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  • MDPI AG  (2)
  • Park, Sunghoon  (2)
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  • MDPI AG  (2)
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  • 1
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 16 ( 2022-08-21), p. 4911-
    Abstract: Background: Long-term trends in influenza-related hospitalizations, critical care resource use, and hospital outcomes since the 2009 H1N1 influenza pandemic season have been rarely studied for adult populations. Materials and Methods: Adult patients from the Korean Health Insurance Review and Assessment Service who were hospitalized with influenza over a 10-year period (2009–2019) were analyzed. The incidence rates of hospitalization, critical care resource use, and in-hospital death were calculated using mid-year population census data. Results: In total, 300,152 hospitalized patients with influenza were identified (men, 35.7%; admission to tertiary hospitals, 9.4%). Although the age-adjusted hospitalization rate initially decreased since the 2009 H1N1 pandemic (52.61/100,000 population in 2009/2010), it began to increase again in 2013/2014 and reached a peak of 169.86/100,000 population in 2017/2018 (p 〈 0.001). The in-hospital mortality rate showed a similar increasing trend as the hospitalization, with a peak of 1.44/100,000 population in 2017/2018 (vs. 0.35/100,000 population in 2009/2010; p 〈 0.001). The high incidence rates of both hospitalization and in-hospital mortality were mainly attributable to patients aged ≥60 years. The rate of intensive care unit admission and the use of mechanical ventilation, continuous renal replacement therapy and vasopressors have also increased from the 2013/2014 season. The incidence of heart failure was the most frequent complication investigated, with a three-fold increase in the last two seasons since 2009/2010. In multivariate analysis adjusted for covariates, among hospitalized patients, type of hospitals and 2009 H1N1 pandemic season were associated with in-hospital mortality. Conclusions: We confirmed that the rates of hospitalization, critical care resource use, and in-hospital mortality by influenza have increased again in recent years. Therefore, strategies are needed to reduce infections and optimize resource use with a greater focus on older people.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662592-1
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  • 2
    In: Pharmaceutics, MDPI AG, Vol. 13, No. 11 ( 2021-11-04), p. 1861-
    Abstract: Limited studies have investigated population pharmacokinetic (PK) models and optimal dosage regimens of meropenem for critically ill adult patients using the probability of target attainment, including patients receiving extracorporeal membrane oxygenation (ECMO). A population PK analysis was conducted using non-linear mixed-effect modeling. Monte Carlo simulation was used to determine for how long the free drug concentration was above the minimum inhibitory concentration (MIC) at steady state conditions in patients with various degrees of renal function. Meropenem PK in critically ill patients was described using a two-compartment model, in which glomerular filtration rate was identified as a covariate for clearance. ECMO did not affect meropenem PK. The simulation results showed that the current meropenem dosing regimen would be sufficient for attaining 40%fT 〉 MIC for Pseudomonas aeruginosa at MIC ≤ 4 mg/L. Prolonged infusion over 3 h or a high-dosage regimen of 2 g/8 h was needed for MIC 〉 2 mg/L or in patients with augmented renal clearance, for a target of 100%fT 〉 MIC or 100%fT 〉 4XMIC. Our study suggests that clinicians should consider prolonged infusion or a high-dosage regimen of meropenem, particularly when treating critically ill patients with augmented renal clearance or those infected with pathogens with decreased in vitro susceptibility, regardless of ECMO support.
    Type of Medium: Online Resource
    ISSN: 1999-4923
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2527217-2
    SSG: 15,3
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