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Clinical Autonomic Research - 相似文献
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Cristina Miglis N.J. Rhodes J. Liu J. Gener E. Hang M.H. Scheetz 《International journal of antimicrobial agents》2019,53(1):95-97
The quantitative importance of active antimicrobial treatment relative to other modifiable and non-modifiable risk factors for mortality has not been well defined in the literature. Here we quantify the impact of active antimicrobial treatment on mortality relative to other disease modifiers in patients with Gram-negative bloodstream infection (GNBSI). Patients with at least one positive blood culture who were treated with ≥24 h of cefepime for GNBSI were included in the study. To examine in-hospital survival, a full primary model and a base model with the least significant covariate from the primary model were established. Relative importance of covariates was calculated using percentages of difference in log-likelihood values when each covariate was iteratively added to the base model. A total of 154 unique patients with GNBSI were included. The primary model included active cefepime therapy (P?=?0.004), normalised days to positive culture (P?=?0.091), intensive care unit (ICU) at time of treatment (P?=?0.001), modified Acute Physiology and Chronic Health Evaluation (APACHE) II score on day zero (P?=?0.025), history of leukaemia (P?=?0.008) and prior immunosuppressive therapy (P?=?0.088). Active antimicrobial therapy displayed a relative importance of 32.2%, which was second to ICU residence at the time of culture. Amongst all covariates in the model, active antimicrobial therapy was the only modifiable variable and contributed significantly to in-hospital survival in acutely ill patients with GNBSI. 相似文献
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Mitchell G. Miglis Srikanth Muppidi Cynthia Feakins Lori Fong Thomas Prieto Safwan Jaradeh 《Clinical autonomic research》2016,26(1):67-73
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Patients with postural tachycardia syndrome (POTS) often describe symptoms of fatigue, sleepiness, and lack of refreshing sleep. We aimed to provide further objective measures of sleep in patients with POTS.Methods
POTS patients (n = 18) were selected based on autonomic testing and evaluation at our center. Controls (n = 16) of similar age, gender, and BMI were selected from new patients referred to the Stanford Sleep Disorders Clinic for any sleep-related complaint. All patients underwent polysomnography and completed several sleep questionnaires and a 2-week sleep diary.Results
POTS patients and control subjects were of similar age (27 ± 10.2 vs. 29 ± 5.4 years, p = 0.92) and Body Mass Index (21 ± 3.8 vs. 24 ± 4.1, p = 0.14). The majority of subjects in both groups were females (72 % POTS vs. 81 % controls). POTS patients scored higher on subjective fatigue scales but not sleepiness scales. POTS patients scored in the normal range on the BDI and the “evening” category on the MEQ. Their sleep diaries were not different from controls. With the exception of mild OSA, slightly reduced %REM and prolonged REM latency, their PSG data were normal and no different from controls.Conclusions
It is unlikely that the sleep-related complaints of POTS patients are the result of a primary sleep disorder unique to POTS. We propose that a combination of factors such as body fatigue, chronic pain, and other somatic symptoms common in POTS patients might be the underlying reason for sleep-related symptoms in POTS.7.
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Clinical Autonomic Research - 相似文献
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Sinn Dong In Muppidi Srikanth Miglis Mitchell G. Jaradeh Safwan 《Clinical autonomic research》2021,31(1):127-129
Clinical Autonomic Research - 相似文献
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