The Effects of Different Antihypertensives, Steroids, and Beta Blockers on COVID-19 Outcomes in a CKD and Non-CKD Cohort in Detroit, Michigan

Initial studies during the COVID-19 pandemic reported angiotensin converting enzyme 2 inhibitors (ACE2i) could be associated with worse disease course due to potential increase in ACE2 receptors which SARS-CoV2 virus uses for cellular entry. Subsequent studies refuted such concerns, reporting that continued use of ACEis and angiotensin receptor blockers (ARBs) in hypertensive individuals is protective. However, there remains a paucity of data evaluating effects of various antihypertensive medications, steroids, and beta blockers in chronic kidney disease (CKD) populations and in individuals with normal kidney function. This study was designed to evaluate the potential risks associated with antihypertensive medications and COVID-19 outcomes in a cohort of mostly Black and Caucasian patients admitted to the Detroit Medical Center for COVID-19. We collected data from 330 patients using inclusion criteria of age \u3e 18 years and a positive SARS-CoV2 PCR test. We used the mean, standard deviation/standard error of mean, and percentages when appropriate for the description of patient characteristics. Group differences (CKD vs. non-CKD) were compared using the Pearson χ2 test. P-values of \u3c0.05 were regarded as significant. On regression analyses, the odds of death during hospitalization for COVID-19 infection was not significantly associated with either biological sex, race, or CKD status in our sample population. The odds of dying in the hospital were higher in patients who were on calcium channel blockers (OR 2.99, 95% CI 1.29-6.93) and steroids (OR 4.23, 95% CI 1.17-15.31). The only significance for ICU admission was obtained for steroid use (OR 1.872, 95% CI 1.059-3.311)

Demographic and Psychosocial Factors Associated with Suicide Mortality Among Childbearing-Aged Individuals: A Case-Control Study

Objective: Examine pregnancy-related, demographic, psychosocial and healthcare utilization factors associated with suicide mortality among childbearing-aged women. Methods: Data from nine health care systems in the Mental Health Research Network were included. A case-control study design was used in which 290 childbearing-age women who died by suicide (cases) from 2000-2015 were matched with 2,900 childbearing-age women from the same healthcare system and enrolled during the same time period who did not die by suicide. Conditional logistic regression was used to analyze associations between patient characteristics and suicide. Results: Women who died by suicide were more likely to have mental health or substance use disorders (aOR = 2.36, 95%CI: 1.46, 3.82) and to have visited the emergency department in the year prior to index date (aOR = 3.35, 95%CI: 2.39, 4.68). Pregnancy (aOR = 0.17, 95% CI: 0.04, 0.78) and delivery of a liveborn baby (aOR = 0.39, 95% CI: 0.16, 0.92) within a year before index date were associated with lower risk of suicide mortality. Women who experienced pregnancy loss were more likely to die by suicide (aOR = 1.41, 95% CI: 0.49, 4.06), but this was not statistically significant potentially due to small sample size (n = 6 cases; n = 21 control). Conclusions: Childbearing-aged women with mental health and/or substance use disorders, prior emergency department encounters may benefit from routine screening and monitoring for suicide risk. Future research should further examine the relationship between pregnancy loss and suicide mortality

Factors Associated with Suicide Mortality Among Childbearing-Aged Individuals: A Case-Control Study

Purpose: Examine pregnancy-related, demographic, psychosocial and healthcare utilization factors among childbearing-aged individuals who were pregnant, postpartum or who experienced pregnancy loss Methods: Data from nine health care systems in the Mental Health Research Network was included in this sample. A case-control study design was used in which 290 childbearing-age individuals who died by suicide (cases) from 2000-2015 were matched with 10 childbearing-age individuals from the same healthcare system and enrolled during the same time period who did not die by suicide (n=2,900). Conditional logistic regression was used to analyze associations between pregnancy/postpartum/pregnancy loss status and suicide. Results: Participants in the sample who died by suicide were more likely to have mental health or substance use disorders (aOR=2.68, 95%CI: 1.69, 4.26), and more likely to have visited the emergency department in the year prior to index date (date of suicide death) (aOR=3.50, 95%CI: 2.50, 4.83). Pregnancy (aOR=0.14, 95% CI: 0.03, 0.63) and delivery status (aOR=0.38, 95% CI: 0.16, 0.87) within a year before the index date was associated with lower risk of suicide. Although a higher percentage of those who experienced perinatal loss died by suicide (aOR=1.43, 95% CI: 0.51, 4.00), this was not statistically significant potentially due to the small sample size (n=6 cases; n=21 control). Conclusions: Although pregnancy and delivery may be protective against suicide, perinatal loss may confer higher risk of suicide. Individuals with anxiety, depression, substance use disorders and prior emergency department encounters who experience pregnancy loss may benefit from routine screening and monitoring for suicide risk

Factors associated with suicide mortality among reproductive age women: a case-control study

OBJECTIVE: Examine demographic, psychosocial, pregnancy-related, and healthcare utilisation factors associated with suicide mortality among reproductive age women. METHODS: Data from nine health care systems in the Mental Health Research Network were included. A case-control study design was used in which 290 reproductive age women who died by suicide (cases) from 2000 to 2015 were matched with 2,900 reproductive age women from the same healthcare system who did not die by suicide (controls). Conditional logistic regression was used to analyse associations between patient characteristics and suicide. RESULTS: Women of reproductive age who died by suicide were more likely to have mental health (aOR = 7.08, 95% CI: 5.17, 9.71) or substance use disorders (aOR = 3.16, 95% CI: 2.19, 4.56) and to have visited the emergency department in the year prior to index date (aOR = 3.47, 95% CI: 2.50, 4.80). Non-Hispanic White women (aOR = 0.70, 95% CI: 0.51, 0.97) and perinatal (pregnant or postpartum) women were less likely to have died by suicide (aOR = 0.27, 95% CI: 0.13, 0.58). CONCLUSIONS: Reproductive age women with mental health and/or substance use disorders, prior emergency department encounters, or who are of racial or ethnic minority status were at increased risk of suicide mortality and may benefit from routine screening and monitoring. Future research should further examine the relationship between pregnancy-related factors and suicide mortality

Integrated Ocean Drilling Program Expedition 327 Preliminary Report: Juan de Fuca Ridge-Flank Hydrogeology The hydrogeologic architecture of basaltic oceanic crust: compartmentalization, anisotropy, microbiology, and crustal-scale properties on the eastern flank of Juan de Fuca Ridge, eastern Pacific Ocean, 5 July–5 September 2010

Integrated Ocean Drilling Program (IODP) Expedition 327 and related experiments focus on understanding fluid–rock interactions in young, upper ocean crust on the eastern flank of the Juan de Fuca Ridge, delineating the magnitude and distribution of hydrologic properties; the extent to which crustal compartments are connected or isolated (laterally and with depth); the rates and spatial extent of ridge-flank fluid circulation; and links between ridge-flank circulation, crustal alteration, and geomicrobial processes. Expedition 327 built on the achievements of IODP Expedition 301 and subsequent submersible and remotely operated vehicle (ROV) expeditions. Both drilling expeditions installed subseafloor borehole observatories ("CORKs") in basement holes to allow borehole conditions to recover to a more natural state after the dissipation of disturbances caused by drilling, casing, and other operations; provide a long-term monitoring and sampling presence for determining fluid pressure, temperature, composition, and microbiology; and facilitate the completion of active experiments to resolve crustal hydrogeologic conditions and processes.During Expedition 327, two basement holes were cored and drilled at Site U1362. Hole U1362A was cored and drilled to 528 meters below seafloor (mbsf) (292 meters subbasement [msb]), subjected to geophysical logging and hydrologic testing, and instrumented with a multilevel CORK observatory. Hole U1362B was drilled to 359 mbsf (117 msb), subjected to a 24 h pumping and tracer injection experiment, and instrumented with a single-level CORK observatory. Both CORK observatories include monitoring of pressure and temperature and downhole fluid and microbiology sampling. Wellhead samplers will be added and a long-term cross-hole test will be initiated during a postdrilling ROV expedition scheduled for Summer 2011. In addition, part of an instrument string deployed in Hole U1301B during Expedition 301 was recovered, and a replacement string of thermal sensors was installed. Finally, a program of shallow sediment coring was completed adjacent to Grizzly Bare outcrop, a suspected site of regional hydrothermal recharge. Thermal measurements and analyses of pore fluid and microbiological samples from a series of holes aligned radially from the outcrop edge will elucidate rates of fluid transport and evolution during the initial stages of ridge-flank hydrothermal circulation

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically