GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study
    Springer Science and Business Media LLC ; 2021
    In:  Critical Care Vol. 25, No. 1 ( 2021-12)
    Details
    In: Critical Care, Springer Science and Business Media LLC, Vol. 25, No. 1 ( 2021-12)
    Abstract: The COVID-19 pandemic has led highly developed healthcare systems to the brink of collapse due to the large numbers of patients being admitted into hospitals. One of the potential prognostic indicators in patients with COVID-19 is frailty. The degree of frailty could be used to assist both the triage into intensive care, and decisions regarding treatment limitations. Our study sought to determine the interaction of frailty and age in elderly COVID-19 ICU patients. Methods A prospective multicentre study of COVID-19 patients ≥ 70 years admitted to intensive care in 138 ICUs from 28 countries was conducted. The primary endpoint was 30-day mortality. Frailty was assessed using the clinical frailty scale. Additionally, comorbidities, management strategies and treatment limitations were recorded. Results The study included 1346 patients (28% female) with a median age of 75 years (IQR 72–78, range 70–96), 16.3% were older than 80 years, and 21% of the patients were frail. The overall survival at 30 days was 59% (95% CI 56–62), with 66% (63–69) in fit, 53% (47–61) in vulnerable and 41% (35–47) in frail patients ( p   〈  0.001). In frail patients, there was no difference in 30-day survival between different age categories. Frailty was linked to an increased use of treatment limitations and less use of mechanical ventilation. In a model controlling for age, disease severity, sex, treatment limitations and comorbidities, frailty was independently associated with lower survival. Conclusion Frailty provides relevant prognostic information in elderly COVID-19 patients in addition to age and comorbidities. Trial registration Clinicaltrials.gov: NCT04321265 , registered 19 March 2020.
    Type of Medium: Online Resource
    ISSN: 1364-8535
    URL: Article
    DOI: 10.1186/s13054-021-03551-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2051256-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    The Association between 〈b〉〈i〉Helicobacter pylori〈/i〉〈/b〉 and Colorectal Neoplasia
    S. Karger AG ; 2023
    In:  Medical Principles and Practice Vol. 32, No. 1 ( 2023), p. 77-85
    Details
    In: Medical Principles and Practice, S. Karger AG, Vol. 32, No. 1 ( 2023), p. 77-85
    Abstract: 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 〈 i 〉 Helicobacter pylori 〈 /i 〉 ( 〈 i 〉 H. pylori 〈 /i 〉 ) and colorectal neoplasia (CRN) are frequent entities. Epidemiological data suggest an association between 〈 i 〉 H. pylori 〈 /i 〉 positivity ( 〈 i 〉 H. pylori 〈 /i 〉 +) and CRN, whereas pathophysiologic considerations substantiate a possible causal relationship. However, the relationship between CRN and 〈 i 〉 H. pylori 〈 /i 〉 + may also be mediated by shared risk factors. Therefore, the aim of this cross-sectional study was to evaluate a possible independent relationship between 〈 i 〉 H. pylori 〈 /i 〉 and CRN in a Central European cohort. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We included 5,707 asymptomatic patients. All patients underwent screening colonoscopy and upper gastrointestinal endoscopy. We assessed the association between any CRN and advanced CRN with 〈 i 〉 H. pylori 〈 /i 〉 + using multilevel logistic regression. We adjusted for age, sex, a positive family history of colorectal cancer, and cardiovascular risk. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 1,082 patients (19%) were 〈 i 〉 H. pylori 〈 /i 〉 + and 4,625 (81%) 〈 i 〉 H. pylori 〈 /i 〉 −. Patients with both CRN and 〈 i 〉 H. pylori 〈 /i 〉 had more cardiometabolic risk factors. In univariate (aOR 1.20; 1.10–1.31) and multivariable analysis (aOR 1.20; 1.08–1.32), 〈 i 〉 H. pylori 〈 /i 〉 + was associated with the diagnosis of any CRN. However, 〈 i 〉 H. pylori 〈 /i 〉 + was associated with the presence of advanced CRN (aOR 1.26; 0.96–1.64) only in trend. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 We found a clustered co-occurrence of CRN and 〈 i 〉 H. pylori 〈 /i 〉 . This association persisted after correction for shared cardiometabolic risk factors. We suggest that our analysis emphasizes the clinical value of 〈 i 〉 H. pylori 〈 /i 〉 eradication. Whether “test and treat” 〈 i 〉 H. pylori 〈 /i 〉 is warranted to prevent CRN remains unclear but is at least a possibility given the simplicity of “test and treat.”
    Type of Medium: Online Resource
    ISSN: 1011-7571 , 1423-0151
    URL: Article
    DOI: 10.1159/000528794
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1482963-0
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    A sex-specific propensity-adjusted analysis of colonic adenoma detection rates in a screening cohort
    Springer Science and Business Media LLC ; 2021
    In:  Scientific Reports Vol. 11, No. 1 ( 2021-09-07)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 11, No. 1 ( 2021-09-07)
    Abstract: The prevalence of colorectal adenoma and advanced adenoma (AA) differs between sexes. Also, the optimal age for the first screening colonoscopy is under debate. We, therefore, performed a sex-specific and age-adjusted comparison of adenoma, AA and advanced neoplasia (AN) rates in a real-world screening cohort. In total, 2824 asymptomatic participants between 45- and 60-years undergoing screening colonoscopy at a single-centre in Austria were evaluated. 46% were females and mean age was 53 ± 4 years. A propensity score for being female was calculated, and adenoma, AA and AN detection rates evaluated using uni- and multivariable logistic regression. Sensitivity analyses for three age groups (group 1: 45 to 49 years, n = 521, 41% females, mean age 47 ± 1 years; group 2: 50 to 54 years, n = 1164, 47% females, mean age 52 ± 1 years; group 3: 55 to 60 years, n = 1139, 46% females, mean age 57 ± 2 years) were performed. The prevalence of any adenoma was lower in females (17% vs. 30%; OR 0.46, 95% CI 0.38–0.55; p  〈  0.001) and remained so after propensity score adjustment for baseline characteristics and lifestyle factors (aOR 0.52, 95% CI 0.41–0.66; p  〈  0.001). The same trend was seen for AA with a significantly lower prevalence in females (3% vs. 7%; OR 0.38, 95% CI 0.26–0.55; p  〈  0.001) that persisted after propensity score adjustment (aOR 0.54, 95% CI 0.34–0.86; p = 0.01). Also, all age-group sensitivity analyses showed lower adenoma, AA and AN rates in females. Similar numbers needed to screen to detect an adenoma, an AA or AN were found in female age group 3 and male age group 1. Colorectal adenoma, AA and AN were consistently lower in females even after propensity score adjustment and in all age-adjusted sensitivity analyses. Our study may add to the discussion of the optimal age for initial screening colonoscopy which may differ between the sexes.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-021-97163-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2615211-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    Cardiovascular Risk Assessment by SCORE2 Predicts Risk for Colorectal Neoplasia and Tumor-Related Mortality
    MDPI AG ; 2022
    In:  Journal of Personalized Medicine Vol. 12, No. 5 ( 2022-05-23), p. 848-
    Details
    In: Journal of Personalized Medicine, MDPI AG, Vol. 12, No. 5 ( 2022-05-23), p. 848-
    Abstract: Objectives: The European Society of Cardiology endorsed SCORE2 to assess cardiovascular risk. The aim of this observational, retrospective study was to assess whether SCORE2 is associated with colorectal neoplasia in an asymptomatic screening population. Further, we evaluated if SCORE2 predicts tumor-related mortality. Methods: We included 3408 asymptomatic patients who underwent a screening colonoscopy. We calculated SCORE2 for each participant and stratified patients according to their predicted 10-year risk of cardiovascular disease: SCORE2 0–4.9%, SCORE2 5–9.9%, and SCORE2 ≥ 10%. We assessed the association between SCORE2 as a continuous variable, the presence of colorectal neoplasia using multilevel logistic regression, and SCORE2 and mortality using Cox regression. Results: In total, 1537 patients had a SCORE2 of 0–4.9%, 1235 a SCORE2 of 5–9.9%, and 636 a SCORE2 ≥ 10%. The respective rates of colorectal neoplasia were 20%, 37%, and 44%. SCORE2 was associated with the presence of any (OR 1.11 95%CI 1.09–1.12; p 〈 0.001) and advanced colorectal neoplasia (OR 1.06 95%CI 1.08–1.13; p 〈 0.001) in univariate analysis. After multivariable adjustment (age, sex, family history, and metabolic syndrome) a higher SCORE2 remained associated with higher odds for any (aOR 1.04 95%CI 1.02–1.06; p = 0.001) and advanced (aOR 1.06 95%CI 1.03–1.10; p 〈 0.001) colorectal neoplasia. SCORE2 was associated with both all-cause (HR 1.11 95%CI 1.09–1.14; p 〈 0.001) and tumor-related mortality (HR 1.10 95%CI 1.05–1.14; p 〈 0.001). Conclusions: We found that SCORE2 is associated with the presence of colorectal neoplasia. Clinicians could kill two birds with one stone calculating SCORE2. In patients with a high SCORE2, screening colonoscopy aside from cardiovascular risk mitigation could improve outcomes.
    Type of Medium: Online Resource
    ISSN: 2075-4426
    URL: Article
    DOI: 10.3390/jpm12050848
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662248-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    sST2 Levels Show No Association with Helicobacter pylori Infection in Asymptomatic Patients: Implications for Biomarker Research
    Springer Science and Business Media LLC ; 2023
    In:  Digestive Diseases and Sciences Vol. 68, No. 8 ( 2023-08), p. 3293-3299
    Details
    In: Digestive Diseases and Sciences, Springer Science and Business Media LLC, Vol. 68, No. 8 ( 2023-08), p. 3293-3299
    Type of Medium: Online Resource
    ISSN: 0163-2116 , 1573-2568
    URL: Article
    DOI: 10.1007/s10620-023-08005-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2015102-0
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    Screening for chronic liver diseases in the general population reveals an unexpectedly high prevalence of hepatitis C and advanced NAFLD
    Elsevier BV ; 2020
    In:  Journal of Hepatology Vol. 73 ( 2020-08), p. S325-
    Details
    In: Journal of Hepatology, Elsevier BV, Vol. 73 ( 2020-08), p. S325-
    Type of Medium: Online Resource
    ISSN: 0168-8278
    URL: Article
    DOI: 10.1016/S0168-8278(20)31152-1
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2027112-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 7
    Online Resource
    Online Resource
    Variations in end‐of‐life care practices in older critically ill patients with COVID‐19 in Europe
    Wiley ; 2022
    In:  Journal of Internal Medicine Vol. 292, No. 3 ( 2022-09), p. 438-449
    Details
    In: Journal of Internal Medicine, Wiley, Vol. 292, No. 3 ( 2022-09), p. 438-449
    Abstract: Previous studies reported regional differences in end‐of‐life care (EoLC) for critically ill patients in Europe. Objectives The purpose of this post‐hoc analysis of the prospective multicentre COVIP study was to investigate variations in EoLC practices among older patients in intensive care units during the coronavirus disease 2019 pandemic. Methods A total of 3105 critically ill patients aged 70 years and older were enrolled in this study (Central Europe: n = 1573; Northern Europe: n = 821; Southern Europe: n = 711). Generalised estimation equations were used to calculate adjusted odds ratios (aORs) to population averages. Data were adjusted for patient‐specific variables (demographic, disease‐specific) and health economic data (gross domestic product, health expenditure per capita). The primary outcome was any treatment limitation, and 90‐day mortality was a secondary outcome. Results The frequency of the primary endpoint (treatment limitation) was highest in Northern Europe (48%), intermediate in Central Europe (39%) and lowest in Southern Europe (24%). The likelihood for treatment limitations was lower in Southern than in Central Europe (aOR 0.39; 95% confidence interval [CI] 0.21–0.73; p = 0.004), even after multivariable adjustment, whereas no statistically significant differences were observed between Northern and Central Europe (aOR 0.57; 95%CI 0.27–1.22; p = 0.15). After multivariable adjustment, no statistically relevant mortality differences were found between Northern and Central Europe (aOR 1.29; 95%CI 0.80–2.09; p = 0.30) or between Southern and Central Europe (aOR 1.07; 95%CI 0.66–1.73; p = 0.78). Conclusion This study shows a north‐to‐south gradient in rates of treatment limitation in Europe, highlighting the heterogeneity of EoLC practices across countries. However, mortality rates were not affected by these results.
    Type of Medium: Online Resource
    ISSN: 0954-6820 , 1365-2796
    URL: Issue
    URL: Article
    DOI: 10.1111/joim.v292.3
    DOI: 10.1111/joim.13492
    RVK:
    XA 54380
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2006883-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 8
    Online Resource
    Online Resource
    Non-alcoholic fatty liver disease is not independently associated with Helicobacter pylori in a central European screening cohort
    Edizioni Minerva Medica ; 2023
    In:  Minerva Medica Vol. 113, No. 6 ( 2023-01)
    Details
    In: Minerva Medica, Edizioni Minerva Medica, Vol. 113, No. 6 ( 2023-01)
    Type of Medium: Online Resource
    ISSN: 0026-4806 , 1827-1669
    URL: Article
    DOI: 10.23736/S0026-4806.22.07928-9
    Language: English
    Publisher: Edizioni Minerva Medica
    Publication Date: 2023
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 9
    Online Resource
    Online Resource
    The Impact of Educational Status on the Occurrence of Colonic Diverticula: Insights from an Austrian Cohort Study
    S. Karger AG ; 2024
    In:  Medical Principles and Practice Vol. 33, No. 3 ( 2024), p. 242-250
    Details
    In: Medical Principles and Practice, S. Karger AG, Vol. 33, No. 3 ( 2024), p. 242-250
    Abstract: 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 Education often reflects socioeconomic status. Research indicates that lower socioeconomic status may increase the risk of diverticulosis, and according to data from the USA, diverticular disease is a significant and costly health problem. Our study explores the link between educational level and colonic diverticula occurrence. 〈 b 〉 〈 i 〉 Subject and Methods: 〈 /i 〉 〈 /b 〉 We conducted a cohort study on 5,532 asymptomatic Austrian patients who underwent colonoscopy, categorizing them by education level using the updated Generalized International Standard Classification of Education (GISCED). Logistic regression models, adjusting for age, gender, metabolic syndrome, diet, and activity, were used to determine the association between education and diverticulosis. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Overall, 39% of the patients had low educational status, while 53% had medium, and 8% had high educational status. Colon diverticula were less frequent in patients with medium (OR 0.73) and high (aOR 0.62) educational status. Medium educational level remained associated with lower rates of diverticulosis after adjustment for age and sex (aOR 0.85) and further metabolic syndrome, dietary habits, and physical activity (aOR 0.84). In higher education status, this phenomenon was only seen by trend. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Low education correlated with higher colon diverticula risk, while medium education showed lower rates even after adjustments. This trend persisted at higher education levels, highlighting the potential for strategies for cost reduction tailored to socioeconomic conditions.
    Type of Medium: Online Resource
    ISSN: 1011-7571 , 1423-0151
    URL: Article
    DOI: 10.1159/000538308
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2024
    detail.hit.zdb_id: 1482963-0
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 10
    Online Resource
    Online Resource
    Management of intoxicated patients – a descriptive outcome analysis of 4,267 ICU patients
    Springer Science and Business Media LLC ; 2022
    In:  BMC Emergency Medicine Vol. 22, No. 1 ( 2022-12)
    Details
    In: BMC Emergency Medicine, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12)
    Abstract: Intoxications are common in intensive care units (ICUs). The number of causative substances is large, mortality usually low. This retrospective cohort study aims to characterize differences of intoxicated compared to general ICU patients, point out variations according to causative agents, as well as to highlight differences between survivors and non-survivors among intoxicated individuals in a large-scale multi-center analysis. Methods A total of 105,998 general ICU patients and 4,267 individuals with the admission diagnoses “overdose” and “drug toxicity” from the years 2014 and 2015 where included from the eICU Collaborative Research Database. In addition to comparing these groups with respect to baseline characteristics, intensive care measures and outcome parameters, differences between survivors and non-survivors from the intoxication group, as well as the individual groups of causative substances were investigated. Results Intoxicated patients were younger (median 41 vs. 66 years; p 〈 0.001), more often female (55 vs. 45%; p 〈 0.001), and normal weighted (36% vs. 30%; p 〈 0.001), whereas more obese individuals where observed in the other group (37 vs. 31%; p 〈 0.001). Intoxicated individuals had a significantly lower mortality compared to general ICU patients (1% vs. 10%; aOR 0.07 95%CI 0.05-0.11; p 〈 0.001), a finding which persisted after multivariable adjustment (aOR 0.17 95%CI 0.12-0.24; p 〈 0.001) and persisted in all subgroups. Markers of disease severity (SOFA-score: 3 (1-5) vs. 4 (2-6) pts.; p 〈 0.001) and frequency of vasopressor use (5 vs. 15%; p 〈 0.001) where lower, whereas rates of mechanical ventilation where higher (24 vs. 26%; p 〈 0.001) in intoxicated individuals. There were no differences with regard to renal replacement therapy in the first three days (3 vs. 4%; p =0.26). In sensitivity analysis (interactions for age, sex, ethnicity, hospital category, maximum initial lactate, mechanical ventilation, and vasopressor use), a trend towards lower mortality in intoxicated patients persisted in all subgroups. Conclusion This large-scale retrospective analysis indicates a significantly lower mortality of intoxicated individuals compared to general ICU patients.
    Type of Medium: Online Resource
    ISSN: 1471-227X
    URL: Article
    DOI: 10.1186/s12873-022-00602-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2050431-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...