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1. Työkyvyn arviointi ja tukeminen keuhkosairauksissa vaatii yhteistyötä

Author

Vuokko, A. (Aki), Jantunen, H. (Hanna), Avellan-Hietanen, H. (Heidi), Harju, T. (Terttu), Karjalainen, J. (Jussi), Karvala, K. (Kirsi), Lindström, I. (Irmeli), Selinheimo, S. (Sanna), Suojalehto, H. (Hille), Vuokko, A. (Aki), Jantunen, H. (Hanna), Avellan-Hietanen, H. (Heidi), Harju, T. (Terttu), Karjalainen, J. (Jussi), Karvala, K. (Kirsi), Lindström, I. (Irmeli), Selinheimo, S. (Sanna), and Suojalehto, H. (Hille)

Abstract

Tiivistelmä Keuhkosairaudet aiheuttavat harvoin pysyvää työkyvyttömyyttä. Työssä jatkamista tuetaan varhaisella työkyvyn selvittelyllä ja työn muokkaamisella, joissa otetaan huomioon myös psykososiaaliset ja toimintaympäristön näkökulmat. Työkyvyn arviointi keuhkosairauksissa vaatii yleensä erikoissairaanhoidon ja työterveyshuollon yhteistyötä. Astmapotilaan työkyvyn selvittelyjen yhteydessä suositellaan taudin systemaattista arviointia ja hoidon optimointia sekä toiminnallisten oireiden huomioimista.

Published
2023

2. Occupational asthma, rhinitis and contact urticaria from greenhouse work.

Author

Lindström, I, Hölttä, P, Airaksinen, L, Suuronen, K, Suomela, S, and Suojalehto, H

Subjects
*URTICARIA, *OCCUPATIONAL asthma, *OCCUPATIONAL diseases, *EXPIRATORY flow, *RHINITIS, *ALLERGIES
Abstract

Background The current knowledge about occupational allergic diseases among greenhouse workers is scant. Aims To describe greenhouse workers' occupational allergic diseases. Methods We identified 28 greenhouse workers with occupational allergic diseases in 2002–2020 by conducting a systematic search in the patient register of the Finnish Institute of Occupational Health. All the patients worked in tomato- or cucumber-growing greenhouses and showed immunoglobulin-E-mediated sensitization to occupational agents. Specific inhalation challenges or workplace peak expiratory flow monitoring confirmed occupational asthma (OA), nasal allergen challenges confirmed occupational rhinitis (OR) and open skin tests confirmed occupational contact urticaria (OCU). Results Most patients had more than one occupational disease and were sensitized to several workplace agents. Tomato plants were the most common cause of occupational diseases and induced 22 allergic diseases in 14 patients. Cucumber plants caused occupational diseases in 10 patients (3 OA, 7 OR and 6 OCU). The pest control mite Amblyseius swirskii and a mixture of parasitic wasps Encarsia formosa and Eretmocerus eremicus both induced two OA cases. Three patients had an occupational disease caused by storage mites and three others had a work-related systemic reaction to a bumblebee sting. Conclusions The greenhouse workers typically suffered from several occupational allergic diseases and were sensitized to cultivated plants, various pest control organisms and storage mites. All these can cause OA and OR, but in this study, OCU was only induced by cultivation plants. Cucumber plant is a novel cause of OA and OR, and A. swirskii is a novel cause of OA. [ABSTRACT FROM AUTHOR]

Published
2023
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3. Sputum Inflammatory Patterns are Associated with Distinct Clinical Characteristics in Subjects with Occupational Asthma Independently from the Causal Agent

Author

Migueres, N, primary, Vandenplas, O, additional, Walusiak-Skorupa, J, additional, Wiszniewska, M, additional, Munoz, X, additional, Romero-Mesones, C, additional, Suojalehto, H, additional, Lindström, I, additional, van Kampen, V, additional, Merget, R, additional, Mason, P, additional, Maestrelli, P, additional, Sastre, J, additional, Quirce, S, additional, Rifflart, C, additional, Godet, J, additional, and de Blay, F, additional

Published
2022
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7. Sputum Inflammatory Patterns are Associated with Distinct Clinical Characteristics in Subjects with Occupational Asthma Independently from the Causal Agent.

Author

UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (MGD) Service de pneumologie, Migueres, N, Vandenplas, Olivier, Walusiak-Skorupa, J, Wiszniewska, M, Munoz, X, Romero-Mesones, C, Suojalehto, H, Lindström, I, van Kampen, V, Merget, R, Mason, P, Maestrelli, P, Sastre, J, Quirce, S, RIFFLART, Catherine, Godet, J, de Blay, F, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (MGD) Service de pneumologie, Migueres, N, Vandenplas, Olivier, Walusiak-Skorupa, J, Wiszniewska, M, Munoz, X, Romero-Mesones, C, Suojalehto, H, Lindström, I, van Kampen, V, Merget, R, Mason, P, Maestrelli, P, Sastre, J, Quirce, S, RIFFLART, Catherine, Godet, J, and de Blay, F

Abstract

Clinical heterogeneity in sensitizer-induced occupational asthma (OA) and its relationship to airway inflammatory profiles remain poorly elucidated. To further characterize the interactions between induced sputum inflammatory patterns, asthma-related outcomes and the high- or low-molecular-weight category of causal agents in a large cohort of subjects with OA. This multicenter, retrospective, cross-sectional study was conducted among 296 subjects with OA ascertained by a positive specific inhalation challenge who completed induced sputum assessment before and 24 hours after challenge exposure. Multivariate logistic regression analysis revealed that sputum eosinophilia ≥3% was significantly associated with a high dose of inhaled corticosteroid (odds ratio [95% confidence interval], 1.31 [1.11-1.55] for each 250-µg increment in daily dose), short-acting b2-agonist use less than once a day (3.54 [1.82-7.00]), and the level of baseline nonspecific bronchial hyperresponsiveness (mild: 2.48 [1.21-5.08]); moderate/severe: 3.40 [1.44-8.29]). Sputum neutrophilia ≥76% was associated with age (1.06 [1.01-1.11]), male gender (3.34 [1.29-9.99]), absence of corticosteroid use (5.47 [2.09-15.16]), short-acting b2-agonist use once or more a day (4.09 [1.71-10.01]), ≥2 severe exacerbations during the last 12 months at work (4.22 [1.14-14.99]), and isolated early reactions during the SIC (4.45 [1.85-11.59]). The findings indicate that sputum inflammatory patterns in subjects with OA are associated with distinct phenotypic characteristics and further highlight the differential effects of neutrophils and eosinophils on asthma-related outcomes. These associations between inflammatory patterns and clinical characteristics share broad similarities with what has been reported in nonoccupational asthma and are not related to the type of causal agent.

Published
2022

18. Infections, antibiotic treatment and mortality in patients admitted to ICUs in countries considered to have high levels of antibiotic resistance compared to those with low levels

Author

Michalopoulos, A., Groeneveld, J., Lev, A., Sprung, C., Vakalos, A., Kotanidou, A., Zakynthinos, E., Filos, K., Pneumatikos, I., Moraiti, A., Clouva-molyvdas, P., Mandragos, K., Kyriazopoulos, G., Karampela, I., Koulenti, D., Myrianthefs, P., Ioannidou, E., Mouloudi, E., Chalkiadaki, A., Bitzani, M., Routsi, C., Armaganidis, A., Sofianos, E., Harjola, V., Berezowicz, P., Jacobsen, K., Espersen, K., Fogh, B., Betsch, H., Vincent, Jean-Louis, Vanhems, Philippe, Walther, Sten M., Sakr, Yasser, Rello, Jordi, Leone, Marc, Pickkers, P., Lipman, Jeffrey, Holmbom, Martin, Antonelli, Massimo, Hanberger, Håkan, Kocak, S., Ulger, F., Guven, H., Turkmen, A., Dogruer, K., Adanir, T., Demirkiran, O., Tugrul, S., Cakar, N., Akinci, I., Uzel, N., Togal, T., Topeli, A., Turkoglu, M., Guven, M., Akan, M., Bodur, H., Bosnak, M., Kizilkaya, M., Ozgencil, E., Kaya, A., Fistikci, H., Ates, C., Atalan, K., Jacobson, S., Owall, A., Kokinsky, E., Rudenstam, J., Häggqvist, J., Hulting, J., Sellgren, J., Arvidsson, S., Schindele, M., Hammarskjöld, F., Friberg, H., Petersson, J., Paulsson, A., Lindström, I., Stiernstrom, H., Peterzén, B., Blomqvist, H., Petersen, P., Soto Ibáñez, J., González, J., Izura, J., Corcobado Márquez, C., Rico-Feijoo, J., Sierra, R., Rello, J., Posada, P., Briones Lopez, M., Jara, R., Luis, V., Maria Jesus, H., de la Torre-Prados, M., Felices, F., Sanchez Garcia, M., Macias Pingarrón, J., Garcia-Fuentes, C., Cerdá, E., Serrano, N., Barcenilla-Gaite, F., Sirvent, J., Montejo González, J., Guerrero Gomez, F., Amador Amerigo, J., Borges, M., Sánchez-Olmedo, J., López Ciudad, V., Moreno, M., Esteban, E., Vallés, J., De Rojas Román, J., Yuste, I., Ugarte Peña, P., Sole-violán, J., Bustinza, A., Albaya, A., Latour-Perez, J., Navarro, J., Garcia, F., Martin Delgado, M., Rovira, A., Ramos-gómez, L., Garro, P., Silva, J., Iglesias, L., María Jesús, L., Pueyo, L., Lorente, C., Martinon-Torres, F., Aguilar, G., Martinez-Sagasti, F., Blesa Malpica, A., Valencia, M., Zavala, E., Bustamante Munguira, E., Arribas, M., Insausti, J., Vegas Pinto, R., Bocero, L., Estella, A., Esteban-Reboll, F., Lopez Camps, V., Antón Caraballo, E., Muñoz, E., Olaechea, P., Escriba, A., Santos, I., Campiñez, Burgueño., Moreira, P., Pizzamiglio, M., Conti, V., Kahveci, A., Nydahl, A., Lind, D., Caballero Zirena, A., Guerrero, F., Palomar, M., Einar, V., Agvald-Ohman, C., Wyon, N., Johansson, L., Gil, B., Mariscal, F., Galvan, B., Espinosa, E., Lesmes Serrano, A., Mesalles Sanjuan, E., Manzano Ramirez, A., Quintana Tort-Martorell, E., Monton Dito, J., Ibañez, A., Garcia del Valle, S., Alemparte-Pardavila, E., Monedero, P., Naveira-Abeigón, E., Jorda, R., Alvarez, M., Rubio, O., Bouw, M., Afonso, Susana, Matos, Ricardo, Carneiro, A., Amaro, P., Ribeiro, R., Paiva, J., Galdos-Anuncibay, P., Nieto, M., Ruiz, J., Perez Calvo, C., Mañez, R., França, C., Moreno, R., Dias, C., Sousa, A., Rezende, A., Mourão, L., Ponce, P., Oliveira, T., Esteves, F., Den Boer, S., Bakker, J., Van Berkel, G., Borg, M., Gullo, A., Gianesello, L., Martinelli, L., Antonelli, M., Bassetti, M., Telo, L., Alves, M., Almeida, E., Leite, A., Pádua, F., Costa, H., Póvoa, P., Lopes, V., Carmo, E., Febra, C., Martins, A., Castelo-Branco Sousa, M., Bártolo, A., Junker, A., Erno, P., Klepstad, P., Loevstad, R., Bergmans, D., Rodgers, M., Pham, C., Speelberg, B., Wesselink, R., Ammann, J., Vet, J., Gille, A., Kuiper, M., Kieft, H., Blom, H., Vogelaar, J., Corsten, S., Ten Cate, J., Rosseel, P., De Pont, A., Della Rocca, G., Biancofiore, G., Morelli, A., Ranieri, MV., Cotogni, P., Alessandro, D., Clementi, S., Ferraro, F., Giuseppe, N., Sforza, D., Castiglione, G., Marino, G., Fumagalli, R., Santagostino, G., De Negri, P., De Gasperi, A., Oggioni, R., Conte, V., Sicignano, A., Marri, I., Locicero, M., Guadagnucci, A., Chieregato, A., Fiore, G., Sorbara, C., Munch, C., Ruatti, H., Lorella, P., Borrelli, F., Panella, L., De Blasi, R., Ceriani, R., Colonna, S., Abbruzzese, C., Rosano, A., Caspani, M., Emmi, V., Stelian, E., Scolz, S., Guberti, A., Margarit, O., Giarratano, A., Rosi, R., Marzorati, S., De blasio, E., Minerva, M., Petrucci, N., Mangani, V., Lazzero, A., Sapuppo, M., Cecilia, P., Borelli, M., Greco, S., Vesconi, S., Sofer, S., Cohen, J., Kishinevsky, E., Selçuk Üniversitesi, Hanberger, H, Antonelli, M, Holmbom, M, Lipman, J, Pickkers, P, Leone, M, Rello, J, Sakr, Y, Walther, S, Vanhems, P, Vincent, J, Betsch, H, Fogh, B, Espersen, K, Jacobsen, K, Berezowicz, P, Harjola, V, Sofianos, E, Armaganidis, A, Routsi, C, Bitzani, M, Chalkiadaki, A, Michalopoulos, A, Mouloudi, E, Ioannidou, E, Myrianthefs, P, Koulenti, D, Karampela, I, Kyriazopoulos, G, Mandragos, K, Clouva molyvdas, P, Moraiti, A, Pneumatikos, I, Filos, K, Zakynthinos, E, Kotanidou, A, Vakalos, A, Sprung, C, Lev, A, Kishinevsky, E, Cohen, J, Sofer, S, Vesconi, S, Greco, S, Borelli, M, Cecilia, P, Sapuppo, M, Lazzero, A, Mangani, V, Petrucci, N, Minerva, M, De blasio, E, Marzorati, S, Rosi, R, Giarratano, A, Margarit, O, Guberti, A, Scolz, S, Stelian, E, Emmi, V, Caspani, M, Rosano, A, Abbruzzese, C, Colonna, S, Ceriani, R, De Blasi, R, Panella, L, Borrelli, F, Lorella, P, Ruatti, H, Munch, C, Sorbara, C, Fiore, G, Chieregato, A, Conti, V, Guadagnucci, A, Pizzamiglio, M, Locicero, M, Marri, I, Sicignano, A, Conte, V, Oggioni, R, De Gasperi, A, De Negri, P, Santagostino, G, Fumagalli, R, Marino, G, Castiglione, G, Sforza, D, Giuseppe, N, Bassetti, M, Ferraro, F, Clementi, S, Alessandro, D, Cotogni, P, Ranieri, M, Martinelli, L, Gianesello, L, Gullo, A, Morelli, A, Biancofiore, G, Della Rocca, G, Borg, M, De Pont, A, Rosseel, P, Ten Cate, J, Van Berkel, G, Corsten, S, Bakker, J, Vogelaar, J, Blom, H, Kieft, H, Kuiper, M, Gille, A, Vet, J, Ammann, J, Den Boer, S, Wesselink, R, Speelberg, B, Pham, C, Rodgers, M, Bergmans, D, Groeneveld, J, Loevstad, R, Klepstad, P, Erno, P, Junker, A, Bártolo, A, Castelo Branco Sousa, M, Esteves, F, Martins, A, Oliveira, T, Ponce, P, Mourão, L, Febra, C, Carmo, E, Lopes, V, Póvoa, P, Rezende, A, Costa, H, Moreira, P, Pádua, F, Leite, A, Almeida, E, Alves, M, Sousa, A, Telo, L, Dias, C, Paiva, J, Ribeiro, R, Amaro, P, Carneiro, A, Moreno, R, Matos, R, Afonso, S, Bouw, M, França, C, Rubio, O, Mañez, R, Campiñez, B, Alvarez, M, Jorda, R, Naveira Abeigón, E, Monedero, P, Alemparte Pardavila, E, Garcia del Valle, S, Perez Calvo, C, Palomar, M, Guerrero, F, Caballero Zirena, A, Arribas, M, Bustamante Munguira, E, Ruiz, J, Iglesias, L, Zavala, E, Valencia, M, Blesa Malpica, A, Martinez Sagasti, F, Nieto, M, Aguilar, G, Martinon Torres, F, Lorente, C, Insausti, J, Vegas Pinto, R, Santos, I, Escriba, A, Olaechea, P, Muñoz, E, Antón Caraballo, E, Galdos Anuncibay, P, Lopez Camps, V, Esteban Reboll, F, Estella, A, Bocero, L, Ibañez, A, Pueyo, L, María Jesús, L, Silva, J, Garro, P, Ramos gómez, L, Rovira, A, Martin Delgado, M, Monton Dito, J, Garcia, F, Navarro, J, Latour Perez, J, Albaya, A, Bustinza, A, Sole violán, J, Ugarte Peña, P, Yuste, I, De Rojas Román, J, Vallés, J, Esteban, E, Quintana Tort Martorell, E, Moreno, M, López Ciudad, V, Manzano Ramirez, A, Sánchez Olmedo, J, Borges, M, Amador Amerigo, J, Guerrero Gomez, F, Montejo González, J, Sirvent, J, Mesalles Sanjuan, E, Barcenilla Gaite, F, Serrano, N, Cerdá, E, Lesmes Serrano, A, Garcia Fuentes, C, Macias Pingarrón, J, Espinosa, E, Sanchez Garcia, M, Felices, F, de la Torre Prados, M, Maria Jesus, H, Luis, V, Jara, R, Briones Lopez, M, Posada, P, Galvan, B, Mariscal, F, Gil, B, Sierra, R, Rico Feijoo, J, Corcobado Márquez, C, Izura, J, González, J, Soto Ibáñez, J, Petersen, P, Johansson, L, Blomqvist, H, Peterzén, B, Wyon, N, Stiernstrom, H, Lindström, I, Paulsson, A, Agvald Ohman, C, Petersson, J, Friberg, H, Einar, V, Hammarskjöld, F, Schindele, M, Arvidsson, S, Sellgren, J, Hulting, J, Häggqvist, J, Rudenstam, J, Lind, D, Kokinsky, E, Owall, A, Jacobson, S, Nydahl, A, Atalan, K, Ates, C, Kahveci, A, Fistikci, H, Kaya, A, Ozgencil, E, Kizilkaya, M, Bosnak, M, Bodur, H, Akan, M, Guven, M, Turkoglu, M, Topeli, A, Togal, T, Uzel, N, Akinci, I, Cakar, N, Tugrul, S, Demirkiran, O, Adanir, T, Dogruer, K, Turkmen, A, Guven, H, Ulger, F, Kocak, S, İç Hastalıkları, and OMÜ

Subjects
Male, Pediatrics, Cross-sectional study, health care facilities, manpower, and services, Antibiotics, Resistance, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], Prevalence, Drug Resistance, law.invention, Medical microbiology, law, Pathologie maladies infectieuses, Antibiotic, Critically ill, Infection, Aged, Anti-Bacterial Agents, Bacteria, Bacterial Infections, Cross-Sectional Studies, Europe, Female, Hospitalization, Humans, Middle Aged, Treatment Outcome, Drug Resistance, Bacterial, Intensive Care Units, Infectious Diseases, Critically ill -- Care, Mortality rate, Bacterial, Intensive care unit, SAPS II, Beta lactam antibiotics, Research Article, Human, medicine.medical_specialty, medicine.drug_class, Intensive Care Unit, Bacterial Infection, Antibiotic resistance, Internal medicine, Settore MED/41 - ANESTESIOLOGIA, Anti-Bacterial Agent, medicine, Cross-Sectional Studie, business.industry, Aminopeptidases -- Analysis, Klinisk medicin, Polypeptides, Bacterial diseases -- Diagnosis, Antibiotics -- Therapeutic use, Clinical Medicine, business
Abstract

Background: Antimicrobial resistance is an increasing concern in ICUs worldwide. Infection with an antibiotic resistant (ABR) strain of an organism is associated with greater mortality than infection with the non-resistant strain, but there are few data assessing whether being admitted to an intensive care unit (ICU) with high levels of antimicrobial resistance is associated with a worse outcome than being admitted to an ICU with low rates of resistance. The aim of this study was, therefore, to compare the characteristics of infections and antibiotic treatments and patient outcomes in patients admitted to ICUs in countries considered as having high levels of antibiotic resistance and those admitted to ICUs in countries considered as having low levels of antibiotic resistance.Methods: Data from the large, international EPIC II one-day point prevalence study on infections in patients hospitalized in ICUs were used. For the current study, we compared the data obtained from patients from two groups of countries: countries with reported MRSA rates of ≥ 25% (highABR: Greece, Israel, Italy, Malta, Portugal, Spain, and Turkey) and countries with MRSA rates of < 5% (lowABR: Denmark, Finland, Netherlands, Norway, and Sweden).Results: On the study day, 1187/2204 (53.9%) patients in the HighABR ICUs were infected and 255/558 (45.7%) in the LowABR ICUs (P < 0.01). Patients in the HighABR ICUs were more severely ill than those in the LowABR ICUs, as reflected by a higher SAPS II score (35.6 vs 32.7, P < 0.05) and had longer median ICU (12 days vs 5 days) and hospital (24 days vs 16 days) lengths of stay. They also had higher crude ICU (20.0% vs 15.4%) and hospital (27.0% vs 21.5%) mortality rates (both P < 0.05). However, after multivariable adjustment and matched pair analysis there were no differences in ICU or hospital mortality rates between High or LowABR ICU patients overall or among those with infections.Conclusions: Being hospitalized in an ICU in a region with high levels of antimicrobial resistance is not associated per se with a worse outcome., 0, SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2014

21. Infections, antibiotic treatment and mortality in patients admitted to ICUs in countries considered to have high levels of antibiotic resistance compared to those with low levels

Author

Hanberger, H. Antonelli, M. Holmbom, M. Lipman, J. Pickkers, P. Leone, M. Rello, J. Sakr, Y. Walther, S.M. Vanhems, P. Vincent, J.-L. Betsch, H. Fogh, B. Espersen, K. Jacobsen, K. Berezowicz, P. Harjola, V. Sofianos, E. Armaganidis, A. Routsi, C. Bitzani, M. Chalkiadaki, A. Michalopoulos, A. Mouloudi, E. Ioannidou, E. Myrianthefs, P. Koulenti, D. Karampela, I. Kyriazopoulos, G. Mandragos, K. Clouva-molyvdas, P. Moraiti, A. Pneumatikos, I. Filos, K. Zakynthinos, E. Kotanidou, A. Vakalos, A. Sprung, C. Lev, A. Kishinevsky, E. Cohen, J. Sofer, S. Vesconi, S. Greco, S. Borelli, M. Cecilia, P. Sapuppo, M. Lazzero, A. Mangani, V. Petrucci, N. Minerva, M. De blasio, E. Marzorati, S. Rosi, R. Giarratano, A. Margarit, O. Guberti, A. Scolz, S. Stelian, E. Emmi, V. Caspani, M. Rosano, A. Abbruzzese, C. Colonna, S. Ceriani, R. De Blasi, R. Panella, L. Borrelli, F. Lorella, P. Ruatti, H. Munch, C. Sorbara, C. Fiore, G. Chieregato, A. Conti, V. Guadagnucci, A. Pizzamiglio, M. Locicero, M. Marri, I. Sicignano, A. Conte, V. Oggioni, R. De Gasperi, A. De Negri, P. Santagostino, G. Fumagalli, R. Marino, G. Castiglione, G. Sforza, D. Giuseppe, N. Bassetti, M. Ferraro, F. Clementi, S. Alessandro, D. Cotogni, P. Ranieri, MV. Antonelli, M. Martinelli, L. Gianesello, L. Gullo, A. Morelli, A. Biancofiore, G. Della Rocca, G. Borg, M. De Pont, A. Rosseel, P. Ten Cate, J. Van Berkel, G. Corsten, S. Bakker, J. Vogelaar, J. Blom, H. Kieft, H. Kuiper, M. Gille, A. Pickkers, P. Vet, J. Ammann, J. Den Boer, S. Wesselink, R. Speelberg, B. Pham, C. Rodgers, M. Bergmans, D. Groeneveld, J. Loevstad, R. Klepstad, P. Erno, P. Junker, A. Bártolo, A. Castelo-Branco Sousa, M. Esteves, F. Martins, A. Oliveira, T. Ponce, P. Mourão, L. Febra, C. Carmo, E. Lopes, V. Póvoa, P. Rezende, A. Costa, H. Moreira, P. Pádua, F. Leite, A. Almeida, E. Alves, M. Sousa, A. Telo, L. Dias, C. Paiva, J. Ribeiro, R. Amaro, P. Carneiro, A. Moreno, R. Matos, R. Afonso, S. Bouw, M. França, C. Rubio, O. Mañez, R. Campiñez, M. Alvarez, M. Jorda, R. Naveira-Abeigón, E. Monedero, P. Alemparte-Pardavila, E. Garcia del Valle, S. Perez Calvo, C. Palomar, M. Guerrero, F. Caballero Zirena, A. Arribas, M. Bustamante Munguira, E. Ruiz, J. Iglesias, L. Zavala, E. Valencia, M. Blesa Malpica, A. Martinez-Sagasti, F. Nieto, M. Aguilar, G. Martinon-Torres, F. Lorente, C. Insausti, J. Vegas Pinto, R. Santos, I. Escriba, A. Olaechea, P. Muñoz, E. Antón Caraballo, E. Galdos-Anuncibay, P. Lopez Camps, V. Esteban-Reboll, F. Estella, A. Bocero, L. Ibañez, A. Pueyo, L. María Jesús, L. Iglesias, L. Silva, J. Garro, P. Ramos-gómez, L. Rovira, A. Martin Delgado, M. Monton Dito, J. Garcia, F. Navarro, J. Latour-Perez, J. Albaya, A. Bustinza, A. Sole-violán, J. Ugarte Peña, P. Yuste, I. De Rojas Román, J. Vallés, J. Esteban, E. Quintana Tort-Martorell, E. Moreno, M. López Ciudad, V. Manzano Ramirez, A. Sánchez-Olmedo, J. Borges, M. Amador Amerigo, J. Guerrero Gomez, F. Montejo González, J. Sirvent, J. Mesalles Sanjuan, E. Barcenilla-Gaite, F. Serrano, N. Cerdá, E. Lesmes Serrano, A. Garcia-Fuentes, C. Macias Pingarrón, J. Espinosa, E. Sanchez Garcia, M. Felices, F. de la Torre-Prados, M. Maria Jesus, H. Luis, V. Jara, R. Briones Lopez, M. Posada, P. Galvan, B. Mariscal, F. Gil, B. Sierra, R. Rico-Feijoo, J. Corcobado Márquez, C. Izura, J. González, J. Soto Ibáñez, J. Petersen, P. Johansson, L. Blomqvist, H. Peterzén, B. Wyon, N. Stiernstrom, H. Lindström, I. Paulsson, A. Agvald-Ohman, C. Petersson, J. Friberg, H. Einar, V. Hammarskjöld, F. Schindele, M. Arvidsson, S. Sellgren, J. Hulting, J. Häggqvist, J. Rudenstam, J. Lind, D. Kokinsky, E. Owall, A. Jacobson, S. Nydahl, A. Atalan, K. Ates, C. Kahveci, A. Fistikci, H. Kaya, A. Ozgencil, E. Kizilkaya, M. Bosnak, M. Bodur, H. Akan, M. Guven, M. Turkoglu, M. Topeli, A. Togal, T. Uzel, N. Akinci, I. Cakar, N. Tugrul, S. Demirkiran, O. Adanir, T. Dogruer, K. Turkmen, A. Guven, H. Ulger, F. Kocak, S. the EPIC II Group of Investigators

Subjects
health care facilities, manpower, and services
Abstract

Background: Antimicrobial resistance is an increasing concern in ICUs worldwide. Infection with an antibiotic resistant (ABR) strain of an organism is associated with greater mortality than infection with the non-resistant strain, but there are few data assessing whether being admitted to an intensive care unit (ICU) with high levels of antimicrobial resistance is associated with a worse outcome than being admitted to an ICU with low rates of resistance. The aim of this study was, therefore, to compare the characteristics of infections and antibiotic treatments and patient outcomes in patients admitted to ICUs in countries considered as having high levels of antibiotic resistance and those admitted to ICUs in countries considered as having low levels of antibiotic resistance.Methods: Data from the large, international EPIC II one-day point prevalence study on infections in patients hospitalized in ICUs were used. For the current study, we compared the data obtained from patients from two groups of countries: countries with reported MRSA rates of ≥ 25% (highABR: Greece, Israel, Italy, Malta, Portugal, Spain, and Turkey) and countries with MRSA rates of < 5% (lowABR: Denmark, Finland, Netherlands, Norway, and Sweden).Results: On the study day, 1187/2204 (53.9%) patients in the HighABR ICUs were infected and 255/558 (45.7%) in the LowABR ICUs (P < 0.01). Patients in the HighABR ICUs were more severely ill than those in the LowABR ICUs, as reflected by a higher SAPS II score (35.6 vs 32.7, P < 0.05) and had longer median ICU (12 days vs 5 days) and hospital (24 days vs 16 days) lengths of stay. They also had higher crude ICU (20.0% vs 15.4%) and hospital (27.0% vs 21.5%) mortality rates (both P < 0.05). However, after multivariable adjustment and matched pair analysis there were no differences in ICU or hospital mortality rates between High or LowABR ICU patients overall or among those with infections.Conclusions: Being hospitalized in an ICU in a region with high levels of antimicrobial resistance is not associated per se with a worse outcome. © 2014 Hanberger et al.; licensee BioMed Central Ltd.

Published
2014

25. Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study

Author

Keth, Th, Azoulay, E, Echeverria, Pm, Vincent, Jl, Collaboratorsmargarit, A, Valentini, R, Alan Javier, Z, Bevilacqua, C, Curone, M, Rabuffetti, R, Comignani, P, Torres Boden, M, Chertcoff, F, Cardonatti, G, Adén, F, Marcos, L, Dónofrio, M, Fernández, R, Lamberghini, R, Balasini, S, Teves, J, Las Heras, M, Sinner, J, Ceraso, D, Curcio, D, Aguilar, L, Weller, C, Cardonnet, L, Santa Cruz, R, Manrique, E, Bernardez, D, Iolster, T, Chiappero, G, Ramos, P, Vergara, J, Moine, I, Ilutovich, S, Jannello, G, Waschbusch, M, Rios Picaza, G, Raimondi, A, Miriam, M, Lovesio, C, Caridi, M, Leong, T, Orford, N, Reece, G, Ernest, D, Hawker, F, Tan, J, Giannellis, C, Ihle, B, Bersten, A, Mcinnes, J, Tallott, M, Mcfadyen, B, Vibert, J, Parr, M, Tran, K, Sutton, J, Webb, S, Groves, N, Cole, L, Long, D, Bass, F, Erickson, S, Lipman, J, Delzoppo, C, Thomas, J, Dobb, G, Daley, M, Roberts, B, Santamaria, J, Young, J, Festa, M, Holland, R, Mullany, D, Williams, P, Corkeron, M, Gales, M, Banerjee, A, Yung, M, Mutz, N, Hiesmayr, M, Faybik, P, Fitzgerald, R, Firlinger, F, Zasmeta, G, Zink, M, Sieber, W, Hildegard, J, Bakondy, R, Schlieber, J, Filzwieser, G, Beer, R, Joannidis, M, Schuster, R, Scherzer, W, Smolle, K, Fitzal, S, Manzoor, R, Brunain, J, D'Hondt, A, Huylenbroeck, G, Van der Schueren, M, 't Kindt, H, Slock, E, Rijckaert, D, Raemaekers, J, Bourgeois, M, Van Cotthem, I, Nackaerts, G, Gusu, D, Gadisseux, P, Vancollie, O, Lignian, H, Michel, P, Fraipont, V, Vander Stappen, M, Forêt, F, De Bels, D, Devriendt, J, Massaut, J, Biston, P, Roman, A, Lambermont, B, De Meulder, A, Frederic, V, Sottiaux, T, Ruyffelaere, P, Collin, V, Anane, S, Kleiren, P, Simon, M, Machayekhi, S, Frans, E, Leroy, G, Berghmans, T, Joseph, R, Eerens, J, Laterre, P, Lagrou, B, Rutsaert, R, Pisarek, W, Dive, A, De Waele, J, Spapen, H, Damas, P, Malbrain, M, Hidalgo, J, Baptista, M, Salgado, D, Braga, M, Avila, C, Westphal, G, Caser, E, Alves, A, Friedman, G, Luz, M, Assuncao, M, Reis, H, Gomes, A, Silva, U, Nogueira Fh, W, El Dash, S, Valiatti, J, Barbosa, A, Coelho, C, Knibel, M, Minelli, C, Caovilla, J, Teixeira, G, Hovnanian, A, Rea Neto, A, Lobo, S, Lugarinho, M, Souza, P, Ferreira, D, Duarte, P, Oliveira, M, Marques, J, Machado, R, Rehder, P, Mataloun, S, Grilo, M, Quesado, P, Moock, M, Ferreira, F, Teles, J, Silva, E, Morais, A, Bruzzi de Carvalho, F, Wanderley, M, Velasco, M, Brandão da Silva, N, Feijó, J, Souza Dantas, V, Costa Filho, R, Japiassú, A, Villela, D, Santos, C, Passos, R, Alheira Rocha, R, Silva, R, Houly, J, Aldrighi, J, Hatum, R, Suparregui Dias, F, Ferreira, L, Ferro, L, Gomez, J, Fleury, R, David, C, Resener, T, Mendes, C, Germano, A, De Marco, F, Lage, S, Salluh, J, Torelly, A, Sad, R, Oliveira, G, Lima, R, Paranhos, J, Rocha, M, Bitencourt, W, Grion, C, Forte, D, Guimarães, H, Piras, C, Stephanova, L, Lyubenov, L, Tsarianski, G, Dimov, G, Green, R, Levasseur, J, Ward, R, Lesur, O, Poirier, G, Wax, R, Wood, G, Cook, D, Marshall, J, Herridge, M, Ferguson, N, 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Smuszkiewicz, P, Mikaszewska Sokolewicz, M, Goraj, R, Kubler, A, Bártolo, A, Castelo Branco Sousa, M, Esteves, F, Martins, A, João, Hs, Oliveira, T, Ponce, P, Mourão, L, Febra, C, Carmo, E, Lopes, V, Póvoa, P, Rezende, A, Costa, H, Moreira, P, Pádua, F, Leite, A, Almeida, E, Alves, M, Sousa, A, Telo, L, João, S, Dias, C, Paiva, J, Ribeiro, R, Amaro, P, Carneiro, A, Moreno, R, Matos, R, Afonso, S, Bouw, M, França, C, Ibrahim, A, Tabacaru, R, Ionita, V, Tulbure, D, Filipescu, D, Pascanu, S, Grigoras, I, Copotoiu, S, Popov, D, Lebedev, E, Olga, I, Yaroshetskiy, A, Lugovkina, T, Dmitry, B, Malinin, O, Lekmanov, A, Abulmagd, M, Arabi, Y, Alhashemi, J, Ali, A, Maghrabi, K, Debek, A, Malik, M, Jankovic, R, Palibrk, I, Maravic stojkovic, V, Malenkovic, V, Surbatovic, M, Bumbasirevic, V, Lim, N, Loh, T, Tan, H, Sekeresova, H, Koutun, J, Firment, J, Malik, P, Trenkler, S, Muzlovic, I, Kosec, L, Ozek, B, Kasnik, D, Tomic, V, Knafelj, R, Svigelj, V, Du Plessis, H, Raine, R, Bhagwanjee, S, Richards, G, Goosen, J, De Jager, J, Schleicher, G, Rubio, O, Mañez, R, Burgueño Campiñez, M, Alvarez, M, Jorda, R, Naveira Abeigón, E, Monedero, P, Alemparte Pardavila, E, Garcia del Valle, S, Perez Calvo, C, Palomar, M, Caballero Zirena, A, Arribas, M, Bustamante Munguira, E, Ruiz, J, Blanco Vicente, A, Zavala, E, Valencia, M, Blesa Malpica, A, Martinez Sagasti, F, Nieto, M, Aguilar, G, Martinon Torres, F, Lorente, C, Insausti, J, Vegas Pinto, R, Santos, I, Escriba, A, Olaechea, P, Muñoz, E, Antón Caraballo, E, Galdos Anuncibay, P, Lopez Camps, V, Esteban Reboll, F, Estella, A, Bocero, L, Ibañez, A, Yagüe, G, Pueyo, L, María Jesús, L, Iglesias Fraile, L, Silva, J, Garro, P, Palma, L, Ramos gómez, L, Rovira, A, Martin Delgado, M, Monton Dito, J, Garcia, F, Latour Perez, J, Albaya, A, Bustinza, A, Sole violán, J, Ugarte Peña, P, Yuste, I, De Rojas Román, J, Vallés, J, Esteban, E, Quintana Tort Martorell, E, Moreno, M, López Ciudad, V, Manzano Ramirez, A, Sánchez Olmedo, J, Borges, M, Amador Amerigo, J, Guerrero Gomez, F, Montejo González, J, Sirvent, J, Pujol, I, Mesalles Sanjuan, E, Barcenilla Gaite, F, Serrano, N, Cerdá, E, Lesmes Serrano, A, Garcia Fuentes, C, Macias Pingarrón, J, Espinosa, E, Sanchez Garcia, M, Felices, F, de la Torre Prados, M, Maria Jesus, H, Luis, V, Jara, R, Briones Lopez, M, Posada, P, Galvan, B, Mariscal, F, Rello, J, Gil, B, Sierra, R, Rico Feijoo, J, Izura, J, González, J, Soto Ibáñez, J, Agabani, H, Petersen, P, Johansson, L, Blomqvist, H, Peterzén, B, Wyon, N, Lindström, I, Paulsson, A, Agvald Ohman, C, Petersson, J, Friberg, H, Einar, V, Hammarskjöld, F, Schindele, M, Arvidsson, S, Sellgren, S, Hulting, J, Häggqvist, J, Rudenstam, J, Lind, D, Kokinsky, E, Owall, A, Jacobson, S, Stiernstrom, H, Nydahl, A, Eggimann, P, Stocker, R, Loderer, G, Loetscher, R, Heer, K, Zender, H, Cottini, S, Pagnamenta, A, Eich, G, Felleiter, P, Marco, M, Pugin, J, Shu Hui, W, Hsieh, K, Toomtong, P, Khwannimit, B, Kietdumrongwong, P, Khaldi, A, Messadi, A, Labbene, I, Frikha, N, Atalan, K, Ates, C, Kahveci, A, Ozgencil, E, Kizilkaya, M, Bosnak, M, Bodur, H, Akan, M, Guven, M, Turkoglu, M, Topeli, A, Togal, T, Uzel, N, Akinci, I, Cakar, N, Tugrul, S, Demirkiran, O, Adanir, T, Dogruer, K, Turkmen, A, Guven, H, Ulger, F, Kocak, S, Nalapko, Y, Rady, S, Alsabbah, A, Elahi, N, Al rahma, H, Rahman, M, Kashef, S, Cuthbertson, B, Gunning, K, Myint, Y, Bewley, J, Burnstein, R, Haji Michael, P, Wrathall, D, Folan, L, Nesbitt, I, Ratnaparkhi, A, Pambakian, S, Booth, M, Watters, M, Sherry, T, Buehner, U, Barrera Groba, C, Bothma, P, George, N, Frater, J, Hollos, L, Mclellan, S, Hunter, J, Garrioch, M, O'Keeffe, N, Divekar, N, Eggert, S, Smith, S, Vincent, A, Withington, P, Macmillan, C, Webster, R, Vuylsteke, A, Appadu, B, Barrera groba, C, Mcquillan, P, Blunt, M, Parekh, N, William, D, Jones, C, Krige, A, Schuster Bruce, M, Boyden, J, Boulanger, C, Swann, D, Walker, J, Wigmore, T, Law, R, Baldwin, F, Muench, C, Robinson, S, Crerar Gilbert, A, Rhodes, A, Mahambrey, T, Cameron, L, Thornton, J, Stotz, M, Russell, M, Longmate, A, Kitson, R, Browne, B, Thorniley, A, Gonzalez, I, Swart, M, Singer, M, Gautam, N, Prasad, V, Watson, D, Szakmany, T, Cardy, J, Binning, A, Loveland, R, Gannon, J, Martinelli, G, Nightingale, P, Howes, J, Steingrub, J, Ammons, L, Fisher, M, Gandhi, N, Martin, G, Deutschman, C, Dean, N, Michetti, C, Belzberg, H, Hutchinson, K, Van der kloot, T, Afessa, B, Kaufman, D, Iqbal, J, Ost, D, Afifi, S, West, M, Wunderink, R, Stein, S, Hagg, D, Jimenez, E, Blosser, S, Chhangani, S, Kleinpell, R, Reich, H, Fields, E, Willms, D, Castellanos Mateus, P, Melnik, L, Oud, L, Chi, E, Halfon, R, Badr, A, Restrepo, M, Pohlman, A, Branson, R, Simpson, S, Kett, D, Jacobs, T, Park, P, Wahl, W, Patricia, C, Hammersley, J, Papadimos, T, Sawyer, R, Freire, A, Rodriguez, W, Ryan, A, Margolis, B, Groth, M, Escanda, H, Baraibar, J, Paciel, D, Bagnulo, H, Hitta, F, Nadales, P, Albornoz, H, Salmen, Z, Pacheco, C, Bui, T, Potie, F, and Nguyen Huu, C.

Published
2011

26. Infections, antibiotic treatment and mortality in patients admitted to ICUs in countries considered to have high levels of antibiotic resistance compared to those with low levels

Author

Hanberger, H, Antonelli, M, Holmbom, M, Lipman, J, Pickkers, P, Leone, M, Rello, J, Sakr, Y, Walther, S, Vanhems, P, Vincent, J, Betsch, H, Fogh, B, Espersen, K, Jacobsen, K, Berezowicz, P, Harjola, V, Sofianos, E, Armaganidis, A, Routsi, C, Bitzani, M, Chalkiadaki, A, Michalopoulos, A, Mouloudi, E, Ioannidou, E, Myrianthefs, P, Koulenti, D, Karampela, I, Kyriazopoulos, G, Mandragos, K, Clouva molyvdas, P, Moraiti, A, Pneumatikos, I, Filos, K, Zakynthinos, E, Kotanidou, A, Vakalos, A, Sprung, C, Lev, A, Kishinevsky, E, Cohen, J, Sofer, S, Vesconi, S, Greco, S, Borelli, M, Cecilia, P, Sapuppo, M, Lazzero, A, Mangani, V, Petrucci, N, Minerva, M, De blasio, E, Marzorati, S, Rosi, R, Giarratano, A, Margarit, O, Guberti, A, Scolz, S, Stelian, E, Emmi, V, Caspani, M, Rosano, A, Abbruzzese, C, Colonna, S, Ceriani, R, De Blasi, R, Panella, L, Borrelli, F, Lorella, P, Ruatti, H, Munch, C, Sorbara, C, Fiore, G, Chieregato, A, Conti, V, Guadagnucci, A, Pizzamiglio, M, Locicero, M, Marri, I, Sicignano, A, Conte, V, Oggioni, R, De Gasperi, A, De Negri, P, Santagostino, G, Fumagalli, R, Marino, G, Castiglione, G, Sforza, D, Giuseppe, N, Bassetti, M, Ferraro, F, Clementi, S, Alessandro, D, Cotogni, P, Ranieri, M, Martinelli, L, Gianesello, L, Gullo, A, Morelli, A, Biancofiore, G, Della Rocca, G, Borg, M, De Pont, A, Rosseel, P, Ten Cate, J, Van Berkel, G, Corsten, S, Bakker, J, Vogelaar, J, Blom, H, Kieft, H, Kuiper, M, Gille, A, Vet, J, Ammann, J, Den Boer, S, Wesselink, R, Speelberg, B, Pham, C, Rodgers, M, Bergmans, D, Groeneveld, J, Loevstad, R, Klepstad, P, Erno, P, Junker, A, Bártolo, A, Castelo Branco Sousa, M, Esteves, F, Martins, A, Oliveira, T, Ponce, P, Mourão, L, Febra, C, Carmo, E, Lopes, V, Póvoa, P, Rezende, A, Costa, H, Moreira, P, Pádua, F, Leite, A, Almeida, E, Alves, M, Sousa, A, Telo, L, Dias, C, Paiva, J, Ribeiro, R, Amaro, P, Carneiro, A, Moreno, R, Matos, R, Afonso, S, Bouw, M, França, C, Rubio, O, Mañez, R, Campiñez, B, Alvarez, M, Jorda, R, Naveira Abeigón, E, Monedero, P, Alemparte Pardavila, E, Garcia del Valle, S, Perez Calvo, C, Palomar, M, Guerrero, F, Caballero Zirena, A, Arribas, M, Bustamante Munguira, E, Ruiz, J, Iglesias, L, Zavala, E, Valencia, M, Blesa Malpica, A, Martinez Sagasti, F, Nieto, M, Aguilar, G, Martinon Torres, F, Lorente, C, Insausti, J, Vegas Pinto, R, Santos, I, Escriba, A, Olaechea, P, Muñoz, E, Antón Caraballo, E, Galdos Anuncibay, P, Lopez Camps, V, Esteban Reboll, F, Estella, A, Bocero, L, Ibañez, A, Pueyo, L, María Jesús, L, Silva, J, Garro, P, Ramos gómez, L, Rovira, A, Martin Delgado, M, Monton Dito, J, Garcia, F, Navarro, J, Latour Perez, J, Albaya, A, Bustinza, A, Sole violán, J, Ugarte Peña, P, Yuste, I, De Rojas Román, J, Vallés, J, Esteban, E, Quintana Tort Martorell, E, Moreno, M, López Ciudad, V, Manzano Ramirez, A, Sánchez Olmedo, J, Borges, M, Amador Amerigo, J, Guerrero Gomez, F, Montejo González, J, Sirvent, J, Mesalles Sanjuan, E, Barcenilla Gaite, F, Serrano, N, Cerdá, E, Lesmes Serrano, A, Garcia Fuentes, C, Macias Pingarrón, J, Espinosa, E, Sanchez Garcia, M, Felices, F, de la Torre Prados, M, Maria Jesus, H, Luis, V, Jara, R, Briones Lopez, M, Posada, P, Galvan, B, Mariscal, F, Gil, B, Sierra, R, Rico Feijoo, J, Corcobado Márquez, C, Izura, J, González, J, Soto Ibáñez, J, Petersen, P, Johansson, L, Blomqvist, H, Peterzén, B, Wyon, N, Stiernstrom, H, Lindström, I, Paulsson, A, Agvald Ohman, C, Petersson, J, Friberg, H, Einar, V, Hammarskjöld, F, Schindele, M, Arvidsson, S, Sellgren, J, Hulting, J, Häggqvist, J, Rudenstam, J, Lind, D, Kokinsky, E, Owall, A, Jacobson, S, Nydahl, A, Atalan, K, Ates, C, Kahveci, A, Fistikci, H, Kaya, A, Ozgencil, E, Kizilkaya, M, Bosnak, M, Bodur, H, Akan, M, Guven, M, Turkoglu, M, Topeli, A, Togal, T, Uzel, N, Akinci, I, Cakar, N, Tugrul, S, Demirkiran, O, Adanir, T, Dogruer, K, Turkmen, A, Guven, H, Ulger, F, Kocak, S, Kocak, S., FUMAGALLI, ROBERTO, Hanberger, H, Antonelli, M, Holmbom, M, Lipman, J, Pickkers, P, Leone, M, Rello, J, Sakr, Y, Walther, S, Vanhems, P, Vincent, J, Betsch, H, Fogh, B, Espersen, K, Jacobsen, K, Berezowicz, P, Harjola, V, Sofianos, E, Armaganidis, A, Routsi, C, Bitzani, M, Chalkiadaki, A, Michalopoulos, A, Mouloudi, E, Ioannidou, E, Myrianthefs, P, Koulenti, D, Karampela, I, Kyriazopoulos, G, Mandragos, K, Clouva molyvdas, P, Moraiti, A, Pneumatikos, I, Filos, K, Zakynthinos, E, Kotanidou, A, Vakalos, A, Sprung, C, Lev, A, Kishinevsky, E, Cohen, J, Sofer, S, Vesconi, S, Greco, S, Borelli, M, Cecilia, P, Sapuppo, M, Lazzero, A, Mangani, V, Petrucci, N, Minerva, M, De blasio, E, Marzorati, S, Rosi, R, Giarratano, A, Margarit, O, Guberti, A, Scolz, S, Stelian, E, Emmi, V, Caspani, M, Rosano, A, Abbruzzese, C, Colonna, S, Ceriani, R, De Blasi, R, Panella, L, Borrelli, F, Lorella, P, Ruatti, H, Munch, C, Sorbara, C, Fiore, G, Chieregato, A, Conti, V, Guadagnucci, A, Pizzamiglio, M, Locicero, M, Marri, I, Sicignano, A, Conte, V, Oggioni, R, De Gasperi, A, De Negri, P, Santagostino, G, Fumagalli, R, Marino, G, Castiglione, G, Sforza, D, Giuseppe, N, Bassetti, M, Ferraro, F, Clementi, S, Alessandro, D, Cotogni, P, Ranieri, M, Martinelli, L, Gianesello, L, Gullo, A, Morelli, A, Biancofiore, G, Della Rocca, G, Borg, M, De Pont, A, Rosseel, P, Ten Cate, J, Van Berkel, G, Corsten, S, Bakker, J, Vogelaar, J, Blom, H, Kieft, H, Kuiper, M, Gille, A, Vet, J, Ammann, J, Den Boer, S, Wesselink, R, Speelberg, B, Pham, C, Rodgers, M, Bergmans, D, Groeneveld, J, Loevstad, R, Klepstad, P, Erno, P, Junker, A, Bártolo, A, Castelo Branco Sousa, M, Esteves, F, Martins, A, Oliveira, T, Ponce, P, Mourão, L, Febra, C, Carmo, E, Lopes, V, Póvoa, P, Rezende, A, Costa, H, Moreira, P, Pádua, F, Leite, A, Almeida, E, Alves, M, Sousa, A, Telo, L, Dias, C, Paiva, J, Ribeiro, R, Amaro, P, Carneiro, A, Moreno, R, Matos, R, Afonso, S, Bouw, M, França, C, Rubio, O, Mañez, R, Campiñez, B, Alvarez, M, Jorda, R, Naveira Abeigón, E, Monedero, P, Alemparte Pardavila, E, Garcia del Valle, S, Perez Calvo, C, Palomar, M, Guerrero, F, Caballero Zirena, A, Arribas, M, Bustamante Munguira, E, Ruiz, J, Iglesias, L, Zavala, E, Valencia, M, Blesa Malpica, A, Martinez Sagasti, F, Nieto, M, Aguilar, G, Martinon Torres, F, Lorente, C, Insausti, J, Vegas Pinto, R, Santos, I, Escriba, A, Olaechea, P, Muñoz, E, Antón Caraballo, E, Galdos Anuncibay, P, Lopez Camps, V, Esteban Reboll, F, Estella, A, Bocero, L, Ibañez, A, Pueyo, L, María Jesús, L, Silva, J, Garro, P, Ramos gómez, L, Rovira, A, Martin Delgado, M, Monton Dito, J, Garcia, F, Navarro, J, Latour Perez, J, Albaya, A, Bustinza, A, Sole violán, J, Ugarte Peña, P, Yuste, I, De Rojas Román, J, Vallés, J, Esteban, E, Quintana Tort Martorell, E, Moreno, M, López Ciudad, V, Manzano Ramirez, A, Sánchez Olmedo, J, Borges, M, Amador Amerigo, J, Guerrero Gomez, F, Montejo González, J, Sirvent, J, Mesalles Sanjuan, E, Barcenilla Gaite, F, Serrano, N, Cerdá, E, Lesmes Serrano, A, Garcia Fuentes, C, Macias Pingarrón, J, Espinosa, E, Sanchez Garcia, M, Felices, F, de la Torre Prados, M, Maria Jesus, H, Luis, V, Jara, R, Briones Lopez, M, Posada, P, Galvan, B, Mariscal, F, Gil, B, Sierra, R, Rico Feijoo, J, Corcobado Márquez, C, Izura, J, González, J, Soto Ibáñez, J, Petersen, P, Johansson, L, Blomqvist, H, Peterzén, B, Wyon, N, Stiernstrom, H, Lindström, I, Paulsson, A, Agvald Ohman, C, Petersson, J, Friberg, H, Einar, V, Hammarskjöld, F, Schindele, M, Arvidsson, S, Sellgren, J, Hulting, J, Häggqvist, J, Rudenstam, J, Lind, D, Kokinsky, E, Owall, A, Jacobson, S, Nydahl, A, Atalan, K, Ates, C, Kahveci, A, Fistikci, H, Kaya, A, Ozgencil, E, Kizilkaya, M, Bosnak, M, Bodur, H, Akan, M, Guven, M, Turkoglu, M, Topeli, A, Togal, T, Uzel, N, Akinci, I, Cakar, N, Tugrul, S, Demirkiran, O, Adanir, T, Dogruer, K, Turkmen, A, Guven, H, Ulger, F, Kocak, S, Kocak, S., and FUMAGALLI, ROBERTO

Abstract

Background: Antimicrobial resistance is an increasing concern in ICUs worldwide. Infection with an antibiotic resistant (ABR) strain of an organism is associated with greater mortality than infection with the non-resistant strain, but there are few data assessing whether being admitted to an intensive care unit (ICU) with high levels of antimicrobial resistance is associated with a worse outcome than being admitted to an ICU with low rates of resistance. The aim of this study was, therefore, to compare the characteristics of infections and antibiotic treatments and patient outcomes in patients admitted to ICUs in countries considered as having high levels of antibiotic resistance and those admitted to ICUs in countries considered as having low levels of antibiotic resistance.Methods: Data from the large, international EPIC II one-day point prevalence study on infections in patients hospitalized in ICUs were used. For the current study, we compared the data obtained from patients from two groups of countries: countries with reported MRSA rates of ≥ 25% (highABR: Greece, Israel, Italy, Malta, Portugal, Spain, and Turkey) and countries with MRSA rates of < 5% (lowABR: Denmark, Finland, Netherlands, Norway, and Sweden).Results: On the study day, 1187/2204 (53.9%) patients in the HighABR ICUs were infected and 255/558 (45.7%) in the LowABR ICUs (P < 0.01). Patients in the HighABR ICUs were more severely ill than those in the LowABR ICUs, as reflected by a higher SAPS II score (35.6 vs 32.7, P < 0.05) and had longer median ICU (12 days vs 5 days) and hospital (24 days vs 16 days) lengths of stay. They also had higher crude ICU (20.0% vs 15.4%) and hospital (27.0% vs 21.5%) mortality rates (both P < 0.05). However, after multivariable adjustment and matched pair analysis there were no differences in ICU or hospital mortality rates between High or LowABR ICU patients overall or among those with infections.Conclusions: Being hospitalized in an ICU in a region with high level

Published
2014

27. Physics momentum: 'stars' draw majors

Author

Lindström, I

Subjects
Science Education, ComputingMilieux_COMPUTERSANDEDUCATION
Abstract

Over the past decade, the number of University of Arizona students declaring physics as their major has doubled, amid a national decline. According to a recent report by the National Task Force on Undergraduate Physics, it is the university's dedication to its undergraduate physics program which draws students in (1 page).

Published
2003

29. Students' learning as the focus for shared involvement between universities and clinical practice: A didactic model for postgradualte degree project.

Author

Öhlén, Joakim, Berg, L, Björk Brämberg, E, Engström, Å, German-Millberg, L, Höglund, I, Jacobsson, C, Lepp, M, Lidén, E, Lindström, I, Petzäll, K, Söderberg, S, Wijk, H, Öhlén, Joakim, Berg, L, Björk Brämberg, E, Engström, Å, German-Millberg, L, Höglund, I, Jacobsson, C, Lepp, M, Lidén, E, Lindström, I, Petzäll, K, Söderberg, S, and Wijk, H

Published
2012

31. Verksamhetsförlagd utbildning på avancerad nivå - ny utmaning för specialistutbildningar för sjuksköterskor

Author

Petzäll, Kerstin, Wijk, H, Öhlén, J, Lidén, E, German Millberg, L, Jacobsson, C, Söderberg, S, Berg, L, Engström, Å, Höglund, I, Lepp, M, Lindström, I, Nygren, B, Persson, C, Skär, L, Suserud, B-O, Söderlund, M, Petzäll, Kerstin, Wijk, H, Öhlén, J, Lidén, E, German Millberg, L, Jacobsson, C, Söderberg, S, Berg, L, Engström, Å, Höglund, I, Lepp, M, Lindström, I, Nygren, B, Persson, C, Skär, L, Suserud, B-O, and Söderlund, M

Published
2009

32. Documentation of patients' participation in care at the end of life

Author

Lindström, I, Gaston-Johansson, F, Danielson, Ella, Lindström, I, Gaston-Johansson, F, and Danielson, Ella

Abstract

The aim of this study was to describe how patients' participation in the care they received was documented in their health care records during the last three months of their lives. Two hundred and twenty-nine deceased adult persons were randomly identified from 12 municipalities in a Swedish county and their records were selected from different health care units. Content analysis was used to analyse the text. Four categories of patient participation were described: refusing offered care and treatments; appealing for relief; desire for everyday life; and making personal decisions. The most common way for these patients to be involved in their care at the end of their life was by refusal of the treatment and care offered. Characteristic of the different ways of participation were the diverse activities represented. The description of patients' involvement in their life situation at this time indicated their dissociation from the health care offered more than consenting to it.

Published
2006

33. Students’ learning as the focus for shared involvement between universities and clinical practice: a didactic model for postgraduate degree projects

Author

Öhlén, J., primary, Berg, L., additional, Björk Brämberg, E., additional, Engström, Å., additional, German Millberg, L., additional, Höglund, I., additional, Jacobsson, C., additional, Lepp, M., additional, Lidén, E., additional, Lindström, I., additional, Petzäll, K., additional, Söderberg, S., additional, and Wijk, H., additional

Published
2011
Full Text
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34. Nurses' experiences of change: a new professional collaboration model and all-R.N. staffing

Author

Lundgren S, Segesten K, Agelii E, Lindström I, and Elmcrona M

Subjects
Sweden, Enthusiasm, Leadership and Management, business.industry, media_common.quotation_subject, Interprofessional Relations, Staffing, General Medicine, Nursing Staff, Hospital, University hospital, Organizational Innovation, Hospitals, University, Nursing, Models, Organizational, Workforce, Medicine, Humans, sense organs, Models, Nursing, skin and connective tissue diseases, business, media_common
Abstract

Changes in staffing toward a higher number of R.N.'s are common in a number of countries today. This article aims at describing the experiences of a management-induced change from mixed to all-R.N. staffing. All R.N.s in a surgical ward at a Swedish university hospital were interviewed two months after such replacements were completed. The nurses described a period of chaos and conflicts but also of support for the idea and enthusiasm for the future. A more careful planning of the change process is to be recommended.

Published
1994

38. Fast-food-based hyper-alimentation can induce rapid and profound elevation of serum alanine aminotransferase in healthy subjects.

Author

Kechagias, S., Ernersson, Å., Dahlqvist, O., Lundberg, P., Lindström, I., and Nystrom, F. H.

Subjects
CONVENIENCE foods, ARTIFICIAL feeding, SERUM, AMINOTRANSFERASES, HEALTH, MEDICAL research
Abstract

OBJECTIVE: To study the effect of fast-food-based hyper-alimentation on liver enzymes and hepatic triglyceride content (HTGC). DESIGN: Prospective interventional study with parallel control group. SETTING: University Hospital of Linköping, Sweden. PARTICIPANTS: 12 healthy men and six healthy women with a mean (SD) age of 26 (6.6) years and a matched control group. INTERVENTION: Subjects in the intervention group aimed for a body weight increase of 5-15% by eating at least two fast-food-based meals a day with the goal to double the regular caloric intake in combination with adoption of a sedentary lifestyle for 4 weeks. MAIN OUTCOME MEASURES: Weekly changes of serum aminotransferases and HTGC measured by proton nuclear magnetic resonance spectroscopy at baseline and after the intervention. RESULTS: Subjects in the intervention group increased from 67.6 (9.1) kg to 74.0 (11) kg in weight (p<0.001). Serum ALT increased from 22.1 (11.4) U/l at study start to an individual mean maximum level of 97 (103) U/l (range 19.4-447 U/l). Eleven of the 18 subjects persistently showed ALT above reference limits (women >19 U/l, men >30 U/l) during the intervention. Sugar (mono- and disaccharides) intake during week 3 correlated with the maximal ALT/baseline ALT ratio (r = 0.62, p = 0.006). HTGC increased from 1.1 (1.9)% to 2.8 (4.8)%, although this was not related to the increase in ALT levels. ALT levels were unchanged in controls. CONCLUSION: Hyper-alimentation per se can induce profound ALT elevations in less than 4 weeks. Our study clearly shows that in the evaluation of subjects with elevated ALT the medical history should include not only questions about alcohol intake but also explore whether recent excessive food intake has occurred. [ABSTRACT FROM AUTHOR]

Published
2008
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40. Do immigrant patients differ from native Swedish patients with back pain when entering rehabilitation?

Author

Lindström I, Areskoug B, and Allebeck P

Abstract

Back pain affects up to 80% of all people at some time during life. With the increasing migration between countries, there is a need for rehabilitation suitable also for immigrant patients. Most studies on rehabilitation for patients with back pain exclude immigrants. Back pain occurs in all societies, but cultural groups differ in how they perceive symptoms and react to them. In order to plan rehabilitation for patients with back pain, it is important to know whether immigrants have particular needs that should be addressed. The aim of this study was to compare immigrant and Swedish patients with back pain before starting a rehabilitation programme. Nine hundred and forty-three consecutively patients entered an outpatient-based, multidisciplinary, behavioral and cognitive rehabilitation programme including graded return to work in Sweden. Five hundred and sixty-six were Swedes and 377 were immigrants. The patients were sick-listed for at least 6 weeks. Self-administered questionnaires were used to assess demographics, education, occupation, work, pain, pain behavior, health, disability, psychosomatic symptoms, distress, etc. An abdominal muscle test, a back muscle test, a lifting test, a fitness test and a circuit test examined the patients' physical performance. Immigrant patients differed from Swedish patients with back pain when entering an out-patient-based, multidisciplinary, behavioral and cognitive rehabilitation programme for sick-listed patients. Reported health, pain, pain behavior, disability, psychosomatic symptoms, distress and performance in physical tests were poorer in immigrant patients than is Swedish patients, but most work factors, sick-leave, duration of pain and background factors were not different from Swedish patients. Immigrant patients with back pain might have particular needs that should be addressed when planning treatment and rehabilitation programmes. [ABSTRACT FROM AUTHOR]

Published
2002
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44. The effects of low temperatures on intracellular transport of newly synthesized albumin and haptoglobin in rat hepatocytes

Author

Fries, E and Lindström, I

Abstract

Isolated rat hepatocytes were pulse-labelled with [35S]methionine at 37 degrees C and subsequently incubated (chased) for different periods of time at different temperatures (37-16 degrees C). The time courses for the secretion of [35S]methionine-labelled albumin and haptoglobin were determined by quantitative immunoprecipitation of the detergent-solubilized cells and of the chase media. Both proteins appeared in the chase medium only after a lag period, the length of which increased markedly with decreasing chase temperature: from about 10 and 20 min at 37 degrees C to about 60 and 120 min at 20 degrees C for albumin and haptoglobin respectively. The rates at which the proteins were externalized after the lag period were also strongly affected by temperature, the half-time for secretion being 20 min at 37 degrees C and 200 min at 20 degrees C for albumin; at 16 degrees C no secretion could be detected after incubation for 270 min. Analysis by subcellular fractionation showed that part of the lag occurred in the endoplasmic reticulum and that the rate of transfer to the Golgi complex was very temperature-dependent. The maximum amount of the two pulse-labelled proteins in Golgi fractions prepared from cells after different times of chase decreased with decreasing incubation temperatures, indicating that the transport from the Golgi complex to the cell surface was less affected by low temperatures than was the transport from the endoplasmic reticulum to the Golgi complex.

Published
1986
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45. Studies of the mechanism of desensitization of anti-IgE-mediated histamine release from human basophils

Author

Andersson, Rolf G, Bartonek, M, Lindström, Eva, Lindström, I M, Toll, Johan B, Andersson, Rolf G, Bartonek, M, Lindström, Eva, Lindström, I M, and Toll, Johan B

Abstract

Human basophils became hyporesponsive to anti-IgE when exposed to this agent in the absence of Ca2+ for more than 10 min. The desensitization process proceeded in parallel to the releasing-process. The mechanism of desensitization seems to involve a very early step in the release-reaction, since the response to phospholipase A2 and diolein, agents involved in the release-reaction, was not affected by the desensitization.

Published
1989
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46. [Irritant-induced asthma],Ärsytyksen aiheuttama astma

Author

Lindström, I., Suojalehto, H., Hannu, T., Harju, T., Maritta S. Jaakkola, Karjalainen, J., Karvala, K., Kauppi, P., Kilpeläinen, M., Lindqvist, M., Malmberg, P., Nieminen, E. -M, Pallasaho, P., Purokivi, M., Sauni, R., Suuronen, K., Tuomisto, L., and Piirilä, P.

47. [Work aggravated asthma].,Tyon pahentama astma

Author

Purokivi, M., Sauni, R., Timo Hannu, Harju, T., Jaakkola, M., Karjalainen, J., Kilpeläinen, M., Karvala, K., Malmberg, P., Nieminen, E. M., Pallasaho, P., Piirilä, P., Suojalehto, H., Suuronen, K., Tuomisto, L., and Lindström, I.

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