To identify the risk factors and attributable mortality associated with superinfections in febrile neutropenic patients with hematologic malignancies, we prospectively evaluated 333 episodes of fever and neutropenia by means of univariate and multivariate analyses. Superinfection was defined as any infection either occurring during antibiotic therapy or developing within 1 week after discontinuation of antibiotic therapy. Of 333 episodes, 46 (13.8%) were defined as superinfection; these episodes occurred in 46 patients. The risk factors for superinfection in the multivariate analysis were longer duration of profound neutropenia (P < .0001), lack of use of quinolones as prophylaxis (P < .0001), presence of a central venous catheter (P = .02), and persistence of fever after 3 days of antibiotic therapy (P = .02). The crude mortality rate among patients with superinfection was 48%, and the attributable mortality rate was 24% (95% confidence interval, 3%-45%). Identifying risk factors for superinfections in neutropenic patients might allow clinical practices to reduce the negative impact of this complication.
Arq Bras Endocrinol Metab vol 47 nº 2 Abril 2003 166 RESUMOA prevalência de obesidade e a presença de baixo peso ao nascer (BPN) foram avaliadas retrospectivamente em 96 crianças com pubarca precoce (PP), das quais foram selecionados 90 casos com adrenarca precoce. Em 46 prontuários havia informações quanto ao peso ao nascer, sendo 5 excluídos por prematuridade. Foram avaliados os está-dios de Tanner, índice de massa corporal (IMC), presença de acanthosis nigricans e idade óssea (IO). Consideramos como obesidade o IMC ≥ percentil 95 e como sobrepeso o IMC ≥ 85 e < percentil 95. O IMC foi reavaliado em 62 casos após follow-up mínimo de seis meses. A IO foi maior do que a cronológica (7,9±1,97 x 7,0±1,7 anos; p<0,001). O está-dio de Tanner II para pêlos pubianos foi notado em 72% e acanthosis nigricans em 31% dos casos. O peso ao nascer foi de 3.168±528g. Em 12% dos casos havia história de BPN, mas sem diferença com a população geral (10%). Não foi encontrada correlação entre o IMC e o PN. Obesidade foi notada em 31% e sobrepeso em 19%. O IMC aumentou após o follow-up (18±3,0 x 19,4±3,5kg/m 2 , p=0,008). A prevalência de obesidade na PP foi maior do que na população brasileira (31% x 15%, p<0,02). O excesso de peso é um achado comum na PP, entretanto o peso ao nascer é normal. É importante ressaltar que essas crianças devem ser estimuladas a perder peso, pois tanto a PP quanto a obesidade estão associados a um maior risco de desenvolver a síndrome dos ovários policísticos e a síndrome plurimetabólica na vida adulta. ABSTRACT Prevalence of Obesity and Low Birth Weight in Premature Pubarche.The prevalence of obesity and presence of low birth weight (LBW) were evaluated retrospectively in 96 children with premature pubarche (PP), from which 90 cases of premature adrenarche were selected. Information on BW was found in 46 charts, and 5 prematures were excluded. Tanner stages, body mass index (BMI), presence of acanthosis nigricans and bone age (BA) were evaluated. Obesity was considered when BMI ≥ the 95 th percentile and overweight when BMI ≥ the 85 and <95 percentiles. After a six-month follow-up, the BMI of 62 patients was reevaluated. The results showed that BA was higher than chronological age (7.9±1.97 x 7.0±1.7 years, p<0.001). 70% of the sample showed pubic hair in Tanner II stage in and 31% had acanthosis nigricans. The BW was 3,168.2±528.2g. In 12% of the cases a history of LBW was present, a result not different from the general population (10%). No correlation was found between BMI and BW. Obesity was observed in 31% and overweight in 19% of the cases. BMI increased after follow-up (18±3.0 x 19.4±3.5kg/m 2 , p=0.008). The prevalence of obesity was higher in children with PP than in the Brazilian population (31% x 15%, p<0.02). In conclusion, although excess weight is a common finding in PP, birth weight is normal. It is remarkable that these children must be stimulated to lose weight, since PP and obesity are associated with a higher risk for policystic ovary and plurimetabolic syndromes in adulthood.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.