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Outcomes of critically ill cancer patients with Acinetobacter baumannii infection

World Journal of Critical Care Medicine 2015年第3期4卷 258-264页

作者： Silvio A ?amendys-Silva paulina correa-garcía Francisco J garcía-Guillén María O González-Herrera Américo Pérez-Alonso Julia Texcocano-Becerra Angel Herrera-Gómez Patricia Cornejo-Juárez Abelardo Meneses-garcía Department of Critical Care Medicine Instituto Nacional de Cancerología Department of Critical Care Medicine Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Division of Education and Research Hospital de la Mujer Department of Infectious Diseases Instituto Nacional de Cancerología

AIM: To describe the intensive care unit(ICU) outcomes of critically ill cancer patients with Acinetobacter baumannii(AB) ***: This was an observational study that included 23 consecutive cancer patients who acquired AB infections during their stay at ICU of the National Cancer Institute of Mexico(INCan), located in Mexico City. Data collection took place between January 2011, and December 2012. Patients who had AB infections before ICU admission, and infections that occurred during the first 2 d of ICU stay were excluded. Data were obtained by reviewing the electronic health record of each patient. This investigation was approved by the Scientific and Ethics Committees at INCan. Because of its observational nature, informed consent of the patients was not ***: Throughout the study period, a total of 494 critically ill patients with cancer were admitted to the ICU of the INCan, 23(4.6%) of whom developed AB infections. Sixteen(60.9%) of these patients had hematologic malignancies. Most frequent reasons for ICU admission were severe sepsis or septic shock(56.2%) and postoperative care(21.7%). The respiratory tract was the most frequent site of AB infection(91.3%). The most common organ dysfunction observed in our group of patients were the respiratory(100%), cardiovascular(100%), hepatic(73.9%) and renal dysfunction(65.2%). The ICU mortality of patients with 3 or less organ system dysfunctions was 11.7%(2/17) compared with 66.6%(4/6) for the group of patients with 4 or more organ system dysfunctions(P = 0.021). Multivariate analysis identified blood lactate levels(BLL) as the only variable independently associated with inICU death(OR = 2.59, 95%CI: 1.04-6.43, P = 0.040). ICU and hospital mortality rates were 26.1% and 43.5%, ***: The mortality rate in critically ill patients with both HM, and AB infections who are admitted to the ICU is high. The variable most associated with increased mortality was a BLL ≥ 2.6 mmol/L in

关键词： Outcomes Cancer patients Acinetobacter baumannii Intensive care Critical care

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Health production and risk of obesity among Chilean adolescents: Understanding health related behaviors in youth

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Health 2012年第12期4卷 1413-1419页

作者： paulina correa-Burrows Raquel Burrows Ricardo Uauy Cecilia Albala Department of Applied Economics II Rey Juan Carlos University Madrid Spain Institute of Nutrition and Food Technology University of Chile Santiago de Chile Chile

Background: Adolescent obesity is associated with high cardiovascular and metabolic risk. Western diet and reduced physical activity are strong environmental determinants. The “Health Production” model posits that individuals born with a certain amount of health stock, which depreciates over life, but can be augmented by individual behaviors, including exercise and dieting. Objective: To study the association between health production and obesity in a random sample of 1692 Chilean adolescents (14.8 ± 0.7 years old), and to study the effect of gender and socioeconomic characteristics on health production. Method: We used an indicator that considered the quality of food intake and physical activity, establishing three categories: good (GHP), intermediate (IHP) and poor health producers (PHP). Multivariate analysis was used to study the odds of obesity and good health production. Results: There was 31% of GHP, 32% of IHP and 38% of PHP. Obesity (Adj. OR: 1.59;95%CI: 1.04 - 2.42) and abdominal obesity (Adj. OR: 2.24;95%CI: 1.35 - 3.40) were significantly higher in the PHP group, compared to the GHP and IHP group. Health production was significantly associated with socioeconomic factors and gender. Female sex and coming from a less wealthy household significantly reduced the odds of good health production. Conclusions: Poor health production in adolescence, as defined by food intake and physical activity, depreciates individuals’ “health stock”, increasing the risk of obesity. In our sample, health production was strongly associated with socio-economic factors and gender.

关键词： Adolescent Health Adolescent Obesity Health Behavior Health Promotion Non-Communicable Diseases Chile

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