Hospital-acquired influenza infections detected by a surveillance system over six seasons, from 2010/2011 to 2015/2016

In addition to outbreaks of nosocomial influenza, sporadic nosocomial influenza infections also occur but are generally not reported in the literature. This study aimed to determine the epidemiologic characteristics of cases of nosocomial influenza compared with the remaining severe cases of severe influenza in acute hospitals in Catalonia (Spain) which were identified by surveillance. An observational case-case epidemiological study was carried out in patients aged ≥18 years from Catalan 12 hospitals between 2010 and 2016. For each laboratory-confirmed influenza case (nosocomial or not) we collected demographic, virological and clinical characteristics. We defined patients with nosocomial influenza as those admitted to a hospital for a reason other than acute respiratory infection in whom ILI symptoms developed ≥48 h after admission and influenza virus infection was confirmed using RT-PCR. Mixed-effects regression was used to estimate the crude and adjusted OR. One thousand seven hundred twenty-two hospitalized patients with severe laboratory-confirmed influenza virus infection were included: 96 (5.6%) were classified as nosocomial influenza and more frequently had > 14 days of hospital stay (42.7% vs. 27.7%, P <.001) and higher mortality (18.8% vs. 12.6%, P <.02). The variables associated with nosocomial influenza cases in acute-care hospital settings were chronic renal disease (aOR 2.44 95% CI 1.44-4.15) and immunodeficiency (aOR 1.79 95% CI 1.04-3.06). Nosocomial infections are a recurring problem associated with high rates of chronic diseases and death. These findings underline the need for adherence to infection control guidelines

Microbiome to Brain:Unravelling the Multidirectional Axes of Communication

The gut microbiome plays a crucial role in host physiology. Disruption of its community structure and function can have wide-ranging effects making it critical to understand exactly how the interactive dialogue between the host and its microbiota is regulated to maintain homeostasis. An array of multidirectional signalling molecules is clearly involved in the host-microbiome communication. This interactive signalling not only impacts the gastrointestinal tract, where the majority of microbiota resides, but also extends to affect other host systems including the brain and liver as well as the microbiome itself. Understanding the mechanistic principles of this inter-kingdom signalling is fundamental to unravelling how our supraorganism function to maintain wellbeing, subsequently opening up new avenues for microbiome manipulation to favour desirable mental health outcome

Survival, causes of death, and risk factors associated with mortality in Barcelona HIV new diagnoses. 2001-2013

The antiretroviral treatment has supposed a decrease in HIV-related mortality. We assessed factors related to survival in HIV individuals. Causes of death (CoD) in HIV individuals were described. Abstract methods Deaths registered in the Census until 30.06.2013 and 2001-2012 new diagnoses from Barcelona HIV Register were included in the analysis. The CoD were obtained from Death Register. The CoD were classified in external (ICD-10: X), HIV-related (B20-B24, B44.9, C83.7 and C85.9) and non-HIV-related (other codes) causes. Mortality rate was calculated as follow-up person-year per 1000 and its 95% confidence interval (M; 95%CI). Association with mortality of socio-demographic, clinical and epidemiological variables were studied using Cox regression [hazard ratio (HR); 95%CI]. Abstract results Among 3533 new HIV diagnoses, 168 (5%) died (M:8.2; 95%CI: 6.9-9.4). CoD was available in 93 (55%). Among those, 43% died by non-HIVrelated causes (M:1.9; 95%CI:1.3-2.5); 42% by HIV-related causes (M:1.9; 95%CI:1.3-2.5), and 15% by external ones (M:0.7; 95%CI:0.3-1.0). Worse survival was observed in injecting drug users (IDU)(HR:4.7; 95%CI:2.9-7.7) and heterosexual (HTS) men (HR:2.4; 95%CI:1.4-3.9), Spaniards (HR:2.5; 95%CI:1.6-4.0), Gràcia district residents (HR:2.0; 95%CI:1.1-3.7), illiterate/primary education individuals (HR:1.5; IC95%:1.1-2.2), and &lt;200 CD4 subjects (HR:1.8; 95%CI:1.2-3.0). HIV-related CoD were due to infections (48%): most common in men who have sex with men (MSM) (63%), followed by HTS women (60%). Non-HIV-related CoD were cancer (29%): more prevalent in men (32%), people with have secondary/university studies (39%) and HTS men (50%); cardiovascular diseases (22%): in HTS women (57%) and illiterate/primary education individuals (35%) and; liver diseases (19%): in IDU (37%). Abstract conclusion Mortality was associated with being IDU, HTS man, Spaniard, with low educational level and damaged immune system. CoD frequencies in HIVrelated and non-HIV-related were simila

Survival, causes of death, and risk factors associated with mortality in Barcelona HIV new diagnoses. 2001-2013

The antiretroviral treatment has supposed a decrease in HIV-related mortality. We assessed factors related to survival in HIV individuals. Causes of death (CoD) in HIV individuals were described. Abstract methods Deaths registered in the Census until 30.06.2013 and 2001-2012 new diagnoses from Barcelona HIV Register were included in the analysis. The CoD were obtained from Death Register. The CoD were classified in external (ICD-10: X), HIV-related (B20-B24, B44.9, C83.7 and C85.9) and non-HIV-related (other codes) causes. Mortality rate was calculated as follow-up person-year per 1000 and its 95% confidence interval (M; 95%CI). Association with mortality of socio-demographic, clinical and epidemiological variables were studied using Cox regression [hazard ratio (HR); 95%CI]. Abstract results Among 3533 new HIV diagnoses, 168 (5%) died (M:8.2; 95%CI: 6.9-9.4). CoD was available in 93 (55%). Among those, 43% died by non-HIVrelated causes (M:1.9; 95%CI:1.3-2.5); 42% by HIV-related causes (M:1.9; 95%CI:1.3-2.5), and 15% by external ones (M:0.7; 95%CI:0.3-1.0). Worse survival was observed in injecting drug users (IDU)(HR:4.7; 95%CI:2.9-7.7) and heterosexual (HTS) men (HR:2.4; 95%CI:1.4-3.9), Spaniards (HR:2.5; 95%CI:1.6-4.0), Gràcia district residents (HR:2.0; 95%CI:1.1-3.7), illiterate/primary education individuals (HR:1.5; IC95%:1.1-2.2), and <200 CD4 subjects (HR:1.8; 95%CI:1.2-3.0). HIV-related CoD were due to infections (48%): most common in men who have sex with men (MSM) (63%), followed by HTS women (60%). Non-HIV-related CoD were cancer (29%): more prevalent in men (32%), people with have secondary/university studies (39%) and HTS men (50%); cardiovascular diseases (22%): in HTS women (57%) and illiterate/primary education individuals (35%) and; liver diseases (19%): in IDU (37%). Abstract conclusion Mortality was associated with being IDU, HTS man, Spaniard, with low educational level and damaged immune system. CoD frequencies in HIVrelated and non-HIV-related were simila

The Availability and Nature of Physician Information on the Internet

Background Although patients are commonly using the Internet to find healthcare information, the amount of personal and professional physician information and patient-generated ratings freely accessible online is unknown. Objective To characterize the nature of online professional and personal information available to the average patient searching for physician information through a standardized web search. Design, Setting, and Participants We studied 250 randomly selected internal medicine physicians registered with the Massachusetts Board of Registration in Medicine in 2008. For each physician, standardized searches via the Google search engine were performed using a sequential search strategy. The top 20 search results were analyzed, and websites that referred to the study subject were recorded and categorized. Physician rating sites were further investigated to determine the number of patient-entered reviews. Main Measures Number and content of websites attributable to specific physicians. Key Results Websites containing personal or professional information were identified for 93.6% of physicians. Among those with any web sites identified, 92.8% had professional information and 32.4% had personal information available online. Female physicians were more likely to have professional information available on the Internet than male physicians (97.5% vs. 91.7%, p = 0.03), but had similar rates of available personal information (32.5% vs. 32.5%, p = ns). Among personal sites, the most common categories included social networking sites such as Facebook (10.8% of physicians), hobbies (10.0%), charitable or political donations (9.6%), and family information (8.8%). Physician rating sites were identified for 86.4% of providers, but only three physicians had more than five reviews on any given rating site. Conclusions Personal and professional physician information is widely available on the Internet, and often not under direct control of the individual physician. The availability of such information has implications for physician–patient relationships and suggests that physicians should monitor their online information