Publications by authors named "Furmanek S"

During the COVID-19 pandemic, a significant decline in was observed; however, re-emerged globally in 2023. Here, we describe a current outbreak of infections in the United States (US). More than 287 million patient records from all 50 states in the US were reviewed to identify patients with a diagnosis between 1 January 2017 and 30 September 2024.

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  • * The study was retrospective and involved matching patients based on age and antibiotic usage to analyze recurrence rates, finding a significantly lower recurrence rate in the tapered vancomycin group (5.3%) compared to the standard group (28%).
  • * The results suggest that tapering vancomycin might be a more effective treatment for initial CDI infections, but more extensive studies are needed to confirm these findings.
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Introduction: This study aims to explore the predictive roles of echocardiographic parameters and biomarkers in determining outcomes among hospitalized COVID-19 patients experiencing cardiovascular events.

Methods: A retrospective cohort study was conducted involving 49 COVID-19 patients who encountered cardiovascular events during hospitalization and underwent echocardiography. Our findings revealed notable associations between echocardiographic parameters and survival time.

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  • Pneumonia is a common issue for people who have received solid organ transplants, affecting both their health and the success of the transplant.
  • A study analyzed clinical data from nearly 7,500 patients, separating solid organ transplant (SOT) recipients from non-transplant (NT) patients, revealing that SOT recipients tend to be younger, more often male, and have more health complications.
  • Findings indicate that SOT recipients face significantly higher mortality rates, especially at the one-year mark, highlighting the need for careful monitoring and follow-up care for these patients.
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Background: The effects of SARS-CoV-2 have varied between significant waves of hospitalization.

Research Question: Are cardiovascular complications different among the first, delta and omicron waves of hospitalized COVID-19 pneumonia patients?

Study Design And Methods: This was a multi-centre retrospective study of patients hospitalized with SARS-CoV-2 pneumonia: 632 were hospitalized during the (March-July 2020), 1013 during the (September 2020-March 2021), and 323 during the (January 2022-July 2022). Patients were stratified by wave and occurrence of cardiovascular events.

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  • A study was conducted to investigate the prevalence and outcomes of community-acquired pneumonia (CAP) in immunocompromised hosts (ICHs) compared to non-ICHs among hospitalized adults in Louisville from June 2014 to May 2016.
  • Out of 7449 patients with CAP, 10% were identified as immunocompromised, with advanced-stage cancer being the most common condition.
  • The study found that ICHs had significantly higher mortality rates at hospitalization (9% vs 5%), 30 days (24% vs 11%), 6 months (44% vs 21%), and 1 year (53% vs 27%) compared to non-ICHs, highlighting the impact of socioeconomic
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  • Pneumococcal pneumonia is a significant issue among hospitalized patients with community-acquired pneumonia (CAP), with a study conducted in Louisville, Kentucky, from 2014 to 2016 investigating its epidemiology and impact in the US.
  • Out of 5,402 CAP patients tested, 708 (13%) had pneumococcal pneumonia, equating to an estimated 226,696 hospitalizations annually in the US.
  • The study revealed that the most common serotypes were 19A, 3, and 22F, and mortality rates increased significantly over time, with 25.4% of patients dying within a year of hospitalization, particularly affecting low-income and racially diverse communities.
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  • Most RSV cases are diagnosed using nasal swabs, but testing other specimen types can improve detection rates significantly.
  • A study containing 1766 patients showed that adding saliva, sputum, and serology tests resulted in a higher diagnosis rate of RSV compared to using nasal swabs alone.
  • The combined testing led to a diagnosed rate increase from 3.2% to 6.2%, with sensitivities indicating that saliva, sputum, and serology are more effective than NP swabs alone.
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SARS-CoV-2 and influenza are primary causes of viral community-acquired pneumonia (CAP). Both pathogens have exhibited high transmissibility and are recognized causes of pandemics. Controversy still exists regarding the clinical outcomes between patients hospitalized with CAP due to these viruses.

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Although Clostridioides difficile infection (CDI) incidence is high in the United States, standard-of-care (SOC) stool collection and testing practices might result in incidence overestimation or underestimation. We conducted diarrhea surveillance among inpatients >50 years of age in Louisville, Kentucky, USA, during October 14, 2019-October 13, 2020; concurrent SOC stool collection and CDI testing occurred independently. A study CDI case was nucleic acid amplification test‒/cytotoxicity neutralization assay‒positive or nucleic acid amplification test‒positive stool in a patient with pseudomembranous colitis.

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The spectrum of disease severity and the insidiousness of clinical presentation make it difficult to recognize patients with coronavirus disease 2019 (COVID-19) at higher risk of worse outcomes or death when they are seen in the early phases of the disease. There are now well-established risk factors for worse outcomes in patients with COVID-19. These should be factored in when assessing the prognosis of these patients.

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Background: Hospitalized patients with SARS-CoV-2 community-acquired pneumonia (CAP) and associated comorbidities are at increased risk of cardiovascular complications. The magnitude of effect of cardiovascular complications and the role of prior comorbidities on clinical outcomes are not well defined.

Research Question: What is the impact of cardiovascular complications on mortality in hospitalized patients with SARS-CoV-2 CAP? What is the impact of comorbidities and other risk factors on the risk of developing cardiovascular complications and mortality in these patients?

Study Design And Methods: This cohort study included 1,645 hospitalized patients with SARS-CoV-2 CAP.

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Background: Neuraxial blocks is the recommended mode of analgesia and anesthesia in parturients with Coronavirus 19 (COVID-19). There is limited data on the hemodynamic responses to neuraxial blocks in COVID-19 patients. We aim to compare the hemodynamic responses to neuraxial blocks in COVID-19 positive and propensity-matched COVID-19 negative parturients.

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Objective: To study cardiovascular events and clinical outcomes in patients with elevated glycated hemoglobin (HbA1c) levels and/or admission hyperglycemia and those with type 2 diabetes hospitalized with SARS-CoV-2 pneumonia.

Methods: This was a multicenter retrospective study of 1645 patients hospitalized with SARS-CoV-2 pneumonia. Diagnosis of SARS-CoV-2 pneumonia required a positive reverse transcription-polymerase chain reaction result for SARS-CoV-2, presence of new or worsening pulmonary infiltrates on computed tomography scan or chest x-ray, and at least one of following: (1) new or increased cough, (2) temperature of >37.

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Objectives: This study aimed to determine the stool specimen collection and Clostridioides difficile (C. difficile) testing frequency from inpatients and long-term care facility (LTCF) residents with new-onset diarrhea.

Methods: A cross-sectional study was conducted in all wards of 9 adult hospitals (3532 beds) and 14 LTCFs (1205 beds) in Louisville, Kentucky to identify new-onset diarrhea (≥3 loose stools in the past 24 h and not present in the preceding 24 h) among Louisville adults via electronic medical record review, nurse interviews, and patient interviews during a 1-2 week observation period in 2018-2019.

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Controversy exists regarding the clinical effectiveness of the 23-valent pneumococcal polysaccharide vaccine (PPSV23) for the prevention of serotype-specific community-acquired pneumonia (CAP). The objective of this study was to define the effectiveness of PPSV23 for the prevention of CAP hospitalizations due to vaccine-contained serotypes. This secondary analysis was a nested case-control, test-negative study design of adult patients hospitalized for CAP between 1 June 2014 and 31 March 2017.

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Objectives: Electrocardiographic (ECG) changes have been associated with coronavirus disease 2019 (COVID-19) severity. However, the progression of ECG findings in patients with COVID-19 has not been studied. The purpose of this study was to describe ECG features at different stages of COVID-19 cardiovascular (CV) events and to examine the effects of specific ECG parameters and cardiac-related biomarkers on clinical outcomes in COVID-19.

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Background: Patients with chronic obstructive pulmonary disease (COPD) have poor outcomes in the setting of community-acquired pneumonia (CAP) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The primary objective is to compare outcomes of SARS-CoV-2 CAP and non-SARS-CoV-2 CAP in patients with COPD. The secondary objective is to compare outcomes of SARS-CoV-2 CAP with and without COPD.

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Background: Heart rate score (HRSc), the percentage of atrial sensed and paced beats in the largest 10 beat/min bin of a device histogram and mean intrinsic heart rate (MIHR), predicted survival in nonrandomized studies of implantable defibrillator (ICD) patients. We evaluated whether HRSc and MIHR independently predicted mortality and heart failure (HF) hospitalization in the prospective, randomized, controlled INTRINSIC RV trial.

Methods And Results: The INTRINSIC RV trial enrolled 1530 patients receiving dual-chamber ICDs.

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  • * Key findings indicated that lower platelet counts and higher blood urea nitrogen levels were linked to in-hospital mortality, while elevated inflammatory markers and poor respiratory function were associated with other severe outcomes.
  • * The research highlighted significant relationships between various biomarkers related to inflammation, coagulation, and organ function with disease severity, though the exact causal mechanisms need further exploration.
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  • The CURB-65 score and Pneumonia Severity Index (PSI) are tools used to predict the risk of mortality in patients with community-acquired pneumonia (CAP), including those infected with SARS-CoV-2.
  • A study comparing the effectiveness of these scores in predicting in-hospital mortality showed higher mortality rates for patients with SARS-CoV-2 CAP (19%) compared to non-SARS-CoV-2 CAP (6.5%).
  • Adding D-dimer and procalcitonin to the scoring systems provided minimal improvement in predicting outcomes for SARS-CoV-2 CAP patients.
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Background: Influenza is associated with excess morbidity and mortality of individuals each year. Few therapies exist for treatment of influenza infection, and each require initiation as early as possible in the course of infection, making efficacy difficult to estimate in the hospitalized patient with lower respiratory tract infection. Using causal machine learning methods, we re-analyze data from a randomized trial of oseltamivir versus standard of care aimed at reducing clinical failure in hospitalized patients with lower respiratory tract infection during the influenza season.

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is a primary etiologic agent of CAP in immunocompromised adults (ICA). Data on clinical outcomes of ICA hospitalized with pneumococcal pneumonia (PP) is limited. The objectives of this study were (1) to define clinical presentation and outcomes of ICA hospitalized with PP and (2) to compare the data to non-immunocompromised adults (non-ICA) hospitalized with PP.

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