San Pedro; Argentina.Fil: Chiapella, Luciana C.. Universidad Nacional de Rosario. Facultad de Ciencias BioquĂmicas y FarmacĂ©uticas; Argentina.Fil: Chiapella, Luciana C. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas (CONICET); Argentina.Fil: Grendas, Leandro. Universidad Buenos Aires. Facultad de Medicina. Instituto de FarmacologĂa; Argentina.Fil: Daray, Federico. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas (CONICET); Argentina.Fil: Daray, Federico. Universidad Buenos Aires. Facultad de Medicina. Instituto de FarmacologĂa; Argentina.Fil: Leal, Danilo. Universidad AndrĂ©s Bello. Facultad de IngenierĂa; Chile.Fil: Nicolis, Orietta. Universidad AndrĂ©s Bello. Facultad de IngenierĂa; Chile.Fil: Bonadies, MarĂa Eugenia. Universidad de Buenos Aires. Facultad de Farmacia y BioquĂmica; Argentina.Fil: Ponteville, Christiane. Universidad de Buenos Aires. Facultad de Farmacia y BioquĂmica; Argentina.Fil: Catalano, Mara. Universidad Nacional de Rosario. Facultad de Ciencias Exactas, IngenierĂa y Agrimensura; Argentina.Fil: Catalano, Mara. Universidad Nacional de Rosario. Facultad de Ciencias Exactas, IngenierĂa y Agrimensura; Argentina.Fil: Dillon, Justina. Universidad Nacional de Rosario. Facultad de Ciencias Exactas, IngenierĂa y Agrimensura; Argentina.Fil: Carnevali, Graciela H. Universidad Nacional de Rosario. Facultad de Ciencias Exactas, IngenierĂa y Agrimensura; Argentina.Fil: Justo, Claudio Eduardo. Universidad Nacional de la Plata. Facultad de IngenierĂa. Departamento de Agrimensura. Grupo de Aplicaciones MatemĂĄticas y EstadĂsticas (UIDET); Argentina.Fil: Iglesias, Maximiliano. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas. Instituto de EstadĂstica y DemografĂa; Argentina.Fil: GĂłmez, Pablo SebastiĂĄn. Universidad Nacional de CĂłrdoba. Facultad de Ciencias Sociales. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas; Argentina.Fil: Real, Ariel HernĂĄn. Universidad Nacional de LujĂĄn. Departamento de Ciencias BĂĄsicas; Argentina.Fil: Vargas, Silvia Lorena. Universidad Nacional de LujĂĄn. Departamento de Ciencias BĂĄsicas; Argentina.Fil: LĂłpez Calcagno, Yanil. Universidad Nacional de LujĂĄn. Departamento de Ciencias BĂĄsicas; Argentina.Fil: Batto, Mabel. Universidad Nacional de LujĂĄn. Departamento de Ciencias BĂĄsicas; Argentina.Fil: Sampaolesi, Edgardo. Universidad Nacional de LujĂĄn. Departamento de Ciencias BĂĄsicas; Argentina.Fil: Tealdi, Juan Manuel. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Buzzi, Sergio MartĂn. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas. Departamento de EstadĂstica y MatemĂĄtica; Argentina.Fil: GarcĂa BazĂĄn, Gaspar. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Monroy Caicedo, Xiomara Alejandra. Universidad Nacional de Rosario; Argentina.Fil: BermĂșdez Rubio, Dagoberto. Universidad Santo TomĂĄs. Facultad de EstadĂstica; Colombia.Fil: Ricci, Lila. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Centro Marplatense de Investigaciones MatemĂĄticas; Argentina.Fil: Kelmansky, Diana Mabel. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de CĂĄlculo; Argentina.Fil: Rapelli, Cecilia. Universidad Nacional de Rosario. Facultad de Ciencias EconĂłmicas y EstadĂstica. Escuela de EstadĂstica. Instituto de Investigaciones TeĂłricas y Aplicadas de la Escuela de EstadĂstica; Argentina.Fil: GarcĂa, MarĂa del Carmen. Universidad Nacional de Rosario. Facultad de Ciencias EconĂłmicas y EstadĂstica. Escuela de EstadĂstica. Instituto de Investigaciones TeĂłricas y Aplicadas de la Escuela de EstadĂstica; Argentina.Fil: Bussi, Javier. Universidad Nacional de Rosario. Facultad de Ciencias EconĂłmicas y EstadĂstica. Instituto de Investigaciones TeĂłricas y Aplicadas de la Escuela de EstadĂstica; Argentina.Fil: MĂ©ndez, Fernanda. Universidad Nacional de Rosario. Facultad de Ciencias EconĂłmicas y EstadĂstica. Instituto de Investigaciones TeĂłricas y Aplicadas de la Escuela de EstadĂstica (IITAE); Argentina.Fil: GarcĂa Mata, Luis Ăngel. Universidad Nacional AutĂłnoma de MĂ©xico. Facultad de Estudios Superiores AcatlĂĄn; MĂ©xico.Fil: RamĂrez GonzĂĄlez, Marco Antonio. Universidad Nacional AutĂłnoma de MĂ©xico. Facultad de Estudios Superiores AcatlĂĄn; MĂ©xico.Fil: Rossi, Laura. Universidad Nacional de Cuyo. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Vicente, Gonzalo. Universidad Nacional de Cuyo. Facultad de Ciencias EconĂłmicas; Argentina. Universidad PĂșblica de Navarra. Departamento de EstadĂstica, InformĂĄtica y MatemĂĄticas; España.Fil: Scavino, Marco. Universidad de la RepĂșblica. Facultad de Ciencias EconĂłmicas y de AdministraciĂłn. Instituto de EstadĂstica; Uruguay.Fil: EstragĂł, Virginia. Presidencia de la RepĂșblica. ComisiĂłn Honoraria para la Salud Cardiovascular; Uruguay.Fil: Muñoz, MatĂas. Presidencia de la RepĂșblica. ComisiĂłn Honoraria para la Salud Cardiovascular; Uruguay.Fil: Castrillejo, AndrĂ©s. Universidad de la RepĂșblica. Facultad de Ciencias EconĂłmicas y de AdministraciĂłn. Instituto de EstadĂstica; Uruguay.Fil: Da Rocha, Naila Camila. Universidade Estadual Paulista JĂșlio de Mesquita Filho- UNESP. Departamento de BioestadĂstica; BrasilFil: Macola Pacheco Barbosa, Abner. Universidade Estadual Paulista JĂșlio de Mesquita Filho- UNESP; Brasil.Fil: Corrente, JosĂ© Eduardo. Universidade Estadual Paulista JĂșlio de Mesquita Filho â UNESP. Instituto de Biociencias. Departamento de BioestadĂstica; Brasil.Fil: Spataro, Javier. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas. Departamento de EconomĂa; Argentina.Fil: Salvatierra, Luca Mauricio. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Nahas, EstefanĂa. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: MĂĄrquez, Viviana. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Boggio, Gabriela. Universidad Nacional de Rosario. Facultad de Ciencias EconĂłmicas y EstadĂstica. Instituto de Investigaciones TeĂłricas y Aplicadas de la Escuela de EstadĂstica; Argentina.Fil: Arnesi, Nora. Universidad Nacional de Rosario. Facultad de Ciencias EconĂłmicas y EstadĂstica. Instituto de Investigaciones TeĂłricas y Aplicadas de la Escuela de EstadĂstica; Argentina.Fil: Harvey, Guillermina. Universidad Nacional de Rosario. Facultad de Ciencias EconĂłmicas y EstadĂstica. Instituto de Investigaciones TeĂłricas y Aplicadas de la Escuela de EstadĂstica; Argentina.Fil: Settecase, Eugenia. Universidad Nacional de Rosario. Facultad de Ciencias EconĂłmicas y EstadĂstica. Instituto de Investigaciones TeĂłricas y Aplicadas de la Escuela de EstadĂstica; Argentina.Fil: Wojdyla, Daniel. Duke University. Duke Clinical Research Institute; Estados Unidos.Fil: Blasco, Manuel. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas. Instituto de EconomĂa y Finanzas; Argentina.Fil: Stanecka, Nancy. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas. Instituto de EstadĂstica y DemografĂa; Argentina.Fil: Caro, Valentina. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas. Instituto de EstadĂstica y DemografĂa; Argentina.Fil: Sigal, Facundo. Universidad Austral. Facultad de Ciencias Empresariales. Departamento de EconomĂa; Argentina.Fil: Blacona, MarĂa Teresa. Universidad Nacional de Rosario. Facultad de Ciencias EconĂłmicas y EstadĂstica. Escuela de EstadĂstica; Argentina.Fil: Rodriguez, Norberto Vicente. Universidad Nacional de Tres de Febrero; Argentina.Fil: Loiacono, Karina Valeria. Universidad Nacional de Tres de Febrero; Argentina.Fil: GarcĂa, Gregorio. Instituto Nacional de EstadĂstica y Censos. DirecciĂłn Nacional de MetodologĂa EstadĂstica; Argentina.Fil: Ciardullo, Emanuel. Instituto Nacional de EstadĂstica y Censos. DirecciĂłn Nacional de MetodologĂa EstadĂstica; Argentina.Fil: Ciardullo, Emanuel. Instituto Nacional de EstadĂstica y Censos. DirecciĂłn Nacional de MetodologĂa EstadĂstica; Argentina.Fil: Funkner, SofĂa. Universidad Nacional de La Pampa. Facultad de Ciencias Exactas y Naturales; Argentina.Fil: Dieser, MarĂa Paula. Universidad Nacional de La Pampa. Facultad de Ciencias Exactas y Naturales; Argentina.Fil: MartĂn, MarĂa Cristina. Universidad Nacional de La Pampa. Facultad de Ciencias Exactas y Naturales; Argentina.Fil: MartĂn, MarĂa Cristina. Universidad Nacional del Sur. Departamento de MatemĂĄtica; Argentina.Fil: Peitton, Lucas. Universidad Nacional de Rosario. Facultad de Ciencias EconĂłmicas y EstadĂstica; Argentina. Queensland Department of Agriculture and Fisheries; Australia.Fil: Borgognone, MarĂa Gabriela. Queensland Department of Agriculture and Fisheries; Australia.Fil: Terreno, Dante D. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas. Departamento de Contabilidad; Argentina.Fil: Castro GonzĂĄlez, Enrique L. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas. Departamento de Contabilidad; Argentina.Fil: RoldĂĄn, Janina Micaela. Universidad Nacional de La Pampa. Facultad de Ciencias Exactas y Naturales; Argentina.Fil: GonzĂĄlez, Gisela Paula. CONICET. Instituto de Investigaciones EconĂłmicas y Sociales del Sur; Argentina. Universidad Nacional del Sur; Argentina.Fil: De Santis, Mariana. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas; Argentina.Fil: Geri, Milva. CONICET. Instituto de Investigaciones EconĂłmicas y Sociales del Sur; Argentina.Fil: Geri, Milva. Universidad Nacional del Sur. Departamento de EconomĂa; Argentina. Universidad Nacional del Sur. Departamento de MatemĂĄtica; Argentina.Fil: Marfia, MartĂn. Universidad Nacional de la Plata. Facultad de IngenierĂa. Departamento de Ciencias BĂĄsicas; Argentina.Fil: Kudraszow, Nadia L. Universidad Nacional de la Plata. Facultad de Ciencias Exactas. Centro de MatemĂĄtica de La Plata; Argentina.Fil: Closas, Humberto. Universidad TecnolĂłgica Nacional; Argentina.Fil: Amarilla, Mariela. Universidad TecnolĂłgica Nacional; Argentina.Fil: Jovanovich, Carina. Universidad TecnolĂłgica Nacional; Argentina.Fil: de Castro, Idalia. Universidad Nacional del Nordeste; Argentina.Fil: Franchini, Noelia. Universidad Nacional del Nordeste; Argentina.Fil: Cruz, Rosa. Universidad Nacional del Nordeste; Argentina.Fil: Dusicka, Alicia. Universidad Nacional del Nordeste; Argentina.Fil: Quaglino, Marta. Universidad Nacional de Rosario; Argentina.Fil: Kalauz, Roberto JosĂ© AndrĂ©s. Investigador Independiente; Argentina.Fil: GonzĂĄlez, Mariana VerĂłnica. Universidad Nacional de CĂłrdoba. Facultad de Ciencias EconĂłmicas. Departamento de EstadĂstica y MatemĂĄticas; Argentina.Fil: Lescano, Maira Celeste.
Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study
Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9â27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6â16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2â1.8), stage II (OR 1.6; 95% CI 1.4â1.9), and stage III or worse (OR 2.8; 95% CI 2.3â3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat
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Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study
Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9â27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6â16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2â1.8), stage II (OR 1.6; 95% CI 1.4â1.9), and stage III or worse (OR 2.8; 95% CI 2.3â3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat
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