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Nosocomial meningitis in intensive care: a 10-year retrospective study and literature review
Sofia R. Valdoleiros,Cristina Torrão,Laura S. Freitas,Diana Mano,Celina Gonçalves,Carla Teixeira 대한중환자의학회 2022 Acute and Critical Care Vol.37 No.1
Background: Nosocomial meningitis is a medical emergency that requires early diagnosis, prompt initiation of therapy, and frequent admission to the intensive care unit (ICU).Methods: A retrospective study was conducted in adult patients diagnosed with nosocomial meningitis who required admission to the ICU between April 2010 and March 2020. Meningitis/ventriculitis and intracranial infection were defined according to Centers for Disease Control and Prevention guidelines.Results: An incidence of 0.75% of nosocomial meningitis was observed among 70 patients. The mean patient age was 59 years and 34% were ≥65 years. Twenty-two percent of patients were in an immunocompromised state. A clear predisposing factor for nosocomial meningitis (traumatic brain injury, basal skull fracture, brain hemorrhage, central nervous system [CNS] invasive procedure or device) was present in 93% of patients. Fever was the most frequent clinical feature. A microbiological agent was identified in 30% of cases, of which 27% were bacteria, with a predominance of Gram-negative over Gram-positive. Complications developed in 47% of cases, 24% of patients were discharged with a Glasgow coma scale <14, and 37% died. No clinical predictor of complications was identified. Advanced age (≥65 years old) and presence of complications were associated with higher hospital mortality. Conclusions: Nosocomial meningitis in intensive care has a low incidence rate but high mortality and morbidity. In a critical care patient with CNS-related risk factors, a high level of suspicion for meningitis must be employed, but diagnosis is hindered by several confounding factors.
( Camila Oliveira Serra ),( Paula Mara Gomes Leite ),( Andráa Beatriz Bezerra ),( Laura Freitas ),( Lucas Veras ),( Marcela Deda Costa ),( Leila Luiza Conceição Gonçalves ),( Leonardo Yung Dos Santos 대한폐경학회 2022 대한폐경학회지 Vol.28 No.1
Objectives: This study aimed to compare the climacteric symptoms, quality of life indices, and self-care attitudes in women before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This cross-sectional study was conducted between January 2020 and September 2021. The sample consisted of 342 climacteric women who were divided into two groups: before the pandemic (BP group; n = 62) and during the pandemic (DP group; n = 280). The Menopause Rating Scale and Women’s Health Questionnaire were used to measure the health-related quality of life and degree of climacteric symptoms reported by women. Results: During the COVID-19 pandemic, women were able to decrease their somatic symptoms derived from the climacteric period (BP group: 7.84 ± 4.46, DP group: 5.94 ± 9.20; P = 0.003). Conclusions: There was no worsening in the self-reported symptoms, quality of life, and self-care attitudes of climacteric women because of the COVID-19 pandemic. Moreover, only somatic symptoms decreased during the pandemic.