Prevalence Trend and Predictors of Clostridium Difficile Infection in Sickle Cell Disease Patients
Siddharth BhesaniaIvan CancarevicKishan PatelMadiha ZeeshanRenu BhandariPritika ManaktalaAlena VarantsovaJanki BhesaniaNima GhalehsariShobha MandalAchint PatelSonal PaulParag MehtaEshan U. Patel
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Acute chest syndrome
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在治疗的选择和老病人的幸存上识别 comorbidity 的影响的目的(≥ 70 年) 与先进非小的房间肺癌症(NSCLC ) 。方法临床的特征和 177 个老病人，有好表演地位，的治疗的选择 PS ≤ 1 ) 回顾地在肿瘤学部门被分析，上海肺的医院，在到 2005 年 12 月的 2005 年 1 月之间。幸存数据仅仅在收到了化疗的那些被分析。所有病人被 comorbidity 的数字作为没有(0 ) 成层，温和(1 2 ) 并且严重(≥ 3 ) 组。结果病人，收到了化疗，的比例温和、严重的 comorbidity 是显著地不同的(79.3%，76.2%和57.4%， P = 0.038 )，并且也有关于在三个组之中的辩解的放射疗法率显著地不同(21.7%，11.7%和37.0%， P = 0.014 )。中部的幸存和 1 年的幸存在没有评价，温和、严重的 comorbidity 组，是 13.6 对 10.2 对 7.6 个月并且 53.5% 对 41.3% 对 20.8% 分别地(木头等级， P = 0.071 ) 。在 univariate 并且多，变量考克斯为分析建模，仅仅严重的 comorbidity 是有 NSCLC 的老病人的幸存的一个独立危险因素。相对比率(RR， 95% CI ) ：(2.09， 1.06 4.15 ) ， P = 0.034。结论 Comorbidity 可以稍微与先进 NSCLC 影响老病人的治疗的选择，但是仅仅严重的 comorbidity 是幸存的一个独立预示的因素。
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Objectives: In this study, we examined the validity of Clostridium difficile culture results as a proxy measure of Clostridium difficile infection, and inferred the epidemiologic characteristics of Clostridium difficile infection by tracking the trends of Clostridium difficile culture results. Methods: We reviewed the medical records to figure out the actual possibilities of Clostridium difficile infection of those with positive or negative results of Clostridium difficile culture during the time span from January 2012 to March 2012. We calculated the positive and negative predictive value of Clostridium difficile culture results for Clostridium difficile infection. Furthermore, epidemiologic characteristics of Clostridium difficile infection in a tertiary general hospital in 2012 were analyzed. Result: The estimated positive predictive value of Clostridium difficile culture tests for Clostridium difficile infection was 100%, and the estimated negative predictive value was around 94.4~99.3% depending on the cutoff value of possibility of Clostridium difficile infection. A total of 622 cases were identified as Clostridium difficile infection in a tertiary general hospital in 2012 and there were 4.9 patients with Clostridium difficile infection per 1,000 inpatients. Conclusion: In conclusion, we identified that Clostridium difficile culture results can be used as a proxy measure of Clostridium difficile infection.
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Comorbidity may be an important reason for head and neck surgeons to treat elderly patients less intensively. This article provides an overview of the influence of age and comorbidity on choice of therapy, postoperative complications, and survival.Several retrospective studies show that elderly patients can undergo surgery if they do not have severe comorbid disorders. Severe comorbidity influences the rate of postoperative complications, and the higher complication rate in older patients reported in some studies is probably due to a higher level of comorbidity. Comorbidity also affects the survival of cancer patients, but several studies have failed to detect a relation between age and survival after correction for comorbidity. Thus, although severe comorbidity may influence the choice of treatment, patient age as such should not be a reason to exclude patients from intensive therapy.If severe comorbidity is not present, elderly patients should receive standard treatment for head and neck cancer. Treatment choice should be based on medical findings and patient preference, not on chronologic age.
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